PODCAST: Factors That Can Prevent Weight Loss

Thanks for joining us for episode 113 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering following question from a listener:

“Hello, and thanks for the great show on your approach to weight loss. I found it extremely valuable. On a related note, I was wondering if you could do a show discussing plateaus or problems reaching one’s goals. I have implemented the advice you give, but I’m not seeing any results. I’m going for a similar moderate weight loss as discussed on the weight loss episode, maybe about 15 pounds or so. I’m 5’1” and currently at about 125 pounds. For a few weeks I’ve been eating about 1,850 calories per day and my weight hasn’t changed one way or the other. What would you think are some potential issues that might be causing the problem? I’m okay if weight loss doesn’t happen, but I’m wondering if it’s a sign that there’s something I need to pay attention to just for the sake of my health.”

While we provided a strategy on how to begin working towards healthy weight loss in episode 91, today we go beyond the basics and give you an action plan of what to do when all of your effort to reach your weight loss goal seems futile. Join us for fresh insight as we dig deeper into multiple factors that can be at play when weight is at a standstill.

You’ll learn how to determine if your thyroid health is a concern and hear the significant role your microbiome plays in weight regulation. We also give you insight into often overlooked factors such as consistency in your healthy habits, why you’ll want to resist the common advice to increase intense exercise in your workout routine, and the importance of your mindset around the weight loss process. Be sure to tune in to hear even more!

Here’s what Laura and Kelsey will be discussing in this episode:

  • The importance of a calorie deficit for weight loss
  • How over exercising can stress the body and affect the HPA axis
  • The effect of elevated cortisol on weight and accumulation of abdominal fat
  • The importance of rest and recovery after exercise
  • The connection between a history of yo-yo dieting and HPA axis dysregulation
  • The test we recommend to check HPA axis function and thyroid health
  • How subclinical hypothyroidism can affect weight loss
  • The impact that your microbiome has on your weight regulation
  • The two tests to get to assess gut health
  • The ways that mold exposure can affect weight loss
  • The effect of a constant calorie deficit on your metabolic rate
  • The importance of consistency and time in your diet and workout routine
  • The significance of cultivating good habits that lead to weight loss instead of focusing on the number on the scale
  • How tracking progress in other areas related to the healthy habits you implement can ensure consistency

Links Discussed:

TRANSCRIPT:

Kelsey: Hi everyone! Welcome to episode 113 of The Ancestral RDs podcast. I’m Kelsey Kinney and with me as always is my cohost Laura Schoenfeld.

Laura: Hey everybody!

Kelsey: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me at KelseyKinney.com, and Laura at LauraSchoenfeldRD.com.

Over the next 30 to 45 minutes we’ll be answering your questions about health and nutrition, and providing our insights into solving your health challenges with practical tips and real food.

Laura: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re in iTunes, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer an upcoming show.

Kelsey: Today on the show we’re going to discuss what to do if you’re having trouble losing weight despite feeling like you’re doing everything right. But before we get into the question for the today, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com.

Kelsey:Welcome back everybody! Here’s our question for today’s show. Hello and thanks for the great show on your approach to weight loss. I found it extremely valuable. On a related note, I was wondering if you could do a show discussing plateaus or problems reaching one’s goals. I have implemented the advice you give, but I’m not seeing any results. I’m going for a similar moderate weight loss as discussed on the weight loss episode, maybe about 15 pounds or so. I’m 5’1” and currently at about 125 pounds. For a few weeks I’ve been eating about 1,850 calories per day and my weight hasn’t changed one way or the other. What would you think are some potential issues that might be causing the problem? I’m okay if weight loss doesn’t happen, but I’m wondering if it’s a sign that there’s something I need to pay attention to just for the sake of my health.”

Kelsey:Great question. If you guys haven’t listened to episode 91, our first podcast about weight loss which this person is referring to, I would definitely recommend checking that out before you pop into this episode because we do discuss sort of the things to start with for weight loss, and then of course we’ll jump into things that might be preventing you from actually losing weight in this podcast.

But the first thing that comes to mind for me, and I think, Laura, this is probably similar to what you would think about this as well is that at 5 ‘ 1” and 125 pounds, that 1,850 calories per day sounds a little bit high to me because in doing calculations I’m not getting 1,850. Granted we don’t know her exercise level, so she could be doing a ton of physical activity in which case she would maybe need 1,800 calories. But if she was trying to be on let’s say a 15% calorie deficit, she would need to be doing like 6 or 7 days of pretty intense exercise for her to need 1,800 calories per day.

Basically if she is doing a normal amount of exercise, like maybe 3 to 5 days a week, moderate intensity, or maybe some days that are a little bit more intense, some days that are less intense, I would calculate that she probably needs more like 1,650 calories or around 1,600-1,700 calories, somewhere between there. That’s the first thing that stands out to me and I would imagine that that is probably why she’s not losing weight.

Now again, if she is exercising a lot, she’s doing that pretty much every day and it’s fairly intense exercise, then yes, she cold need that amount of calories. But that much exercise actually could be preventing her from losing weight, too. I’ll jump into that in a second. But Laura, do you kind of get the same calculations when you’re doing this?

Laura: Yeah, I mean like you said we don’t have specific details about her exercise routine which can definitely affect your calorie needs for weight loss. Obviously if you’re just say walking an hour a day versus if you’re doing Cross Fit 6 days a week, that’s going to affect that. But as you said, generally for most people they’re not going to be doing 6 to 7 days a week hard exercise. If they are, that could be something that’s preventing them from actually losing weight.

I think to figure out her calorie needs for a deficit, we would need more information. But like you said, a good guess would probably be closer to that 1,600 to 1,700 for a larger deficit. It could be even lower depending on what her exercise levels are because if she’s not training a lot, she could actually have even lower needs for a deficit. Now that’s not necessarily she’d want to continue on indefinitely, but when you’re trying to lose weight in the short term you do need to be in a deficit.

Kelsey:Yeah, absolutely. That’s my first thought. Definitely if you are doing moderate to intense exercise 3 to 5 days a week at 5’ 1”, 125 pounds, your needs are going to be more in the 1,600 to 1,700 range. I’d give that a shot. I would think that that is what is preventing your body from losing weight provided that you’re doing that amount of exercise.

But if you are actually doing this much exercise, you’re doing 6 to 7 days per week of intense exercise and that’s where you got that 1,800 number from, then I would actually recommend cutting back on your exercise a little bit. Because what can happen with too much exercise, and I think we’ve discussed this a few times on the podcast previously, basically you’re essentially stressing your body out a little bit too much. Your HPA axis can get a bit out of whack when you’re doing that much intense exercise.

So yes, it sounds like you would be fueling it appropriately, but you’d still be in a deficit which could just be a little tough when you’re doing that much exercise because your body is just going to be kind of wiped out and it’s going to have a negative impact on your HPA axis, which is your stress control center.

If your HPA axis is constantly getting activated, let’s say you’re doing this much exercise, maybe you work a full time job that’s fairly stressful, you’ve got other emotional stressors in your life, I mean that’s a lot of stress heaped onto your body. What can happen is that will raise your cortisol levels potentially. For a lot of people, that higher cortisol level can prevent them from losing weight. Sometimes they’ll notice that you get more of that belly fat or fat in the abdominal area that just seems to stick there, it doesn’t really go away. Potentially you may not have ever really had fat accumulation in that area before, but all of a sudden you feel like that’s where you’re fat is going. That’s a sign that you might have too much cortisol hanging around in your blood because your body is overly stressed.

If you’re doing that much exercise, I would definitely recommend reducing it. I know that can sound a little bit counterintuitive to some people because a lot of us think that of course more exercise is better when it comes to weight loss, but sometimes that’s not true. In fact I’d probably say often times that’s not true because you don’t need to be stressing your body out that much by exercising so much. You just need to be consistent with your exercise whether that’s twice a week or 4 times a week. But somewhere between that I’d say 2 to 4 I would say is my ideal in terms of how much intense exercise you’re doing. Walking and that sort of thing, you can do every day. I wouldn’t necessarily consider that exercise. But anything more than that, so if you’re doing a Cross Fit class, or you’re doing powerlifting, or weight lifting, somewhere between 2 and 4 times a week I think is probably a good place to aim for.

Laura: Yeah. I personally have been consistent with honestly like 2 days a week for the last 2 years most of the time. Some days I’ll do 2 days a week and that’s been plenty for me to see pretty sustainable weight loss. I’ve combined that with appropriate nutrition.  We can obviously talk about what appropriate nutrition is, but I feel like that whole idea of exercising more if you’re not losing weight is really prevalent. Like you said, it’s not only maybe not necessary, but can actually cause problems.

Even if somebody’s not holding on to body fat from that, I find that a lot of my clients, and I’ll put myself in this category too, that if I’m over exercising…or I don’t even want to say over exercising. There’s just a balance of how much training you can do before you start seeing the negative impact on cortisol. With cortisol…cortisol is weird because some cortisol in short spurts does help with body fat burning, but if it’s chronically elevated then that’s going to prevent you from burning body fat and it’ll actually induce stored body fat around the midsection particularly.

But the other difficult thing that cortisol does with weight loss is that cortisol does act on the aldosterone receptors in the body. Aldosterone is our body’s primary hormone for controlling blood pressure by affecting fluid balance. If your blood pressure is low, you hold on to more fluid to bring it up. If you’re blood pressure is high, you can excrete fluid by urination to bring it down. That’s one of the main roles of aldosterone.

But cortisol actually has somewhat of an effect on those same receptors and if you have high cortisol, the time can actually cause you to hold onto to more water in general which isn’t necessarily a bad thing on a short term basis. I know for me and a lot of my clients after a hard workout the next day you might be up a couple pounds because you’re holding on to more water if you have some inflammation from the actual breakdown of the muscle or just if the workout was kind of harder, it’s normal to hold on to some water. But the problem is if you’re training 6 days a week, you’re basically going to just be holding onto that water all the time and that can mask any sort of weight loss that you’d be seeing and it also makes you feel a lot bigger than you might be if you weren’t training that hard.

Kelsey:Right.

Laura: That was something that I personally experienced in the last couple months with my getting ready for my wedding. I wasn’t necessarily trying to lose weight, but I was like maybe I’ll just like increase my training frequency to 3 to 4 four days a week instead of 2 to 3, just going a little bit more. Honestly, my weight started to go up.  I was like, umm, alright, well that’s obviously not something that I want to be doing. I didn’t need to lose weight necessarily and if I gained some weight it wouldn’t have been the world, but I’m not going to work harder in order to gain weight.

Kelsey:Right.

Laura: I was like, okay, let’s go back to what I was doing because that clearly is not working well with my body and I think just the stress of that was too much for me to handle. I dropped back down to 2 a week and then my weight went back down and it has been pretty stable over the last couple months. It’s like that was a very strong signal to me that even 4 days a week doesn’t sound like that much, but it was just too much for my body.

Like you said, that doesn’t count things like walking, or hiking, or low intensity cardio that doesn’t necessarily stress your body out. But any of those more intense activities that would potentially would be a stressor on your body, if you’re doing that too frequently for your particular I guess either needs or I guess…how would we describe it? Physiology I guess. You tend to be someone who is more sensitive to stress or has other stressors going on that could compound the exercise stress, then training a lot actually can be very counterproductive and could prevent actual weight loss from happening.

That might have been a little bit more detail than this person needed, but I think it’s really important to talk about that just because there is so much of this myth out there that if you’re not losing weight, that you need to exercise more. Some people do. I mean obviously if there’s people out there that aren’t training at all or all they’re doing is low level of cardio, then adding some more stressful type activities like weight training or high intensity intervals could be helpful. Because like we said, a little bit of cortisol is helpful for burning fat, but most of the people that we work with are not in that camp of not exercising enough.

Kelsey:Yeah. I would also throw the other way around in here too. Sometimes I have clients that they’re doing 2 to 4 days a week of high intensity exercise, but then the other days or outside of those times where they’re exercising intensely, they’re just sedentary entirely. For those kind of people I think it’s really great to add some of this low level, non stressful activity like walking, hiking, gardening, really anything even just like random household chores where you’re moving around but you’re not doing anything super intense. I think that can a long way to help somebody lose weight too. If that sounds familiar to you as well, you may want to consider adding some of that low level activity if you’re exercising consistently and you’re doing that a few days a week, but outside of that you’re not really active, that could be a great thing to add too.

The other thing I would say to think about with exercise is just that if you are somebody who is exercising a lot like this, or let’s say you have a really physically intense job so it’s hard for you to really cut back on that exercise necessarily, you need to make sure that you are resting like an athlete because you are training like an athlete. We’ve talked about this before in the podcast as well, but I just want to make that clear here too, just that if you are doing that much activity, you really need to take your resting seriously because otherwise you’re really going to over activate that HPA axis, your cortisol is going to shoot up, it’s going to stay there consistently and be problematic at that point. To prevent that from happening, you really need to make sure that you are getting adequate rest depending on how much exercise you’re doing. We just wanted to throw that out there to start with because this person sounds like either they calculated their calories a little bit wrong, or they’re doing probably too much exercise unless they’re resting a ton.

We just want to throw that out there before we kind of dig into the other causes of weight loss plateaus because there are some people out there, and I’m sure there’s some of you listening that this really resonates with you, that you have probably tried a range of caloric intakes, you listened to our first episode, you tried to calculate your calories, maybe you started at one calorie intake that didn’t work for you, so you did another one, maybe you went a little bit lower or a little bit higher. You’ve kind of been all over the place with your caloric intake. Same thing with exercise, you tried exercising less, you’ve tried exercising more and nothing is working. We definitely understand that that can be a frustrating situation. We do want to talk about some of these underlying health issues that might be playing a role because that’s sort of what this person was asking about saying I don’t need to lose weight and I’d be okay if I don’t lose weight, but I do want to make sure that if I’m not losing weight because of some underlying health issue, I want to know what that health issue is so that I can address it. I think that’s really smart way to approach this.

I’d like to talk a little about some of the things that I start to think about when somebody isn’t losing weight.  One of those things of course is the HPA axis like we just discussed. If you are exercising a lot or you’ve got a really stressful life, you maybe you moved recently, I mean that’s a huge stressor. It’s one of the biggest stressors actually for people. You need to keep those things in mind and say okay, even though it doesn’t necessarily feel super stressful for me, I know that it’s really stressful for my body to be exercising this much or to be going through this process of moving or I have a lot of work. Anything like that is going to put a toll on your body and you need to keep that in mind. That may absolutely be part of the reason why at this point in your life or reasons of all these stressors in your life that you’re not losing weight right now.

You need to give your body a break, calm down that stress in your life, give yourself some time to settle in if you just moved, or if you have a really busy season at work, wait for that to die down a little bit before you try to lose weight. Because adding a caloric deficit on top of so many other stressors is just, it’s frustrating first of all because you’re not going to lose weight which is the end goal and it’s just of course another stressor on top of all the other things going on.

You definitely need to make sure that you’ve addressed your HPA axis. One other thing you can kind of think about if you are wondering if HPA axis issues is something that’s going on for you is if you are a historical dieter. If you’ve been yo-yo dieting for a lot of your life, I find, and I’m sure this is true for you too, Laura, that the clients that this history of dieting that they most often have HPA axis issues as well.

Laura: Especially the majority of the yo-yo dieters that I work with are kind of in the chronic calorie deficit. They just never take a break from dieting. When we say yo-yo dieting, there might be some periods of time where they stop caring and they’ll just eat whatever and a lot of times that’s when they gain a lot of the weight back. But then they’ll start dieting again and maybe not seeing results they’ve seen before. It’s rare for me to work with someone who has a history of weight cycling that isn’t under eating at the moment.

Kelsey:Yeah, absolutely. If you have a history of dieting, or just chronic caloric deprivation I guess, you’ve got a stressful life, or you’re doing lots of exercise and you’re potentially not recovering like an athlete, and you’re having trouble losing weight because despite trying a lot of different ranges of calories, you should definitely consider that your HPA axis might be dysfunctioning.

What we do both in our practice and in our Paleo Rehab program is we recommend a test called the DUTCH test which is a urine test that looks at how your HPA axis is functioning. You can also add sex hormones on top of that if you think there might be some hormonal issues that are playing a role into this as well. That would be something to just check on. Do a DUTCH test, see how your HPA axis is functioning, and then you can at least rule that out or know that it’s an issue and start to work on that.

Another thing that I tend to think about when weight loss plateaus is hypothyroidism. This is honestly probably the first thing that I think of if somebody’s having trouble losing weight because it’s such an easy thing rule out most of the time that I just want to make sure that it’s not playing a role in everything that’s going on.

If you have trouble losing weight, seemingly no matter what you do, that would honestly be the first thing I would recommend checking. That’s really easy. You can just ask your doctor for a full thyroid panel. That includes TSH, T3, reverse T3, and thyroid antibodies. Sometimes you may see on some of your older blood work that maybe your doctor’s only testing TSH. That’s okay, it’s not ideal because we can get other information from those other levels so I do like to see everything. But if your doctor is only testing TSH, that can at least give you a sense of whether things might be going okay or not.

With TSH, the normal lab value that you’ll see on most lab reference ranges, it usually goes up to 4.5 or 5. But actually the latest research shows that anything over 2.5 or even 2 in some of the studies I’ve seen should probably be considered subclinical hypothyroidism. That means that while you may not necessarily have super high levels of TSH, meaning that you’re quite hypothyroid and everything like that, it’s not in the really functional range, it’s not in the ideal range that you want TSH to be in.

If you’re somebody who only has maybe 15 pounds to lose and you’re still potentially in a healthy weight range, your doctor’s, if they see something that’s still within the normal range, usually it’s your thyroid is fine, your body just wants to stay at this weight, nothing’s going on, you’re fine. While yes, you’re probably overall fine and you’re probably healthier than a lot of people, your thyroid is not doing super great. It’s not in the ideal range. You want to see that below 2.5 or potentially 2.

If you see it over that and your doctor is telling you that there’s nothing going on, honestly I would recommend seeking out a second opinion, somebody who is maybe more in the functional medicine world who keeps up on the research with TSH and with all these functional ranges because you can definitely have trouble losing weight if you’re at 2.5 or higher. If that’s you, if you’re looking back on your old TSH ranges and you’re seeing that your consistently above 2.5, I would definitely seek out somebody to work with on that.

Laura: The other thing to keep in mind is that the TSH can also be normal in the functional range and that doesn’t mean your thyroid function is optimal. I recently had a patient who her TSH was 1.6 something, and if she had just tested TSH her thyroid would have looked perfectly fine even from a functional range perspective. But she had the full thyroid panel done and her free T3 was low, like clinically low, and her reverse T3 was clinically high. She had other symptoms of hypothyroidism like high cholesterol, she was having a hard time losing weight, she had fatigue. There’s just a lot of symptoms of the hypothyroidism that again, if they had just looked at TSH they would have said it’s not your thyroid. But getting that full thyroid panel done showed that it clearly was at least partially involved, maybe not the whole story, but definitely something to address.

It was interesting because she wanted to know if she should kind of pursue medication for that. I told her that actually if the TSH is normal, and the free T3 is low, and the reverse T3 is high, then taking medication can actually make that worse potentially because the problem is not that she’s not producing enough T4 hormone, it’s that the T4 hormone is getting converted into reverse T3 instead of the normal T3. Taking extra T4 hormone and even extra T3 hormone wouldn’t necessarily solve the problem and could potentially make it worse.

Kelsey:Right.

Laura: That was a good example of a case where the thyroid we believe is involved for sure, but the treatment for that isn’t necessarily thyroid hormone. There’s a lot that can go on with thyroid dysfunction that can affect weight loss and getting a full thyroid panel done will help identify is it that I’m not producing enough hormone? Is it that my conversion is low? Am I over converting to reverse T3? All of those different labs will guide the way that you approach that. Because for her if she took medication, it could make things worse and we’re really attacking it from more of a chronic dieting/gut infection perspective with her which is why we believe her reverse T3 production is high.

I know we could do a whole show on thyroid and we probably should at some point, but I think it’s just important to remember that even the functional TSH doesn’t necessarily tell you the whole story.

Kelsey:Yeah, absolutely. Another thing to consider if you’re having trouble losing weight is your gut health because your gut health is a really important factor when it comes to weight regulation. It specifically comes down to your microbiome in your large intestine because that plays a really big role in how your body stores fat. If you guys haven’t seen one of my recent blog posts, I would really recommend that you check it out. It’s called “Can Your Gut Bacteria Help You Lose Weight?” We’ll link to that in the show notes. But I go over the impact that your microbiome has on your weight regulation in a lot more detail than I’ll talk about today.

But to simplify it a lot for the sake of the podcast, basically what happens is that when you have dysbiotic or imbalanced bacteria in your gut, you end up with a lot of inflammation because when you’ve got those bad gut bugs hanging around in your gut, it leads to a high level of a toxin called lipopolysaccharide, or LPS. If you’ve got a lot of LPS in your gut, that’s going to cause a lot of inflammation in the gut itself which leads to leaky gut. And then once your gut is leaky, that LPS, and other antigens, and potentially problematic things kind of slip through those spaces between the gut cells that really should be a lot smaller than they are right now. That LPS goes through the blood stream, gets to other places in the body, and causes a lot of inflammation. Essentially you end up with body wide inflammation and that high level of body wide inflammation is highly associated with a lot of metabolic conditions. That includes obesity, it includes insulin resistance, all those things that kind of go in the same category and are grouped together like that, highly, highly associated with high levels of LPS.

If you’ve been doing everything right, you’ve maybe ruled out hypothyroidism or just any sort of thyroid dysfunction, you’ve checked on your HPA axis and it’s at least doing okay and hopefully doing fine, and you’re still having trouble, I would definitely consider looking into your gut health and testing your gut bacteria. You do not need to have digestive problems to have imbalanced flora. I want to make that really clear because this is something that you can very easily overlook if you’re somebody who doesn’t have any sort of digestive issues, like you have totally regular bowel movements, you don’t get bloated, you never have abdominal pain or anything like that, you just really never even think about your digestive health because it’s perfect, you can absolutely still have imbalanced bacteria. Just because you are the picture of perfect gut health, or digestive health I suppose I should say, does not mean that your gut bacteria is also perfect.

This is something that you can only really determine by testing. What would I recommend doing is getting both a SIBO test probably and a stool test. A SIBO test is going to look at the bacteria in your small intestine and check for something called SIBO which is small intestine bacterial overgrowth. It’s essentially just looking to see if you’ve got too much bacteria growing in your small intestine, which again can cause that body wide inflammation to happen. A stool test is going to look in your large intestine, which is where your microbiome is housed. That’s going to look at more of the balance of good and bad bacteria in your microbiome, make sure you don’t have any parasites or pathogens, anything like that.

But I definitely have seen this to hold people back from weight loss. It’s those people that have been through everything. They’re like what the heck is going on? I can’t lose weight. I actually really need to lose weight. I’d say this is probably more for people who are significantly overweight, however I think it can still happen if maybe you’re still within a normal BMI range but it’s higher than you’ve historically been in your life for whatever and you can’t figure out why. I think gut health can play a role there too. But I will say that I think it’s definitely more correlated with significant amounts of weight. If you’re obese or you have maybe pre diabetes or some degree of metabolic dysfunction, really, really common to have gut issues.

You definitely want to check these things, get tested for this stuff. You can do that with a practitioner. I do also offer both of these tests actually in my Build Your Biome program. If you haven’t checked that out yet, definitely get on the waitlist for next time we open that up because you’ll be able to do that testing and then obviously I kind of walk you through what to do if things go wrong in those tests. Either work with somebody or do a program that can walk you through this stuff. But it’s absolutely just so important to just check on not only for metabolic health of course, but your gut health plays a role in pretty much every other part of your health as well. It’s really good to just make sure things are going okay in your gut.

Laura: Yes! Nothing to add from me about the gut side of things.

Kelsey:Alright, cool. The last thing I’ll mention here is that I start to think about with trouble losing weight is mold exposure. I’ll admit that I’m possibly a little bit biased on this one because I’ve gone through this myself and I think it’s a lot more common than people think. We don’t know exactly why mold exposure causes people to have difficulty losing weight, but I have to think that it has something to do with the fact that it’s a really big stressor. If you’re living in a place that’s got a lot of mold, your body is not going to be happy about that. It’s going to be a stressor on the HPA axis. And of course we just talked about when you’re consistently chronically stressed or you’re HPA axis is being consistently chronically activated, that’s going to cause a lot of problems.

The other piece of this is that being exposed to mold is going to cause a lot of inflammation. We can think about it kind of like what we just talked about with the gut health where if you’ve got this body wide inflammation going on, that really messes with the way that your body regulates your weight and the way your body regulates fat accumulation, and fat storage, and fat breakdown. All of those things get affected when your body is hugely inflamed which definitely happens when you’re chronically exposed to mold.

If this is something maybe you’ve never heard about or never even considered, you do want to start to think about it. Like problems with gut health, being exposed to mold can be silent in many ways. You don’t have to see mold in your house, or smell mold, or anything and it can still be there. I can tell you that that was the case for me. I had no idea that there was mold in the house that I was living in, but it was there. You can do some of these tests. Nothing is perfect, there’s no really great way to figure out 100% if your house has mold other than if somebody rips your wall open and finds it.

The testing can be kind of a screening thing in combination with some symptoms that may also lead you to believe that you are being exposed to mold. Some of those symptoms include things like fatigue, brain fog, concentration issues, lightheadedness or dizziness, headaches, skin problems, lots of static shocks, shortness of breath, light sensitivity, and night sweats.  I mean that’s first of all just a small clip of how many symptoms can go along with this, and of course these symptoms can go along with a lot of other conditions as well. Don’t assume that if you have fatigue and brain fog that you definitely are being exposed to mold. You certainly want to look at other things in your life that could be causing those kinds of symptoms. But if that sounds like you, and you’re having trouble losing weight, and you really addressed all these other things, then it’s definitely worth looking into if that’s you.

If you’re exposed to mold and you know that it’s in your house, you’re going to have to have someone either remediate it or move. Because both of these things can be really stressful and expensive, I do kind of like to wait to address this stuff as the last piece. Which I know even in my mind it doesn’t make total sense because I think about it like well, if I’m exposed to mold, I need to get out of there asap, which is absolutely true. But because the testing isn’t perfect, it’s really hard to know 100% if you are being exposed to mold unless like I said somebody rips through your wall and finds it, which that’s going to typically be fairly expensive and kind of a nuance obviously if somebody is ripping through your house, I like to leave that as one of the later things that I start to address with somebody.

I want to make sure their HPA axis is doing well, that their thyroid is doing well, that their gut is doing well. And then if we’re still having trouble, we’ve tried a bunch of different calorie ranges, we’ve tried a bunch of different amounts of exercise and everything and we’re still just not seeing any progress, that’s when I’m going to recommend that we start to go down the mold road.

Laura: I think the mold issue, like you said, it’s a lot more common than people might think and it’s easy to miss. Like you said, it’s kind of very general symptoms that don’t necessarily point exactly to the mold thing. Fatigue and brain fog obviously could be related to anything so it tends to be a little harder to find in the beginning. But as you’ve experienced, it makes a big difference if that is a trigger or a root cause that once that’s dealt with, things definitely improve significantly.

Kelsey:Yeah. I would say this might be more your scenario if you have a lot of other health issues going on. For me, I gained weight during that process. I think we talked about it on previous episodes that I had gained probably like 15 pounds in a year or two and really randomly and didn’t really know why but I felt horrible otherwise too. There was a lot of other health issues going on that I couldn’t really figure out. It ended up being related to both mold and I think gut issues possibly related to the mold too, like fungal issues potentially. I do think that with mold it’s not going to be just that you can’t lose weight.

Laura: Right.

Kelsey:Keep that in mind. You’re going to have a lot of other kind of weird symptoms going on if mold is an issue. Don’t just assume because you’re having trouble losing weight that mold is something you should absolutely pay attention to.

Laura: Definitely.

Kelsey:Anything else to add here, Laura?

Laura: Yeah. I think this was something we were chatting a little bit about before we got on the call today. Weight loss is really hard for a lot of people. There’s some people that they do these tricks and tips that we talked about in the first episode and everything works, and it’s fine, and it’s great, and all they need is to just keep doing that and it is successful. And then there’s a lot of other people and a lot of times people that end up in our one on one consulting that these kind of tips don’t work for.

It can be really hard because like we were saying across this entire episode, there’s a lot of different things that can affect weight. One of the hardest things I would say is to find the right balance between exercising enough, but not too much, and then also being enough of a deficit, but not too much of a deficit that it causes problems. Sometimes finding that spot for your body can take a long time.

And then there’s also the concept of with weight loss you don’t always want to be working toward weight loss because if that’s the case, you’re going to be causing your body to make metabolic changes to hold on to calories more efficiently. If you’re always in a chronic calorie deficit, your overall metabolic rate is going to drop and then you’re just going to maintain your weight at a lower calorie intake. That’s often times what makes weight loss so hard for people is that as the more they try to lose weight, the more their body will fight to keep the weight the same.

Kelsey:Right.

Laura: There’s two things that I think are really important for weight loss that when you’re struggling I think can get kind of hard. One is consistency. Consistency is I’d say one of the most important factors for weight loss for the average person. Sometimes it really just takes a while for your body to respond to the changes that you’ve made in your diet and exercise routine. If you’re not seeing progress after a couple of weeks, like I think this person said they’ve been doing it for three weeks, right? Or they said a few weeks, I’m sorry. I don’t know what a few is. I don’t know if it’s two, or four, or whatever, but I’m assuming it hasn’t been months. We already established that 1,850 calories might just be a little high for them and that cutting it down a little bit might start to see more progress there. But I also think that sometimes it really just does take some time of consistency in your workout and your diet routine to actually see progress.

Just using myself as an example, I was working on training and eating to support my training for I want to say like seven or eight months before I even saw any significant weight loss from that. That weight loss came from a period of reduced calorie intake, so essentially I had been building this six to eight month process of building muscle, working on my strength, all that stuff. Weight was pretty much staying the same, maybe a three to five variance across that time. And then when I was in a calorie deficit for a couple months, that’s when I lost 10 to 15 pounds total. The consistency over that time and even just continued consistency over the last two years in my case, that has allowed my weight to settle at an amount that is normal for me. It doesn’t take a lot of thought, it doesn’t respond extremely to any sort of variance. If I go out to eat and have some alcohol on the weekend, yeah, maybe I’ll go up a couple pounds, but it comes right back and it’s not stuck like a lot of people will experience.

The consistency piece is huge and I think sometimes we live in this Biggest Loser culture where people expect, like if I’m not seeing a pound of weight loss a week, then something’s not right. It doesn’t always work that way, so we need to definitely give a couple of weeks at the specific calorie intake and the exercise frequency that you’re doing before you assume it’s not right for you.

With this person, definitely drop down a little bit because again, we’re fairly confident your calorie intake is too high for weight loss. But once you go down to that 1,600 to 1,700, give it a month and don’t look at it after a week or two and say my weight’s not changing, so this obviously isn’t right.

Kelsey:Right.

Laura: Consistency over time is super important. And then the other thing that we were discussing before we got on the call was the mindset piece, which again could be its own podcast definitely. But we find in our clients that a lot of times the people who are the most stressed about their weight and the most, I don’t even know how to describe it. I hate to use the word negative, but it’s almost this kind of mindset where any change in the wrong direction will totally tank their mood for the day. Or they have so much anxiety around picking food, or the workouts that their doing, they hate and they don’t want to do it. Those kind of negative thoughts around the weight loss process is I think something that really does stall progress for people because if you’re so stressed about your weight and you gain a pound over the weekend and you flip out about it because you’re like oh my gosh, it’s took me two weeks to lose that and I just gained it back in a day! That kind of really all over the place mindset around weight loss – and it kind of plays into the consistency piece to – but I feel like that tends to affect success for whatever reason.

We were saying we don’t know if it’s a chicken or the egg thing where it’s like maybe the people who have a harder time losing weight are the ones that tend to get more upset about it. But I really do find that the people who I work with that are the most successful are the ones that don’t let these little blips in the radar totally derail their mood and their positivity about the process. They don’t take it as seriously, which I know sounds a little counterintuitive to say relaxing about it is going to make you gain weight because I’ll just eat whatever what I want. I actually feel like the relaxation around the weight loss process helps because you don’t swing back and forth between super restrictive eating a perfectly “clean” diet and then the minute something goes wrong, you’re just like screw this, I don’t want to do this anymore.

The consistency comes from a little bit more stability as far as the emotions are concerned and not letting a little bit of weight regain or a little bit of slowed progress totally derail how you feel about the process. Because for whatever reason, I don’t know if it’s stress or that anxiety tells your body that something’s wrong and holding on to weight is a safe thing for it to do, or it’s just that the emotional swings around the weight loss process affect the actual behavior around diet and exercise. I honestly don’t know, but I really do feel like keeping weight loss as enough of a priority that you’re being consistent with your food and exercise, but not so important that like I said your whole day, the mood of the whole day is affected by if your weight has gone down or not. I feel like that’s something that is another somewhat challenging balance to strike. But if you’re able to strike that balance, the weight loss process is a lot easier over the course of 6-12+ months.

Kelsey:I absolutely agree and I think I have a little bit of a theory on why that might be. I think what I tend to see and what I have personally experienced myself as well is that when you’re less tied to that weight, like the actual number on the scale, you tend to be more tied to the consistency of your habits. Really putting most of your effort into making sure that you’re cultivating the right sort of habits that will eventually lead to weight loss and you know that that’s true, so you’re not as worried about the weight right now, today, in this moment because you know that the habits that you’re putting in on a regular basis are going to get you there eventually and that’s more of your focus.

I have definitely seen that to be way more helpful for people because then of course you’re more focused on the habits so you are more likely to do them consistently. Whereas somebody who is more focused on the number on the scale, they’re going to potentially, at least what I see a lot of the times, they are like, everything I’m doing is not working. Nothing’s working, so why am I even bothering? They tend to go through these phases of being really perfect with their diet like you were saying before, and then being really not great with their diet. That sort of swinging all around the place I think is not very helpful because again, it’s not very consistent.

I think the key here is to of course make sure that there’s no other health issues going on that are preventing you from losing weight. But if everything looks good and you’re having a little bit of trouble, try to focus more on the habits that you’re trying to cultivate that will eventually lead to weight loss rather than focusing on that ultimate goal of weight loss. Because sometimes just focusing on that can make it very elusive and it’s not going to actually work out a lot of the times because you’re not putting the effort and the focus on the habits.

Laura: Right. It’s also important to remember that scale weight is just one way to measure progress. Sometimes your scale weight isn’t changing at all, or could even be going up, and you’re still technically making fat loss progress. I’m not saying that’s always the case, but I feel like that’s an area where people can get really discouraged because all they’re looking at is their actual scale weight and that’s either staying the same or going up even. That’s enough to like we said, kind of derail somebody’s consistency because they’re like well screw it, this isn’t working, I’m just going to do something different.

Tracking other things can also help. It doesn’t necessarily only have to be physique related. I mean certainly you can do something like a DEXA scan or body calipers to estimate your body fat percentage and retest over time to see if that’s changing. Or if you’re clothes are fitting differently, that can indicate progress.

I think it’s good to track other things are affected by these habits. I really like seeing progress in the weight that I can lift at the gym. That’s something that I think does drive a level of consistency for me at least that doesn’t have anything to do with my weight. Being able to see progress there even if my weight is staying the same, it’s not like the only reason I’m working out is to lose weight and if I’m not losing weight, I say screw it. Having a reason to work out beyond the weight loss or body composition changes is always a good thing as well.

But like I said, it’s possible that you can have some changes in your body composition without that being tracked on the scale. I think that’s something else I’ve been noticing in my own fitness journey or whatever we want to call it because I honestly haven’t been trying to lose weight so I wasn’t intending on seeing weight loss progress. I was trying to keep my weight stable because with my dress for my wedding and all the fittings and stuff, I really didn’t want to significantly change size in any way. I was like, alright, let’s just stay constant. But ironically even though my weight’s been pretty much the same for the last three to six months or something, my dress still seems to be getting a little bit loose on me. And then people keep asking me if I’m losing weight. I’m like, no, I’m not. I’m not doing anything…I’m like I said training twice a week, eating pretty consistently, not dieting or anything. I have dessert, I have alcohol sometimes. It’s like I’m not doing any sort of crazy restrictive dieting. But I honestly feel like it’s that consistency over the last two years,  I mean it’s really been that long of a process to get to the point where I’m at with my physical fitness.

With the weight loss, it’s like as far as I’m aware, I’m not losing any weight. But the dress fitting differently and people asking me if I’m losing weight, I think indicates that I’m probably am actually still having body composition changes that I’m not aware of or tracking. That’s not to say that my goal is to lose body fat, but I think it just goes to show that that consistency and kind of more laid back approach can really work well for people.

It doesn’t have to be this white knuckle, oh my gosh, I’m always dieting and I never get to have anything that I enjoy eating! I feel like everyone thinks weight loss has to be horrible. And for a lot of my clients and myself included, the process was not that exhausting or awful. It just was a matter of being patient, and being consistent with habits, and not using food as an emotional…I guess crutch is the way to describe it.Weight loss is a fun topic.

Kelsey:Complicated.

Laura: I know. Everyone is different. Obviously I’m only 30, so I’m sure when I’m in my 40s my weight won’t respond as quickly to the changes that I make. I’m sure once I have babies, that’ll probably affect my ability to be as fit as I am right now. There’s a lot of things that will play into that. But I think it’s just really important to remember that the consistency piece and the stable emotions around it is something that is super important and I don’t think people appreciate how important that is because they’re so used to everything being “eat 1,000 calories a day, and work out seven days a week, and dieting should be hard, and blah, blah, blah. It’s just like I don’t think that’s really helpful for most people.

Kelsey:Yeah. And the patience piece I feel like is just super important especially if you do have something else going on, some of these underlying health issues that are playing a role too. Those things do not go away overnight. Sometimes especially with something HPA axis dysfunction, once you have that, yes, you can get better, but there’s always going to be some degree of a propensity towards HPA axis dysregulation. There will be periods of your life where you’ll notice that stressors start to creep back in and then maybe it becomes harder to lose weight at that point.

You do really have to keep that in mind too that if you’ve ever had any of these underlying health issues, they’re to a degree going to…I don’t want to say stick with you, but it’s something you’re always going to have to keep in mind at the very least. That patience piece is really key because if you just are beating your body up trying to lose weight when there’s other health issues going on or other health issues that you’ve dealt with in your past, your body is not going to be happy with you and then you’re not going to be happy with your body because it’s not doing what you think it should be doing.

You just have to be patient, you have to be kind, and you have to just trust the process and just be consistent with everything. Eventually you’re going to see the results that you want. Sometimes the results aren’t what you think you want. You might realize that those results are down the road as you are patient and consistent with everything. I just want to make that really clear and drive that point home that the patience piece of this is really, really key if you’ve got any other sort of health conditions going on as well.

Laura: Well, I think that’s a good place to wrap up the conversation about this. Obviously we can talk about it for probably another five episodes and still have things to say. But we appreciate this person asking because again, the original podcast covers the basics, but there are obviously a lot of different factor that can affect weight loss for individuals. We’ll see everybody here next week!

PODCAST: Recovering From Autoimmune Disease With Eileen Laird

Thanks for joining us for episode 112 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are excited to be interviewing Eileen Laird!

Eileen Laird is a writer, podcast host, and autoimmune warrior who manages rheumatoid arthritis with the help of the autoimmune paleo diet and lifestyle. She’s the author of the book, A Simple Guide to the Paleo Autoimmune Protocol and the editor of the popular Paleo AIP Instant Pot E-Cookbook. Her popular blog, Phoenix Helix, receives over 1.5 million unique visitors annually. There, she features recipes, research, and personal stories about the autoimmune experience. She also hosts the Phoenix Helix Podcast, the first paleo podcast to focus 100% on autoimmune health. You can find her at PhoenixHelix.com.

Today’s podcast provides to those with autoimmune disease hope and inspiration to live an empowered life. Eileen shares her journey of reclaiming her life from rheumatoid arthritis by combining diet and lifestyle changes with conventional medicine.

Listen as we discuss with Eileen her personal experience with the autoimmune paleo diet and what she finds to be the biggest mistake people make when starting. We also talk about other important approaches to treatment such as emotional factors involved in healing and her decision to utilize conventional medicine.

Here are some of the questions we discussed with Eileen:

  • Would you mind telling us your story and sharing what you’re personal experience with autoimmune disease has been?
  • How long ago was it that you discovered the plaeo approach?
  • Did you start with the typical paleo diet or did you do anything special in the beginning?
  • Were there any foods that were major issues for you that you discovered through this process?
  • Where there any foods that you were surprised that you could eat without problems?
  • What was your experience with the reintroduction protocol?
  • Did you ever have any symptoms that were not joint pain related that you knew were a problem?
  • What would you say is the most common challenge or mistake that you see from your readers who are implementing the autoimmune protocol?
  • What kind of emotional or mental health factors have been an important part of your autoimmune disease treatment approach?
  • What made you decide to take a more conventional route to treatment and rely on allopathic medicine as an option for improving your overall health?
  • How long did the process take you from first staring medication to finding one that really worked for you?
  • Did you get any backlash on your blog when you shared your story of deciding to try medication?

Links Discussed:

TRANSCRIPT:

Laura: Hi everyone! Welcome to episode 112 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is my cohost Kelsey Kinney.

Kelsey: Hey everybody!

Laura: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Laura, at LauraSchoenfeldRD.com, and Kelsey over at KelseyKinney.com.

We have a great guest on the show today who’s going to be sharing her insight into recovering from autoimmune disease. We’re really glad she’s joining us. For those of you with an autoimmune condition, we hope you’ll learn a lot today.

Kelsey: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re in there, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer or suggest a guest you’d love for us to interview on an upcoming show.

Laura: Before we get into our interview for today, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com

Laura:Welcome back everyone! We are so happy to have with us today Eileen Laird! Eileen is a writer, podcast host, and autoimmune warrior who manages rheumatoid arthritis with the help of the autoimmune paleo diet and lifestyle. She’s the author of the book, A Simple Guide to the Paleo Autoimmune Protocol and the editor of the popular Paleo AIP Instant Pot E-Cookbook. Her popular blog, Phoenix Helix, receives over 1.5 million unique visitors annually. There, she features recipes, research, and personal stories about the autoimmune experience. She also hosts the Phoenix Helix Podcast, the first paleo podcast to focus 100% on autoimmune health. You can find her at PhoenixHelix.com.

Welcome to the show, Eileen! We’re so glad you’re with us.

Eileen: Thank you for having me. I’m excited to be here!

Laura: Absolutely. I know that your book A Simple Guide To the Paleo Autoimmune Protocol has been one that I’ve been recommending to a lot of my clients who are just getting started with AIP. I just love how short it is, which I know sounds really silly, but there’s a lot of autoimmune books out there that when they get them they’re like textbooks which I think can be a little bit overwhelming for people that are just getting started. I’ve had a lot of really good feedback about your shorter guide, which certainly isn’t too short to be helpful, but it’s short enough that it’s not overwhelming. I’m really glad that that’s something that’s out there to refer patients to.

Eileen: Thank you so much. That was exactly my goal is I wanted it to be an unintimidating introduction to the diet that people can really just go ahead and get started. And then if they want to dig further, there’s so much great information out there.

Laura: I think you’re pretty popular within the paleo community. But if there are anyone listening on our call today that doesn’t know who you are, would you mind telling us your story and just sharing what your personal experience with autoimmune disease has been?

Eileen: Yeah, absolutely. I was a healthy 43 year old woman. I was working full time as a massage therapist and I did a lot of deep tissue therapy, so I was pretty strong. I hiked on the weekends for fun and the most recent vacation I had taken was to Moab, Utah where we were doing 10 mile pretty strenuous hikes in the canyons. It was so fun!

Life was good and I didn’t have any of the typical triggers for autoimmune disease that some people do. Nothing bad happened, there were no tragedy’s that led to it.  I wasn’t sick first. Sometimes that stimulates it. I just woke up one day and I had a pain in one foot that I thought was weird but I figured it would go away. And then the next day this same pain was in the other foot on the exact same spot. By the end of the week, I couldn’t walk without limping. Within a short period of time, within I’d say a month or so it spread to my hands and then within a few months it was throughout my body. It was Rheumatoid Arthritis.

If you had asked me to share this story five years ago, I cried every time I talked about it. I think anyone new to an autoimmune diagnosis it’s just so devastating. It’s not something you ever want to hear. It’s not curable. The prognosis is usually really scary. It’s just where you continue to lose function and abilities over time with Rheumatoid Arthritis. It attacks the joints and it can cause permanent damage to those joints. The pain is just really hard to describe. I can tell you that in my 43 years prior I had experienced nothing to that level so I thought it deserved its own word. It was something I felt like I could not survive but at the same time I was still alive. I had to find a way to make it through.

I did hop on the internet looking for solutions. I’m so thankful the internet was out there. I heard about the paleo diet and lifestyle and started implementing that. That was the first effort I had made that started to make a difference. It started to decrease my inflammation instead of increase it. It was like a light at the end of the tunnel for me.

Laura: How long ago was it that you discovered the paleo approach?

Eileen: This all happened in 2012. I think my first symptom was in January, I was disabled by April or May to the point that I couldn’t work, and then I started paleo in June.

Laura: Oh, so it was pretty fast turnaround. You didn’t have months or years that you were not aware of the approach. It sounds like you got on Google pretty fast once you got your diagnosis.

Eileen: I absolutely did and I think that’s partly personality, is I didn’t want to take a medication. And I know we’ll be talking more about how that changed for me over time, but I was really hoping to avoid that path and I was disabled so I needed to do something. I think a lot of people come to paleo if the medication isn’t as successful as they had hoped. They try the conventional “easy” path first maybe, and then if that doesn’t work then they’re ready to make the kind of changes necessary in their lifestyle. For me since I wanted to avoid the medication, I dove right into the diet and lifestyle.

Laura: I would think it may also have to do with how severe the symptoms are since autoimmune diseases can obviously manifest as a variety of different things. Sometimes I’ll talk to people who have an autoimmune disease and let’s say they have Psoriasis on their scalp or something and it’s annoying, but it’s not debilitating. The idea of totally overhauling their diet and getting rid of gluten, and dairy, and all these things that are part of a normal diet, it sounds a little bit crazy to them. But for your experience being so severely disabled by it, I would assume you would have done anything at that point.

Eileen: Yes. What do they say? They say it’s when the pain of not changing is higher than the pain of changing. I think that’s really true. I was at rock bottom. You’re absolutely right, there are milder versions of RA too where people just their wrists kind of hurt and they can no longer lift weights, but they can still do most of daily life. So the motivation is not going to be as high than if you were in my case where I was limping crossing my living room, I didn’t have the strength in my wrists to lift a pan, I couldn’t raise my arms above my head to wash my hair, I couldn’t sleep because it hurt to lie down on my joints.

I had a new flare every night in a different joint of my body. I had pain body wide, but then one joint would be chosen for that night’s joint and it would leave me gasping and I would have to immobilize it. My shoulder might go into a sling, my wrist into a brace. Or if it was my jaw, I actually couldn’t open my mouth to speak or to eat. It was terrifying. It was definitely, they call it rapid and severe onset.

Laura: With the diet approach, you started with just the typical paleo diet? Or did you do anything special in the beginning?

Eileen: What I should tell people too is because paleo is kind of, now I think it’s maybe a little bit more well known, but it’s still not totally mainstream. When I first thought of diet, I tried vegetarian and vegan first when things were first going wrong and that didn’t help at all. My inflammation continued to get worse and I now understand why because I was kind of increasing the grains and the legumes. That didn’t work.

And then I did just try regular gluten free, sugar free. I remember back then, which makes me laugh now, hoping that I wouldn’t have to do anything that strict for that long. And now it seems like that would be so easy. But that didn’t help either frankly. It helped me feel better ironically for just a couple of days and then the inflammation just came right back.

But yeah, the first gateway into paleo was actually GAPS. I learned about the GAPS diet at the same time I learned about Paleo. I did a kind of a combination of those two things and I had seen the autoimmune protocol information out there. There wasn’t a ton, but there was some and it intimidated me. I just thought it was too restrictive. I was coming from a standard American diet and I was hoping paleo would be enough. I will say that for some people, it is. I think not everyone has to go full AIP. I gave that a shot first and it did make a big difference. And then about five months in, I plateaued in my healing and I knew I wanted to feel better than that.

What changed is my flares became moderate instead of severe a few times per month instead of daily. I could walk maybe a half mile, that was all. But I was back at work part time.  So my life got better, but I knew it could get better than that. Then I think for me, I was finally ready for AIP. In the beginning, honestly, it was too much for me.

Laura: Did you combine the autoimmune protocol with GAPS? I know GAPS tends to be a lot more focused on kind of gut health foods and avoiding certain things that would potentially flare gut infections, that kind of thing. Did you just transition from GAPS to AIP, or did you combine them?

Eileen: I combined them for a while and then I tested out the GAPS theory on myself later. I did GAPS kind of by itself first, except I also removed nightshade vegetables because of the RA connection. Then when I went AIP, I continued to eat low starch which was kind of the GAPS mindset. Both of them focus on bone broth, nutrient density, all of that, so I kept that going. And then I went through my full AIP elimination and reintroductions before I then tested my starch tolerance just to see which starches did and didn’t work for me or if I even needed to limit them at all. It turned out that I was lucky that I came in though the GAPS doorway because I do have some starch sensitivity. I can eat some, but if I eat too much, it increases inflammation for me.

Laura: Now that you’ve been experimenting with the paleo diet, the GAPS diet, autoimmune protocol for the last I think I guess we’re going on five years now, is that right?

Eileen: Yeah, almost.

Laura: What have you discovered to be the most important dietary factors in your success in the last five years?

Eileen: In terms of food or being able to keep it going?

Laura: Well, actually that’s a good question. I was thinking more were there specific foods that like you were saying before with starch that you realize you were starch intolerant or had some starches that you didn’t do well with. A lot of the clients that I work with, and Kelsey, I don’t know if you’re the same here, but they’ll do the autoimmune protocol and reintroduction and they’ll find that there’s only a handful of autoimmune specific foods that really trigger their symptoms and that they can reintroduce things. Were there any foods that were major issues for you that you discovered through this process?

Eileen: Yeah, and I’m glad you mentioned that because I think it’s really clear and we really try and get the message out there that the AIP elimination phase is just a phase and reintroductions are really important. But yet you still find people who kind of either miss that information or are afraid of reintroductions or something. I am just like the two of you, I really think the reintroduction part of it is important when people are ready and expanding our diet is important and that’s how we personalize it.

Yeah, I was excited for reintroductions actually. For me the main triggers I found were nightshades and dairy. I never tried to reintroduce gluten by the way so I really don’t know if that’s a trigger for me. But nightshades and diary were the biggest. Nightshades the absolute biggest which kind of fits the RA stereotype.

For dairy it was interesting. I think the reason it was inflammatory for me is I do have a hormone response to dairy even the raw, grass fed, goat, doesn’t matter what kind of animal, whether it’s organic or not, pastured, none of that. They all have hormones to help babies grow and somehow that triggers something in my body. I know the hormone/autoimmune connection is pretty strong. When you’re having hormone swings, it can cause autoimmune flares. That might have been why. But those were the two for me that were the biggest and that I’m real careful to avoid.

Laura: Where there any foods that you were surprised that you could eat without problems?

Eileen: Ironically for me, I think I had a little denial where I was hoping I would almost get everything back – do you know what I mean? – with the reintroductions. But at the same time I will say that when a reintroduction failed, although there was a grief to that and then you have to kind of get through the flare that happens, but that information is so clear that it made it there was no willpower needed at that point to avoid those foods going forward because the clear connection, the pain was made for me.

I got eggs back to the point that I could seriously eat a high number of eggs every single day and have no inflammatory reaction at all. I do try and have a diverse diet so I don’t necessarily do that, but that’s really nice because that’s such a convenient food and that is one that’s a trigger for a lot of people. I’m grateful that that’s not one for me.

Chocolate is fine for me which made me really happy. I can have nuts and seeds kind of more in moderation. I find that those actually, I think from a gut irritant perspective if I have them every day I’m going to start to feel some low grade inflammation that doesn’t feel good. If I have them once and a while, they’re just delicious with no real negatives.

I did reintroduce white rice later on and I have no autoimmune reaction to that at all. It just tends to tap sugar cravings if I eat too much of it. I like having that just because it’s a convenience food and it tastes really good with a nightshade free curry recipe I have. I try not to get in the habit of having that all the time. And then later on like I said I tested the starch situation, and so sweet potatoes actually are pretty inflammatory for me. Plantains I can have once in a while, just not a ton. The GAPS-allowed veggies like butternut squashes and so forth, beets, and carrots that are pretty low starch I do well with those.

Laura: The reintroduction process I almost think is potentially more difficult than the elimination protocol. The only reason I mention that is because the rules for the AIP protocol are very, I don’t want to say black and white, but it’s pretty much eat these foods, don’t eat these foods and that’s the protocol. I find that a lot of my clients really struggle with the reintroduction process because it’s so individual. They have to be paying attention to their symptoms and sometimes these symptoms don’t show up right away.

I think with the reintroduction period you definitely want to give it a few days before you try another food. But there’s also the concept that it’s more of a dose response issue. If you’re eating it a lot overtime, then eventually you’ll start seeing problems. What was your experience with the reintroduction protocol? Did you find that super frustrating? Or was it easy for you? How did you go about that?

Eileen: It requires a lot of patience and at a time when people are maybe feeling really deprived. It’s a hard psychological combination I think. And then what you said is absolutely true. I actually recommend a second phase reintroduction. For example, when I tried nightshades what I made it was taco burgers with some chili powder. I flared so severely the next day and that pain lasted for two weeks so there was no need to do a second test. For me I knew that was not good. But then when I reintroduced almonds, it seemed fine. Then I went ahead after 72 hours had passed and had no flare, I ate them every day for about five days. By the end of five days I was starting to feel worse so that was a way for me to discern the foods that I can have once in a while versus the foods I can have every day. When I did the same second phase test on eggs, after five days I was still fine.

I recommended people do that because I do think in the long run that helps you. What’s hard is that extends your reintroduction process. But if you don’t do it like you said, say you get three foods back in you thought were fine, and you’re a month and a half down the road and you’re starting to feel a lot of inflammation again, you can’t really tell what’s causing that.

Laura: Did you ever have any symptoms that were not joint pain related that you knew were a problem?

Eileen: Insomnia was my first symptom, interesting, because that would happen usually the night of the food introduction for me if it was a problem food. I don’t usually have insomnia. Or I didn’t, now I’m 49 so occasionally that happens. But anyway, so that was one. Digestive stuff sometimes.

I did reintroduce legumes later down the road because I was curious since some people do well with those. I got depressed for a few days. That was a mood, like a brain response for me. For me typically the joints are the biggest place I pay attention to. But yeah, your body can communicate lots of different ways.

Laura: I think that’s one of the hard parts with autoimmune disease is you may be paying attention to one symptom that’s your biggest issue, but you don’t realize that that food is triggering other problems. Just being able to be that attuned to your body’s changes can be challenging.

And then there’s the thought that maybe that symptom was just random and it just was a coincidence that that day you weren’t feeling so good, or you were tired, or you didn’t sleep well. It’s like was it the food. Was it just a hormonal thing? Did I just watch TV too late? Anything that can contribute to that. It can make it a lot harder for people that don’t have those really strong reactions like the one that you had with the chili powder.

Laura: Absolutely. That’s why I think it is helpful if you think it’s okay to eat it every day for a little bit without adding anything new just to see what happens. I will say although it’s a hard process, I think it’s a really empowering one and I feel like I’m very tuned into my body.

But I’m glad you mentioned that it’s not always the food because later on down the road when you’ve done the reintroduction process, and you’ve even done that phase two that I recommend, and you kind of know which foods are your good and bad foods, people will often suddenly think that they now are developing new food intolerances. A lot of times it is those other things. It’s stress, or it’s hormones, or who knows? Maybe you painted your house and you got fumes going. To really look outside just the food angle so that people don’t just restrict, restrict, restrict as their response to trying to feel better.

Laura: Right. And then there’s also the issue that comes up a lot with our clients where restricting too much actually leads to problems and symptoms. The fatigue issue I think is a big one where yeah, that can be caused by a food sensitivity, but it could also just be caused by not eating enough. A lot of people that are doing the autoimmune protocol, if they’re not really careful it can be really easy to start getting malnourished because they’re just avoiding too many foods.

Eileen: I agree. And then the stress of that, like the fear of food itself can really wear you out. In a way it’s this huge holistic journey where also I think the mind/body piece is really important and just to try and just really be centered all the time without trying to be perfect all the time. It’s just kind of tricky. I think just trying to hit all those areas and do the best we can and give ourselves a lot of grace and then breathe deeply as often as you can remember to do so.

Laura: On that note, what would you say is the most common challenge or mistake that you see from your readers who are implementing the autoimmune protocol?

Eileen: Thinking it’s all about the food is definitely a really common mistake. In some ways a mistake, other ways, I get it where it’s kind of like you said the yes/no list is easier to follow. The first time you’re kind of entering this community it makes sense to hit diet first, but pretty soon you need to address those other areas. Everything from sleep from stress management.

The other piece is I think, and I think it happened to me and it happens to a lot of people, is the pursuit of health becomes an obsession. It becomes your entire world. You stop having fun in any other way and all of your free time is spent researching whether it be books, podcasts, blogs, all of that kind of stuff. All of your conversations are centered around disease and healing through diet and lifestyle. I think you can kind of, I don’t know, the world can get kind of small and very unbalanced.

I think it’s really important to just find a time every day when you aren’t talking or thinking about your health, what brings you joy and make time for joy in your life. That’s hard when you’re at your worst, but it’s actually super important even then because you need joy more than ever I think when you’re experiencing a lot of pain. But then also as you move forward to just widen your life that as you get healthier, do more things that don’t have to do with trying to get healthier, and ironically they help you get healthier.

Laura: It’s so hard when you’re like do this to get healthier, but don’t think about it as getting healthy thing. It should be because you’re just trying to enjoy yourself. It can be a little bit of a tough thing to instruct people on. For you in that area, what kind of lifestyle or maybe emotional or mental health factors have been an important part of your autoimmune disease treatment approach?

Eileen: In the beginning when I was flaring, meditation was super important to me. I’m not someone who I would say meditation was pain relieving, but it calmed me down so that my emotions weren’t, like I wasn’t in pain emotionally. I wasn’t being tortured emotionally by the physical pain I was experiencing. Which can feel very counterintuitive, but I think if you do any research on the internet on meditation and pain, that’s often what happens. It’s weird. It’s like you can be peaceful in that experience.

As I got better, I actually meditated less. But there are times when I just know I really need it. I try to just take time to relax every day. At this point like five years in, I’m doing a lot better, but I can still get in a zone where I just don’t take time to take a break if I’m having a busy work day. I do try a few times per day, I work from home now so this makes it a little easier. Sometimes if it’s a super busy day, I might just go lie down for 10 minutes and breathe deeply. It’s not a nap, but it’s just like a parasympathetic reset which helps. If it’s a nice day, I get outside if I can.

In terms of joy in my life, being able to get back to hiking was really nice. But I also like reading like total fluff novels where nothing really bad happens to anyone, or watching something really funny. I like spending time with my friends. Just simple things in life to just keep it balanced.

There have been times when I’ve really struggled with certain decisions or the difficulties of having rheumatoid arthritis. I don’t know if you’ve all heard of Byron Katie, but she has a technique called “The Work” that kind of helps you break free when you feel trapped by an emotion or a though that’s just dogging you, or you feel stuck in your life and you can’t move forward. There’s a technique called “The Work” that helps you work though that. That has helped me at pivotal junctures in my journey.

Laura: I feel like I’m familiar with her name. Kelsey, do you know more about her?

Kelsey: No. that’s where I’m at as well. Familiar with the name, but not beyond that.

Eileen: If people are curious, they can just go to TheWork.com. I actually also interviewed her on my podcast, so they can find that episode. But it’s pretty cool. It’s very helpful for me.

Laura: Yeah, definitely. I think in our Paleo Rehab program we do a whole module on emotional health and healing from negative thinking, and trauma, and that kind of thing. Which I mean it’s a very basic skimming of the things that can contribute to HPA axis dysregulation. I feel like with autoimmune disease, I know this wasn’t your experience, but I feel like this actually happens with a lot of people where they have some kind of major stressful event or a traumatic event even and that can trigger the autoimmune disease. Whether or not healing from that is going to 100% solve their symptoms, maybe not. But I do think it sounds like it’s a really important part of the healing journey even if it’s just helping with your mental and not necessarily doing anything from a physical health perspective.

Eileen: Yeah, I absolutely agree with you on that. I’m so glad that you cover that angle. They’ve done research even that childhood adversity can make you more vulnerable to chronic illness. There are things you can do to kind of, if you look it up online, kind of like reversing childhood adversity. I’m trying to think. Donna Jackson Nakazawa is an author who has written a book called Childhood Disrupted. That’s a resource for people.

But if you had a really rough childhood, you aren’t just stuck with the negative consequences of that. There are things you can do even now even if you have autoimmune disease maybe with that being one of the influential factors. There are things you can do to kind of help your nervous system reset now if that makes sense from how it maybe was set to be super sensitive when you were young. We might be getting totally off track now. But anyway, there’s things you can do.

Laura: No, I think it’s important!

Kelsey: It’s great.

Laura: Yeah, it’s really important. I mean like I’ve said, we’ve scratched the surface of this in our Paleo Rehab program where we talk about how your HPA axis gets kind of set to work a certain way when you’re either in your childhood and you experience something negative. I don’t mean for this to be negative, but you can actually have this happen in the womb if your mother experienced something traumatic when she was pregnant. It’s just crazy how far back it can go where even if it’s not something you experienced during your lifetime, if your mother was exposed to stress or trauma during pregnancy, that can affect how your body’s hormonal system works for the rest of your life.  It’s crazy.

I mean I think it’s one of those things whether or not you can do anything about it is questionable, but just understanding that some of this stuff is not under your control I think can sometimes take, well it depends on the person I guess, but sometimes it can take some of the stress out of it if you feel like okay, there’s things that I don’t have control over and I don’t have to blame myself for feeling like I overreact to things or I tend to be a more stressed period, it’s my fault, when there might have been some stuff in your earlier life or even before you were born that would affect how you react to things in your current life.

Eileen: Yeah, I think that you’ve touched on two really important things. One is that there are things you can do even if that’s the case. But then the other thing is, yeah, blame is just not healthy at all. A lot of us do that I think probably for anyone who gets any serious diagnosis. But for me it’s like you try and figure out how did this happen to me? What did I do to cause it? That’s kind of a really unhelpful question because there’s so much blame involved and there are a lot of people who have frankly have done a lot more that could cause something and nothing happens. It’s really not as simple as cause and effect. I think sometimes it can help to kind of go back and just see some puzzle pieces fall into place if we can remove all feeling of like blame and shame from that puzzle piece.

Laura: It’s always interesting, I’ll have people ask, I don’t understand why I can’t handle this type of lifestyle, but my friend can or this blogger can. It’s just interesting to see how much either genetics or epigenetics, which is the environment’s effect on your genetics, can affect how you tolerate certain diet and lifestyle habits.

There’s a lot of people out there that develop chronic illness because of let’s say a really stressful work environment that they were in for 10 years or something and there was some kind of traumatic event that triggered the symptoms. Whether or not it would have ever come up without that stress, we don’t know. But I don’t think everyone is going to tolerate stress the same way. Some people really do not thrive in those kind of environments.

If you can nip that in the bud before you get a chronic illness, that’s great. But sometimes it really does take a pretty significant issue developing before people are willing to change their lifestyle. It’s one of those things that it’s almost like you don’t know that it’s a problem until it’s too late almost. But you can make changes now. If you realize that the stress is causing problems, then it’s more about what can you change in your current life than trying to go back and rewrite history or something.

Eileen: Yeah, absolutely. I can’t not have rheumatoid arthritis, but I can have a much better life with rheumatoid arthritis with the things I do to take care of myself than I would have if I’d just gave up and just kind of abused myself. Which some people do. I mean it’s almost a culture to do that.

Laura: I feel like this could be a good transition to a topic that I would love to talk to you about because I think it doesn’t get discussed enough in the alternative health community. When it does get discussed, I feel like there’s a lot of negativity surrounding it. As you’ve shared on your website, you use a combination of both alternative treatments and conventional medicine to manage your rheumatoid arthritis. What made you decide to take a more conventional route to treatment and to maybe rely on the allopathic medicine as an option for improving your overall health?

Eileen: I’m really glad to have this conversation with you because I agree, it doesn’t happen very much. Because I’m someone who thought I would never go on medication, and now I am taking medication, I’ve been through that journey. I’ve been someone who was anti-medication. I was someone who thought that the side effects were worse than the benefits.

Let me start from a personal perspective. For me I did really well with the paleo AIP personalized diet and lifestyle. For a couple of years I was very stable, but I was never in remission. I was honest on my blog from day one that I needed one Aleve tablet twice a day to manage the pain that remained. That’s super low for someone with rheumatoid arthritis, but that meant that the disease was still active in my body. But I called it, it was a whisper where it used to be a scream and it really didn’t interfere with my life very much.

And then a couple of years in as I got a little bit older and my hormones started doing the perimenopausal swings more, I started getting an increase in symptoms again. It wasn’t as bad as it was at onset, but it reminded me of that. I started having those little flares moving around my body. But if it hit my jaw, instead of not being able to open my mouth at all, it was kind of hard to open it and it hurt to open it, things like that. I got nervous when that started happening.

Then I started losing range of motion in my joints and that’s the scariest thing I think for someone with rheumatoid arthritis because that’s where the damage can be permanent. I lost my ability to make a fist with my hands and I lost the ability to lift my left shoulder over my head. That’s when I considered medication for the first time and it was a super hard decision for me. Anyone out there who’s struggling with that decision, there’s this huge resistance to it, there’s this fear about it of what it’s going to do because it is a lifetime medication usually. You do hear all the scare stories about how bad it is for you.

But in the end, although I’m not 25 anymore, I’m still in my 40s. I will hopefully live quite a long time and I don’t want to be losing joints along that way. I went to the doctor, was open to medication for the first time. They did some x-rays to kind of track what was happening and they showed that damage was actively happening and very quickly. I think that’s one thing about my particular RA is it moves very fast when it decides to move. It’s not a slow thing.

I went through a process, I think I’ve been on medication a little over a year now and it was a trial and error journey. I tried different ones before finding one that works. I’m on one now that is working really well. What I encourage anyone who’s going through that is your goal and your rheumatologist’s goal is to help you find a medication that is helping you far more than it hurts. Ideally, I’m in a situation right now where I’m on a medication that I’m not experiencing any negative side effects from. That was something I didn’t even think was possible. But some of the ones I tried in the beginning were unhelpful and harmful. It can go both ways. I think of it kind of like the paleo journey is a big self-experiment figuring out what does and doesn’t work for you and medication can be the same way. There are a lot of different medications you can try, different combinations you can try if you need it to try and find the one that works for you.

And then as we were talking about the emotional part of it, I think really making peace with the decision. I didn’t want to hate taking my medication because I thought that would interfere with its ability to help me. There is something called the nocebo effect. A placebo effect is when something helps you even when it’s not a “real” medication. A nocebo effect is when you block a potential thing from helping you because you refuse to believe it can.

In the beginning I felt like every time I took it I was like I hate this! That wasn’t helpful. I actually went to a facilitator of that of that Byron Katie method of “The Work” and we worked it through and got through all of those fears until I just instead just said every time I took it this is either going to help me or it’s going to teach me. If it teaches me that it’s not good for me, I’ll stop taking it. And if it helps me, I’m so grateful. That was how I approached it and now I have one that’s helping me. And every time I take it, I say I am really grateful for this medication for helping me.

Laura: That’s awesome.

Kelsey: That’s really cool. I was just wondering too, I know this is going to be different for everybody of course, but how long did that process take you from first staring medication to finding one that you felt like really worked for you.

Eileen: It is really different. Some people are wicked lucky. They seriously just get on one and they try it and it’s awesome. They just are like why did I not take that before? And then other people frankly had a worse experience than me that they had such a scary side effect that they never want to touch a medication again.

Mine was less dramatic than that. They started me on Methotrexate, which ironically improved my blood markers and had no impact on my joint pain whatsoever, which isn’t actually all that uncommon. It’s like my blood work looks fabulous, but I still feel really not good.

They tried me on Prednisone, which for me it was unusual. I always thought that was in my back pocket that I could try if I ever did have flares like I had at rheumatoid onset. I learned that it turns out I don’t really get much benefit from Prednisone. That was interesting to find out. I think I metabolize it in a way that it just clears my body very quickly. I got the kind of negative adrenal side effects, but I got minimal anti-inflammatory benefit. I would say Aleve is more powerful for me than Prednisone which is kind of crazy. That’s what I learned whereas other people, they tell them Prednisone makes them feel like super woman. Some people do well on it.

For me the biologics were the category of medication that started doing some good. I tried Humira first and it improved my symptoms, but I was not satisfied with that being enough because I was already doing pretty great before I started medication. So I’d say it only gave me like a 10-20% improvement and I was still having symptoms. They switched me to another one called Cimzia that it’s as close to remission as I’ve ever felt. I’ve been able to go off the Aleve. I don’t need that anymore. It’s not like I never have little sensitive joints here and there, but it’s seriously less than it was when I was medication- free even at my best on paleo. That was really interesting.

The other thing I will say, a lot of times people will say it turns off your immune system so you’re sick all the time. I will say again it’s personal, I think for some people that’s true. They say they’re either in remission and sick, or their autoimmune activity is active. Some people do seem to almost have an on/off switch, but I think that’s more rare.

For me that’s not the case at all. The medication is trying to get rid of the overactive part of my immune system while still letting that core level go. I caught my first cold since getting RA five years ago because that was one silver lining of it never being in remission was it was always keeping everything at bay. I got over it in three weeks without it progressing to anything serious. That was a nice test of my immune system for me. It didn’t cause a flare when I got sick and I also was able to get better, so that tells me my immune system is not shut off.

Laura: I feel like that’s something that there’s all these ads for things like Humira and all these medications on TV and you see all the side effects that they list, which obviously they have to and I’m not saying they’re not serious, but I think people will get really freaked out by those and then they’ll just be 100% opposed to using any sort of medication whatsoever to deal with autoimmunity because they’re scared that it will just cause way worse problems than it solves. Which as you explained before, that might be true for certain medications. But to me it sounds like the medication piece has been a really important part of your overall physical health and healing over the last couple years. Do you agree with that?

Eileen: Absolutely. I will say, some people say why don’t you just go back to eating a standard American diet? I really see that paleo diet and lifestyle as complimentary medicine also and I think one of the reasons why I was able to find a medication that is finally is this successful for me is because I have addressed a lot of the inflammation at its root so the medication doesn’t have to work quite so hard.

I will say my rheumatologist is like blown away every time I come on.  He’s just really funny. He’s like I cannot believe that you are taking nothing but this. Because most people, I know a lot of people who take for example a biologic, Methotrexate, and maybe Celebrex, a prescription anti-inflammatory with Prednisone during flares. All of the medications I tried, they still need to take because they’re not doing any diet and lifestyle.

Laura: They’re talking them all at the same time, not just one?

Eileen: Yeah, Prednisone maybe off and on during flares. But the other three all the time. I think that’s the RA cocktail. It’s the most common prescription if someone has a more than just a mild version of the disease. I think people who are milder, they are often still on three medications, but they are different ones. I think it’s Sulfasalazine, Plaquenil, and then an anti-inflammatory. For me it’s just the biologic.

It’s funny that I can talk about this so calmly because I will say I was one of those people, I was so scared and I tried not to be a blogger who spread that kind of fear because I knew enough people in the community who weren’t able to get off their medications that I was already before I needed medication trying to combat that feeling of failure people had.

There was almost like this weird thing that happens in the community where if say someone has RA, goes paleo, and they go into remission, that is awesome. I’m so happy for them. But they’re not superior to someone who goes paleo and doesn’t go into remission. They’re luckier. Maybe whatever is going on in their body, the diet had a much more powerful effect. Maybe their symptoms aren’t as complicated in terms of other factors. Maybe their disease isn’t as aggressive. It changes, it’s a lifetime journey so we may need help at some times and not help at others.

When I went on medication, I actually did a podcast called “Medication Decisions” if people want to find it. I interviewed I think it was five people, some who always took medication and never tried to go off it. There was one women Jamie from Gutsy By Nature, she has Crohn’s and she’s had surgeries and her life has been threatened by her disease. She just said that wasn’t a risk she was willing to take to ever go off it. But she is paleo and it makes her feel better. Then there are other people who have such negative reactions that they’re afraid to go back on, one who’s never needed medication, one who’s gone on and off medication, one who’s found one that works. So different experiences that people share.

But what I thought was interesting, the two people who are not on medication, I thought that they would say they would never take it. But when I asked them that question, they paused and they said, how can I say never?  I have a serious illness that could threaten my abilities or my life and nothing is off the table. They’re like right now I’m not talking it because right now I don’t need it. I think that’s the question. It’s like do you need it or do you not? Some people really don’t need it right now. But if you are losing abilities or you’re in excruciating pain, I think it’s worth considering.

Laura: Right. Or there’s also the thought that maybe the medication really is the best option and that may be in autoimmune disease or other illnesses. I know Kelsey and I work with a lot of clients that have small intestinal bacterial overgrowth, or SIBO, and I’ve worked with some people before who just refused to do any sort of antibiotic treatment. There are alternatives, but for some people the antibiotics are really the most effective treatment.

It just stinks when you are working with someone who wants to get better, but they have just totally removed one treatment option off the table. It’s like I definitely understand wanting to do things naturally and wanting to minimize or avoid medication if possible, but at the end of the day like you said sometimes the medication is either the best option or a really important component of your healing that won’t get that same level without it.

Eileen: Yeah. I think that you’re so right what you said in the beginning that medication is so villainized in this community that people are really afraid of it, like of all kinds, the antibiotics too. I’ve known people who have needed surgery and tried to tell their doctors to not give them antibiotics in the hospital. I’m like have you not heard of resistant Staph infections? I mean this is your life. You can rebuild your gut but you can’t come back from the dead if you get struck down by something. Often when you point that out to someone they’re able to see more clearly, but instead they just have “antibiotics – bad” kind of in neon lights in their eyesight. I can see why you do run into that.

I don’t believe everyone should be taking them as overprescribed as they are. But you’re right, there’s times when you need them. I guess I feel the same way about autoimmune medication now. The functional medicine practitioners, the best ones don’t villainized the medication, there’s still a lot out there that do.

Laura: Yeah.

Kelsey: Yeah. I think there’s these two things that happen I think when you start to think about medication. I’ve seen this in my own clients, and Laura, I’m sure you’ve seen the same where on the one hand there’s this fear of the negative side effects or negative things about medication. But then like you were talking about before, there’s also this fear of failure or feeling like you are a failure if you have to resort to medications to control a disease that truly I mean you don’t really have much control over. I think that it’s really important to separate those things and recognize them for what they are too. And then think through logically and emotionally think about what emotional factors are holding you back from in terms of how you think about medications.

Because that’s one thing that as a practitioner, I have really tried to educate patients on as much as possible because like I said, I do see a lot of people who whether they’re fearful of side effects or think that it means that they’ve failed if they take medications, either way it’s like Laura said, it’s taking an option off the table that could be a really good choice for them. I hate to see people do that when they haven’t really thought it through logically and emotionally and made that decision from a place of education.

Eileen: I couldn’t agree more. That feeling of failure, you just have to work it through. Because you’re absolutely right, you’re not a failure. I went through that. Absolutely. I’ve always been someone who tries to be pretty transparent on my blog and honest about the journey and so I wanted to go public with this. It was scary in some ways to do. It’s like okay, Phoenix Helix is going to come out saying she’s trying medication. I wasn’t quite sure how the community at large would respond to that. I got hundreds of people commenting saying that they needed medication and they felt like failures and it was so nice to see some voice that it is sometimes needed.

It’s been interesting ever since I’ve gone on medication I would say there are the medication free people out there still, so there are still some people who are. I think like Laura said, maybe it depends on the disease to a certain extent too. But when it comes to something like RA, Crohn’s disease, some of the more aggressive ones, again there are still exceptions where there are medication free people out there, I think they’re really rare frankly.

Laura: Did you get any backlash on your blog when you shared that?

Eileen: Only one out of a zillion comments. I’m a big fan of delete if you’re mean to me. I just don’t put up with that because I just feel like my blog and my community is kind of all about love and support and if you are respectful…one thing that did happen and continues to happen are people who are trying to help me cure myself. And that can be a button for me in terms of an emotional button. It depends on how it’s presented. A lot of people were like have you tried everything from iodine supplementation to bee sting therapy.

Often if it was my reader, and they knew me well, and they were just coming from the heart, I would just reply with frankly after five years, I’ve tried almost everything. Not bee sting therapy by the way, but I looked it up and ironically the research on bee sting therapy says it works for rheumatoid arthritis in conjunction with immunosuppressant medication, but it doesn’t work without. I just thought that was just kind of funny and I don’t want to get stung by bees.

Kelsey: That doesn’t sound very fun.

Eileen: I had one woman tell me if I stopped drinking kombucha, I wouldn’t have rheumatoid arthritis anymore. For her, I just cut her off. You get that. I’ve had one woman email me because she was a spiritually enlightened being who could work with my energy channels and cure me. When I replied to her saying that I have addressed this from a holistic perspective and I’ve had professionals really help me  and I feel really grounded, she’s just like, yes, but you haven’t had me, claiming to cure. That’s frustrating. I don’t like those things.

I think anyone with autoimmune disease gets that at some point in their life anyway. It’s just that as a public figure who’s taking medication I get that more often. But only one person got kind of mad and I think he was really afraid. He said oh great role modeling, you’re risking cancer and whatever else and telling people about that. I was just like oh honey, you got to work that through on your own.

Laura: I would think that the response about have you tried this or these are all these things that you could do instead, that’s still coming from a perspective of fear about medication. At the end of the day, if you had said I did bee sting therapy and it is making me feel a lot better, I don’t think anyone would have gotten mad and said you shouldn’t be doing bee sting therapy. Just think, you could…I don’t even know… you could die from a bee sting allergy or something. I just feel like there’s something about medication in the alternative health community that people really are not happy about. Either there’s this fear around it or there’s this assumption that everything can be fixed from a natural perspective.

Eileen: For psychological medication too, right?

Laura: Oh yeah, definitely.

Eileen: There’s so many people who do have major mood improvements by going paleo, which is awesome. I’ve known people who lost all of their panic attacks, anxiety disorder, depression. But other people who don’t just feel like failures if they still need help.

Laura: Right. There’s some medications that I think people are really just overly fearful of. I know autoimmune medication has to be one of them and the antibiotics are definitely some of the bigger ones as well. I was on antibiotics for like 6 to 8 months for Lyme disease back in, gosh I want to say it was like 2011 or 12 or something. It’s funny because I forget how sick I was back then, but the antibiotics were super helpful.

I think that having a fear about medication prevents people from getting the help that they need if they really have started to exhaust all their options. It can be something as simple as using a medication to help your skin if you’re having a lot of acne. Yeah, the diet is going to help, but sometimes you just need a little boost and doing something after you’ve done the research to make sure it’s not something that’s not worth the benefit, like there are some acne medications that increase your risk of IBD, that kind of thing. I don’t know if that’s a great trade off. But if it’s something like autoimmune disease where your day to day life is really being significantly impaired by your symptoms, then the tradeoff of potential chronic issues down the road, it may be worth it to some people.

I think everyone needs to be comfortable making their own decision in that matter and not letting the fear mongering that happens on the internet about medication prevent them from even considering that as an option.

Eileen: I couldn’t agree more. I’ve been through this journey so anyone who is in that fear space, I get it. You can get to the other side. And it’s just like you said, there are times when the benefits outweigh the risks and I think we need to open our minds up to that possibility in this community more often.

Laura: Yeah, I just remember I posted, I forgot exactly what I had posted months ago on my Facebook page about how sometimes medication is the best option for treatment. It was basically about this whole topic where people tend to avoid medication. I just remember getting some responses that are like, this is crazy! Medication is never the right option! It’s just amazing to see how angry people get when you even suggest medication as an option for treatment.

The good news is it sounds like your community is generally supportive and just wants to feel better and is willing to use any means necessary and not going to totally eliminate a certain treatment option just because it’s gotten such a negative halo around it as we might say.

I feel like I don’t know if we intended to talk so much about medication, but Kelsey, I know it’s something that for me a lot of my clients really need to hear this, and I’m sure you’re in the same situation where either there’s fear, or guilt, or I almost wonder if it’s like a pride issue if they feel like I can do this without medication and I don’t need rely on a doctor. At the end of the day, that’s really hindering people’s ability to feel their best and really live a life that is as unencumbered by disease as possible.

Eileen: Yeah, I agree. You’re still going to move forward. If you decide to try medication, you’re still going to move forward doing that with your eyes open and mindfully and do everything you can to help that medication work. If it doesn’t work for you or the side effects are bad, then you definitely can stop taking a medication at any time too.

It sounds maybe strange to some who’s never thought of it, but it can be an empowering journey just like the paleo diet and lifestyle can be. It’s about feeling better and it’s about your own choices. No one’s forcing anything on you, and you get to experiment and see what works, and you can advocate for yourself in the doctor’s office for what you need. It’s all about living the best life possible, like Laura said.

Laura: No one is saying if you do medication that you have to give up on any other options like diet, or lifestyle changes, or supplements, or anything like that.

Kelsey: Right.

Laura: It’s just a tool in the toolbox as they say.

Eileen: Exactly. And you’re right that it’s a tool that a lot of us have refused to pick up.

Laura: We’re definitely going to share a couple of the resources you mentioned on the show, especially that “Medication Decisions” podcast. It sounds like that would be a really great one for a lot of our listeners to hear. Is there anywhere else that you’d like our listeners to check you out, either a website or a specific books or anything like that?

Eileen: I think you had them all in the intro, but you can just find me at PhoenixHelix.com. Everything I do is there. My books, my social media, my podcast, so you can find everything there. But you can also find my podcast in the same name wherever you listen.

Laura: Awesome! We really appreciate you coming on, Eileen. I think this was a great discussion that’s going to be very helpful for a lot of people. We’re just really glad to have you as part of the community.

Eileen: Thank you so much! It was an honor to be on.

Laura: Alright. Well, we’ll see everybody here next week!

PODCAST: How To Test For Gut Dysbiosis

Thanks for joining us for episode 111 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering following question from a listener:

“I’m looking for some guidance with a gut issue I’ve been experiencing. I already know from listening to your show that I need to stop treating the symptoms and get to the root of the issue. I’m just wondering what specific tests I should ask my doctor to order and what the names are. Every month I get inflammation in my intestines. It’s tender when I press on my lower belly. I can tell things aren’t digesting correctly from my stool and I eat low FODMAP when this comes up and it clears eventually and then we’re back to the same issue. My doctor mentioned an antibiotic blast as a treatment. Is this a smart thing to try? Blasting my gut with antibiotics sounds intrusive and I worry about the good bacteria being destroyed.”

Digestive problems are hard enough to deal with, but even harder can be figuring out the cause. Often an imbalance of gut bacteria is the culprit, but how do you know if that’s at the root of your digestive distress?

Today’s podcast is all about the ins and outs of testing for unbalanced gut bacteria to uncover the root cause of your symptoms. We’ll walk you through which laboratories and specific tests we recommend for both SIBO and large intestine dysbiosis to take the guesswork out of the process. We even cover the gut and hormonal health connection as well as other health conditions related to unbalanced gut bacteria to help you further in the process of determining the root cause.

Here’s what Laura and Kelsey will be discussing in this episode:

  • The two gut bacterial imbalance tests to have done if you have any digestive problems
  • How gynecological issues can cause digestive symptoms
  • The connection between gut health and hormonal health
  • Guidelines for choosing a lab and testing method for a SIBO test
  • Why working with a practitioner to interpret SIBO test results is recommended
  • How to approach your doctor on the subject of SIBO testing
  • Recommended stool tests to check for large intestine dysbiosis
  • The benefits of doing a functional medicine stool test over a conventional one
  • Health conditions other than digestive that are related to gut dysbiosis or SIBO
  • The reasons to get tested before beginning treatment with antibiotics or antimicrobials
  • How the Build Your Biome program can help walk you through the process of testing

Links Discussed:

TRANSCRIPT:

Kelsey: Hi everyone! Welcome to episode 111 of The Ancestral RDs podcast. I’m Kelsey Kinney and with me as always is my cohost Laura Schoenfeld.

Laura: Hey everybody!

Kelsey: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me at KelseyKinney.com, and Laura at LauraSchoenfeldRD.com.

Over the next 30 to 45 minutes we’ll be answering your questions about health and nutrition, and providing our insights into solving your health challenges with practical tips and real food. Make sure you stick around until the end of the show when we’ll be sharing exciting updates about our personal lives.

Laura: If you’re enjoying the show, subscribe on iTunes so that way you never miss an episode. While you’re in iTunes, leave us a positive review so that others can discover the show as well! And remember, we want to answer your questions, so head over to TheAncestralRDs.com to submit a health-related question that we can answer on an upcoming show.

Kelsey: Today on the show we’ll discuss how to assess your gut health to determine if you have any pathogenic or unhealthy bacteria. But before we get into that, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com

Kelsey:Welcome back everybody! Here’s our question for today’s show:

“I’m looking for some guidance with a gut issue I’ve been experiencing. I already know from listening to your show that I need to stop treating the symptoms and get to the root of the issue. I’m just wondering what specific tests I should ask my doctor to order and what the names are. Every month I get inflammation in my intestines. It’s tender when I press on my lower belly. I can tell things aren’t digesting correctly from my stool and I eat low FODMAP when this comes up and it clears eventually and then we’re back to the same issue. My doctor mentioned an antibiotic blast as a treatment. Is this a smart thing to try? Blasting my gut with antibiotics sounds intrusive and I worry about the good bacteria being destroyed.”

Kelsey:Really good questions in here. I’m going to be talking about a lot of different things that I discussed in an article that I recently wrote. If you want all of this information in an easy to digest format that you can just check off and make sure you’re testing for everything with the names of the tests all written out for you, you can just check out that blog post. I’ll link to that in the show notes just so you guys can get to that really easily. This person obviously has a little bit more specific questions in here too, so I’ll touch on those as well.

The first thing that I think about when somebody comes to me with any sort of digestive problems is like this person mentioned, getting to the root of the issue. I mean digestive issues can be caused by many different kinds of infections. Sometimes you may not even have an infection. You might have some sort of autoimmune type disease that is causing digestive problems and it doesn’t really have a whole lot to do with the digestive system.

But I like to rule out the more obvious answers first of course. That would include things like SIBO, which is small intestine bacterial overgrowth, and dysbiosis of the large intestine. That can be something that I like to call insufficiency dysbiosis which essentially just means that you don’t have enough good bacteria, or it can be a combination of not having enough good bacteria and having too much bad or commensal bacteria. Those are the two things that I test for a lot in my practice. Honestly they are the two things that I would recommend that you get tested for right off the bat if you have any sort of digestive issues.

This person’s problem sounds like it’s fairly cyclical and one thing you want to think about if that tends to be the case for you, like you’re not necessarily noticing your digestive problems all the time, I’ve had quite a few people at this point that they don’t end up having any sort of infection, or overgrowth, or anything like that. I don’t know if this person is a woman, but it actually ends up being some sort of ovarian issue like they have cysts or something going on gynecologically so that’s causing bloating and can cause digestive problems as well.

I definitely think it’s still a good idea to rule out the digestive problems. You can have both too. I mean you can have bacterial imbalance in your gut that causes digestive problems along with some gynecological issues that can cause problems as well. Laura, do you see that at all in your clients where they have any sort of gynecological issues that are causing digestive issues?

Laura:Yeah, I think it’s kind of a weird chicken or the egg scenario because I have some clients that I think they’re gut dysbiosis is actually contributing to hormonal imbalances. For example, there are certain types of bacteria that produce toxins or LPS toxins basically can affect estrogen elimination.

Kelsey:Yep.

Laura:Whether or not the person is overproducing estrogen or if they’re not clearing it out well enough because of a gut infection, that’s definitely something that I see a lot. The combination of gut issues and hormonal issues, even amenorrhea is pretty common with a lot of my clients. And then there’s always the shifts that happen around the menstrual cycle with digestive function that may not be related to gut bacteria specifically.

Kelsey:Right.

Laura:But I do think there’s a lot of connections between gut health and hormonal health in general. Like I said, it’s kind of a chicken or the egg scenario where it’s like okay, did the hormones change first and then that affected the gut health or vice versa? It’s just interesting to see how certain symptoms of like let’s say their hormonal issues will be affected by treating SIBO or dysbiosis.

Kelsey:Yeah, absolutely. That’s something I see a lot. Because you’re right, especially I find that estrogen clearance can be highly, highly affected by somebody having dysbiosis or SIBO. You just have a lot of problems getting rid of estrogen. It gets reabsorbed and you get estrogen dominance which can cause a lot of symptoms as well.

I just wanted to mention that because if this person is a woman, it’s something to think about. If you haven’t had a GYN appointment in a while, I would definitely at least go to that, get everything checked out, make sure it’s all functioning appropriately. Because like I said, I’ve seen a few people having cysts or other issues gynecologically that can lead to dealing with digestive symptoms like bloating where if you feel like you’ve tried everything and you cannot figure out what the heck is causing your bloating or your digestive problems, that is something that I’ve seen happen with quite a few clients. Just make sure you’re thinking about that as well.

Laura:I’m actually doing just like a little on-air Google search. I’m pretty sure that endometriosis can cause bloating.

Kelsey:Yeah.

Laura:I believe that would be potentially cyclical as well. I would definitely rule out endometriosis as part of this process. I feel like gut health is related to everything.

Kelsey:Yeah.

Laura:As far as this whole treatment of bacterial issues is concerned, and I know you’re going to talk about this, but I don’t know if that’s something great to do without doing some testing first because I would hate for this person to get a ton of antibiotics if their issue is endometriosis.

Kelsey:Yeah, absolutely. Now that I’ve seen that happen quite a few times with my digestive clients, and honestly it was something that just occurred to me through being in clinical practice for a while and having some female clients that we just could not for the life of us figure out what was going on with their digestion. They would have all these problems and then they had no bacterial imbalances, or we cleared them and everything was looking good digestively, but still these symptoms remain. For the first person, it just happened randomly that they got diagnosed with some gynecological issues. And then from there on out, I was like okay, I’ve got to make sure everybody is getting checked out for this if it could just be something like that and it has almost nothing to do with digestive system itself.

Absolutely, if you’re a woman listening and you’re got digestive problems especially if they’re not consistent, though I will say you can absolutely have consistent digestive problems that are gynecologically related, but definitely if they’re cyclical, please do get checked out to make sure that there’s nothing else going that could be causing your digestive problems that really has nothing to do with the digestive system.

I just want to drive that point home because for me that was something that like I said I learned through clinical practice. It was not something that I even really considered until I saw it happen a couple times and then a little light bulb went off in my head and I was like okay, make sure everybody gets checked out for this stuff.

Other than that, or if you’re a man, you know that’s not part of the issue here, of course you definitely want to be testing for some bacterial imbalances. The two that I am typically doing in my own practice and what I recommend in my Build Your Biome program as well are like I said SIBO and a stool test which is going to test for the bacteria in your large intestine.

It sounds like this person has not had any tests I think. It sounds like they’re also working with a doctor to potentially get these tests. The ones that I am using right now and I’m not incredibly partial to these I’ll say. There are a lot of good tests out there, but these are just the ones that I am tending to use these days. For SIBO testing I use BioHealth Labs, but there’s tons of SIBO tests out there now since it’s becoming more and more of a popular topic. But I just use BioHealth. The only thing you want to make sure depending on what lab you order from is that it’s a three hour test because you want all of that information. I’ve seen some other SIBO tests, I saw one actually that was like an hour and that to me didn’t really make a whole lot of sense.

The reason you want it to be so long is because we want to see what happens as it gets into the large intestine as well to kind of help you to determine if something is truly a positive test because what you’ll tend to see for that is a double peak where your gasses will increases before the 120 minute mark which is when for most people the solution that you’re drinking will head into the large intestine. The large intestine of course is where our micro biome is. It has tons of bacteria and so they are absolutely going to ferment that solution and they’re going to produce a lot of gas as a result.

If something is really positive, then you’ll see the first peak at some point before the 120 minute mark and then you’ll see another even larger peak after the 120 minute mark because that’s again when it’s heading into the large intestine. You want a longer test so that you can see when it gets into the large intestine and that will help you to determine if your test is truly positive.

Because the thing with SIBO testing as is is that there’s no real gold standard for SIBO testing. These breath tests are the best thing we have and they’re not perfect by any means. That’s just something to think about. It’s sometimes why doctors will say they don’t want to do SIBO testing or they think it’s unproven or something because there’s just again not gold standard in the testing and these tests aren’t perfect. But to me that’s a little silly I think just for me because I’ve seen so many people benefit so much from clearing SIBO and this is really the best way we have right now to determine if somebody has it. It seems crazy to me to not use what we have right now even though it’s not perfect.

Now there’s two different types of solution that you might drink or substrate for a breath test. Actually I mean there’s other ones too, but the two main ones are glucose and lactulose. I prefer the lactulose test for the most part at least for a screening test for the first test that you do because it tends to pick up on more people that have SIBO. You might get some false positives in there, but I’d rather make sure that somebody who does have SIBO gets it picked up by the test rather than have somebody who doesn’t have SIBO get a false positive. I do like that as definitely as the first test. And then if you want to retest, that’s when I might use a glucose test just because it is a little bit more accurate. It will tend to have less false positives, but you might miss a couple people who actually do have SIBO because they might get a false negative.

That’s something to think about wen you’re deciding or talking with your doctor about which kind of test you want to get. If you’ve never had a SIBO test, I do recommend getting a lactulose test and then from there you can do the glucose test as a retest or as you retest you can still do the lactulose. There’s no issue with doing that as your retest. But definitely for your first test, at least from my opinion and what I’ve done in practice, that seems to make the most sense is to the lactulose.  Laura, do you do SIBO testing?

Laura:Yeah, I’ve started to order those now in the last maybe six months or something because at first I was just finding doctors to get it for my patients, but after we had a couple of patients that couldn’t find a doctor to do it, I jumped on the testing myself bandwagon. Because I’m like alright, I’m not going to spend all this time trying to hunt down a GI doctor for this person when I can just order that for them myself. Definitely have started doing that lately. I do the lactulose hydrogen and methane test, the same one that you do I think, the BioHealth.

Kelsey:Yeah, and BioHealth now has started to offer the glucose test as well. I think they didn’t offer it before and now you can do either lactulose or glucose, or you an even do both them together.

Laura:A combination.

Kelsey:Yeah, not at the same time, but you can order two different tests for each one if you want to be super thorough about it. BioHealth you can only really get that through a practitioner or a healthcare provider, so just be aware of that.

Commonwealth Labs was the other one that you could order yourself as a patient, but they actually just closed rather suddenly. They were a big lab doing lots and lots of SIBO tests. I don’t know the full details about their closure, but I do know that you can’t order form them anymore. Or if you have a SIBO test from them that you haven’t submitted yet, don’t because I don’t think they’re even processing anymore SIBO tests that have been sent out. You’re probably going to want to think about a different lab to work with.

Do you know of any other tests that people can get on their own because I always just order the BioHealth and I assume you do to, so I actually don’t really know of any that can do just online themselves.

Laura:I’m not sure. They might have it on Direct Labs.

Kelsey:Oh yeah, that’s true. I think they do.

Laura:I haven’t really looked into that. The thing about the substrate is that glucose is not a controlled substance so I think that one would be the one you could order on your own.

Kelsey:Yeah.

Laura:As far as the lactulose is concerned, you do have to have a doctor. It looks like on Direct Labs they have a couple of different, oh yeah, they have the BioHealth kits available. They usually tend to be more expensive.

Kelsey:Right.

Laura:Yeah, BioHealth charges $60 more than I charge for the test for my patients. It’s a little bit more expensive. But to be fair, then you have to pay for somebody to order it for you and give you the results. That’s the only other thing just thinking about that with tests, I feel like interpreting a SIBO test is kind of an art.

Kelsey:Yes.

Laura:Ordering it on your own and not having somebody look over it with you is not a good idea. Maybe you might get a very clearly positive test, but I know I’ve had a lot of tests recently that had a lot of nuance to them and I’ve had tests that they say that they’re positive and they might be, but they’re not definitely positive. To go into a full on SIBO protocol from that result I would say is maybe not the best idea. I feel like you have to work with somebody who can interpret them correctly because they can be a little bit confusing.

Kelsey:Yeah, and this is why I say these tests aren’t perfect because there’s not even a consensus necessarily on how to interpret these tests at this point. We’re getting closer to that. I think it was Dr. Pimentel who came out with an article this year actually that aimed to do that, to come up with a consensus for how to interpret SIBO testing. I’ll see if I can find that and link to it as well because it’s pretty interesting and it actually changes a little bit of what we had previously thought to be positive.

Just as an example, when you had high methane gas, Dr. Pimentel specifically at that point in time was saying that anything over 3 parts per million was positive. I believe in this latest article they’ve changed that to 10 parts per million. That’s again looking through all the data available. I don’t know if that’s his personal opinion at this point, but certainly from all the research that we have available to us, it does seem to suggest that anything over 10 parts per million…I think it’s 10, we can double check…but anything over 10 parts per million for methane, it should be considered positive. That changes things a little bit than what they were before if you were following Dr. Pimentel’s interpretation advice. All that to say that, yes, Laura is absolutely right, SIBO interpretation is a little bit tricky, definitely is a bit of an art for sure. I do really suggest working with somebody once you have that.

The reason why somebody would go order that themselves I find is typically that their doctor for whatever reason, like I was saying before, they don’t want to do the SIBO test or they don’t even know what SIBO is necessarily so brining that up to them and asking for a test can feel like a big hurdle. Some people just choose to order the test themselves and then bring it into a doctor because then they’ve got some proof in their hand coming in and the next step is how to deal with that, not can I even be tested for that, will you test me for that. That’s something to consider.

Now I do want to mention though that SIBO testing through a doctor is becoming more and more common. Depending on where you live and the kind of doctors that are around you, you may be able to get a SIBO test done by your doctor and get it covered by insurance. That is definitely an option to think about especially if you’re on a budget and you really just want to make sure it’s covered by your insurance.

If that’s you, if you’ve got an open minded primary care, they can definitely order the test for you. Even if they’re not super familiar with SIBO, if you feel comfortable having a good conversation with them about it and saying, look, these are my digestive symptoms, I’ve done a bit of research…I know doctors always hate to hear that when patients have done their own research. But as long as you come in from a place of respecting their degree, respecting how much time they’ve spent to get that, and all the research they’ve done, and all the hard work they’ve put into it, I find that patients actually have a really good success rate with getting the SIBO test done. Even if they have to refer you to a gastroenterologist in the area who maybe does the SIBO testing in office, that’s an option as well.

I like to just make sure that people go into that conversation not coming from this perspective of I read all about this online, you’re an idiot for not knowing what SIBO is, blah, blah, blah, blah. I think you can kind hit a hard wall if you come in with that attitude. Just really come at it from a place of respect and open mindedness, listen to what they have to say.

But at the end of the day, I find that most doctors, they struggle I think with digestive health clients a lot of the time because it can be difficult to get somebody results, get somebody feeling better from digestive problems when they’re not looking at these bacterial infections. They often come to a point where they are like I really don’t know what to do next, and if my patient is coming in asking for this test, I’m not opposed to it. That’s often the attitude from doctors that I’ve heard about from my patients who have gone to ask them for testing. Just go into it with a good attitude and you probably will have decent luck.

That’s SIBO. I think that’s everything I want to mention about SIBO. Like I said, BioHealth, that’s what Laura and I both use as a lab, but there are plenty of other ones out there. If you’re ordering it on your own, you can order it through DirectLabs.com depending on what state you live in. New York and New Jersey I think are the only two that you may not be able to order them through Direct Labs. I can order a test for somebody in New York and they just have to basically check off a box that says I didn’t collect this specimen in New York and then BioHealth will be able to run the sample. But that’s the only thing to think about.

Laura:Direct Labs says that services are not available in Maryland, New Jersey, New York, and Rhode Island.

Kelsey:Okay, so there we go. If you’re in one of those states, you’re probably going to have to work with a practitioner and you will need to go to another state to actually take the sample. But again you just have to check off that box saying I didn’t take the sample in New York or any of these other states and BioHealth will be able to run it.

You can do lactulose or glucose testing. We recommend lactulose for at least that first test. There’s lots of labs out there, BioHealth is just the one that we tend to use. But you can definitely check out others as long as they are three hour tests, they’re looking at both methane gas and hydrogen gas because whether you’re hydrogen positive or methane positive is going to affect the way that you clear that bacteria out of your small intestine. We need to know if you have too much methane or too much hydrogen, or both. If you’re only getting a hydrogen breath test and it’s not looking at methane, you’re missing out on a really big piece of the picture there. Anything else you’d add about SIBO testing, Laura?

Laura:I don’t think so. I guess that the question about the sugar that you’re using is interesting because I know I think it was this week I was asking you about a client of mine that had a dextrose SIBO test from a GI doctor and I was looking at it and there was literally no hydrogen gas production at all. It said it was a negative test. I was just like I don’t know if that is legitimate. We’re running a new one with the lactulose.

But it was just really odd because I didn’t even know they had a dextrose test. The funny thing about dextrose is that’s one of the sugars I know Dr. Siebecker I think is her name, she recommends dextrose a sweetener because it doesn’t feed the bacteria. I’m like I don’t know why that would be a SIBO test using dextrose.

Kelsey:Interesting.

Laura:But honestly, I have no idea. I just was very surprised to see that from a GI doctor, like an actual MD. If you are getting a SIBO test done through your MD or any practitioner I should say, ask them exactly what they’re testing, what the sugar solution is especially if you’re paying for it out of pocket because you don’t want to spend a couple hundred dollars on a test that’s totally useless.

Kelsey:Exactly. Just to talk about that no gas production thing. I’ve had that happen, not nothing, yours was literally zero which was really weird.

Laura:Yeah, it was like flat lined and the doctor was like well, it’s negative.

Kelsey:I don’t know about that.

Laura:I’m like I don’t think you’re supposed to have nothing. I think you’re supposed to at least see some gas at the end.

Kelsey:Yeah. I’ve had a couple patients that at this point I think it’s literally been two patients where they had really oddly low gas results for both methane and hydrogen, no spike at the end or anything. I actually, like when that happened with BioHealth, I called in and I was like this makes no sense. They were like, yeah, this makes no sense, we should retest. If you get a really weird test result like that, definitely consider retesting. But that’s something of course that you can work on with your healthcare practitioner as well if they think it looks really weird.

Laura:Did you have to pay for the retest, or did they just send you one?

Kelsey:No, they sent me one.

Laura:That’s nice.

Kelsey:Yeah, it was really nice.

Laura:Good to know.

Kelsey:I think they were like perplexed by it as well because it just made no sense whatsoever. I think that’s it about SIBO testing. Honestly, that’s the first one that I usually test for unless somebody wants to do both SIBO testing and stool testing together to just get everything out of the way. For both of these tests you want to be off of probiotics, prebiotics, any sort of antimicrobials or antibiotics for two week prior. Because of that prep time, a lot of times people just want to get it all done in one shot.

Next it would be stool testing. If you just started with SIBO testing, let’s say that comes back negative. Next step would be stool test. If it comes back positive, you’d of course want to deal with SIBO first, retest for SIBO. If you still have SIBO after retesting, you’re going to have to work with somebody to go through more treatment for that, get rid of it, retest again, make sure it’s gone. Once you then get a negative test for SIBO and let’s say you’re still having symptoms, that’s when I would move onto a stool test.

For stool testing you’ve got a lot of different options. I used to recommend the Doctor’s Data test or I’ve had a lot of patients come to me with Genova testing for stool tests just because I think for many people that is a least partially covered by insurance. If they’re going to an Integrative MD, their doctor’s ordering that test for them at least getting partially covered. All of these tests I think are all really pretty good.

The one though that I have been using lately is called the GI-MAP test. I’ll link to that. It’s from Diagnostic Solutions Laboratory. The interesting thing about this test is it’s all PCR technology meaning that they’re looking at the DNA of bacteria to see if it’s present in your stool. Doctor’s Data for example, they do some PCR and then they do sections that are cultured as well. For some things they do both the PCR and a culture. That’s a good way to look at things. You can see both. But for a lot of people the Doctor’s Data test is really, really expensive. Depending on where you’re ordering that from, I believe you can do, I’m positive actually that you can do Doctor’s Data through Direct Labs. But again, pretty expensive. I think it’s in the mid to high 300s depending on how many stool samples you’re sending in.

The GI-MAP test is one stool sample. Like I said it’s all PCR so it’s only looking at the DNA which is a very accurate way of looking at it. You don’t necessarily need as many stool samples for something like Doctors Data to pick up things on cultures. I’ve been using that lately. I really like it. But like I said, I’m not hugely partial to any one lab. The GI-MAP is just the one that I’m tending to use these days. It’s what I recommend in my Build Your Biome class, but I give you options for getting the Doctor’s Data test, or a BioHealth test, or Genova you can also order I believe through Direct Labs as well.

The thing about these stool tests because if you’re somebody with digestive problems, you probably most of you have probably been to a gastroenterologist and they have possibly recommended a stool test for you. That’s like the typical conventional stool test. It’s really looking mostly for parasites, which of course is a good thing and it definitely can diagnosis some of those parasites. I think most of these tests even now are not PCR so they’re only looking at cultures, which like I was saying before is just a little bit less accurate than looking at the DNA. It’s just much easier to find bacteria when you’re looking for the DNA rather than trying to make everything grow in a petri dish.

You can miss a lot of things I think with those conventional tests and they’re not testing for as much information that you would get from some of the more functional medicine, integrative medicine stool tests. They’re not looking at your good bacteria to see how much good bacteria you have. They’re not necessarily looking at your commensal bacteria which is just bacteria that in a certain lower amount is fine, but if they start to take over, if they start to overgrow a little bit because maybe you don’t have enough good bacteria, then they can become pathogenic and cause you symptoms. This is not to say that you shouldn’t do a conventional stool test, I just think that you can miss a lot with that and it’s worth doing a integrative or functional medicine type stool test, something like the GI-MAP test, the Doctor’s Data, BioHealth, Genova, any of those brands are going to just give you a lot more information.

If you’ve done SIBO tests, that ends up being negative eventually, you do a stool test, what that can show like I was mentioning at the beginning here is that you could have too low amounts of good bacteria, you can have high amounts of commensal bacteria which can potentially be pathogenic, you can have parasites, you can have yeasts so things like Candida can show up on these tests. It really looks at quite a lot. Once you find something on that test, you can do antimicrobials, you can take prebiotics to help bring up good counts of bacteria. It gives you a lot information that you really can do something about.

I like both of these tests. I like doing SIBO and stool. Like I said, some people choose to do them both together, but others I like to just do SIBO first. If they’re on a budget, they don’t have the money to do both at the same time, I’ll start with SIBO and then move on to the stool test. Laura, do you do stool testing at all, or are you just doing SIBO at this point?

Laura:I’ve been using the BioHealth GI Screen right now. It tends to be kind of easier to do the SIBO and the stool test through them at the same time and get everything sent. That’s what I’ve been doing. I kind of do the same thing where depending on the person’s symptoms, we might do one or the other or do both at the same time. What I like about doing both at the same time is it kind of speeds up the process of identifying the problem.

Kelsey:Yeah.

Laura:I’ve had some people that we did the SIBO test which came back negative and then we were like alright, well let’s do the stool test now. That just adds time to the treatment. If somebody can afford to do both, I like to do both because then you know this is covering kind of everything as far as what could be going on in your gut. Obviously you can get false negatives and the BioHealth stool test isn’t going to cover all the different things that could be an issue, but I think it’s a really good place to start and it’s not crazy expensive to do it.

Kelsey:Yeah, I agree. I think it’s a good option. Actually a lot of practitioners will recommend that you do two different tests from different labs. They’ll often combine the Doctor’s Data test with the BioHealth test just to have first of all two different samples going to two different labs because not every lab necessarily is going to pick up on potential pathogens or parasites and things.

So it doesn’t hurt to have two, but for me at least with the clients I’m working with, at that point it becomes a lot of money that you’re spending on tests. To be honest, I am usually just going one stool test if we even get to that point of needing a stool test. But yeah, I think BioHealth is a really good option and if you have the money to do it, doing two different tests from two different labs is not a bad idea either.

Laura:I think that’s what they do at The Kresser Institute. They do I think it’s the Doctor’s Data, maybe the Bio Health.

Kelsey:I think it is.

Laura:I don’t remember which two. That’s just to kind of increase the likelihood of finding what’s going on.

Kelsey:Exactly.

Laura:Obviously every test has a risk of missing something.

Kelsey:Yeah, absolutely. Just one thing to mention about digestive issues in general is that you don’t necessarily have to have digestive problems to have issues with your gut health. In the article that I’ll link you guys to that I wrote recently about this topic, I do go through a lot of different conditions that are associated with either SIBO or dysbiosis that for many people they don’t get any digestive symptoms along with those conditions yet they are definitely more likely to have unbalanced bacteria. Just keep that in mind.

Potentially if you don’t have digestive problems, you may not be listening to this episode anyway. But just in case you are and you never tested your gut health but you have some other kind of health condition going on, it really does not hurt to test your gut health because like Laura said before, your gut health affects pretty much other body system that you have. If you’ve got some other health condition or other symptoms that seemingly do not relate at all to your digestive system, so you’re not getting bloating, you’re not having diarrhea or constipation, anything like that, like your digestive system seems to be working perfectly, it doesn’t necessarily mean that your bacterial balance is on point. Definitely consider doing some of these tests that we’ve talked about today even if you don’t have digestive problems.

Laura:I thought one of the interesting ones you had on that list was restless leg syndrome. I’m actually working with someone right now and we’re getting her SIBO tested that had RLS. Her doctor just put her on medication which is not an unusual treatment. She’s got other symptoms that sound like SIBO. It’s just interesting. It’s not that she doesn’t even have gut symptoms, that’s the crazy part. She does have gut symptoms and it’s almost like why wasn’t that tested? But I guess like you said earlier, it’s not a super common thing that the average doctor would be doing at this point.

Kelsey:Yeah, it’s really funny because I was just walking my stepmom through this process because got really bad food poisoning back in November and she’s been having digestive issues ever since. She had some digestive problems prior to that, but nothing really severe. After the food poisoning incident, things just were taken to another level let’s just say.

That’s first of all something that’s been highly, highly associated with SIBO infection is having food poisoning at some point especially if that seems to trigger ongoing digestive issues. I was shocked that she went to her gastroenterologist and she was like I’m having all these problems, I had food poisoning back in November. She actually was given antibiotics for her food poisoning and she had it again after November as well. Just lots of indicators that SIBO is what was going on. They do SIBO testing in house and they did not recommend that she do SIBO testing.

I was like, what! I just did not understand. I had to tell her you need to ask for SIBO testing. You have many, many indicators that that’s what’s going on. She asked them and they were like, oh yeah, sure, we do that right in house. I was like are you kidding me? How is that possible that you wouldn’t immediately recommend her to be tested for that?

Laura:I know. I always think it’s funny when it’s like the patient asks for it and the doctor is like okay, sure. It’s just like why did they have to ask? It’s just that’s an example of where being informed is important and going in and assuming your doctor is going to say no is not always the case. Because again, it’s pretty common for them to be like, alright, let’s try it because they’re kind of willing to do whatever it takes to find out what’s wrong, but they just may not have thought about it.

Kelsey:Absolutely. Push for testing that you feel like you should do. Again, come into it with a good attitude. But it’s your health, nobody cares more about it than you do. If you feel like you need to maybe find a new doctor or push harder with your current doctor to get the testing that you think you might need, I’m all for being a patient who is very informed and can have open and honest conversations with their doctor.

I want to touch on this last question that this person had briefly here which was they said, “My doctor mentioned an antibiotic blast as a treatment. Is this a smart thing to try? Blasting my gut with antibiotics sounds intrusive and I worry about the good bacteria being destroyed.”

Definitely a valid concern here. Yeah, I would be a little wary of that as well especially given that it sounds like the doctor decided that no testing is necessary before doing that. Now of course, listen to your doctor, have conversations with your own doctor. I’m just a Dietitian so I can’t really comment that much on prescriptions or any sort of pharmaceutical treatment here. But I will say that you should definitely consider some other options.

To me it seems logical to do some testing before just jumping into, especially an antibiotic blast. I will say that sometimes if somebody can’t afford testing or anything like that and they just have a lot of digestive symptoms, sometimes I will try an antimicrobial protocol with them. But I feel a bit more comfortable with antimicrobials than somebody just jumping into antibiotics which of course can have quite a damaging effect on your large intestine microbiome.

But if your doctor was talking about an antibiotic like Rifaximin for example that only stays in the gut, it doesn’t go out outside the gut really, it doesn’t go into the bloodstream to affect other parts of the body, Rifaximin is actually quite interesting in that it’s considered a you-biotic because it actually increases counts of good bacteria in the large intestine which is really unusual for an antibiotic. It’ll kill bacteria in the small intestine while increasing counts of good bacteria in the large intestine. If it was that, I’d feel more comfortable with it.

This is just speaking from my own personal opinion. If I was the patient I think I would feel more comfortable doing that than going on any other kind of antibiotic that is going to have a much larger effect on other areas of my body. But again, for me personally I would definitely want some testing first if I was going to jump into pretty much any antibiotic treatment, but if you can’t afford it for whatever reason or it’s just not an option, I’ve sometimes had people in other countries where they can’t get SIBO testing.

Laura:Actually, did you know that BioHealth can send SIBO testing internationally?

Kelsey:I did, yes.

Laura:Oh, okay.

Kelsey:Sometimes I’ve had people though in really faraway places that the shipping is just so exorbitant that they can’t. That’s more so specifically for like the stool testing tends to be for whatever reason more expensive. I think BioHealth, from what I remember, I believe they have a flat rate international shipping fee which is great.

If somebody just can’t get testing for whatever reason, whether that’s finances or anything else, that’s when you would maybe want to consider just jumping into an antimicrobial protocol or potentially antibiotics. Again, I feel way less comfortable with that. But for the most part, I mean for anybody who can do testing, I would definitely recommend doing it first.

Laura:Yeah. It’s one of those things doing some antimicrobial herbs may not cause a huge problem, but I would prefer not to do it if we don’t have testing. That’s kind of my approach too. I’ve had a couple clients that I did some just mild antimicrobials just to test to see if that helped because they couldn’t afford the test or because it just wasn’t feasible. I’ve seen recommendations to go on these hardcore SIBO antimicrobial protocols without testing and I’m just like I don’t know if that’s the best idea.

I mean it’s certainly an option and it’s up to the person if they want to do that, but it’s getting testing first I think is a really good idea. Especially because like we were saying earlier in the episode, it could be completely unrelated to your gut bacteria and then you’d be doing all this antimicrobial treatment for no reason and that could potentially affect your beneficial flora. Testing is always going to be recommended in my opinion. I don’t like to do things just making assumptions.

Kelsey:Yeah, I agree. And especially for SIBO in particular like I mentioned before, if you have methane positive SIBO versus hydrogen positive SIBO, how do you deal with those different types becomes different especially with antibiotic treatment. Now with antimicrobials there’s less of a difference, but there’s certainly some particular supplements that you can add for methane positive that you wouldn’t necessary need for hydrogen. It does change how you would deal with it and so having that testing makes a big difference.

The other thing I want to mention about that too is that for SIBO and stool testing, you just get so much information that you kind of need that. Because if you are just going to give somebody Rifaximin for example, because like I said that only really affects small intestine, it’s only clearing out bacteria in the small intestine and not the large intestine for the most part. If your problem is dysbiosis in the large intestine or a parasite in the large intestine, it’s not really going to have much of an effect there. It’s only going to be affecting your small intestine.

That’s why I feel less comfortable with that antibiotic blast approach. Whereas with antimicrobials, they’re going to have more of an effect in both areas, so both in the small intestine and in the large intestine. That makes a little more sense if you don’t know that’s going on necessarily. But yeah, I agree, testing is really important if you can afford it, if you’re able to get it if at all possible, you really should do that before jumping into any of this stuff.

I think that’s all I have to say. This is a huge topic obviously. Honestly, if somebody sat here and asked me questions, I could talk about it for days. But I’ll leave it here for now. I’ll link you guys to that article that I wrote if you want everything written down in terms of the tests that you want to ask for and all that.

But if you need further help on this, you guys probably know by now that I have an online program called Build Your Biome. You can work with me personally on this stuff too, but I put a ton of time into that Build Your Biome program. It’s really comprehensive. If all of this stuff is pretty new to you and you just want someone to walk you through the whole process of doing all these sort of tests, and talking to your doctor if you need to do what, or working through it on your own, my program does go through all of that. I’ll put a link in the show notes for the program as well.

Laura:Sounds good. I like online program option because obviously a lot of people are not going to be able to afford to work with us one on one. Anytime I have somebody that contacts me that has a gut issue that their budget is in that kind of couple hundred dollars range, I’m like alright, I’m just going to send them to Kelsey’s gut health program because I feel like you do a really good job of covering all those topics in your program.

Kelsey:Well thank you!

Laura:It makes me jealous, I need to get my own group program started at some point.

Kelsey:Yeah, it’s really nice to be able to refer people to that because it’s like okay, here’s all of my thoughts on this topic in one place. It’ very nice to just be able to point people to that because dealing with gut issues too is generally a pretty long process. People who are working with me one on one, I mean that’s a three month minimum usually for working with me on it because it just tends to take a long time to deal with. But yeah, you can obviously get that at a way lower price and all that information just in an online program so it’s great to be able to have that option for people.

Laura:Awesome.

Kelsey:Cool.

Laura:As promised, we do have some personal life updates that we wanted to share at the end of the episode. If you are totally bored by that stuff, now is your opportunity to turn off the podcast. But for those of you who like this kind of thing, we’ve had some feedback that some people like it at the end, other people miss it at the beginning. I think for now we’re going to keep it at the end because I think we both like the fact that people can just stop listening when this comes up.

We understand that some people are not listening to hear about our personal lives, which I totally understand. We’re not that excited of people. But those of you that do like hearing about our business and our personal stuff going on, hopefully you guys are willing to hang around to the end to listen to it. Today’s update, I’m just laughing because oh my God, I can’t wait until we can stop talking about this. I think this is going to be the last wedding update ever.

Kelsey:Pre wedding. You have to do a post wedding recap.

Laura:I’ll just be like, it was great! I don’t want to talk about it! But we are just getting into June now so it’s my official wedding month, and Kelsey, it’s just about your one year anniversary of your wedding.

Kelsey:Yeah!

Laura:We just wanted to update about that. I’m just laughing because seriously I’m at the point where I’m like this just needs to happen already because I feel like I just had my entire life in the last six to nine months be completely wedding focused. I shouldn’t say completely wedding focused because obviously I have a business that I run and everything, but it’s almost like I feel like this has become my new normal to always have this stuff hanging over my head needing to be dealt with.

Kelsey:You’ll feel so free and like oh my gosh, I have so much brain capacity!

Laura:Well hopefully it’s not permanently damaged. I’m just going to not know what I’m supposed to do with myself. Maybe I’ll have an online program creation because I’m not planning a ridiculously complicated wedding. When I was first starting the planning process last year, I was like oh I’m going to be such a chill bride, it’s going to be so laid back and stuff. Now I was just showing Kelsey my day of timeline.

Kelsey:I about had a heart attack looking at it.

Laura:I am developing my inner type A person. It’s been an amazing process of learning how to be stupidly, creepily organized and OCD. But it’s one of those things that, I don’t know, just when you’re spending this much money and it’s like your one and only wedding, which I fully intend this to be my one and only wedding, even God forbid something ever happened to Josh, if I ever got married again I’m like nah, that’s not happening again.

Kelsey:Yeah. I can only do this once.

Laura:I’m like part of me is like wishing I hadn’t done all the different things that I committed to because I feel like when you’re in the beginning planning stages, it’s like it’ll be cool to do this and it’ll be cool to do that.

Kelsey:Yeah.

Laura:And then in the last couple weeks you’re just like…

Kelsey:Why did I do this?

Laura: Now I have to figure out how all of these little pieces of the puzzle are actually going to fit together and they don’t always look like they’re going to fit together. It’s just like this is ridiculous, why did I sign myself up for this?

There’s just been a lot going on. Luckily I have a day of coordinator who’s been really helpful. I don’t know how I would have done it without having one just because she helped me create the timeline and there was so many things that I wouldn’t have thought of. It was nice to have someone who kind of knows what questions to ask, that kind of thing. Even with her help, there was still things we had to work around. I have two bridesmaids with infants. Well, what is an infant, technically?

Kelsey: I don’t even know.

Laura: My sister has seven month old and then one of my bridesmaids literally just gave birth like three days ago, two days ago.

Kelsey:I think those are babies, definitely.

Laura:Well, the two days ago, that’s an infant. That’s newborn status that she has. Just trying to create a timeline that allows for them to do what they need to do to take care of their babies, and then coordinating with Josh and his groomsmen. I’m just like oh my gosh, this is getting crazy.

I think it’ll be cool when it’s happening because I kind of will have done everything I needed to do to prep for it and I can’t change anything at that point. I’m just going to outsource any crazies to my day of coordinator and just be like, I don’t even want to know, don’t even tell me unless it’s like absolutely 100% essential that I know. I feel like I want to designate one of my bridesmaids as the second in command that gets told first and decides if I need to hear about it.

Kelsey:That’s a good idea.

Laura:I’m like I really just don’t even want to know. It’s just kind of funny because I feel like I’m generally a pretty laid back person. My fiancé is the most laid back person. To be fair, none of this is his fault. This is all my fault. But it’s like just the level of complexity that this whole thing, just I don’t know, it evolved into this monster that I just I feel like I don’t have any control over it anymore.

It’s just funny because we have just all these little things that need to be dealt with, like I have a vegan and a kosher aunt and uncle that we had to get them special meals. I had to figure out getting gluten free, vegan cupcakes as dessert option since we have a normal cake.

Kelsey:Wow!

Laura:One of my fiancé’s uncles requested that we have Mountain Dew as one of the drinks. I’m just like alright, whatever, we’ll just to the grocery store and get a six pack or something because they don’t have Mountain Dew at the bar. It’s just like all these little things like that. One of my bridesmaid’s skirts came in the wrong color.

Kelsey:Oh no!

Laura:And it just happens to be the one that just had her baby so it’s like she’s already got a bunch of complications with finding a dress to fit into post pregnancy.

Kelsey:Right.

Laura:The fact that the skirt was like bubblegum pink when the color is supposed to be a muted blush basically.

Kelsey:Oh gosh!

Laura:That was fun because she texted me the photo and was like I don’t know what to do! I’m like panicking texting my fiancé because I’m like I don’t want to bother her because she’s literally a day away from having a baby, but this obviously can’t be the dress that she wears.

Kelsey:Everybody’s all muted, she’s like the hot pink.

Laura:I know! It was like a tulle skirt so it looked like a bubblegum pink ballerina basically. I felt so bad because I knew that she didn’t mean to do that at all and she had ordered the skirt on Etsy and it just totally came in the wrong color. It’s just like one thing after the next and then trying to get my house ready for my fiancé to get down here tomorrow. It’s amazing how many different pieces of the puzzle have been all needing to be put together in the last couple weeks. I feel like it’s getting there.

Kelsey:But you’re almost there.

Laura:I know, I know. Nine days.

Kelsey:Almost there, which is super exciting. This is particularly the worst time I feel like because you’re like, like I was saying before it’s like oh my gosh, why did I do this? My wedding, it doesn’t like it was anywhere near as complex as what you’re working on and even I at that point was like maybe we should have just had our small family which we did in June rather than doing both that and then having a huge reception in October. I understand the feeling.

Laura:I feel like on the day of and after everything’s said and done, I’ll feel happy that I did all this. I hope that’s what’s going to happen.

Kelsey: Question mark?

Laura: It’s funny because I’m like I’m 100% confident about the marriage choice. My fiancé and I have a great relationship, I’m not worried about that whatsoever. So I guess I should be thankful that that’s not what’s making me in panic mode. It’s just all the different moving pieces that, again, totally my fault for deciding that I wanted all this complexity. Which honestly the funny part is I don’t really feel like the actual final product is going to look that complex.

I don’t know how some people have these super complicated, really over the top decorated weddings because I am barely doing any DIY stuff. We have a DIY ceremony arch that Josh is making from some trees from his backyard and we have a couple of little DIY things. We have some picture frames that are going to be going up on the mantle inside. But other than that everything is being done by other people.

It’s just like coordinating everything is crazy.I just am like I can’t even believe how many different timelines I have to put together for different people. I literally have on my timeline I need to be finished eating lunch at this point and brush my teeth at this time so I can start my makeup. It’s just like oh my gosh, I’m not the kind of person that is this scheduled.

Kelsey:That’s so funny.

Laura:It’s just funny because I put my reception table arrangement together and sent all that to my caterer who’s coordinating the rentals, and I have my weather game plan because we’re trying to have the ceremony outside, but if it’s too hot or raining we have to have it inside. I have some backup rentals for that. It’s funny because my caterer was like oh you’re so organized, this is great. I’m like I feel like you need to tell my mom this because if she ever heard someone call me organized, she’d be like are you joking? I feel like it’s just kind of amazing to see the kind of skills that you can whip out when something’s that important. I think for me it’s more of an interest and priorities issues if I’m not organized because I just don’t care. But if I care I can be the most organized person on the face of the earth apparently.

Kelsey:Right, you can pull it together when it’s necessary.

Laura:I think it’ll be good though. I’m just glad my fiancé is coming down tomorrow finally. I’m like it’s been almost like 3 weeks since I saw him.

Kelsey:I know, that’s super exciting!

Laura:Yeah, I think it’s just going to kind of take a lot of the panic out of me.

Kelsey:I’m sure.

Laura:That nonstop knot in my stomach that’s been going on through the whole week this week because it kind of feels like I’m doing it all by myself. I know my fiancé is doing his best to help me, but again, it’s I made all these decisions and I kind of have to like deal with them.

Kelsey: Follow through.

Laura:Yeah. But there’s all these little decisions that I didn’t even know we had to make. I was telling you before we got on the call that now we’re trying figure out what song we want to play after the ceremony. We know what song were going to go down the aisle to, but what are we going to play coming back from the ceremony, back down the aisle? I’m just like I don’t even care! It doesn’t matter!

Kelsey:Who cares! Just play something!

Laura:I know. I’m in hardcore decision fatigue at this point and I’m just like I don’t know. But then when I try to outsource the decision, like I was trying to have my fiancé pick the song and he’s sending me the options and I’m like, no, no.

Kelsey:No, I’m sorry, I need to make this decision myself I think.

Laura:Yeah, It’s my own fault. Like I said, I think when all is said and done it’ll be beautiful and fun, and we’ll have these great pictures, and we’ll have some video. Then I’ll be in Mexico for a week in a coma just dead.

Kelsey:Yeah, you’ll get to chill out there. That’s a good idea. We did a little bit of a crazy thing. We weren’t even planning on doing anything after our wedding because we had actually gone to Japan earlier in the year. We kind of counted that as our honeymoon. But then we ended up going to Budapest after because the timing just worked out well, which was a little crazy. I probably, I don’t know, I’ve talked about this before on the podcast. I’m a trip person, not a vacation person. I think while it would have been awesome to lay on the beach somewhere, I don’t know if I could have actually physically done it without wanting to get up and run around the whole place and check everything out while I was there. But I think that’s going to be great for you guys after all these decisions and after all the stress. Like oh man, just sitting on a beach in Mexico sounds perfect.

Laura:Yeah, we have a pool on our balcony so I don’t even have to leave the room.

Kelsey:What! That’s amazing!

Laura:I don’t know if I’m going to get bored. I feel like I’m so exhausted that I’ll be too tired to get bored. But we’ll see.

Kelsey:It’ll be impossible.

Laura:It’s an all-inclusive and I’ve never done all inclusive before so there’s just like unlimited food and drinks and they literally have a full bar in our bedroom that’s being stocked. I’m just like I don’t know what we need with five bottles in our liquor in our bedroom, but okay.

Kelsey:Sounds good! That’s awesome! I have to say being one year out of marriage, definitely you’re like brining me back to all of that when you’re talking about how stressful and decision fatigued you are. I can remember that all too well. But being a year out, I’m like, man, I’m so happy I don’t have to do that again. Now the decision is what are we doing for our anniversary? We’re going to go to DC this weekend and we’re going to stay in a fancy hotel and just like explore the area. And we’ve actually planned a vacation to the Azores in Portugal for September which is kind of I guess…

Laura:Your second anniversary.

Kelsey:Yeah, my second anniversary, which is actually technically in October, but whatever, close enough. But that’s more of like the most I guess relaxing vacation I could agree to which is because it’s this archipelago off of Portugal. So we’re on an island, but it’s apparently like supposed to be Hawaii of the east so it’s tons of hiking and volcanoes, and just really cools views. You basically drive around the island, check out all the cool stuff. We’re staying in really nice hotels there for a week. I’m really looking forward to that. It’s like a very different kind of vacation than I normally do, but I think it’ll be really awesome.

Laura:Very cool. I feel like I like a half and half vacation, like some lounging and beaching it and then some activity. When I went to Costa Rica and Nicaragua, there was like beach time and then also hiking, and surfing, and all that active stuff. I don’t know if we’re going to do anything active on the honeymoon. I feel like honestly right now all I want to do is get in bed and not get out for like a week, so that might happen. But I think they do have some activity options if we got bored.

Kelsey:I doubt you will. It’s going to be great to just like lounge.

Laura:I honestly can’t even think that far in advance because it’s like the wedding stuff is so imminent that I’m like alright, we’re just going to get to Mexico and we’ll decide from there what we’re going to do because obviously the weather is going to be a little unpredictable so we might just have to decide the day of what we’re going to do.

Kelsey:Yeah.

Laura:I’m just like oh my gosh, like not having an alarm set, not having to be on an computer at all, not having to make any decisions about anything except what do I want to have to drink or what do I want to eat? That’s all I have to decide about. That’ll be nice.

Kelsey:It’s all right in front of you. It’s like oh, what restaurant do we go to? It’s like everything is here. I barely have any choices.

Laura:Apparently I can just walk to my closet and be like what liquor do I want to get trashed on? No, I’m just kidding. I don’t drink. I mean I guess I drink like that sometimes, but I don’t drink in excess. I might have a nice whisky neat or on the rocks or something at a bar, but I’m not going to get trashed in my hotel room.

Kelsey:That’s doesn’t sound like you, Laura.

Laura:I feel like that’s a little too far in the laziness category if you can’t even leave your room for a drink. But we’ll see. They have swim up bars which I’ve never done before.

Kelsey:What! That’s awesome!

Laura:Noelle Tarr and her husband Ken hooked us up with this, so shout out to them for getting us the hookup with all of the different honeymoon related things. This package, they got us a discount on it and we have a butler, we have a dinner on the beach scheduled.

Kelsey:Wow!

Laura:We have couple’s massage, like full on honeymoon setup.

Kelsey:That’s awesome!

Laura:Definitely appreciate Noelle and Ken getting us that. Apparently their baby is due the week we’re there. So I’ll have to be at least on Instagram a little bit to see if there’s any announcement there. We’re very excited.

Kelsey:That’s awesome! That sounds like you’re going to live it up in honeymoon world, which is great.

Laura:Honeymoon world. That’s sounds nice. I’m like maybe we’ll just skip the wedding.

Kelsey:Yes, like Disney World but honeymoon.

Laura:Yeah, I’m excited. I think next time we record, gosh, I’ll be a month long married person at that point I think.

Kelsey:Yeah.

Laura:Maybe not a month, maybe just a couple weeks. But next time we talk for one of these updates, I will tell everybody all the fun stuff that we did or all the hotel room drinking that we did if the weather is awful.

Kelsey:I’m very much looking forward to your recap of not only your wedding, but also this epic honeymoon.

Laura:Yes. Maybe I’ll do a blog post with some photos or something. But I’m just like I can’t wait until all of this is happening so I can just stop thinking about it.

Kelsey:Probably talking about our weddings on this podcast, we’re like convincing half of the world’s population to never plan a wedding.

Laura:Maybe, but then if the recap thing is like oh my gosh, it was amazing! I loved all of it! It was the best thing ever! That might turn the tables saying no you should go through this totally stressful process to have an amazing wedding. I’m hoping that’ll be the case.

Kelsey:I can say it’s worth it.

Laura:I know.

Kelsey:A year out I’m very happy I did it.  I will say that.

Laura:That’s what I’m hoping is it’s not like oh I was right, I shouldn’t have done that. I doubt that’ll be the case.

Kelsey:I doubt it too.

Laura:Anyway, like I said, I’ll give everyone the lowdown on all the stuff that we did and maybe have some photos available online to show people. But it’s coming! We’re almost there!

Kelsey:Whoo-hoo! An early congrats from me and we’ll obviously hear from you after that.

Laura:Thank you. Hopefully I’m still alive and functioning brain at that point. It’s really getting close to brain damage at this point.

Kelsey:Wedding equals brain damage.

Laura:Anyway, thanks everyone for joining us and if you’re still on I hope you’re enjoying these updates. Like I said, if you have any opinion about how these updates should go, I think we’re sticking with the end of it. But if you have a strong opinion let us know because it’s obviously your interesting in our updates we want to make sure that you get the opportunity to hear from us. But if you have a question for us to answer on the podcast, you can always go to TheAncestralRDs.com to submit that as well. But we will be here next time. I think we have an interview on our next show. But either way, we’ll look forward to having you here next week.

Kelsey:Alright. Take care, Laura.

Laura:You too, Kelsey.

PODCAST: How The Pill Affects Your Thyroid Health With Dr. Jolene Brighten

Thanks for joining us for episode 110 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are super excited to be interviewing Dr. Jolene Brighten!

Dr. Jolene Brighten is a Functional Medicine Naturopathic Doctor, herbalist, bestselling author, speaker, and mother. Dr. Brighten earned her doctorate in Naturopathic Medicine from the National College of Natural Medicine. She received her Bachelor’s Degree in Nutrition Science and completed graduate coursework in molecular nutrition at Cal Poly, San Luis Obispo.

Dr. Brighten is renowned women’s hormone and autoimmune disease expert who takes a root cause approach to help women reverse disease and fall back in love with their life. She supports women struggling with hormonal imbalances including adrenal and thyroid, autoimmune conditions and digestive disorders.

In her patient centered practice, Dr. Brighten thrives on navigating the space between conventional and alternative medicine, all while working with patients to help them achieve optimum balance, health, and happiness.

The birth control pill is so commonplace in our society that not many of us think too much about it when prescribed. This game changing conversation with Dr. Jolene Brighten will educate and support you in making decisions that are right for your body.

Join us for an amazing discussion as Dr. Jolene Brighten dives deep into the surprising effects of the birth control pill on thyroid health and other body systems that are not widely known or talked about. A sample of what you’ll also hear is the symptoms of post birth control syndrome, nutrition to support coming off the pill, and alternative birth control methods.

Here are some of the questions we discussed with Dr. Brighten:

  • How did you get into Naturopathic Medicine?
  • What are some of the most common health conditions that you see in your clients that you’re working with?
  • Why do we see hypothyroidism and specifically Hashimoto’s so much more often in women than in men?
  • Can we talk a little bit about how the ovary/adrenal/thyroid axis fits together when it comes to thyroid disease?
  • How does the birth control pill play into high estrogen preventing thyroid hormone from getting into the cells properly?
  • What’s the process of coming off the birth control pill when having a chronic illness? How do you support your body before you come off of that?
  • What are your favorite recommendations for alternative birth control methods that you educate your patients on?
  • What are some symptoms of post birth control syndrome?

Links Discussed:

TRANSCRIPT:

Kelsey: Hi everyone! Welcome to episode 110 of The Ancestral RDs podcast. I’m Kelsey Kinney and with me as always is my cohost Laura Schoenfeld.

Laura: Hi everybody!

Kelsey: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me at KelseyKinney.com, and Laura at LauraSchoenfeldRD.com.

We have a great guest on our show today who is going to talk to us about how oral birth control sabotages the thyroid and why you should ditch the pill if you’ve got a thyroid condition. We’re super happy that she’s joining us and we think you’ll really enjoy this episode.

Laura: If you’re enjoying the show, subscribe in iTunes so that you never miss an episode. While you’re in iTunes, leave us a positive review so that others can discover the show as well! And remember, we want to answer your questions on our show, so head over to TheAncestralRDs.com to submit a health-related question that we can answer or suggest a guest that you’d love for us to interview on an upcoming show.

Kelsey: Before we jump into our interview, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com

Kelsey:Welcome back everybody! Today we are so excited to have Dr. Jolene Brighten with us! She is a Functional Medicine Naturopathic Doctor, herbalist, bestselling author, speaker, and mother. Dr. Brighten earned her doctorate in Naturopathic Medicine from the National College of Natural Medicine. She received her Bachelor’s Degree in Nutrition Science and completed graduate coursework in molecular nutrition at Cal Poly, San Luis Obispo. Dr. Brighten is renowned women’s hormone and autoimmune disease expert who takes a root cause approach to help women reverse disease and fall back in love with their life. She supports women struggling with hormonal imbalances including adrenal and thyroid, autoimmune conditions and digestive disorders. In her patient centered practice, Dr. Brighten thrives on navigating the space between conventional and alternative medicine, all while working with patients to help them achieve optimum balance, health, and happiness. Welcome, Jolene!

Dr. Jolene Brighten: Hi! It’s so great to be here. Thank you for having me.

Kelsey:Absolutely. It’s our pleasure for sure! I want to jump right into the good stuff here. Would you mind telling our audience a little bit about your background? How did you get into naturopathic medicine? What brought you there?

Dr. Jolene Brighten: It was quite the journey indeed. It actually started in childhood when I was obsessed with consuming medical text books. I was that weird seven year old with Gray’s Anatomy. I was really interested, my best friend’s mom was a pharmacist, and the pharmacology of plants and how to utilize those always really interest me.

What happened to me in my childhood is I actually got really sick and I had chronic gastritis which is really odd for a child to have. I struggled with digestive issues for many years until they finally discovered H.Pylori and my doctor tested me for it and that’s what I had. At that time I was 17 when they finally found it and it had really started when I was in grade school, and at that time they said well, you’re going to be on proton pump inhibitors for the rest of your life. We haven’t really tested these in people your age, but this is what we know is that you’ve got heartburn, you’ve got gastritis, this is what you have to do.

It was then that I started just making observations about how food affected my body. I actually found by making shifts and changes in my diet that I eliminated my heartburn and my digestive symptoms got better. That’s when I really decided I’ve got to study nutrition. Food is medicine. I saw the light at that moment. That’s where I took the next step to going into getting my undergrad in Nutrition Science. I actually studied Didactics simultaneously and I thought I might be an RD, but I really, really loved the science and I didn’t really love what the RDs told me what went down in hospitals.

Kelsey:Yeah.

Dr. Jolene Brighten: I was like I don’t see myself in the hospital situation. It was actually there that I went over the deep end into science as I say because I started working in recombinant DNA technology. I was studying nutritional biochemistry and how to actually manipulate genes to make animals produce different kinds of milk.

Long story short is that through all of that I saw that we were…so this is the stuff that we’re all against now, like how GMOs came about. It was in those moments that I really recognized that we weren’t asking enough questions and there was no respect about nature. There was no respect for nature. Yeah, we can manipulate these genes, we can do all these things, but I was the only one asking what does this do to the nutritional value? What does this do in someone’s body?

I laugh about this that in science we actually don’t know as much as we think we do. I recognized that and I stumbled one day upon the website of Naturopathic Medicine. I was in grad school and I was a yoga instructor so I had a private nutrition and yoga practice going. At the time I found Naturopathic Medicine, I was like this is everything that resonates with me. Albeit I’m a lot more of a science side of things, but I’ll say that that was what I’m looking for is someone to train me and to teach me how to respect the body, and work with the body, and ask the body why and go deeper with all of that. Once I found Functional Medicine I was like ah-ha! There’s that science part of me. That’s the jam right there.

That’s my story and journey and it really started I think like many of us feeling sick and then basically taking the bull by the horns and figuring it out and realizing that there is so much potential and there is so much we can do with our bodies to work with them.

Kelsey:Now you have your own Naturopathic Medicine practice, right?

Dr. Jolene Brighten: Yes. I have a clinic in Oakland, California and then we have a clinic in Portland, Oregon as well. We call them the sister clinics.

Kelsey: Very cool. What are some of the most common health conditions that you see in your clients that you’re working with at those clinics?

Dr. Jolene Brighten: We’re a women’s health practice. We call ourselves a root cause women’s health practice. We’re primarily working with women with autoimmune conditions and hormone imbalances. Where we really love work is on the inner section of how the hormones are actually influencing the autoimmune disease and how the autoimmune disease is affecting the hormones. We like to work on those two big categories there.

What we see a lot of of course is Hashimoto’s. It’s the most common type of autoimmune disease that predominantly affects women. We treat a lot of Hashimoto’s, a lot of thyroid conditions. We certainly see many women who are wanting to conceive. We’ve got an amazing pre-conception program and then we take them through pregnancy and then we set up post-partum plans. In their third trimester we have our game planned to prevent post-partum depression and post-partum thyroiditis which affects about 1 and 12 new moms who give birth.

These are the kinds of things that we’re seeing is a lot about women who are in their fertile years. Of course what comes with that is a lot of PMS, a lot of anxiety, depression, the emotional symptoms, the other things that happen when our hormones aren’t balanced. Also I work in all of that, I treat so much SIBO. This is something when I start talking about it, people are like, whoa, wait, you treat SIBO? I’m like pretty much every Hashimoto’s patient has SIBO. It’s something that I work a lot with some of these big supplement companies too on developing things for SIBO as well.

It comes as a surprise, but when estrogen is off or thyroid is off and all this kind of things, it’s going to affect your gut. And conversely, if your gut is not working right, all of your hormones are definitely going to be affected.

Kelsey:Exactly. I work with a lot of digestive health clients as my main clientele so I know exactly what you’re talking about here. But I could see why people might be a little bit confused. You’re talking about all these hormone things, these autoimmune things, and then all of a sudden gut health is coming out of here too. But you’re right, it’s all totally connected. When you start to focus on one or the other, you end up kind of having to loop everything in and treat everything at the same time.

Dr. Jolene Brighten: Yeah, and that’s the thing we need people to understand is that we treat the whole person. We’ve got to look at every system especially when you’re a thyroid patient. Every single cell in your body needs that hormone, so every single system is going to be affected and then vice versa. We have to be looking at that whole person, not to mention that next level of like what you think every day and what comes out of your mouth every day is affecting everything. You treat a lot of SIBO, then you know that the nervous system, and the negative self-talk, and some of these ways that people approach stress can have a lot to do with the dysfunction of their gut.

Kelsey:Absolutely. Today we’re going to talk a little bit about thyroid issues and how birth control, specifically things like the pill, can negatively impact a thyroid condition. Before we jump into some of the nitty gritty stuff about that, let’s maybe talk just a little bit about hypothyroidism in general, specifically Hashimoto’s, and why that is more common in women. Why do we see that happen so much more often in women than in men?

Dr. Jolene Brighten: Hypothyroidism is when there’s too little thyroid hormone. Your questions are great. We see Hashimoto’s is the most common cause of hypothyroidism. 90-97% of women, which I do have a lot of men in my practice with this as well, but predominantly women, it’s going to be due to an autoimmune condition.

Autoimmunity is when your body gets really confused and decides that your thyroid gland is worth attacking. It’s a confused immune system. There’s a lot we can dive into about autoimmune disease, but to cut to the chance, it’s because of the immune system attacking and destroying the thyroid that now you no longer have gland available to actually produce thyroid hormone.

This is mostly found in women and we know that you have 5 to 8 times higher risk once you get in your 30s of developing Hashimoto’s or hypothyroidism. Just to differentiate the two, you can have hypothyroidism and it can be due to other causes, but what I want to say is that with Hashimoto’s what we’re looking for are antibodies, anti TPO and anti thyroglobulin antibodies.

But what’s important to recognize is that, I kind of approach hypothyroidism like if I can’t find another root cause, then I’m going to assume this is Hashimoto’s. The reason for that is because the research has shown 10 even to as high as 50 % of people with Hashimoto’s will be serotype negative. That means you’re never going to show antibodies. What’s the best absolute best way we can tell if you have Hashimoto’s is that we can actually just go and biopsy your thyroid crazy, so just go in and take a little bits of your thyroid all over the place and look at them under a microscope. As you could imagine, that’s highly invasive, not really the ideal, and nothing I’ve ever sent out for.

It’s just an important distinction because I’ll hear all the time from women, no, I don’t have Hashimoto’s, I’m hypothyroid. Well nothing else is going on and honestly I’m basically like if you go on a gluten bender or you have a really high stressful point in your life, I’m going to test you again. Because to me, and I’ve seen this time and again with patients, it’s usually just a matter of time.

A lot of that can come through when we start strengthening their immune system, and balancing your hormones actually balances your immune system. This is why we think women are much more likely to develop autoimmune disease. There’s other theories, but a big one is that women have cycles and that estrogen spikes and dips throughout the cycles. If you see when women are at most risk of developing autoimmune disease is in her 30s. Well, what’s happening in our 30’s? Our DHEA and our progesterone have begun their decline which is protecting us against estrogen and cortisol.

Why that’s important is because what you’ll see in the research studies is that too much estrogen, and you’ve got immune system chaos. And too little estrogen, and you’ve got immune system chaos. It’s kind of like this Goldilocks effect. It’s like so many things in the body, the Goldilocks effect. The other time when you’re going to see it, peri-menopause is very high risk. And then I also see post-menopausal women start to have a lot of immune dysfunction.

What we know is that that estrogen really that gives us the robust immune system and helps it behave. I just want to be clear, estrogen is not bad. It’s an amazing, amazing hormone. But the name of the game with hormones is all about having the balance.

We compound all of that, and you guys are definitely on my tribe, but you compound that with we live in a society that’s a complete evolutionary mismatch to how we’ve actually developed. Women are more stressed out and exposed to more toxins than ever before. They’re bathing themselves in these exogenous estrogens basically so to speak that are grabbing onto receptors and causing all this hormone confusion.

But also I work with a lot of moms, motherhood is a complete evolutionary mismatch. Going through peri-menopause, going through these major life events, we as women need community. From research we know when we’ve got our tribe, when we’re hanging out with our ladies, our progesterone is up, our stress hormones are down. You can optimize your hormones just by getting together with your girlfriends once a week. I mean that’s awesome! But back in the day when we were going through some big stuff, we would have the medicine woman of the tribe or the other women’s wisdom. They would just encircle us, and envelop us, and teach us, and guide us, and help us not be alone in this journey.

What I see in my patients so much is everybody is on overdrive, cortisol just is pumping through the roof. Getting your hormones in balance, it takes a lot of finesse and you paying attention to really how are you living your life and is it incongruent with how your body needs to you live your life?

Kelsey:You mentioned cortisol, you mentioned thyroid hormone, and you mentioned estrogen. I’d love to talk a little bit about the ovary/adrenal/thyroid axis, which sounds a little complicated, but how that all fits together when it comes to thyroid disease.

Dr. Jolene Brighten: I would just say for your listeners if you feel like you have to listen to this again, no worries because you and I know it’s complicated. There’s a definite interplay. I love that you bring this up because I feel like this isn’t talked about enough and I think it’s something that it’s really easy in medicine to get myopic and to be just like you just have a thyroid issue, you just have an adrenal issue. The body just doesn’t work that way. In my experience, you can’t shift one hormone without them all feeling the effect.

Like what we were talking about, estrogen goes up, so estrogen dominance. I‘m sure you ladies see a lot of this especially if you’re treating the gut. With estrogen dominance we can have a relative estrogen dominance or just a frank estrogen dominance. But relative is the most common. This goes back to what I was saying, we’re stressed out. What happens when we’re stressed out? We push. The body is like hey, you’re stressed, not a good time to have a baby. How about we just focus on survival? It chooses cortisol over progesterone.

Let’s be clear, your body is not betraying you. Your body’s got your back, okay? Now it’s choosing cortisol over progesterone. Now your estrogen is higher than it should be. This is where we see the relative estrogen dominance. Why that matters is because it’s all about who gets to the receptors and who gets to stimulate the receptors most. It’s kind of like there’s two kids in the family and it’s like who gets mom’s attention? Whoever is the loudest. I’m a mom, so that’s why I can say that.

What happens is that estrogen starts grabbing on these receptors and estrogen is inherently inflammatory. Inflammation has a time and place, but in our modern age there just seems to be too much of it. Estrogen is causing inflammation. What happens is that the cells begin to get rigid. They won’t accept things like cortisol, and they won’t accept things like thyroid, and they won’t accept things like insulin. It’s just a little bit harder to communicate. And at the same time while the estrogen is going up, your body is like we can’t have all that estrogen, this is dangerous, so let’s make more sex hormone binding globulin. Also what goes with that is let’s make more thyroid binding globulin, let’s make more cortisol binding globulin.

Now that estrogen being high means you’re grabbing onto whatever hormones you can make, you’re grabbing onto them. And then in addition to that, you can’t communicate so much with the cell. The pituitary, the hypothalamus, how the brain is talking to all these glands is like we need more. Well now it starts screaming at the thyroid or screaming at the adrenals. This is where so much of what’s called adrenal fatigue, this is one of the ways adrenal dysfunction, which is how the brain and the adrenal glands are talking, can really get off.

I just want to say that this is really an important piece to recognize that it can actually all start with this estrogen dominance. Now like domino effect the adrenal glands are now getting imbalanced. As that starts to happen, the DHEA, all of those, so DHEA and your cortisol is coming from your adrenal glands. DHEA is a great anti-aging hormone, but it’s also a precursor to testosterone and estrogen.

I’m sure you guys have seen it where cortisol is declining and DHEA is through the roof, and that’s when ladies can start pushing too much estrogen. This is the one that’s a little bit confusing, but yeah, what’s going on with your adrenal glands can actually lead to a further hormone imbalance. It’s a little more well known is that if the adrenals are dysfunctioning, then you don’t have that cortisol to keep the immune system in check. You’ve got estrogen starting to drive immune system chaos. That’s really where an autoimmune disease can come from.

But at the same time, the way we like to look at this is that your adrenal glands, they’re kind of like the pilot light and the thyroid is the furnace. You never have a thyroid issue without an adrenal issue and vice versa. It always seems that pilot light will try to burn brighter basically when that furnace starts to dampen down because your body is like I still want to get up in the morning and seek out food, like I’ve got to figure out how to get it going, and it starts compensating. Then we start seeing issues with thyroid and adrenal function.

To bring it all back home to well what’s up with the progesterone, and the estrogen, and the thyroid is that you can have your pituitary is talking to your thyroid fine, so your TSH, your thyroid is responding correctly, your T4. But then you might not be converting which can be due to inflammation and gut stuff, and other things. But even if you are converting, you might not get that thyroid hormone at the cellular level because of those estrogen levels and the inflammation that’s going on. This is a whole lot of information!

Kelsey: It’s good though.

Dr. Jolene Brighten: But it’s to say like, ladies, every single thing is connected. If you’re working with a practitioner, they need to be looking at all systems and all hormones. It isn’t one snapshot in time. When we’re testing, we’re doing day 3 FSH, LH, estradiol. We’re looking at how is your brain communicating to your ovaries? How are your ovaries responding? That’s not where we’re looking for the estrogen dominance. We’re looking that you’re properly developing a follicle.

I want to just say as I start talking about this, we know now that less than 50% of women report that they want to be mothers. We know that less women want to be moms. I don’t know if you guys hear this a lot, but I hear this a lot from women that are like I don’t care about my fertility because I never want to be a mom, I don’t care about taking care of that. I’m like whoa, whoa, whoa, whoa, whoa. From an evolutionary perspective you are the most robust and healthiest of yourself when you are fertile. It’s actually a good marker for your health. Whether or not you want to have a baby, ladies, you always want to be cultivating yourself to be the most fertile because that’s when you get to bathe in this glorious hormonal harmony that your body can make. When our hormones are right, it’s not just about us feeling good and our mood being good, we actually are more productive, we serve our communities more. As women when our hormones are right, we are an unstoppable force.

Kelsey:Yeah.

Dr. Jolene Brighten: Always be cultivating your fertility. But I don’t want to dive too deep into the labs if that’s not the direction we want to be going here. But it’s all to say that you have to be checking those labs at the right times of the month. Especially with thyroid in the functional medicine space, people kind of start to freak out where they’re like your TSH is 2.5 to 3 and we need to start on medication. It’s like, maybe, but we should probably retest and just see is that true? Does that hold? With the only caveat being is if you’re pregnant.

My ladies that are like I want to get pregnant right now, if your TSH is 2.5 or higher, we have to start you on a medication because pregnancy is literally a stress test for the thyroid. If you’re not medicated, the risk of miscarriage is really high. In hypothyroid women, especially with antibodies they have two to three-fold increased risk of miscarriage.

My practice, my focus, and this is from me having personally experienced a miscarriage is to do whatever we can to prevent that. That’s my one caveat with starting thyroid hormone right away with a TSH of 2.5 is that…my motto in my clinic is that we don’t mess around, we don’t risk babies. We don’t mess around with that. We go by this is what the American Thyroid Association has said is the standard of care to protect as many mothers and babies as possible. That’s the caveat.

Kelsey:Got it. Okay. When it comes to thyroid disease and hormones, you’ve been talking a lot about estrogen and when estrogen is high there’s a lot of inflammation and you can’t get thyroid hormone into the actual cells. Did I understand that correctly first of all?

Dr. Jolene Brighten: That is correct, yes.

Kelsey:Okay, just as a recap. With that idea in mind that when estrogen is really high, it’s preventing thyroid hormone from getting into the cells properly, how does the birth control pill play into that?

Dr. Jolene Brighten: Great question! What is the birth control pill? It’s essentially a pill you pop every day to induce estrogen dominance on yourself. Sometimes there’s some progesterone in there. No, let’s be clear, it’s progestin, ladies, it’s nothing like the wonderful progesterone you make. But that’s essentially what the pill is, is it’s estrogen dominance.

This is what gets me fired up. Most women who have been prescribed the pill were never even told how the pill works, how the pill effects their body. They’re on it and they don’t even know. Let’s share that so that everyone knows. There’s several mechanisms where the pill will work. The predominant one, this is like this is how the pill really shuts it down is that we flood your system…well not we, I’m not giving you that, but you flood your system, you pop that pill, you flood your system with so much hormones that it tells your pituitary, shut it down, I don’t need you stimulating my ovaries to make anymore hormones. Shut it down means no follicle stimulating hormone, no luteinizing hormone, you never make an egg, you don’t ovulate. Therefore, your periods are not periods while you’re on the pill. They are just withdrawals from a drug.

I say that like, listen up! If you are listening to this and you’re like, wait a minute, is she bashing the pill? I just want to say if you cannot have a baby and that is the only way you can prevent not having a baby tired and true, I want to support you in that because I’ve been there. I was on the pill for 10 years. I could not have a baby. I also didn’t know all of this. But through my practice, I just want to say that I’m not anti-pill, but I am pro educating women about the pill because if you’re going to pop that pill, you should absolutely know what it’s doing in your body.

But that’s great, if you don’t want to have a baby, it shuts down your brain, it shuts down the whole fertility mechanism. But when all of that is happening, so that’s shutting down that mechanism. It’s kind of silly to me that doctors would ever even say like you can just get off the pill and everything will just be fine. It won’t happen like that. It’s like how can it not have an effect? That just is silly, it doesn’t make any sense. How can it not have an effect? You pumped yourself with so many hormones that it stopped your brain from working correctly. That’s really profound to me. That’s one thing to recognize.

The minor other mechanisms, I’ll just mention one, is that it will thicken your cervical mucus. Those progestins can do that and that’ll prevent sperm from swimming up. For our focus and what we’re talking about here and what women should really know is it shuts down your brain and it induces estrogen dominance.

If you’ve got hypothyroidism, this is something that I used to think…and this is me being a little bit hopeful I think, and we had to test it really…but I used to think in my practice women with hypothyroidism, maybe we can stay on the pill. Maybe I can support you enough to be able to make those changes. But I’ll say that time and again what I’ve observed especially in thyroid disease is that women will get a 60 to maybe 80% improvement and they’ll never move again. What being on the pill is like with thyroid disease, if you’ve got any kind of health condition and you’re on the pill is literally like walking up a downward moving escalator. You have got to hustle if you’re going ever make it to the top. It is everyday work.

When my patients come to that place of recognizing that this is a huge amount of work to maintain my health and really achieve the life I want, they get off the pill and they have such tremendous gains that part of me, I now, my perspective is now we actually have changed it in my clinic and I’m testing women’s hormones on the pill and then I’m testing them the first month off the pill. We’re starting to track data in this. I’m taking women off of it sooner and I’m actually seeing that they get better quicker. My perspective has shifted and I’m like okay, we’ve got to support you in the best way we can to transition this because as you guys know, post birth control syndrome is a very real thing.

Kelsey:Yeah.

Dr. Jolene Brighten:  I wish I would have known about that and had prepared for that when I came off the pill, oh my gosh! That’s like the roller coaster that nobody tells you about or preps you about. I want to make sure that I’m supporting them first. Just people listening, you don’t just jump off the pill. You need a backup method to make sure you don’t get pregnant. That’s first thing. It’s so individualized. You’ve got to figure that out. You’ve got to read everything and you’re the only person that can answer that for yourself. Then you need to really start supporting your body and then come off the pill.

What I’ll say about that is we’re taking women off of it sooner, of course I say it like that, it’s with their consent. They’re a player in this. We’re never going to force anyone to do anything. But we’re seeing that they get better way quicker and healing their gut is so much easier.

Kelsey:Yeah.

Dr. Jolene Brighten: I mean so much easier, which is definitely something we can talk about in terms of how the pill is affecting the gut and the thyroid hormone if you’d like to get into that.

Kelsey:Sure!

Dr. Jolene Brighten: I will tell you a story. I’m a really big nerd. I get journal articles delivered to my inbox and every Saturday morning I love reading them. I’ll never forget when this study came through and my jaw just dropped and I still get blown away. Out of Harvard University, they found that the use of oral contraceptives, so birth control pill, was linked to a 300% increased risk of Crohn’s disease.

Kelsey:Wow!

Dr. Jolene Brighten: You take that pill for 5 years and you’re going to throw yourself into an autoimmune bowel disease. Which as you ladies know, Crohn’s disease, when it gets going it’s a fierce one.

Kelsey: Yeah.

Dr. Jolene Brighten: And it’s difficult because what do we have to do to heal autoimmune disease? We have to heal the gut and we have to get nutrients in. What they said in that study though was we recommend that before a doctor prescribes the pill that they actually do a family history or a genetic test on women because this is really significant. You ask any women who’s on the pill, did your doctor mention this to you? Did your doctor mention that you can develop an inflammatory bowel disease if you have a family history? Did your doctor take your family history first? No.

Kelsey:Right.

Dr. Jolene Brighten: Is that because their doctors are bad? No, it’s not that their doctors are bad. It’s that their education is limited. They only have so much bandwidth and so much to learn, but nobody is teaching them about this. Your doctor doesn’t know what they don’t know. I just want to make that clear. Let’s not hate on MDs. If you’re in a car accident, I want them. That’s who I want. Not me, you don’t want to see me.

There’s that one piece. What does that tell us about the pill? We know about the birth control pill is it absolutely skews the microbiome and it creates intestinal inflammation. If you’re creating intestinal inflammation, that’s leaky gut. We know the pill is associated with leaky gut. What is one of the, I call it the three ingredients of developing autoimmune disease? It is leaky gut. There you go. The pill is already putting you at risk for autoimmune disease.

But where do you convert your T4 to T3? Let me back up and say your thyroid will produce T4, which is inactive thyroid hormone and a little bit of T3, which is active. That’s your metabolism, your energy, all the good stuff is your T3. You only make a little bit. Most of it has to be converted in the periphery. We’re talking like kidneys, liver, and gut. If your gut isn’t working correctly, then you’re not going to convert as much T4 to T3. Now mood’s tanking, hair is falling out, just everything is going downhill. You’ve got those hypothyroid symptoms.

And then what happens? Well now you don’t have enough T3 so now you don’t make enough stomach acid. If you don’t make enough stomach acid, you don’t secrete pancreatic enzymes, gallbladder doesn’t work correctly. Now we’re at risk for pathogens coming in, we’re slowing our motility, we’re not absorbing our nutrients as well. Now we’re getting nutrient depletions. You also don’t have T3 to stimulate your motility. Why do I say all my Hashimoto’s, all my hypothyroid patients have SIBO? Because at the crux of SIBO is a motility issue and anyone who hasn’t had enough T3, they get constipated. So ladies, that’s why we get constipated if we don’t have enough T3. I also have Hashimoto’s so I can speak to this. Now you don’t have motility. So what do you get? Now pathogens.

We could take two people, and same is true if you’ve ever had SIBO or are hypothyroid. If you’re one of those people, I can expose you to the same amount of Salmonella that I would expose someone with a normal working gut to. The normal working gut will likely handle it and pas it though. We all get these low dose exposures to these pathogens. But if you’ve got comprised motility, now you’ve got an infection. There was time for it to flourish and now we’ve got an infection. Now what happens? Now cortisol issues.

You can see how it’s not simple. There are no simple answers especially when it comes to what birth control can do to the body and the aftermath of that. I really like to drive that home that there’s a lot of ways that it’s touching your system. But it’s my opinion if you have ever been on the birth control pill and you have not committed to healing your gut, you need to do that. If you have not worked hard on getting on a whole foods diet, maximizing nutrient absorption, getting your nutrients up…I have seen this in patients who they took the pill, they’ve been off of it for like a decade, and they are like yeah when I came off the pill I had x,y,z, it never stopped. They’ve seen all these other practitioners that have been tracked over the years. They’re nutrient depletions never came back until we really fix the gut and loaded them up.

That’s when we’re running these organic acid tests and things like that because the pill, even though it’s broad sweeping and it does all of these things in the system, that’s the tricky thing about post birth control syndrome. You can have all of the symptoms or one of the symptoms. You’re an individual. This is where it’s really important as patients, we need you to be tracking this data and telling us what’s not normal because you’re the only person living in your body so you’re the only one who has that data set. I can run the labs, but I’ve got to look at it in conjunction with your story.

To bring it full circle, why is that important? Why do I want to say that? Because your symptoms are not in your head. They are absolutely not in your head. If you feel like whatever is going is on is not normal and your doctor is not listening, you need a second opinion. Because what you feel in your body, if you feel it’s off, as a doctor I think that is super important data. That is highly valuable and I need to listen and I need to ask why.

Kelsey:Yeah, that’s such a refreshing perspective I have to say. I’m really happy that you brought up how birth control actually works because I was put on birth control as a young teenager for acne. No education, nothing. I knew absolutely no idea how it worked. My doctor basically said nothing to me about it whatsoever. It was just like this will help your acne, get on this. I think I was on that probably for at least 7 years of my life which is crazy especially as a young kid.

It’s just unbelievable to think that there are so many women out there who have been on the pill for really long periods of time without getting any education as to how it affects other body systems. Especially bringing it back to thyroid disease too, it’s like well if you either have genetic history of that, family history of that, or you already have some sort of thyroid disease and then you’re getting prescribed the pill, man, some education would have been real nice right about then.

Dr. Jolene Brighten: Right? Can I speak to your getting prescribed the pill for acne? I’m going to just be straight up. I don’t think anything pisses me off more than that because what doctors do is they say here’s a symptom, let me suppress it. Why is post birth control syndrome so hard? Because 60% of women are on the pill for symptom control instead of preventing pregnancy. Now that is a huge disservice in women’s health.

You tell a young girl your body is talking to you, something’s off, let me just shut it up. And then 10-15 years later she comes off the pill, well what would you do if for 10 years you had something really big important to say? You’d start screaming the second you had a voice. That’s what your body is doing because your body wants you to survive. Your body is very investing in you surviving.

You got prescribed it for acne. I took the pill to prevent pregnancy. But this is what’s really scary to me is that, so I lecture about this to other practitioners, they don’t recognize that 60% of women are on the pill for symptoms. What is the most common? It’s irregular periods. So, oh, I can make your period regular! No, no, you can make my drug withdrawal regular. Let’s be real, let’s call it what it is, not shaming. When we treat symptoms, we acknowledge we’re treating symptoms. When we’re treating root cause, we acknowledge that. It’s important we fully disclose to the patient what we’re doing and why.

With PCOS, it’s the number one, that’s usually the number one thing that gets masked with the pill. But if you’re a woman who has irregular periods and you’re put on the pill, almost as high as 40% of them will never ever have their period come back. They will never ever be fertile again and motherhood was just stolen from them. To me, that is something as a doctor you should be disclosing and it’s actually within our Hippocratic Oath to be disclosing this stuff before we prescribe the pill.

But what’s the problem? Is it that your doctor is withholding information? No, your doctor doesn’t know. If I die in this mission, I will make sure that as many people know about this as possible because there are a lot of women popping this pill without anybody talking to them about what could happen to their body.

Kelsey:Absolutely. It’s depressing hearing it come out of your mouth. I’m like, man, this is terrible. But you’re so fired up about it. It’s great!

Laura: Jolene, something I see in a lot of my patients because I work with a lot of hypothalamic amenorrhea type clients, it amazes me how many of them their doctor’s would be really kind of pushing the pill really hard. It’s one thing to offer it as an option, but I’ve had some clients before who kept emailing being like I don’t know, my doctor really wants me to do it. I’m like just give it a couple months because we’re working on basically like nutritional recovery of hypothalamic amenorrhea caused by under eating, over training kind of situation.

It’s just crazy because it can take several months if not years to see that recover because they’re malnourished for a long time. But it always just drives me nuts when I get these emails from clients that are like my doctor is really pushing me hard and I’m kind of running out of…I don’t know what the word is. Just they don’t feel confident enough to keep saying no. I’m like, no! Just wait, please wait! We haven’t even been doing it that long. You’ll be fine! Then it’s just funny to see a couple months later they’re like, well I got my period. I’m like yeah, see I told you! It’s just crazy.

Dr. Jolene Brighten: Yeah. I’m so happy that you’re doing that work because it’s so true. As we know, our toolkit is vast. I don’t get worried when people are like I’ve tried everything. I’m like, I doubt it because there’s a lot out there. But just to speak to that pressure that comes from doctors…. So what’s going on? What are we getting worried about in hypothalamic amenorrhea? Let me just say, hypothalamic amenorrhea is when your brain isn’t communicating to your ovaries. There’s this mismatch that happened in there.

What’s the worst thing you could do? Shut it down again? That’s what the pill is going to do, it’s going to shut it down again. Basically if you’ve done any work, it doesn’t even matter…because it puts you back to step one.

But where does this come from when patients start to get where they’re like maybe I should just do what my doctor says. This is my perspective. One is if your doctor educated you well enough you would know what the best decision is for you. The doctor is worried because if you don’t have enough estrogen, so after a period of time your bone, your heart, your brain, they’re all going to start degrading. Definitely seen that.

I think patients relinquish their power a little too quickly to doctors. Our clinic, my entire clinic’s motto is we don’t heal our patients, we teach them how to heal themselves because this idea that you should do what your doctor says without question, I’ve been a rebel from day one. I wouldn’t do that. My doctor was like you’re on a PPI for life and I was like, no, I’m going to figure this out, I’m going to do something different. That’s what I want my patients to do as well. If you’re a patient listening to this, this is your body, okay? If you don’t like what your doctor is saying, maybe it is the right answer for you, but I think it’s important that they emailed you and said okay I want you to chime in on this as well.

Something I want to say though and speak to the fact that what if your period is not coming back and you do need hormones? It’s not the pill. If you need hormones, look at bio identical hormones that you can use topically, maybe an oral progesterone. But you have that option. To me whenever we’re going to give something, we want risk to benefit analysis taking place with that. With me sometimes it depends on how long the patient hasn’t had their period for and then I run an N-telopeptide on my patients which is something that looks at bone turnover so I can understand are we losing bone. This is something I run in my peri-menopausal woman too if I’m starting them on thyroid because every endocrinologist and everyone out there freaks out about T3 because they’re just like your doctor is just going to make you lose bone. I’m like we’ll just measure it and we’ll see what happens.

That’s just for ladies who are like well maybe I do need hormones. You can always go with topical bio identical and that’s going to bypass your liver which makes your liver really happy. You want your liver always happy. But you can use a really, really low dose with that. Honestly, in my opinion there’s a million things that come between you….Actually I don’t even think women really need to choose the pill. It doesn’t work. It’s not root cause medicine. It’s going to cause you more trouble in the long run. Just not worth it.

Just super grateful for you ladies doing that work. There’s not enough of us. I think right now there’s not enough of us and we need more of us doing this work so women have a place to go.

Kelsey: Yeah, absolutely. Just a quick recap here. The pill is terrible for pretty much every body system. In case you haven’t gotten that from what Dr. Jolene has been telling us. It really does not serve your body well.

What I’d like to cover now is let’s say a woman is on the pill, she’s got thyroid disease or she’s got some other illness or chronic condition that obviously the pill is not great for. What’s the process to maybe consider coming off of that? How do you support your body before you come off of that? What are the other options out there? What’s your favorite couple recommendations that you educate your patients on as for alternative birth control methods?

Dr. Jolene Brighten: Sure. If you’re listening to this and you’re on the pill right now and you’re freaking out, the first thing to do is get on a prenatal or a multivitamin. Get on some good nutrition or good nutraceutical basically. You’ve got to start taking something like that. But what’s the issue? Your gut might not be absorbing it.

What I’m going to say right now is not sexy, it’s not glamorous, but it’s the tried and true of what works. First thing is you’ve got to dial in your nutrition. You have no option but to be eating a nutrient rich diet. What I’m saying right now, you’ve got to be doing while you’re on the pill and you got to do at least for a month before coming off the pill. You’re going to eat a really nutrient dense diet.

Depending on what’s going on in your gut, you may start your probiotics, you may start fermented foods. I love utilizing all of those things, but if you’ve got SIBO, you’ve going to feel way worse.  It can also be a test. If you eat fermented food and you bloat and you feel awful, then you need to test. That’s always what we need to be doing. Even though I’m going to be talking generally, I’m a very big proponent of always testing. We want to know what’s going on. You’re an individual and I like targeted therapies because I like my patients to get better like yesterday instead of 10 years from now. I want you better fast!

Look at eating the fermented, the prebiotics. If you’re someone who’s got constipation, if that’s your issue, the way you’re going to detox the pill, your liver is going to ready it up, it’s going to take all that estrogen, ready it up for excretion, and put it in the gut. If you don’t poop every day, you don’t move your estrogen out. If that’s the case for you, you can utilize things like triphala or magnesium, but I want you to understand that that’s chasing a symptom and that’s treating a symptom. You’ve got to poop though, so you got to poop, but you need to work that up further. If you start taking magnesium, you shouldn’t require magnesium every day to have a bowel movement. If that’s the case, we have a problem there.

I get frustrated because I have too many patients to come to me where practitioners who are like well if you poop everyday with magnesium, just keep taking that. I’m like you shouldn’t be dependent on anything for your body just to work.  With caveats being if you don’t have organs anymore, then you’re going to be dependent on things to replace the function. No all or nothing statements there.

The other thing that I like to do is before a woman comes off the pill is I do like to get the nutrient testing. I’m running an organic acid, I’m running inflammatory markers. I’ll actually say that before I would ever put someone on the pill, I would run fibrinogen, I run factors for looking at clotting. I would run your genes, I run your genes to look at your clotting factors. I would run things on inflammatory bowel disease. That’s me, I will be checking everything on that. I actually like to check those things crazy.

I mean the fibrinogen levels, oh let me explain that. Fibrinogen is a marker for clotting. What is the biggest, scariest thing the pill could do? We didn’t even talk about this. Everyone has heard this. Throw a clot, a clot in your brain, a clot in your heart, clot in your legs, a clot in your lungs. It’s not good as you can imagine. What’s something that we can track and measure with that? Well, fibrinogen. I run advanced inflammatory panels. Everybody’s inflamed on the pill. That’s why I’m running these while they’re still on the pill to see this.

They come off and we’re doing things, so we’ve got to work on the inflammation, the gut. We’re doing things like fish oils coming in. We have people making sure, so if you’ve got a thyroid issue, we’re usually aiming for two servings of seafood a week. We’re getting our selenium and our iodine. It’s always the big no-no to just jump on iodine because you have a thyroid condition. That’s one sure way to flood you. I like using the seafood twice a week or even eating kelp with that so we’re really nourishing the thyroid. And then we’re using organ meats as well. Whether that’s if I can get patients doing like bone marrow, beef heart, things like that, again, really nutrient dense foods. Of course I love the bone broth, and the collagen, and all of that for healing the gut.

I’m cautious that if you’re listening to this, I don’t want to tell you like take L-glutamine, take marshmallow, do these things to heal your gut because I really do believe that if you think you need to start going to those higher level supplements that you actually need a provider to work with on that. It’s something because it’s just enough times that patients coming in with grocery bags full of supplements because they listen to someone speak online who said all of these things would be good and they’re like well I didn’t get better. It’s like well you only needed 3 out of 30 of these things and then we need to do it in a very nuanced way.

I just want to be cautious about that because I also don’t want to make it sound like it’s super, super easy either. But what I will say, one thing that we definitely do with all of the ladies is we get them going with turmeric because it’s great definitely for the liver detoxing, great for the gut, great for their brains because our brains definitely go through a loop with all that estrogen. And then we’re feeding them healthy fats. I do an upgraded turmeric latte kind of action where I’m putting MCT oil in there, and grass fed butter, and I use collagen as well. We’re just doing this kind of upgraded beverage that they’re drinking everyday because we need those healthy fats for our brain but also so that you start making your hormones. Your brain shut you down from making your own hormones.

I mean the pill makes a lot of us gain weight and so a lot of ladies are still on the fat free bandwagon. But please, please, please, if you’re thinking about coming off the pill and you want to make your own hormones, get those healthy fats in. That’s another really big focus. But of course, you’ve got to be absorbing them. So much comes down to the gut.

Once you come off the pill, once you’re coming off of that, depending on where a woman’s at, we might do things like tinctures, or seed cycling, and all those kinds of things. But we’re definitely supporting liver detox because we want all of those fake hormones out of your body as soon as possible. I want to speak to this point. I’m speaking a lot about nutrition. I told you it wasn’t going to be the big sexy stuff because it’s really the foundational stuff. For a lot of women they’re going to need to go beyond that. But I want to be really clear that if you are not doing the foundations, it doesn’t matter how many supplements you take. It doesn’t matter if you take a medication. No medication or supplement can undo an unhealthy diet and lifestyle.

Kelsey: Yeah.

Dr. Laura Brighten: You absolutely have to start there. As women come off the pill, that’s where we’re going to support the liver and we’re going to support phase one and phase two liver detox. I just want to say I can see benefits of juice cleanses. There’s a time and a place for these. I’m really not a huge fan because you can become a metabolic obscenity. That’s what I call those things where I’m like you literally just cussed out your body with what you did. A lot of people with thyroid issues, adrenal issues, hormone issues, they need to keep their blood sugar controlled tightly.

But what I want to say is that if you’re not eating high quality protein that you’re absorbing every day, you’re not running phase two liver detox. Let me explain why this is important. Your liver has two phases of detox. Phase one packages up, get it ready to go. Those are actually more toxic intermediates. The toxins have now been made more toxic basically and then you have to push it into phase two.

This is where people get sick on “liver detoxes,” I’m doing little air quotes right now, is because they do things that push off phase one. It’s like “I love Lucy” in the chocolate factory. The answer isn’t to speed up phase one. The answer is to take care of the bowels in phase two otherwise you’re stuffing the chocolates everywhere. It’s not a good scene.

Kelsey: Right.

Dr. Jolene Brighten: What does phase two really rely on? A lot of amino acids. This is something where you absolutely, it’s non-negotiable, you have to be eating high quality proteins. I would say, I was a vegetarian for 10 years. I am not anti-vegan or vegetarianism. They absolutely have a harder time though detoxing and coming off the pill. We’ve been tracking this and I can say it that I’ve seen it enough times.

We definitely respect people where they’re at. But at the minimum if you’re a vegan or vegetarian, I really encourage you to try at least getting collagen in to get those amino acids. And let me say this, that if you don’t eat animals because you don’t want to support the husbandry practices or you want to look out for the planet, let me say this, when you consume the end product, so collagen being from the hide of a grass fed animal, that life was sacrificed as it was. You actually help close the loop in fully honoring and utilizing that animal and showing it a lot of respect. You put your dollar vote to vote towards the farmers who love their animals, who take care of their animals, and who take care of the planet and are looking out for that.

I just want to say that because there can be a lot of guilt around giving your body actually what it needs. But please understand that if you actually, you’re buying bone broth, you are really honoring the process of a really high quality animal and the respect of nature. That dollar vote helps our planet tremendously. I just want to make that really clear.

Kelsey: I love that perspective!

Dr. Jolene Brighten: Good! I’m glad that you do. I mean I don’t want to be disrespectful. Again I was a vegetarian for 10 years and so I definitely understand that it’s an identity in a lot of ways. A lot of people come to that with a lot of morals and conviction. I want to honor and respect that and help them see that actually we can all work together.

What would Native American’s do? How did they live? When they took an animal’s life, they honored that animal’s life and they used the entire animal. I belong to the Cherokee Nation in Oklahoma.

Kelsey: Wow!

Dr. Jolene Brighten: Actually, I’m part Native American and so I think a lot about these things. That’s something I really feel like it’s one way to give yourself permission to heal yourself. It doesn’t mean you’ll need it forever, but you give permission and at the same time you honor your mission and you actually help all of us change the way things are being done to our planet right now.

Kelsey: Love it, love it!  I mean I think that’s a really needed sentiment for a lot of people out there who think about meat that way and just feel guilt surrounding that. I love what you have to say about that.

Dr. Jolene Brighten: Thank you!

Kelsey: We talked about this process of preparing your body for coming off the pill which is to support your different body systems through a nutritious diet, maybe some supplementation. I would add here and I’m sure you would agree, focus a lot on stress management as well. And then of course like you mentioned, diving deeper into the gut if there might be any issues there. Then you come off the pill and we’ve kind of touched on the topic of post birth control syndrome. I just want to talk about maybe you could enlighten our listeners who aren’t super familiar with that just some of the symptoms that they might experience after coming off the pill and when they can expect to maybe feel better from those symptoms that are not a lot of fun.

Dr. Jolene Brighten: Post birth control syndrome, I kind of giggled about this the other day that I was like post birth control syndrome is like the new leaky gut, the new adrenal fatigue. I’ve been in this arena long enough to remember when anyone who said leaky gut was called a quack. It always makes me giggle because I’m like you know you guys were still discovering anatomical structures in the human body that we’ve been dissecting forever. So many we should just honor and respect that we don’t know everything and that’s okay.

Kelsey: Right.

Dr. Jolene Brighten: This is one that not a lot of people have heard of, but it’s very real. I appreciate you actually asking this because it’s going to validate a lot of women who are like oh my gosh, I thought this was in my head! We see post birth control syndrome, the symptoms that I’m going to go into, they usually arise within the first four to six months of coming off the pill. They can be immediate. I just had a patient just last week that it was like she came off the pill and then immediately it was not a good scene for her. I will say the caveat is that she should be post-menopausal but her doctors were keeping her strung out on the pill for a long time. Women listening to this, if you’re still having your period and you’re 56 and you’re on the pill, it’s really time, you got to get off.

Let me go back. Four to six months, these are the symptoms that usually pop up. We already talked about amenorrhea, so women may not have their periods come back. Conventionally speaking, the rule is that if your cycles were regular before the pill, then after three months of no cycles, we should test. If your cycle was irregular, then it’s like okay well that could be four to six months later then we would test. I disagree. I think by month two if it’s not coming back, let’s start the testing process. As you know but your listeners might not know, is that tests can take about two to four weeks to turn around the results. For me I’m like we don’t waste any time.

There’s the amenorrhea, or a loss of menstruation. Or on the flipside, your periods might come back with a vengeance. You might have really heavy, painful periods. Or you might have what is a luteal phase defect which is your cycles are really short so your period is coming every two to three weeks. You don’t have enough progesterone going on. Of course infertility is another symptom of that. Hypothyroidism, there can be a transient hypothyroidism that I see in women being on the pill and coming off of it. It’s something that I’ve actually seen resolve with coming off the pill. Acne for sure.

Kelsey: Yeah.

Dr. Jolene Brighten: Acne and then fluctuations in weight. The body composition can change. Breasts can be bigger, breasts can get smaller. Your butt might get bigger, your butt might get smaller. It just all depends on the hormones which is again why you need a hormone expert in this business. Because when patients start telling me symptoms, I’m like I know exactly what hormones we’re talking about and then I’m going to them them and make sure. Migraine headaches, any kind of pain syndrome starting to come on, depression, anxiety, mood swings, irritability, anger, and changes in the bowels as well. Because if the pill’s been disrupting your microbiome and offending your gut basically and you come off of it, your gut is going to start trying to restore itself. I’m telling you you’re going to need a lot more support.

And then any kind of inflammatory or immune changes and immune imbalances. Usually the trend with the pill is you come off the pill and the inflammation starts to come down. But I have seen women with autoimmune disease as they’re coming off of it, this is something I learned many years ago and we protect against this now, is that the autoimmune disease there can be like a transient flare moment. I’ll tell you the canary in the coal mine, what tells me and most of my patients it’s coming is they start getting flu-like symptoms. They think they’re getting a cold after coming off the pill.

If that is you, you need to get some fish oil, probably probiotics, get your vitamin D checked and look at that. Those are three players we know that can start balancing your immune system right away. But if you can’t get your vitamin D checked in time, let me tell you, what is a vitamin D deficiency? It’s a nature deficiency. Why all of a sudden do we see humans having all these vitamin D deficiencies? Because we never go outside.

Kelsey: Right.

Dr. Jolene Brighten: The root cause solution is get your butt outdoors! Start moving your body. Go out there and spend some time in the sun because as you said, that stress reduction piece is really important. So two for one there. You can go outside in the sun, walk, move around, and you’ll be amazed if you can do 10 minutes of that how much happier and even keel you’re going to be throughout the day.

Does that make sense? Those are some of the symptoms that we see. Like I said, you can have all or none…or excuse me, all or one, not none, that makes no sense…one of these symptoms. It’s important, there’s not a whole lot of us practitioners out there. I’ve been reaching out to who else is doing this work. I’m getting a lot of people reaching out to me. We’re not at a place where a lot of people are super savvy in the knowledge about this. I’ve been developing protocols around this for the last five years.

Let me just say ironically when I went into practice I was like I don’t ever want to deal with birth control, I don’t want to be prescribing that and dealing with it. And it’s hilarious now because what is one of the most common denominators of all of our patients? I’m sure it’s true for you. They’ve touched that pill in some point in their lives. We see all of these fallouts that I’m like there’s no way it didn’t play a role. There is no way it didn’t play a role.

Kelsey: It’s so interesting too because in the scheme of things sort of this new thing, like there hasn’t really been a generation of women that have been on the pill for 10 or 15 years and we’re just now starting to deal with those women who have had that happen to them.

Dr. Jolene Brighten: Yeah, I mean that was me. I was on the pill for 10 years and then I came off it. Once upon a time, you never did the pill. The research is like more than 10 years you have risk. You know what else I want to say? If you’re a woman listing to this and you’re over the 35, you’re at a much higher risk of having a stroke or an adverse event from that birth control pill. If you’re a woman over 35 and you’re smoking, oh my goodness! That is super dangerous behavior to be engaging in. If you’re a woman has migraines with auras, you are at a really high risk for stroke as well. What is the pill usually prescribed for? Oh you’re having hormonal headaches? Let’s just go ahead and give you the pill.

This has been well documented in the research forever I feel like for like since the first time I ever started reading research papers, which is dating myself a little bit. But it’s been in there, it’s been in the research for a long time. But you know what? Doctors in a seven minute visit can’t give you the time to talk to you about that. That’s why you, and me, and Laura, we’ve got to go out there and talk about this.

Kelsey: Yeah.

Dr. Jolene Brighten: When we see change in medicine, for everyone listening, practitioners, we can say all that we want. We don’t make the changes. It’s the patients demanding their doctors to do better that makes the changes. If you’re listening to this and you’ve felt disempowered in any way around the birth control pill, know that you are the catalyst for change. We’re out here, this podcast is fantastic. We’re out here educating your listeners, but it’s going to be your listeners who mobilize. It’s going to be these women who are like I deserve better than this. You know what ladies? We do deserve better than this in women’s medicine. It’s going to be them demanding better of their doctors that we’re going to change this. I tell you in my lifetime, we’re going to change this. It’s not going to be me who changes it, it’s going to be the women I educated and empowered for them to have a voice to speak for themselves.

Kelsey: Absolutely. Amen! I love that!

Dr. Jolene Brighten: I didn’t answer your question about what are the alternative forms of birth control.

Kelsey: Oh yeah! We got so fired up about all these topics.

Dr. Jolene Brighten: As you can tell, I’m all about the sisterhood and that’s looking out for each other because I think the moment women wake up and see that if we all work together, oh my goodness! The world will change, it will change.

Kelsey: Yeah!

Dr. Jolene Brighten: Here’s the deal, alternatives to the pill. Now again I’m going to say it, you’re the only person living in your body. You’re the only person that can make this decision. I don’t make medical decisions for my patient. It’s my job to educate them. You lay it all out basically like here’s the menu and let’s go through what you might want to select. We’ve got food sensitivities, you’re going to go and you’re going to ask your waiter or waitress a million questions about the menu. That’s what I do. I present it in that way. I’m like let’s go, ask me all the questions.

I’ll say that predominately within my practice that women go with is actually the fertility awareness method. And then they’re using technology they’re leveraging technology which is super rad that we can do this. I don’t know about you, but I love Taking Charge Of Your Fertility. I think it’s a great book.

Kelsey: So good!

Dr. Jolene Brighten: But I will never chart, I will never chart.

Kelsey: I’m too lazy.

Dr. Jolene Brighten: And then there’s systems where you could put that in. I wouldn’t do that. Oh my gosh, ladies, I was the worst about tracking a period until we had apps. But, your period, it’s the fifth vital sign says ACOG. All the big heads of gynecology said that your period is so important that we should evaluate it along your temperature, along your blood pressure, all of that. Keep that in mind. Why are we giving women the pill? When we give them the pill, we miss out on data that’s crucial.

Why do my patients choose the fertility awareness method? Daysy is the predominant one that my patients select because you pop it into your tongue and within seconds you’re done. And then there’s a light and you’re like okay, I can have sex unprotected or not. Why they choose the fertility awareness method is because I teach my women in their practice how to be their own hormone detective. I give them the data point. My patients are awesome like this. We joke that we have our own little lab and they’re tracking all of their data.

There’s certain points in their cycle I want them tracking. I come from a big research background so I’m not like I want you to look out for x,y,z because I don’t ever just want to just basically assert the outcome I want to see. I just want you to tell me day 10, around 10, how are you feeling? Around day 14, how are you feeling? What’s going on? My patients will use fertility awareness method because it helps them get really dialed into their own body.

Once they’re dialed into that, my patients have started to notice…I have a lot of Cross Fitters in my practice. And you know that’s an intense exercise and for some women especially I’ll say if you’ve ever been on the pill, I have seen that hypothalamic/pituitary/ovarian axis is much more sensitive to stressors. It’s more fragile is what I call it. I’ve had women that actually will compete at Cross Fit, like some women are like day 7 to 10, like early in their cycle and they’re ovulation is delayed. They see what that stress has actually done to change their body. It doesn’t mean you should never do Cross Fit or ever do that, but isn’t that really interesting to know about how your exercise is affecting their body?

Kelsey: Yeah.

Dr. Jolene Brighten: I’ll say it feels like women at first are like, I don’t know, it feels really labor intensive, or does it work? That’s always the question. I actually have an entire article written on this because I just was so sick of MDs telling my patients that they were either too stupid, too lazy to do this, and it didn’t work. I’m like, no.

What we know about the fertility awareness method is that there was actually a study that showed that when the fertility awareness method was used the way that it should be…so this is important, we can’t talk about all this, you need a fertility awareness coach or someone like me or yourselves that can teach you how to do this. If women are taught, this is the difference, if the doctor teaches the woman, she’s very, very successful in this….Everybody thinks that birth control has these really high efficacy rates, like it really, really works. But actually with the level of education doctors are doing and how much women understand it, and because it makes most women feel so sick, it’s actually not as effective. Actually fertility awareness method, really it rivals it.

There was study that showed that for pregnancy there was 0.6 pregnancies per 100 women per 13 cycles. What does that mean? Over a year they tracked them and less than one women out of 100 got pregnant using unprotected sex the entire time. They were using unprotected sex outside the fertile window and then during the fertile window they said they either abstained or there was no unprotected.

I don’t believe in abstinence because evolutionary speaking, your body won’t allow it. Your body will drive you to breed. The reason why I say I don’t believe in abstinence, let me explain this what happens in the physiology. On about day 10 you spike your testosterone. We all know like testosterone does a lot, but we all know the first place our minds go, we’re like woo-hoo! Libido! Libido spikes around day 10 so that you really want to have intercourse. Then what you do is you capture the sperm. Yes, you capture the sperm and it lives in your body for about 5 to 6 days. Guess what comes 5 to 6 days later? An egg!

On the day you’re most inclined to want to have sex, that drive can overcome even your best of willpower I will tell you especially if you’re in a monogamous relationship because they’re right there next to you. That’s why I say I don’t believe in doing the abstinence part. That’s when I’m like use a condom, use a condom. Nobody likes condoms, I know that. But if you don’t want a baby, I think it’s a small sacrifice. From someone who has a baby I’m going tell you if you don’t want a baby, you just use that condom because that’s way less work.

The other thing some of my patients, most of my patients don’t want to use any hormones because they’re having a lot of issues with their hormones.  I say that because Mirena IUD is always the reflex. If you don’t want to do the pill, the doctor is like do the Mirena IUD. Here’s what I’m going to say is that all of this birth control stuff, all of these birth control methods, we get dismissed left and right as women. If you go online, and this is what I think, if there enough women are telling me they place the Mirena IUD and then they were manic or they had anxiety, I see those are the two predominant things, and then they have it removed and they’re fine. I’ve seen this so many times. There are support groups out there everywhere of like hundreds of thousands of women saying this. But everybody in medicine, everyone in science is saying it’s not possible. I am saying it’s not possible that this many women say this and something’s not going on.

Kelsey: Yeah.

Dr. Jolene Brighten: To me I don’t know enough about that. What I’ll also say is that they just released a new one, Skyla, it’s a new IUD that’s hormonal. I got really upset about this because, you can tell I get upset around a lot of things on this subject. I got upset about this because they just pulled the male birth control study. The men have lower incidence of reporting depression than women do, but women, we get dismissed anytime…we had a million women in this study and they still dismissed us that we were having depression. But in a male study, less than 5% of men are depressed and they pull the study. In the same quarter they released Skyla which is throwing 20 something percent depression rates in women.

Kelsey: Wow!

Dr. Jolene Brighten: And they’re not dismissing that. I got really upset about that because I have a whole article about medical gender bias because that’s exactly what it is. The burden of not getting pregnant will always fall on us, ladies. It will always fall on us. The pharmaceutical companies are not very motivated to improve upon this because no matter what, they’ve got us as a customer. They’re got us. I get it.

Let’s just acknowledge too that since the introduction of the pill, we made more money, we’ve graduated college at higher rates, it has absolutely helped us propel ourselves as women. But it came at a cost. There’s a price there. This is not just shame, don’t feel guilty if you ever took the pill. I took the pill and I’m not staying up all night over it. You learn better, you do better. That’s what we do. Nobody has ever healed their body by hanging out in their past and trying to heal that. You don’t go and harp on that. We’re right now in present time. We have the past data, that’s good to know. What can you do right now in present time? And that’s where we focus.

Kelsey: This has been an awesome episode I have to say! I’m fired up now. I want to go dig into all this research too. I think everything that you said throughout this episode is so important for women to hear. And especially of course if you’ve got any other type of chronic illness going on, you really need to take a look at your hormones, especially so if you are on the pill or you have been on the pill and you never really necessarily recovered fully from being on the pill because you didn’t know it maybe had such a damaging effect. There are alternatives as you’ve discussed and there’s a way to come off the pill in a way that’s going to support your body as much as possible and get you on that road to healing as fast as possible, which is really important to everybody.

Dr. Jolene Brighten: Yes!

Kelsey: We’re going to have to have you back on again sometime I think because seriously I could talk to you forever about this stuff. I think we’ve given women listening a place to start and that’s really important. We’ve educated them on what the pill does, how it affects your body, and why you might want to consider alternatives.

What I appreciate about your perspective is that you support the women themselves. It’s not like you’ve decided that the pill is bad and so you’re telling your patients don’t go on the pill. You’re supporting their education around their own body and their own health and then like you said, laying out the menu for them and then talking though every question that they have so they can make the right decision for themselves.

Dr. Jolene Brighten: Yeah. At the end of the day, it’s really the patient who should be in charge of their health. The way I see it is that I’m just more of the trail guide. It’s not me who takes the steps. That’s why in my practice I’m like we really have to honor the work the patient is doing because when we get to the end of healing journey, did I take all of those steps? No. I just showed them the way. They did it. We need to honor them in all of that.

I feel really sensitive about talking about this subject that I don’t ever want a women to feel like she’s being judged in this. If you’re making what you feel is the best decision for your body, then I just want to support you in that because I can’t possibly know what’s best for you. I don’t live in your body. That’s why I’m also cautious of I don’t say what my favorite birth control is because I don’t want you to be like, oh I just did this because Dr. Brighten’s favorite. Who cares what I think? All that matters is what you think.

In my clinic, we’re all about strengthening and empowering women. Our name is Rubus Health, and for those of you that don’t know, Rubus idaeus is red raspberry leaf which is the herb that we use to strengthen and support the womb space. That’s how we see ourselves is that we’re here to strengthen and support women overall because truly for every women’s life that we effect and we help her elevate, she creates a ripple effect and she goes out and she changes her community and it’s a beautiful thing to see.

Kelsey: Amazing! If people want to learn more about you, your practice, everything you’ve got going on, where can they find you?

Dr. Jolene Brighten: You can find me at DrBrighten.com. The names a little tricky but DrBrighten, so brighten like the sun. You can find me there. I definitely have way more information on this topic. If you’re wanting to do a deep dive I’ve also got lots of information there for you to go check out. And then of course you can always hit me up on my Facebook page. That’s where I tend to answer the most questions in the comment sections of things that I post there. You can always hit me up there and I’m happy to answer any questions that you might have regarding this episode because I know there’s a whole lot we couldn’t even cover in this time. I’m grateful for the time that we did get together and what we’ve been able to do in this time to set women up for success with this.

Kelsey: Absolutely. We’ll link to that in the show notes. I just want to thank you for taking the time out of your day to do this interview. Like I said, I think it’s going to help so many women to just be educated on this whole topic. I got some education too, which is always fun on a podcast.

Dr. Jolene Brighten: Awesome! You all asked great, great questions. Most people I get on with, they have no idea what I’m talking about and so they’re like wait, wait. And it’s great because we give the really basic stuff.  Your questions, I just want to say that I loved this interview because you let me go on that deeper level which is where I really like to go. I just really appreciate how you really got in there and got deep and you brought out things that I think are really going to help so many women. Thank you for just being an amazing interviewer!

Kelsey: Thank you!

Dr. Jolene Brighten: And inviting me to be on here because I just love you guys! You guys are doing amazing work in this world.

Kelsey: Thank you so much, and you are as well. Thanks so much Dr. Brighten and we will hopefully have you on another time! Take care.

Dr. Jolene Brighten: Take care.

PODCAST: Body Positivity And Food Freedom With Sarah Vance

Thanks for joining us for episode 109 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are thrilled to be interviewing Sarah Vance!SarahVance

Sarah Vance is a body image and self-worth coach, host of the Reclaiming You Podcast, and creator of the life changing Breaking Boundaries program. She specializes in helping women all over the world let go of diet dogma, body hate, perfection and all or nothing thinking so they can step into the badass woman within feeling worthy, confident, loved, free, and enough in whatever body they have. Grab your taste of freedom with “5 Mindshifts to Embrace Your Body and Have Food Freedom” at SarahVance.com.

The body positivity movement is gaining momentum in our society that assigns value to a person based on appearance and where thinness is the ideal. Sarah Vance has gone through the process of freeing herself from a life fighting against her body and now empowers others as well to live in the freedom of body acceptance.

This episode is full of information and inspiration sure to spark radical change in your mindset around body image and dietary dogma. Join our conversation today as Sarah tackles cultural narratives forming the belief that self-worth is dependent on body size and shape. Just some of what you’ll hear is the role of social media on body image, the biggest myth about the body positivity movement, and Sarah’s take on food addiction.

Here are some of the questions we discussed with Sarah:

  • Can you tell us a little bit about your story, where you got to where you are today, and why you got into the business of body image coaching?
  • Why do you think women believe that they’ll be happier or more satisfied if they’re leaner or if their bodies look more toned?
  • How do you think social media plays into the poor body image we’re seeing in so many women?
  • What do you feel like is the biggest myth about the body positivity movement?
  • What do you find to be the hardest part of body acceptance for your clients when they first come to you?
  • What are some practical ways that the women listening right now can feel more comfortable in their body without having to actually change their physical appearance?
  • How can a woman love herself the way she is and still make changes in her diet and lifestyle so that she feels healthier?
  • What does food freedom mean to you?
  • Where do you feel food addictions come from and do you think that sugar is something that can be addictive?

Note: We discuss the work of Gabor Mate and a book entitled The Body Keeps The Score during our conversation about addiction. Please note the correction that The Body Keeps The Score is written by Bessel van der Kolk.

Links Discussed:

TRANSCRIPT:

Laura: Hi everyone! Welcome to episode 109 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is my cohost Kelsey Kinney.

Kelsey: Hey everyone!

Laura: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Laura, atLauraSchoenfeldRD.com, and Kelsey over at KelseyKinney.com.

We have a great guest on our show today who is going to dive deep with us into body image, self-worth, and food freedom. We’re so glad she’s joining us and we hope that you’ll get some great insights from this episode.

Kelsey: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re there, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer or suggest a guest you’d love for us to interview on an upcoming show.

Laura: We’ve got a really great interview for you guys today. We’re super excited about it! But before we get started, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com

Laura:Welcome back everyone! Our guest on the show today is Sarah Vance. Sarah is a body image and self-worth coach, host of the Reclaiming You Podcast, and creator of the life changing Breaking Boundaries program. She specializes in helping women all over the world let go of diet dogma, body hate, perfection and all or nothing thinking so they can step into the badass woman within feeling worthy, confident, loved, free, and enough in whatever body they have. Grab your taste of freedom with 5 Mindshifts to Embrace Your Body and Have Food Freedom at SarahVance.com.

Welcome to the show, Sarah!

Sarah: Thank you so much for having me!

Laura: We’re really glad you’re with us. We have lots of really cool questions to ask today. We’ll see how many we get to. But I know that you may be a little bit of a new face for a lot of our audience since you’re not super in the Paleo/ancestral health community.

I think, I’m trying to remember if I came across you through, I want to say it was Maddy Moon. That’s my guess. I feel like everyone kind of has a little connections to everybody in this health and nutrition world and everything.

What I would like to hear from you and so that way our audience can get to know you a little bit better is tell us a little bit about your story, where you got to where you are today, and why you got into the business of body image coaching.

Sarah: That’s such a loaded question, but I’m going to do the Cliff’s Notes of this to keep it a little bit short. But basically I had grown up in a family that was full of body builders, and then I graduated college and I became a nurse. The reason why I say that is because those two things I think had a major impact on my overall journey to where I got to in my journey and where I am today.

Basically when I became a nurse I was very aware that I wanted to do something to take care of my body. What I thought that I wanted to do was start being a bikini competitor. But before that, I had just had started going to the gym, I started being a little bit more aware of my nutrition and everything kind of seemed a little bit not as disordered. It was just thoughtful and I didn’t seem to have an “issue.”

I did that and I actually got into strength and really, really enjoyed it. And then I actually went to an event to support somebody that was in powerlifting. While I was there, I saw a bikini competitor and I was like, oh my God, I want to do that!

At that time in my life there was a lot of stuff going on. Like I said, I was a new nurse and on top of that I was a new ICU nurse so I was being exposed to a lot of things that I never dealt with in my entire life like death, trauma, things like that I hadn’t been exposed to in my life. I was also going through a really difficult relationship with my partner at the time. My family had moved states away, my best friend had moved states away, so I was just going through a lot with this stuff in my life.

I saw this bikini competitor and I was like, oh my God, that’s the answer! Like she looks so happy, she’s confident, she’s beautiful, she’s getting all this attention. I want to be just like her. I ended up hiring a bikini competitor coach and that’s when things really started to get more disordered. I initially started dieting and it was a very rigorous plan obviously that was very low on calories, I was exercising a ton in the gym. I thought all of this would make me be confident, and feel good in my skin, and make me happy.

Fast forward through I think a year and a half of competing all the way to be National Bikini competitor, I was severely disordered with my eating and how I felt with my body. I had a lot of anxiety around food, I was bouncing from restriction to bingeing, I had symptoms which are created because of restriction and over exercising so I had no period, my hair was falling out, my sex drive was nonexistent, my sleep cycle was a complete disaster, I had GI upset if I would eat foods that I “wouldn’t have let myself have.” Overall I was just miserable. My energy was low. I just wasn’t feeling great.

I remember working with one of the top photographers in the fitness industry on the day after my competition at the National Level Bikini competitor and I was just like, is this it? This is it? But when you’re so disordered in that mindset, it’s difficult to shed light on it and it’s difficult to get out of it.

What I had to do, and I find this to be very common, is that I became a personal trainer. This was because A. – I was so disordered that it was one way that I could continue my disordered relationship was to work in the industry. And 2 – I thought what I was doing was the way to help people.

I ended up going to California for a fitness entrepreneurship expo something or other, it was a business thing. I was working with another top photographer and during this time I had been doing rigorous training with eating severe, very low calorie, was very obsessed with my body still, completely unhappy, but I was like this is it! I was going to be there, and I was going to be this top fitness model, and everything is just going to be great, and I’m going to make all this money, and get all this praise. And I just thought this is going to be great! I was exercising two a days in the gym, six days a week feeling a ton of guilt, shame, just the whole stuff that comes along with disordered eating, and body hatred, and body obsession.

I walked into this photographer and I’m like thinking I’m on cloud nine. I’m like I look great! This is awesome! I felt like shit, but I was like I look great! He said to me, don’t worry, we’ll Photoshop your stomach. That is such a prominent moment in my life because it made me realize the illusion that I had been buying into and the illusion that I was now selling to other individuals because I had been buying into an idea, a façade of what is considered to be health, happy, confident, successful, all this other stuff and now I was actually going to be selling that to other people. It just didn’t feel right.

I thought other people are actually looking up to me, they’re coming to me for advice, they’re coming to me, they’re giving me praise. People are looking at me and this is one big lie. I am not happy, I am not confident, I am not healthy by no means mentally, physically, emotionally. I am completely obsessed with my body and it’s just not me. I don’t feel like me and this is a lie.

You would think that would be enough with the physical symptoms as a nurse knowing, hey, not having a period is probably that’s a sign of something’s going on. But it took me a long time like I said to get out of this disordered mindset because there’s a lot that goes into it with upholding your identity and letting go and there’s a lot of fear that’s involved.

Nonetheless, I continued training people, more specifically just women. I specialized in just training women and I really started taking the route of not taking clients that had goals of intentional weight loss where they would just come to me for wanting to feel good in their bodies. Which was all great, but when I would do the initial consultation I started hearing all these amazing women, these really brilliant human beings that had beautiful souls just be so down on themselves and beat themselves up.

It was the first time that I had heard everything that I was vocalizing to myself behind closed doors or in my own mind. It’s the first time that I had heard it outwardly being vocalized from other women and I thought this is not okay. Why are we collectively beating ourselves up, and we don’t see how amazing we are, and we’re not living our lives on the basis of what we look like, or a jean size, or all this fear?

That’s really what prompted my own journey was my own suffering as well as seeing how this was affecting so many other people. That was a process of overcoming that. This is where you kind of lose that whole thing of and then I was fine. That’s not how it goes. It’s a long process to undo some of this stuff. It’s messy, it’s uncomfortable, and you have to work through a lot of stuff. But eventually I decided that I didn’t want to continue this. I mean I really had to sit with myself and ask myself is this how I see myself five, ten years from now? What if I have kids? What do I want to teach them? What example do I want to give other women? That was really prominent for me to help me along my own journey.

With enough work, introspection work, and just moving through fear, and letting go of a lot of ideals, and just teaching myself everything that we’ve been taught by society is not the truth, I am doing what I do today. Basically I help women get off the diet cycle, learn to embrace their bodies as is, and know that they’re worth is in who they are. Ultimately help them live their lives because that’s really what I think many of us want to do. We think that’s going to be found in looking a certain way, which isn’t the case. I help them just become more free within their body and ultimately going out to live their lives because we all have better things to do than worry about our size, weight, shape, or even level of healthiness.  That’s kind of in a nutshell.

Laura: Awesome! That’s so cool. It’s funny when you mentioned in the beginning that it started because you wanted to be healthy, and I feel like that’s so often the case for people have this idea that I just want to be healthy, and I just want to make good choices, and I just want to feel good. I don’t think that everybody gets into that disordered mindset when they start to make healthy changes in their diet and exercise routine, but it is interesting how addictive it can be when people start to see visible progress in their physique and then they start to get attention for it, and then it’s like well if this is what people like to see, then maybe that means I need to get thinner, I need to look better.

It can be a very slippery slope, like you said. Even just working in the industry that you were in with the training, I feel like people expect you to either look a certain a way or you expect for yourself to look a certain way and have a certain approach to fitness that requires some level of self-hatred.

Thanks for sharing that. I feel like it’s really important for our listeners to know where you’re coming from since you’ve been through it. I know a lot of people that are listening are either in that kind of down phase right now or they’re trying to get out of it and they want to know what to do.

Why do you think that these really amazing women who have a lot going on for them, are great people, they’re intelligent, they have jobs that they like, they have families, things that are going on for them that are really great, why do you think that they believe that they’ll be happier or more satisfied if they’re leaner or if their bodies look more toned?

Sarah: I think that there’s a few reasons why this happens. I mean first and foremost we really have to look at the cultural narrative that we have around bodies, and especially with women. As women historically we’ve been conditioned to believe that our appearance is our most important thing about us.

When you look at that, and really take that in, and really open up your eyes to see how image driven our society and our culture is, and then on top of that look at what image are we actually seeing more frequently, I think it’s only like 5 percent actual bodies are being represented in the media, it’s not that we’re blaming completely the media, but the cultural narrative as a whole is conditioned to uphold that ideal which is the idea that thinness or a thin body is the epitome or the goal, and fatness or a fat body is something to look down upon.

On top of that, we have these narratives attached to both sides of these where a thin body represents success, health, beauty, worthiness, love, all this cultural stuff that we’ve been conditioned to believe, not being lazy. Whereas a fat body has all these narratives that we’ve been conditioned to believe, that they’re lazy, that they don’t take care of themselves, that they’re not worthy, that they’re not beautiful, that they are not successful, that they are passive, all this stuff.

We have to really look at the bigger picture here and think of how our culture and society has really made us believe that one body is more worthy than another body and that comes to representation. Representation is huge and we are not seeing that much representation in our general society and culture. You can see that with just going through the checkout store, what types of bodies are you seeing? Especially when we’re talking about health, or fitness, or beauty, what are you typically seeing? You’re seeing one type of ideal.

We are actively racing and actively running physically and figuratively from this other side which is a larger body or weight gain and we’re erasing anything that is commonly associated with that such as stretch marks, such as cellulite, such as belly rolls, or back rolls, or anything of that sort because we have been conditioned to believe that these bodies have associated narratives which simply is not the case.

Laura: Do you think this has been a problem more recently with all the social media apps and that kind of thing that have been really becoming popular in the last five, ten years. I’m trying to think of how long these apps have even been available. How do you think these social media, like Instagram or Facebook, that kind of stuff, how does that play into the poor body image we’re seeing in so many women?

Sarah: I think that we have always lived in an image obsessed culture and now that we have things like social media at our fingertips where we’re always having media be at our hands, because before it would be like we’re watching TV, we’re on a magazine, or we see a billboard when we’re driving, now it’s literally at our hands. How much time are we spending on our phones? Let’s be honest here. I spend probably a decent amount of time on my phone. I think that’s very common for our society.

I think that it does and is playing into having a higher impact on this. Studies have shown that there is a correlation. We can’t really say this is a causation, but there is a correlation that due to social media, that we are having a higher prevalence of body dissatisfaction and disordered eating. I think that is because on social media we are being portrayed as perfection. We see one picture and we can manipulate that picture accordingly. We have Facetune, we have apps that can manipulate your body, we can pick a certain picture based on what we want to look like, and we can really create this perfect illusion of people, and lives, and bodies, and that we have it all together, and everything is just perfect because of the media driven that we have on social media. I think it really does play into that.

When you look at social media, I want to say it could be damaging, but it can also be uplifting because there are obviously Thinspo, Fitspo, there’s even pro-anorexia and things like that on social media which is extremely damaging. It holds all these ideals which is really, really problematic, really problematic and damaging to people. It does not help people. It furthers their disorder, it furthers the body hatred, it furthers these ideals related to health, size, weight, and shape, and beauty. But on top of that, we do have the power to create our social media to be one that is uplifting to us and that would be through following individuals, following things that really uplift your soul.

One of the things I always tell people is to shift your social media because yes, it can really play into body dissatisfaction through comparison, but it also can help you on your journey towards accepting your body and having food freedom. That is through following a wide range of bodies. Like I said, we only see 5 percent represented in the media. We have the power to expand what’s called our visual diet and that is what we actually see in the media through the power of social media. That would mean following people that have bodies like yours and larger. Follow fat people, people of color, trans people, different abilities, all these things that encompass the wide range of true bodies that you could see.

It has been proven to show that when we expand our visual diet, it does affect how we not only view ourselves, but how we view other people, and then how we’re going to treat ourselves and other people to be from a place of compassion, respect, and kindness. So yes, social media has I think played a correlated role and increased body dissatisfaction, but we also have the power to create social media on our own phones and Facebook or whatever to actually help us versus damage our self-worth.

Laura: I think people need to remember that you don’t have to be following someone who is posting eating disorder promotion type posts. If it’s somebody that makes you feel badly about your body because of what they look like, that in itself could be a problem. I work with a lot of women who, I don’t think that they’re specifically seeking out Fitspo and pro-anorexia that kind of website, but if you’re following people that are only posting these really beautiful, perfectly posed, probably the 80th out of the 100 photos that they had taken that day, that’s going to definitely make you feel like that’s what you’re supposed to look like or that’s what this person looks like all the time. I agree with you that getting a figure diversity of people that you follow in your social media if you are active on it is definitely helpful to create something more normal.

It’s interesting with the body positivity movement, I think that’s related to what you were saying about following different people, different size bodies, different races, just in general a larger variety of people. What do you feel like is the biggest myth about the body positivity movement?

Sarah: There is just so many myths. I feel like we could probably do an entire show dedicated to just that. I had to think about this one which way I was going to go with this conversation. But I think the biggest one, and the most damaging one, and the pervasive of upholding the ideals in which we’re actually trying to undo within the body positive movement is the idea that body positivity glorifies obesity. I think that is one of the most prominent backlashes that I hear when I am speaking on body positivity or that you just see in general.

The thing that I want to say about this is first and foremost, obesity is a word that the healthcare system, which is extremely fat phobic, has made up on the standard of BMI. I don’t know if any of you have really undone any of the narrative around BMI, but it really is a load of bullshit. It’s not supposed to be used as a measurement of one single person. It really was historically supposed to be used to look at a greater population. On top of that, it has no indication on the basis of health.

When people are saying well you’re glorifying obesity, it really is basically saying a certain size, shape, or weight is bad because it automatically is an assumption that that body is unhealthy. With the body positive movement, first of all it’s not about health, so that’s another myth. It’s not about health. It’s about the liberation of bodies in general regardless of your health status to be in a place of respect, compassion, and kindness and you are deserving of that and worthy of that regardless of how close to this idea of health, which is also problematic in our society, you are.

With idea of glorifying obesity…okay, so we undid the idea of obesity, I think we can dive into that a little bit more, but just know that that is not a phrase that is appropriate. When we look at that, separate that out, then we can really look at the health component and understand that fat bodies can and are healthy. That isn’t saying that all fat bodies are healthy, but it is saying that we need really look at the narrative that we have been conditioned to believe around fat bodies. Fat bodies can and are healthy. That doesn’t mean that all fat bodies are, just like skinny or think bodies can be unhealthy.

The other thing is that body positivity absolutely does glorify fat bodies without a doubt. It glorifies all bodies. It glorifies and normalizes bodies that we are not traditionally seeing in our culture and our society. Non-abled bodies, trans bodies, fat bodies, different abilities, all that stuff. It really is a process of normalizing these bodies because we’re not seeing them. It really is glorifying them.

When we talk about glorifying this body, it really is about liberating people from body hate, diet culture, and fat phobia which is an oppressive component. When you think of the myth that body positivity glorifies obesity, that in of itself, that statement in and of itself is an oppressive statement because that’s upholding all of these fat phobic ideals. That in and of itself is just a complete myth.

On top of that, if someone is concerned about health, because that’s usually the story attached to that particular statement that well it’s just that I’m concerned about health, the way to be concerned about someone’s health is not to tell them that their body should not exist. It has been proven time and time again that if you’re really concerned about somebody’s health, doing it from a weight neutral perspective will get you much further in helping that individual actually have sustainable health measures that are not associated with weight. They will be able to participate in those behaviors more when it’s from a place of compassion, respect, and kindness.

On top of that, like I said before, fat bodies are not necessarily unhealthy. If we really want to talk about health, which I think is a conversation that isn’t being talked about enough, if we are really, truly concerned about health and the health of people in general, we need to make health be more accessible to people. We need to be talking about mental health and prioritizing mental health because it isn’t prioritized right now and it isn’t being talked bout. We need to talk about how we can make health be more accessible to other people that don’t have the resources or education to have it available? We need to talk about how can we help these individuals with their given situation because everybody’s situation is different based on class, based on education, based on just so many different factors. If we were really concerned about health, we really need to take it from a political and social component versus just on this basis that is out of fat phobia and oppression.

Laura: I feel like the whole “obesity epidemic” has really just changed the conversation around health to focus on weight so much. Like you said, two parts are really the biggest issue. One is that I would say the body acceptance and body positivity is not, like you said, it’s not specifically about whether somebody is healthy or not. It’s about them being able to not hate their bodies basically.

And then the other side of the coin is that like you said, the weight equaling health issues is something that a lot of people on social media are going to argue. If you’re showing people who are overweight, obese and yet they’re healthy, that doesn’t necessarily jive with a lot of people especially anyone who’s trying to sell a certain image as their product for health and fitness.

I definitely agree with you. I feel like body positivity doesn’t tell somebody that just don’t care about your body, or don’t take care of it because it doesn’t matter. It’s more don’t hate your body, don’t try to beat your body into submission to achieve a certain look that our society says is acceptable.

Sarah: On top of that, nobody is out there saying you should be fat. That is not what is happening. That’s really not what is happening. Fat people are just saying I have the right to exist in this world without oppressive constructs that upholding these ideals that are actually harming me, and preventing me from living my life fully, and prohibiting me from getting healthcare that I deserve. Because that’s a real issue when it comes to fat bodies and people of size is that they are, because of culture and our society, they really are not getting the healthcare that they deserve and it’s really problematic.

We have bigger issues to look at if we really want to care and uphold this concern card in our face. We have bigger things to talk about than just weight itself.

Laura: Definitely. When you’re working with clients who are struggling wtih body positivity or even I like to call it body neutrality where it’s almost that your thoughts are not just circling around your body all the time. It’s that you’re thinking about other things and your body is just kind of just this neutral experience. What do you find to be the hardest part of body acceptance for your clients when they first come to you?

Sarah: I work with so many people from so many different backgrounds and so many different histories with eating and body so everybody really is super different. But I think that one of the biggest things is just letting go of the thin ideal and working through their own internalized fat phobia which is very challenging because the thin ideal is upheld by our culture and our society and it’s literally going against the grain of everything that you hear, just like you said. Especially because it gets to the point where people can say okay, all bodies are good bodies, all bodies are worthy of respect, compassion, and kindness, but then we have wall that kind of gets thrown up where we have this health thing that gets in the way.

I think that’s another component that is really challenging to kind of undo, that narrative that health is completely within our control and that our weight, size, and shape is completely within our control, because it isn’t. Actually 95 percent of the individuals who go down the route of intentional weight loss end up gaining that weight back and then some of those and then some within five years.

I think it really is when we have to take a step back and look at the reality of the situation. You don’t even need statistics, or research, or data to help you through that. You can look at your own journey through dieting and intentional weight loss and see, has it been sustainable for you? If it has, great! Maybe you’re part of that 5 percent or maybe you’re finally at your set point which is something that is not within our control. But historically speaking, many people are bouncing from binge/restrict, binge/restrict and they’re outside of their set point or forcing themselves outside of their set point.

I think it is a matter of undoing so much stuff. But I think the biggest thing is letting go of the thin ideal, the idea that a smaller body equates to happiness, love, respect, worthiness, confidence, and all that stuff, that in order to live your life to the fullest and be fulfilled in your life, you have to be a certain way. That’s probably the number one thing. And the second thing would be undoing the health narrative that we have been conditioned to believe as well.

Laura: I always hear a lot of my clients who are struggling with this whenever they use the term fat, it’s almost like it’s an insult or it’s the worst thing that could ever happen to them is if their body gets fat or if they gain fat. It’s just really interesting to me because if you think about all the things that you could want to avoid in being a person in general, so you maybe want to avoid being mean, you want to avoid being greedy, or harmful to other people, things like that that are more of a moral issue potentially, I feel like fatness has kind of fallen into this morality problem where people say I can’t be fat because that’s bad and that makes me a bad person.

It sounds like that’s kind of one of the bigger issues that a lot of your clients are dealing with where they see fatness or having bodyfat as either indicating that they’re not a good person or it just changes their identity of themselves even though it’s actually not really related to their self-identity whatsoever.

Sarah: It comes back to the very first thing that we talked about which is the cultural narrative that we’ve conditioned to believe. I mean historically speaking, if you looked at the history of how bodies have been presented, it actually was the opposite where fat bodies were seen as more worthy. It’s all intertwined with class, and race, and sexism. It really is one of those things that we’ve all been taught

It’s problematic because just like you said, we have 54 percent of females that would rather be hit by a truck than be deemed fat. We have 54 percent of individuals that would much rather die, be seriously injured, or paralyzed than been seen or identified as fat. We have 81 percent of 10 years old that are afraid of being fat and some of those are actively dieting. I mean come on now! This is why we have to really look at this and how prevalent our beliefs are around fat and how damaging it is to people. It is very, very damaging. It’s a real, real fear and a real belief that needs to be undone and that’s what I help individuals do and that’s what I’m out doing now.

Laura: For those listeners who are identifying with some of these things that we’re talking about as far as having that negative thought about their body, feeling like they’re fat, feeling like they need to lose weight to be happy or even be comfortable…I hear that a lot with my clients that they say they just want to be comfortable in their body and that’s why they want to lose weight. To be fair, I understand if you are not eating foods that nourish you or if you’re not exercising at all, then yes, you can start to feel uncomfortable in your body and it can start to not feel good. But for most people, their weight is not going to directly impact how comfortable they feel in their body and it is really more about their mindset.

What are some practical ways that the women listening right now can feel more comfortable in their body without having to actually change their physical appearance?

Sarah: I think one of the first things, I kind of want to back up here, is that the statement I feel fat is just not real. I mean like I said, fat is not a synonym for I don’t feel loved, I don’t feel heard, I don’t feel like I belong, I don’t feel like I’m accepted, I feel overwhelmed, I feel stressed, I feel physical discomfort. If we really want to be talking about how to feel comfortable, we really to get behind what does that actually mean when you are trying to say that you feel fat?

I think that’s one thing is to be really honest with yourself because fat is by no means a feeling. I have a whole blog on that dedicated to how you can use that to kind of almost be a red flag to help guide you to what’s really going on because attacking your body oftentimes, actually I’m going to say all the time is not going to help you reduce those emotionally discomforts which is really happening. The underneath part is what’s really going on and we have been conditioned to just say, well I feel fat, which is just inappropriate. That’s not what we’re actually feeling. When we can be curious about what’s behind that, then we can address it. We can say okay, how can I start to feel like I’m accepted, or loved, or worthy? Maybe I need to go here.

The other topic of comfortable in your body, I completely understand. I think one of the biggest things is to distinguish between physical discomfort and emotional discomfort because physical discomfort is very easy to take care of. If you‘re in clothes that don’t fit your body, you’re going to feel physically uncomfortable. And then what’s going to happen? It’s going to just have all that inner critic within your mind just be amplified and you’re going to have all these emotions that pop up that are from everything that we have been taught. If you’re feeling physically uncomfortable, especially when it’s something that’s easily changeable like your clothes, or pain, or that you need rest, or whatever, those things are often times a little bit easier to navigate through.

But oftentimes what I see with the individuals that I work with is that it’s not that the physical discomfort that is more pressing. It actually is the emotional discomfort that is more problematic. Emotional discomfort is actually more powerful than physical discomfort. It’s important to understand what is the emotion that’s actually there and I think that still gets behind what does this mean then? What does it actually mean if you feel your rolls on your body, or you get out of breath, or you have difficulty with mobility, or you get winded going up the stairs, or your jeans aren’t fitting you, what does it actually mean?

It’s the story that we’ve attached to it that is the actual problem. If you have jeans that don’t fit, get better jeans. If you have difficulty going up the stairs, okay, maybe work on endurance. That doesn’t require you to change your body. You can work on those things from a very weight neutral, compassionate, loving manner and work through that physical discomfort. But it’s the connection, the story that we’ve attached to it. When you can get behind the story and be curious and work through that, then you can get to a more place of being comfortable. I actually just did a blog on that as well about distinguishing between the two. I think first and foremost is just having awareness. Is this physical discomfort, or is there emotional discomfort?

Laura: Definitely. With the physical discomfort, I think that’s an area that is so difficult to blend the idea of body positivity and then making changes to improve your health or how you feel. I think that can be a really tough area for people to kind of combine because most of the fitness and health related stuff on the internet or the kind of things that you’re going to be exposed to are going at it from a sense that you’re not good enough or you are not worthy enough until you accomplish this level of health or fitness. Whereas we’re trying to approach it from an area where it’s treating your body well and taking care of your body actually can be an act of self-love and it doesn’t require you to hate your body or to have negative thoughts to drive those behaviors.

When you’re working with people, I’m sure that you’re not telling them to just not care about what they eat, and to not care about moving their body, and to like you said glorify obesity or glorify unhealthy behaviors, but it is difficult to come at it from a self-love approach for a lot of people.

How can a woman love herself the way she is and still make changes in her diet and lifestyle so that she feels healthier? Like you were saying maybe it’s that she’s feeling winded walking up stairs and that’s uncomfortable for her. So how can you eat healthfully, exercise appropriately, live in the way that’s treating your body well and still experience that food freedom that you were talking about?

Sarah: When I first start talking with my clients, health is kind of on the back burner. When it comes to undoing all this stuff, you do have to put health on the back burner. We have to unlearn things before we can introduce health as an idea because we have to really detach weight and health. If you’re listening, one thing that I would suggest would be getting on board with Linda Bacon, Body Respect. That book is life changing and will help you kind of navigate through that.

But the one thing that I do is I tell them don’t worry about it, just eat whatever you feel like eating. You do go through a phase if you’re coming through restriction where you’re going to have to put health on the back burner and start to undo that narrative until you get to a place of actually having food be very neutral where it’s no longer looked in a dogmatic approach where it’s black and white, healthy vs. unhealthy because nobody can actually definitively define that. What I consider to be “physically healthy” for me maybe physically unhealthy to another person. We have to be able to respect ourselves and not be concerned with society’s idea of health, but what is actually good for us in this given situation.

We do have to kind of put health on the back burner for a moment and prioritize mental health. That really is if we’re talking about health, we’re prioritizing our mental wellbeing first and then we can consider physical wellbeing. Later on down the road, yes, you can absolutely start to participate in “healthful behaviors” from a place of compassion, respect, and kindness. That’s going to be when you start to take a neutral component where you’re not using shame, guilt, disrespect, and punishment, where you’re just doing it and saying okay this is how I want to treat my body. This is what feels good for me, this is a way of honoring my body.

We also need to know you don’t owe anybody this idea of health. It’s not a moral thing which I think is also prominent in our culture where health is kind of a moral issue. But it isn’t. Undoing the narrative first and putting health on the back burner, prioritizing mental health, and then later on down the road you can incorporate those things that make you feel good and you can consider your health. It oftentimes is easier and more sustainable in a more long lasting, compassionate way of doing it.

If you take a weight neutral component and you say how do I want to feel first of all, how is this helping me in my life? Because if you really think of it, health is supposed to add to our lives, it’s not supposed to take away. It’s supposed to help us add to our life and help us continue living the most radiant, amazing, badasss life that we want to. It’s what helps us keeping showing up. Expanding it to be a measure of self-care kind of an umbrella, like greying out just this dogmatic approach where we’re prioritizing not only physical health if that’s what we value, but also our mental, emotional, spiritual, psychological, and social health. Those all encompass who we are as a person.

It’s a process that kind of takes some time to go and approach it from health. But if the one thing I guess that I would say is to detach from the idea that weight equates to health and do it from a place of compassion, respect, and kindness. I think it really comes down to your intention behind it. How do you want to feel? What’s your intention and what’s the purpose in your life for this?

Laura: Awesome! We were talking a little bit about this concept of food freedom which you mention a lot in your website. I know that’s something that has been a little bit more prominent in my personal brand as well as this idea of being able to eat in a way that you feel good about regardless of whether that’s healthy versus unhealthy or health minded versus just enjoying food. There’s a lot of different reasons that people will choose what they’re eating. What does food freedom mean to you?

Sarah: The basis of it for me is that you don’t spend too much time thinking about food. You have other things to do in your life than worry about food. You’re eating in attunement with your body so you’re listening to your body’s cues versus a meal plan, or what you think you should eat, or specific calories. You’re eating what your body tells you that you want to eat and you’re stopping and honoring those cues of your body.

You are also not having guilt, shame, and rules associated with it because there are going to be moments where you eat when you’re not hungry. There are going to be moments where you’ll emotionally eat because it’s a very normal thing and it’s a matter of not having those things beat yourself up and go into that shame cycle which perpetuates the diet cycle.

Food freedom really just is an easy way to eat in the absence of shame, guilt, rules, and it’s a place of compassion, respect, and kindness. In all honesty, you don’t spend all that much time on it. It just becomes a thing in your life, but not like so prominent in your life. It just is food. Food becomes food, that’s it.

Laura: I always love when I’m working with someone and by the end of the time we’re done together they’re like the best thing that happened was that I’m not spending my evenings just reading nutrition blogs or listening to nutrition podcasts, which is kind of ironic because I’m like I’m putting myself out of business basically.

But that would really be the goal is that we get people to a point where they’re not really thinking about it anymore. Obviously you have to think about it in the sense that eating does require some level of thought, but it’s not something that’s on their mind all the time. They’re not researching health conditions, and diets, and exercise plans, and following people on social media that they are trying to copy their diet or get a perfect food plan, like you were saying. I think being able to get to a point where it’s just a very small component of your day to day mental space and to the point where you have to think about what to eat just to get some food into you, but you’re not just ruminating on it all day, all the time and that’s what you’re spending your free time doing as well too.

I think that’s really cool because again, Kelsey and I work with a lot of people that struggle with this and our goal is always to get them to the point where they kind of almost get on autopilot and they don’t have to think about it so much. It’s just they know what makes them feel good, they know what foods they like to eat, and it’s just easy for them to make these decisions.

I did want to talk a little bit about a topic that comes up all the time in the health world in the clients that I work with where people have sugar addiction, or I’m sorry, I should put that in quotes because I’m not sure when say the term sugar addiction, it’s kind of an interesting term. But what do you think about people having really bad sugar cravings, feeling like they’re addicted to sugar, or feeling that they’re addicted to food in general? I have people that will come to me and say I can’t eat sugar because I’m addicted to it and if I start eating it I just won’t stop. Where do you feel these addictions come from and do you think that sugar is something that can be addictive?

Sarah: I actually did an entire podcast, it’s an hour long conversation on this specifically. Its episode 17 of the Reclaiming You Podcast. It’s a big conversation nonetheless. I will preface this with saying I am by no means an expert. I’m not a researcher. I’m a medical professional, but I’m not a doctor and this is not my specialty, addition.

I was very curious about this myself because we do see it quite a bit. I come from a background where I felt the same thing. I was like something is seriously wrong with me. I have a food problem, specifically sugar because I can’t keep it around the house and then I binge on it. I thought what’s up? What’s up with all this? Because when people work with me they will often times see, no, I didn’t have a sugar addiction, it was just all this other stuff. I’m like, yeah.

This is my opinion, but I do not think sugar addiction is real. But there isn’t research to solidify it and there isn’t enough research to dismiss it. If you’re looking at it from a research basis, it still is kind of we threw it up in the air and we’re still trying to figure it out. But for me personally, I just can’t get behind it and there’s a few reasons why.

First of all when we’re talking about “food problems” and specially this issue when it comes to sugar, when people are saying I just can’t keep it around the house, there’s so many complex things that tie into this. Some of the questions that I am very curious about and even come to research too with the research data that is kind of looking at this topic is can we actually be addicted to the substance food which is something that we need to sustain and survive in this world? Or is there something else going on? That was one of the biggest things that I kind of wanted to look at.

What I do know though is that if you’re not eating enough, and specifically carbohydrates, your body is going to actively want, what? Probably sugar and carbohydrates. The reason why many of us crave sugar is because our bodies are freakin intelligent and they know that these hyper-palatable things are easily digestible. If you’re not eating enough carbohydrates in your diet in general, your body is probably going to want those foods.

If you’re restricting, you’re probably going to go to the other side where you end up eating or “binge eating.” This is very common with restriction. When we pull the pendulum back on one side which is restriction, and then we let up, so we let the pendulum go, we’re going to swing all the way over to the other side. This is a very, very normal component to letting go of the diet mentality is this swing that comes from restriction when we let go initially where we’re now eating and consuming things. But what happens is that we often feel guilt, shame about that stuff, right? The only thing that we know how to do to kind of help us feel “back in control” is to pull the pendulum back and start restricting again.

The one thing that we have to look at is the history of dieting and the history of restriction. If you’re actively restricting, and you’re actively dieting, and you’re not getting enough food in your diet in general, then the chances are you’re probably doing to be “bingeing” around these items. But when you look at restriction, it’s two parts. It’s not only the physical restriction, so not allowing yourself to physically have the food, but it also is emotional and mental restriction. A lot of people don’t know about that component of it. What that is, is that fear, it’s the guilt. It’s the oh my gosh, I messed up! Oh my God, I did something wrong because I did eat the whole box of cookies. If you would allow yourself some grace, compassion, and realize you didn’t do anything wrong, then chances are if you work through all that fear and that narrative, then you’re actually going to have a more, the pendulum is kind of going to find it’s center around “normal.”

When we talk about food addiction, some of the other things that I’m concerned about is we’re not looking at the difference between dependency and true addiction. Those are two very different components. Dependency, I’m dependent on caffeine. I am not addicted to it. There is a difference. Dependency is when your body physically does change and you’ll have symptoms. Can you have some dependency around sugar? Maybe. But the addiction component, I’m just a little iffy about that research.

When we look at the research around addiction in and of itself, Gabor Mate is a really prominent person when it comes to this and I have his TED Talk when he talks about addiction. When he specifically talks about addition, he’s talking about addiction as a whole. He really says that addiction, true addiction stems from trauma. It’s trauma, it’s not the substance, it’s behavior. We have to look at what is “addiction” doing? It is alleviating discomfort.

One of the things that I think is important to look at is not only the history of dieting, and restriction, and what we’re actually eating, and the mental restriction, but also how are we dealing and coping with emotional discomfort? Do we have trauma in or lives? Are we having shame around our body, and our food, and everything else?

The research really is looking at, when it looks at “food addiction” it’s looking at, who do you think? Larger size bodies, right. Of course it’s looking at people that are “obese.” There’s no doubt about it that people of larger size are dealing with stigma and shame in our culture which is a traumatic event. On top of that, we also know that 50 percent of women are dieting at any given moment. If we are going to look at food addiction and sugar addiction, we have to really be critical of the research and ask I think these questions.

But from my personal experience of people that I’ve worked with and my colleagues that are in this industry, what we have noticed is that when we undo the diet mentality and we allow ourselves full unconditional permission to eat food including sugar, that the idea of sugar addiction actually is not existent. It really was on the basis of restriction and emotional discomfort

Kelsey: I have to say that Laura and I,  as Laura mentioned, we work with a lot of people that are dealing with this “addiction” whether it’s to sugar or if they kind of feel like they are kind of addicted to food in any sense. I totally agree with that sentiment that it can be related to restriction because at least for me, that’s what I have seen time and time again with these clients that feel like they’re addicted to sugar, or food, or any one thing from their diet. It’s often because they are so focused on restricting some component of their diet whether that’s calories overall or like you said carbohydrates.

I love your example of it really swings them to the other side of the pendulum where they then end up kind of overdoing it and “binge eating” whether that’s sugar, or other types of carbohydrates, or whatever. But that is really, really common for me to see and I assume, Laura, you see the same thing.

Laura: Yeah. It’s funny because I feel like it can be the mental restriction side of things definitely, but then even just the physical restriction. I’ve mentioned a few times I did this fasting experiment with my church a couple of months ago and it was really funny because there was no morality associated with food that I was eating. It was more just an experiment to see how I can unhook myself emotionally or spiritually from food and just eating very plain plant based foods. But I think there was a level of physical, I was going to say malnourishment that kind of came up during that period of time that then started triggering sugar cravings in me. I was like what the heck? I haven’t had sugar cravings in so long and now all of a sudden a week into this vegan religious fast I’m starting to be like where’s the chocolate!

It’s just kind of funny because I think that concept of malnutrition in general and also just like if you’re not eating carbs that you’re going to crave sugar because like you said, your body is not stupid. When you’re malnourished, you’re going to start looking for the easiest source of nourishment.

Sarah: Right.

Laura: A lot of times that comes across to us as sugar cravings, but really it’s just your body wanting food.

I’m really glad that you mentioned the whole concept of trauma and addiction. Is it Gabor Mate? Is that how you pronounce his name?

Sarah: I think it’s Gabor Mate, one of those.

Laura: It’s funny because we actually used his work in our Paleo Rehab program for people with HPA axis dysregulation becuase we have a whole module on trauma. It’s a very basic overview like here’s some things that could be a problem, go work with someone if you think that’s you. I have his book which is called The Body Keeps The Score. Note: The Body Keeps The Score is written by Bessel van der Kolk.

We kind of used that as a little bit of a way to inform that module because at the end of the day I do think that there is a lot of emotional trauma that develops over people’s lives and then they start using food, and fitness, and control over those things as a way to try to deal with those emotions even though it’s obviously not very effective. I’m really glad that you brought that up.

Sarah: It’s a really complex topic. I literally did an entire hour long thing. I’m not saying that everything I’m saying is right because I think there’s still research out there looking at it. But I think as people, we need to be critical of the research and ask these questions if we really want to be making such a proclaim that food and sugar is addictive.

But what I’ve found too is that just a simple just eating enough food in general can do wonders with how individuals feel when it comes to this whole sugar addiction. And then like for me now, I mean as a self-proclaimed past “sugar addict” I have all sort of shit in my house and it’s fine and I forget about it. And that’s what oftentimes my clients end up having and experiencing as well. It’s pretty magical to see.

But I think that we throw it out especially in health industry and the fitness industry a little bit too much where it’s super problematic to say that somebody’s addicted to something when there isn’t enough research to even say that. It’s really, really problematic none the less.

Laura: I liked what you were saying about it being a physiological dependency potentially because if somebody is eating a very high sugar, refined carbs, low protein, low fat kind of diet, which a lot of people that are doing a normal western diet are eating that way, that can cause blood sugar dysregulation that will make you feel like want sugar when your blood sugar drops. But if you’re eating a pretty balanced, I say whole foods, but like kind of protein, carbs, and fat balanced diet and you’re getting all the different components that our bodies generally need to function, a lot of times the whole concept of sugar addiction is not even there anymore because your body’s not having these wild blood sugar swings because you’re trying survive on caffeine and sugar throughout the day as opposed to just eating a solid meal that contains all the different things that you need.

I do see that under eating or eating a not very well balanced diet either restricting certain things or generally just not eating the foods that the body needs to function is going to potentially lead to those symptoms of sugar dependency. But then once the diet if fairly balanced, it’s really not something that I see in a lot of my clients. At the end, I shouldn’t even say the end, usually the first thing that happens when people start eating enough, and eating all of the different components of the diet, and not restricting carbs, or restricting fat, the first thing that they say is I don’t feel like I’m obsessed with food anymore.

Sarah: Right.

Laura: It’s not just emotional. Certainly the emotional side of things is huge, but at the end of the day, if you’re body isn’t getting what it needs, it’s going to start making you obsessed with food.

Sarah: Yeah. I don’t know if you guys are familiar with the Minnesota Starvation Study at all or if you looked at that or have done any episodes on it. But this was a study done, I don’t remember, it was done way back many years ago because it would be completely unethical now.

Laura: Yeah, I think it was in the 40s.

Sarah: Yeah, it was completely unethical. But I mean they literally took people and put them into severe caloric restriction and it showed all these symptoms that we often associate things like agitation, preoccupation, physical manifestations, it’s all they could think about. They were kind of just acting weird. It truly does show the power of what happens when you’re not feeding yourself adequately like the grownass human that you are. It’s an interesting study to look at if you haven’t looked at it yet, just to your listeners if they haven’t looked at it.

Laura: I know Kelsey, I’m sure you’re familiar with it right?

Kelsey: Yeah.

Laura: I mean it’s one of things that I think when you’re deep into it with your career being a nutritionist, you’re aware of it, but there may be some people out there that aren’t. Like you said, it was not something that would probably be replicated in terms of the actual experiment.

Sarah: No.

Laura: But to be fair, there’s probably a lot of people doing some n=1 starvation studies right nowand experiencing the same kind of response that those, I think it was soldiers. I think they actually took soldiers…and it was funny because the starvation diet was 1,500 calories or something, so it was like still a lot more food than what some people out there are eating. I think that’s a really great study to look at. Like you said, it probably won’t ever be done again, but you certainly don’t want to be doing it in your own life.

Sarah: Yeah. The only thing that they’re looking at now are mice and unfortunately we’re not mice so we’re a little bit more complex. The biggest claim that comes up is well what about the study about the mice that decided to go towards the sugar water versus the cocaine? Then it was like it’s more addictive than cocaine! What they didn’t talk about is that when these mice were already predisposed to sugar and then they took it away. It’s almost you had them at a higher caloric intake and then you took it away, so of course they’re going to want it. On top of that your body physically needs sugar for energy and survival. It doesn’t need cocaine.

And then it also found that when these mice and these rodents were continuously allowed to eat sugar, that in the beginning they did have this high influx of wanting it all the time. But then when they were allotted sugar constantly, so like that unconditional permission that I talk about, it actually went back down and it normalized to where they didn’t want it. It’s just really interesting to kind of like I said just be critical of the data out there and not latch on to everything that everybody says.

Laura: Yeah, I love that. I feel like, like you said, this is a huge topic that we definitely want to send our listeners to your podcast on it because I think the sugar addiction and sugar cravings thing is so common in the Paleo community as being this horrible thing and that sugar is like you said worse than drugs basically.  I think that perspective on sugar being this evil thing that’s going to kill people is not only scientifically inaccurate but really damaging from just a mindset and food approach perspective.

Sarah: Yeah.

Laura: Even if it was something that wasn’t ideal to be eating a ton of, it doesn’t mean having some of it is going to kill you. It’s not an actual poison. It’s not arsenic or something, which to be fair is even, we do get a little bit of arsenic in our food all the time.

It’s one of those things that these narratives which I feel like sell really well for books and programs that help people break the sugar addiction and that kind of thing, it’s not necessarily something that’s actually helpful for a lot of people.

Sarah: I mean look at how they’re using it. What is it? It’s out of fear, right? It’s out of fear and insecurity. Nobody wants to die, nobody wants to be “unhealthy.” It’s a fear tactic. And it is, it’s a great selling point, but it only gets you so far.

Laura: Right.

Sarah: It really does. And it doesn’t feel good. We all know that. It doesn’t feel good to start a process or a journey out of disrespect and hate. If you think that’s what’s going to help you have any type of freedom or acceptance, then no, that’s not how it works.

Laura: Yeah. Cool. Well, is there anything that you feel like you want to share with our listeners or are there any particular places that you want us to send them so that they can learn more about these really important topic?

Sarah: I would just say that come on my website, check out many of the blogs that I have. I have a free community on Facebook that is dedicated to anti-dieting, and body positivity, and health at every size. You can get that link in my e-book that I have. Check out my podcast because I have a lot of guests on there and like I said, this conversation around sugar addiction, and we talk about perfection. There’s just a lot of stuff. I am very prominent on Instagram obviously. You can follow me there where I just have little tidbits that I throw out here and there about all this stuff that I am talking about.

At the end of the day, if I could say one thing it’s just to have your listeners know that their worth is not on the basis of their appearance. It really is inherent from who they are and knowing that who they are is enough. You can get to a place of peace around food, body, and even movement if that’s what you really want. You don’t have to buy into everything that our society has taught you.

Laura: Awesome! We’ve really appreciate your time and your expertise on this topic, Sarah. It’s awesome that you’ve been through it yourself so you have the compassion and empathy for this experience. But you also clearly know a lot about not only the science but just the practicalities of getting out of this situation.

Were so glad that you were on the show with us today! Everyone, if you want to check Sarah’s work out, it’s SarahVance.com. Sarah is spelled with an “h,” SarahVance.com. We’ll also link to her website, her social media pages, and some of those podcast topics that she mentioned in the show notes for this podcast episode over at TheAncestraRDs.com, episode 109. Well thanks for joining us everybody and we will see you here next week! Thanks again, Sarah!

Sarah: Thank you.

PODCAST: Low Hemoglobin: Potential Causes And Dietary Treatment

Thanks for joining us for episode 108 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering following question from a listener:

“I recently found out I have low-ish hemoglobin within normal values but on the low end. I talked with my doctor and it’s probably due to my rather heavy periods. I already eat a moderate amount of red meat, apparently it is the best source. Can I safely increase my consumption of red meat or would it be better to take iron supplements?”

When finding low hemoglobin levels, generally the first line of defense is to reach for an iron supplement. But did you know that there are other factors beyond iron deficiency that can contribute to low hemoglobin?

Today we’ll be discussing various factors that can contribute to low hemoglobin and sharing how to increase your intake of iron from food when iron deficiency is the true culprit.  We also delve into the safety of red meat consumption and share which foods and nutrients affect the absorption of iron.

Here’s what Laura and Kelsey will be discussing in this episode:

  • The safety of red meat consumption
  • Reference ranges for functionally low hemoglobin
  • Definition of hemoglobin and its function in the body
  • Symptoms of low hemoglobin
  • Health conditions that can contribute to low hemoglobin levels
  • Nutrient imbalances that can contribute to low hemoglobin
  • Iron deficiency as a cause of low hemoglobin
  • The role of gastrointestinal malabsorption in iron deficiency
  • Foods and nutrients that hinder the absorption of iron
  • Why eating liver is preferred over iron supplementation
  • The effect of inflammation on hemoglobin levels
  • The importance of getting ferritin levels checked along with iron
  • Dietary sources of heme and non-heme iron
  • How vitamin C can improve the bioavailability of non-heme iron
  • Recommended types of iron supplements

Links Discussed:

TRANSCRIPT:

Laura: Hi everyone! Welcome to episode 108 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is my cohost Kelsey Kinney.

Kelsey: Hey everyone!

Laura: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Laura, atLauraSchoenfeldRD.com, and Kelsey over at KelseyKinney.com.

Over the next 30 to 45 minutes we’ll be answering your questions about health and nutrition, and providing our insight into solving your health challenges with practical tips and real food. Stick around until the end of the show when we’ll be sharing updates about our businesses and personal lives.

Kelsey: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re there, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer on an upcoming show.

Laura: Today on the show we’re going to be discussing what to do if you have low hemoglobin levels including further testing and dietary treatment. But before we get into our question for the day, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com

Laura:Welcome back everyone! Here’s our question for today’s show:

“I recently found out I have low-ish hemoglobin within normal values but on the low end. I talked with my doctor and it’s probably due to my rather heavy periods. I already eat a moderate amount of red meat. Apparently it is the best source. Can I safely increase my consumption of red meat or would it be better to take iron supplements?”

Laura:There’s a couple of different things that we want to cover in this question. There was something I was going to save until later, but I actually feel like I want to cover it first because I think it’s important that we deal with this wording of the question.

This person obviously is a menstruating female. We don’t know her age, but we can guess that she’s in her 20s to 40s. I mean certainly she can be younger than that, but most of our listeners are not teenagers. When she says can I safely increase my consumption of red meat, to me that indicates a level of fear around red meat as a food and its health effects.

Anytime somebody asks if they can safely do something, you’re assuming that there’s a level that it’s then unsafe. For this person, it sounds like she feels a certain amount of red meat intake would then be unsafe. I have noticed in a lot of my clients, and Kelsey, I would assume you have to, that there does tend to be a lot of fear around red meat in general especially people in the 20s to 40s range. Well, I’d say older than that too.

Kelsey:Yeah.

Laura:But anyone who grew up with the food pyramid and the little triangle at the top that’s like eat sparingly red meat and stuff like that because it’s bad for you. It’s just this kind of insidious belief that red meat is unhealthy. There is this underlying concern about red meat that I don’t necessarily think is warranted. I would be curious to know what this person is afraid of if she does eat “too much” red meat.

There are some thoughts that excessive red meat would cause heart disease, cancer, inflammation, lots of different types of chronic disease. I know sometimes there’s been studies that are like “too much red meat causes diabetes,” which I think is just total BS.

There’s a lot of these correlative studies where they look at populations, red meat consumption, and then they correlate it with different conditions. Sometimes it’ll show an increased risk of certain long term conditions. However, that is not enough information to actually suggest that red meat is unhealthy to eat in high quantities.

The other question is even if it was unhealthy for certain populations to overeat on red meat, which there definitely are some that shouldn’t be overeating on red meat, that doesn’t mean that this young menstruating woman is one of those people that is actually at any sort of elevated risk for health issues.

I’m not going to go into a ton of detail about who would benefit from lowering their red meat consumption and who shouldn’t worry about it at all. There’s an article round-up kind of thing and a podcast on Chris Kresser’s website that we’ll link to in the show notes. One is a report on red meat called “The Truth About Red Meat” that kind of goes into details about different articles that explain why or why not red meat is a problem, what these reports are really showing when they do these reviews of population data. That’s a really great resource.

And then Chris also has a podcast on red meat called “Does Red Meat Increase Your Risk of Death?” If you’re thinking about safely eating red meat and there’s a concern that eating too much red meat will kill you, that would be a good podcast to listen to. Like I said, there may be some people could benefit from a lower red meat intake and maybe at some point we’ll do a show on who those people are, but a young woman with heavy periods and low hemoglobin probably isn’t one of those people.

Kelsey:Right.

Laura:Anything to add there, Kelsey?

Kelsey:Yeah, I just agree. I think people get very concerned about this idea that red meat can be harmful to their health, but I think it’s really important to remember that there’s distinct differences between different types of populations and how they are going to respond to red meat. Like you said, a young menstruating female who is at risk of iron deficiency, she’s not somebody we’re going to be worrying about typically.

Laura:Once we’ve kind of moved past the question about safely increasing red meat consumption, I think we should talk about first of all when we’re looking at hemoglobin and low hemoglobin as being a problem, first we want to know what symptoms or what issues can low hemoglobin cause and then also what could be actually contributing to low hemoglobin beyond just iron deficiency. Because I think iron deficiency is definitely cause in the general population, but for somebody who is eating a pretty healthy diet, eating iron rich foods like red meat, it may not be that their iron is too low. We want to talk about the different nutrients that can contribute to low hemoglobin so that way they’re not just over focusing on iron and not thinking about what else can be contributing.

The person who asked this person didn’t give us an exact number of her hemoglobin, but it’s possible that her levels, even though they’re in the normal range, that they would actually be considered functionally low. Functionally low just means within the reference range but possibly low enough to cause suboptimal functioning or symptoms.

The laboratory reference range typically is for men and women is between 12.6 to 17.7 grams per deciliter. That does depend on the lab. Some labs do give sex different ranges, but that’s kind of the general range that listed. For functional reference ranges, men would be between 14 to 15 grams per deciliter and women would be 13.5 to 14.5 grams per deciliter. If a woman, say this girl has 13.0 grams per deciliter as her hemoglobin, even though that’s within the reference range, it is functionally low and could cause some problems. If you’re checking your hemoglobin and you’re a woman and it’s below 13.5, you may want to make some of the adjustments that we’re discussing today.

If you don’t know what hemoglobin is, just to give you a very brief overview, hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs. Basically when you breathe in oxygen, oxygen gets into your bloodstream, the hemoglobin is what attaches to that oxygen and then delivers it to the rest of the body, and then it exchanges that oxygen for carbon dioxide when the tissues have used it, and then it brings it back to the lungs for exhalation.

Hemoglobin is made up of four protein molecules that are called globulin chains that are connected together. Each of those globulin chains contains an iron containing porphyrin compound called heme. That’s why it’s called hemoglobin. Heme is what contains the iron and that iron atom is crucial transporting oxygen and carbon dioxide in the blood. The iron contained in the hemoglobin is actually what’s responsible for the blood’s red color. Hemoglobin is basically the molecule that carries the oxygen and the carbon dioxide between the tissues and the lungs.

Hemoglobin also plays an important role in the shape of the red blood cells. If you are low or high in hemoglobin it can affect the kind of donut shape of the red blood cells and make it harder for those to carry the gasses that they’re supposed to carry.

When you do have low hemoglobin it’s typically one of the major forms of anemia and it can cause symptoms like general fatigue, weakness, pale skin, shortness of breath, dizziness, cravings for things that aren’t food – so things like dirt, ice, or clay – a tingling feeling in the legs, swelling of the tongue or sore tongue, cold hands and feet, fast or irregular heartbeat, brittle nails, headache, and the list goes on.

But those are some of the more common symptoms, which is interesting because I think a lot of things can cause any of these symptoms. But if you are having a bunch of them and then you also get your hemoglobin checked and it’s low, I think fixing your hemoglobin levels is a good place to start with those.

There is a good amount of information about iron in general in Chris Kresser’s training program for practitioners called The Kresser Institute. I think the reason that it has a lot of stuff on iron is because Chris has done a lot of stuff on iron overload in the past, but he does have some information in there about iron deficiency and low hemoglobin.

Low hemoglobin can be caused by iron deficiency but it can also be caused by just normal pregnancy. Having a drop in hemoglobin is common in pregnancy. There are certain nutrient imbalances that we’ll talk about that can lead to low hemoglobin that are not just iron. Lead poisoning, which I don’t think is super common, but certainly if you were exposed to lead, that could cause low hemoglobin. Something called ineffective erythropoiesis, which just means that you’re not creating red blood cells and that then lowers your hemoglobin levels. Hemolytic anemia, hypothyroidism, chronic kidney disease, liver disease, chronic inflammation, certain bone marrow disorders, porphyria, and I forget exactly what that is. But there’s vasculitis, hypopituitarism, hypergonadism, and certain drugs.

As you can see, lots of different things can cause low hemoglobin. We’re not going to talk about all of these because some of these are outside of the scope of a podcast, but there are some nutrient imbalances and other issues that can contribute that we will talk about. With the more common causes of low hemoglobin, I do think that that nutrient imbalance issue tends to be one of the more common things.

Again, iron deficiency can definitely be a cause. It’s probably one of the more common causes in the general population that doesn’t eat red meat, or is vegetarian, or isn’t eating a very healthy diet, or eats a lot of grains and things that might block the absorption of iron.

Kelsey:This woman it sounds like maybe because she’s scared of red meat, I would guess she’s probably not eating a whole lot of it right now.

Laura:Yeah. I mean moderate is kind of vague. Moderate can be once a day or moderate can be once a week. I don’t know what she means by moderate, but I think most people think eating red meat more than three times a week is dangerous. That’s generally the number I tend to see. Then there’s people in the Paleo community that eat it every day. It’s one of those things that everyone is going to have their own interpretation of what moderate is. But if you’re not eating it at least three to five times a week, I would say that’s a low intake of red meat.

Red meat isn’t the only thing that contains iron. There is iron in other meats, and shellfish, and some plant foods. But it’s not very well absorbed from plant foods, which is why meat tends to be a better source of it. But if you’re iron deficient, usually that is going to come from an inadequate dietary intake which we were just talking about. There could be some gastrointestinal malabsorption which is super common especially in people with celiac disease.

Kelsey:Yeah.

Laura:If you have undiagnosed celiac and you’re eating gluten even occasionally, that can cause inflammation of the gut lining and then you’re not going to be absorbing any minerals very well. Iron is definitely one of the more common ones that you don’t absorb.

That’s not the only thing that can cause GI malabsorption. You can also have things like IBD, like Chron’s or ulcerative colitis that make it harder for your body to absorb that iron, or just IBS, or gut dysbiosis, that kind thing. And then especially with people with ulcerative colitis with general bleeding in the gut, so blood loss if you’re getting blood in your stool, you might be losing iron that way. Or if you have a heavy period, that’s another place that people tend to lose a lot of blood for obvious reasons. But it’s more blood than what would be normally lost during the menstrual cycle if you have a heavy period. That’s three more typical causes of iron deficiency. Kelsey, are there any that I missed?

Kelsey:No, I mean not that I know of. But I would just say for the GI stuff in particular, if you have any degree of gastrointestinal symptoms like even if it’s just bloating or excessive gas, it’s something that you really think a lot about, but you having really any type of nutrient imbalance or deficiency that you’re seeing, I would definitely get checked, do a full workup really for gut issues. Being tested for celiac disease, taking a stool test, maybe doing a SIBO test as well, just covering your bases to make sure that there is nothing that is impeding absorption of these nutrients. Honestly I think it’s more common than people think. They feel like they have to have some major issues gastrointestinally to prevent the absorption of nutrients, but I don’t think it has to be horrible for people to not be absorbing their nutrients as well as they could.

Laura:Right. I think if you combine mild malabsorption with lightly low dietary intake, it’s kind of like a perfect storm for having deficiency of certain nutrients. It’s not like you have to be vegan or have an insane parasite or something to have iron deficiency. Now certainly that will make it a lot lower. You’re probably going to see actually clinical low hemoglobin, but there’s a lot of things that can affect your absorption and intake of iron in general.

Don’t think that just because you eat a Paleo diet and you eat red meat a few times a week that you’re covered. There are some ways that you may be not getting as much as you think you are.

Kelsey:Right.

Laura:Some of that can just be from eating too many foods that are going to impact absorption of iron. If you’re not eating a lot of iron rich foods, you eat a ton of plant foods, a lot of that iron that you’d be getting from the plant foods you may not be absorbing. You think you’re getting a lot of iron potentially, but then you’re not if you’re eating lots of high antinutrient content foods, which unfortunately most plant foods except for fruits and starchy vegetables tend to be high in antinutrients.

Kelsey:Yeah.

Laura:And then the other nutrient imbalances that tend to be an issue would be most of the B vitamins in particular folate, B6, and B12. If you’re deficient in any of those, that can cause low hemoglobin.

The other mineral that can be lead to low hemoglobin is copper. Copper is one of those nutrients that a lot of people worry about getting too much copper, but you could potentially be getting not enough copper in your diet and that would cause some low hemoglobin as well.

Those nutrient imbalances are really the main ones that are going to contribute to low hemoglobin. I think it’s important here to note that the easiest dietary source of all of these nutrients, so all three of those B vitamins, iron, and copper, is liver. For anyone who does have low hemoglobin, or iron deficiency anemia, or any kind of anemia really, they should try to be eating at least 4 ounces of liver per week on top of other iron rich foods.

If you’re eating red meat, that’s great, but you might want to get something that’s a little bit stronger in those nutrients and going to be a lot higher dose of those things that we need a lot of. Four ounces of liver a week is not a ton. I mean I hate, well I shouldn’t say hate. It’s a strong word. I am not a big fan of liver.

Kelsey:I hate liver.

Laura:It’s not easy necessarily to get that in, and if you can’t eat it, there’s other things you can do like supplements or liver shots or whatever. I can link to an article that I’ve written called “Hate Liver? Eat it Anyway With These Tips.” I think that would be helpful for people to check out if you are afraid or you hate liver and don’t want to eat it.

But this would be where I would start with someone if they are potentially either iron deficient or just worried about nutrient deficiencies in general. I’d much rather see someone either eat liver or use desiccated liver supplements as opposed to going straight into those high dose iron supplementation recommendations that a lot of doctors will recommend.

High dose iron is potentially constipating which is not comfortable for a lot of people. And if you already have a GI issue, that’s really not going to be helpful. And the question is, is having a high dose of a super easily digested iron source actually safe in the long term?

Kelsey:Right.

Laura:If people are worried about eating red meat, I would be more concerned about taking tons of iron over the long run. You’re not necessarily getting those other nutrients that help you use that iron appropriately. That’s why I think liver tends to be a better option than doing an iron supplement.

Kelsey:Just to note on those iron supplements too, you might see some out there that say that they’re non constipating, but I will tell you that I’ve had so many clients try to take iron supplements that claim that and for most people it’s actually not true. They still get even if it’s a little bit less constipated, it’s still enough. You guys know that I work with digestive clients for the most part, so for people with constipation, even if it’s less constipating, it’s enough usually that it’s going to be a problem.

Laura:Yeah. To be fair, the dose will affect how much of a problem that is. If you’re taking a 10 milligram iron supplement, that’s going to be way different than…I think saw a client that was using like 70 milligrams at one point.

Kelsey:Gosh!

Laura:That amount is going to definitely impact your constipation.

Kelsey:Yeah.

Laura:If you do need some iron, we’re not anti iron supplementation 100%. I want to be clear about that. Some people will need some iron supplementation if their iron is very low. But I think a liver supplement is definitely a better way to start. Really if somebody is super low in iron, normally they’re going to get an infusion anyway. They’re not just going to use pills because you’re not going to get as much of a quick benefit from that.

Whenever I see somebody on a super high dose iron supplement, I do wonder not only what impact that has on their body over the long run from an inflammatory state, but also iron feeds pathogens.

Kelsey:Right.

Laura:If you’re doing a ton of supplemental iron, that could potentially be contributing to a gut infection. Getting down a bit of a rabbit trail right now, but there’s a lot of things to think about.

Kelsey:There is.

Laura:You don’t want to just be taking a ton of iron supplementation because you have low hemoglobin when it may not even be related to iron. Again, there is a couple of other things, like the ineffective erythropoiesis is usually genetic. I think sometimes exercise and oxygen exposure can affect your erythropoiesis. If you’re in a low oxygen environment, I think that actually ups your erythropoiesis. That’s why people that train for marathons often train in high altitude areas. But most of the time erythropoiesis is related to genetic issues. You’re not really going to be in a state where you’re not getting enough erythropoiesis because you’re getting too much oxygen or something like that.

And then hypothyroidism can definitely be a problem. Iron deficiency can actually contribute to hypothyroidism, and then the enzyme called thyroid peroxidase is dependent on iron. So that can be something that either if you have any sort of hypothyroidism issues or if you are not getting enough iron in your diet, that can contribute to hypothyroidism, and then that can reduce your hemoglobin production. It’s kind of like a roundabout way of getting iron deficiency causing low hemoglobin, but it could just be that you have a thyroid issue and your thyroid hormone is not high enough.

And then chronic inflammation, again tends to be a much more common reason for people to have low hemoglobin. There is something called anemia of chronic disease and it’s pretty common with a lot the inflammatory conditions like some kind of malignancy or cancer, autoimmune disease, inflammatory bowel disease, any sort of chronic immune activation, metabolic syndrome. Any time there’s going to be a lot of inflammation going on, there’s going to potentially some anemia.

If you are having any sort of elevation of C reactive protein or any other inflammatory markers, what happens is your body starts to store iron and ferritin. So you can have high levels of ferritin, but then it starts to decrease iron absorption to try to prevent iron from being available to pathogens. Like we said, iron can feed bacteria and if you have a chronic infection, your body may start to try to keep that iron away from pathogens which can then lower hemoglobin.

Again, if you’re under a lot of inflammation or oxidative stress, that can increase ferritin production which is shuttling a lot of the iron into ferritin as opposed to hemoglobin. Most of the time if you’re getting your iron checked, you should also be checking your ferritin as well because there’s a big difference between iron deficiency low hemoglobin and chronic disease and chronic inflammation causing a shift from hemoglobin to ferritin. You definitely want to get your ferritin checked as well.

And then if you are interested in learning more about how chronic inflammation and iron storage issues can affect your hemoglobin, we would strongly recommend checking out a podcast by Chris Masterjohn called “Why You Need To Manage Your Iron Status And How To Do It.” He has a lot of information about not only what to look for when you’re testing your iron levels, but also what causes high or low iron status, and then how to fix that if you do have a problem. That’s going to give you way more information about this than what we just talked about, but I just wanted people to be aware of the fact that having low hemoglobin isn’t always indicate low iron intake. It could just be that your body is pushing iron into different areas to prevent more oxidative stress, or more inflammation, or overgrowth of pathogens.

Kelsey:Right. And that’s why I think it’s really important that whoever you’re working with, whether that’s your doctor or a different healthcare practitioner, that they’re really thinking about all the underlying reasons why you might come back with a functionally low hemoglobin level or even a truly low hemoglobin level.

I recommend not just looking at hemoglobin itself. Like Laura was just saying, you should definitely at the very least be looking at your ferritin as well, but I would say a full iron panel would be a great idea. That includes things like hemoglobin, ferritin, total iron binding capacity, unsaturated iron binding capacity, iron saturation. That would also cover if you’re on the other end of the spectrum too. If you are prone to iron overload as well. That would kind of check out that side of things too.

But the point is you really need to think about what could be causing this because if it’s due to heavy periods, then fine, you can just work on increasing your levels of absorption and eating more iron in general. But if it’s due to something like a lot of oxidative stress, or a lot of inflammation like Laura was just talking about, just eating more iron in your diet and focusing on better absorption, it could be counterproductive even.

That’s why you really need to make sure that you’re healthcare practitioner is thinking about this stuff because they may just assume that you’re not getting enough iron. A lot of practitioners or doctors who don’t really dive into it, they may just write off the bat recommend an iron supplement rather than even thinking about this stuff. At the very least, you want to ask for a full iron panel. And then as Laura was talking about before too, there are other nutrient imbalances that can lead to low hemoglobin. You want to be taking a look at those as well.

Chris, in his podcast that Laura just mentioned, talks a lot about this stuff as well. Again, just a reminder if you want to dive deeper into this stuff, he has a really excellent podcast on the topic and it’s just more complex than we can get into here and he overviews it very, very well.

Now of course like I said, if your low hemoglobin is simply due to heavy periods, then you do want to focus on increasing your iron consumption and your absorption of that iron. Laura had mentioned previously that there are different types of iron. There’s heme iron and non heme iron. Heme iron is in animal products and non-heme iron is in both animal and plants. But it’s the only type that’s found in plant food. You can’t get heme iron from plant foods.

What we’ve seen in the research and just how the body works is that heme iron is much better absorbed than non-heme iron. Liver, as Laura said, is a great option, clams are actually a really great source of heme iron, and of course the infamous red meat that this person is a little bit worried about. Those are the greatest things that you can include in your diet to be getting a lot of iron overtime and as you’re eating every single day and making sure you’re getting a lot more than this person maybe is getting currently. Because like I said before, I think it sounds to me even though she says moderate, just the language she’s using, and again we don’t know this person or haven’t talked to her and seen her dietary intake, but I would guess that’s she would probably be eating a low amount of red meat in my eyes. I probably wouldn’t consider it moderate. But again, we don’t know her.

The best sources of non-heme iron are things like legumes, greens, seaweed, and potatoes. Because this person’s iron levels aren’t super low theoretically, she’s just got functionally low levels of hemoglobin,  so let’s just say we’re assuming for the sake of this podcast right now that it is truly just due to heavy periods and not getting enough iron. She definitely needs to make sure that she’s getting at least a couple servings of clams, liver, and red meat on a regular basis.

Laura mentioned before the four ounces of liver per week. I’d say, yeah, four to six ounces of liver per week would be great. And then on top of that, it’s hard to say because of course we don’t know exactly how low her hemoglobin level is, but I would say at least three servings of red meat and maybe a serving of clams per week. Or she could swap out the clams for maybe another serving or two of red meat if she didn’t want to eat that regularly. But essentially getting up there in the red meat consumption somewhere between at least half your day’s of red meat and then if she’s not eating clams every week, maybe adding another two or three servings. That’s almost a daily intake of red meat at that point in addition to the liver.

That’s going to of course depend on her actual absorption of it too. Like we talking about before, gastrointestinal issues could certainly play a role in preventing her from absorbing it well. If she was my client, I would definitely look into any signs of GI issues and do some testing in relation to those symptoms to make sure that she’s absorbing things well. Because if she’s not, then we’re going to want to clear up any GI issues so that she’s absorbing better, potentially right now as she’s dealing with that stuff, give her even more iron so that hopefully she can get a little bit more out of it in terms of her absorption.

The other piece of this too is just improving absorption of iron in general. There are some things that you can do just from a food combination standpoint that can make your absorption a bit better. One of the things you can do is try to eat your iron rich foods away from calcium rich foods because calcium locks iron absorption essentially. Let’s say you’re somebody who tolerates dairy, you eat dairy on a regular basis, if you’re going to eat a serving of liver, you probably want to not eat dairy with that meal because again, that calcium contained in the dairy is going to block the absorption of iron. You just won’t get as much out of eating that liver. If you’re working hard because you don’t really like liver in the first place to get really get that into your diet, it’s just going to not give you as much benefit if you’re eating it with dairy.

As Laura mentioned previously too, she was talking about the fact that iron absorption is blocked by things that are called antinutrients in plant matter. These include things like polyphenols and phytates. If you are trying to get a lot of your iron intake from fruits and vegetables, you’re going to have a little bit more trouble because these things, the polyphenols, phytates, all these kind of antinutrients that are contained in plant foods are going to inhibit your non-heme iron absorption.

But what you can do to help this a little bit is to add vitamin C which improves the bioavailability of non-heme iron in the presence of those antinutrients. You want to supplement with vitamin C to help increase your absorption of iron from fruits and vegetables. You don’t necessarily even have to supplement I would say, but you could also just think about combining high vitamin C foods with high iron foods. That would be something to consider. But if you really wanted to get the most bang for your buck, I’d say a vitamin C supplement is certainly not a bad idea.

Laura:That’s only with plant iron.

Kelsey:Exactly.

Laura:That won’t affect if somebody has liver and they want to have orange juice with it, it’s not going to increase their absorption of the liver.

Kelsey:Exactly, yeah. It’s really going to help you if you want to increase your iron absorption from plant foods in general, but I would say it’s especially important if you are trying to get most or even half of your iron from eating a lot of plant foods. It can be useful, but if you’re planning on getting on the majority of your iron from heme sources which are the animal sources, you don’t need to worry about that quite as much.

One thing Chris Masterjohn talks about in his podcast, so I won’t go too much into detail with it here but I do want to mention it, is that Nrf-2 stimulating supplements can help to inhibit your ability to heal from anemia as well. That includes things like milk thistle and green tea extract. If you’re taking supplements that are meant to stimulate Nrf-2, you’re certainly not helping the situation if you do have anemia. I would recommend that if you are interested learning more about that that you definitely listen to Chris’ podcast. Of course he dives into the whole pathways and everything that make this an issue. So if you want to learn the why behind that, definitely take a listen to that.

We were talking about supplements before, so I do want to come back to that because like we said, we’re not opposed to supplements whatsoever. There are definitely some people who need them and who would benefit from them if they are iron deficient. They can be useful. Like I said before, the one thing to consider if you have GI issues, especially if you have constipation, is that they do tend to be constipating even if they are not supposed to make you constipated. When you take them in smaller amounts it’s typically not a huge deal, but I’ve certainly had clients who even in the lower doses for a seemingly non-constipating supplement, they still have issues. I would just be careful with that if you suffer from constipation in any degree.

This is also something Chris mentioned in his podcast, he says that, Chris Kresser has a few supplements that he recommends. One of them is Iron Smart Liposomal Iron. The other is Proferrin ES Heme Iron. If you’d like to take an iron supplement, you can check out either of those. They are some of the better supplements on the market when it comes to iron supplements because there’s a lot of really bad iron supplements out there. Mostly it’s because they are constipating, and they’re not using the right forms, they’re probably not well absorbed as what Chris is mentioning here.

If you need to take a supplement or if you have been recommended a supplement, definitely take a look at it. It should say that it’s hopefully non-constipating. It should have some good forms of iron. You can see from the ones that Chris recommends, one of them is a heme iron and one of them is a liposomal iron. You can just tell right off the bat just from those names that they’re going to be better absorbed than probably most typical iron supplements.

Just be careful with your iron supplementation. I would say a lot of the times because when doctors are recommending iron supplements, they’re typically not the greatest at least from what I see from my clients. I don’t know, Laura, if you see the same thing when they get a recommendation from their doctor, and honestly sometimes a pretty high dose, it’s not a great form. I would imagine it’s going to be pretty constipating. I would at least ask about these other options with your doctor. Say you’ve heard about these two other options, would they be willing to let you do that.

Of course as we said before, if you have really low iron oftentimes you’re actually going to get an infusion to help bring up your iron levels rather than supplementation because that can take a lot longer.

I personally like to recommend food sources over supplements whenever I can. Like Laura said before, even if you have to go to a liver supplement prior to jumping on board with an iron supplement, that can be a really great idea as well.

Laura:I feel like we covered this pretty well. And again, Chris Masterjohn’s podcast is way, way more detailed about this. If you are interested in learning more, we would definitely recommend going to his website which is ChrisMasterjohnPhD.com I believe. We’ll link to that in the show notes so again if you wanted to get a much more detailed look into this topic, that’s where you want to go.

But hopefully this gave everyone a good overview and gave you some food for thought if you have any issues with anemia, a low hemoglobin level, or anything like that. Of course if you have high iron, this is going to be something that doesn’t apply to you and you may be one of those people that wants to limit red meat or things like liver. Again, Chris covers that in his podcast. Definitely go check it out if you have any questions about iron status. But anyway, up next is our updates!

Kelsey:Welcome to the update section! Like we’ve been talking about in our previous episodes or last couple episodes, we are trying this out. Again just as a reminder, if you guys have any strong opinions on whether or not you like our updates at the end or at the beginning, let us know. You can leave a comment, you can write to us on the contact tab on our website TheAncestralRDs.com. But we always love to hear from you and we’d especially love to hear from you in regards to what you guys prefer. With that, Laura, what’s going on with you?

Laura:Well, I know everyone’s totally tired hearing about my wedding.

Kelsey:Maybe they’re not. Maybe they love it.

Laura:I don’t know. Some people I’m sure are sick of it. I know sometimes I’m sick of it, so I wouldn’t blame you if you’re sick of it. But just based on when this podcast is scheduled to publish, this will actually be my last episode as a non-married person.

Kelsey:Ahh! Crazy!

Laura:I know, it’s weird. It’s far enough in advance that doesn’t feel like it’s that close to when we’re actually recording it, but now that my schedule has been creeping into June, I’m just like oh my gosh! I actually have to make my schedule fit around my wedding and my honeymoon.

It’s kind of like a weird very surreal thing because it’s still several weeks away at this point. But it’s definitely exciting and I’m sure if you guys follow me on social media, you’ll be seeing stuff about it over the last it seems like a million years, but over the last couple of weeks just as far as getting ready for it, and how soon it’s coming up, and being excited.

Kelsey:What are you working on right now? Where are you at currently?

Laura:I’m getting close to paying. I’ve put deposits on everything so now paying for everything is going to be coming up.

Kelsey:Fun.

Laura:I did have my first dress fitting after they’ve done some alterations this past weekend, so that was definitely more enjoyable than I expected. I feel like both the dress shopping experience and this try on experience were better than I was expecting.

Kelsey:That’s good.

Laura:I personally, I hate trying on clothes because most of the time they don’t fit me very well. But there’s something nice about…like I feel like my physique is definitely more dress friendly and then the fact that it’s being fitted to me exactly I think is a nice experience and it’s not like I’m squeezing in in certain areas or it’s too baggy in other areas.

I was super excited when I got to see it for the first time. There’s definitely some adjustments that’s it’s going to need. I bought my dress off the rack so there’s more adjustment that it would it needed had I gotten one that was custom made for me.

Kelsey:Right.

Laura:You didn’t get a custom dress right?

Kelsey:I got it a completely off the rack dress. I didn’t do anything to it actually.

Laura:But I think wasn’t the dress you got supposed to be bought that way?

Kelsey:Yes. I mean I’m sure people do alter it slightly. I bought a very like cheap dress that I ended up loving and I bought it kind of last minute, which was surprising because I had bought a different dress and I just realized I don’t think I love this. I just wanted something different so I ended up buying something just like from an online website and luckily it fit perfectly. It was great!

Laura:I think the ones that are designed to be bought off the rack do end up having a little bit more stretch to them that’s been what I’ve heard. They just tend to allow for more I guess shape differences.

Kelsey:Yeah, for sure.

Laura:Whereas the ones that are designed to be actually fit to you really are quite structured. Mine I got it off the rack and it was probably at least a size bigger than it should have been, maybe two sizes. I don’t really remember honestly what the size was. I think it was somewhere around like 8 to 10 range and I think I’m a size 6 now. I honestly have no idea. But it needed a significant amount of taking in and then there’s just some areas of it that don’t fit perfectly because of the fact that I got it off the rack. The bust area doesn’t totally fit because it’s just designed for a larger person so there’s some things that needed to be adjusted still. But I’m really excited about it. I think it looks really pretty. It’s super comfortable.

Kelsey:I’m excited to see it!

Laura:I know, I know! Hopefully I’ll have pictures fairly soon after to show people even just a little preview or something. It’s just funny because when I was telling my fiancé that I was going, he was like oh you should send me pictures so I can see what it looks like. I’m like ha-ha, very funny!  Obviously he’s joking.

But anyway, it’s been an interesting couple of weeks because I tend to vacillate between being very happy with my fitness and eating routine and then just this level of pressure of looking a certain way on your wedding day tends to kind of sneak in there. Coming up to the dress fitting, I was like I really hope it looks good. I just don’t want to feel like not pretty in it. When I was trying it on, I was actually like really glad with how it looked.

That’s how I felt when I bought it. It just seemed like it was just fit really well for me and like I said it’s super comfortable and just kind of exactly the style I was looking for. I was very happy with it when I bought it, but there’s always that fear that you’re going to try it on and be like this isn’t what I thought it was going to be! Because I’ve seen too many of those TLC “Say Yes To The Dress” shows where people are like I hate it! It’s like why did you buy it if you hate it?

Kelsey:I think it’s weird too especially with wedding dresses because you leave it there. It’s not like you have it at home and you can try it on again and you’re like I do love this, I don’t know what I’m driving myself crazy about. But when it’s not with you or they’re hanging on to it, you can’t just go try it on necessarily. I feel like that plays into that fear a lot.

Laura:You’d think that, but I bought my dress in October and I took it home with me. I brought it home in the car from the place in Savanah that we bought it. I don’t think I tried it on at all between then and trying it on at the first tailor session. I brought it to a tailor locally to get it taken in and stuff. I just didn’t feel like trying it on.

I don’t know, it’s weird. I don’t think I’m the kind of person that would really like a dress and then hate it later. Usually I’m pretty immediately not into it if I’ve tried it on. This one was the opposite experience. I tried it on and I was like this is really nice, I like this! It wasn’t like I fell in love with it and I was like falling all over myself, but I do think it’s what I wanted, so I feel good about it. There’s always that little bit of anxiety about trying it on and it not fitting or if your weight has changed at all. I personally hate the fact that I feel like I have to be maintaining a certain shape at this point.

Kelsey:Right.

Laura:It kind of stressful, but it’s not that big of a deal because my dress is not the kind of dress that needs to be super tight. If it’s a little loose, it’s not that big of a deal. I think I’ve had some give if I gain some weight, but I don’t really see why I would gain weight. I think most people tend to lose weight before their wedding because of the stress. Anyway, that was one of the more recent things that I did. Again, this episode is literally days before my wedding, so I was trying this on well before then. I’m not that big of a procrastinator.

But then there’s just been some other things I’ve been kind of updating like certain guest count things. We thought a certain number of people were going to come and now the number is changing, or the people that we didn’t think we’re going to come that are going to come and have certain dietary restrictions, that kind of thing. I have gluten free people, I have vegan people, I have like strict, strict kosher people. Just trying to managing all those things is interesting just because I think the people that are in my gluten free or Paleo type eaters are going to be totally different than my uncle who eats vegan.

Kelsey:Right.

Laura:It’s just like kind of complicated, but luckily my catering company is really good at managing dietary restrictions. We have to make some decisions about the cake. I’m trying to think if there’s anything else major. Literally it’s most just paying for things, which I think had been one of my biggest stressors recently just making sure I had enough money for everything because it’s just a lot of money.

Kelsey:Of course, yeah.

Laura:It’s kind of scary to write that large of checks multiple times in a row.

Kelsey:It’s like this is horrifying.

Laura:Yeah, like multiple four figure checks. Luckily none of them were five figures.

Kelsey:That’s good.

Laura:But certaintly four figure checks are scary. And just dealing with getting a lot of RSVPs. I will say there’s a fun part about RSVPs that you just get mail every day, like actual mail and not junk mail. That’s been kind of fun to just see little cards in the mail. Although it is sad when you see people that you wanted to have there that can’t come, which is understandable, but also kind of a bummer when you’re excited to see certain people and then they can’t come.

Kelsey:Yeah, I loved getting those in the mail and people would write little notes, like I’m so excited to come! It feels so great.

Laura:Yeah.

Kelsey:There’s something to be said about getting stuff in the mail every day. It’s exciting.

Laura:I know. It’s very silly because it’s not like I don’t know all this stuff is coming. It’s just I like to check my mailbox every day now. I think that’s pretty much everything that I’m planning on with the wedding right now. It’s just I feel like we’re in the crunch time or at least we’re getting into it. It’s far enough away that there’s still time, but close enough that I need to start getting on the ball with things.

I feel like there is this little cloud over my head about feeling like I’m not doing something that I’m supposed to be doing, which may or may not be true, but it’s just that anxiety that I’m like missing something. Luckily I have a day of coordinator that I’m going to be meeting with in I guess a week or two. I don’t remember the exact date, maybe two weeks. But she’s going to help with organizing everything and making sure I have done everything that I’m supposed to do.

Kelsey:That’s good.

Laura:That’s probably going to be helpful I feel like somebody else helping me because it’s really hard to do this on your own and then also run a business which is you’re doing everything yourself for that as well.

It’s definitely an experience and I’m excited about it. I am going to be glad when it’s over because it’s just an extra level of stress. It was funny when you were talking about your program creation that you’ve been doing recently and kind of finishing up with, I’ve had my own program idea on the back burner for a long time. I feel like once the wedding stuff is done and once all of the major…how do I describe this?…I guess life combining that needs to happen once my then husband moves in with me and brings all of his stuff that we need to kind of like go through and combine. We do have to help him move from Ohio, so that’s going to be its own effort.

Kelsey:Right.

Laura:But once all of that’s done, I do want to start working on a program. So I’m kind of excited for the wedding to be over because of that because I feel like I’m in a bit of a holding pattern from a business perspective because I just don’t have the time to do more than what I’m doing. As you were saying last time, it is a ton of work.

Kelsey:Yeah.

Laura:Trying to plan a wedding, and run a busy one on one practice, and then adding a program creation onto that just isn’t possible, or smart, or desirable, or anything positive. I’ve just been putting it off for good reason. It’s not just procrastination. It’s literally like I would die if I tried to add another thing onto my plate.

I have kind of dabbled in some preprogram creation surveys and that kind of thing for my audience to see what people to get a sense for what I should be doing, but I think the real bulk of the creation is probably going to start toward the end of the summer once things have kind of settled down, we have our house kind of in order, and our animals are getting along, and all that stuff.

Kelsey:Oh yeah, that’s a whole other thing to think about.

Laura:Yeah, it’s a lot. I forget to who I was talking to, I think I was talking to one of my friends recently about how I feel like weddings are stressful enough when you live in the same town as your fiancé or you may live with the person before you get married and you’ve already done all of the life combining stuff, but basically the month of June is going to be insane for me.

Kelsey:A life overhaul.

Laura:Other than having a baby, I don’t really see how it could be any more drastic than what it’s going to be for me.

Kelsey:Yeah!

Laura:Basically going from living alone, having a phone based relationship with my fiancé, having an hour or so phone conversation on a nightly basis and that being my interaction with him for the day, having my dog but not having to worry about his relationship with another animal, and just trying to figure out how my daily work schedule is going to change. Because there are days that I’ll be on the phone with clients from 10 am until I think most recently I finished with a client at like 8 pm. That’s not going to be able to happen frequently when I’m married because that’s just ridiculous.

Literally even details like I have a queen bed and we’re going to have to upgrade to a king bed, and rearrange the furniture, and I’m going to have to get rid of some clothes because I have kind of fully infiltrated all the closet space in my townhouse now. It’s just like so many things.

I’m trying not to get overwhelmed by it because obviously I want to enjoy the day, I want to enjoy my honeymoon, I want it to all be very in the moment. But there are all these other things that are going to be happening around that time that it’s just like I feel a little bit…I don’t know how to describe it. I don’t feel paralyzed, it’s just kind of like waiting for that stuff to happen. I know it’s coming and it’s probably like I said like having a baby for the first time where you’re like you know it’s coming, and you’re life is going to be totally different, and you’re preparing for it as best as you can, but there’s only so much you can prepare for before you just have to do it.

Kelsey:Yeah.

Laura:Anyway, that’s kind of my update. Oh, I don’t want to go on too long because I know I’ve already been talking a lot, but I wanted to say thank you for everybody who was wishing me well for my 30th birthday which was recently. It was awesome! I had a really good weekend. I had been a little down because I didn’t think my fiancé was going to be able to get in until late on the Friday night, which my birthday was on a Friday. He ended up surprising me and getting a red eye the night before and getting there in the morning.

Kelsey:So cute!

Laura:Yeah. One of my friends had set up a coffee date with me. It was funny because I was coming from the gym and I was originally was just going to go straight from the gym, but I was like I have like 15 minutes. I can put some deodorant on and take my hair out of the ponytail, use some dry shampoo,  wash my face a little. I was like I should look a little presentable going to a public space like this. And then of course she like totally bait and switched me and my fiancé showed up instead. I was like sobbing my face off because I was so happy that he was there. I was just feeling really down that I didn’t think he was going to be able to spend more than, I think it was 44 hours total for the weekend. I hadn’t seen him for a month and it was just kind of getting stressful.

It was really good. He and my best friend’s husband, who my best friend has the same birthday as me which is super fun, they coordinated a bunch of activities. We went out to dinner at this new restaurant. It’s really funny, it’s called Brewery Bhavana and it’s a brewery/dim sum/flower and bookshop.

Kelsey:Wow!

Laura:Yeah. I feel like belongs in Brooklyn or something.

Kelsey:Yeah, it sounds like it.

Laura:It’s got a really cool vibe. But anyway, so we went there for dinner and then we met up with a big group of people for dessert. I didn’t have any clue that any of this stuff was happening.

Kelsey:That’s so fun!

Laura:I never had a surprise done for me like that before. I was really happy and we had a really good time and got to check out some cool places around Raleigh that I haven’t seen yet like a whisky bar that’s in walking distance to my house. I’m like this could be really dangerous for my budget and my liver maybe. But it was really good.

I got some messages after the podcast saying happy birthday and congratulations on making it to 30, which is really no different than being 29. Thanks everybody for your well wishes! Like I said, I had a great birthday so now next up is the wedding!

Kelsey:That’s awesome! He’s obviously a keeper.

Laura:Yes, yes, definitely a keeper. It’s just funny it’s like I feel like I should have business updates, but I’m just so distracted.

Kelsey:Your life is being completely changed.

Laura:I know. And to be fair, I do work a lot. Just so you know, I’m still working with somewhere in the 15 people per week average. It’s not like I’m not doing anything with my business. It’s just I’m in kind of cruise control mode right now as opposed to doing any major changes. But again, hopefully once all this insanity in my life settles down I can then kind of shift gears and start focusing on a program because I really, really want to do it. Hearing you do it and talking about how you felt doing it makes me more motivated.

Kelsey:Good, I’m glad to hear that. You’ll get to it. I felt the same way last year. I was just like I’m just holding on for dear life until this wedding is over and then I’ll feel like I will have more time to focus on my business and how I want to see it change and progress. Now you’ve seen that progression and it did actually happen, so it will happen for you as well.

Laura:Yes. I just need to like you said, get through the hurricane. Alright, well that was my life update. Hopefully that wasn’t super boring. Next time, well actually maybe not next time. We’ll see. At some point I will be talking about how amazing my wedding was, how amazing the honeymoon was. But that will be a couple episodes from now. Anyway, thanks for listening everybody and we will see you here next week!

PODCAST: Factors That Affect Meal Timing And Frequency

Thanks for joining us for episode 107 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering following question from a listener:

“What are your thoughts on meal timing and the number of meals in a day? What factors should be taken into account? Do you recommend going according to your hunger or having some sort of a basic structure or plan?”

There are those of us who thrive on sticking to three meals a day and those that feel the need to graze throughout the day. How do we know how often we should really be eating? It turns out there are many factors that influence meal timing and frequency for each of us.

Today we clear up the confusion so you can determine how often you should be eating and figure out meal timing strategies that work for your lifestyle. Just some of what you’ll learn are reasons why you may need to eat more or less frequently than the typical three times per day, why hunger signals may not be the best indicator for meal timing, and guidelines for meal timing around workouts.

Here’s what Laura and Kelsey will be discussing in this episode:

  • Why eating three times per day is generally recommended for people with digestive issues
  • An explanation of the migrating motor complex and why it’s important to allow enough fasted time between meals
  • How people with low blood sugar may need to eat more than three times per day
  • The importance of eating adequate calories during meals for those with low blood sugar
  • How to spread your calories out throughout the day if eating your daily caloric intake within three meals is difficult
  • Why intermittent fasting may be of benefit for those with reoccurring SIBO infections
  • How eating according to hunger signals is generally recommended
  • How following an eating schedule can help those with low blood sugar prevent sugar crashes
  • Why having an eating schedule can help those prone to under eating
  • How stress can affect hunger signaling and meal timing
  • Guidelines for timing properly balanced meals and snacks pre and post workout
  • The potential negative effects of fasting before and after exercise
  • Factors that can influence your need for a bedtime snack
  • Busting the myth that eating before bed causes weight gain

Links Discussed:

TRANSCRIPT:

Kelsey: Hi everyone! Welcome to episode 107 of The Ancestral RDs podcast. I’m Kelsey Kinney and with me as always is my cohostLaura Schoenfeld.

Laura: Hey everybody!

Kelsey: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me at KelseyKinney.com, and Laura at LauraSchoenfeldRD.com.

Over the next 30 to 45 minutes we’ll be answering your questions about health and nutrition, and providing our insights into solving your health challenges with practical tips and real food. Stick around until the end of the show when we’ll be sharing updates about our businesses and personal lives.

Laura: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re over in iTunes, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer on an upcoming show.

Kelsey: Today on the show we’re going to be discussing meal timing and how to figure out how often you should be eating. Before we get into our question for the day, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue.

Kelsey:Welcome back everybody! Here’s our question for today’s show:

“What are your thoughts on meal timing and the number of meals in a day? What factors should be taken into account? Do you recommend going according to your hunger or having some sort of a basic structure or plan?”

Kelsey:This is a good question because I feel like there’s so much different information out there about meal timing and what is best and depending on certain conditions. I think it can get a little bit confusing when you’re not working with somebody one on one to help determine what kind of plan you should be on or if you should really be doing intuitive eating where you’re listening to your hunger signals and all that. I think this a great topic for today.

We’ll start with the amount of meals in a day because I think that’s where a lot of the confusion comes first of all. For most people, I will say that I have them eat three meals a day, so the standard breakfast, lunch, dinner. But there’s definitely some other health conditions that can change the way I want somebody to eat. I really work through the client intake form with that person seeing if there’s any underlying reasons why we might want to have them eat more or less times in a day.

I’ll talk about some of those conditions in a little bit, but to explain why I start with three meals a day, I come from a digestive perspective because a lot of the clients that I end up working with have some degree of gut issues that are going on and that’s why we’re working together. Because of this, I’ve looked into meal timing from a digestive perspective as well.

One of the main reasons why I recommend three meals per day is because this leaves enough fasted time for the migrating motor complex to work. The migrating motor complex is essentially a cleansing mechanism for your digestive system. What it does is it moves undigested food, and particles, and bacteria through your GI tract. It’s kind of got that peristaltic movement, those waves moving things through your digestive system. It’s thought that when your stomach grumbles when you’re hungry, that that’s actually the migrating motor complex working.

That’s to say that this process only really happens when you’re not digesting. It starts when there’s no food in your stomach or your intestines, or I guess there would be some in your intestines but it’s already for the most part digested, broken down, you’ve absorbed your nutrients from it for the most part. Really it’s just the undigested fibers and things that are moving through the system. It only works when you’ve stopped breaking down nutrients and you stopped breaking down food and absorbing nutrients. That’s to say that you have to be fasted some of the time for this process to work.

This is a really, really important process for anyone, not just somebody with digestive concerns, although it’s more important for them. But of course all of us want to have at least a functioning digestive system. Even if you’re digestive system is really healthy right now, it’s still very important for make sure that this process happens on a regular basis.

Most people generally recommend to leave somewhere between three and five hours between your meals so that the migrating motor complex has some time to cleanse the digestive tract. If you’re eating three meals a day, generally you’re going to leave about three to five hours between your meals. Five hours is certainly on the longer end of things and for some people that’s going to be too much. They’re not going to feel great if they’re fasting for five hours between their meals. But somewhere between three and five hours, that’s going to put you at somewhere about three meals a day including when you’re sleeping, when you’re waking up, and all that kind of stuff.

Because of that, I start with this idea that somebody should eat three meals per day. But of course if you’ve got other conditions going on that make it difficult for you to eat only three meals per day or if you have conditions that make it better for you to eat less than three meals per day, that’s when I would work with somebody one on one about. But I can walk you guys through my thought process behind this.

I’d say the most common reason somebody would eat more than three times per day is because they’ve got low blood sugar. Laura, I’m sure you work with people like this as well who if they’ve got low blood sugar, generally they’re going to feel better when they eat more than three times per day. That’s just because it helps to keep their blood sugar a little bit more stable. They may not even be able to go three hours between meals without having their blood sugar crash. That means that they might eat more like four or six times per day, somewhere in between there.

For those clients, generally even though they’re going to be eating more than three times per day typically, I want to find out the least amount of times that they can eat per day that still keeps their blood sugar stable. That’s going back to this migrating motor complex idea. I want them to be fasting for some amount of time every day so that the migrating motor complex has some time to do its work, but of course we don’t want their blood sugar to be crashing.

Laura:I just want to mention you were saying about frequency of eating, I think we should be clear that we’re not necessarily talking about full meals that many times per day.

Kelsey:Right.

Laura:That can be snacking. The other thing that I wanted to mention, for a lot of my blood sugar clients, I assume you see this as well, if somebody can’t go three hours without eating, it’s probably that their not eating enough at the meal. That’s usually what I find is that the meal is just inadequate and that’s why their getting hungry and low blood sugar within three hours. A lot of times I’ll look at total calories intake before I start adding meals in because most of the time it’s fixed by eating enough at those meals. I just wanted to make that note.

Kelsey:That’s a really good point. Exactly. We’re not talking just about meals necessarily when I’m saying somebody would eat more than three times per day. Once you go over three, typically it could be sort of smaller meals that they’re eating four, six times per day, but that can also include just snacking as well. I’m just saying anytime you stop fasting, meaning you eat anything, that’s what I would consider times that you’re eating per day.

If somebody’s got this low blood sugar going on, that’s definitely a reason why they may end up eating more times per day whether that’s a snack or a meal. But like Laura said, a lot of times this can happen if they can’t even go three hours, a lot of times that’s just because they’re not eating enough at some of their meals. We would go over their calorie intake, look at what’s going on there, see how much they’re eating.

Just as an example, sometimes people won’t eat a big breakfast and then they’re wondering why they can’t make it till 1:00 to eat lunch. It’s like well you ate 200 calories for breakfast, so no wonder you’re starving by 11:00 or 10:00 if you ate at 8:00 or so. It’s really important to look at how many calories you’re eating at each specific meal and then you’re overall caloric intake as well.

But essentially we want to figure out the least amount times that somebody can eat that’s still keeps their blood sugar stable. That will mean that we’re going to look at their calorie intake per meal. We might work on increasing that to see if that helps them go longer between meals, but sometimes it doesn’t. Sometimes it truly is just issues with hypoglycemia that eating more calories doesn’t necessarily fix. Those kind of people, they may just need to eat some snacks in between meals and still keep their overall caloric intake within a range that makes sense for them, but split it up through more times per day that they’re actually sitting down and eating something. But to allow the migrating motor complex to work as well as it can, I like to keep that to the lowest amount of times possible.

That’s just from the perspective of not wanting to have to feel like you’re eating literally constantly. People generally want to eat the least amount of times per day as they can as well.

Laura:Yeah. I think that’s why intermittent fasting is so popular because it’s like, oh, I don’t have to eat a meal. It takes some effort out of my morning for me. I find that that’s the same for me. I know mentioned, gosh I feel like it was months ago, but I did that vegan fast thing for my church and I was just eating nonstop all day and it was awful. I was like I can’t deal with this. I just hate eating so much.

Kelsey:Yeah, it’s a pain.

Laura:I don’t means so much volume wise, I mean just frequency and having to think about eating every couple of hours. The less you have to think about food I think is always better, with the understanding that there’s some amount of times you have to eat to function.

Kelsey:Right.

Laura:You can’t just not eat and function during the day. But anything you can do to condense those frequency I think is usually good for most people.

Kelsey:Yeah, absolutely. Going back to calories for a second here, another reason why somebody might end up eating more than three times a day is also if they just have a really hard time getting all their calories in just three meals per day. This could be somebody who’s trying to gain weight, or it could be somebody who has been under eating for a really long time so their digestive capacity isn’t up to speed quite yet. Eating what to us we would consider a full meal for them meaning that it’s a breakdown of their overall calories within three meals per day, that could just feel like a lot to their digestive system at that point.

We may want to split that up into three meals plus a snack or two to get their calories. What that generally looks like is of course splitting your calories between three meals per day, and then if that feels like too much to eat at a meal, taking out maybe 200 calories from one meal, 200 calories from another and having two snacks with those 200 calories between meals can make a lot of sense for somebody because it’ll end up just feeling more comfortable for them.

For somebody who’s like an athlete who just really has to eat a lot of calories every day to keep up with their activity level, it can be really tough to just eat three times per day and get all those calories just from again a comfort standpoint here. That’s where you may end up eating more than three times per day when really there’s no underlying health condition that would mean that you need to do that, but just from a comfort standpoint you’re going to feel much better splitting up your caloric intake a little bit more.

Just with the people who have an under eating for a long time, they will usually start like I said by adding a couple snacks in between just to kind of gradually get them to feeling a little bit better when they’re eating larger meals overtime. Eventually I do like to get them to the point where they can those calories in three meals per day and maybe one snack rather than two or three.

Again, over time with those people I’m generally pulling them back in terms of the amount of meals or snacks per day that they’re eating to allow more fasted time. But at the end of the day, if they just feel better eating more times per day because they want to just eat some snacks and have their meals, that’s completely fine. There’s nothing wrong with eating that way. I just like to if possible again leave more fasted time just to help the digestive system work a little bit better.

On other end of the spectrum here is who needs to eat less than three meals per day. Usually the reason why you would end up eating less than three meals per day is because they’re doing some type of intermittent fasting. We have a whole episode on this so you guys can listen. We’ll link to that episode on intermittent fasting because there are different ways of doing this, but for a lot of people that looks like just skipping the first meal of the day.

Some of the reasons why you might do that are reasons like if you’ve got insulin resistance, it can help a little bit with that. If you’re trying to lose weight, just not thinking about food as much only eating twice a day within a certain time frame, still getting the right amount of calories, it’s not like we’re just skipping a meal necessarily. You’re still eating the right amount of calories for you given that you’re trying to lose weight within that time period. But that can be helpful for a lot of people when they’re trying to lose weight.

Again, those with digestive issues. If we want to leave more fasted for the migrating motor complex to work, intermittent fasting can be a good choice, but I will definitely say that it is not necessary at all. I don’t want to make it sound like it is necessary to have good digestive health that you need to do some degree of intermittent fasting. It’s absolutely not. You can eat three meals per day, you can even eat some snacks. You’re going to have some fasted time in there. It’s going to make the migrating motor complex do its job. Don’t worry about that. Don’t feel like you need to do some intermittent fasting to help the migrating motor complex. It will do its work.

But a reason I would think more about intermittent  fasting for some people with digestive issues is for example if I have a client who has recurrent SIBO infections, so they’re very likely to get SIBO infections over and over and over again. I’ve definitely had clients like this. There’s some thought that either the migrating motor complex, like the nerves there can be damaged to some degree so that it doesn’t work as well, or maybe they have some sort of gut structural issue that causes them to be more likely to get SIBO reinfections. Those are the people that I would maybe think okay, maybe we should leave some more fasted time than just a normal person or even somebody who has had SIBO once but isn’t really prone to reinfection.

For those kind of people doing intermittent fasting or at least some type of lengthened fasting can be helpful. But for most people, even if you have had SIBO or you have had gut dysbiosis or anything like that, typically not necessary for the migrating motor complex to do its job. I just want to make that really clear. I don’t want to make it seem like you need to do that.

Laura:One thing about the fasting, I think sometimes people tend to look at it as you’re either doing intermittent fasting or you’re not. But you can just have a couple days during the week that you do it.

Kelsey:Right.

Laura:You don’t necessarily have to do it every single day to get the benefits. For some people doing fasting may not line up well on the days that for example they exercise because they need more calories. But if you have a pretty low key lazy day and you don’t need those extra calories and you want to do some fasting for any of the reasons that Kelsey just mentioned, it’s okay to do it once in a while.

I know I’ll sometimes not have my first meal until noon just randomly. It’s not planned or anything like that. It’s not like if we’re talking about intermittent fasting, it either has be all the time or never at all. There’s a lot of different options for that. Some people will do it once a week and that’s all they do.

Kelsey:Right, exactly. Good point. Okay. So those are some of the reasons that you might eat more than three meals per day or less than three meals per day. This person was also asking about how do you determine your schedule for eating. Do you just listen to your hunger signals or do you have some sort of set schedule or plan?

I think for me, what I like to encourage is for people to listen to their hunger signals because of course we have those hunger signals for a reason. I like that intuitive way of eating, really paying attention to your body’s signals overall and that includes of course when your body is telling you that it’s hungry. That’s my preference, but there are definitely some reasons why you may need to be on more of a schedule than just listening to your body.

One of those examples is for people with low blood sugar. For them when they are really having trouble controlling their blood sugar issues, it can be helpful to be on a schedule or at least a little bit more of a schedule than just truly only listening to your hunger signals because it can help to preemptively prevent a blood sugar crash rather than them having to deal with the crash after the fact and just bringing their blood sugar back up.

We want to of course prevent the blood sugar crashes as much as possible. It’s going to be more comfortable for them. They’re more easily able to stick within whatever calorie needs that they actually need to eat because sometimes when you have a blood sugar crash, it’s like just give me anything, I need to get my blood sugar up, which is of course the more imminent thing that you need to deal with. But overtime if you’re doing that consistently, a lot of people can end up over what they’re calorie needs actually are as well. I think that that’s one instance where it can be helpful to be on a little bit more of a schedule than just listening to your hunger signals.

And then also if you’re having trouble eating enough calories because for these people just listening to their hunger signals, it might tell them maybe when they’re supposed to eat, but it won’t give them signals that they need to eat as much as they probably do need to eat. For these people, like I said before they’re going to probably need to eat more often and sometimes that might mean eating when they’re not necessarily feeling super hungry. That’s another instance where you may end up eating a little off from your actual hunger signals, but it ends up being a lot more comfortable for them. They end up hitting their goals a lot more easily.

But for everybody else, I would say listening to your hunger signals usually works pretty well. I’m sure there’s other things that I’m not thinking about right now, but those are the two that really stand out to me as when you would want to be on a little bit more of a schedule. But for most people, listening to your hunger signals is a pretty good way of doing things.

Laura:I have one additional comment about the hunger signals thing. This is from personal experience as well as client experience. If you’re the kind of person that your appetite is negatively impacted by stress, I think that’s another time where having a schedule can work really well because I know for me when I’m really busy, which is lately all the time, not every single day, but it’s been pretty consistent in the last couple months, but if I don’t kind of schedule lunch into my calendar, I can easily go until 2:00 or 3:00 before I am actually experiencing the kind of symptoms that are from inadequate food intake.

I say symptoms because for me it’s not really hunger. I mean sometimes it is, but usually it’s other symptoms that I haven’t eaten. Like for me, I get really cold. That’s like the first sign that I need to eat more. I’ll just feel my hands get cold, I start to shiver a little bit even if the temperature in the room hasn’t changed at all.

Kelsey:Headaches?

Laura:I don’t personally get headaches, but I know that’s definitely a symptom of things like low blood sugar and not eating enough.

Kelsey:Yeah.

Laura:I think brain fog would probably be more of a cognitive symptom for me personally, but again, this is just my personal experience. There’s a lot of different ways that these inadequate food intake symptoms can come up.

I’ll talk about this in a second, but for me it also tends to affect my workouts because I do have a regular workout schedule. If I need to make sure I’m eating a certain amount of times prior to that workout, I have to schedule it. I can’t just wait until I’m hungry because I may not be hungry until right before I go to the gym.

For me I’d say I tend to schedule meals as much as I can at least during the week. Maybe on weekends I’m a little bit more flexible because my schedule is a lot looser and depending on the weather, depending on what I have going on that weekend, it may change when I eat. But generally during the week, I literally put it into my calendar to eat lunch because if I don’t, things can happen. When you run your own business, you can fill your whole schedule up for the whole day if you wanted to.

For me it’s just really important to make sure that I actually set aside that time because a lot of times if I don’t, it’s too late. By the time I realize that I needed food, it’s like I’ve already caused the problems that are caused by not eating enough.

Kelsey:Right.

Laura:I think that’s just something important to realize that it’s not always just about hunger. A lot of my inadequate food intake clients especially struggle with not having appetite during the times that they should be eating. The typically healthy, non-stressed person is going to have regular appetite signaling. But again, if you’re like me and your appetite tends to get negatively impacted by being stressed or busy, you really do need to consider scheduling.

Obviously if you’re not hungry at all, you don’t have to force feed yourself tons of food, but having some kind of schedule of eating I think is super important for preventing the problems that are associated with having that eventual blood sugar crash that comes when you haven’t eating enough.

Kelsey:Right. I would say actually on the other side of the spectrum too, if you are somebody who when you’re under stress you tend to overeat because you’re just kind of emotional eating, I think scheduling your meals can make sense too because then you just know okay, this is when I’m supposed to eat, this is when I’m going to go eat lunch, this is when I’m going to have a snack. And even maybe thinking about what you might have as a snack can help to potentially prevent some of the overeating that might happen as a result of being stressed as well.

Laura:Well I think like you were saying before, a lot of the recommendations you made are going to work well for most people. The three meals a day I think is pretty culturally normal.

Kelsey:Yeah.

Laura:I think that’s really where most cultural norms have kind of settled on. I don’t think snacking a ton is normal for most other societies. I mean there might be some level of snacking, but I think American’s kind of have this snack obsession that a lot of other countries don’t have.

Kelsey: Yes.

Laura: I don’t think snacks are bad, but I think we need to try to have a regular meal pattern that’s not either eating all day grazing, or skipping meals and having these problems that come from either inadequate food intake or going really long without eating and then essentially bingeing later.

The average person, three meals a day, maybe a snack is going to work for most people. Now there’s a couple of different reasons that extra meals may be necessary. Kelsey kind of touched on one of them which would be workout needs for higher calories, but the extra calories is one part of it. I think meal timing around workouts is another thing people need to consider.

Depending on when you work out, you may need to adjust your meal timing. That’s something I was just mentioning a few minutes ago where for me a lot of my weekday workouts are afternoons. They’re at like 1:00, 1:30, which is somewhat unusual for the average person. I tend to like working out at that time because it’s a nice break from the first chunk of work during the day and then I can do some more work later. But that means I need to eat lunch at least an hour beforehand so that way I’m not still digesting a ton by the time I get to work out and I’ll also have enough time to get that food into my bloodstream so that it’s actually available as fuel.

I’d say most people end up working out in the morning before work, or in the evening after work, or about at lunch time. Those are the three most common times for people to be working out. Depending on what time you work out, you may need to adjust your eating schedule and also the timing of certain types of foods that you would be eating.

If you’re working out before work and you don’t like to have breakfast before working out, I would say you need to be cautious about what type workouts you’re doing if you’re not going to eat. If you are doing the type of workouts that need fuel to have better performance and better stress response, then either getting a snack a little bit before the workout, having some kind of carb and protein containing beverage during the workout is an option, or making sure that you’re eating enough the night before to cover that workout in the morning.

I think there’s this assumption that especially if you’re trying to lose weight that you should be working out fasted because it burns more fat. Technically you do burn more fat for fuel if you are working out fasted, however burning fat for fuel doesn’t necessarily translate into burning fat off your body or your storage.

Kelsey:Yeah.

Laura:Really if you’re trying to lose weight, the amount of calories that you eat for the whole day is going to play much more of a role than whether or not you’re fasted and burning fat during the workout. If you’re doing a really high intensity workout either of heavy weight training or HIIT training like sprints or just intervals in general, you’re not going to generally perform as well if you’re fasted. There is just that glucose need for those types of workouts that if you’re fasted your body is not going to necessarily going to be able to create the level of glucose you need for optimal performance.

It depends on what your goals are. I’d say most people really benefit from having some amount of food before exercising. Generally you’re going to want to eat some kind of balanced meal or snack within two hours of the training time. If you’re working out in the morning, maybe you need to have a small amount of food before going to the gym. Or again, if it’s as simple as making some kind of beverage that has some sort of protein and carb blend, that can help. It is better than nothing.

And then if you’re working out in the afternoon or the evening, just making sure that you’re not having your last meal prior to two hours to that training. If you’re working out at 6:00, try to have a snack around 4:00, 4:30, something like that.

Or if you’re working out like I do around lunchtime, either having a snack before the workout and then having lunch after. Or if it’s just after that lunchtime like the 1:00, 1:30, making sure again lunch by noon if you’re going to be working out at that time. Again, just looking at your workout schedule and trying to make sure you’re not going in without having eaten I guess like I said within two hours of training.

This is specifically for that high intensity type of workout. If you’re doing something like long, slow, steady state cardio like a long walk, or a jog, or a bike, elliptical machine for 30-45 minutes and you’re not going super high speed, you probably don’t have to worry about it so much because those workouts can run on fatty acids as a fuel type and you’ll be fine. If that’s really your typical workout, you don’t have to worry about eating beforehand. But if you’re doing things like Cross Fit, or powerlifting, or high intensity intervals, that’s where you really want to make sure you’re timing the food intake at most two hours before the exercise itself.

Kelsey:Yeah. I was just going to say that for a while I was going to powerlifting classes that were either at 5:45 or 6:45. I learned very quickly that I needed a snack sometime between when I was eating lunch. I typically am a late lunch eater, so maybe around like 2:00, 3:00 I may eat lunch. But even then, if I was doing a workout at like 5:45 or 6:45, I generally found that I preformed a lot better when I added a midafternoon, or I guess if I was eating at 3, more like an evening snack before I went to the class and then ate dinner afterward, that worked out a lot better.

Laura:Like I said, if your goal is to lose body fat, working out fasted for people who are very overweight I think it can be helpful to help them tap into that body fat. I almost wonder if that’s more of a metabolic issue that an actual calorie burn issue. But if you’re just trying to lose 10, 15, 20 pounds or less, I mean some people are really just trying to lose like 5 pounds, working out fasted is not going to benefit that.

Again, it’s really about the total calories at the end of the day. Being in a deficit but not going into workouts hungry or totally not fueled, because that’s going to impact your ability to push yourself. You’re going to feel more tired and weak. Especially it’s generally about 20 minutes into your training that you’re going to start hitting that wall. A lot of people call it bonking. You’re generally not going to be able to push yourself into any sort of high performance zone with working out.

You can kind of phone it in for a workout and you’ll be fine. It’s not like you’re going to get nothing out of it. But I think that people that do train at a higher level, they’re going to notice a difference between a high performance, high energy workout compared to one that they’re bonking. You’re not going to see as good muscle gain or cardiovascular gain if you’re not able to push yourself into that higher performance zone.

Generally eating is going to help with the performance which will then show more fitness improvement, and hypothetically that’ll help with body composition goals. And then the other issue is if you’re pushing yourself really hard without the appropriate fuel, you do risk raising your stress hormones, so things like cortisol and adrenaline to help provide that glucose that you need for your workout. That can definitely cause problems in the long run not only with health, but also with body composition.

You’re kind of actually in the long run hurting your progress if you’re always going into a workout fasted. Once in a while, it’s not going to kill you obviously. But if you’re doing it all the time with the goal of leaning out, you’re actually probably doing worse for yourself than if you were to eat before the training session. That’s pre workout. Again, that can be a meal, that can be a snack.

Post workouts, the same way. It doesn’t have to be full meal. Although some people do like to have a meal afterwards as their recovery meal. It is recommend to have some type of high protein meal or snack within two hours of training especially if you are doing the high intensity, heavier type of training. Some people think they have to eat within 30 minutes of working out to get the protein into their muscles, but that’s not accurate. It’s really you have a good two hour windows so you don’t have to slam a protein shake right after working out to get the benefit.

But you don’t want to wait hours after you work out to eat something. There are people that will work out at like 5:00 and then they’ll eat dinner at 8:00 or something, and that’s really waiting too long. Or maybe they go in the morning and they work out and they’re not super hungry after because sometimes exercise can actually suppress your appetite and then you don’t eat until lunch or something. You don’t want to be skipping the post workout meal.

I think that’s another myth in the health community that if you don’t eat after your workout that you’ll prolong the fat burning after the workout. Which hypothetically is true, but I think in the long term, it actually causes more harm than good for body composition goals, especially for women.

Stefani Ruper of Paleo for Women has a really good article that we’ll link to about how fasting after training actually increases testosterone in women. Which if you have low testosterone, it’s hard to say whether or not this would be harmful or not. But most women at least in the younger premenopausal years, they actually don’t want to get too much testosterone because that can cause PCOS type symptoms, so things like acne, weight gain, irregular periods, that kind of thing.

If you are having PCOS type symptoms, and you’re not overweight, and you work out a lot, you might want to look at your meal timing after working out to make sure you’re not fasting for too long after training. And basically the evidence that she has shows that women who repeatedly fast after workouts experience significant long term testosterone elevation. So again, not a great hormonal situation if you are experiencing those PCOS type symptoms.

And then the other benefit of eating post workout is that it does reduce muscle soreness. If you’re experiencing a lot of soreness after workouts, look at how soon you’re eating afterwards. I would also say if you’re not gaining strength or muscle size if that’s a goal to look at that as well. Because again, if you’re not eating within two hours of training, you’re not maximizing your amino acid uptake into the muscles post training. When you train, you do break down muscle tissue and it needs to get rebuilt and the maximum rebuilding time is within that two hours of post training window.

I would say if you are training with any sort of frequency, I say frequency literally if your training like twice a week is probably a good way to think about this, and just make sure that you’re timing your meals and snacks pre and post workout appropriately so that way you are maximizing your performance at the workout and then also minimizing the negative hormonal effects of fasting pre or post workout.

That’s kind of the workout side of things. Kelsey, do you have anything to add before I add one more little thing to think about

Kelsey:I don’t think so, but I think that’s a really good point. You got to think about that. Like I said, my experience for sure and definitely when I worked with clients, I think it does make a really, really big difference just even from a performance, like how good…or not even performance. I guess I’d say just how good you feel during your workout, like how pleasurable the workout is and not making your feel like crap when you’re working out. Making sure that you’re eating around your workout makes a big difference.

Laura:Definitely. Alright. The last potential timing adjustment that you want to think about is the bedtime snack, which I know we’ve talked about in the past. Both of us use bedtime snacks in our clients frequently. I wouldn’t say all the time, but pretty frequently.

I find that people who are having trouble sleeping oftentimes can benefit from a bedtime snack, especially if they’re finding that they’re either having a hard time falling asleep or if they’re waking up around like 2:00 in the morning or a couple of hours after falling asleep. The reason that the bedtime snack can help is because it helps keep your blood sugar steady overnight.

If you didn’t eat enough during the day or if you are having blood sugar dysregulation, a lot of times you’ll have the issue of either just waking up for no reason in the middle of the night or some people will wake up hungry, which is think that’s a pretty clear sign that you need to eat something. But it’s not always. I think people expect to be hungry if they’re having a low blood sugar, but again, it doesn’t happen that way.

The other thing that can happen overnight if you’re having a blood sugar drop is actually having to get up to pee. That could affect your night time urination. Getting up to pee once and a while is not abnormal, but if it’s every single night or if it’s more than once a night, you really need to think about the bedtime snack thing.

Again, if you’re finding yourself waking up in the middle of the night and you don’t know why, try the bedtime snack. Basically that is just eating within 30-60 minutes of going to bed. It doesn’t have to be a meal, it can just be a small snack or kind of desert type of thing. A lot of things I’ll recommend generally having some carbs with either fat or protein on the side. That can be things like a banana and a tablespoon of nut butter, or a cup of frozen berries with some coconut milk drizzled on top, or something like that.

It’s not anything crazy, it doesn’t have to be cheesecake or something. But having some kind of light dessert or a small snack, like I know some of my clients like to do a half of sweet potato with some butter on it. Super simple, it doesn’t have to be anything crazy.

Some of the snack bar type things can be helpful. I know when I’m feeling hungry before going to bed, I’ll have an RX bar or something just to get a little carbs and protein before bed to help me sleep better.  This is something where not everyone is going to need a bedtime snack. There’s a couple of different things that are going to affect your need for a bedtime snack. Snacking in general as Kelsey was mentioning before can be affected by your total calorie intake for the day. If you’re struggling to get enough calories, having some food before bed can be helpful. If you’re under a lot of stress and your blood sugar is dysregulated because of stress, sometimes having a little bit of food before you go to bed can sometimes help. Especially if it helps you sleep better, that’ll help with your stress resilience.

The days that I work out, I notice I tend to be more hungry before bed. Again, if you’re working out really hard and you’re struggling to get in enough food during the day, having a bedtime snack can definitely help with your sleep. Sleep is super important for your recovery, so if you’re working out pretty regularly and intensely, you should consider doing the bedtime snack.

But again, I think mainly the people who want to look at the bedtime are anyone who’s struggling with sleep issues. Because again, not everyone is going to have this problem, but a lot of people are experiencing blood sugar drops overnight that are causing them to wake up. That would be something to try out if you are struggling with sleep or either not falling asleep well, being hungry before bed or overnight, or if you’re just waking up for no reason, having to pee, that kind of thing. That would be a time where even if you’re not hungry, trying out a bedtime snack can be helpful.

Again, that kind of goes outside of the eating when hungry recommendation, but as we said a few times in this episode, eating when you’re hungry is not always the best indicator of meal timing. Something to try. It may not work for you, but a lot of our clients really do benefit from that so it’s something worth experimenting with if you are struggling with sleep quality.

Kelsey:I would say we’ve had a lot of luck with this recommendation. And especially for those people who have been in our Paleo Rehab program, I think this is one of the things we hear a lot of good feedback on. As people go through the program they’re like, oh my gosh, the bedtime snack made such a big difference! I feel like I can sleep through the night, it’s amazing!

Yeah, for sure, if you are having trouble sleeping in anyway, I would say it’s at least worth experimenting with to see if it helps because we’ve just seen so many clients and participants of our program that just have benefitted immensely.

Laura:Yeah. I think this tends to be another issue where people that are trying to lose weight don’t want to eat before bed because they’ve learned from Oprah or whoever that eating after 5 pm is going to turn all into fat, which is total BS.

Kelsey:Yeah.

Laura:Don’t think that eating before bed is automatically going to make you fat or something. It’s great if you can get all your meals in before bed, and you can eat enough, and sleep well, and all of that, but eating a snack before bed is not going to be some fat gaining issue.

Kelsey:Yeah.

Laura:I hate when people are afraid to eat before bed because they’re like I heard you’re not supposed to eat at night and it all turns into fat. Which is total garbage. Again, I don’t like to be all about calories, but I think people do need to realize that most of weight gain is a calorie imbalance for various reasons. It’s not always that you’re over eating, it can be that you’re under expending. But people who are struggling with under eating really need to be okay with the bedtime snack idea.

Kelsey:Absolutely, I know. It’s BS guys, it’s BS. We’ll leave it at that.

Laura:Yes. It’s one of the myths that we’ll bust today.

Kelsey:Yeah.

Laura:Well hopefully that answers this lady’s question. If you do have any further questions about meal timing or any of this stuff that we talked about today, please go to TheAncestralRDS.com. We have a contact tab. You can submit your question through that and we will potentially answer it on an upcoming show. Now we will get into our updates for the week.

Now it’s time for our updates. We’ve had a little bit of an interesting experience with our updates in the last couple of months/the last however many years we’ve been doing podcasting. We’ve been bouncing around a little bit with the updates and we definitely want you guys to keep giving us your feedback about things because at the end of the day we want to make the show what you guys want, not necessarily what we think is optimal or whatever our little Google searches on “how to do a podcast” come up with.

I guess a couple of weeks ago we published our 100th episode that was basically like a massive update. We did get some interesting feedback about that episode from people who are frequent listeners/people that have been listening to our podcast for the whole time that’s it’s been on the air. Some of our more loyal listeners have mentioned that they really do like the updates…which is good, I’m glad that you guys are enjoying this part of it…with some people saying that they like them in the beginning because they felt like it was a more personable intro. And then other people said that they understand why we are moving the updates to the end because with newbies or people that don’t really want to hear about our personal lives or our businesses, that way they can hang up on the call or the podcast and they don’t have to necessarily listen through that to get to the meat of the episode.

If you guys do have a strong opinion about this, if you’re one of our loyal listeners who is still on the air right now, just let us know what you think. If you really, really, really want the updates in the beginning, please let us know because we’re definitely willing to move them back there. But if you do feel like where we’ve moved them to the end of the show has been working fine for you and you still enjoy listening to this part of the show, just let us know. Like I said, your feedback is really helpful and the more information we get from you guys about what you want, the better we can make this show for you.

With that, Kelsey, do you have any updates for us?

Kelsey:Really on the spot there. Yeah! As a lot of people that are listeners know, I’ve been working on my Build Your Biome program and I did a beta run of that. By the time this podcast comes out, we’ll actually most likely be in their second launch of it. But when we are recording this, I am just finishing up the content for the first beta run. They’re in week seven right now. They just started week seven and it’s an eight week program.

I just finished everything, which is super excited and feels really, really great because it’s more content first of all than we have in Paleo Rehab because Paleo Rehab is a five week program. This is eight weeks and it’s just been so much work that I have just been sort of driving myself a little bit crazy trying to get it all done and really make sure it’s something I’m super proud of. It’s just been a lot and it feels amazing to be pretty much done with that.

I’m really looking forward to launching it again soon for more people to join because we had 50 people in the beta. It’s actually a really good size for a beta I think because I’ve gotten a lot of awesome feedback. As you know, Laura, doing a beta group is really all about the feedback. It’s incredibly helpful to just see what people like, what they dislike, what they felt maybe was missing, or the kind of ah-ha moments that they’re getting that maybe for me was like, oh of course I’ll include this, it’s probably something everybody knows. But for some people, it’s mind blowing information that really makes a difference for them.

It’s been really interesting to see the feedback. I’ve sent out a couple feedback forms to everybody in the course so far and then I’ll do a big overview feedback form at the end of the course next week. I’m really looking forward to seeing what people have to say, but so far the feedback has been really amazing and really helpful.

I’m going to do a little bit of changes to the course, like maybe add a couple things. I don’t think it’ll be anything major. I’m actually really happy so far with people saying that the information I’ve included has been exactly what they were looking for, which is always a little bit hard to guess exactly what people are looking for, but I think I did a pretty good job with that, or so it seems with the feedback. That’s really great too and it means that of course I don’t have to change too, too much about it.

Like I said, really I think I’m going to actually just add a couple things and that’s going to be it, which means that I get to launch it again really soon which is exciting. You guys will probably, by this time this comes out you’ll have seen those emails and everything and possibly you’re in my course now. If you are, I’m super happy to have you and excited to do this with you guys again.

I’ve been going back and forth. Originally I had been thinking that this course would turn into a course that’s always offered and doesn’t have a live component to it. But doing this first beta round live made me realize that at least for now I think I’m going to keep it live because I’ve really been liking doing the live Q & A’s and that’s what I got a lot a lot of great feedback on from people who are like, those are amazing! They’re super helpful, it helps to personalize the course for people.

At least for now, I’m going to keep it that way until I can figure out if there’s things that I could add that would help people get that degree of personalization without me being there, which maybe be impossible, we’ll see. But since I’m enjoying it now, it’s something that’s easy enough for me to do once a week, I’m going to keep doing it. And I like the comradery that goes along with doing a live course too. That’s what I’m thinking, but we’ll see how it progresses.

For any of you listening that run your own online business or you’re a nutritionist thinking about doing courses like this, I have to say that courses for me are incredibly fulfilling, even if it’s incredibly stressful at the same time, I really liked making this course and I feel really proud of all the work that I’ve put into it. I did a word count of all the videos that I wrote up and it’s 40,000 words, which is crazy!

Laura:Oh my gosh! It sounds like you could just put that into a book.

Kelsey:I was telling my husband the other day, I was like I looked up the average word count for a non-fiction book and it’s 40,000 words and I just wrote 40,000 words for this course. It’s pretty much a book, although I’m sure it’s not as tight as a book would be and it would be cleaned up a lot if it was turned into a book.

Laura:Maybe that’s your next project.

Kelsey:It very well might be I think. That’s a really big accomplishment and it feels great to say I did this. I put all this work into this and I’m so proud of it. The fact that people are now telling me that like I said, it’s exactly what they were looking for, it makes me feel really good to say it that way.

Laura:Yeah, that’s awesome!

Kelsey:I’m really looking forward to the next round. For the foreseeable future it will be live but it may eventually turn into an evergreen course. I think it’ll be launched or I’ll have groups going a little bit more often than we did for Paleo Rehab because for Paleo Rehab, Laura, do you remember how often we did that in the first year? Did we only do it twice?

Laura:I think we did it twice. I’m trying to remember if it was two or three times. We had the beta group.

Kelsey:Right.

Laura:And then I know we had at least one launch. I don’t remember if we had a second.

Kelsey:I don’t either. I think it’ll be more often than that, though of course this is a two month program so there’s only a certain amount of times we can fit that into a year.

Laura:Yeah, although you can technically, you can overlap it.

Kelsey:Right, that’s true too.

Laura:I think the reason we didn’t launch Paleo Rehab as frequently is because organizing both of our schedules to fit that course is a lot harder than just you deciding I’m going to do my Q&As on these days and stuff. For your individual program, you could probably launch it as frequently as you wanted to with the live Q&As running whenever it fits your calendar.

Kelsey:Yeah.

Laura:Although I would think you wouldn’t want to run it too often because the size of the group probably helps for that community aspect. You don’t want to be like having three people going though it at a time or something like that.

Kelsey:Yeah, exactly. The other interesting thing that I realized going through the beta group is that the people who are joining my course are all along the spectrum of where they are in their journey. Some people already know they have SIBO or something like that and then there’s some people who are total beginners.

The other piece of this is that I realized I’m going to have to like we did with Paleo Rehab allow people that if they want to waive their right to a refund, they can just access the whole course at once because I’ve set it up very chronologically starting from the beginning phase of if you just have symptoms and you have no idea why, then walk through this process and you can figure it all out. But for some people they are like halfway through that process and while the beginning stuff is still really helpful for them, that next piece of information that they need is maybe like halfway through the course.

I think that’s the other piece of it too for me is I learned that that’s definitely got to be an option, which I’m fine with. But it’s always a fine balance of do I try to convince this person to walk through it step by step or just say go ahead and grab all the information that you need. Because I think that when you do that, that step by step stuff is so important for some people because otherwise they’ll just miss the stuff that honestly ends up being the most important for them. It’s a fine line, but I think I determined that I’m going to have to allow people to do that since they’re further along in their journey.

Laura:I think sometimes people will think they know what they need and they want what they think they want. There’s something to be said for that, but then there’s also the fact that you don’t know what you don’t know. If you want to skip through content and then you just never look at it because you have ten or twelve weeks or whatever it ends up being of stuff to look at, and you go straight to week five and you skip week one through four, yeah maybe it’ll be okay, but there may be stuff that you missed that you didn’t realize was important.

I definitely feel like in group programs having that week by week setup is better. But like you said if you want to give people the option, it’s their choice if they want to go outside of the structure that you set for them.

Kelsey:Yeah, exactly. Overall it’s been going really well even though it’s so much work. But I’m really happy now because I can feel like I can kind of slow down, although now I’m like now I have to think about…

Laura:Now what’s next?

Kelsey:Yeah, how do I get more people to the group? How do I help more people? All of that. Now it’s a whole different ballgame I guess. But it does feel really great to be finished with the content at the very least.

Laura:I literally just started my…market research I guess for what my program is going to be. Hearing you talk about it I’m like, oh my gosh, I have so much to do! I am starting from scratch. I’m sure I’ll have more time to focus on it than I do right now, but it’s just kind of like a little… I think it can be daunting to look at stuff when you’re starting. I think that’s relevant to anything that you’re looking at doing.

Looking back on it when you’ve finished, it’s like I’m so glad I did it! I know it was a lot of work, but it was so worth it. It’s just getting over that hump of procrastination in the beginning where you’re like this is going to be so much, but I have to do it!

Kelsey:Yeah, the other thing too is that for me I think I started off only thinking it was going to be a six week course and it wasn’t even sure if I wanted to make it that long. And then of course it turned into eight weeks. I think you have to think it’s going to be shorter and easier than it ends up being, and then you’re not quite as overwhelmed when you first start.

Laura:Right.

Kelsey:Just tell yourself it’s going to be really easy, it’s only going to be four weeks, and then it’ll turn into a massive program, but you won’t notice.

Laura:I feel like I’ll probably take a lot longer to finish it than you, but that’s just because I’m the biggest procrastinator on the face of the earth.

Kelsey:Me too. This was years in the making, but just in my brain. As soon as I actually started, that’s when things had to really get going.

Laura:Well, I’m excited for you! I’m excited to see the program and see what kind of results people get. Hopefully next time we can update about more launches or timelines for that so that people listening can get in on it as well if they’re not already on your list. But imagine if they’re on your email list, they’ll get announcements about that, right?

Kelsey:They will, yeah.

Laura:Cool. Well, thanks for the update, Kelsey! We will see everybody here next week!

PODCAST: How To Choose A Gym And Personal Trainer (Part 2)

Thanks for joining us for episode 106 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today is part two of our answer to the following question from a listener:

“I would love your criteria or recommendations for choosing a gym and a personal trainer. I don’t have much knowledge in this area and I’m intimated by and typically avoid the gym though I think it could be a benefit to me. At this point it’s been years since I worked out in a gym, so I feel like I’d be starting at ground zero.”

If you enjoyed last week’s episode, don’t wait to tune in to hear part two of this information packed show! Just some of what we’ll be talking about is the motivating forces in your fitness routine, the importance of finding a trainer whose personality jives with yours, and barriers to consider that can prevent you from getting to the gym consistently.

Equipped with practical tips and knowledge from stories of our personal experience, you’re sure to have what it takes to go out there and find the gym and personal trainer that’s right for you!

Here’s what Laura and Kelsey will be discussing in this episode:

  • The role motivation plays in your fitness routine
  • Why competition during workouts can either be helpful or counterproductive
  • How personal and financial accountability can be a motivating force
  • Why having fun with the type of movement involved in the activity is important
  • How defining and reaching goals is a motivating factor that can help you persevere during rough patches
  • Why progress is not always a linear process in strength training
  • Balancing your budget with what will motivate you when choosing a gym and trainer
  • Virtual options such as online coaching from a trainer that can be of benefit
  • How physical limitations or state of health will affect the type of activities and level of support from a trainer that you choose
  • Why it’s important to find a trainer whose personality type jives with yours
  • Why you should try out a few different gyms to find which atmosphere works best for you
  • How location of the gym is a factor to consider to ensure consistency
  • The importance of considering the type of equipment the gym has

Links Discussed:

TRANSCRIPT:

Laura: Hi everyone! Welcome to episode 106 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is my cohost Kelsey Kinney.

Kelsey: Hi guys!

Laura: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Laura, at LauraSchoenfeldRD.com, and Kelsey at KelseyKinney.com.

Over the next 45 minutes we’ll be answering your questions about health and nutrition, and providing our insight into solving health challenges with practical tips.

Kelsey: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re there, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer on an upcoming show.

Laura: Today on the show we’re going to be discussing how to find a gym and a personal trainer that really works for you. If you are listening to our show regularly, you’ll know that this is a two part episode and that part one was released last week. If you haven’t heard that one, make sure you listen to it first so that this one makes sense. But otherwise, we’re ready to start with part two!

But before we get into our question for the day, here’s a quick word from our sponsor:

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Laura:Welcome back everyone! As I mentioned, this is part two of our podcast on how to find a gym and a personal trainer that you really like. Our original question from last week is this:

“I would love your criteria or recommendations for choosing a gym and a personal trainer. I don’t have much knowledge in this area and I’m intimated by and typically avoid the gym though I think it could be a benefit to me. At this point it’s been years since I worked out in a gym, so I feel like I’d be starting at ground zero.”

Laura:Let’s jump back into part two! I think motivation in general is a huge factor. It’s tough because motivation is kind of like a very nebulous topic and I’ve seen a lot of people suggest that motivation is kind of garbage and it’s not a real thing. I think motivation does exist, but you can’t just will yourself into doing something with motivation.

Kelsey:Right.

Laura:I think you really have to think about what gets you more fired up and interested in doing something and thus will actually encourage you to do it. For some people, and I think a lot of people actually, competition with others is very motivating to them and they like to go to group classes where there’s some level of competition.

I think that’s why Cross Fit is so popular for a lot of people is because they have that friendly competition aspect. I think right now the Cross Fit games are going on when we’re recording this and I think that’s just a good example of where that competition can push people to work harder. That’s great if people like it. I know I personally hate it.

Kelsey:Yeah, same.

Laura:I’ve actually recently added some MetCon classes to my schedule just to increase my cardiovascular capacity a little bit because I’ve been finding that that is a weakness that has to be improved upon for my current workouts. I’ve been going to some MetCon classes and it’s so funny how cranky I get when other people are either beating me or if they’re…I don’t want to say cheating because cheating is a strong word, but if they’re like not doing all of the reps and then they finish minutes before me and I’m the last person doing it, I’m like you didn’t do it the full way! I get really pissed basically if I’m competing with other people.

Kelsey:That’s funny, so just being around other people within a workout makes you feel like you need to compete with them essentially?

Laura:Yeah.

Kelsey:Got it.

Laura:Then I either get mad that they’re beating me or I get mad that they’re cheating and not doing the full workout. It’s stupid, but I recognize that this is an issue for me. I think it’s one of the reasons that I used to get injured more often when I was working out in things like Cross Fit or these boot camp classes and stuff because I was so focused on being the best or being in the top five or something, or just being better than some arbitrary person in the class where I’m like okay, I can do better than her so I’m just going to make sure I’m done before her every time.

Kelsey:Right.

Laura:It makes me stop paying attention to what my needs are and what my limitations are and start thinking I need to push harder or do something different to beat that person. For me it’s not a healthy environment in general to be doing lots of group classes. But for other people they find the group atmosphere to be more motivating, and they’re encouraged, and they like to have that teamwork kind of experience where maybe they’re doing a group workout and they get to cheer other people on. For different people that competition aspect is going to either motivate them and have them enjoy the workout more. Or if you’re like me and it makes you angry during the workout or it makes you feel like you’re pushing yourself too hard, then maybe that’s not the best way to motivate yourself.

Kelsey:Right.

Laura:For me I think the accountability to my trainer is motivating to me because I have to build my whole schedule around getting to the gym at the time that I’ve scheduled. There’s a factor of financial accountability. If I skipped it I would lose the money that I paid for it, which is like I said is not trivial. Also just I would feel bad if I just skipped it because my trainer waiting for me and he’s scheduled that time for me. That accountability for me definitely motivates me to go.

I would say the financial accountability actually motivates me to work harder, not so hard that I hurt myself because I’m going to get any benefit if I push myself too hard. But it pushes me to work a little harder maybe than I would have if I wasn’t paying for it because my thought is well, if I’m paying this money to be trained by someone, I better show up for it, and put effort into it, and not just screw around or not try.

Kelsey:Yep, that makes sense. Coming from a little bit of a different perspective, I do group classes. I have a coach, but depending on what time I go there can be anywhere from just one other person there with me or quite a few other people with me, maybe ten or so. I have found that it motivates me.

First of all, my financial contribution is not insignificant either. It’s probably a lot less than what you’re doing for one on one coaching, but it’s still nothing to sneeze at. For me that definitely motivates me to go a certain amount of times per week usually because I know I’m paying essentially this much per class or this much per times I go, so I don’t want that price to raise necessarily if I go way less than that per week.

That’s really motivating to me to actually be consistent about it because sometimes life gets busy and I don’t have time for things or I’m just really exhausted. Of course I’ll take a break when I need it and certainly when I was making my gut health program I ended up only going to the gym twice a week instead of three or four times per week as I had been because I just was too busy, too tired to do things, which is fine. But honestly I think if I hadn’t been paying that much money per month, knowing myself, I probably would have gone even less to the point where I was going less than I could have just because I was overwhelmed.

I think that two times per week worked out really well for me because I was able to keep up my strength and I was getting some movement in. I wasn’t just sitting at my computer all the time. I know that for myself that was really important for me to go at least twice a week to keep things healthy for me. If I didn’t have that financial contribution or if my coach wasn’t there waiting for me, I know myself, I know I wouldn’t have gone quite as much.

And then from the competition standpoint, it’s interesting because I do the group classes so there is that opportunity for competition. I’m the same way, if I feel like I’m competing with people, I can drive myself a little crazy I think. But doing the group classes has actually taught me not be as competitive.

I think actually what helped that the most is that I go to a gym where everybody’s really strong. There aren’t that many beginners in the classes I go to at this point, so I’m easily pretty much the least strong person in these classes.

I think that actually taught me to just forget everybody else, forget what they’re doing and focus only on myself because literally I think I would drive myself absolutely crazy if I was trying to compete with people who have been doing this for five or ten years, are way stronger than me, they’re nowhere near where I am at the very beginning of my strength journey.

Luckily that didn’t deter me, but I can easily see how it would. That’s the kind of person who wouldn’t be right for a group class of course.

Laura:I think it depends on, like you said, the atmosphere. If everyone’s way better than you, you might be able to more easily say I’m not competing with them because it’s stupid. But if everyone’s the same or around the same level of fitness, that competition could be more noticeable, which for some people again, that gets them motivated, that makes them more excited, they have fun. Some people really competition.

I don’t not enjoy competition. I used to play volleyball, and I used to play lacrosse, and I’ve done other sports in the past. It’s not like I hate competition and get super stressed by it or anything like that. But if it’s just like an experience where it’s doesn’t really need to be a competition, but then I feel like I should be doing better than other people, it’s like a bad habit of mine to get way too focused on what other people are doing and how that compares to what I’m doing. I don’t know, maybe that means I should do more group classes to get over that.

Kelsey:No. I think you play to your strengths. You’re doing exactly what you need to do in order to improve your strength and your physical fitness, and if that means working with some of your personality traits that are already there, that’s fine. I don’t think we always have to be picking and choosing different things about us that we absolutely have to work on all the time.

Laura:Right, that’s true.

Kelsey:It’s okay to play to your strengths.

Laura:Yeah, definitely.

One thing other than the accountability, well I should say there’s two more things that for me are somewhat motivating during my workouts. I do find that there is a level of funness, I don’t know if that’s a word, but I do enjoy the actual movement when I’m doing it.

And again, sometimes this is stuff that I don’t do on a regular basis. Like if I go running when I’m at a beach, that’s fun. It’s not necessarily something I do all the time, but I enjoy it and so it’s motivating to go run on the beach. There’s times in my workouts at the gym that I have a good time, or I enjoy the challenge, or I enjoy the sense of accomplish once I’ve done something. Which I think kind of plays into my second area of motivation that really pushes me to continue is either reaching goals that I’ve set for myself, and some of them are arbitrary, but others are…like getting a chin up was a goal that I had and that was really fun and exciting when I hit that.

Generally either reaching goals, or setting PRs with certain lifts, or being able to do something that you didn’t think could ever do, that can be really fun and it can be exciting to see how you can accomplish difficult things after you’ve been consistently training for a while.

Beyond just the financial and personal accountability piece, I do actually enjoy myself when I’m at the gym and what’s helpful having a coach is that he’s tracking my progress for things. When he tells me that we’re going to do this squat, and it’s this weight, and it’s this many reps, and this is going to be a volume PR for you if you’re able to do this, it kind of just gets in my head that okay, this is going to be a challenge and I can do it. And I’m not competing with anybody. Sometimes I have to remind myself that it’s okay if I can’t do it.  But it is definitely more motivating when I can see even just a little victory in front of me to be able to accomplish. It just makes it a little bit more fun than if I was just going to the gym and doing the same thing over and over and not really ever seeing any changes or progress.

Kelsey:Yeah.

Laura:That can definitely affect your motivation if either if the type of movement is fun, so if you’re dong Zoomba for example, that might just be fun regardless of what the outcomes are. Or if you’re doing something that does have a goal attached to it and you’re reaching those goals, then that can be super fun as well.

Kelsey:Yeah, I think the PR piece of this has been especially helpful for me when it comes to something that I find really difficult and that I have been having trouble with. For example, squats have recently been my least favorite movement. I pretty much don’t like them when I do them.

It’s better now, but there was a period of time maybe, I think it was a month or two months ago where I actually had to go down in weight for my squats just in my normal training cycles because my form wasn’t good and as soon as the weight got heavy, my core would just not be working and so my squats just ended up looking not great. I went down in weight to kind of work on form just to build up my strength a little bit better before I went up to heavier weight.

That was really demotivating for me because I felt like, man, I’ve been doing all this stuff and I really feel like I’ve been progressing in a lot of other ways. It kind of sucks to have to move down in weights now. But what did motivate me was saying, okay, I have this end goal being able to do a bodyweight squat, and that was what I was working on. I was going through a really tough squat heavy cycle where I was squatting multiple times a week, which is not usually typical. My goal at the end of it was to be able to do this bodyweight squat.

Even though I wasn’t really liking squats at that time because I just felt kind of demotivated by the fact that I had to go down in weight, there was also this motivating aspect of knowing that I was really working towards something. That allowed me to push through these kind of negative thoughts about myself and how I could do squats.

Eventually at the end of that cycle, I actually went over my goal which was great. But that was huge for me and it really allowed me to get through that cycle that was really, really difficult for me and kind of mentally tough a lot of the time as well.

Laura:At the end of the day with progress…and when we say PRs it just means personal records. So if people aren’t familiar with what that terms means, it just means you’re doing something that you hadn’t done in the past. There’s a lot of things that can affect your progress and when people expect to have linear progress, I think that’s when they get disappointed because there will be times when they’re ability goes down.

Just as an example for me, at one point I could deadlift I think 255 was my max at one point. That was about a year ago I want to say that I was able to able to do that. And then since then I lost about maybe 15 to 20 pounds of bodyweight and now my max deadlift is like 215 or 220. Hypothetically you could say that’s a huge drop in strength and that’s a failure, or that’s like oh man, I can’t believe I can’t do that anymore. But if you take into account all the things that affect strength and deadlift ability, I’m like well no wonder I can’t deadlift as much because I have 20 pounds less of strength that I can do that with

Kelsey:Right.

Laura:I feel like with strength training if you’re always expecting to be making consistent linear progress, it can be a little disappointing when it doesn’t happen. But I think if you are looking at strength training as just like a longer term process that there’s going to be ebbs and flows in, then you don’t take those regressions as seriously because you know that this is normal, sometimes you regress and then you make gains.

So there’s just different things that will happen that will affect the objective amount of weight that you’re lifting. If you think about deadlifting as a percentage of your bodyweight, then maybe that’s actually gone up if you lost weight. There’s just some different ways to look at things that can make it less demotivating.

But there’s a couple more things that this person should consider as part of their decisions. I think one of the more practical things would be their budget. Kelsey and I were kind of talking about that a minute ago where there’s this fine line between paying enough money to be motivated and not paying so much money that you can’t afford it or you’re not able to feed yourself.

The training that I do is definitely on the higher end of the budget spectrum. It’s not as high as it could be. My trainer is actually not very expensive for what he charges. I think part of that is because I live in Raleigh. I’m sure if I was trying to do what I was doing in New York, I’d be paying like double.

Kelsey:Yeah, let’s say that’s out of my budget here certainly.

Laura:It depends on where you live and it depends on what your budget is, but you have to kind of balance your budget with what motivates you. If your budget is $50 a month, then maybe you just want to go to a gym by yourself. There’s a lot of really good online guides that you can download to help give you a workout routine to follow so you’re not doing it 100% on your own, but you are essentially just training by yourself and kind of relying on your understanding of that guide. Which that works great for a lot of people, so there’s nothing wrong with that. But you’re not going to necessarily have that motivation of accountability or the financial investment that’s going to increase your motivation.

I hate to say it, but when you spend a lot of money on something, you’re going to probably be a lot more committed it than if you don’t spend any more on it or you spend very little. But again, we want to make sure that that spending money is still within the person’s budget.

And then there’s that midlevel where you can do group classes, kind of like what Kelsey’s doing where you’re spending enough money that you don’t want to waste it and you definitely want to go because you don’t want to spend 100, 200, 300 dollars a month for classes that you end up not even using. But that might not be as expensive as doing the one on one. It can kind of be more budget friendly without missing that financial accountability piece that can be really helpful for motivation.

And then the training one on one, again kind of on the higher end of that spectrum, and of course it can depend on how frequently you’re training. If you’re training once a week with a trainer and then doing another couple days on your own, that’s going to be cheaper than if you were training four days a week one on one.

Kelsey:Right.

Laura:The number of times you see a trainer is going to affect the budget. For someone who’s getting over an injury or is really starting from scratch and really needs that one on one help to get back into it, it might be worth the investment to at least commit to a trainer for a period of time.

That’s kind of what my thought process had been two years ago when I started. It was like I’m just going to work with a trainer until I get back into shape and I feel more comfortable. Because I was feeling nervous about training after my car accident and I was like I’ll just do it for a couple months and then I’ll maybe switch to a group class or just start going by myself.

Kelsey:We see where that got you.

Laura:I know. At this point, I haven’t quit. I imagine at some point I will. I don’t really anticipate training one on one with somebody for my entire life, but at this point I don’t see myself quitting anytime soon.

That’s one of those things that just because you do one on one training for a month or two doesn’t mean that’s what you have to do forever. You might just look at it as a short term investment in building the skillset to learn how to work out in a safe, and appropriate, and effective way and then you switch to a group class or you switch to just training on your own just to continue that progress without having to spend as much money.

Kelsey:Yeah.

Laura:You could always start with one thing and then transition to the next level or a previous level when your budget changes. If you’re starting with a lower budget and you want to train alone and then you get to the point where my budget afford the group classes now and I want to go up to a group class, then you can do that.

Or if again you invest a little bit more in the beginning and do the one on one training and then you’re at the point where you’re like okay now this is kind of not worth it anymore, I’m going to drop down to the group class and save some money and still get motivation and training from somebody and some assistance, but it’s not going to be quite as expensive.

I think the budget piece is a big factor for most people, if not everybody, or at least people that don’t make a million dollars a year or something. You kind of want to get into that sweet spot between paying enough money that you’ll be motivated to do it if you do find that to be a motivator, and then not paying so much that it’s not sustainable for at least enough time to get what you’re looking for.

Kelsey:Yeah. One other option that I’ll throw in here too is that a lot of coaches will do online coaching or online group coaching. It could be private or it could be a group. I know my coach, he actually has an online coaching group where you’re a part of a Facebook group essentially and everybody is supposed to send in videos of some of their lifts every week and he’ll comment and critique their lifting technique and tell them what things to work on. I think he does the programming for everybody as well. At least at the time of this recording, that’s $30 a month which I think is a steal.

If you don’t have anybody either locally to you that you feel comfortable with, or if you can’t afford a one on one trainer or even group coaching, but you know you need at least somebody else looking at your lifts or anything you’re doing objectively, an online coach can be a really good option that spans both the financial aspect and the coaching aspect to get you something that’s at least more helpful than just going by yourself but still financially feasible for most people.

Laura:It’s kind of amazing how the internet has really changed the options for people. I feel like even ten years ago you might have had to work one on one with someone in person and now they have like you said the online coaching, there’s the kind of workout routines that are put together by a coach that maybe they have videos that you can watch to learn how to do the movements. There’s a lot more options now for that that maybe didn’t exist in the past.

Again, I really like the one on one stuff. It’s funny, when I think about changing to something where it’s totally virtual, I get a little bratty and say I don’t want to do that. My schedule may change, my budget may change, my priorities may change even if my budge doesn’t, so maybe at some point I’ll be more interested in that kind of thing.

Kelsey:Yeah.

Laura:But again, everyone is going to be different and you have to just figure out what level is going to work for you, and your budget, and your motivation.

Kelsey:Absolutely.

Laura:It’s funny, I feel like this episode is a lot longer than I was expecting.

Kelsey:I know.

Laura:This will be a short one, yeah. But there’s a couple more things that you would want to consider. I’ll just go through my list quickly and then Kelsey, if you have anything to add, just let me know.

One thing to consider that I think you and I probably use as part of our decision making process was physical limitations that you might have. That might include previous injuries, post childbirth. If you are a new mom that’s recently given birth but you want to get back into working out, I would look at childbirth as basically like an injury where you have this significant change to your physical structure that you basically have to rehab from.

I’m not saying that childbirth is something that people should look at negatively, I’m just saying that you need to treat your body like it’s been through this kind of traumatic physical experience and not just like try to go back into what you would be doing if you hadn’t just given birth.

Kelsey:Right.

Laura:That’s something to definitely consider. If you have a chronic illness, kind of like what Kelsey was saying with her situation, her limitation, having either physical pain or nervous system issues, or inflammation, or whatever is going on, you may need a little bit more support or coaching to be able to do the kind of workouts that someone who is generally healthy would be able to do.

There may be some genetic issues, like I know there’s some genetic issues out there that affect people’s joint laxity or tendon laxity so then they tend to dislocate things easier. That might mean you want to train with somebody to prevent those kind of injuries.

Just generally, the more limitations you have on your physical abilities, the more need for an expert support system that you would need, so either working with someone one on one or working in a small group so that way you can get help because you’re going to have higher risk of injury or higher risk of causing worsening of health if you are overdoing it, or doing things in a bad form, or whatever is going on that’s not ideal.

Again, some of these limitations may be temporary. My car accident injury general seems to be temporary. There are some things that I can be a little bit careful about, trying to avoid any sort of quick head and neck movements because that’s reactivated my injury in the past. There’s some  things that are still potentially lingering, but that injury seems to be fairly dealt with at this point.

There might be things that like the post childbirth, generally temporary situation. I mean there may be some permanent changes that happen, but the immediate post childbirth situation is going to be a lot different than a year or two down the road. That might affect what you’re doing right now, but in a year from now you could be back to what you were doing before. Don’t necessarily assume that just because you need a little bit of more help now to get over a limitation that you’re always going to need that help. You might get to a point where you can get back to your normal routine and be fine.

Those limitations I think are going to affect not only the type of movement that you choose, but also the level of support that you’re going to work with if you do want to get a trainer or work in a group class. Any thoughts on that, Kelsey?

Kelsey:I completely agree, wouldn’t add anything I think. I had sort of the same experience just coming from the chronic illness side of things is just that I was starting from basically ground zero, which it sounds like this person asking this question was. I just felt like I needed more support. Even if maybe I didn’t necessarily truly need it, I needed it mentally. Maybe if I didn’t need it physical necessarily, I definitely needed it mentally. I think you have to think about that as well.

You were mentioning there was just a little bit of fear going back into things for you, That definitely indicates needing more support both from the physical perspective and from the emotionally and mental perspective as well.

Laura:I still feel like there’s times where there’s things that I would not being doing if I was training on my own from a fear perspective. That doesn’t necessarily go away.

Kelsey:No, definitely not.

Laura:I’m less afraid than I was after my car accident, for sure.

Kelsey:Yeah.

Laura:My last comment about finding a personal trainer is to consider what kind of personality you like. For me, I’ve worked with some either Cross Fit coaches or boot camp instructors. I’ve never had a one on one trainer until the coach that I’m working with now. But I get a little bit like, I don’t want to say sensitive. Well, sensitive I guess is the right word. If somebody is being hardcore drill sergeant, I’m trying to think of an example because it’s been so long since I worked with somebody like this. But if they’re rude or if they’re kind of like, come on! You can do better than that! Or, push yourself! That kind of stuff, I’m like eww, shut up, leave me alone!

That kind of personality for me just annoys me and is not motivating to me, whereas I would describe my coach, Matt, as having a calm, instructor type personality. He doesn’t really get super riled up about anything. Sometimes he’ll be like, if I start to grind through a lift or soemthing, he’ll say something like, come on, you got this! Or something. But he doesn’t tell me to push harder or demean me or something in order to “motivate” me. I find that a lot of the coaching is a lot more instructive as opposed to trying to yell at me to make me work harder.

That personality type works really well for me. I would get really annoyed if he was being too drill sergeant-y or even too cheerleader-y. I would be like alright it’s not that big of a big deal, calm down if they were like, you got this! You’re so amazing! Like I said, everyone is going to have a different experience there. Some people love the super cheerleady trainers.

I used to go a barre studio locally because one of my friends recommended it. It wasn’t terrible, but I always just felt a little stupid in the classes because of the music and way that the instructor was so again, like a cheerleader basically. I was just like this is so goofy and I don’t really like this.

Kelsey:You didn’t jive with it.

Laura:Yeah. And again, nothing wrong with that if you do like that kind of atmosphere, but it wasn’t the kind of atmosphere that I really enjoyed going to. My current atmosphere is much more intellectual, and kind of looking at the lifts from a technical perspective, and also having a little bit of pushing to do things harder than I would normally push myself.

I feel like I trust my coach’s expertise and I trust that he has my best interest in mind. That means that if he tells me to do something, I know that he knows my limitations, he knows my injuries, he knows what I’ve failed at in the past. If we’re trying something that I’ve had trouble with in the past, he’s going to be a lot more flexible with changing it than if it’s something that he knows he can do and he’s going to be like, alright, you can do this, you’ve done this before, you’re fine. Whereas other times he’s like alright, you don’t have to do that. I know it’s uncomfortable, so we’ll just skip it.

He has a very good willingness to change the workouts as necessary. If I come in and tell him that I slept like garbage the night before or if I didn’t have time to eat before the workout, which is rare because I try not to go on a workout fasted, but it it’s occasional, he’ll change things based on my immediate limitations.

Some people are manipulative and will kind of whine and get out of things, and if their coach is too lenient, maybe that’s not a good fit for you. Maybe you need someone who’s a little bit more strict. Whereas I have this kind of relationship with my coach where sometimes I’ll roll my eyes at him or I’ll be like oh I don’t want to do this! He’ll be like just do it! But if I say I don’t know, I feel really uncomfortable with this, he’s like alright, we’ll skip it, we’ll just do something else. We kind of got to the point where he knows when to push me and when to give me lenience. That I think generally is a good experience for most people.

But you have to be able to find the personality of a trainer that jives with yours. Because again, you may need someone who’s super intense and does not let you get away with anything, or you may need someone who’s super gentle and a cheerleader type and not going to ever push you to the point of feeling really upset or scared or anything. Everyone’s going to have a different experience. That’s where I think testing out trainers is important because you won’t really know until you had some level of experience with them and seeing how they coach and seeing if you feel comfortable with them.

And again, the relationship I have with my coach has definitely been two years in the making. So we’re at this point where we have a lot of understanding of what the other person’s style is, what their needs are, and it just allows for a lot more appropriate of a workout that I’m getting pushed and challenged, but I’m not ending up injured. I haven’t cried at the gym in a while, so knock wood that won’t happen again.

Kelsey:I think the personality piece of it is so important because of course you want to find somebody who has got the experience that they need to be able to coach people effectively, they maybe have certain certifications. All that is important and you want them to have the background that makes them a good coach. But like you said, there’s going to be different people that just respond differently to different things.

I just have a funny little anecdote that I have to share here. I tried out a couple different coaches, a couple different gyms before landing on the one that I’m at now. My coach who I absolutely love is like the perfect personality for me, and it sounds kind of like yours, Laura, where he’s motivating but listens to any limitations. There’s none of that like you got this! Overly cheerleading kind of thing other than if you’re grinding through a lift and you kind of need that at that time.

The gym I had gone to prior to landing here was a total drill sergeant of a coach and oh my gosh, I did a couple sessions with him and I was just like I don’t think I can do this. One time I was there, and I was just working out by myself at that time because it was a weird scheduling thing. I just needed to come in and get it done and he was training somebody else while I was there. This woman, he was just like yelling at her, screaming at her to get her to do better on stuff and she started crying during the workout.

I’ve definitely cried at the gym before too, but this was different. This was due to complete breakdown because he was just screaming at her trying to get her to work harder. That was like the last straw for me. I just said I can’t do this. I can’t work with somebody like that. That’s just totally not my style. It’s not going to motivate me and especially at that point I was rehabbing from having been suffering with chronic illness issues for a while. I was like this is just not the personality that I need at this point in time.

Laura:Right, yeah. Just to make sure people don’t think my trainer was like yelling at me, I cried because I failed at a lift that had kind of freaked me out. I tend to be a little bit like crying dominant when I’m stressed out. If I get really scared of something and then all a sudden it’s over, I can sometimes start crying from that. For me the crying was because, I forget what lift it was. I think it was an overhead press. Overhead presses just scare the crap out of me. I don’t know why. They just really make me uncomfortable.

Kelsey:They’re scary, yeah.

Laura:I think it was a heavier overhead press that I failed at and I just got really frustrated and upset. Like I said that’s why I cried. I didn’t cry because my coach was yelling at me.

Kelsey:There was no screaming.

Laura:No, no. Like I said, I haven’t cried in a while. I think it’s because I’ve gotten a little bit more mental toughness with some of that kind of stuff. If your coach is making you feel bad about yourself, then that’s not a good situation no matter what if they’re yelling at you or if they’re just like being…I don’t know, there’s a way that you can make someone feel bad by not…I don’t know how to describe it. It’s almost like not caring about what they’re doing or not being excited or happy for them when they do things.

Again, you’re going to have to test them out before you can figure that out. That personality type in a trainer is going to make a big difference. They could be the most well educated and effective trainer in the world, but if they’re a jerk to you, you probably don’t want to train with them.

Kelsey:Yeah. To be fair, this coach I think was just overwhelming this person because they were doing a really tough workout. And all the screaming I’m sure did not help, but I think that she was actually the kind of person where it did motivate her in a way. But I was just like that is not me, I’m not that person. To be fair, I think the coach was sort of reading the situation at least hopefully appropriately at that time. But I just knew that that was not the right personality for me.

And then just a couple of other things to think about especially if you’re working out on your own in terms of picking a gym, and we talked a little bit about this piece of it before, is just the environment, the atmosphere that you’re going to be exposed to. Actually this applies to if you’re working in a group coaching atmosphere as well because there’s going to be different types of people in a group coaching depending on what kind of gym you’re at and so you want to make sure that the type of people you’re surrounded by as well as the gym atmosphere itself is something that really works for you and motivates you.

Just as an example, if you think about the atmosphere of Planet Fitness, I don’t know if people have those everywhere. I assume they’re everywhere at least in the U.S.

Laura:They’re pretty ubiquitous in the United States.

Kelsey:Yeah. Comparing that to an Equinox gym, again I don’t know if that’s a New York only thing. Do you have Equinox?

Laura:No, but I’ve seen them because I used to live up in that New Jersey/New York area.

Kelsey:It’s just like a very high end kind of gym, pretty expensive, like juice bars and everything in there and just really high end different kind of clientele. Whereas Planet Fitness, not that the financial aspect of it makes the biggest difference necessarily, but it’s like a $10, $20 a month gym. It’s often very overcrowded just because I think a lot of people sign up for it because it’s so cheap. You just get a very different atmosphere at both of those places.

You have to think about what kind of atmosphere is going to be motivating to you and maybe try out a few different types of gyms to see which atmosphere works best.

Laura:I always just think of the Planet Fitness, they have that lunk alarm I think it’s called.

Kelsey:Yes.

Laura:That’s because they don’t want people grunting or dropping weights or anything. Which I kind of get it, but I also feel like when I’m training with my coach and I’m doing a heavy deadlift, yeah if I drop the weight a little at the end, it’s going to make a lot of noise and I wouldn’t want to work at a gym that was going to set an alarm off because I made too much noise when I was working out.

Kelsey:Yeah, no thanks. Definitely consider that. It does make a big difference and I think a lot of people tend to overlook that in favor of either budgetary concerns or just a lot of other considerations when it comes to a gym. But it’s something that you should really pay attention to because I think it’s one of the things that could mean the difference between going consistently or avoiding the gym because you don’t like the atmosphere.

Laura:Right.

Kelsey:And then I think it’s also really important to consider what’s going to…I think motivate is the wrong word here, more like make it easy for you to go to the gym more often or as often as you would like to.

Laura:Reduce the barriers, minimize the barriers.

Kelsey:Exactly, minimize the barriers to you getting there on a regular basis. I worked with clients that they need their gym to have childcare because otherwise they’re just not going to be able to go to the gym as often because they need someone to look after their kids if they’re going to the gym. That’s a consideration you have to think about if you’ve got children or if you know that not having somebody to take care of your children is going to prohibit you from actually getting to the gym.

Laura:One thing I wanted to mention about that is that might be a barrier removal or it may be a motivator because I just think about a lot of my friends who have kids that are like the gym is the only opportunity I have to get childcare. I mean it’s not for free, but it’s like they don’t have to pay a babysitter and they’re like that’s my me time to drop my kids off at the daycare in the facility and then go workout.  That might be a motivator to get to the gym because it’s your only opportunity to have time without your kids.

Kelsey:Exactly, yeah. Another thing to consider is where your gym is in relationship to your house or to your work, and when you’re planning on going. If you know that you’re going to drive past a gym on your way home from work every day and if you drive right past it and go home, you’re going to feel bad about it. Or even if it’s just that that makes it easier for you to actually go because you’re literally driving right past it, that’s something to think about because you just want to take all these potential barriers away.

If having to go home first before you go to the gym means that more than likely you’re just going to end up on the couch and never get up again to go the gym, then yeah, find a way to get to the gym before you actually go home for the night. That’s going to make it a lot easier for you to go there consistently.

You need to think about your personality. I think a lot of what we’ve talked about today does really come down to personality and what kind of person you are. Think about the barriers that would prevent you from getting to the gym consistently and be very honest with yourself when you’re going through this because it’s easy to say I can motivate myself to go home and then go to the gym after. But if you really sat down and thought about it, you’d say even if I could, it would still be so much easier for me if I didn’t have to go home first. Finding a gym on my way home from work is going to mean the difference between going consistently and going every once and while.

I think that’s really important to think about. Another thing to consider is just what kind of equipment you need. For example, I have a blink fitness which I think is a local chain here right around the corner, like super close, two minute walk. I went there for a while because it was a good price and it seemed like a nice gym. But I realized pretty quickly that even though they had some of the equipment that I wanted to use for strength training, people were always on it and there was always a line. I just didn’t want to deal with that as part of my workout routine because if I was there and I saw a bunch of people, and usually it’s like a bunch of hunky guys broing out over by the weight section, I was like I just don’t want to deal with this when I go to the gym. I could and I certainly could probably motivate myself to do that, but I knew that would be a barrier for me to actually doing it consistently and not wasting time while I was at the gym waiting for people to do their sets.

Make sure that they have the right type of equipment. Some really budget gyms may not have strength training equipment or free weights that you could actually use to do barbell training. Or even if they do have it, people could always be on it and it could just drive you crazy or you would waste a lot of time at the gym.

Last thing to mention with all of this is that you should always try the gym at least once before you commit to anything. That goes for group coaching, goes for one on one sessions, it goes for working out on your own. Just anytime you’re signing up for anything, you really should try to at least once, if not a couple times to make sure that your personality jives with your trainer, or the atmosphere of the group coaching, the other people in your group, that you like being around those people and being in the group coaching, or just the atmosphere of the gym is just something that works well for you.

Most gyms if it’s not like a group coaching or a one on one type of situation are typically going to allow you one or two week trial to come in and try things before you actually sign up. If you’re doing that, it’s really important to go at the time that you would normally be going because that was something that I think I did incorrectly when trying out a few gyms. I was like I’ll just check it out when I have time. And then I ended up going to the gym at a completely different time usually than I looked at it and the atmosphere was really different. It was really crowded at the times I was going. That made a huge difference in my experience of the gym itself.

Just make sure you try it even if it’s something you have to pay for. If you’re doing one on one training session, you’re going to have to pay for that typically. Most of the time they won’t give you that for free the first time, but it does depend on the person obviously. But it’s worth it to spend a little money to make sure that you really like something before you commit to it long term.

Laura:Some gyms have this thing where they’re like they’ll give you a discount if you sign up for a whole year or something. Which that’s good if you know you want to go there, but don’t do that if it’s the first time you’re going.

Kelsey:Exactly.

Laura:Cool! Well that was a lot of information.

Kelsey: I know.

Laura: Hopefully helpful. I think some of it was definitely based on Kelsey and my experience with picking a gym, and that has worked out well for both of us at this point. Hopefully this will help the person asking the question.

If you have a question either about fitness, or nutrition, or anything health related that you want to submit, go to TheAncestralRDs.com and there’s a contact tab that you can click and submit your question that way and we may answer it on one of the next shows. But anyway, thanks for joining us and we’ll see you guys here next week.

Kelsey:Alright. Take care, Laura.

Laura:You too, Kelsey.

PODCAST: How To Choose A Gym And Personal Trainer (Part 1)

Thanks for joining us for episode 105 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering the following question from a listener:

“I would love your criteria or recommendations for choosing a gym and a personal trainer. I don’t have much knowledge in this area and I’m intimated by and typically avoid the gym though I think it could be a benefit to me. At this point it’s been years since I worked out in a gym, so I feel like I’d be starting at ground zero.”

Have you been wanting to begin to improve your fitness level, but are intimidated by the process of finding the right gym and personal trainer that will work for your needs?

We’ve got you covered! In this two part episode, we will be discussing how to choose a gym and personal trainer that’s right for you.

Join us for part one today as we walk you through the factors to consider when choosing a gym such as identifying you goals and determining which activities will help you reach them. We even begin to delve into the benefits of having a personal trainer.

Be sure to join us next week for part two!

Here’s what Laura and Kelsey will be discussing in this episode:

  • The importance of determining what type of activities you enjoy when choosing a gym
  • Why you should try new and different activities regardless of preconceived notions
  • The balancing act of adding variety while maintaining consistency with activities in your workouts
  • The importance of time, frequency, and consistency when looking for results from workouts
  • Why it’s crucial to determine your fitness goals and identify what type of activities will help you accomplish them
  • How considering your strengths and weaknesses will help you determine workout goals
  • The important role a personal trainer plays in determining and coaching your through your strengths and weaknesses

Links Discussed:

TRANSCRIPT:

Kelsey: Hi everyone! Welcome to episode 105 of The Ancestral RDs podcast. I’m Kelsey Kinney and with me as always is my cohost Laura Schoenfeld.

Laura: Hey everybody!

Kelsey: We are Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Kelsey, at KelseyKinney.com and Laura at LauraSchoenfeldRD.com.

Over the next 45 minutes we’ll answering your questions about health and nutrition, and providing our insight into solving health challenges with practical tips and real food.

Laura: If you’re enjoying the show, subscribe on iTunes so that way you never miss an episode. While you’re over there, you can leave us a positive review so that others can discover the show as well! And remember, we want to answer your question on the show, so head over to TheAncestralRDs.com to submit your health-related question that we can answer on an upcoming show.

Kelsey: Today on the show we’re going to discuss how to find a gym and a personal trainer that really works for you. This will be a two part episode and part two will be released next week. Before we get into our question for the day, here’s a quick word from our sponsor:

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Laura:Welcome back everyone! Here’s our question for today’s show:

“I would love your criteria or recommendations for choosing a gym and a personal trainer. I don’t have much knowledge in this area and I’m intimated by and typically avoid the gym though I think it could be a benefit to me. At this point it’s been years since I worked out in a gym, so I feel like I’d be starting at ground zero.”

Laura:I feel like this kind of asks two separate questions because finding a gym versus finding a trainer I think there’s going to be different things that you look for. When we talk about finding a gym, we really have to think about the different types of gyms and what kind of activities this person wants to be doing because I think when people think about gyms and personal trainers, they’re thinking about weight lifting or doing some kind of cardio machine like a bike, or an elliptical machine, or a treadmill. There’s a lot of different types of gyms out there that do a lot of different types of movement. For you and me, I think we’re really kind of focusing on the strength training side of things right now.

Kelsey:Right.

Laura:We can talk a little bit more about how we found our personal places that we workout or people that we train with, but I think we need to establish the fact that gyms don’t have to be weight training. There’s a lot of people out there that really hate weight training and don’t want to do it and then will avoid exercise because that’s what they associate with the gym.

There’s a lot of different things that people can do to be active or to work out that are not weight training related and may still be at a gym or maybe at some kind of studio type of thing like a barre class, or Pilates, or something like that that’s not really the same type of gym but may actually be a really fit for the person.

Ultimately my feeling is just to start when you’re thinking about this question is to think about what do you actually enjoy doing because if you don’t like working out with weights, you can try it, you can experiment with things that maybe you’re not sure about or you’re not sure if you enjoy, but generally for most of my clients I would say not to get into something that you don’t actually like doing because it’s probably not going to be enjoyable over the long run and you may or may not be very willing to stick to it. That would be the absolute starting point for most people.

Kelsey:Yeah, I was just going to add that granted if you‘ve tried something you know you don’t like it, then yeah, of course, I agree, I wouldn’t’ recommend trying to do something just because you hear it’s healthy or whatever, but you personally just don’t really like it.

But I do think that a lot of people have preconceived notions about certain types of activities and they sort of just decide not to pursue a kind of activity because of what they think about it or what they think it’s going to be like. Along the lines of what you just said before, certainly try something out if you’re not sure if you’re going to like it. I would really encourage people to do that if there is something that you have maybe heard a lot about and you think it’s probably a really great fit for you in terms of your actual goals but you’re not sure about the activity itself or what kind of people you’d be surrounded by.

Just for strength training for example, I think a lot of people think about those weight lifting bros in a gym and they’re like I don’t really want to be a part of that or that’s just not my scene. And there are a lot of gyms that do strength training and weight lifting that are nothing like that.

I think it’s really important to just open your mind up, toss out those preconceived notions and maybe try a few different places if there’s a specific type of activity that you are interested in but maybe a little bit hesitant about.

Laura:If you had experience with certain types of workouts that you know you really just don’t enjoy as a consistent thing, then again not forcing yourself to do it just because somebody says it’s good for you is I think a reasonable thing to do.

Kelsey:Yeah.

Laura:Just as an example, I had a couple of times in my life where I’ve tried to get into running as a consistent workout and I think the only time I ever actually enjoyed it was when I was living in Australia after I graduated from college and I was living on a beach called Bondi beach. If anyone has been to Australia, I’m sure they have heard of Bondi Beach. Or if you live in Australia, I know you’ve heard of it.

It was this really beautiful kind of built up beach area where there was a path that went from Bondi to a beach called Coogee and it was a couple miles long, I don’t remember exactly how long it was. But it essentially went from right around where I lived up in north Bondi past a bunch of really amazingly beautiful beaches and then up around these cliffs, not like a dangerous cliff, but enough that you can see a lot of things when you’re out there. Sometimes I would see dolphins in the ocean, or whales, or people were surfing.

It was just like a really cool experience and that was the one time I ever really enjoyed running as a workout because it was just so beautiful and half the time I would stop in the middle of a run and just watch dolphins or something.

Kelsey:Right.

Laura:Every other time I’ve tried to get into running on a consistent basis at least, I really just don’t like it. I don’t usually feel very good when I’m done. I usually tend to get a lot more sore than my current workout routine. Nowadays I’ll occasionally go for a run if it’s really nice out or if I want to go somewhere…I like to run on the beach so that’s one place that I will do running if I’m at the beach, like when I’m at The Perfect Health Retreat once a year or so. But otherwise generally running as part of my actual weekly routine never worked out because I just don’t have enough desire or interest in it.

It’s kind of an example of a workout where maybe you do it once in a while or maybe it’s like I do it on vacation because I can go run on the beach and it’s nice. But if it’s not something that you actually really enjoy, it’s probably not going to be something you stick with.

Kelsey:Yeah, I feel the same way about running. There’s been points in my life where it was fun for a while, but it’s never something that I have stuck with long term and I think it’s just because it’s not for me. I don’t really like it that much compared to all the other types of activities out there.

Laura:I think another thing that people tend to not consider when they’re thinking about joining a gym or changing their workout routine, this person that asked the question says that it’s been years since he or she worked out. Maybe this isn’t an issue for them, but I would say if you are somewhat active already and you’re looking to change things, one thing people need to think about is whether or not their workout routine could benefit from either more variety or more consistency.

What I mean by that is in variety maybe you’re doing the same thing every day that you go to the gym and you’re just getting really bored and maybe you’re not getting new results or you’re not really seeing any changes to your body that you used to see when you were doing that workout. If you’re in that situation and you want to start experimenting with different types of gyms or different workout routines, that variety that you can add will keep things a little bit interesting. You may find yourself more motivated because it’s more fun when you’re starting something new.

You may keep your current routine, so let’s say you’re doing a strength training routine, but then you figure you want to throw something else interesting in like acroyoga, like just something random that maybe you want to try out. Maybe you’re not going to just full on acroyoga as every workout that you do, but having that variety will help keep things interesting in your schedule and maybe just increase the likelihood that you’re enjoying yourself and not feeling bored.

But there’s a flipside to variety in your workouts and that is that if you’re doing too much variety you’re probably not going to see any significant results from a strength or a big body change because if you’re not doing things consistently, you’re just not doing it enough to actually see progress.

If you’re on the other end of the spectrum and you keep bouncing around between one day you do barre, and then another day you do yoga, and then you do weight lifting one day, and then you go for a run another day, it’s not that that’s bad. You’re not going to hurt yourself if you’re being super diverse with your activity choices.

But I will say that from a results perspective, and this is something I’ve experienced in the last couple years from training consistently, is that you really only start to see results when you are doing something more frequent and in a consistent way where you’re doing it week in and week out for a long time. I think people will kind of get all gung ho about a certain type of workout and they’ll do it for like a month and say I don’t see results, I’m just going to do something else.

I’ll say that a lot of the results that I’ve experienced, and I don’t know if you can agree this this, but the results I’ve seen in the gym personally a lot of them took months if not close to a year to actually accomplish. Just as an example, being able to do a chin up was one of my original goals for weight training and I think it took me somewhere in the 8 to 10 months range to even just get one chin up in the 2 to 3 times a week I was working out.

I know a lot of women that I work with have a goal to get a chin up and the problem is that if you’re not training for chin ups at least once or twice a week every week for months, you’re probably not going to get one.

Kelsey:Right.

Laura:That’s fine, getting chin up is not like some miraculous life changer. But if you do have goals like that, you can’t just be bouncing around between a bunch of different workouts every time that you go to the gym. You really do need some level of consistency.

I think depending on where you’re starting, if you’re just square one, not doing anything, I would say find at least one thing to get consistent in before you start bouncing around a lot. But then if you’ve been doing one thing for months and you’re getting a little bored, then you can say okay, what kind of variety might that be? For some people, it might be going from normal powerlifting to Olympic lifting. I’m not making a huge change, but just doing something a little bit different to keep it interesting. Or it might mean adding in something that’s totally different from what you’re used to doing, but it just gives you a little bit of variety.

Kelsey:Yeah and I would say with consistency, that doesn’t mean you have to do something like 5 or 6 times a week to be consistent with it.

Laura:Right.

Kelsey: I think probably for most activities I’d say twice a week is probably the minimum to really feel like you’re going to progress the longer you do that. Once a week I’m sure you would make some progress overtime, but it might just take you a lot longer. Or just thinking from a strength perspective here, I think if you only did that once a week and you’re doing other things the other days, you may not build the strength that you were hoping to by adding in strength training. I’d say twice a week is probably the minimum that you want to do something to be really consistent with it and really see improvements overtime.

Laura, I completely agree and I had the same experience with strength training. And I haven’t been doing it for nearly as long as you at this point. I’m trying to think of how long it’s been for me, maybe 9 months, something like that.

Laura:When you say nearly as long, I’ve only been doing it for 2 years, so that’s not super long in the grand scheme of things.

Kelsey:True.

Laura:I know a lot of women that they’re like in their tenth year of training and they’re my age. It’s all relative.

Kelsey:It is, it is. I definitely didn’t see really major improvements in anything until I’d say at least four months where I was like noticing, wow, I feel like I have maybe a little bit more muscle or just feel generally stronger.

If you’re giving something a month long try, while you might see some improvement, it’s generally not enough time to notice a major difference in either body composition, or just your general strength, or your general ability to move around differently than you could before. You really do have to give these things some time and certainly some consistency to really see results.

Laura:If you’re going to try something out for a month, it would be more to figure out if you actually enjoy it as opposed to saying whether or not it’s going to be what you want to get the results that you’re looking for. I think if you’re starting from ground zero like this person that asked the question is, you may see faster results in the beginning.

I think that was something I experienced at the gym because I had just come off a couple of months of not working out at all because of my car accident and so I was very out of shape. I think you get that kind of initial bump in fitness from going from nothing to working out somewhat consistently. But then I found that there was a little bit of improvements for a while, but it kind of started to build on itself, and then eventually several months in, that’s was when I started to see more results.

The trial thing, you can definitely figure out if you enjoy something from just an activity perspective. But just to use yoga as an example, if you go into a class twice a week and then by the end of the month you’re like I should be able to do a handstand by now and I can’t, a lot of these things take many months if not years to actually be able to do.

I remember when I was doing yoga, it used to be like I just want to be able to hold crow for a period of time. I wasn’t doing it consistently enough to actually see that happen. I started to feel a little frustrated, but then I was also kind of realistically thinking well if I’m only doing it once a week, I’m probably not going to see miraculous crow just emerge from once a week of doing yoga.

Kelsey:Right.

Laura:I think it’s one of those things people can feel a little discouraged especially if you’re in a group class and there’s someone there that’s been going for years and you keep comparing yourself to them. That’s one thing I really like about personal training because there’s nobody to compare yourself to except to your previous self.

But it’s important to remember that you will get fitness benefits from doing things that are not consistent. I don’t want people to feel like if I can’t do something twice a week, I might as well not even do it. There are good reasons to do yoga once a week, or take a run once a week, or a hike once a week. But if you’re trying to accomplish anything beyond just maintenance fitness, then you need to do it more than once a week.

Kelsey:Yeah, absolutely. That’s probably a good segue into talking about what are your goals, what do you want to get out of wherever you’re going to go?

I know for me, I think I’ve talked about this on the podcast before that I tend to go through these phases of what type of activity I’m doing. I was doing yoga for a while, and then I was doing kickboxing, now I’m doing strength training. Strength training has actually been the longest one for me I think.

The reason I ended up starting that was because I truly just felt kind of weak. Like many of our listeners know, I was dealing with a health condition that I couldn’t really exercise for a long period of time. At the end of that once I started feeling better I was just like, man, I feel really weak. I just want to feel strong. My goal was to put on muscle and I wanted to change my body composition as well and adding more muscle was a big part of that.

Of course you started strength training a little bit before me and so I was hearing about your experience as well and that certainly led me more along that path I think. I was just really excited to start that. My goals definitely fit within what strength training would provide. Not that I couldn’t have gotten stronger from other activities, but I knew that that was my biggest priority and I definitely felt like strength training would be the activity that would get me there the fastest.

I think it’s important to think about what you actually want to accomplish whether that’s a body composition change, or a strength change, or maybe you’re going on a trip soon and it’s a heavy hiking trip and so you really feel like you need to have the ability to hike up steep hills. All these different types of things that you can train your body to do better, you need to think about what kind of activities are actually going to get you there.

Laura:I think with strength and I’d say mobility as well, some of that can just be general life preparedness, which I know is a big Cross Fit thing where it’s like you’re basically prepared for all situations and everything that could ever happen. Which not everyone is going to be able to be that level of fitness where it’s like I could climb a building if I had to get away from a zombie or something. But just generally feeling like you can function in daily life, for a lot of people that is their goal.

Just thinking about with strength training how that affects, especially as a woman I feel like it’s really nice to be able to do things physically that give a level of independence, which maybe sounds a little sexist, but I think whatever, that’s my experience that if I can do something that requires strength, I feel like I can take care of myself a little bit better. Or even just something silly as carrying all your groceries into the house in one trip, or moving furniture by yourself, that kind of stuff.

It might not be that you have some strength goal as far as being able to compete in a powerlifting tournament, or deadlift 200 pounds, or whatever these goals might be, it may just be that you want to feel like you can handle whatever life throws at you better and there are some certain types of exercise that’s going to improve that. Whether that’s walking or jogging to build your cardiovascular strength, or weight lifting to increase your muscle strength, or maybe you have a history osteoporosis in your family and you want to avoid that, so that’s where strength training can help.

The goals don’t have to be performance related from athletic perspective. Or when we talk about body composition, it doesn’t just have to be like I want to be sub 20% body fat as a woman or something which would be pretty lean. I think there’s a lot of benefit that can come that maybe won’t leave you looking like a power lifter, or a bodybuilder, or something. And that’s okay. It may just be that you’re a little bit overweight and you want to try to get into a more healthy weight category and that might be the goal that once you hit you don’t really feel like you have to keep pushing a lower weight or anything like that.

Just getting really clear about your goals I think is super important. Or there may be some things that you want to accomplish like running a marathon, which that’s something I probably will never want to do. Maybe a half marathon. I’ve done a 10 mile race before, but running a marathon to me sounds awful. But for some people that’s like that’s a great goal and I want to do that before I die. I have friends that are like ultra-marathoners that have run 50 miles.

Kelsey: Oh my gosh!

Laura:Yeah, so everyone’s going to have their own desires as far as what they want to accomplish and that’s going to impact what you do. Because if you want to run a marathon, doing powerlifting 3 times a week probably won’t get you there. It might give you a little bit of a boost, but you shouldn’t be training for a marathon by weight lifting. And vice versa, if your goal is to get strong, then running 100 miles a week and not doing anything else may not be the best training strategy for you.

If your overall goal is just wellness, which it sounds like this person, they said that going to the gym could be a benefit to them. Whatever the benefit is, whether that’s just health or energy, or being able to handle life challenges or anything like that, I’d say something that’s fairly rounded between strength training and cardio type movement. And cardio doesn’t mean going on the elliptical for an hour. Cardio could literally mean a hike or something, or swimming, or something that just is lower intensity but kind of gets your heart rate up just to build your cardiovascular capacity. Those two things combined I would say are generally good for overall fitness.

Kelsey:Yeah.

Laura:If you’re literally looking to be fitter, then doing something like that is fine. You don’t have to do anything crazy to just get generally fit. I think what you and I do is probably a little bit beyond what we would need for general fitness.

Kelsey:Yeah, I would agree.

Laura:I’m not saying it’s extreme by any means, but it’s definitely more than what we would need if our goal was just overall health.

Kelsey:Yeah.

Laura:It really just depends. And then the other thing that could be taken into consideration here is when you’re thinking about your goals, because I think a lot of people will say I don’t know what my goals are, and I don’t want to lose weight necessarily, and I don’t really care about getting super strong, so what should I set a goal for because that’s the only thing people will think about.

I think there’s two things you can look at when you’re setting goals. One you can look at what you’re good at get better at it. Let’s say you’re pretty strong but you want to get stronger, then focusing on building strength could be more fun because it’s something you’re good at. Whereas like we were saying running, we’re not really that good at running and we don’t enjoy it that much so trying to get better at running may not really actually be a good goal for us.

Kelsey:Yeah.

Laura:The other side of the coin would be if there’s something that you’re bad at and you want to improve, like for example if you’re really inflexible and you can’t even touch your toes and you want to be able to do that, then working on your flexibility for a while might make sense.

I know for me, depending on what I’m good at versus not so good at will somewhat affect my workout goals and it will affect how I work with my trainer. An example is I’m just a very naturally flexible person. I don’t really have to work at it. I mean I’m not like a Cirque du Soleil artist or something, but I am very flexible.

Building more flexibility for me actually doesn’t really make sense or make me any healthier because I’ve actually found that my hyper-flexibility has almost caused some problems like with some back pain and that kind of thing. With yoga and stuff, I was finding that I was injuring my back from doing lots of sun salutations, or just a lot of bending and kind of back and forth forward folds, back bends, that kind of thing. I was realizing that that actually wasn’t making me feel good because I just had too much flexibility and pushing more flexibility was causing some problems.

Whereas we’ve established in my training that one of the things that is a limitation for building strength at this point for me is my core. I tend to have a weaker core. I think some of that is from the over-flexibility and some of that is also from sitting as much as I do unfortunately.

Kelsey:Laura, we’re the same person. You’re stating all of my problems as well.

Laura:Yeah. For me with the training that I’m doing with my coach, a lot of what we do is focused on core strength. Now that doesn’t necessarily mean I’m doing sit ups all day or planks for hours, but a lot of the stuff like heavier squats, or deadlifts, that kind of thing that can definitely involve the core and the heavier things get, the more strength you need to go up in the weight. Focusing on that actually has helping with my overall fitness and physical function on a daily basis because I have more core strength and then I don’t hurt myself doing things as much because my core is more activated.

That’s an example of where if you are too dominant in one area and you keep pushing that dominance, you could actually cause problems. And then if you’re weak in an area, working on building that weakness a little bit can make you stronger elsewhere.

That’s just something to think about with goals because again with core strength, I know everyone is like I want abs and visible abs is like everyone’s goal for whatever reason. But core strength isn’t just about what you’re abs look like, it’s also about how they function. I’d say it’s even more about how they function and thus building core strength for most people is a good goal. It may not make them look any different in a bathing suit necessarily, but they’ll feel better, and they’ll feel stronger, and they won’t throw out their back as easily when they’re moving or whatever happens in life.

This is the kind of goal that maybe is a little bit less obvious compared to something like weight loss or achieving a certain time in race or something like that, but I think it’s a really important goal for people that want to just generally be healthier.

Kelsey:Yeah. You were talking before about that you can push something you’re good at further if you enjoy it because most people of course enjoy things that they’re good at more than doing things that they’re bad at. But what I have found to be helpful for myself is to basically combine what I am good at and what I’m bad at.

For me for example, strength training is actually a really good mix of things that I feel like I’m good at and bad at. The flexibility piece, like you were saying you’re almost hyper-flexible, as am I. That at first was a good thing because a lot of people aren’t flexible enough for example to do a normal squat position. Their ankles aren’t very flexible and so they can’t get into the right position. At first I was very motivated by the fact that my coach was like, oh you actually have all this flexibility so you can kind of get into these positions that for a lot of people that’s what holds them back in the beginning.

I was able to actually build strength a little bit I guess I’d say more quickly from the beginning because I didn’t have to worry about that flexibility piece of it. And now the flexibility piece of it its almost what’s holding me back at this point and what I have to work on and why I have to work on building core strength because I can kind of get into these almost weird positions that cause my core not to be as activated and not to hold me up as much.

It’s kind of a mix of things that I’m good and bad at. And at different times during my lifting career thus far, those things have been a benefit to me or a detriment to me. All this to say basically is that I feel like that mixture of incorporating things that you’re good at and that you’re bad at is for most people going to give them that right amount of motivation to continue with things because you feel like you’re getting better at the things that you’re bad at while you’re also not totally neglecting the things that you’re good at. You’re still pushing things forward that you’re already good at so that feels good of course, and then combine that with the fact that you’re improving things that maybe you were bad at before also motivates you.

Laura:I think just generally being balanced with different areas of fitness is going to just help everything be easier. Like you were saying if you aren’t flexible, it’s going to make it hard for you to do certain movements. But then if you’re too flexible, it’s going to make it hard as well. That’s something that it can be really challenging to figure that out on your own. We’ll talk about this in a second, but this person was asking about finding a personal trainer and that’s where I think getting a trainer can actually really be helpful because you may not be aware of what your weakness are.

If you’re not good at squatting, you may think that that’s because your legs aren’t strong. But you may work with a trainer who points out the fact that you just either can’t get the ankle mobility, and maybe you’ll raise up your heels or something to help with that and then start to build more strength. Or maybe you, again like me and Kelsey have some issues with core strength that once the weight gets heavy you start to lose your tightness and then that makes it hard to stay in the squat position.

Having somebody to actually coach you through the areas that you are struggling with and then also help you build the areas that you are good at and kind of mixing that in so that you don’t just go through a workout and just hate life the whole time because you’re just like this is too hard and I hate this!

Having some stuff that you’re good at can make the workout a lot more fun. That’s where having a trainer or a coach actually can be super helpful to make sure you’re balancing things. Because I think a lot of people when they’re working out on their own if they don’t have a plan, they’ll end up just doing that they are doing because it’s less hard and less uncomfortable. Which it’s not the end of the world if you go and do the same thing all the time, but you’re really not going to make any progress if you’re just focusing on increasing the things that you’re good at.

It can be really hard not only be objective about what you’re not good at, but then also push through the discomfort of not being good at something to get better at it and that’s where having a coach I think actually really comes in handy because if they’re the ones that are putting together the routine for you, you’ll have a little bit more balance across that spectrum of building things that you’re good at as well as improving things that you’re not so good at.

Kelsey:Right, yeah. I have to say that I have loved having a coach. I had started doing weightlifting on my own kind of, or at least sort of in the beginning I had for a period of time done it on my own. And boy, there is such a big difference when you actually have somebody coaching you and making your programing for you. I just wasn’t making really any progress on my own and I think that’s because really I didn’t know what I was doing. I didn’t know how to program the right kind of workout schedule and I didn’t know what things I wasn’t doing right necessarily.

Having that coach really allowed me to see things objectively. Like you were saying before, there were things in my squats that I can’t notice on my own when I’m just doing it, but somebody else watching me can certainly notice. That objective eye is really helpful as is of course somebody who knows how to make a workout program that’s going to address you’re weaknesses and also improve what you’re already good at.

Laura:Definitely. That’s not the only benefit of a coach. It’s definitely one of the bigger ones, but as I found in the last couple of months as life has gotten kind of crazy, and tiring and stuff, that for me I think I’m at the point where I could probably do a pretty good balanced workout routine and I know generally what I need to focus on to improve certain things.

I think there’s still benefit of having the coach, but because I’ve been doing it for two years I’m probably at the point where I could do my own workout if I wanted to. However for me the real benefit at this point seems to be coming from the motivation piece because right now at least because of how busy I am and there’s so many things that I have to do that it would be super easy to just not go to the gym on a certain day if I’m tired or if I have a lot of stuff that I have to get done. Right now having my sessions scheduled with my trainer means that I’m not going to skip it because I paid for and I can’t just bail. I mean I could, but then I would lose money and it’s not a cheap session, so it’s not like I’m like oh it’s just 10 bucks, I’ll just skip it.

We have a lot to talk about with this episode. What we’re going to do is actually cut this one into two different parts. If you were enjoying what we were talking about today, just tune in next week and we’ll be finishing our conversation about how to pick a gym and a personal trainer if you’re starting from scratch. We hope you’ll join us next time and we’ll see you around.

PODCAST: Is Late Night Eating Unhealthy?

Thanks for joining us for episode 104 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering the following question from a listener:

“I recently read an article in a major newspaper stating that eating late at night has again been found to be bad for you. According to the article, it can raise risk of cardiovascular disease, weight gain, and deteriorate sleep quality. Personally, I find it very hard to avoid eating at night. If I don’t, I tend to feel hungry when going to bed or I wake up too early because I’m hungry.Sometimes this happens even if I eat rather close to bedtime. I wonder if this might be from some metabolic problem like issues with insulin, leptin, melatonin, or something else. What foods would you recommend to avoid waking up hungry? What’s your take on whether it is actually bad to eat late at night? I found contradicting information when trying to research the topic.”

We keep hearing the warnings to curb late night snacking, but many of us can relate to the familiar hunger pangs of the nighttime munchies. Is hunger at night really a problem that can lead to negative health outcomes?

On today’s show we’ll be discussing whether or not nighttime snacking is detrimental to health and the reasons why you may experience late night hunger. You’ll come away with fresh insight into this controversial topic as well as practical tips on how to promote healthy hunger signaling.

Here’s what Laura and Kelsey will be discussing in this episode:

  • Effects of circadian rhythm disruption on hunger signals
  • Situations where eating before bed is not harmful and can even can be beneficial
  • Why appetite may not be regulated simply by the concept of calories in and calories out
  • Research that suggests increased hunger at night is normal and based on circadian rhythms
  • How the time you eat dinner can affect appetite level before bed
  • The effect under eating calories during the day has on nighttime appetite and waking up hungry during sleep
  • The importance of maintaining blood sugar balance in regulating hunger
  • The effects of stress on cortisol levels, blood sugar, and emotional eating
  • The prevalence and possible causes of night eating syndrome
  • How consistent meal timing and macronutirent balance throughout the day can help balance hunger signals
  • The importance of a nutrient dense diet in supporting healthy hunger signaling
  • Tips on how to support healthy circadian rhythms

Links Discussed:

TRANSCRIPT:

Laura: Hi everyone! Welcome to episode 104 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is my cohost Kelsey Kinney.

Kelsey: Hey everyone!

Laura: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Laura, at LauraSchoenfeldRD.com, and Kelsey at KelseyKinney.com.

Over the next 30 to 45 minutes, we’ll answering your questions about health and nutrition and providing our insight into solving health challenges with practical tips and real food. Stick around until the end of the show where we will be sharing updates about our businesses and our personal lives.

Kelsey: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. While you’re there, leave us a positive review so that others can discover the show as well! And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health-related question that we can answer on an upcoming show.

Laura: Today on the show we’re going to be discussing the causes of hunger late at night and how to solve your night eating habits if they’re truly contributing to poor health. Before we get into our interview, let’s hear a quick word from our sponsor:

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Laura: Welcome back everyone! Here is our question for today’s show:

“I recently read an article in a major newspaper stating that eating late at night has again been found to be bad for you. According to the article, it can raise risk of cardiovascular disease, weight gain, and deteriorate sleep quality. Personally, I find it very hard to avoid eating at night. If I don’t, I tend to feel hungry when going to bed or I wake up too early because I’m hungry. Sometimes this happens even if I eat rather close to bedtime. I wonder if this might be from some metabolic problem like issues with insulin, leptin, melatonin, or something else. What foods would you recommend to avoid waking up hungry? What’s your take on whether it is actually bad to eat late at night? I found contradicting information when trying to research the topic.”

Laura: I think what I would like to do is first talk about the controversial suggestion that eating at night is bad for you because I think when we talk about that kind of research, of course just keep in mind that newspapers and magazines like to be a little bit sensational with research information.

This study, I don’t know what study they’re referring to, but it could have been something that said people who eat later than 10:00 at night tend to have obesity, heart disease, poor sleep, blah, blah, blah. A lot of these studies are correlational. I would not be surprised if there was a correlation between people who eat late at night and these health issues. However we have to think about why that correlation would exist and not just say well if there’s a correlation, it must mean eating late at night is bad for you.

There’s a couple of different things that I feel like could lead to late night eating at least in the west, maybe not in third world countries, but in the western modernized cultures. A lot of people tend to stay up a lot later than they maybe should. You and I might go to bed at like 10:00 or something on a normal night, but I’d say the average American is probably not going to bed that early unless they’re super committed to good bedtimes.

Kelsey:Right.

Laura: There’s a lot people that stay up late watching TV, or doing work, or just playing around on the internet, or whatever. But a lot of people are going to bed 11-12, 1:00 in the morning later. If you are staying up that late, first of all it just adds extra time awake compared to when you have dinner. If you’re eating dinner at let’s say like 6:00 or 7:00 and then you don’t go to bed until midnight, you’re going to have a 5 or 6 hour gap between eating dinner and going to bed. It’s no wonder that you’d be hungry because a five or six hour break between eating, you’re generally going to be ready for another meal.

A lot of people, they’ll stay up late and then they end up eating before they go to bed. That lack of sleep the next day can affect their hunger, maybe it affects their caffeine intake. If they’re staying up late and then they wake up in the morning and they’re tired, and then they need caffeine, and then that kind of triggers some sugar cravings, and then they may end up just eating more food in general.

If they’re already eating breakfast and then they’re eating a fourth meal at 10:00 or 11:00 at night, then overeating in general is going to lead to weight gain, and metabolic syndrome, and cardiovascular disease especially if it’s overeating of junk food. Which again, most American’s if they’re eating late at night, they’re not going to be eating a steak and sweet potato. They’re going to eating packaged foods, or desserts, that kind of thing, or ice cream. Ice cream in moderation, not a big deal. But if you’re eating ice cream on top of an overly junky diet, then that might not be so helpful.

Then the other thing that I’m thinking could contribute to poor health outcomes is if you’re chronically staying up late and eating late at night, that could disrupt your body’s natural circadian rhythms which then would negatively impact sleep. If you’re just overall not supporting circadian rhythm entrainment, that can make you sleep more poorly, or have weird wake up times, or just generally not having a normal pattern of sleeping. And then those circadian rhythm disruptions can also lead to things like inflammation, metabolic syndrome, insulin resistance, that kind of thing. That could potentially be causing some problems too.

I also don’t particularly associate these affects with someone who’s eating a healthy diet and they just have a little extra food before going to bed to make sure that they’re not hungry and they sleep better. I think this is something that you and I recommend for a lot of people to have a little bit of food right before bed if they’re struggling with not sleeping well, or if they’re super active, or maybe they’re just having a hard time getting enough calories in at their normal meals and they need a little extra before going to bed to make sure that they sleep well.

Even if you are sleeping well, I don’t really think there’s any problem with having a bedtime snack. I don’t think there’s going to be an increased risk of obesity or heart disease if you have a little food before going to bed. I would imagine you’re on the same page there, Kelsey?

Kelsey: Yeah. I think there’s a big difference between what you were talking about, that overconsumption where if that is leading you to over consume calories consistently, then yeah, that might cause a problem. But if it’s within your overall caloric expenditure and you’re eating part of those calories at night, I certainly don’t think there’s anything wrong with that.

Laura: Even just the food quality, I mean we don’t like to be overly consumed with calories, but if you’re food quality is better it’s going to affect your calorie intake.

Kelsey:Right.

Laura: If you have a banana and some almond butter right before bed, you’re probably not going to eat as much as if you had Doritos or something.

Kelsey:Exactly.

Laura: There’s a lot to be said for palatability and the processed junk food versus something that’s fairly healthy and it’s just another part of your diet. It’s funny because we just last week talked about the person who was potentially under eating and this would be a situation where maybe having a bedtime snack is actually helpful because she was eating 1,800 calories and we thought she needed at least 2-300 more. She could throw in a banana with a tablespoon of almond butter and easily get that 200 calories right before bed and that could end up just overall making her feel better, helping her sleep better so that way she wakes up more refreshed in the morning. There are some people out there that late night eating might actually be helpful.

There are some reasons that people might be hungrier at night that we’re going to cover, but one issue that I wanted to discuss was the question of whether or not being hungry at night is actually abnormal because from this question we’re assuming she feels that eating late at night is – or actually I should say he or she, we don’t know the gender – but eating late at night is unhealthy and associated with some kind of metabolic problem or having that drive to eat late at night. But when I was doing research to just look into that topic and see is that weird, is that abnormal, is that unhealthy to have a higher hunger level at night, there’s actually some research from the last couple years that suggests that having a higher amount of hunger in the evening is actually normal and based on circadian rhythms.

We may think that your overall appetite is generally regulated by your calorie balance, so if you haven’t had enough food, you’re going to be hungry. If you had too much food, you’re going to be full. Which it does, I mean that definitely impacts your hunger signals if you’re overeating or under eating. But the problem with that being the only thing that’s going to drive appetite is that if it truly was just based on calorie surplus versus deficit, it would make more sense for us to be the hungriest in the morning because we’ve gone 8 to 12 hours without eating, minimum. If you did that during the day, if you went 12 hours without eating, you’d probably be a lot hungrier.

Kelsey:Right.

Laura: But we do it overnight just fine. That to me and the research that I saw indicates that it’s not just about calories in and calories out, it’s also about the time of the day and the type of hormones that are released at different times of the day to stimulate or suppress appetite.

Appetite is actually generally the lowest in the morning for most people. The research that they’ve done, most people only get about 16 to 18% of their daily calories at breakfast. A lot of people skip breakfast all together. A lot of the intermittent fasting type recommendations play off that lower appetite and have you do the fasting in the morning when you’re really actually not that hungry for the most part. I mean some people wake up super hungry. I know I tend to get hungry about an hour after waking up.

Kelsey:Yeah, same here.

Laura: But a lot of people, they’re not even hungry at all and intermittent fasting actually works well because they don’t have to worry about eating. But that would like I said indicate that there’s something happening that makes our bodies crave less food in the morning and more food at night potentially.

The research that I looked at was from 2013, and I’ll link to this paper in the show notes just so you guys can check out the study too. But it was from Oregon Health and Science University and Harvard University and their research found that the body’s internal clock, which is that circadian rhythm system, actually could be the cause of having late night cravings or having hunger in the evening.

What they did with this study is they took a bunch of participants and they essentially reset their internal clocks. All of our internal clock systems are based on light and dark exposure, eating, exercise. There’s a lot of different things that affect our circadian rhythms. I don’t remember exactly how they did this, but they basically got everyone on the same schedule to make sure that they were waking up the same time, going to bed at the same time, eating meals at the same time, just basically trying to reset their internal clocks. And then what they did for two weeks is they put the volunteers in a lab suite like a hotel room where they turned the lights really dim so that the person could never really tell what time of the day it was or even what day of the week it was. This actually sounds like kind of torture in my opinion.

Kelsey:Yeah, it does.

Laura: They didn’t have any TV, internet, phones, or visitors for two weeks. Oh my gosh, I’m like who the heck would volunteer to do that?

Kelsey:Seriously.

Laura: You better be paying a lot of money. I don’t know, maybe you would feel like super refreshed after.

Kelsey:Maybe, yeah like after camping or something.

Laura: Only just being in the dark room alone. That’s actually really bad. Well anyway, that was the study. They put them in this dim room for two weeks and the light never changed and then the researchers varied what time each participant ate and slept. And then so that affected each volunteer’s body clock. Even if they went to sleep at 2:00 in the afternoon, it felt like nighttime to them and basically they just had no idea what time it was. If they were going to bed at 2, it’s almost like they were in another country and they had that jet lag experience where all of a sudden you’re like oh it’s 2:00 with my body’s time, but it’s dark out so I’m going to go to bed.

Kelsey:Right.

Laura: But the people ate all the same amount of food and it was regular intervals. They tested their hunger and just had the participants rate how hungry they were. Even though they had totally phase shifted everyone’s circadian rhythms so that they were in different time zones essentially, everyone was the hungriest when their body’s internal clock thought it was evening no matter what they were doing. It didn’t really matter if they were awake, or asleep, or if they were doing any sort of activity or anything. The hunger really came on the strongest in the evening.

They identified the circadian peak in hunger to be occurring at about 8 pm and the circadian trough, which is the opposite of the peak in hunger occurred at 8 am. Essentially if people just have no concept of what time it is and their bodies just start to get into the somewhat arbitrary 24 hour rhythm, their hunger is highest at 8 pm and lowest 8 am.

Kelsey:I’m trying to clarify here a little bit. Is that 8 am 8 pm based on the actual time or what the researchers were making them think the time was basically?

Laura: It was based on what the researchers were making the person’s body think it was.

Kelsey:Okay, got it.

Laura: It’s kind of like when you travel, let’s say you fly to Europe and they are 5 hours or 6 hours later than us, and then you readjust to that Europe time, you’d still be getting that trigger of hunger at 8pm in Europe time even though your body came from the United States where it was only 3:00 in the afternoon technically.

Kelsey:Okay, got it.

Laura: Your body kind of adjusts to that new 24 hour cycle. If they’re going to bed at 2:00 in the afternoon, it felt like it was maybe 10:00 for that person.

Kelsey:I see.

Laura: They were having their hunger peak at noon because they thought noon was 8 pm and 2:00 was 10 pm. Does that make more sense?

Kelsey:Yes, that makes more sense. Got it.

Laura: It’s obviously very complicated, but I think the interesting thing was just finding that once people got into this phase shifted 24 hour cycle that they just had no idea what time it was, their body still had that peak and trough in hunger that averaged around a peak at 8 pm and a trough at 8 am.

Hypothetically if that applies to all people, you should be basically at your hungriest around 8:00 at night and at your least hungry at 8:00 in the morning. That’s with the assumption that somebody’s got a 24 cycle of circadian rhythm that’s fairly consistent and doesn’t change a lot, and their not staying up really late one night and then going to bed earlier the next night.

Kelsey:Right.

Laura: But generally if you’re going to bed and waking up at the same time most days, you should be experiencing your highest hunger amount at 8:00. That’s not super late, but you can imagine if somebody’s eating dinner at like 6 or 7 and then they have that hunger peak later, they may experience some hunger right before going to bed. And then if they unfortunately believe that eating anything before bed is going to cause health problems, they may avoid it and then they will wake up hungry and not feel good. That’s just exacerbated if they didn’t eat enough during the day. My point of going over this research is to suggest that being hungry at night is not abnormal.

Kelsey:Yeah.

Laura: There’s a lot of different things that can contribute to late night hunger that we’ll go over in a second, but if you are feeling the most hungry at say like somewhere between 7 or 9 pm, that’s not bad, or unhealthy, or abnormal. I just want people to keep that in mind because again I think there’s a lot of random crappy recommendations out there that are like don’t eat past 5 or don’t eat right before going to bed because it’s going to be stored as fat. It’s like no, that’s only going to be stored as fat if you overeat that day.

Assuming you’re not in a major calorie surplus, depending on what time of the day you eat, it shouldn’t really affect your health that much. If your circadian rhythms are messed up because you’re staying up too late, that could be a different story. But the actual time that you’re eating shouldn’t really make a huge difference.

Kelsey:Yeah, and I think that piece about the circadian rhythm is really important because a lot of us have messed up circadian rhythms. Maybe we are getting hungry at weird times or we’re just like adding on another four hours of being awake that maybe we shouldn’t be awake if we’re staying up till midnight or even later than that. I think there’s a lot to be said about making sure your circadian rhythm is on target and you’re consistently going to be and waking up at the same time.

But one thing that I was thinking as you were talking through this is that I think culturally in the U.S. we tend to eat pretty early for dinner, which having just come back from Europe, I tended to eat a lot later there because a lot of restaurants don’t even open until 7 or 7:30. Honestly, I think I like that better. I tend to be a later eater at night and apparently from this research that seems to make more sense just by biologically that around that 8 pm time would be when most people are going to be generally the most hungry.

I think that may play a role in it too. If this person is from the U.S., if you’re eating at 5 or 6 pm, your body is just going to be hungry later. Even if you’re going to bed at 10 pm which is a totally normal time to go to bed, that still is quite a long time before you would eat again. I would imagine that by 10 pm you might start to be getting a little hungry.

Laura: Yeah, it’s kind of funny, I had a friend in high school who was French, his family was from France. He used to eat dinner at like 11:00 at night, which to me is just outrageous. I’m like if I’m eating at 11:00 at night, there is something that went seriously wrong that day. It’s just funny because it is such a cultural thing.

Kelsey:Yeah.

Laura: I know in Europe they tend to do afternoon naps, maybe not all of them but there is that siesta type of thing.

Kelsey:And they’ll also tend to have a snack at that evening time. Maybe like 5 or 6 they’ll eat a little something, have a drink, and then they’ll eat way later for their real dinner meal.

Laura: Right. It’s not that we’re suggesting people should eat dinner at 11, but what we’re suggesting is that if you’re eating dinner super early, it’s not that weird that you’d be hungry before bed.

Kelsey:Right, exactly. Let’s talk a little bit more about some of the reasons why you might be hungry late at night. One of them of course is just that if you’re eating at 5 or 6, being hungry four hours later is completely normal and to be expected I would think.

Another thing that I would say that I see very, very commonly in my own practice and Laura, I ‘m sure this is the same for you, is that a lot of our clients will tend to just not eat enough over the course of the day. This is because maybe they’re stressed out at work, they don’t have time to eat to like sit down and have a full meal at work, they’re just sort of working throughout their meals. They’re not paying a lot of attention to their hunger signals necessarily and so they may not be eating enough as they move through their day. Maybe they’re skipping breakfast because they’re trying to rush to work.

There’s a lot of reasons why somebody may not be eating enough during the day. And then when dinnertime comes around, maybe they’re eating more of a normal amount but because they haven’t eaten a lot for breakfast and lunch, by the time after dinnertime rolls around, 8-9pm, they’re still hungry. Dinner didn’t fill them up enough so they will still feel like they need to eat something at night in order to not go to bed hungry or wake up hungry.

Like I said, for me this is probably the number one cause of why somebody who feels, like this person is explaining, that they have to eat at night because otherwise they’re not going to sleep well because they’re waking up hungry maybe even in the middle of the night or they can’t fall asleep because they’re hungry, but they feel like they shouldn’t eat because they’ve heard that it’s bad for them or whatever.

What I would highly recommend that this person does is use an online calorie calculator. We’ll try to link to one here. There’s a lot of them out there where you can just put in your height, your weight, your age, your activity level and it will spit out a calorie recommendation for you. Just track for a couple days and see how close or not you are to that target because chances are you’re probably going to be under eating fairly significantly from what that number comes out as.

Once I have people who are experiencing what this person is talking about, once they start to eat that number of calories overall and it’s coming from real whole food sources, they find that they’re not as hungry at night or they don’t feel like they absolutely need a snack before going to bed as long as they’re getting all of those calories that they needed between their three meals in the day.

Even if you do want to have a nighttime snack and that’s part of your overall calories, that’s fine too, but you won’t be waking up hungry or feeling like you’re hungry when you’re going to bed. You’re going to be perfectly satisfied.

That is a really, really common reason why somebody might feel like they absolutely have to have something to eat before they go to bed otherwise they’ll wake up hungry. Laura, I assume you see this very often as well.

Laura: Yeah, I mean I can say that I even have had that issue for myself, which is kind of annoying because anytime I’ve tried to purposefully lean out a little bit this tends to happen. Even if I’m just a couple hundred calories below what my needs are during the day, I’ll end up feeling super hungry right before bed and then I usually end up needing a snack.

Kelsey:Yep.

Laura: I’ve definitely experienced that before and it kind of stinks because it’s like on one hand you’re like I have this deficit I’m supposed to be doing. But then you’re like I need to sleep so I’m just going to eat. I always err on the side of eating. But it’s very, very common.

Kelsey:Yeah, absolutely. Another thing that can play into that too is just having low blood sugar. Sometimes you can get enough calories but your blood sugar ends up being too low because for example, and this may not be the case for this person, but maybe they’re eating a lot of processed carbs or something and that’s spiking and lowering their blood sugar, or they’ve got something like adrenal fatigue which is causing blood sugar imbalance.

There’s a lot of things with blood sugar that can happen that make you feel hungrier at times even if you are eating enough calories. One of those things just to consider is exercise. If you do a lot of exercise during the day, sometimes that will end up tanking your blood sugar later in the evening. And of course when you’re blood sugar is low, your body says okay, it’s time to eat. It’s going to turn on those hunger signals for you.

Even if you do that calculation, you see that you’re eating enough, but you’re still having some of these issues, think about the other health conditions going on, think about your lifestyle factors that may be playing into getting low blood sugar and work on those. You may find that that fixes the problem too.

One of those lifestyle factors in addition to exercising is also stress because of course that’s going to mess with your cortisol levels which really plays a controlling factor in your blood sugar. Anytime your blood sugar gets too low, your cortisol is going to raise to help break down proteins and other things to create glucose. Basically when you’re cortisol is out of whack, oftentimes your blood sugar is going to be out of whack. You really need to make sure that your stress levels are under control so that you’re cortisol is normal which will help you to maintain a more normal blood sugar level so you won’t get those really strong hunger feelings when you’re under a lot of stress.

Even outside of the cortisol aspect of stress, I think that just stress in general as I’m sure many of you can relate to, when you’re stressed out, a lot of us tend to reach for comfort foods or just eat from an emotional eating perspective where when we eat it tends to relax us and helps us to cope with the stressors in our life.

This is something that like I said, I’m sure a lot of us have experienced when you have a stressful day, a lot of times you’re just like I just want to go sit down and eat something or grab a sugary snack because it’s going to just give me that little boost that I need to help me get through whatever is going on. That’s a really common thing to experience especially at night because your day is over, a lot of the stressors are over, but a lot of times they’re still taking their toll on us and we just want to relax at that point at night and so we’re going to do anything even if it’s subconsciously to help reduce that stressor and eating can certainly be one of those things.

I think along with this, a lot of us when we watch TV, it’s pretty typical at least in American culture to associate TV or movie watching with snacking. I think that this goes along with the stress piece but it can also be outside of stress too, just that association of watching TV or watching a movie and having something to munch on while you do that, your brain just kind of associates the two. Again, it’s this unconscious sort of reaction that your body does and you just reach for a snack or you want to have a snack when you’re watching TV.

Again, I think this can play into that stress piece because we watch TV as a way to relax at the end of the day and then adding the snacking on top of that is another way to reduce the stressors from our daily lives.

If you notice that that is you, you feel like you’re just eating while you’re watching TV at night, or you’re just eating as a way to kind of cope with stressors in your life, definitely pay action to those stressors and try to reduce them, do some stress management techniques, deep breathing, yoga, that kind of thing to help to manage those stress levels in a way that doesn’t involve eating because you may be triggering a hunger reaction when you’re not really hungry but your body just wants some way of reducing that stress.

Another thing to think about is sleep deprivation. Of course when you are sleep deprived, this is going to raise your stress level again. As a way to reduce that stress level or to get a boost to push through a sleep deprived state, your body is going to want to eat some food. A lot of times it’s not great food either, it’s the sugary stuff, the processed stuff, the comfort foods that we’re going to want to reach for at that point again to either reduce that stress level of having a lot of things to do when you’re sleep deprived or to help boost your energy to get through that sleep deprived state.

Laura: I feel like stress and sleep deprivation are often connected as I’ve been experiencing recently. It’s funny because I don’t know which one comes first. Sometimes I think it can be they just play off each other. I know for me if I am sleep deprived, for example if I’m traveling late and I get home at 12:00, and I don’t get to bed until super late, and then I feel exhausted the next day, I know that my stress resilience is a lot lower when I’m tired.

Kelsey:For sure.

Laura: And then on the other hand, if I’m super stressed during the day, that tends to make me a little bit more amped up at night and then I can’t fall asleep.

Kelsey:A vicious cycle.

Laura: Yeah, so I think stress and sleep deprivation can definitely play off each other. Then like you said, eating, especially sugar and fat basically, is going to be an easy way for your body to feel comforted, but assuming you’re eating enough during the day, maybe isn’t the best solution.

Kelsey:Right, it’s just adding on calories as a way to comfort the body, which isn’t necessarily a bad thing in the short term, but if that’s consistently happening overtime, that’s when you get into trouble.

Laura: I think that also takes us back to the whole circadian rhythm disruption issue because if you’re not going to bed, even if you’re sleeping 8 hours, if you’re not going to be until super late, that’s going to affect the 24 hour cycle that you’re in, kind of like what we talked about with that study. If your circadian rhythms are messed up, you may just have this hunger that comes at night for that reason that we talked about before that has nothing to do with how much you’ve eaten, what you’re stress levels are, things that are a little bit more fixable. In that situation, you definitely need to focus on getting your 24 hour clock to a more normal state, which definitely going to bed on time, and minimizing stress in the evening, and not doing things that are going to disrupt your circadian rhythms right before bed is good. We’ll talk about some strategies for that later.

But I wanted to just quickly mention there is an actual eating disorder called night eating syndrome. It’s not very common. Experts estimate that about 1 to 1 ½ % of the general population and then 6 to 16% of patients in weight reduction programs, and then 8 to 42% of bariatric surgery candidates experience night eating syndrome.

Kelsey:Wow!

Laura: I’ll mention why that might be in a second, but the average population around 1 to 1 ½ %, so not very common in the typical person. Night eating syndrome is characterized by a lack of appetite in the morning which then leads to overeating at night and then often times waking up in the middle of the night to eat as well. Sometimes there’s people who they don’t even remember getting up to eat so they’ll have almost this, I don’t want to say narcoleptic kind of experience, but it’s like they’re sleeping – not narcoleptic….

Kelsey:Sleepwalking?

Laura: Yeah, sleepwalking but sleep eating when they get up and go downstairs and eat and they don’t even remember that they’ve done this.

Kelsey:I feel like I watched a science class video about this way back when.

Laura: Yeah, possibly.

Kelsey:Where somebody would get up in the middle of the night and they were eating spoonfuls of mayonnaise and wouldn’t remember it at all.

Laura: Ugh, gross! I’m just imagining eating mayonnaise on a spoon. But yeah, it can be like seriously I guess a disorder as opposed to just making decisions to eat that way. For those people, there is definitely a lot of evidence that there’s either an imbalance in neurotransmitters or their hunger signaling hormones like leptin and ghrelin.

There’s been some brain scans of these people with night eating syndrome that show that they typically have an elevation of serotonin transporters. What that means is that their serotonin ends up getting up taken out of the synaptic, I forget what it’s called. Basically where serotonin is supposed to hang out and be active, it gets taken back into the neurons and then it’s not active. So then basically you’re having less serotonin activity and that actually ends up impairing both the circadian rhythms and boost satiety as well as mood so they can have a lot of depression and anxiety, that kind of thing because they are having lower serotonin.

The other problem that adds to this, which I think you probably get a handful of people who have this serotonin transporter imbalance that affects their risk of this, but then there’s that extra level of kind of the more neurological, cognitive problem where either the person is dieting to lose weight and the restriction of the calories during the day makes their brain increase their hunger signals, and then they’re trying to starve themselves all day, and then they end up overeating at night, and then they feel a lot of guilt and shame around that. It’s kind of this cycle of behavioral decisions that just keeps them in that pattern. Especially if you’re eating a ton at night, you’re not going to be hungry in the morning.

Kelsey:Right.

Laura: Even if you’re a normal eater, if you go out to a big dinner the night before a lot of times you’ll wake up like I’m not even hungry, I’ll just have some coffee or something. But if it’s happening every night that the person is not eating anything in the morning and then they’re eating ton at night, they might not have that hunger in the morning and then that is just a self-fulfilling prophecy.

But then the other problem especially if somebody is overweight or obese is that there’s that shame factor of eating a lot a night so then probably it turns into more neurological disorder as opposed to a physiological disorder. It’s kind of more like the typical eating disorder that comes from body image issues, or negative emotions, or control, and that kind of thing. But basically the person feels all this shame around eating. I think it ends up being they end up just bingeing because they feel guilt and then they are almost trying to self-medicate with the food.

Kelsey:Right.

Laura: Again, it can kind of be more of that cognitive behavioral problem. But I do think that there could be some more biological triggers that are happening. Again serotonin deficiency or transporter issues, or if the person’s circadian rhythms are super screwed up, that could start the behavior and then it’s kind of like a cognitive behavioral response where they feel guilt and shame around the behavior and then that triggers more of it.

Kelsey:Right.

Laura: It’s a very complicated issue and the research that I was looking at shows that it’s very difficult to treat and a lot of people just don’t feel capable of overcoming it.  But I would say we have a couple of thoughts about how to reduce hunger at night. So if you do feel like the hunger and the eating at night is actually contributing to some health problems, like let’s say you are bingeing at night and then not being hungry in the morning and kind of stuck in this cycle, assuming you don’t have a severe serotonin issue, then there are some behavior changes that can help.

I do want people to remember, we’re going to talk about how to avoid late night hunger and eating too late if that is something that is causing problems, but I do want people to just keep in mind that eating food just before going to bed, like having a snack or maybe having a later dinner, it’s not really that big of a deal in the grand scheme of things. A lot of people can really benefit from having a bedtime snack, having a little food before they go to bed. Other people like to have their dinner later like you were saying. It’s culturally more acceptable certain places to eat late at night. So don’t necessarily think if you’re hungry at 9:00 that that’s weird. It’s not weird in other countries.

Also, if you’re eating breakfast in the morning, that can sometimes affect how much you need to eat at night. If you’re doing things like intermittent fasting or just accidently skipping meals, that’s going to make you more hungry at night. Eating consistent meals across the day and eating in the morning may help shift your overall food intake earlier. And then it can also can actually promote a shift in those circadian rhythms that may move your hunger signaling closer to what that 8 pm biological norm is. If you’re finding that you’re getting these strong hunger signals at 10:00 at night, it might be that your circadian rhythms are just shifted a little bit.

Kelsey:Right.

Laura: Getting your meals earlier in the day will you move it a little bit more to the normal 24 hour cycle that you’d be on. And then just making sure that your food is balanced, a lot of times when people eat breakfast, they’ll maybe just do one major macronutrient. The typical American diet is going to be very carb based breakfast which that can also kind of set people up for blood sugar dysregulation and hunger during the day, and then that can lead to hunger at night.

I’d say the more common thing we see in our Paleo type clients is that they’re doing very low carb breakfast or maybe they’re doing something like bullet proof coffee in the morning which is all fat. If you’re not getting carbs in the morning that might trigger some carb craving at night, which whether or not you indulge in those cravings, I don’t think it really affects how you crave them. If you’re overall low carb or if you tend to do more of the carb back loading where you have a lot of carbs at night, just be aware that’s actually causing you to have hunger in the evening.

And then protein obviously a lot of our Paleo clients don’t have trouble getting enough protein, but if you are not eating much protein, that’s going to affect how well you control blood sugar as well and that could cause hunger not only in general during the day, but then especially at night.

Kelsey:Yeah, absolutely. And then just considering that you really should be eating a nutrient dense diet. Regardless of how your macronutrient balance is split up and how many calories you’re eating overall, all that kind of stuff, you do need to be eating a nutrient dense diet because simply being deficient in some nutrients, your body is going to at that point be searching for those micronutrients in your food. You may end up eating more because your body is like, okay, eat this, eat this, eat this, let me see if I can get some of the micronutrients that I need from any of these foods. It can kind of make you more hungry than you might be otherwise if you’re eating a nutrient dense diet and you’re getting all the micronutrients that you need.

I’m sure this is not a necessary statement for this audience, but in case there’s somebody who is at the beginning of your whole food journey, this can really, really help with reducing some of the hunger signals that you might get that even if you’re eating an adequate amount of calories is still there.

And then you also within that idea try to focus on higher fiber carbohydrates like potatoes, and sweet potatoes, and plantains and really limit your refined grains and sugar especially if you tend to get low blood sugar a few hours after eating them. Because of course if you’re a fairly typical American and you’re eating a refined grain or refined type snack late at night and then a few hours later you’re about to go to bed and your blood sugar is tanking at that point, you’re going to feel hungry and you’re possibly not going to feel like you could go to sleep at that point because maybe your cortisol goes up because you don’t have enough blood sugar at that point.

This can certainly make that cycle continue a little bit more easily if you’re not eating things that would balance your blood sugar very well. Again, this goes along the lines of that nutrient dense diet. But for blood sugar issues specifically, you really want to pay attention to not eating a lot of refined grains and sugar and focusing more on those higher fiber carbohydrates.

If you do eat refined grains, just make use that you’re eating them as part of a whole meal rather than eating your refined grains as a snack on their own. If you’re eating a bag of chips for example, essentially on its own it’s not going to balance blood sugar as well as if you ate a bit of white rice with a meal that has fat and it has protein. That’s going to make your blood sugar a lot more stable than if you ate it on its own.

And then also don’t go to bed too late. As you guys know we’ve talked about circadian rhythm a lot in this episode and how a lack of sleep can raise your stress levels as well. Making sure that you get not only enough sleep but that you also are sleeping at a relatively normal time, paying attention to when it gets light out and when it gets dark out and sort of trying to follow that pattern as much as you can, that’s really going to help make sure your circadian rhythm is on target.

Along those lines too, you want to make sure that you’re not getting a lot of light exposure at night. Turn off your overhead lights, use lamps or turn off your TV, or use orange goggles to reduce the amount of blue light that you’re being exposed to from a TV, or from your iPhone, your computer, any of those things. And then make sure you get sunlight exposure when you wake up so that you are getting that blue light when you’re supposed to get it. That’s going to help set your circadian rhythms in a more normal manner.

And as you can imagine, if you’re going to bed really late because your circadian rhythm is off, like we talked about before, you’re going to be hungrier because if you ate at 5 or 6 and then you’re going to bed at 11 or 12, that’s a good amount of time that you have in between when you’re eating and when you’re going to bed. It’s perfectly normal to be hungry at that time. But of course if you went to be maybe a couple hours earlier, you wouldn’t feel as hungry.

Or if you know that for you 8:00 is about when you’re getting most hungry, you may want to actually consider moving your dinner a little bit later potentially if you’re going to bed at like 10 or so. So think about that, don’t go to bed midnight, 1:00. Really try to get your circadian rhythm on a good schedule and that hungriness that you’re feeling at night should hopefully not be as much of a problem.

And then another thing to consider of course is to focus on your stress management. As we discussed, stress is huge when it comes to eating at times when we aren’t really hungry or promoting hunger signals that aren’t necessary because those comfort foods or just eating in general is going to reduce stress levels, help us to cope with stressors in our daily lives. Don’t ignore stress as a trigger for your hunger levels especially if you know overall that you’re eating enough calories. Implement some stress management techniques like deep breathing, yoga, tai chi, mediation. Anything that you personally like and enjoy, make sure you’re incorporating that on a regular basis.

Laura: Alright. Well, that was a lot of information.

Kelsey:It was.

Laura: It’s funny, when we were researching that I was like we could probably talk about that for 20-30 minutes. And now I’m like, wow, actually it’s like 45.

It’s funny because she asked what foods would you recommend. I think that individual food is not so much of the issue as much as it is timing and macronutrient balance. I don’t think it’s helpful to tell you what food to eat. I think everyone is going to have a different experience with what foods make them feel the best and what their general preferences are. At the end of the day, the timing and the balance is really more important than the individual foods that you’re eating.

Kelsey:Absolutely.

Laura: Cool! Well, that does it for the question. Now we’re going to get into some personal updates in a moment. But if you have a question that you’d like us to answer, please go to TheAncestralRDs.com. Click the contact tab and you can submit your question there and we will hopefully answer it on an upcoming show. But otherwise, we are going to just chat a little bit about personal life stuff. If you’re jumping off, then we’re excited to see you next week!

Kelsey:Welcome to the updates section of our new and improved Ancestral RDs podcast which we’re trying out.

Laura: Hopefully improved.

Kelsey:Hopefully improved, we’ll see. You guys can always submit your comments, hopefully nice comments or at least semi nice.

Laura: Constructive.

Kelsey:Yeah, constructive would be a better word. Laura, what’s going on with you these days?

Laura: Goodness! I feel like the last couple weeks have just kind of been a ramp up into wedding planning, which at this point when this podcast is aired it will be a little over a month away.

Kelsey:Wow!

Laura: It’s weird because it’s like I feel with wedding planning you have this kind of big bump in the beginning where you have to make all the decisions about all the major things like your venue, and your photographers, and your caterers, and all this stuff that’s like these big decisions. There’s a lot of checks that come out of your checkbook for four figure sums.

Kelsey:Right.

Laura: And then there’s this lag. There’s this kind of low point in between then and the kind of crunch time where you might be making some decisions about things, but otherwise it’s a lot of just kind of daydreaming about what is my hair going to look like? Those little things that you really don’t have to decide about, you’re just kind of like on Pinterest for way too much time. And then you get into this period, I want to say it’s like the two to three mark depending on how long you’ve been engaged because for me my engagement is going to be fourteen months long and…or no, not fourteen. Fourteen is how long we’ve been together before we got engaged.

Kelsey:Got it.

Laura: I think it’s nine months for the engagement.

Kelsey:Okay.

Laura: I don’t even remember.

Kelsey:I was like God, time has flown!

Laura: Yeah, seriously. Fourteen months from first date to wedding day basically. It’s funny because for some people that sounds really long and then for other people…one of Josh’s cousins got married three months after he met his wife and they’ve been married for fifteen years.

Kelsey:Wow!

Laura: Yeah, it’s like different strokes for different folks. But for me a nine month engagement is fairly quick and a fourteen month relationship before getting married is fairly quick. I feel like for me the speed of the engagement maybe affects those amount of stress times. Then the fact that I have a long distance relationship probably impacts that as well because at the time of this recording I’m only going to see my fiancé maybe five or six total days before the wedding weekend.

Kelsey:Wow!

Laura: We still have two months at this point. It’s kind of getting to the point of our long distance that we’re barely get to see each other, so that’s been a  little stressful.

Kelsey:Right.

Laura: But it’s been really interesting because I know with wedding planning there’s a lot of logistics and I guess expectation management that has to happen with family and friends and all that. That’s normal I think for everybody. But then there’s been this weird experience that I’ve had that all of a sudden I have been dealing with some pretty unpleasant emotions about the whole thing. I don’t know if you had this experience at all. I know you and your husband were together for what, like ten years?

Kelsey:Ten years, yeah.

Laura: I don’t know if you had kind of just felt pretty comfortable about everything. But for me the wedding is going to be 180 degree shift in my life. I think I mentioned this before. At first the first couple of months, super excited, everything was very fairytale, like it’s wedding planning, and Pinterest, and all that stuff. And then I don’t know what happened, but in the last couple weeks, I think part of it is the distance but part of it I think is just the proximity of the date. All of a sudden all that excitement kind of shifted into anxiety and kind of unhealthy fear about things.

Kelsey:About the wedding itself or just that your life is going to change so much?

Laura: Probably a combination. I have the wedding itself being this kind of expensive, intense event that there’s a lot of expectations around for myself and for my family. My fiancé is kind of like he’s just happy to be marrying me, so he could do a city hall event and he wouldn’t even care. Which at this point I’m like, dang it! Why didn’t I do that? There’s all the expectations around the weekend itself and then there’s the life shift that’s going to happen.

It’s funny because at first I was like not sure why I was feeling so nervous, and stressed out, and literally having waking up in the middle of the night with my heart racing and panic attacks. Not like a legit panic attack, but like feeling very cranked up emotionally and stressed. It’s funny because I was thinking about it, I’m like what is wrong with me? Nothing in my relationship with my fiancé has changed. There’s been definitely some challenges with the whole distance piece which that I think creates an extra level of stress that isn’t necessarily normal.

Kelsey:Of course.

Laura: We both deal with it differently. His tendency is to totally shut down when we’re stressed about that. My typical reaction is to just word vomit it and cry.

Kelsey:Nice.

Laura: It’s totally opposite, just be telling him everything that I’m sad about and crying. Luckily he’s totally cool with that otherwise we probably wouldn’t be getting married because he would not want to be married to me.

But it’s just been really interesting because like I said it’s almost this weird, I don’t call it this, this is what it is, is cognitive dissonance where it’s like you believe you should feel just happy, and joyful, and excited and just blissful leading up to your wedding, at the wedding, post wedding, everything. And then there’s this underlying sense of, honestly the way I describe it is dread which sounds like really bad, but the more I’ve been digging into it in the last week or two because I really want to figure out what the heck is going on, and if there’s something wrong with me, and why am I feeling this way, it turns out that this is actually super common.

I feel like the reason I’m sharing this is because just in case anyone listening to the podcast is getting married or will get married at some point. Just take it from me, it’s very normal to feel these experiences, these emotions, these negative feelings even if you are in an amazing relationship. I think a lot of times people think if they’re freaked out about getting married it’s because they are not marrying the right person.

For me I’m like 100% confident logically that I am marrying the right person, but I think there’s just that level of life change and going from being single and living alone, and kind of running my own schedule, and being self-employed where I’ll be working some days on the weekends, or working at 7:00 in the morning, or 9:00 at night, not having anyone else’s schedule that I have to worry about, cooking my own food and not worrying about feeding somebody else. There’s just a lot of things that are going to change once I’m married.

I feel like just recently it’s all kind of been, I guess I’ve been realizing it. I hadn’t really thought about it and then I was like, oh crap! Everything is really going to be very different all at once. It’s going to change within 24 hours between the day of the wedding and the day after.

Kelsey:Yeah.

Laura: It’s funny because at first I was feeling a lot of guilt around the anxiety because I felt bad that my fiancé was seeing how freaked out I was, and I was like I promise it’s not because of you! You’re not doing anything wrong! You could imagine how if you’re getting married to someone and they’re freaking out, you’re like uhh…

Kelsey:Oh gosh! Yeah.

Laura: Maybe there’s something wrong here! But I spent the weekend kind of digging into some things about why I was feeling that way. I think it helped a lot. I’m probably going to write a blog post about it because again I feel like a lot of women probably have this experience of panic even if they’re in a really good relationship before marriage.

Kelsey:Yeah.

Laura: What was your experience?

Kelsey:I was just thinking about that as you were talking about this. I think for me, because I know exactly that feeling that you’re talking about where it does feel like this dread which sounds like a terrible word, but it is sort of that feeling. But I think it was a little different for me in that because we had been together for so long at that point, the deep fear for me was that oh my God, what if this life change of being married now changes what we have for the worse?

For some reason that just little mindset shift changes things in a bad way because things are great now and they’ve been great for ten years, what if this one thing changes everything? Which is totally silly when you think about it, but it is that cognitive dissonance where you’re really happy about what’s going to happen, but at the same time there’s a lot of fear and anxiety surrounding that decision seemingly for no real logical reason.

Laura: I think the fear of marriage changing the relationship, I’ve definitely experienced that too. Like I said I’m in a different situation than you are, but I have that kind of anxiety too feeling like once we’re married it’s just going to be boring and we’re not going to put any effort in.

Right now with the distance the way it is we have to put a lot of effort into connecting with each other and talking a lot, and it’s good. It’s funny, I feel like I kind of hate that I’m saying this, but the distance has kind of forced us to learn how to talk to each other which is a good thing. It sucks right now, but it’s a good thing for the long run. But then there’s that little fear in my head that once we’re together all the time, we’re just not going to talk anymore because there’s not going to be that need to, and then our relationship will get stale, and we won’t have the level of romanticness.

It’s funny, I wrote this list of all the things that I would be potentially nervous about with the wedding and it’s like almost two pages typed.

Kelsey:Oh my gosh!

Laura: I told my fiancé about that and he’s like, wait, you have two pages of a list? I’m like well I’m just being very through. I’m trying to figure out all the different things I’ll be afraid of. It’s just funny because he’s like so the opposite of me. He copes by getting super chill and not letting anything bother him. I’m just like here’s all the 50 different things that I’m potentially a little bit nervous about that’s all compounding into this anxiety situation.

It doesn’t help that I also was like maybe I’ll try to lean out a little bit in the next month or two. Then I start to get into the mild under eating state and my body is like, no, screw that, you need to eat right now otherwise I’m going to keep you up all night.

The last couple of weeks have been really interesting because on one hand feeling the anxiety and nervousness…like anxiety and depression obviously there’s the clinical experience of those that are different than just the short term mood dysregulation.

Kelsey:Right.

Laura: But it’s just funny to have those feelings and I’m like I don’t understand why I’m not happy right now. I should be excited, it’s getting closer. I don’t know, it really took a lot of sitting with the emotions and not judging myself for the emotions because I think when you think that that’s abnormal, it’s very easy to judge yourself and say what’s wrong with me? Why am I feeling this way? I’ve been experiencing the emotions mindfully as best as possible and then trying to dig into why I feel this way. I think it’s been good. I feel like as much as I hate experiencing this, I think it’s good because I won’t go into the marriage being completely blindsided by the changes that are going to happen.

Kelsey:Right.

Laura: But also want to be mindful of not having low expectations or poor expectations, expecting things to be bad. It’s kind of balancing losing the fantasy of what things are going to be like because I think a lot of girls have that experience that it’s like being married is going to be this wonderful, amazing, perfect, love story like The Notebook or something.

I think when you have those expectations obviously you’re going to get disappointed. But then you also don’t want to be going in thinking this is going to suck, our relationship is going to go down the toilet because then I think that can affect how you act.

I feel like for me it’s been this process of finding the balance between not having these expectations of it being a fairytale, but also not believing that being married is going to negatively change our relationship and kind of going into it saying I’m going to keep my expectations low enough that I don’t get disappointed, but not so low that I end up acting in a way that is stemming from those beliefs, if that makes sense.

Kelsey:Yeah, makes total sense. I think one thing that at least for me when I have a lot going on in my life, which certainly two months out from your wedding that second wind of a lot of things that you need to do, and approve, and all that kind of stuff is probably at least started by now. For me when I have that sort of time in my life where a lot of things are going on, I have to make a lot of decisions, it’s just like you feel really busy all the time, it almost seems to trigger some of that anxiety too.

It’s almost like you think more about these things because your body is just in this state of overwhelm too where I would maybe wake up in the morning like with my heart racing or just kind of like not sleeping as well because my mind is racing as well. I feel like it almost forces you to think about these things more than you would otherwise even though you have a lot of other things going on that you could be thinking about.

I don’t know if that’s completely just me, but that was definitely my experience as well. I feel like that happens not only just with wedding planning, but any time in my life where I have a lot of things going on, my brain is just on overdrive I think.

Laura: My business I’d say is definitely busy. This year has been a lot busier than other years have been from a client perspective and then I’ve been doing some things to try to build it from a marketing perspective, so it’s been slightly more busy.

But you’re right, I feel like being an entrepreneur and self-employed you’re always busy unless you’re purposefully taking a break. I think that can compound the stress of the wedding planning. You’re probably like me where you’re somewhat of a perfectionist and you want to do things the right way.

Kelsey: Mm hmm.

Laura: It’s funny because with the wedding it’s like yeah, it’s a really important day and it would be good to have it go as smoothly as possible and also be what you want it to be. You put all this effort in for months and it’s like I want it turn out the way I want it to.

Kelsey:Right.

Laura: But at the end of the day, one, it’s probably there’s going to be things that don’t go the way that you expected. And two, I don’t really think anything that bad is going to happen that it could ruin the whole day. I mean I guess some people can have that experience, but realistically most people get through their wedding and they have a great time and they’re really happy with it. I think there’s just that level of anxiety that I have to make sure everything is perfectly set up so that there’s nothing that happens that’s bad.

Kelsey:Yeah.

Laura: It’s that level of perfectionism that definitely adds a layer of stress. I’m trying to manage that. I’m trying to be more laid back about it. It’s funny, I feel like I’m really not that type A of a person, but this wedding planning thing as turned me into one. I don’t like having to be this organized. I don’t like having to have all these balls that I’m juggling. Once the wedding is over, the honeymoon is going to be probably a total crash which is good because I’ll have unlimited food and sleeping.

Kelsey:Sounds great.

Laura: Yeah and just don’t have to pay for anything so if I feel like having tacos at 1:00 in the morning, I can have tacos. It’ll be nice and then after that I’ll have to figure out if I need to take a little…it’s not like a break, but almost just kind of like slow the hustle a little bit after the wedding and just kind of chill out and not be on this overdrive mode because I feel like I’ve been on it basically since September and I’m just like I can’t wait to not be thinking about this stuff anymore.

Kelsey:Yeah, and you’re going to have a husband at home at that point too.

Laura: I know, it’s crazy!

Kelsey:Give your body a little bit of a break from maybe some other things going on in your life.

Laura: Let him do everything.

Kelsey:Yeah.

Laura: Let him just do all the chores.

Kelsey: Exactly.

Laura: It’s just kind of funny, it’s just like so weird. The whole long distance thing from day one, like its fine, we’re doing fine with it. But it’s just so weird to think about one day he’s actually going to be in my house all the time. That’ so weird!

Kelsey:Yeah, I bet that’s weird. I can imagine.

Laura: It’ll be good.

Kelsey:I’m sure it will.

Laura: But I’m like I hope I have some alone time. If I need to I can always leave the house.

Kelsey:Well I am very excited for you, Laura. I hope everything goes as planned and it’s all as great as you imaged it to be with a dash of realistic expectations.

Laura: Perfect.

Kelsey: Which it sounds like exactly what you’re going for.

Laura: Well, that’s the hope. Hopefully by the time this podcast airs I’m not in a total panic attack mode all the time.

Kelsey:Let’s hope.

Laura: Yeah. Right now I’m like this better not be the next two months because I really need to be sleeping.

Kelsey:Yeah. Well, I’m wishing you good sleep from here on out.

Laura: Thank you.