Three and a Half Years Later – 100 pounds weight maintenance

Note: This article is 3 of 3 anecdotal accounts of a former client’s personal health journeys. It represents their unique experience and is not intended as medical advice or scientific evidence.


Introduction

J at start of journey“In October 2019, I began my food addiction recovery and weight loss journey with Joy, and after recently rereading the post that I wrote for her website in May 2021, I was overwhelmed with gratitude.”


Maintaining Recovery and Weight Loss

J in 2024
“J” in 2024

“I continue to be in remission of food addiction and disordered eating and have maintained a weight loss of well over 100 pounds. As well, improvements in the symptoms of both depression and ADHD have been sustained.

In order to remain in remission, I avoid foods that are addictive for me, including all sugar and flour products. I have found it important to eliminate all “cheat days” so that I do not return to my addiction. Each day, I eat nutritious, satisfying, and enjoyable food based on the Meal Plan that Joy designed for me, and updated as my weight normalized.

A decade ago, I could never have imagined eating this way. I can honestly say that my favourite foods are steak, squash, and Brussels sprouts with butter. I have no desire to return to eating the sugary and processed foods that I binged on in the past.”

Navigating New Health Challenges

“Joy has been an invaluable support on my health journey. She is incredibly thorough, knowledgeable, and caring. I recently returned to work with Joy due to some health concerns I had been facing and she advocated for me to return to my doctor to undergo more comprehensive thyroid testing. Finally, after many years of confusing symptoms and doctors’ appointments, I was diagnosed with hypothyroidism.

Once I was diagnosed, Joy adjusted and tailored my Meal Plan to my hypothyroidism and history of obesity and food addiction. I am very grateful for Joy’s knowledge and insight. I truly have been profoundly blessed.

One of the most important first steps I took in 2019 was reaching out to Joy, as well as to a clinical counselor, and a food addiction support group. I hope my story continues to provide hope to anyone who is wondering if it is possible to be free from their addiction to food.”

~J.H., October 10, 2024

 
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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Thyroid Medication can Worsen Blood Sugar Control in People with Diabetes

Introduction

Did you know that thyroid medication can worsen blood sugar? The “highlights of prescribing information” sheets available to pharmacists and doctors for medications such as Synthroid® (generic: levothyroxine) and Cytomel® (generic: liothyronine) warn that both these types of thyroid medication can worsen blood sugar control in diabetics and increase the need for diabetes medications, including insulin. I didn’t know this.

Even though I had been diagnosed with type 2 diabetes more than twelve years ago and with hypothyroidism this past August, when I was prescribed thyroid medication, neither the pharmacist nor my doctor mentioned this potential side effect. He was well aware that for three years prior to my diagnosis of hypothyroidism, I had been in remission of diabetes, controlling my blood sugar through diet alone.

When I began taking thyroid medication, I started to periodically feel unwell, similar to how I felt with high blood sugar. I began to test my blood glucose more often and discovered it was routinely spiking as high as the mid-to-high 10 mmol/L (~190 mg/dl) for seemingly no reason.

Effect of thyroid medication on blood sugar
A blood glucose reading showing an unexpected spike after starting thyroid medication

The Connection Between Thyroid and Glucose

It is essential that people diagnosed with any form of diabetes (type 1, type 2, gestational diabetes) as well as hypothyroidism know that their thyroid medication can impact their blood sugar control. While those with type 1 diabetes monitor their glucose closely, many people with type 2 diabetes rarely check regularly and may miss these significant spikes.

The “Highlights of Prescribing Information” for both Synthroid® and Cytomel® warn that therapeutic use of these medications in patients with diabetes mellitus may worsen glycemic control and result in increased insulin requirements. They recommend carefully monitoring blood sugar after starting, changing, or discontinuing thyroid hormone therapy.

Prescribing Information for Synthroid
Page 1 of the Synthroid prescribing information highlighting warnings for diabetic patients

Understanding the Biological Mechanism

A paper published recently explains how thyroid hormones contribute to a rise in blood glucose. In the liver, thyroid hormones increase the expression of glucose transporter 2 (GLUT2), leading to increases in both gluconeogenesis and glycogenolysis. Additionally, thyroid hormones increase lipolysis in adipose tissue, which further stimulates hepatic gluconeogenesis [7].

Natural Desiccated Thyroid (NDT) Warnings

Even products like Armour Thyroid® or ERFA desiccated thyroid® contain the same warnings in their product monographs. They state that thyroid hormone therapy in patients with concomitant diabetes mellitus aggravates the intensity of symptoms, requiring appropriate adjustments of therapeutic measures.

Product Monograph Erfa Thyroid
Precautions listed in the Erfa Thyroid product monograph regarding diabetes

Final Thoughts…

If you have any type of diabetes and have also been diagnosed with hypothyroidism (including Hashimoto’s disease), it is very important that you monitor your blood glucose regularly. Contact your doctor if you notice a worsening in your blood sugar control to evaluate your need for dosage adjustments or additional medication.

Consider adopting a diet that is lower in carbohydrates. According to a 2019 consensus report from the American Diabetes Association, reducing overall carb intake has “the most evidence for improving glycemia” [3]. However, if you take certain medications, please seek medical oversight before adopting a very low-carbohydrate diet.

More Info

Learn about me and the dietary support that I can provide for managing your blood sugar with concurrent hypothyroidism by viewing the Comprehensive Dietary Package.

If you were previously diagnosed with type 2 diabetes and recently diagnosed with hypothyroidism, view the Hypothyroid Management Package.

 

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

References

  1. U.S. Food and Drug Administration. (2020). Highlights of Prescribing Information for Synthroid (levothyroxine sodium). [https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021402s034lbl.pdf]
  2. U.S. Food and Drug Administration. (2018). Highlights of Prescribing Information for Cytomel (liothyronine sodium). [https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/010379s054lbl.pdf]
  3. Evert, A. B., et al. (2019). Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care, 42(5), 731-754. [https://doi.org/10.2337/dci19-0014]
  4. AbbVie Inc. (2022). Armour Thyroid (thyroid tablets, USP) Prescribing Information. [https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=56b41079-60db-4256-9695-202b3a65d13d&type=pdf]
  5. ERFA Canada 2012 Inc. (2017). Thyroid (Thyroid Tablets, USP) Product Monograph. [https://pdf.hres.ca/dpd_pm/00034857.PDF]
  6. Talwalkar, P., Deshmukh, V., & Bhole, M. (2019). Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India. Diabetes, Metabolic Syndrome and Obesity, 12, 369-376. [https://doi.org/10.2147/DMSO.S181470]
  7. Eom, Y. S., Wilson, J. R., & Bernet, V. J. (2022). Links between Thyroid Disorders and Glucose Homeostasis. Diabetes & Metabolism Journal, 46(2), 239-256. [https://doi.org/10.4093/dmj.2022.0013]
 
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Hypothyroidism Update – six months of treatment since diagnosis

Introduction

This update marks just over six months since I was diagnosed with profound hypothyroidism and began medication and nutritional treatment. It is written from a subjective perspective and thus is categorized as part of my personal story, “A Dietitian’s Journey.”

At the beginning of June 2022, our family was in Tofino for the marriage of my youngest son. The groom’s eldest brother assumed that my inability to walk on the sand for family photos or to get up out of a chair was a result of me having “aged.” He had no idea that I was hiking for several hours at a time just the summer prior.

Hypothyroidism physical changesI knew something was wrong. For several months, I assumed my exhaustion and joint pain were carry-over effects from Covid. But a photo taken just before the wedding told me it had to be something else. Gradually, I went from looking fit after losing 55 pounds to looking like I had regained everything. I later found out it wasn’t fat, but an accumulation of mucin in the skin—a hallmark sign of myxedema. You can read more about those skin changes here.

The Challenge of Diagnosis

Two weeks after the wedding, my doctor confirmed a diagnosis of hypothyroidism. It had actually taken almost a decade to get diagnosed because of the limitations placed on which tests doctors can requisition. There is also the reality that the most common symptoms are often dismissed as “just aging.”

Many believe it is normal for older adults to have body aches, fatigue, constipation, or forgetfulness. These are not typical signs of aging; they are common symptoms of hypothyroidism. Because these symptoms are so non-specific, they often go unaddressed in short medical appointments.

Addressing Hair Loss and Recovery

My diagnosis was just the beginning. Three months later, I lost half my hair due to telogen effluvium, a form of diffuse hair loss that can occur after profound stress or thyroid disorders. When the loss continued due to androgenic alopecia, I began researching nutrients with evidence for restoring hair growth, which I wrote about here.

Six month recovery updateThis past weekend was my second son’s wedding, and the difference is incredible. Instead of medical compression stockings and orthopedic shoes, I wore regular dress pumps. While it will still take time for the mucin to fully resolve, my face and legs no longer look swollen and “inflated.” I felt human again and wasn’t self-conscious in family photos.

Being on the correct dose and mix of thyroid hormones has made a significant difference. My hair is gradually growing back, and I even have eyelashes and eyebrows returning. It is my hope that by the time these newlyweds celebrate their first anniversary, the residual symptoms will be entirely behind me.

Final Thoughts…

If you have wondered if your symptoms are consistent with hypothyroidism, you can download a checklist of signs here to help you have an informed discussion with your doctor.

To your good health!

Joy

You can follow me on:

Twitter/X: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 
Nutrition is BetterByDesign
 

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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Alopecia Universalis – a clinician’s personal story of complete hair loss

Introduction

Three years ago, Tim Rees, a clinician from Germany, lost all his hair a second time to alopecia universalis (AU). As a registered clinical nutritionist, he felt he had lost his credibility to help others with autoimmune conditions, and when he expressed those feelings in a recent blog, it struck a chord with me.

Tim Rees
Tim Rees with his son in 2022

“All my hair fell out, but it was my response to it that destroyed me. You could be forgiven for thinking this is all centered around vanity, but the thing that crushed me was that it made me feel like a fraud.” — Tim Rees, registered clinical nutritionist.

As a clinician, I felt similarly when I lost half my hair in September of 2022. I wondered if others would consider me a “failure” for not having been able to prevent it. What makes a clinician knowledgeable is their training and ongoing study, and I do not believe that a clinician diagnosed with an autoimmune disorder or metabolic disease is disqualified from being able to help others. On the contrary, provided they remain objective, a clinician’s ability to understand their clients’ struggles from “both sides of the desk” may be an asset.

Alopecia Universalis

Alopecia universalis (AU) is an advanced form of alopecia areata (AA), which is a condition that causes round patches of hair loss. In alopecia universalis, there is a complete loss of hair on the scalp and all over the body. It is an autoimmune condition in which the immune system mistakenly attacks the hair follicles [1].

[Image illustrating the difference between Alopecia Areata and Alopecia Universalis]

A Clinician’s Personal Story

Below is an excerpt of Tim’s story, shared with permission from his blog:

“Three years ago my hair started falling out for the second time. My immune system killed my hair follicles and the hair dropped away like oak leaves in autumn. Alopecia Universalis, not a single hair remained on or in my body.”

“The thing that crushed me was that it made me feel like a fraud. Alopecia, one of the most visible autoimmune diseases one can have, undermined my work and, I thought, my credibility as a nutritionist helping people with autoimmune conditions. But that’s not true. I’ve done amazing things with nutrition for myself and my clients.”

“This year will be different. I’m plastering this all over social media. Firstly, it’s a part of my acceptance. You must accept how things are today in order to make a difference tomorrow. Secondly, it’ll help to keep me motivated and compliant for however long it takes to allow my body to heal.”

The Path to Restoration

Tim plans to use an exclusion diet as well as nutritional supplements to support his recovery. He also intends to integrate other approaches including the use of sauna, cold thermogenesis, exercise, and circadian rhythm optimization. I applaud Tim’s boldness in stopping “hiding” and living his journey in a public way. I wish him the very best in achieving his goal.

Final Thoughts…

It is important to keep in mind that what may work for Tim may not work for others diagnosed with the same condition. I previously wrote two referenced articles related to nutrient supplementation and hair loss, Nutrients of Importance and Supplements with Evidence to Restore Hair Loss.

Since taking nutritional supplements is not without risk, I would encourage anyone considering this to first consult with a qualified healthcare professional to determine which nutrients may be low or deficient based on lab work.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

References

  1. National Institutes of Health (NIH). (2023). Alopecia Universalis. Genetic and Rare Diseases Information Center. [https://rarediseases.info.nih.gov/diseases/614/alopecia-universalis]
Nutrition is BetterByDesign

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© 2025 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Hair Loss in Hypothyroidism – nutrients of importance

Introduction

The previous article titled “Hair Loss – Root Causes” was about the three most common types of hair loss, including androgenic alopecia, alopecia areata, and the most common form of diffuse hair loss, telogen effluvium, which is the type often associated with hypothyroidism. This article explains the role of specific vitamin and mineral deficiencies in hair loss and how treating them can help restore hair growth.

As explained in a previous article, telogen effluvium (TE) is the most common form of hair loss in hypothyroidism and is where the hair often comes out in clumps in the shower or a brush. Hair loss is usually from all over the scalp but may occur more on the temples, the part, and the crown of the head [1]. In a study of more than 1200 people with thyroid disorder, half (50%) of people aged 40 years old and older had either alopecia areata or androgenetic alopecia [2].

What makes the hair loss associated with thyroid dysfunction particularly challenging is that it occurs 2-3 months after the overt symptoms of thyroid disorder begin, which is usually once they’ve already begun thyroid hormone treatment for hypothyroidism.

The pictures below are of me and are provided for illustrative purposes only. The one on the left was taken at one of my son’s weddings in June 2022, just before being diagnosed with profound hypothyroidism. The photo on the right was taken three months later, after beginning hormone replacement treatment, and the hair loss and shiny scalp are very apparent.

Comparison of hair loss before and after hypothyroidism diagnosis
No hair loss at the height of untreated hypothyroidism, telogen effluvium hair loss 3 months later

Hair loss in hypothyroidism

Normally, 90-95% of hair follicles are in the growth (anagen) phase, with only 5–10% being in the resting (telogen) phase. Only a few follicles are in the transitional (catagen) phase [1] at any one time. At the end of the telogen phase, the hair falls out, and under normal circumstances, that would amount to ~100-150 hairs per day.

In telogen effluvium, the growth phase slows down, and up to 50% of the follicles move into the telogen phase, where shedding occurs. As can be seen in the photo above, at 3 months, I had lost 50% of my hair. It wasn’t only half the hair on my head that I lost, but also lost 1/2 my eyelashes and part of the outer third of my eyebrows.

Hypothyroidism can result in hair loss, but nutrient deficiencies can sometimes underlie hypothyroidism (such as iodine or iron deficiency). If any of these nutrients are found to be deficient or suboptimal, correct supplementation can support the regrowth of hair, but the timing of supplements with respect to thyroid medication is essential. Thyroid medication needs to be taken at least half an hour before food or vitamin/mineral supplementation, or two hours afterwards.

The Role of Iron and Selenium

Iron deficiency is very common, and one of the deficiencies that contributes to telogen effluvium [3,4], and iron is often low in hypothyroidism [5]. In some cases, treating iron deficiency may in itself be sufficient to restore thyroid function [5]. The body requires sufficient iron to convert inactive thyroid hormone (thyroxine/T4) into the active hormone (triiodothyronine/T3).

Woman assessing hair healthIt has been recommended that to reverse significant hair loss due to telogen effluvium, one should maintain serum ferritin at levels of >157 pmol/L (70 ng/dL) [4]. Best food sources of heme iron include oysters, clams, and liver. Vitamin C is also required for optimal absorption.

Selenium was identified in the 1990s as a component of the enzyme that activates thyroid hormone through the conversion of inactive T4 to active T3 [6]. Selenium is also used by the body for the formation of glutathione, a powerful antioxidant that protects the thyroid from inflammation and oxidative stress.

Brazil nuts as selenium sourceFood sources include Brazil nuts, with just 2 nuts meeting the daily requirement of 200 mcg. Other sources include mushrooms, eggs, and fish such as cod and halibut.

Zinc, Vitamin D, and Vitamin B12

Zinc plays a key role in the metabolism of thyroid hormones, specifically by regulating the enzymes involved in the activation of T4 to T3, as well as regulating thyrotropin-releasing hormone (TRH) and thyroid-stimulating hormone (TSH) synthesis [8].

Zinc rich seafoodGood sources of zinc include red meat, poultry, and seafood such as oysters, crab and lobster. It is important to be tested first to know if there is a zinc deficiency before taking a supplement, as excess zinc can reduce copper levels.

Vitamin D – In Canada, between 70% and 97% of the population demonstrates vitamin D insufficiency [9]. It is now known that non-autoimmune hypothyroidism is associated with vitamin D deficiency [12]. A randomized trial found that supplementing with vitamin D improved TSH and calcium levels in hypothyroid patients [13].

Tuna as vitamin D sourceNaturally good sources of Vitamin D include fatty fish such as salmon, mackerel, and tuna.

Vitamin B12 – people with Hashimoto’s disease have a higher prevalence of pernicious anemia [14], which is caused by a deficiency of vitamin B12. Vitamin B12 deficiency can mimic symptoms of hypothyroidism, such as fatigue and weakness. Best sources include organ meats, clams, sardines, and beef.

Hair Regrowth and Recovery

[UPDATE: December 11, 2022] The photo at the bottom was taken today — three months later. It clearly shows the regrowth of hair, which is the result of both hormone replacement treatment and three months of nutrient supplementation. Results will vary depending on individual nutrient deficiencies.

Hair regrowth progress photo
Hair regrowth after 3 months of thyroid treatment and nutrient supplementation

Below is a photo of eyelashes growing back in almost a month later (December 13, 2022), without any mascara or eyeliner.

Eyelash regrowth progress
Eyelashes growing back in

Final Thoughts…

While treating hypothyroidism requires optimal thyroid replacement medication, determining if nutritional deficiencies are contributing to the condition is essential. Assessing dietary intake and conducting blood tests can support the recovery from hair loss. Remember that taking supplements wisely is key—nutrients like selenium can be toxic in excess, and biotin can interfere with thyroid hormone tests.

More Info?

If you have been diagnosed with hypothyroidism and would like to ensure you have adequate intake of nutrients known to be important in thyroid health, please view my Hypothyroid Management Package. Learn about me here.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

References

  1. Malkud, S. (2015). Telogen Effluvium: A Review. Journal of Clinical and Diagnostic Research, 9(9), WE01-WE3. [https://pmc.ncbi.nlm.nih.gov/articles/PMC4606321/]
  2. Vincent, M., & Yogiraj, K. (2013). A descriptive study of alopecia patterns and their relation to thyroid dysfunction. International Journal of Trichology, 5(1), 57-60. [https://pmc.ncbi.nlm.nih.gov/articles/PMC3746235/]
  3. Almohanna, H. M., et al. (2019). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and Therapy, 9(1), 51-70. [https://pmc.ncbi.nlm.nih.gov/articles/PMC6380979/]
  4. Trost, L. B., et al. (2006). The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. Journal of the American Academy of Dermatology, 54(5), 824-844. [https://pubmed.ncbi.nlm.nih.gov/16635664/]
  5. Ghiya, R., & Ahmad, S. (2019). SUN-591 Severe Iron-Deficiency Anemia Leading to Hypothyroidism. Journal of the Endocrine Society, 3(Suppl 1), SUN-591. [https://pmc.ncbi.nlm.nih.gov/articles/PMC6552785/]
  6. Winther, K. H., et al. (2020). Selenium in thyroid disorders — essential knowledge for clinicians. Nature Reviews Endocrinology, 16(3), 165-176. [https://pubmed.ncbi.nlm.nih.gov/31996813/]
  7. Mistry, H. D., et al. (2012). Selenium in reproductive health. American Journal of Obstetrics and Gynecology, 206(1), 21-30. [https://pubmed.ncbi.nlm.nih.gov/21798189/]
  8. Severo, J. S., et al. (2019). The Role of Zinc in Thyroid Hormones Metabolism. International Journal for Vitamin and Nutrition Research, 89(1-2), 80-88. [https://pubmed.ncbi.nlm.nih.gov/29954271/]
  9. Schwalfenberg, G. K., et al. (2010). Addressing vitamin D deficiency in Canada: a public health innovation whose time has come. Public Health, 124(6), 350-359. [https://pubmed.ncbi.nlm.nih.gov/20488494/]
  10. Forrest, K. Y., & Stuhldreher, W. L. (2011). Prevalence and correlates of vitamin D deficiency in US adults. Nutrition Research, 31(1), 48-54. [https://pubmed.ncbi.nlm.nih.gov/21310306/]
  11. Botelho, I. M. B., et al. (2018). Vitamin D in Hashimoto’s thyroiditis and its relationship with thyroid function and inflammatory status. Endocrine Journal, 65(10), 1029-1037. [https://pubmed.ncbi.nlm.nih.gov/29998918/]
  12. Ahi, S., et al. (2020). Vitamin D deficiency in non-autoimmune hypothyroidism: a case-control study. BMC Endocrine Disorders, 20(1), 41. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7083169/]
  13. Talaei, A., et al. (2018). The Effects of Vitamin D Supplementation on Thyroid Function in Hypothyroid Patients: A Randomized, Double-blind, Placebo-controlled Trial. Indian Journal of Endocrinology and Metabolism, 22(5), 584-588. [https://pmc.ncbi.nlm.nih.gov/articles/PMC6238315/]
  14. Ness-Abramof, R., et al. (2006). Prevalence and evaluation of B12 deficiency in patients with autoimmune thyroid disease. American Journal of the Medical Sciences, 332(3), 119-122. [https://pubmed.ncbi.nlm.nih.gov/16969200/]
 
Nutrition is BetterByDesign
 

Privacy Policy | Terms of Use

 

© 2025 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

To Hell and Back – recovering from hypothyroidism (a Dietitian’s Journey)

Note: This article is 6 of 6 articles that have been posted to this website and are in a separate category from research articles, and that category is called “A Dietitian’s Journey”. These 6 articles document my recovery from profound hypothyroidism (June 3, 2022 – October 31, 2022) and represent only my personal experience. They should not be treated as scientific evidence or medical advice. 

A Dietitian’s Journey (Part I) documented my personal weight-loss and health-recovery journey (March 5, 2017 – March 4, 2019) and is not posted on this web page.


Introduction

Last Monday, I went to the lab for updated blood work, including a thyroid hormone panel, additional thyroid antibody tests, and an iron panel. I have moved past the frustration of there being no pricelist available for consumers who are self-paying for lab tests, and am now focusing on the lab test results and the dietary changes that I need to make in light of those, as I am recovering from hypothyroidism.


The results came back late Monday afternoon and I met with my doctor to discuss them on Thursday, The good news is that based on calculation estimates converting the bovine Natural Desiccated Thyroid (NDT) medication that I had been taking, to a mixture of Synthroid® (a synthetic T4 medication) and Cytomel® (a synthetic T3 medication), my free T4 and free T3 are almost perfect. As my doctor said when we met, “between your research and my experience, we got this”.

This is a beautiful picture.

 
TSH, fT4 and fT3 levels on T4/T3 thyroid hormone replacement medication

It shows, as my doctor and I had hoped, that my free T3 (the active thyroid hormone) is in the higher part of the reference range (65.5%); a level considered optimal by endocrinologists and thyroidologists who are well-versed in the use of the combination T4/T3 medications that I have been prescribed.

While my free T4 could be in the higher part of the range on the type of medication that I am taking, it may slightly lower because of the feedback from having sufficient free T3. That’s okay! I am feeling so much better, although it will take another year or more until I am really well again.

As expected, my TSH (Thyroid Stimulating Hormone, the pituitary hormone that tells the body how much thyroid hormone to make) is low because the amount of free T3 is optimal. This is a classic feedback loop where free T3 provides feedback on the pituitary gland, indicating that there isn’t a need to make more thyroid hormone. Think of it like a thermostat.  When the room gets warm enough, there is feedback on the thermostat that no additional heat is required, and it turns it off until the room gets cold again.

Of importance, my TSH is not considered “suppressed” (TSH ≤0.03 mU/L) but “low” (TSH = 0.04-0.4 mU/liter) [1], so there is no increased risk of cardiovascular disease or bone fractures. Those with a “high” TSH (>4.0 mU/liter) — which was the level that I was at before being treated, and those with a “suppressed” TSH (≤0.03 mU/L) both have an increased risk of cardiovascular disease, abnormal heart rhythms and bone fractures. Those with “low” TSH (0.04-0.4 mU/liter) as I have, do not [1,2]. So more good news.

I have been diagnosed with Hashimoto’s disease (also known as Hashimoto’s thyroiditis), which is an autoimmune disease, and the diagnosis is based on both the symptoms of hypothyroidism, along with the presence of thyroperoxidase antibodies (TPO-ab) and thyroglobulin antibodies (TG-ab) in the blood [3].

In many cases of hypothyroidism, it is these antibodies that contribute to the gradual disappearance of thyroid cells and the development of hypothyroidism.  In my case, it was the trauma to the thyroid that resulted from surgery that I had 30 years ago to remove a benign tumour that was the major contributor to the eventual decrease in thyroid function.

Before being diagnosed, as you can read about here, I had all the classic symptoms of hypothyroidism, including body aches, joint pain, fatigue, feeling chilled, constipation, dry skin, hair loss, being forgetful, and even feeling depressed.

By the point I realized that these symptoms were not consistent with long-COVID (which is what I initially suspected) or aging (which my sons assumed), I had developed some of the symptoms of severe hypothyroidism [3], including difficulty with speech, significant water retention, and peripheral edema (swelling) of the ankles and face [3]. There are more photos of what I looked like when I was very sick here, as well as photos from the beginning part of my recovery.

To hell and back – 5 months of recovery from hypothyroidism
 

Thyroperoxidase-Ab = 9 (<35 IU/mL)

Thyroglobulin Ab = 14 (<40 IU/mL)

The blood tests indicated that while I have some thyroperoxidase antibodies (TPO-Ab) and thyroglobulin antibodies (TG-Ab), I do not have Hashimoto’s disease (autoimmune) as neither was over the lab cutoffs.

As diagnosed by my doctor based on previous lab results and symptoms, I have hypothyroidism, but based on this lab work, it is not autoimmune in nature.

Gliadin and Transglutaminase

For many years, I avoided gluten-containing products because I thought I was gluten-intolerant, although not celiac.

A year ago, I stumbled across some novel ingredients and had an idea to create low-carb breads to provide dietary options for those with diabetes. My goal was to enable people who would not otherwise consider a low-carbohydrate diet to be able to adopt one, for health reasons.   I was mainly thinking of those from bread-centric cultures, such as South East Asians (Indian) and Hispanics, but in time, I developed many more types of low-carb bread. 

I was aware of the connection between high gluten consumption and leaky gut syndrome, but against that, I weighed the serious morbidity and mortality linked to uncontrolled diabetes. I had come across many people who would rather stay diabetic, and potentially lose their toes or vision, than give up bread and developing these breads seemed like the lesser of two evils. 

Since being diagnosed with hypothyroidism, which I had been developing over the previous 9 years (more about that here), I learned that the gliadin fraction of gluten structurally resembles transglutaminase. Transglutaminase is an enzyme that makes chemical bonds in the body, and while present in many organs, there are higher concentrations of transglutaminase in the thyroid.

In leaky gut syndrome, gliadin (and other substances) result in the gaps in between the cells of the intestinal wall widening. This results in the immune system of the body reacting to food particles that are inside the intestine, which it normally would not see. It is thought that the immune system reacts to gliadin and creates antibodies to it, seeing it as a foreign invader.  Since gliadin and transglutaminase have very similar structural properties, it is thought that in those with leaky gut syndrome, the immune system begins to attack the transglutaminase in the thyroid and other tissues, contributing to the development of autoimmune conditions, including Hashimoto’s. 

A-1 Beta Casein and Gluten

A few years ago, I had leaky gut syndrome but it resolved with dietary changes, including avoiding gluten and A-1 beta casein dairy (you can read about what A-1 beta casein dairy is here).  Naturally, as I had been working on recipe development for the low-carb bread book, I had been eating gluten as I tested them. I also became more liberal in including dairy products from A1-beta casein cows, when I hadn’t used them in years. That started when there was severe flooding last year in Chilliwack last year due to heavy rains after the summer, and that was where my goat milk came from.  Even once the roads were open again and the highways rebuilt, I never really went back to using goat milk, which is naturally A-2 beta casein. In the interest of an abundance of caution, I will go back to using dairy products from A-2 beta casein cows, or from goat or sheep milk (that are naturally A-2). Humans produce A-2 beta casein protein, and using milk from A-2 beta casein animals does not result in an immune response. It is not seen as “foreign.”

From what I’ve read and in discussing it with my doctor, it is likely that my hypothyroidism has been developing over the last 30 years, related to the surgery I had to remove a benign tumour. Further supporting that my becoming hypothyroid has been a long time in the making, I have had high-normal levels of TSH over the last 9 years — which happens to be a time period over which I was avoiding both gluten and A-1 dairy. Given that, I think it’s logical to conclude that my hypothyroidism is primarily related to the destruction of thyroid tissue in the invasive surgery connected to the removal of the tumour. Further supporting this hypothesis, I currently have fairly low levels of TPO and TG antibodies, so I suspect they have begun developing fairly recently. Since a 2018 study reported that both TPO-antibodies and TG-antibodies are decreased in hypothyroid patients following a gluten-free diet [4], it seems wise for me to go back to avoiding gluten, to lower my TPO-antibodies and TG-antibodies as close to zero as possible.

Cruciferous Vegetables

Cruciferous vegetables such as Brussels sprouts, broccoli, bok choy, cauliflower, cabbage, and kale are known as goitrogens. Goitrogens are naturally occurring substances that are thought to inhibit thyroid hormone production. The hydrolysis of a substance known as pro-goitrin that is found in cruciferous vegetables produces a substance known as goitrin, which is thought to interfere with thyroid hormone synthesis [5]. Since cooking cruciferous vegetables limits the effect on the thyroid function, and eating cruciferous vegetables has many health benefits, I will usually eat them cooked, but not in huge quantities. Some studies found a worsening of hypothyroidism when people ate very large quantities of these (e.g. 1 – 1 ½ kg / day) so it is recommended that intake of these vegetables be kept relatively constant day to day, and limited to no more than 1-2 cup/day. I’ve decided that when I do eat them, to keep intake to the lower end of that range and eat more non-cruciferous vegetables instead.

Iron Deficiency and Low Stomach Acid (hypochlorhydria)

I now know why I am still so tired. I asked my doctor to run an iron panel, and the results show I have low iron. Previous results indicate my vitamin B12 are fine, and I continue to supplement methylated folate and B12, so I know those are not a problem.

While my iron stores (ferritin) are okay, they are not optimal, i.e., ferritin = 93 (15-247 ug/L) instead of >100ug/L.

My hematology panel is low-normal i.e. hemoglobin = 122 (115-155 g/L), hematocrit = 0.37* (0.35-0.45 L/L), MCV = 88 (82-98 fl), MCH = 29.5 (27.5-33.5 pg), MCHC = 334 (300-370 g/L)

My serum iron and iron saturation are very low, i.e., serum iron = 11.9 (10.6-33.8 umol/L), iron saturation = 0.15 (0.13-0.50)

Low iron status is common with hypothyroidism, but it was surprising to me because I eat beef liver, or chicken livers every week, and also take a heme polysaccharide supplement (like Feramax®), so it may be due to an absorption problem.

Low stomach acid (hypochlorhydria) is common in hypothyroidism, and since low pH is needed for iron absorption, I have made dietary changes to improve that.

Final Thoughts…

I am very grateful that my doctor recognizes my knowledge as a clinician and is receptive to me advocating for my health. I am incredibly fortunate that he involves me in decisions regarding blood tests, as well as discussing medication types and dosages.  As for the dietary changes and supplementation, he is content to let me handle that!

I hope that out of my experience, which I have called “to hell and back” I can help others better understand hypothyroid symptoms, diagnosis and treatment options so that they can discuss them with their doctor.

To your good health,

Joy

 

 

Copyright ©2022 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

 

 

Hair Loss – root causes (Part 1)

Introduction

Hair loss can be a very distressing symptom, especially when it is noticeable to ourselves and others. However, before outlining strategies for addressing it, we first need to understand what’s causing it. That is the purpose of this article.  The next article will address strategies for helping to restore hair loss through diet and nutrient supplementation.

There are different types of hair loss with various causes, including genetic, autoimmune, severe stress, as well as nutrient deficiency and nutrient excess. Below are a three of the most common types of loss.

Male pattern baldness
Male pattern baldness

Androgenic Alopecia is the most common type and affects up to 50% of men and women [1]. In men, it is called ‘male pattern baldness,’ and is mainly seen on the crown of the head and on the temples.  In women, it  is called ‘female pattern baldness,’ and is mainly seen at the crown of the head, with a wider center part [2].  Androgenic alopecia is a genetic disorder that involves both maternal (mother’s) and paternal (father’s) genes, with sons being 5-6 times more likely to have it if their fathers were balding [1]. Since it is genetic, there is no ‘cure,’ but growth may be improved by using products such as minoxidil (Rogaine®) or rosemary extract which has been found to be as effective as minoxidil in studies [2]. One drawback is that treatment needs to continue indefinitely or loss will reoccur when treatment is discontinued [6].

Autoimmune and Stress-Induced Hair Loss

Alopecia areata is an autoimmune disorder where the body’s immune system attacks the follicles. Hair often comes out in clumps, usually the size and shape of a quarter but it can affect wider areas of the scalp [3]. It can occur in those who already have some form of autoimmune conditions, including thyroid disease. Treatment may involve use of oral or topical corticosteroid medication [3] which are very powerful anti-inflammatory medications, or other medications used in autoimmune conditions. Individual bald spots may be treated using Minoxidil (Rogaine®) [3].

Hair regrowth documentationTelogen effluvium – is the most common form of diffuse hair loss [7]. It usually occurs after a profound stress, shock or traumatic event including after childbirth, as the result of a thyroid disorder, as well as rapid weight loss. It has been reported after a sudden and significant calorie restriction diet (“crash dieting”) [8],  and has also been reported associated with the popularized ‘keto’ diet [9,10], but I am in agreement with Dr. Stephen Phinney of Virta Health that it should not occur in a well-designed keto diet [11]. 

Clinical hair observationIn telogen effluvium, hair often comes out in clumps in the shower, or in a brush [6]. Loss is usually from all over the scalp, but may occur more on the temples, the part and the crown of the head [7].  Once the cause telogen effluvium is removed, regrowth will usually begin within two to six months [6].

The Phases of Hair Growth

There are three phases of growth; the growth (anagen) phase, the transition (catagen) phase, and the resting (telogen) phase [5]. During the growth phase, follicles produce a shaft beginning from tip to root [5]. During the catagen and telogen phases, the follicles reset and prepare to start making a new hair.

Normal Hair Loss vs Hair Loss in Telogen Effluvium

Normally,  90-95% of follicles are in the growth (anagen) phase, with only 5–10% being in the resting (telogen) phase. Only a few follicles are in the transitional (catagen) phase [7] at any one time.  At the end of the telogen phase, the hair falls out, and under normal circumstances, that would amount to ~ 100-150 hairs per day [7].

In telogen effluvium, the growth (anagen) phase slows down, and up to 50% of the follicles move into the telogen phase, where shedding occurs. i.e., loss becomes 5-10 times greater than normal, with people losing up to 50% of their hair.  Since the period of the most dramatic loss occurs approximately 2-3 months after the triggering event, many people don’t relate the shedding to the event that caused it.

Identifying the cause of hair loss is essential, as once identified and corrected, regrowth will occur [7], but it can take 3-6 months for hair shedding to stop. While many people are anxious that they will go bald, hair loss does not usually exceed 50% of their hair [7].  Once the cause is identified and corrected, regrowth can begin to be seen 3-6 months later [7], but significant regrowth can take 12-18 months [7].

Medications that can interfere with hair regrowth include beta-blockers such as metoprolol and propranolol used in the treatment of abnormal heart rhythms, after a heart attack, or high blood pressure, anti-thyroid medication used in the treatment of hyperthyroidism, and anticoagulants [7].

As outlined in this previous article, hair loss is one of the identifying markers of hypothyroidism that results from a lack of thyroid hormones. Hair growth will begin to occur once optimal thyroid hormone replacement is reached, as mentioned above, it may take 3-6 months for hair shedding to stop, and another 3-6 months for regrowth to be able to be seen [7].  For someone dealing with hair loss, six months to a year to begin to see hair growth can seem like an eternity. 

[I understand this firsthand, as the two photos below are of me.  The one on the left was takenat the beginning of June 2022 at my youngest son’s wedding — a few weeks before being diagnosed with profound hypothyroidism. The photo on the right was taken yesterday, September 3, 2022, exactly three months later. I share these photos so that people can better understand what the hair loss associated with hypothyroidism may look like.]

Clinical photo comparison of hair loss
Hair loss 3 months after diagnosis

Dr. Izabella Wentz, a clinical pharmacist who focuses on thyroid disorders, believes that hair loss is best improved on a medication that contains both T4 and T3, such as desiccated thyroid extract like WP Thyroid®, Nature-Thyroid® or Armour Thyroid®, or a mixture of T4 medication (such as Synthroid®) and a T3 medication such as Cytomel®.  Dr. Wentz also provides a general “rule of thumb” that TSH after treatment should be between 0.5 and 2 μIU/mL [12].

Hair Loss in Nutrient Deficiencies and Nutrient Excess

There are specific nutrient deficiencies that are also linked to different types of hair loss, with the most well-known being iron deficiency. Vitamin C deficiency is also a factor, as it is needed for intestinal absorption of iron.  Zinc deficiency, as well as some B-vitamin deficiency (e.g. niacin, biotin, riboflavin), as well as vitamin D deficiency, can also be associated with hair loss [13].  As importantly, excess in vitamins such as vitamin E, vitamin A, and folic acid are also associated with hair loss [13]. Ensuring adequate but not excessive nutrient intake is essential, and this will be covered in the next part of this article.

Final Thoughts…

Hair loss can be a very distressing symptom, especially when it is noticeable to ourselves and others. Once the cause has been identified and treated, all we do is be patient and wait for the hair to grow.

Hair regrowth can be supported by ensuring a nutrient-adequate diet, as well as with nutrient supplementation, when there is a nutrient deficiency. This will be the topic in Hair Loss – Part 2.

More Info

You can learn about me here. To learn about the support that I can provide to help you ensure that you have adequate intake of nutrients required to convert inactive thyroid hormones (fT4) into their active form (fT3), please view my Hypothyroid Management Package here.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

References

  1. Ho CH, Sood T, Zito PM. Androgenetic Alopecia. [Updated 2021 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. [https://www.ncbi.nlm.nih.gov/books/NBK430924/]
  2. Panahi Y, Taghizadeh M, Marzony ET, Sahebkar A. Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial. Skinmed. 2015;13(1):15-21. [https://pubmed.ncbi.nlm.nih.gov/25842469/]
  3. Medical News Today. Alopecia areata: Causes, diagnosis and treatments. [Updated 2022 Apr 7]. [https://www.medicalnewstoday.com/articles/70956]
  4. Medical News Today. Is Telogen Effluvium reversible? [Updated 2018 Apr 23]. [https://www.medicalnewstoday.com/articles/321590]
  5. Alonso L, Fuchs E. The Hair Cycle. J Cell Sci. 2006 Feb 1;119(Pt 3):391-3. [https://doi.org/10.1242/jcs.02793]
  6. Phillips TG, Slomiany WP, Allison R. Hair Loss: Common Causes and Treatment. Am Fam Physician. 2017 Sep 15;96(6):371-378. [https://www.aafp.org/pubs/afp/issues/2017/0915/p371.html]
  7. Malkud S. Telogen Effluvium: A Review. J Clin Diagn Res. 2015 Sep;9(9):WE01-WE03. [https://doi.org/10.7860/JCDR/2015/15219.6492]
  8. Goette DK, Odom RB. Alopecia in crash dieters. JAMA. 1976 Jun 14;235(24):2622-3. [https://pubmed.ncbi.nlm.nih.gov/946924/]
  9. Dr. Sarah Hallberg: Do ketogenic diets cause hair loss? Virta Health. [https://www.youtube.com/watch?v=PxkfM84lxMU]
  10. Dr. Eric Westman: Hair Loss And Keto. Adapt Your Life. [https://www.youtube.com/watch?v=Cgv92mfTj4k]
  11. Phinney S. Does Keto Cause Hair Loss? Virta Health. [https://www.virtahealth.com/faq/keto-hair-loss]
  12. Wentz I. Hair Loss and Your Thyroid. Thyroid Pharmacist. [https://thyroidpharmacist.com/articles/hair-loss-and-thyroid/]
  13. Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatol Pract Concept. 2017 Jan 31;7(1):1-10. [https://doi.org/10.5826/dpc.0701a01]
 
Nutrition is BetterByDesign
 

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© 2025 BetterByDesign Nutrition Ltd. All rights reserved.

 
LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

More Than Skin Deep – skin symptoms associated with hypothyroidism

Introduction

According to the American Thyroid Association, 6% of the population have some type of thyroid disease and 60% of them (~12 million people) are unaware of it. Assuming the same rate applies in Canada, 2.3 million people in Canada have thyroid disease and almost 1.4 million people are unaware of it. Since changes in the skin may be one of the first clinical signs of hypothyroidism [2] and are often important indications of its progression [4], this article outlines how some of those skin changes may appear.

DISCLAIMER (August 26, 2022): The information in this post should in no way be taken as a recommendation to self-diagnose, self-interpret skin symptoms or diagnostic tests, or self-treat any suspected disorder. It is essential that people who suspect they may have symptoms of any condition consult with their doctor, as only a medical doctor can diagnose and treat.

NOTE: This article also contains aspects of my personal story, which is why it is categorized as A Dietitian’s Journey. My personal experience is not objective data. The pictures are provided only so that people can better understand what some skin symptoms of hypothyroidism may look like. Many more pictures are available in clinical online.


My interest in hypothyroidism is more than academic, as I was recently diagnosed with it. I realize in retrospect that I missed almost all the early signs because I didn’t know what the range of possible symptoms could be. Just as my interest in hyperinsulinemia and type 2 diabetes was birthed in my own diagnosis and eventual partial remission, my interest in this hypothyroidism is no different. Since hypothyroidism can be dangerous if left untreated, my goal in writing this series of articles is to help people know the wide range of symptoms that may be associated with it, and to seek medical attention for themselves or their loved one, when necessary.

As outlined in the article Symptoms of Hypothyroidism Mistakenly Blamed on Aging, people think it is normal for ‘older adults’ to have body aches, joint pain, fatigue, to feel chilled when others do not, experience constipation, hair loss, be forgetful, or to experience depression. However, these are NOT typical signs of aging but ARE common symptoms of hypothyroidism.

Skin Symptoms Associated with Hypothyroidism

As mentioned in a previous article about the role of hormones in metabolic disease, thyroid hormones act on every organ system of the body, and their affect on the skin is no exception. Some skin symptoms such as myxedema don’t appear until much later in the progression of hypothyroidism, while other appear early on.

In this article, I will describe the later symptoms first because they are hallmarks of the progression of disease and indicate that getting medical attention is important. In my own case, it was the symptoms associated with myxedema that made me begin to realize that the tiredness and achy muscles and sore joints that I had been experiencing for over a year was more than post-Covid symptoms.

NOTE: these photos are for illustrative purposes only. Photos of myxedema in the clinical literature are available but are copyrighted. It is for this reason that I am posting my photos only as example, or illustrations.

Below is a photo showing the change in appearance in my left leg from November 3, 2021 (left), to July 16, 2022 (middle), to August 26, 2022 (right).

Effect of the edema of hypothyroidism on lower legs

The photo on the left was taken by me last November while I was doing some stretches. It was still on my phone in mid-July when I took a picture of the swelling in my lower legs and ankles caused by mucin accumulating in the skin. The photo on the right was taken this morning, and while much of the swelling has been reduced, I am still unable to pinch any skin on my legs due to the remaining mucin. I have read that it can take 6 – 8 months for this to resolve.

Visual effect of thyroid medication

It has been only 2 months since I began treatment for hypothyroidism, beginning with a very low dose. The above photo shows what I looked like 2 ¾ months ago at my son’s wedding, and how quickly the myxedema in my face resolved with treatment.

What Causes the Skin Change Known as Myxedema

Myxedema is one several skin significant changes associated with the progression of hypothyroidism. A recently updated dermatology textbook describes myxedema as ‘skin that is cold and pale with abnormally widespread dryness (xerosis) and where a diffuse loss of hair (alopecia) may be present [5].’

When I first saw my doctor after my son’s wedding at the beginning of June, he pointed this out on my legs and said that the cold, waxy skin, along with the swelling is “benchmark symptom” of hypothyroidism. He showed me how it was impossible to pinch and lift any skin on my legs and that pressing on it left no ‘dent’ mark. This lack of a dent means the type of edema (swelling) is “non-pitting edema.” Pitting edema occurs in many other conditions, but this non-pitting edema, along with the cold, waxy skin is characteristic of progressing hypothyroidism.

Other Skin Symptoms of Hypothyroidism

  • Dry skin (xerosis)
  • Thin scaly skin
  • Carotinemia
  • Purpura
  • Telogen effluvium (hair loss)
  • Decrease sweating
  • Poor wound healing

Purpura is caused when small blood vessels burst, resulting in blood pooling just under the skin. It looks a bit like a bruise, but without pain or swelling and it does not change colour in time. Purpura is a non-serious skin hemorrhage that is almost always a symptom of something else and looks like small, reddish-purple spots just beneath the skin’s surface.

75% resolution of purpura
August 20, 2022: purpura 75% resolved, thin dry skin, telogen effluvium (hair loss) yet to be resolved

How My Clinical Practice Is Impacted

Just as my clinical practice changed 5 years ago when I came to understand what hyperinsulinemia was, and how early clinical signs of developing type 2 diabetes are evident as long as 20 years before diagnosis, it is changing again as a result of what I am learning about hypothyroidism.

Final Thoughts…

The list of skin symptoms in hypothyroidism in this article is by no means exhaustive. If you think that you, or someone you know may have symptoms of hypothyroidism, please consult with a medical doctor.

To your good health!

Joy

 

You can follow me on:

Twitter/X: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

References

  1. American Thyroid Association. Prevalence and Impact of Thyroid Disease. [Accessed August 26, 2022]. [https://www.thyroid.org/media-main/press-room/]
  2. Kasumagic-Halilovic E. Thyroid Disease and the Skin. Annals of Thyroid Research. 2014;1(2):27-31. [https://www.remedypublications.com/open-access/thyroid-disease-and-the-skin-654.pdf]
  3. Elshimy G, Chippa V, Correa R. Myxedema. [Updated 2022 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. [https://www.ncbi.nlm.nih.gov/books/NBK545193/]
  4. Medical News Today. What is Myxedema and How is it Treated? [Updated 2022 Apr 22]. [https://www.medicalnewstoday.com/articles/321886]
  5. Patterson JW. Weedon’s Skin Pathology. 5th edition. Elsevier Canada; 2020 Apr 20. [https://www.elsevier.com/books/weedons-skin-pathology/patterson/978-0-7020-7582-7]
 
Nutrition is BetterByDesign
 

Privacy Policy | Terms of Use

 

© 2025 BetterByDesign Nutrition Ltd. All rights reserved.

 
LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Symptoms of Hypothyroidism Mistakenly Blamed on Aging

Introduction

NOTE: This article contains aspects of my personal story which are clearly marked. My personal experience is not objective data. The pictures are provided only so that people can better understand what the “weight gain” of hypothyroidism can look like, and how different it is from ordinary weight gain.


In-person visits to the doctor have been minimal over the past two years, and it has been easy for people to discount symptoms such as body aches, headaches, fatigue, and ‘brain fog’ as having had Covid, or to having ‘long Covid’ [1]. It was only when I began having symptoms that were not consistent with COVID that I began to think that it might be hypothyroidism. 

I am not that old, but at the beginning of June (two months ago), our family was in Tofino (Vancouver Island) for the marriage of my youngest son. The groom’s eldest brother assumed that my inability to walk on the sand, up the path to the hotel, or get up from a chair was a result of my having “aged.”

Hiking before hypothyroidismHe had no idea that I was hiking in North Vancouver and Golden Ears Provincial Park for several hours at a time last summer. I knew that it was abnormal for me to feel so exhausted and for my muscles to feel so weak, and one look in the mirror told me something was very wrong.

In a matter of just a few weeks, I went from looking as I have for the last two years to looking as I did when I was 55 pounds overweight. For the sake of this special occasion, I said nothing to my family, but I was very concerned for my health. It was also exceedingly hard for me to be in family photographs that I knew would be viewed for years to come.

Common Hypothyroid Symptoms and the Aging Myth

Symptoms of hypothyroidism in the older patient
from https://www.thyroid.org/thyroid-disease-older-patient/

People assume that it is normal for ‘older adults’ to have body aches, joint pain, fatigue, feel chilled when others do not, experience constipation, have dry skin or hair loss, be forgetful, or even experience depression. However, these are NOT typical signs of aging but ARE common symptoms of hypothyroidism.

Consider constipation as an example. Chronic constipation affects 15% of adults and is the sixth most commonly reported GI symptom [3]. Within the context of a lack of mobility that we have all faced due to lockdown restrictions, how many people would give increased constipation a second thought?

Untreated Hypothyroidism and Myxedema

Myxedema describes advanced hypothyroidism that occurs when the condition is left untreated or inadequately treated [4]. This term is also applied to hypothyroidism’s effects on the skin, where it looks puffy and swollen and takes on a waxy consistency [4].

Myxedema of hypothyroidism is very different from ordinary weight gain. I hope that by sharing these photos, people will be better equipped to recognize this symptom in themselves or in others, and ensure that medical attention is sought.

The Challenges of Getting Diagnosed

In British Columbia, thyroid testing covered by the provincial health plan is determined by a 2018 document titled Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder [2]. These guidelines outline testing for thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and anti-thyroid peroxidase (TPO).

List of specific symptoms required to qualify for thyroid hormone testing

The problem is that typical symptoms such as cold intolerance, edema, decreased sweating, and skin changes often don’t appear until much later in the progression of the disease.


NOTE: These photos are for illustrative purposes only.

[LEFT: me hiking March 5, 2022. MIDDLE: me at my youngest son’s wedding at the beginning of June, 2022. RIGHT: Me today (August 8, 2022), with 75% of the edema resolved.]

Visual timeline of hypothyroidism progression

UPDATE [August 25, 2022]: The photo on the left was taken 2 ¾ months ago. The photo on the right was taken today, 2 months after beginning treatment for hypothyroidism.

Facial resolution after treatment
Leg edema comparison

While each person may exhibit different symptoms, this is fairly typical of the length of time over which the “weight gain” of hypothyroidism can occur, and also the time frame over which it can resolve with treatment.


The Danger of Myxedema Crisis

It is important to understand that untreated hypothyroidism can progress to a myxedema crisis, which can be fatal. The death rate for a myxedema crisis is between 20-60%, even with treatment [5].

The most noticeable feature of a myxedema crisis is the person’s significant deterioration in mental function [5]. In severe untreated hypothyroidism, people can exhibit significant agitation and even psychosis and paranoia, referred to as “myxedema madness” [6].

Final Thoughts…

By virtue of their age, older adults in British Columbia qualify for thyroid testing. If older people exhibit even a few of the common symptoms of hypothyroidism, this should be brought to their doctor’s attention.

In British Columbia, someone can pay (at government rates) $9.90 for a TSH test, $12.12 for a free T4 test, and $9.35 for a free T3 test [9]. Licensing requirements require doctors who write a lab test requisition to also take responsibility for overseeing care based on those results. Unfortunately, not all doctors are willing to treat those with subclinical hypothyroidism.

More Info

As you can read about under the About Me tab, I will advocate for clients who have symptoms that may be consistent with hypothyroidism or subclinical hypothyroidism to obtain adequate testing to rule out a diagnosis or enable a doctor to make one. You can view the Hypothyroid Management Package here.

To your good health!

Joy

 

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

References

  1. Johns Hopkins Medicine. Long COVID: Long-Term Effects of COVID-19. [Published 2022 Jun 14]. [https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19]
  2. BC Guidelines & Protocols Advisory Committee. Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder. Victoria (BC): Ministry of Health; 2018 Oct 24. [https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/thyroid-function-testing]
  3. Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology. 2020 Apr; 158(5):1232-1249.e3. [https://doi.org/10.1053/j.gastro.2019.12.034]
  4. Medical News Today. What is Myxedema and How is it Treated? [Updated 2022 Apr 22]. [https://www.medicalnewstoday.com/articles/321886]
  5. Elshimy G, Chippa V, Correa R. Myxedema. [Updated 2022 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. [https://www.ncbi.nlm.nih.gov/books/NBK545193/]
  6. Samuels MH. Psychiatric and cognitive manifestations of hypothyroidism. Current Opinion in Endocrinology, Diabetes and Obesity. 2014 Oct; 21(5):377-383. [https://doi.org/10.1097/MED.0000000000000089]
  7. Heinrich TW, Grahm G. Hypothyroidism Presenting as Psychosis: Myxedema Madness Revisited. Primary Care Companion to the Journal of Clinical Psychiatry. 2003; 5(6):260-266. [https://doi.org/10.4088/pcc.v05n0603]
  8. Patil N, Rehman A, Jialal I. Hypothyroidism. [Updated 2022 Jun 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. [https://www.ncbi.nlm.nih.gov/books/NBK519536/]
  9. Government of British Columbia, Ministry of Health. Schedule of Fees for Laboratory Services – Outpatient, Payment Schedule. [Revised 2022 Apr 1]. [https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/medical-services-plan/laboratory_services_schedule_of_fees.pdf]
  10. BC Agency for Pathology and Laboratory Medicine (BCAPLM). Outpatient Payment Schedule, Laboratory Volume Discounting (LVD). [Accessed 2022 Aug 14]. [https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/msp/registers-manuals-and-reports/laboratory-services-outpatient-payment-schedule]
 
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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

From the Mountains Through the Valleys – five year update

Introduction

Tomorrow, March 5, 2022, it is five years since I began my personal health and weight recovery journey that I’ve dubbed “A Dietitian’s Journey”. While it began in 2017, it continues today, and that is the point behind this post.

Five years ago, I was obese, had type 2 diabetes for the previous 8 years, and had developed dangerously high blood pressure. There is no mistaking that I was a very sick woman. You can hear it in my voice in the video below. I could barely walk and talk at the same time.

One Year Later: March 5, 2018

A year after I had adopted a low-carbohydrate lifestyle, I had lost:

  • 32 pounds
  • 8 inches off my waist
  • 8 inches off my chest, 3 inches off my neck, and 1 inch off my arms
  • No longer meet the criteria for type 2 diabetes (achieved without medication)
  • Blood pressure ranging between normal and pre-hypertension without medication
  • Ideal triglycerides and excellent cholesterol levels

Two Years Later: Progress and Challenges

Joy comparison photoTwo years after beginning my journey, I had lost a total of:

  • 55 pounds
  • 12-1/2 inches off my waist
  • Significant reductions in my neck, chest, arms, and thighs
  • Met the criteria for partial remission of type 2 diabetes
  • Maintained ideal lipid levels and improved blood pressure

Then I got Covid, which was followed by months of post-viral symptoms, including finding it very difficult to walk. In the weeks that followed, my middle son would encourage me to go for walks with him. We started by going around the block, then around the neighbourhood, and then gradually increased.

The Fourth Anniversary: March 6, 2021

Joy hikingThen we took up hiking! Four years earlier, I could barely walk and talk at the same time, and for six months, I was hiking every week or two. This photo was taken last year on March 6, 2021 — the 4th anniversary of beginning my journey.

Like most journeys, this one has had ups and downs with both “mountain top experiences” and “valleys”. Recently, there have been a few valleys, but from the mountains to the valleys, there is no looking backwards for me, only forward. I hope my story and persistence serve to encourage you.

To your good health!

Joy

 

Follow Me on:

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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Another Client Journey — freedom from food addiction

Note: This article is 2 of 3 anecdotal accounts of a former client’s personal health journeys. It represents their unique experience and is not intended as medical advice or scientific evidence.


Introduction

J's before and after transformation

After reading the journey of one of my clients, “J” asked if she could tell her story. I thought it would be good for others to hear of her past struggles with disordered eating and how she came to realize she was a food addict. This is “J”, in her own words.


The Cycle of Disordered Eating

“I could not stop eating. I ate in secret and until I was ill. I repeated this behaviour over and over again, despite the negative consequences. For 20 years of my life, from the age of 9 to the age of 29, I struggled with food addiction, disordered eating, obesity, and yo-yo dieting. My mind was incessantly focused on one of three things:

  • what I was going to eat
  • how I was going to keep myself from eating, or
  • how to compensate for what I had eaten

In addition to disordered eating and food addiction, I faced severe depression and ADHD. I isolated myself, struggled with exhaustion, and was unable to focus on my work. I frequently wished I had not been born, or that my life would end. I attempted numerous diets and attended eating disorder treatment programs, but was unable to stop my binge eating and associated compensatory behaviours for any significant amount of time.”

Discovering Food Addiction Recovery

J at her highest weightApproximately two years ago, I reached my highest weight of 250 pounds and decided to make one more attempt to lose weight, and began researching low-carbohydrate and ketogenic diets. Through this research, I discovered books, articles, and podcasts about food addiction. As I read and listened, I became certain that I qualified as a food- and sugar addict.

I learned that sugar and flour are addictive substances and decided to remove them from my diet. I searched the internet for a dietitian who could help me to formulate a meal plan that eliminated the foods that I found addictive. I discovered Joy’s website and contacted her to schedule a Complete Assessment Package. Joy developed a meal plan for me that excluded the foods that were addictive for me and which allowed me to feel satisfied and energized, while losing weight. For the first time, weight loss did not feel like work.

Mental Clarity and Health Restoration

J after 100 pound weight lossI have lost well over a 100 pounds, and am a normal body weight and a waist circumference. I am so thankful for my weight loss, and my improved physical health. Even more importantly however, my depression has been significantly better, and I am truly enjoying life. In addition, my ADHD symptoms have greatly decreased, and my mental capacity has significantly improved.

I have so many reasons to recommend Joy as a dietitian. She supports me in my health, weight loss, weight maintenance, and sugar addiction recovery goals while also understanding and taking into consideration my history of disordered eating. She provides me with much-needed accountability. For the first time in my life, I can complete my work with little procrastinating.

I have been profoundly blessed and am so thankful for the role that Joy has played in my healing journey. I know there are many others who struggle with food addiction, and I hope my story provides some hope.”

 
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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

One Client Journey – down over 200 pounds

Note: This article is 1 of 3 an anecdotal accounts of a former client’s personal health journeys. It represents their unique experience and is not intended as medical advice or scientific evidence.


Introduction

Karen's 200 pound weight loss transformation

It’s been almost three years since I started working with Karen D. in February of 2018 and in that time she has lost over 200 pounds. Yes, two hundred pounds!

When she came to see me the first time, I was only one year into my own weight-loss and health-recovery journey, and was still very much overweight and metabolically unwell, but had come to understand from the scientific literature that a well-designed low carbohydrate diet was both safe and effective for weight loss, as well as for helping put some metabolic conditions into remission.

Karen D down 150 poundsIn April 2019, Karen private messaged me on social media and sent me a photo of herself, after she had lost 150 pounds. It was both delightful and very rewarding to receive this from a client and to see that she had continued to apply what she had learned and was doing exactly what she set out to do. She permitted me to share it on social media with only her first name and the initial of her last name, which I did. All people knew was that this was what one client had accomplished in a year.

Karen's Facebook postLast week, instead of private messaging me an update, Karen decided to post a compilation photo of herself under one I had posted of myself on Facebook. Even though I had not spoken to her in over a year, there was her picture for everyone, including me, to see! Wow!! Karen had lost more than 200 pounds and had every reason to be proud of her accomplishment!

In response to her initiative to share her progress publicly on Facebook, I ask Karen if she would be willing to tell her story in her own words from a client perspective, and she agreed — and her reason for doing so is this;

“I don’t want others living the same life I was stuck in”.

So, if you think you can’t “do it” and that your weight loss goals are “impossible, this post is for you. This is one client story. This is Karen’s journey, in her own words.

Karen’s Self-Directed Start

Karen D at start of journey“I started keto on my own in January 2018, but it really stressed me out. There is so much information ‘out there’, and everything contradicts itself. It didn’t make sense to me. Macros, IF, fat bombs…..even in my coffee. Seriously, don’t mess with my coffee.

I needed help!

In one way I felt ‘lost’, but I did know that not eating lots of “complex carbohydrates” was right for me. I knew that keto was the right option, but this high fat thing scared me, largely because of my history of having had eating disorders since I was 12 years old. There was something about this way of eating that made me feel like I had control over food for a change, instead of food having control over me but I didn’t feel like I grasped it enough to be successful.

Researching Dietitians

I researched dietitians that specialized in low carb eating, as I’d seen dietitians before that just pulled out the Canadian Food Guide and told me to eat oatmeal for breakfast. I came across Joy. Boy did I get excited! You see, I have severe anxiety and always feel like I’m doing something wrong. When I tried to do keto on my own, it was hard to know if it was wrong, or I just felt it was. I needed clear answers and directions. And I was desperate. I had to lose weight.

I started at over 440lbs, last time a scale was able to weigh me. I’d been successful at losing some weight on my own since January but I was on a mission. I was going to do it this time. For me, for my kids, for everything I had. The prospect of working with Joy meant clear answers to my questions, directions on how to really achieve my goals, and SUPPORT! I was going to have help, and not have to try to figure this out myself!

Addressing Fears and Obstacles

Leading up the appointment was nerve racking for me. As a morbidly obese person, you get used to being told how far gone you are and how your health is at jeopardy. Just asking for help sometimes is scary as you don’t know how judged you are going to be. I had so many questions that I wanted to ask, and was just hoping I’d really be “heard”.

My biggest question as a client was “why do I have to eat so much fat?” Is that really necessary? And my second big question as a client was “do I really need to track my macros?” because that flares up my eating disorders. I end up punishing myself if I see how much I’ve actually eaten.

My First Appointment and Meal Plan

It was the day of my appointment and I arrived at Joy’s office. She greeted me so warmly. I remember us talking about my health, my back, my fibromyalgia, my families health diseases. But I also remember how encouraging Joy was about the success I had already accomplished on my own. Joy put together a meal plan for me that made sense and that eased my fears as her client. She explained to me what my body needed, and I needed her explanation. It gave me ‘permission’ not to have to eat all that fat, and I was able to get my head to wrap around this way of eating.

Karen D down 100 pounds
January 1, 2019, down 100 pounds

Eating low carb is a very anti-inflammatory way of eating, so my body just started to feel so much better without all the sugar. I was starting to see huge changes in the way my body moved and looked. I was experiencing amazing non-scale victories that just kept me driven to keep going and wanting more. It wasn’t always easy. Sure, there where set backs and temptations. It took a great mind-change to see things differently.

Sustainable Habits

I didn’t make alternative foods. Didn’t try to find alternative to chips and rice and pasta. I just didn’t eat them anymore. If I accidentally ate an ingredient that wasn’t keto friendly, that didn’t mean I ruined my whole day and should start over tomorrow. It just meant one bad thing went in my mouth.

Same as if I gave into temptation. “Give yourself a break“, I would say to myself. “We aren’t perfect, don’t make your success suffer because of one small stumble. Why start over tomorrow when you can continue today?

Life Restored

Karen D January 2021 This is me today. I’m passionate about this because I’m working on my journey, and it has changed my life. I went from being bed-bound for sometimes weeks at a time, to living a full life now.

I’m working hard to regain my life to the fullest and know that it is something that is possible for anyone who wants to do it. I still have a bit to go before I’m at my ideal weight, but I can see the finish line. I’m going to be there soon.”

 
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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Too Much and Too Little is Killing Us – reducing comorbidities

Introduction

I just got “the call” that my mother has tested positive for COVID-19. She has all of the major comorbidities, so the prognosis is not good. We know that age, obesity, hypertension, and diabetes significantly increase the risk of hospitalization and death. While we cannot change our age, we CAN reduce our weight, lower our blood pressure, and normalize our blood sugar. Achieving a normal weight and waist circumference is our best chance for fighting this off.

I come from a family that always “battled with their weight.” My father died just shy of his 91st birthday, but he spent the last 40 years of his life in poor health due to metabolic conditions. My mother, now turning 85, has struggled with obesity and type 2 diabetes for decades. These conditions are deeply related to diet and lifestyle—factors that could have been put into remission with the right changes.

Shared Comorbidities

When I became obese and developed type 2 diabetes myself, I justified it as “genetics.” I realize now that the high risk was our shared diet and lifestyle. Our comorbidities were adopted, not inherited. I spent years using food as comfort, contributing to the hyperinsulinemia that drives metabolic disease.

Three years ago, I began my own health journey. I lost approximately 60 pounds and a foot off my waist, putting my blood pressure and diabetes into remission. This anniversary marks two years of active weight loss and a year of maintenance.

Joy's Health Recovery Timeline

Joy’s Health Recovery: April 2017, April 2019, and April 2020.

The Challenge of Protective Immunity

A report in The Lancet indicated that while 90% of severe, hospitalized cases develop IgG antibodies, fewer than 10% of non-hospitalized individuals with milder symptoms develop antibodies [1]. This suggests that herd immunity may be a dim prospect. If most people don’t produce antibodies after infection, they are not immune and could potentially be reinfected. Lowering our personal risk through metabolic health is the most proactive step we can take.

The Reward System: Carbs and Fats

For many, the combination of refined carbohydrates and fat results in massive dopamine release from the brain’s reward center—significantly more than when eating either alone [2]. This drives cravings and the “comfort eating” many have turned to during lockdowns. These refined foods contribute to the high rates of obesity and hyperinsulinemia we see today across North America.

We need to differentiate between refined “carbs” and real, whole foods. Eating significantly less processed food and more nutrient-dense whole food is both safe and clinically effective. If we are not willing to admit that obesity and high blood sugar are problems, we remain in denial.

Final Thoughts

It is my hope that presenting this evidence motivates people to consider change. Obesity, hypertension, and diabetes are significant risk factors in this pandemic. If not now, when? I wish each of you good health and a long life.

More Info?

Learn about me and the Comprehensive Dietary Package that I offer.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

References

  1. Altmann DM, Douek D, Boyton RJ. What policy makers need to know about COVID-19 protective immunity. The Lancet. 2020 May 30;395(10238):1527-1529. [https://doi.org/10.1016/S0140-6736(20)30985-5]
  2. DiFeliceantonio AG, et al. Supra-Additive Effects of Combining Fat and Carbohydrate on Food Reward. Cell Metabolism. 2018;28(1):33-44. [https://doi.org/10.1016/j.cmet.2018.05.018]
 
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LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Three Year Health Recovery Anniversary – a personal story

Introduction

I delayed posting this update due to the COVID-19 pandemic, but I thought by now we could all use a little distraction. I hope this post about my health and weight recovery serves as encouragement as to what is possible simply by eating real, whole food and sticking with it.

Joy's 3-Year Recovery Comparison

Me – April 2017, 2019, and 2020

Three years ago, on March 5th, 2017, I didn’t feel well. I took my blood pressure and found I was in a hypertensive emergency. My blood sugar was 13.2 mmol/L (238 mg/dl)—dangerously high, even for someone already diagnosed with type 2 diabetes. As an obese Dietitian with a BMI over 30, I was terrified of a stroke or heart attack. I knew I needed to change immediately.

The Decision to Recover

I treated myself like my own client: I printed my labs, took my measurements, and designed a meal plan as if my life depended on it. In the first year, I lost 32 pounds and 8 inches off my waist. My HbA1C dropped to 6.0%, no longer meeting the criteria for type 2 diabetes.

By year two, I had lost a total of 55 pounds and a foot off my waist. I worked closely with physician colleagues to adjust my carbohydrate intake and manage my medications. I also began focusing on circadian rhythms—changing when I ate and when I was exposed to light to align with my body’s natural 24-hour cycles. My sleep improved, and my fasting glucose finally reached numbers I hadn’t seen in years.

Current Status: Full Remission

I am now a normal body weight with an optimal waist circumference. I am in remission of type two diabetes and hypertension. I went from taking 12 different medications three years ago to leaving my doctor’s office with a clean bill of health and no metabolic prescriptions.

Joy April 2020

April 2020

I didn’t lose the weight quickly, but I gave myself the time needed to get well. The process wasn’t difficult to maintain because it was based on real, whole food. Today, I am “comfortable in my own skin” for the first time in decades. I share my story to encourage my clients: I have been where you are, and I came back.

More Info?

You can learn about me here.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 
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LEGAL NOTICE: The contents of this blog, including text, images, and personal anecdotes, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

Five Pounds or Fifty Pounds of Fat – in very real terms

Introduction

Whether one loses 5 pounds of fat or 50 pounds of fat, I think it is very helpful to visualize just how much that is. Yes, five pounds of fat is much larger than most people realize! This past week, I purchased a life-sized model of 5 pounds of fat from a nutrition supplier. When I received it, I was quite surprised by how much room it took up and just how heavy it felt.

Fat takes up a fair amount of room around one’s waist, or worse, inside one’s abdomen or organs. If someone has 20 pounds of fat to lose, that is four of those fat models distributed over their body: legs, belly, arms, neck, back, and face—and perhaps some in their liver.

5 pounds of fat being held in my hand – © BBDNutrition

Holding 5 pounds of fat like an infant

5 pounds of fat being carried as one would carry an infant

My Personal Journey with 55 Pounds of Fat

I had 55 pounds of excess fat before beginning my journey. Comparing these two full-length photos, it is easy to see how I had the equivalent of one of those fat models over the length of each leg, one distributed between each arm, one distributed over my neck and face, and two spread out around my waist and hips.

Joy's 11-year difference

Progress comparison: May 2008 vs June 2019.

The fat in my abdomen was wreaking metabolic havoc on my body; I had very high blood pressure and had lived with type 2 diabetes for eight years. I chose to follow a low carbohydrate diet to achieve these results, but there is no one-size-fits-all diet that is right for everyone.

More Info?

Learn about me and the Comprehensive Dietary Package that I offer.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 
Nutrition is BetterByDesign
 

Privacy Policy | Terms of Use

 

© 2025 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images, and cited statistics, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this content.

A Little Black Dress – a personal health and weight loss update

Yesterday I had an occasion to wear a new little black dress that I had bought, and remembered the last time I wore one. Ironically, it was for my Master’s convocation just over 11 years ago, and the dress was a size 16. My degree was in Human Nutrition, yet I was very overweight and had pre-diabetes.

May 25, 2008

The degrees on the wall did not help me understand why ⁠— despite my best efforts to “exercise more and eat less”, I was still overweight.  Despite my research related to the neurotransmitter dopamine, it was not known at the time how dopamine is involved in the potent joint reward system of eating foods that are a combination of both carbohydrate and fat (you can read more about that here). 

I did not understand why following the advice of my physician didn’t help.  I ate according to the (then) Canadian Diabetes Association (now called Diabetes Canada)’s recommendation to eat 65 g of carbohydrate at each meal and 25-45 g of carbs at each snack ⁠— along with lean protein and monounsaturated and polyunsaturated fat and participated in exercise several days each week. I ate “plenty of healthy whole grains” and “lots of fruit and vegetables“, along with low fat dairy,  yet a year later progressed to Type 2 Diabetes; what I was told was a “progressive, chronic disease”.

My studies didn’t help me understand the impact of high levels of circulating insulin on obesity and the effect of the after-meal and after-snack rise in insulin and then it’s drop shortly later on hunger. The reality was, the advice we were taught to “eat less and move more” did nothing to address the underlying issue of being hungry every few hours.  In fact, the detrimental effects of high circulating levels of insulin weren’t taught; only the effects of high blood sugar.

My studies didn’t help me understand that “plenty of healthy whole grains” for someone who is already insulin resistant, with high levels of circulating insulin isn’t helpful.  I didn’t understand how eating plenty of fruit was further contributing to my problems;  both because of it’s high carbohydrate load, as well as it being a high source of fructose. I drank 3 glasses of low-fat milk daily, but didn’t understand the effect of all of those extra carbohydrates on my blood sugar, as well as underlying insulin response.  It was not part of what I studied ⁠— either in my undergraduate degree or Master’s studies, because it simply was not well known.

It is only recently (April 18, 2019) that the American Diabetes Association (ADA) issued their Consensus Report which indicated that “reducing carbohydrate intake has the most evidence for improving blood sugar” (you can read more about that here). In fact, the ADA now includes both a low carbohydrate eating pattern and a very low carbohydrate (keto) eating pattern as Medical Nutrition Therapy for the treatment of those with pre-diabetes, as well as adults with Type 1 or Type 2 Diabetes.

While these are not currently part of Diabetes Canada‘s options, they are recommendations available to those in the United States. In fact, the European Association for the Study of Diabetes (EASD) also classifies low carb diets as Medical Nutrition Therapy and Diabetes Australia released their own updated position paper for people diagnosed with Diabetes who want to adopt a low carbohydrate eating plan. 

Many studies already demonstrate that a well-designed low carbohydrate diet is both safe and effective for the treatment of obesity and Diabetes (see the Physician and Allied Health Provider tab on my affiliate low carbohydrate web site for more information) but much of this has only come to light in the years since I graduated with my Master’s degree.

In the last 4+ years since I first learned about the therapeutic use of a low carbohydrate diet, I have read scores of studies in an effort to become well-informed and continue to do so in order to stay current with the emerging evidence.

April 2017 – April 2019

On March 5, 2017 I began what I have called “A Dietitian’s Journey”. Over the subsequent two years, I put my Type 2 Diabetes into remission, lowered my dangerously high blood pressure and achieved a normal body weight and optimal waist circumference.

You can read my story under A Dietitian’s Journey on my affiliate site.

June 15 2019

I have been in maintenance mode for more than three months and have been able to maintain my weight loss and health gains with little effort.

This photo was taken of me yesterday in my new “little black dress”.

 

The bulk of my Dietetic practice in the past focused on food allergy and food sensitivity (including Celiac disease, Irritable Bowel Syndrome, Inflammatory Bowel Disease), but I am now able to provide a range of options for weight loss and improvement in many metabolic conditions, including Type 2 Diabetes, hypertension and abnormal cholesterol that I was unable to offer a few years ago. I offer variety of evidence-based approaches, including a Mediterranean Diet, a plant-based whole foods approach (vegetarian or including meat, fish and poultry), as well as a low carbohydrate approach (which is what I follow).

More Info

Learn about me and the Comprehensive Dietary Package that I offer.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

 

Green Tea Should not be like Buckley’s

Introduction

I came across a social media post about someone who wanted to drink green tea for its health benefits, but couldn’t get over its “bad taste”.  I followed the origin of the thread to Reddit, where people guessed whether green tea’s “off taste” for that person may be genetic, like the taste of cilantro. While that can be the case (i.e. genetic sensitivity to a compound called 6-n-propylthiouracil, which is found in some flavonoids), others touched on whether it was because the person was making tea using supermarket green tea bags rather than loose tea, whereas a few people hit on the complexity of the issue.  In this post, I will discuss some of the factors that affect whether your green tea has a pleasant or “off taste”,  because after all, green tea should be something you actually enjoy and not only drink for its health benefits.

NOTE: The first part of this article is some personal details of my experience learning to prepare multi-ethnic food and beverages, and the second part of the article is specifically about the preparation of green tea and its health benefits.


Once a Foodie, Always a Foodie

I have been adventurous in trying different kinds of food and beverages since I was little, and I remember my parents taking me to an authentic Japanese restaurant even as a kid. 

As a teen, I enjoyed cooking multi-ethnic food and learned authentic Cantonese cooking in the 1970s when my mom took a course in Chinatown. In the 1980’s, I learned authentic Thai cooking from a friend of a family business associate who was from Thailand, and in those days, one couldn’t buy pre-made Thai curry pastes that are available everywhere now. I sourced the raw ingredients in Lao-Thai groceries and hand-pounded them myself in a mortar and pestle (that I still own and use), and I have recipe books sent to me from Thailand.

It didn’t matter whether it was Asian, Middle Eastern or Jamaican; I was a bit of a purist, wanting the ingredients and cooking method to be as authentic as possible. For me, the best way to find out how to make something was to ask someone from that culture who loved to cook.

What was true about food was also true for beverages.

I couldn’t just enjoy a cup of coffee or a glass of wine without knowing more. Whether it was the origin of the coffee beans, the length of time the beans were roasted, or how long the water is in contact with the beans, I needed to know, and I was interested in such things when it was not popular either.

Before “West Coast coffee” was a thing and before there ever was Starbucks® or Peet’s, there was a place called La Vieille Europe on St. Laurent Blvd in Montreal, which was where I got my single-origin, whole bean coffee. As I found out years later, the son of the roaster who owned that store taught the original roaster from Peet’s in the US how to roast beans. Small world.

When I lived in wine country (Sonoma County) of California for a few years in the early 2000s, I was determined to educate my palate to distinguish between different types of wine, which I did. I knew what I liked — which turned out to be an expensive habit when I returned to Canada after 9/11.  At the beginning, I explored the wines of Australia and found some I really liked, but missed the delicious and inexpensive  wines of Sonoma and Napa.

Once again, my palate returned to coffee, but finding a decently roasted coffee in Vancouver BC was harder than I thought. Given that this was the “West Coast”, I was discouraged how difficult it was to find good quality Arabica beans that weren’t over roasted. I stumbled across a few small roasters that did an excellent job, but in time they modified their roasts for “local tastes”, so once again, I was back looking for a new roaster. On a few occasions, I ordered from La Vieille Europe in Montreal because in the 40 or 50 years they have been in business, they never lost their passion for properly roasted, single origin coffee.

Over the 20 years I have lived in Vancouver, I discovered the world of quality tea that is largely unknown to most non-Asian-born Chinese. There was one excellent tea importer in Chinatown that I knew of and one that is still in the Richmond Public market that have single origin estate teas that rival the diversity of the best coffee roaster. Over the past 20 years, I’ve explored different types of tea from China and have come to like a few; my favourite of which is a fermented tea known as Pu-ehr.

Some years ago, I stumbled across matcha tea in a specialty Japanese store before it was a “thing”.  Knowing nothing about it, I have since found out that I had been using ‘culinary matcha‘ (designed for making Japanese sweets) for drinking.  No wonder it tasted bitter, and I needed to blend it with other ingredients to make it palatable. Thankfully, when fresh, it had the same health benefits, which I wrote about in 2013 in this article about the Role of Green Tea Powder (Matcha) in Weight and Abdominal Fat Loss. As you’ll read below, I have since learned about making and enjoying real ceremonial-grade matcha, which is intended for drinking from large matcha bowls.

Learning about Japanese Green Tea

At the beginning of this year, I began to explore green teas from Japan when I discovered Hibiki-An, an online tea importer from the Uji region of Kyoto. My culinary world expanded once again.

Unable to decide between the many different types and grades of tea that they carry, I order a sampler of 3 types of green teas (Sencha, Gyokuro Superior and Sencha Fukamushi).  They came in 4-oz individual bags — the quantity that can reasonably be used up within 3 months, when it is fresh.  All 3 teas were all of “superior” grade, which is not the best quality (as my palate is not developed yet), but is a high-grade tea.

When the tea arrived, it came with very specific brewing instructions (a summary of the much more detailed instructions on their web page). I’ve since learned that different types of green tea require different water temperatures and different lengths of brewing time.

Wow, who knew?

For “cooling” the water to just the right temperature, there is a yuzamashi, which is a small ceramic cup with a spout that the boiled water gets poured into to cool momentarily before being poured into the kyuzu; a special tea pot with a single handle, built-in mesh filter and large opening for the water (see photo, above).

You don’t need to get fancy, though.  I had these things for years from my days exploring different regional teas, but one can use an ordinary bowl to cool the water and any plain ceramic teapot to brew the tea in!

Tea to Water Ratio, Water Temperature and Steeping Time

Each type of green tea has a very specific ratio of green tea leaves to water, and very specific water temperatures and steeping times.

For example, of the three teas in my sample set, Sencha is brewed at 80° Celsius (176 ° Fahrenheit) for one minute, Gyokuro is brewed at 60-70 ° Celicus (140-158° Fahrenheit) for 1 -1/2 to 2 minutes and Sencha Fukamushi is brewed at the same temperature as regular Sencha, but for only 40-45 seconds.

I’ve discovered that following these guidelines using good quality, fresh tea leaves makes a cup of tea that is like nothing I’ve tasted anywhere before. It is not simply snobbery, but the science of what makes for a good cup of tea.

Note: I downloaded several studies that have researched the difference in brewing time, water to tea leaf ratio and water temperature but have decided against boring anyone with the details.

Recently, I became ready to move on to “realmatcha tea and ordered some from the same supplier in Japan.

It came in tiny cans (quantities that should be used up in a 3-week period).

The colour was a bright jade green and the taste had no hint of bitterness whatsoever!

It tastes amazing!

My teas ordered from Japan are my “weekend teas,” and during the week, I drink run-of-the-mill Sencha purchased locally at a Japanese store.

I drink them because I like them and for the health benefits.

Health Benefits of Green Tea

The health benefits of green tea are many. Several large-scale population studies have linked increased green tea consumption with significant reductions in the symptoms of metabolic syndrome, a cluster of clinical symptoms which include insulin resistance and hyperinsulinemia (high levels of circulating insulin), Type 2 Diabetes, high blood pressure, and cardiovascular disease, including coronary heart disease and atherosclerosis.

Catechins make up ~ 30% of green tea’s dry weight, of which 60—80% are catechins. Oolong and black tea, which are produced from partially fermented or completely fermented tea leaves contains approximately half the catechin content of green tea

It is believed that epigallocatechin gallate (EGCG), which is the most abundant catechin in green tea, actually mimics the action of insulin, which has positive health effects for people with insulin resistance or Type 2 Diabetes [Kao et al].

EGCG also lowers blood pressure almost as effectively as the ACE-inhibitor drug, Enalapril, having significant implications for people with hypertension (high blood pressure) and cardiovascular disease [Kim et al].

Green tea catechins also have benefits for weight loss. A 2009 meta-analysis of 11 green tea catechin studies found that subjects consuming between 270 to 1200 mg green tea catechins/day (1 — 4 tsp of matcha powder per day) lost an average of 1.31 kg (~ 3 lbs) over 12 weeks with no other dietary or activity changes [Hursel].

Drinking 8-10 cups of green tea per day is enough to increase blood levels of EGCG into a measurably significant range [Kim et al], but matcha contains  137 times greater concentration of EGCG compared to green tip tea [Weiss et al].

WARNING TO PREGNANT WOMEN. While EGCG has also been found to be similar in its effect to etoposide anddoxorubicin, a potent anti-cancer drug used in chemotherapy [Bandele et al], high intake of polyphenolic compounds during pregnancy is suspected to increase the risk of neonatal leukemia. Bioflavonoid supplements (including green tea catechins) should not be used by pregnant women [Paolini et al].

Green Tea Shouldn’t Taste Bad!

The reason someone would find green tea has an “off flavour” was because the tea was either not fresh, not of a half-decent quality, was brewed at the wrong temperature or for the wrong length of time. Think about it this way; it all a person ever drank was cheap, pre-ground coffee, they might think coffee tasted bad, too.

The fact is, one doesn’t need to order tea from Japan to enjoy a decent cup of green tea! I found the green teas below at a local Japanese grocery store, and when brewed properly, they are great as everyday tea.

If you aren’t adventurous enough to explore ethnic markets or time is limited, I can highly recommend the online supplier I mentioned above as having excellent prices for the quality of green tea, very good explanations on their web page and quick delivery.

For everyday use, I have a little water cooler (yuzamashi) bowl and a small single-handed tea pot (kyuzu), so brewing a decent quality sencha green tea (my daily tea of choice) has become second nature, but as I mentioned above, one doesn’t need special equipment to make a decent cup of green tea!  All you need is the right amount of fresh, good-quality tea leaves steeped for the right length of time in hot water that’s at the right temperature. The only thing to keep in mind is that once the package of tea is opened, it needs to be stored in a sealed, airtight, light-proof container and used up within 3 months or sooner.

Making a good cup of green tea is not really much different than brewing a good cup of coffee. To make a good cup of coffee, one needs to consider the country/countries of origin of the beans, the bean roasting time and temperature, the brewing method involved (drip, espresso, French press, etc), the required water temperatures needed for that method, and the different grind of beans and a specific water-to-ground-bean ratio required for that brewing method. It sounds complicated, but if you have a few types of coffee regularly, it’s not hard.

It’s the same with green tea.

In one sense, there is a lot to learn at first to make a good cup of green tea but on the other hand, once you know a few basics and find a green tea or two you really enjoy, the rest is easy!

Tea has amazing health benefits, but unlike the cough medicine Buckley’s®, there is no need to drink tea that “tastes terrible, but it works”!

More Info

If you would like more information, you can learn about me and the Comprehensive Dietary Package that I offer.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

 

 

Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything you have read or heard in our content.

References

Gayathri Devi A, Henderson SA, Drewnowski A. Sensory acceptance of Japanese green tea and soy products is linked to genetic sensitivity to 6-n-propylthiouracil. Nutr Cancer. 1997;29(2):146-51 [https://pubmed.ncbi.nlm.nih.gov/9427978/]

Hursel R, Viechtbauer W, Westerterp-Plantenga MS. The effects of green tea on weight loss and weight maintenance: a meta-analysis. Int J Obes (Lond) 2009;33:956—61. [https://pubmed.ncbi.nlm.nih.gov/19597519/]

Paolini, M, Sapone, A, Valgimigli, L, ”Avoidance of bioflavonoid supplements during pregnancy: a pathway to infant leukemia?”. Mutat Res 527 (1—2): 99—101. (Jun 2003) [https://pubmed.ncbi.nlm.nih.gov/12787918/]

Kao YH, Chang MJ, Chen CL, Tea, Obesity, and Diabetes, Molecular Nutrition & Food Research, 50 (2): 188—210, February 2006 [https://onlinelibrary.wiley.com/doi/abs/10.1002/mnfr.200500109]

Kim JA, Formoso G, Li Y, Potenza MA, Marasciulo FL, Montagnani M, Quon MJ., Epigallocatechin gallate, a green tea polyphenol, mediates NO-dependent vasodilation using signaling pathways in vascular endothelium requiring reactive oxygen species and Fyn, J Biol Chem. 2007 May 4;282(18):13736-45. Epub 2007 Mar 15. [https://pubmed.ncbi.nlm.nih.gov/17363366/]

Weiss, DJ, Anderton CR, Determination of catechins in matcha green tea by micellar electrokinetic chromatography, Journal of Chromatography A, Vol 1011(1—2):173-180, September 2003 [https://pubmed.ncbi.nlm.nih.gov/14518774/]

Why I Posted My “Before” Pictures When I was Still Obese

INTRODUCTION

It is not uncommon for people to post their “before” pictures after they’ve reached their goal weight to show how much they’ve accomplished, but why on earth did I post pictures of myself when I was still obese and metabolically unwell? That’s a good question.

There’s a saying that “it is not the healthy who need a physician, but the sick” and while people will consult with a Dietitian for many different reasons, those who are significantly overweight find it very difficult to take that first step when it is weight loss they’re seeking. Why?

People feel ashamed of being overweight or obese.

Oftentimes, overweight people feel that they are assumed to be undisciplined or lazy — that their condition is their own fault. They have heard over and over again that;

“If only they would eat less and move more they wouldn’t be so fat!”

or

“If only they ate ‘real food’ instead of ‘junk food’ they would be so much slimmer!”

Really?

If it were that simple, why would 1 in 4 Canadians (and 1 in 3 Americans) be obese?

Because it’s not that simple.

It’s been my experience that many overweight people and obese people often eat what has traditionally been thought of as a “healthy diet”; plenty of fruit and vegetables, low fat dairy products and only brown bread, rice and pasta and they feel frustrated and ashamed of being what is perceived as “a failure”.

Some have told me that sometimes their own healthcare providers have given them the impression that they must be being untruthful about what they’ve been eating because surely if they were eating the way they say, they would have been losing weight. In other words, they are not believed, or in stronger words, they are thought to be lying or at least incapable of accurately assessing how much they are ‘really’ eating.

Why would an overweight or obese person seek help in losing weight from a healthcare professional that views them as undisciplined, lazy or unrealistic about what they are eating?

They don’t.

Often people will try various diets that they read about online because no one will see them try and more importantly no one will see when they give up, feeling once again that they are ‘failures’.

I don’t think that overweight and obese people are failures. I believe many are doing what they’ve been told is the “right thing” but for different reasons. it is not working for them.  My role as a Dietitian is to help people understand what isn’t working and to enable them to be successful — without judgement.

It is for just such people that I posted my “fat” pictures before I ever started to lose weight!

I wanted people to see me as no different and certainly no better than they are, because I’m not. Sure, I have an undergraduate and graduate degree in nutrition, but I don’t get any “free passes” when it comes to losing weight and turning around my own metabolic health. I needed to do it just like everybody else.

I’ve lived each step of my weight loss and metabolic health recovery journey in public because I wanted people to experience in “real time” my frustrations and my victories. I wanted people to see that the path is not linear; that there are twists and turns and stalls, but yes it is possible to be successful. It just takes time and some dedicated work to get well and achieve a healthy body weight.

I look at it this way;

If it took me 20 years to become metabolically unhealthy and obese, what’s a couple of years to become metabolically healthy and normal weight?

Everyone’s weight loss and health restoration journey will be different.

There are no “magic bullets” or “super diets”— but there are different dietary and lifestyle options that can be pursued for success.

I can help.

More Info

If you would like more information, you can learn about me and the Comprehensive Dietary Package that I offer.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

 

Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

Middle-Eastern Style Lentil Soup – whole food plant based

The new Canada Food Guide encourages a whole food plant-based diet which is a good option for those who are metabolically healthy — especially those who are insulin sensitive. The challenge is that I was diagnosed with Type 2 Diabetes 10 years ago and while I am in partial remission now as a result of dietary changes I implemented 23 months ago, on a cold winter day like yesterday I really wanted a bowl of my favourite homemade lentil soup.

I knew from testing my blood sugar in response to different foods that I was beginning to tolerate a small amount of whole, unground legumes such as chickpeas that had been soaked from the dried ones, then cooked. I also knew that leaving the lentils whole rather than pureeing them would reduce the blood sugar response and by adding additional non-starchy vegetables such as spinach and fresh green herbs would also help lower the glycemic response, so in the interest of science (of course) I decided to make the lentil soup and test my response two hours afterwards and the next morning.

The only significant source of carbohydrates that I ate yesterday was the soup which was ~20 g of carbs per bowl.  I was pleased and encouraged that after 23 months of changing how I ate that my blood glucose two hours after eating it was only 5.5 mmol/L (100 mg/dl), which was normal. This morning my fasting blood glucose was 6.3 mmol/L (114 mg/dl) which was significantly higher than what it has been the last few months eating a low carbohydrate diet, but considering the amount of slowly digestible carbohydrate in the soup, it was somewhat understandable.  To more accurately assess my glycemic response to the soup, I should have tested my blood sugar before I ate it, after 30 minutes, 60 minutes and 2 hours after eating it, as I did with my chickpea “experiment” as the 2 hour snapshot after 2 hours doesn’t provide any information as to what was happening to my blood glucose at 30 minutes and 60 minutes, which may have included a spike.

The soup was a nice treat and it was encouraging to me to continue to discover that as time goes on, I can reintroduce small amounts of whole-food carbohydrate sources without unduly impacting my blood sugars. Of course, being in remission from Type 2 Diabetes is not Diabetes  reversal, so I am by no means “cured”, but I am doing much better than 23 months ago.

As I know from several studies, including a 2015 study from Israel (Zeevi D, Korem T, Zmora N, et al. Personalized Nutrition by Prediction of Glycemic Responses. Cell. 2015 Nov 19;163(5):1079-1094), everyone’s glucose response to individual foods is different and the only way to know how each person will respond (whether Diabetic or non-diabetic / insulin resistant) is to test individual response to a specific amount of the food, which is what I did. While legumes are not something I would eat on a regular basis as it would negatively impact my glycated hemoglobin (HbA1C) level, it is certainly nice to be able to have it sometimes.

Of course, for those who are insulin sensitive, this is a delicious whole-food, largely plant based meal.

Below is the recipe for the soup. I included a piece of beef shank, but it can as easily be made without any meat for those that don’t eat it.

NOTE: This recipe is posted as a courtesy for those following a variety of different types of eating styles and not necessarily as part of a Meal Plan designed by me. This recipe may or may not be appropriate for you.

Middle Eastern Lentil Soup

Ingredients

1 medium yellow onion, chopped finely
1 medium carrot, diced
4 cloves fresh garlic, minced finely
2 tbsp olive oil
1 slice of beef shank, optional
2 cups small brown lentils, rinsed well
2 tsp coriander powder
1 tsp cumin powder
1/2 tsp freshly ground black pepper
kosher salt, to taste
1 cup fresh cilantro leaves (coriander greens), chopped
1 cup fresh parsley (flat leaf or curly), chopped
2 300 g packages of frozen chopped spinach, defrosted and squeezed dry
4 liters cold water

Herb Topping (optional)

3 green onions, minced finely
2 cloves fresh garlic, minced finely
1/2 cup fresh parsley, minced finely
1/2 cup fresh cilantro, minced finely
1 tbsp olive oil

Saute the green onions in the olive oil over a medium heat until wilted, but not browned, add the garlic and saute a minute or two then add the chopped parsley and cilantro and continue sauteing until the greens are slightly cooked.  Set aside to top each bowl of soup with, just before serving.

Method

  1. Saute the chopped onion in the olive oil until lightly browned
  2. Add the chopped carrot and saute until partially cooked
  3. Add the beef shank, if using and brown on both sides
  4. Add the minced garlic and saute (being careful not to let it brown as it would become bitter)
  5. Add the coriander and cumin powder, and keep stirring
  6. Toss in the rinsed brown lentils
  7. Season with salt and freshly ground black pepper
  8. Add cold water and stir to dislodge anything that may have stuck to the bottom
  9. Over a medium-low heat, bring to a simmer, skimming off any foam that accumulates from the meat protein
  10. Cook at medium-low for several hours, until the lentils are cooked but not too soft
  11. Twenty minutes before serving, add in the well-squeezed spinach, fresh parsley and fresh cilantro (coriander greens)
  12. Prepare the herb topping and set aside to top individual bowls of soupd when serving
  13. Enjoy!

You can learn about me here.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

Copyright ©2019 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

 

 

Finally Reaching Normal Body Weight – a personal story

Today I reached “normal body weight” according to Body Mass Index (BMI) classification  no longer obese and not even overweight. Normal. It seems surreal.

When I began my health and weight loss journey on March 5, 2017 (19 1/2 months ago) I was obese. My weight bordered between Class I and Class II Obesity and I had multiple metabolic health issues. I was diagnosed with Type 2 Diabetes 10 years earlier, had elevated blood pressure, and abnormal lipids (cholesterol).  Most significantly, I was in denial as to just how ill I really was. The undergraduate and postgraduate degrees on my wall did not inform reality. The mirror did.

I didn’t feel well that day and took my blood pressure. It was dangerously high— classified as a hypertensive emergency. I decided to take my blood sugar too and it was way too high. I sat and considered the numbers of both and considered my options. At the time, I only saw two choices; I could go see my doctor who would have immediately put me on multiple medications or I could change my lifestyle. In hindsight the safest option would have been to do both, but I chose instead to begin to “practice what I teach”.

You see, I had two girlfriends suddenly die of natural causes within 3 months of each other just previous to that day; one of them I had known since high school and the other since university. They were both my age, both chose careers in healthcare, just like I did, and both died from preventable causes. They spent their lives helping others get well, yet unable to accomplish the same for themselves.  It was not for lack of trying, but for not having found a solution before death ended both of their lives. March 5, 2017, I realized that if I didn’t change I would likely die of heart attack or stroke, too. Their deaths may have saved my life.

I began a low carbohydrate diet immediately. I cut refined foods, ate whole unprocessed foods, didn’t avoid the fat that came with whole foods but didn’t add tons of fat either. While it helped a great deal, after several months I realized that I needed to lower my carbohydrates further in order to achieve the remission from Type 2 Diabetes that I sought.  I didn’t simply want to lose weight — I wanted to get healthy!

I consulted the experts and continued to make dietary modifications that got me closer to my goal. The first significant improvement was in blood pressure followed by blood sugar. I lost weight and more significantly lost inches off my waist.  While I hadn’t been formerly diagnosed with non-alcoholic fatty liver disease based on my lab work I more than likely had it. I tweaked and adjusted my Meal Plan many times over the last 19 1/2 months — each time moving myself closer and closer to my goal. Ten days ago I was within an inch of my waist circumference being half my height and now I am within 3/4 of an inch of it. It’s happening!

Body Mass Index (BMI) October 17 2018

Two days ago, I got on the scale and saw a series of digits that I had not seen since my twins were born 26 years ago tomorrow. I decided to crank some numbers.  I did a happy dance. I was almost there.  The photo on the left is weight category.

 

I am not one of those people that the press often writes about that pursued a low carbohydrate or ketogenic diet for “quick weight loss”.  I wanted to get well.  I chose a low carbohydrate diet for therapeutic reasons because it was my underlying high insulin levels which drove my high blood glucose and high blood pressure. To get well, I needed to address the cause, not the symptoms.

So here I am, having reached normal body weight!

Did I think at the beginning that I would actually get to this point? I wasn’t sure. I knew it was possible because I had helped others achieve it, but had never tried myself, so I didn’t know.

For health reasons, I no longer had the option of doing nothing!

At first, I set my preliminary goal as “no longer being obese“. Then I revised it to “being less overweight“.

I found some old photos recently of what I looked like as a young adult and realized what the weight was where I felt and looked my best then reset my goal weight once again. I knew it was entirely doable!

I am almost there!

Then the hard work begins.

Losing weight has been challenging, but not difficult.  Sure, I needed to determine what was holding things up at various stages of my journey and make dietary adjustments just as I do for my clients, but it’s much easier to do that for someone else than for oneself. The “hard work” will be finding out how to eat where I don’t lose any more weight, while maintaining my blood sugar and blood pressure at the best possible level.

If possible, I want to achieve full remission from Type 2 Diabetes and if not, I will learn how to maintain full reversal of symptoms.

I’ve documented the entire process throughout “A Dietitian’s Journey”, including “fat pictures” and lab test results to demonstrate the therapeutic benefit of a low carbohydrate diet and that this lifestyle is both practical and  sustainable.

Perhaps you would like to find out how I can help you achieve your own health and nutrition goals?

More Info

If you would like more information, you can learn about me here.

To your good health!

Joy

 

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

Copyright ©2018 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

My Approach to Eating Low Carb and Links to Popular Recipes

Some people think there is only one type of “low carb” diet; one that includes lots of meat and lots of fat, but that’s not the case.  There are low carb diets that are higher in fat than protein, higher in protein than fat and those that are somewhat of a hybrid. The same thing is true when it comes to “ketogenic” or “keto” diets as it depends what it is being used for. A keto diet for epilepsy or as an adjunct treatment for Alzheimer’s disease or certain kinds of cancer will look very different than one used therapeutically to reverse metabolic conditions like Type 2 Diabetes. There isn’t a “one-size-fits-all” low carb or ketogenic (keto) diet.

As well, there aren’t any “one-size-fits-all” people! Some folks have higher protein needs because of their age or stage of life or the sports they engage and for people seeking weight loss those who have 15 or 20 pounds to lose won’t necessarily need to eat the same way as those with a great deal of weight to lose.

In addition, low carb diets often change over time. For example, those with a lot of weight to lose will often eat differently at the beginning of their weight-loss journey than they do towards the end of their weight loss because their body adapts and changes. As a result, these folks need to have their Meal Plan adjusted over time, whereas someone with a smaller amount of weight to lose may do fine with the same Meal Plan all the way through. Everybody’s different.

How I Approach It

My own meals usually center around some kind of grilled, roasted or stir-fried protein along with a generous serving of fresh low carb veggies plus some added healthy fat such as cold-pressed extra virgin olive oil or a touch of butter just to make things tasty. I don’t hesitate to sprinkle salads with pumpkin seeds or a few nuts, some berries and even a bit of crumbled goat cheese and drizzle it with olive or macadamia nut oil because this way I’m happy to eat a large bowl of it and it keeps me satisfied for hours. For those whose of my clients whose dietary needs are similar, I encourage them to do the same; switching up the type of nuts or seeds they use and changing the type of cold pressed oil they use, as each tastes very different. Even changing the type of vinaigrette from vinegar-based to lemon-based or using different types of vinegar or herbs adds more variety. There are so many kinds of meat, fish, poultry and vegetables that can be eaten and each can be prepared lots of different ways, so there’s no need to get bored eating the same thing.

Reversing Type 2 Diabetes

In a little over a year I’ve lost almost 40 pounds- first eating a low carb diet and then necessarily because of significant hyperinsulinemia (high levels of circulating insulin) and insulin resistance, a ketogenic diet. I’ve put my Type 2 Diabetes into remission while reversing my high cholesterol and high blood pressure and while I’ve not yet arrived at the point where my waist circumference is half my height (lowest risk) I am getting close.

Because I was Diabetic for 10 years and obese for longer than that, I tend to limit my own intake of low carb baked goods (muffins, pancakes and breads) that are often made from ground nuts or seeds and cheese as these are very  energy dense. I still have some of my own excess fat stores to lose as well as continuing to lose fat from places it should never have been in the first place (including very likely my liver) so eating extra dietary fat outside of those found naturally in whole, unprocessed foods (meat, fish, poultry, cheese, egg) doesn’t make much sense.

I do better with a low carb lower fat cauliflower crust pizza  (recipe below) or a low carb zucchini pizza crust (recipe coming soon!) over the very popular “fathead pizza” (based on almond flour and lots of fat from different kinds of cheese) or even my own Crisp Keto Pizza (recipe below) which is high in protein and fat but low in carbs. That’s why there are a few kinds of pizza recipes, so there’s a choice – not just for me, but my clients and visitors to my site. One can’t have too many healthy, tasty ways to eat pizza, right?

Most Popular Recipes

Below are a few of my most popular low carb recipes grouped by type of low carb diet. Please remember, not all recipes will be suitable for your specific health conditions or weight loss goals, so if in doubt please check with your Dietitian or physician. I hope you enjoy them.

Higher Fat Low Carb Recipes

For those that follow a high fat low carb lifestyle, below are a few of my most popular recipes. For me (and quite a few of my clients who are also in the weight loss phase) these are “sometimes foods” and not “everyday foods”.

Low Carb Beer-Batter Fish (seriously amazing)
Quiche Lorraine
Crisp Keto Pizza

Desserts in this category include my  Low Carb New York Cheesecake (amazingly good!) and Low Carb / Keto Ice Cream .

Low Carb Moderately High Fat

Recipes more suited to daily fare for me and those who are in the weight-loss phase of a low carb diet are posted here.  Some of the most popular are;
Crispy Cauliflower Pizza (lower in fat than the Crisp Keto Pizza above)
Low Carb Chow Mein
Low Carb Thai Green Curry
Spaghetti Zoodles with Bolognese Sauce
Low Carb Kaiser Buns great with sliced meat or cheese and lettuce (or used as a hamburger bun!).

This Low Carb Chocolate Chip Pancake recipe was recently posted but I’m pretty sure it will become a favourite, too. It is around my house!

Great everyday side dishes that can accompany a wide variety of poultry, fish, meat and veggies whether for the family or company are;
Low carb high protein broad noodles
Keto Yeast Rolls
Low Carb Roti (Indian flatbread)

Higher Fat Convenience Food Recipes

I have created and posted several recipes for higher fat protein bars if you need an easy, tasty and cost-efficient substitute for expensive low carb convenience bars on the market. These are;

Chocolate Orange Low Carb Protein Bars
Chocolate Mint Low Carb Protein Bars
Low Carb High Fat (Keto) Protein Bars

I even have a Low Carb Green Tea Matcha Smoothie that can be used to target abdominal fat in those following a higher fat low carb eating plan.

If you have questions about how I can help you to lose weight, put Type 2 Diabetes, high blood pressure, or high cholesterol into remission, and adopt a low-carb lifestyle, you can learn about me here.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

Copyright ©2018  BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

Symptoms of Type 2 Diabetes ARE reversible – a personal story

For the last 16-months my goal has been to put my Type 2 Diabetes into remission and to no longer meet the criteria for Metabolic Syndrome. Towards that end, last year on July 11, 2017 I had complete lab work done, including fasting insulin, cholesterol, fasting blood glucose and glycated hemoglobin (HbA1C) and planned to redo the same tests at the same time this July to see how much progress I was making.

The day I had been waiting for arrived!

So, how did I do?

Let’s see where I started from in July 2017;

fasting insulin July 11, 2017

Last year, my fasting insulin was 54 pmol/L which converts to 7.8 μU/ml — well above the ideal insulin sensitive range of 2-6 μU/ml. I was insulin resistant, which was no surprise given I had Type 2 Diabetes for more than 10 years.

What about yesterday – 16 months after starting a low carbohydrate lifestyle?

fasting insulin, July 10, 2018

I went from 54 pmol/L (7.8 μU/ml) to 33 pmol/L (4.8 μU/ml). I no longer have high insulin; in fact, my insulin was now in the ideal range, between 2-6 μU/ml. Very cool!

But then what explains why my fasting blood sugar is still so high?

fasting blood glucose July 11, 2017

I mean, it has dropped a lot from 8.0 mmol/L  (144 mg/dL) last year to 6.9 mmol/L (124 mg/dl) this year, but this was still a huge disappointment.  Yes, many days my fasting blood sugar is in the low 5’s mmol/L (94-95 mg/dl) but not this time. It was at the high end of what it goes to!

Why?

fasting blood glucose July 10, 2018

In the last several months, I’ve been losing a lot of fat from my abdomen (2.5 more inches since the beginning of March, on top of the 8 inches I lost in the first year) and the end result of the action of hormone sensitive lipase on fat cells (adipocytes) is the release of free fatty acids and glycerol. The liver cells (hepatocytes) take the glycerol and turn it into glucose in a process called gluconeogenesis (literally “making new glucose”).  It is this glucose that is produced by my liver from my broken down fat stores that is raising my fasting blood sugar.

The good part is that my fat cells are emptying out.  The bad part is that my liver is making glucose out of it…and what complicates the matter is that I have what’s called “peripheral insulin resistance” from often eating only once a day (time-restricted-eating) and that causes my body to “save” the glucose for necessary processes.  As a result, my body cells don’t take in the excess glucose made by my liver and it hangs around in my blood until I get moving.  Then it will dissipate (provided I eat some breakfast).

What about my glycated hemoglobin (that is effectively the three month average of my blood sugar)?

glycated hemoglobin (HbA1C) July 11, 2017

A year ago, my HbA1C  was 7.5% which is well above the cutoffs of 7% which is set for those with Type 2 Diabetes.

glycated hemoglobin (HbA1C) July 10, 2018

This year it was 6.3% which is below the cutoffs for Type 2 Diabetes of 6.5% and lower than what it was 3 months ago, which was 6.4%. Naturally, it is higher than I would like because it includes all the glucose my liver is making from the fat cells it is breaking down, but sooner or later it is going to run out of that!  Soon my waist circumference WILL be half my height and around that point, my fasting blood glucose should be dropping.  My goal is to see my HbA1C below 5.5 mmol/L (100 mg/dl) and be in full remission from Type 2 Diabetes, not only partial remission which is what I have now.

But celebrating the victory, I am in partial remission of Type 2 Diabetes!!

So how have my lipids changed this last year, with the butter, coconut oil and coconut milk and full fat cream that I have been eating, as well as much more meat than I used to?

Last year, four months into my following a low-carbohydrate diet, this is what they looked like:

Lipid panel, July 11, 2017

 

…and this year?

 

Lipid panel, July 10, 2018

My LDL is down (2.60 to 2.47 mmol/L) , my HDL is up significantly (1.97 to 2.44 mmol/L), my non-HDL cholesterol (chylomicrons and VLDL) is down (2.45 to 2.11 mmol/L) and my already low triglycerides went even LOWER (0.64 to 0.52 mmol/L).

In July 2017 my TG:HDL ratio was 0.35, which is well below 0.87 and this year my TG:HDL ratio was 0.21! This means that of my LDL cholesterol, most are the large fluffy kind (the ‘good’ LDL), and not the small dense kind (the ones that put us at cardiovascular health risk).

I no longer meet the criteria for Metabolic Syndrome which is having 3 or more of the following 5 symptoms:

Criteria for Metabolic Syndrome – from Merck Manual

My waist circumference is significantly <35″

My blood pressure is well below 130/85 (usually around 120/70)

My triglycerides are well below 1.7 mmol/L (150 mg/dl) at 0.52 mmol/L

My HDL is well above 1.29 (it’s 2.44 mmol/L!!)

…but yes, my fasting blood glucose is still > 5.6 mmol/L (100 mg/dl).

So, I’m not “done” yet.

While I didn’t get “perfect” blood work, it’s pretty good for someone that 16 months ago was obese, had been Type 2 Diabetic for 10 years, had been diagnosed 3 years earlier with mast cell disease (which elevates blood sugar and insulin), had extremely high blood pressure and abnormal cholesterol.

Not bad at all.

…and all this by simply reducing my carbohydrate intake and eating whole, real food, including fruit, dairy, meat, lots of veggies and healthy fats from a variety of sources.

Of course, these are only my results. Everyone is different, but at a year, my results closely mirrored the results Virta Health’s study published at one- year study, with 218 subjects that had been eating the same as I have. So, it is certainly not unusual for people following a well-designed low carbohydrate diet to get these kinds of results.

NOTE: There is no “one-size-fits-all” low carbohydrate diet and what works for me may not be what is best for you. Before undertaking a major change in diet, please discuss your plans with your doctor.

Learn about me here.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

Copyright ©2018 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

References

  1. Merck Manual – Metabolic Syndrome (Syndrome X; Insulin Resistance Syndrome), https://www.merckmanuals.com/en-ca/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/metabolic-syndrome

 

Update on My Own Weight Loss Journey

It’s 16 months since I began my own weight loss journey and I thought it would be a good time to do updated “before” and “now” photos, as well as some measurements.

The photo on the left was me “before”.

Not only was I very overweight, but I had Type 2 Diabetes, high blood pressure and high cholesterol and was in denial about how very metabolically ill I was.

I was in denial partly because I believed that I was eating a healthy diet for someone with Type 2 Diabetes. I dutifully followed the recommended diet from the time I was pre-diabetic until I was diagnosed as having Type 2 Diabetes and continued on it because that is what was recommended to control my blood sugar. I deliberately avoided missing meals or fasting, to keep my blood sugar stable.

As per the recommendations for Diabetics (covered in an article I wrote here), I ate 193 – 259 g of carbs per day, plus sufficient daily protein for my age and a little essential fat.  Keep in mind that only the recommended amount of daily carbs adds up to ~800 – 1000 calories per day — and with sufficient protein for my age was another ~4oo calories, plus another ~150 calories or so in olive oil and a few nuts or seeds on my salad. With intake of 1400 – 1500+ calories per day, how was I supposed to lose weight?

If “eating less” wasn’t an option for me then of course, I was expected to “move more”.  If I didn’t move enough to burn off the excess carbohydrates that I was expected to eat as someone with Type 2 Diabetes, then this was my fault. This is why I was fat, right?

Really?

My diet was “healthy” by most people’s understanding — certainly as defined by the Dietary Guidelines (Canada’s Food Guide) as well as the Clinical Practice Guidelines for Diabetes. My bread was whole grain and so was my pasta and I ate brown or red cargo rice (with the husk). Lunch and dinner and my 2 snacks per day were comprised of lots of fruit and vegetables of all kinds along with some lean protein; 3-4 oz at each meal and an ounce of cheese at snacks.  I barbecued meat, fish and chicken all year round and if I did pan-fry something, I always poured off the ‘excess fat’. The quantities I ate were recommended by the guidelines and as evidenced by the fact that I neither gained, nor lost any weight.

Eating 65 g of carbs at each meal along with protein and 45 g of carbs at each of 2 snacks each day along with a bit of protein however didn’t help me avoid getting Type 2 Diabetes — so what was I expecting to accomplish eating this way after I was diagnosed?* It was supposed to help me manage my blood glucose levels, but unfortunately after a few years of eating that way, I ended up getting high blood pressure and then abnormal cholesterol as well, which is common.

*I believe that some people with Type 2 Diabetes do well eating according to the standard recommendations of the Clinical Practice Guidelines and others by following a whole foods, Mediterranean-style Diet. There is also strong research evidence that still others achieve excellent clinical results following a therapeutic low carb or a well-formulated ketogenic diet for a period of time. There is no one-size-fits-all diet for everybody and it is for this reason that I offer people choices.

When I saw my Endocrinologist 2 1/2 years ago, she said that if I kept eating as I had been, that in 2 years I would be on medication for Diabetes, hypertension and high cholesterol — and within 5 years, I would be on insulin. At that time, I discussed with her my intention to eat a low carb diet and how low in carbohydrate I was willing to go, if I needed to. I was expecting a great deal of resistance from her, given some doctors consider a low carb diet unconventional. Her response surprised me. She told me that me that eating very low carb was the best chance that I had to avoid the scenario she outlined above as well as the complications of Diabetes, including blindness and lost limbs. In fact, she recommended less grams of carbs per day than I was intending.

Unfortunately, it took another 2 years before I became metabolically unwell enough to actually implement the dietary change, but with my Endocrinologist’s approval and encouragement, as well as my GP monitoring my health, March 5, 2017 I began changing how I was eating and I’ve never looked back.

Me – July 2 2018 (16 months later)

The photo on the left is of me on the Canada Day stat (July 2nd), which was Monday.

As of today, 16 months along I’ve lost;

  • 39 pounds (18 kg)
  • 10.5 inches off my waist (27 cm)
  • 2.5 inches off my chest (6.5 cm)
  • 3 inches off my neck (8 cm)
  • 1.5 inches off each arm (4 cm)
  • 1.5 inches off each thigh (4 cm)
  • Both my HbA1C and FBG are in the non-diabetic range
  • My blood pressure is normal for someone without Type 2 Diabetes
  • My lipids (cholesterol and triglycerides) are considered ideal.

I still have an inch and a half to lose off my waist to get to where my waist circumference is half my height and I’m guessing that will take me losing another 18 lbs but who knows? Whatever it is, it is. I had a foot to lose from my waist when I started — so what’s an inch and a half more?

Now, “moving more” is possible! Yesterday, as I do most weekends, I walked for 2 hours and wasn’t tired at all. I work out each week doing slow High Intensity Training and love it and am thinking about joining a dance class in September.  “Moving more” is the result, not the solution.

Keep in mind that my results are only relevant to me, as I am ”a sample-set of one” (n=1). As well, my doctor’s recommendations to me may not be the same as your doctor’s recommendations to you. Everyone’s results following a low carb diet will differ, because each person’s Meal Plan will be based on their own medical history, any metabolic conditions they may have, medications they are taking, their family risk factors, starting weight and lifestyle factors. What my journey and yours will have in common if you’re working with me is that it will begin as a moderately low carb intake, where you’ll be eating whole foods from all food categories, with your doctor monitoring your labs and the dosage of any medication that you may be taking.  I’ll gradually lower the amount of carbohydrate you’re eating only as necessary to achieve the clinical outcome(s) that you’re seeking, and with you doctor monitoring the dosage of any medications you’re taking. This often has to occur quite soon after lowering the amount of carbohydrates and in time they may be discontinued entirely.

Some “low carb diets” available on the internet or in popular books promote unlimited amounts of meat, cream, butter, and eggs, and others promote (or promise) “rapid weight loss”.  I don’t do either. But if you are looking for a Dietitian to support your desire to eat a low carb diet in order to lose weight and lower metabolic markers of Type 2 Diabetes, high blood pressure or abnormal cholesterol, then I’d be glad to be part of your healthcare team.

More Info

If you would like more information, you can learn about me here.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 


Copyright ©2018 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the ”content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.