Monday, May 26, 2014

Hashimoto's during the postpartum time, and tackling the Autoimmune Paleo Protocol

A few weeks ago it became apparent that I needed to make some big changes. Somewhere around 9 or 10 months after August's birth I started having a major Hashimoto's flare. I was exhausted. Bone-deep exhaustion that just wasn't explainable by having to get up and nurse a couple of times in the night. Foods that had felt fine a couple of months earlier were suddenly not fine at all.

Ian and I were discussing the book "Grain Brain," which makes the case that consuming grains (even "healthy" whole grains) can cause myriad problems like dementia, anxiety, depression and ADHD. I asked Ian if he thought I was depressed.

"Yes, of course you're depressed," he said.

"How long do you think I've been depressed for?" I asked.

"Since you got pregnant," he answered.

Sometimes it takes someone who has known you forever, who is walking the path with you, to see what's right in front of you. I needed to make a change, and I needed to make it yesterday.

When I got pregnant with August I quickly threw my Paleo lifestyle out the window. Unfortunately. I had actually been dabbling with re-introducing grains into my diet when we decided to get pregnant, and then when the nausea hit suddenly my nutrient-dense Paleo diet was absolutely revolting to me. All I wanted to eat was grains and dairy. And maybe that was fine. Maybe it would have been OK to eat those foods to get through a rocky time. But I kept eating them. I continued through the pregnancy, well after the nausea passed. My Hashimoto's went into remission during the pregnancy and I was able to tolerate foods I normally can't eat - like grains, dairy and eggs. But just because I was tolerating them doesn't mean I was feeling incredible. During the pregnancy I struggled quite a lot with fatigue, which I wrote off as a normal pregnancy symptom. Now I look back and wonder if I could have had more energy if I was eating the best diet for me.

After August was born he was so colicky, and reacted very strongly to me eating lots of healthy foods, like cruciferous vegetables, onions and garlic and other high FODMAP foods. I coped with that reality by continuing to rely on grains to fill the gaps, even though I did cut out dairy and eggs in case they were irritating his gut. And the time just never came when it seemed time to cut out grains. I had come to rely on them. And honestly I didn't want to let them go. As I moved through the postpartum period grains worked less and less for me so I moved away from baking with grain flours and toward eating only whole grains. Then I ate less whole grains. In spite of those incremental changes, I was still feeling crummy.

About a month ago I hit rock bottom. I was experiencing fatigue that was so severe it was affecting my ability to take care of my kids and feed my family. At a naturopath appointment I went on and on and on about how I felt like I had tried everything and was still feeling so terrible. I told her that the best I had ever felt in my life was when I had followed an egg-free Paleo diet. She suggested I try returning to that diet and see if it relieved my symptoms.

I immediately removed grains and eggs from my diet. The biggest thing I noticed was a shift in both my mood and my mental clarity. I told my nutritionist that it was like going from the black and white Wizard of Oz to the first scene in color. The world was brighter. 

But still I felt frustrated that all my symptoms weren't resolving, especially fatigue. Making the transition was difficult. I was feeling sad about loosing lots of foods I had enjoyed, and feeling sorry for myself that maybe I'd never be able to eat them again. My fatigue continued but showed up in a pattern that I couldn't make any sense out of.

A few days later I got a newsletter from our nutritionist - Andrea Nakayama - that included a review of the cookbook The Autoimmune Paleo Cookbook. I had never heard of the Autoimmune Paleo Protocol (AIP). I dove in, ordered the book, got the book The Paleo Approach from my library and started reading as much as I could.

The autoimmune protocol takes the Paleo diet and even further restricts it by removing eggs, nightshades (potatoes, tomatoes, eggplants and peppers), nuts and seeds. That list completely freaked me out. What's left? several people have asked me. Well, meat. Vegetables. Fruit. That's it. I decided that there was no way any human could survive on such a restricted diet. And yet... I started to notice things.

I made a batch of raw hazelnut cookies and after I ate a few I was hit by such a debilitating wave of fatigue that I couldn't move from the floor, when I needed to be getting my kids ready for bed. I made a soup with tomatoes in it and could barely move my arms the next morning when I heard August's first peeps. It was scary.

Suddenly the only thing that sounded worse than giving the Autoimmune Protocol a try was continuing to feel as crummy as I was feeling. So I dove in. It was completely overwhelming.

I made the commitment to follow the protocol just for the next meal. Once I got through that meal, I made the commitment to follow the protocol for the next meal. And I went on like that for a couple of weeks. I stubbornly hung on to a few foods, like raw cacao powder, chia seeds and stevia. I refused to believe those foods could cause anyone problems. But over time I let them all go. I am now following the AIP 100%.

I was talking with my chiropractor the other day and was telling her about these changes I've made to my diet. Her response was "I could never do that," which I hear a lot from people who consider my lifestyle choices, ranging from being Paleo to homeschooling. I always find it to be an interesting comment. "You would," I told her, "if you felt as terrible as I did and this was the only thing that helped."

After following my one-meal-at-a-time approach for enough weeks I started to feel well enough to really step back and see the big picture. I feel so much better. My energy is returning. My enthusiasm for life is returning. Life doesn't feel so overwhelming (even though managing my health needs and special diet, along with Ellie's health needs and special diet, which are often in conflict, is SUPER overwhelming).

This was all confirmed for me when I accidentally ate something containing egg yesterday and was hit with such severe fatigue that I had to spend part of the afternoon in bed. I was so frustrated that I lost part of the holiday weekend to feeling like crap just for eating a tiny amount of hidden egg. At a Paleo food cart of all places!

I haven't figured out yet how long I plan to stay on the AIP. It isn't intended to be a lifelong diet - it is designed to help get an autoimmune flare under control. At some point I should be able to add those verboten foods back in. I certainly can't imagine life without chocolate forever. But the big takeaway lesson for me is that I probably will need to stay within the larger confines of the Paleo diet forever. And I'm coming to a place of acceptance about that. I would rather have energy to play with my kids than eat a gluten-free burger bun. 

Following the AIP has resolved my Hashimoto's symptoms like nothing else ever has. No supplement or lifestyle change or diet has helped me have this steady energy and clear mind like the AIP has. It's not perfect and hiccoughs like my egg exposure feel discouraging, and I am having to re-discover how to keep my blood sugar balanced on a completely different diet, but healing is happening.

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