78- Support For Hashimoto’s Disease with Stephanie Ewals

Bryan: 00:15 Right now it is estimated that 20 million Americans have some form of thyroid disease and about one out of every eight women will develop but thyroid issue sometime in their lifetime and women are five to eight times more likely to have thyroid issues than men. What's up everyone? I'm Bryan Carroll and I'm here to share nutrition and fitness tips to make wellness less complicated. And today we have Stephanie Ewals on to talk about Hashimoto's disease, which is an autoimmune form of thyroid disease. We'll take a look at why more and more people are getting Hashimoto's and what to do about it. But before we dive into this episode, this episode is brought to you by our friends at Garmin. They provide the best fitness and outdoors watches on the planet from the Vivo series to the Fenix series. Their watches are made to be used hard while providing you a ton of different metrics to analyze your progress.

Bryan: 01:10 Personally, I use a Fenix series because of all the mountaineering and outdoor adventures we go on. And after years of abuse, this watch is still holding on strong and never leaves my wrist. You can find out more about the Garmin watches at summitforwellness.com/Garmin now let's dive right into my episode with Stephanie Ewals.

Bryan: 01:33 Stephanie Ewals is a nutritional therapist and founder of out of the woods. Nutrition. Stephanie believes the health of your body affects every aspect of your life and that the majority of chronic health problems are a result of diet and lifestyle. Your body has an amazing capacity to heal, so it is never too late to try nutritional therapy. Thanks for coming onto the show, Stephanie.

Stephanie: 01:55 Thanks for having me.

Bryan: 01:57 Of course. And uh, we always like to discover why people get into the field of health and wellness. So can you dive into your background a little bit and why you became a nutritional therapist?

Stephanie: 02:08 Sure. I think like a lot of us who come, to get certified in nutritional therapy, we have our own health story for sure. And, I was diagnosed with hypothyroidism in 2002 after my second child was born. But you know, they just did a TSH test, found that my TSH was 150, so I was really hyperthyroid and they just gave me, Synthroid or levothyroxine and said, here you go, this is it. So I thought, okay, I gotta to take this for the rest of my life. no big deal. My mom does it, my aunts do it and my uncle does it. it's in the family, but I didn't feel good. even after being on the medication, like you have that little window of, of time when you pretty good and then you don't feel good anymore and it's just like your body.

Stephanie: 03:04 It's not just the medication is not enough. It was a bandaid. so that was in 2002 in 2004 in the middle of a thyroid storm. I lost a child at 34 weeks gestation. So I had a stillbirth and I knew then something was wrong because my, they were testing my thyroid and it was hyper at the time or showing symptoms of hyper, which I now know to be, an autoimmune attack. And, my doctor took me off my medication thinking that would help the hyper symptoms. And it was about a month later, my child had died. So very devastating obviously. And that was it for me. I knew something wasn't right and I knew I wasn't going to get help from conventional medicine. So I started to, started to just research and something in me was like, you have to find a naturopathic doctor, find a naturopath. She diagnosed me with Hashimoto's in 2010 and that was the beginning of the end because I started studying nutrition even more. I started to feel a little bit better. I saw that there was all these things that came into play into how we feel, adrenals, sleep, blood, sugar, digestion, all of that stuff. and then I found nutritional therapy association and I was like, this is it. I have to do this. got certified and now it is my goal to keep women from having to suffer like I did.

Bryan: 04:37 And it's pretty interesting going back to your bio where you say that you believe the majority of chronic health problems are a result of diet and lifestyle and you use suffering from an auto immune condition and you've been able to take care of that mostly through diet and lifestyle, which is super fascinating because traditionally a lot of these is you know, people are taking a ton of different medications to kind of mask the symptoms that they're dealing with. So it's definitely interesting that, uh, you took the route of looking deeper to figure out what's going on.

Stephanie: 05:12 Yeah, I knew, I knew what I was doing wasn't working. I was, I had a, I had two kids. and then I did have a child after, the death of my son and, and she's fine. but I was angry all the time. I was tired all the time. I, I just felt like crap all the time and I was like, I don't want to live the rest of my life like this. And I just knew there was something better out there and I, I had to find it. So, yeah.

Bryan: 05:48 And there's a lot of people that do feel like crap. So can you talk about how, like are women more likely to have issues and men or is it pretty even across the board? A gender wise?

Stephanie: 06:01 No, it appears that, women tend to be the ones who are suffering, more with hypothyroidism and Hashimoto's and, and in, in the u s about about 90% of hypothyroidism is the autoimmune condition, Hashimoto's. and there's a portion of that that is graves' disease to which we can talk about. But, I don't, I don't know why that is. I don't know if there's any studies on it. I, my feeling is that women, especially moms, tend to, not take care of themselves first, put everybody else first. So they were down. And that was definitely the case for me. I was now knowing what signs of adrenal fatigue look like. I had a lower backache almost every night and I knew once I sat down, I was done for the night. So I pushed myself as you know, far as I could until I couldn't take it anymore than I would just sit down and it'd be like, I'm done. I can't move. so I think that's part of it is that we, we tend to, do, do, try to do it all. And I, that's just a guess. I don't know for sure why it is, but I would guess that's part of it.

Bryan: 07:14 Yeah. You just ended up wearing your body down and other parts of the body take a hit. Can you talk about what is that thyroid? Cause we hear a lot of people discuss that thyroid and we see a lot of people with thyroid issues. But what exactly does the thyroid do in the body?

Stephanie: 07:30 Well, so it's a, it's a little, butterfly shaped gland that sits over your, like your Adam's apple area of your neck. And it does everything. It, uh, there are receptors on almost, I believe, I think every cell in the body, but almost every cell in the body for sure, for thyroid hormone. So each one of our trillions of cells needs a little bit of that thyroid hormone to function properly. It affects our metabolism, it affects, it affects how cold or hot we are, like our ability to regulate temperature. Like there's the million and one things that it does. It plays a role in, in our ability to manage our blood sugar and our adrenal health. Like everything liver. yeah. So it's, it's a pretty big deal. You'll, we'll die without it. So inevitably, a lot of people end up having to be on side replacement hormone, which isn't a bad thing.

Stephanie: 08:27 I talked to quite a few people who want to get off of their medication and I tried it once myself and I do not recommend doing it. sometimes the damage is done and and you may need to take the medication the rest of your life and that's okay. It doesn't mean you're a failure at getting well. cause it's not, it's a prescription but it's a hormone that we need. So it's not like, you know, something that you can necessarily manage 100%. Naturally. That being said, there are people who are able to recover. Uh, there's thyroid is known to be able to regenerate. I think it just depends on how much damage is done and how dependent your bodies become on the medication and that kind of thing.

Bryan: 09:12 And earlier you mentioned that you are hypo thyroid and then your doctors at one point thought you were hyperthyroid. So can you talk about the differences between those two different states? I'm sorry.

Stephanie: 09:25 Yup. Hypothyroidism is when your body slows down, everything gets slower. You might feel like, there's cement running through your veins. everything's very slow and like you feel like you're, you're thinking in slow motion. you might be tired, you might might sleep eight hours and, and wake up and feel like you hadn't slept at all. You'll just exhausted all the time. Uh, you can get that weight gain, despite doing everything right. and you're going to have trouble with constipation. so that's where everything slows down. And then when you're hyper, you have heart palpitations, you lose weight really easily. You maybe don't sleep, can't sleep, you have severe insomnia, you might sweat, like night sweats and that kind of thing. You might just feel agitated and nervous all the time. and so for, for my case, when I was pregnant and that was happening to me, that was an autoimmune attack on my thyroid. And when you get the autoimmune attack on your thyroid for Hashimoto's, it's attacking, specific antibodies, thyroid peroxidase antibodies or thyroglobulin antibodies. And that damage to the thyroid tissue causes a release of thyroid hormone, which makes you feel like you're in a hyper state but you're not actually experiencing hyperthyroidism. so for my case, it was the autoimmune attack causing those symptoms.

Bryan: 11:02 Yeah, that's super fascinating how the body can turn on itself. It's also kind of scary that it does that too. And we'll definitely talk about that a little bit here in a moment. But you mentioned a weight gain for hypothyroid, which as people get older, a lot of people experience, some form of weight gain. So is this weight gain a gradual over time or is it typically a lot of weight in a short amount of time?

Stephanie: 11:31 Yeah, if you're hyperthyroid and in, for, for me, when I was first diagnosed with a TSH of one 50, I didn't gain a whole lot of weight. I mean, I had just had a baby so I probably didn't notice. but that wasn't a big issue for me. But yes, it can happen overnight. you can end up gaining five in a week or five pounds in a couple of days. It's just its bio individual as with everything in the body. but it's not something like, you know, the average person gains 10 pounds over a year or whatever it is, a couple of pounds over a year. I can't remember what that statistic is. But yeah, definitely noticeable for a lot of people.

Bryan: 12:15 And so let's start talking a little bit about, Hashimoto's and how the body starts to attack it. So what are some reasons why the body would start to, uh, attack the thyroid and attack the thyroid hormones? Okay. Well,

Stephanie: 12:31 there's, there's genetics in that. I am genetically susceptible because it runs in my family. So there's that component, but you have to turn on those genes or keep the genes turned off. And that's with diet and lifestyle. For me it was poorly managed blood sugar. I'm a, sugar addict. I didn't eat well. I didn't grow up eating a lot of vegetables. I grew up on processed foods. so it's all of that stuff. Somewhere along there I had a mouthful of mercury fillings. uh, very, stressful pregnancy when the attack happened. the pregnancy was stressful. My Life at the time was super stressful. so not managing stress, any one of those things can trigger an autoimmune attack. it just depends again on the person. and then you get, so I loved bread. I still love bread. I don't eat bread anymore, but I used to bake it and, it was my, my thing.

Stephanie: 13:36 I love bread, uh, and the proteins in gluten. And the proteins and dairy are similar to those in the thyroid. So when you're consuming those two foods, you are, the immune system can get confused. So if it's already on alert because of all that other stuff that might be going on, it says, I'm not sure what this is, this protein, doesn't look familiar, but maybe it's like this fixed protein over here in the siren. So we should attack them all. And that's, that's kind of where it starts. And basically with intestinal permeability or what is more commonly known as leaky gut. So you get those proteins leaking through the gut into the bloodstream and then the immune system is like, what is this? I don't know what this is. I'm going to attack it. And then I see something over here that looks like that too. So let's attack that. And for me, that presented as Hashimoto's, you know, and that can be for everybody. It could be different if you could or your joints could be attacked or your skin or you know, any number of autoimmune diseases.

Bryan: 14:42 And that's a really interesting thing because when you go to the, your doctor, they're not gonna tell you that, uh, the Gliadin and gluten can look similar to the same molecule structure as what's in your thyroid. And so if you're eating that, then it can cause your auto immune to flare up as well. So it's, it's stuff like that that I think people need to know more about because it can totally influence influence the way they feel and how their bodies are handling, the healing process from these type of issues or even the managing, not necessarily healing, but just managing symptoms. what, what protein structure in dairy is similar to the thyroid? Is it Casein or is there something else in it? DNR,

Stephanie: 15:30 I do not know if it's Casey. I don't know. I have never even thought to look that up to figure out exactly what protein it is. because when you look at, uh, Kemet biochemistry, you know, amino acids are made up of so many proteins or you know, in different sizes and things like that. But there's so many, only so many combinations. So, it's, it's like there's like one little difference I read in a book somewhere between the protein in gluten and the protein in the thyroid. And that's why it gets confused. I'm sure the same thing is with dairy as well, but I just, I don't know which one it is. Sorry.

Bryan: 16:13 Oh, no worries. and then another question is, you know, it took the doctors so long to diagnose you with Hashimoto's and that happened about nine years ago, even though it's something that's genetic in your family. So if they looked back at the history of your family, that could have helped them, guide them a little bit to figure out what possibly could be going on, uh, with you. And for a lot of people it takes a long time for doctors to come up with a diagnosis for them. So what are some, uh, symptoms or lab markers or anything along those lines that people should be looking at to help guide their doctors to be able to discover if this could be a potential problem that they're having?

Stephanie: 17:01 Well, I would say, you ha you have to be your own health advocate for sure. You, you, you, some doctors won't test anything but TSH and it can be 5.7 and they'll be like, oh, you're fine. There's nothing wrong with you. you know, then they'll, they'll tell you, I am not kidding you, they will offer you antidepressants. I had gone in just not feeling great, still not feeling like things are going right. And my doctor was like, here's some antidepressants. I think you're depressed. I'm like, no, my thyroid's not working. So, you have to find a doctor that's willing to test more than just TSH and then you want to test, T4 I mean free t four free t three, because those are the hormones that are floating around, that are going to go places. and reverse t three is another good marker to test because that will, if that's high indicates that there's some stress in the body, mental or physical.

Stephanie: 18:00 and then the antibodies is what diagnosis Hashimoto's. So TPO antibodies and the tgab antibody, thyroglobulin, antibody, if those are high, you definitely have some sort of autoimmune thing going on, but they can not present and you can still have an autoimmune issue because the hormones fluctuate, especially the antibodies. So, if they're not presenting and you still don't feel well and everything else looks good, you, you should have them tested again. And that is difficult to do as well because conventional medicine generally will only test them once because they're there. treatment plan for anybody with hypothyroidism or Hashimoto's is to give you thyroid hormone, usually a t for only synthetic medication and that's it. They just gradually up the dose as the thyroid tissue dies off. So you, you have to be your own advocate. You have to fight for what you want and you have to remember that you're the customer at your doctor's office.

Stephanie: 19:10 They generally make you feel the other way. Like they're in power, they know what they're doing. You should listen to everything that they do. But if you can find a doctor that's willing to listen to you and work with you based on your symptoms, it's really hard to find a doctor like that, especially because in a lot of states, the only way you can get your prescription is from a medical doctor. I know some states allow naturopathic doctors to write prescriptions and that's fantastic. but so you have to find, you have to work with a doctor in some way. And when I found a doctor that was willing to treat me based on symptoms and she was willing to switch me from synthetic medication to a natural desiccated thyroid medication, which is a porcine glandular medication made from pig thyroid glands. So you're getting both t four and t three in that.

Stephanie: 20:04 she went on maternity leave and I got a call after my labs were done, from the nurse of the doctor who was taking over for her. And they've basically yelled at me and said, don't you know that this medication can cause heart problems? And I was like, I don't think so. And I'm not worried about that. And then I hung up the phone and I found fun. Another doctor, I was like, I'm not going back there because they're probably not going to let me take my medication in some point. You just get tired of fighting. So, yeah, I hope. Does that answer your question? Probably too much.

Bryan: 20:41 I love that you talked about a lot of different lab markers because we've had quite a few people come in and they're presenting some thyroid symptoms and we ask them if they've ever had labs checked and they said that all their labs have always come back and they're totally fine and we take a look at what their doctors have run and typically it's, you know, a standard CWP and then it checks for a TSH only and none of the other markers. So a lot of doctors are only looking at the TSH because that's super easy to run. And then they tell you that your thyroid is completely fine based off of only one marker out of like seven or nine different markers I could be looking at.

Stephanie: 21:19 Yeah. And they're telling you just based on TSH that it's fine because that's what they've been told. So they are told Synthroid, levothyroxine only. Those are the only medications you should be using because they're safe and effective, which by the way, they're not as safe and effective. And there's, there was a big, FDA recall, I think in 2011 I can't remember the date exactly on Synthroid because there was problems with it. But aside from that, yeah, they're, they're just doing what they're told. And the other problem, it's not, I mean, it's not necessarily the doctor's fault. I kind of sometimes make it sound like that or I get a little, uh, excited about this because they're not caring for patients the way they should be, but they have to answer to somebody else, you know, so their clinic may say, this is the standard of care.

Stephanie: 22:10 You cannot deviate from that. That's how it is. So it's sick medicine basically. so I tried to tell people, you're, you're TSH. You want that between one and two to feel optimal. and free t for between one and 1.5. and then free t three is between 300 and 450. PG Slash d L. I've always got to look up what PG meant cause I can never remember. but it's a teeny tiny measurement and you can Google it and convert your labs if you can't, if you can, if your labs don't come that way. and then again, reverse t three, you want that on the lower, lower end. but you should also have your full iron panel done. If you have thyroid problems, you probably want a cortisol set, a salivary test done. but that being said, that can get expensive, especially if you have to pay for that stuff out of pocket.

Stephanie: 23:09 So nutritional therapy is a great place to start because you can, you can bring the body relatively back into balance when thyroid problems are an issue just through diet and lifestyle changes. and obviously you know the medication if you can get it. But if you can only get a synthetic medication. I've been using, GTA from biotics research, which has porcine glandulars in it. And that has made a world of difference for me. So I've, I've talked a lot about that on my podcast about how much that has helped. So I recommend people trying that out too.

Bryan: 23:46 And are there other nutrients or supplements that you like to use when it comes to the thyroid?

Stephanie: 23:53 it depends on the person really. I like to get people, but I want to say something about the labs before I forget cause this is important for people. actually there's a couple things I want to say that's important. so lab values for conventional medicine are done on a bell curve and they're done with a population that has sick people and healthy people in it. So your, your lab values, you know, the, the TSH normal lab value can go up every year because more, you know, they're testing people who are also hyperthyroid but don't necessarily know they're hyperthyroid. So their lab values are not the best to follow, cause you just don't, your population isn't great. So I think that's why functional medicine lab values are always lower. second thing I want to say quickly is if you are on medication and you go to your pharmacy, if they run out of the medication you're on, they'll substitute your thyroid medication without necessarily telling you, you know, you'll, they'll have you sign for it and it see that it's different. But that is a big no, no for thyroid patients because these medications are like, goldilocks medications they're called because we're so, so sensitive to them. So if you find one that works for you, stick with it and ask your doctor to prescribe it. and at the pharmacy, so that they only can, can give you that medication. dispense as written is what you want your doctor to ask for from the pharmacy. and now what was the, what was the, Oh, the supplements getting excited. If you can't tell.

Stephanie: 25:38 I, I like to use food first. a lot of, you know, you'll hear a lot of people in the thyroid world say seleni selenium is really good and selenium is really good. But if you're just taking seleni then you're probably depleting copper. So you want to take these minerals in their synergistic form so that you're, you're not pulling one mineral out of your body because you're taking too much of another one. So I don't recommend just, supplementing because somebody says, so. I really recommend working with somebody to figure out what's right for you. And maybe once you get your digestion working well and you change up a few things in your diet, maybe you won't need any supplements. so sometimes you need them to, you know, if your adrenals are a mess, you might need some vitamin C or some licorice root or Ashwagandha, but Ashwagandha can, it's a night shade and if you're sensitive to night shades, then that's not necessarily the best supplement for you. So it's always best to work with somebody. with that, I think, and most people with autoimmune disease need vitamin D. Fish oil is a real basic one. yeah, that's a tough one to answer because of bioindividuality.

Bryan: 26:56 Yeah. And this will be another tough one because it's got a lot of controversy around it. What is the current consensus on iodine?

Stephanie: 27:07 I I don't personally mess with it. cause I am not, I'm not trained in it so, but I did, I found, some interesting information. what we do know is that iodine can suppress thyroid function so it can keep it from working optimally. there's one study, called the effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto's thyroiditis. And that's a 2003 study. So you can Google that title and you'll probably be able to find that the, the study, uh, they were, they added about, I think it was 556 micrograms of iodine to people's diets each day. that's almost four times the recommended daily allowance, which is about 150 micrograms. But the RDA, most of us know now is the bare minimum to keep you alive. So most of us probably need more than 150 micrograms.

Stephanie: 28:12 so that amount, 556 micrograms a day of iodine was associated with a what's called a youth roid state, which means your, your thyroid is functioning, functioning normally. that being said, not everybody agrees with that. and I, I would like to get some more training on it before I would start supplementing people with iodine. I'm willing to try that on myself. I do a lot of experiments on myself that way, but, it's, there's an enzyme called thyroid peroxidase. It's one of the things that your, that can be affected in an autoimmune attack so your body can attack that, that part of the process of making thyroid hormone. so when, when fibroid hormone is created, there's a selenium in there and there's, iodine and there's an oxidation reaction that, releases hydrogen peroxide. And I believe this millennium is there to, sort of neutralize the hydrogen peroxide so it doesn't damage the thyroid tissue.

Stephanie: 29:22 So there's a lot at play here. and so that, the iodine can suppress the thyroid function by stopping production of the hydrogen peroxide, which then, the intake of iodine limits, the iodine from binding to the thyroid hormone. So when you have t four and you have t three t four means there's four molecules of iodine on the, thyroid hormone, and T3 means there's three, so once been cleaved off, so it affects all of that. So that's not a great answer, but I, I don't mess with it. I would recommend like reading Dr Brownsteins book about Iodine, and seeing what he has to say. And, you know, doctor, Datis Kharrazian says something completely different and then this, Japanese study says something different, so there's, there's no real clear answer, I don't think. and I'm not going to mess with it.

Bryan: 30:24 Yeah. And that's why it's so controversial too. And so, would people also need to be cautious with shellfish as well, especially if you're a Hashimoto's or hypothyroid,

Stephanie: 30:36 you, you, most people are getting, a decent amount of iodine in their diet if they're eating butter and eggs. And, the shellfish and that kind of thing. So I don't think, I think in your diet it's fine. You, you'll know if you don't, if it's not working for you because you won't feel well. So one of the things I do, is help people learn how to listen to their body. Like really get in touch with what's going on in their body so that they can know when something they eat isn't serving them well. And, and you know, we were taught to do the cocoa pulse test so you can measure if your pulse goes up, your body isn't liking it in that kind of thing. so I don't think restricting it from your diet is necessary, but I also think that, you know, consuming a ton of iodized salt isn't necessary either. So get it from real food, not, not from a chemical.

Bryan: 31:34 Yeah, exactly. And then I'm sure the controversy between iodine and no iodine, it's going to be the same controversy as eggs versus no eggs and our diets too. So it's constantly gonna flip flop every couple of years.

Stephanie: 31:49 Yeah, for sure. For sure.

Bryan: 31:52 So can you walk us through like a, a mock, program for someone that has Hashimoto's? Like when someone first comes to you and they were just diagnosed with Hashimoto's, what would be your initial steps to work with them and then what's kind of that or the direction you want to take them?

Stephanie: 32:12 So I always want to see what they're eating. because most of us need some sort of adjustment in our protein, fats and carbohydrates. So we look at that and then obviously I'm doing a nutritional assessment questionnaire. We're going to be able to see where the body's out of balance and generally blood sugar, adrenals, digestion, sometimes small intestine, liver, gallbladder. If any of that is out of balance, then we're working on those. So we're going to make sure your, you're eating well and that you're chewing well and that you're digesting well and that you're drinking enough water. and then there's a lot of conversion of thyroid hormone in the gut or the small intestine and in the liver. So we want to make sure that those two things are working well. So we're gonna work to, repopulate the gut properly and we're going to work to clean up the liver. and, and just depends on the person, what to do first. There's, there's no one size fits all here, so, uh, those are the big ones. And, and making sure the adrenals are working well. So we always, we always want to make sure that we're addressing that in the liver for sure. And then digestion and then what's going on in your gut? Are you absorbing your nutrients

Bryan: 33:31 and uh, a program like this, timeline wise, is this something that is like a three month or a year long or what, what do you think is reasonable that people can actually stick with it?

Stephanie: 33:44 Well, I would say three to six months minimum. Just because it doesn't take you overnight to get sick. You're, when you start to feel those symptoms of hypothyroidism or Hashimoto's, they've been manifesting within your body for years. And when you're, by the time you feel the symptoms, there's a lot of damage that's been done. So you have to, it just doesn't, healing doesn't take overnight. It doesn't happen overnight. Just like getting sick doesn't happen overnight, although it sometimes feels that way. So yeah, I say you have to give it a good three to six months of gut healing, of eating some real food, giving them by giving your body the nourishment that it needs or that it's been wanting for a long time.

Bryan: 34:26 I love that you brought that up because people are so accustomed to getting things right now and that's why a lot of people go with the medication route for any kind of disease. I'm not just talking about thyroid. Yeah. Because it's something that can cover it up or make it feel better right now. But in the long run, things are still happening behind the scenes in their body. So I love that you brought up that the healing process takes a long time. It doesn't happen overnight. Just like you don't get sick over night. Yup. are there any final things you want to touch on when it comes to Hashimoto's and the thyroid?

Stephanie: 35:02 I think that, uh, if you just be, I want everybody to be mindful that, there's around 50 million people in the, in the u s with autoimmune disease in general. Most of us do not look sick. so when, when we have to say no to a social event or we're going, we have to stick to our bedtime routine. don't make us feel bad about that. We, you know, we have to take care of ourselves, especially women, women who are mothers in whatever form their mothers, women who are spouses or partners or whatever. We can be good. I guess people in general, you can't be good for anybody else if you don't take care of yourself. So give yourself some grace and allow that to happen. And and hopefully surround yourself with people who will support you in that because it's really important because, you know, we can't always go out to eat at, you know, just a random restaurant because there might not be anything for us to eat and that's a real pain in the butt, but it's, and we already feel kind of crappy about it. Sometimes, so we don't need the people around us to make us feel any worse. So support those people, they need it.

Bryan: 36:21 Yeah, that's a really good point because if you think about the times you don't feel good and people are trying to push you into situations you don't want to go into. And then you have a friend that's trying to get out of a situation and you're trying to force them into it. They're, they're feeling the exact same thing that you felt when you were in that situation. So I think, like you said, we need to do a better job of understanding that there could be stuff going on with someone that we can't see. And I'm not pushing people into things that they don't want to do. And just respecting boundaries with people.

Stephanie: 36:53 Yeah, exactly. Walk a mile in my shoes and you will, you'll think twice.

Bryan: 37:00 Exactly. Uh, so my final question for you is, do you have a morning routine that you follow that kind of helps to just prepare you mentally for the day, physically for the day, and also to help keep your Hashimoto's in check?

Stephanie: 37:15 I do. I, I first of all make sure my sleeping environment is just right. and then, when I get up in the morning, I lay in bed for about five to 10 minutes and I, I meditate a little bit. I do some deep breathing. I, start my day with some like affirmations. I, uh, you know, every day in every way I am getting better and better. I am loved any, anything that makes you feel good. so I do that. Then I get up, immediately have a glass of water and sometimes I put lemon in it. Sometimes I put electrolytes in it. and I drink that. And then I take my thyroid medication, which I chew up and put under my tongue. So I get it absorbed right into my bloodstream. then I shower and I make a protein shake and I have to drive my youngest child to school every day. So the protein shake is that I can have something, for my adrenal health. Cause if you have adrenal issues, you should eat within one hour of waking. So I get a little protein in a little fat and then we're out the door. I come home and have like a second breakfast is what I call it. and then I go about my work day cause I work home. So yes.

Bryan: 38:38 Awesome. It sounds like a great morning routine and I'm glad that it helps you just kind of set the day and set the tone for the day. That's awesome. Yeah,

Stephanie: 38:46 for sure.

Bryan: 38:47 Well people can find you at out of the woods, nutrition.com. Where else can they find you?

Stephanie: 38:53 I have a podcast called help for Hashimoto's dot com or help for Hashimoto's. I ha I'm on Instagram at a Stephanie Ewals, n t p and I have a Facebook group just for Hashimoto's. It's called health for Hashimoto's. So you can join that. and a Facebook page out of the woods nutrition dash help for Hashimoto's cause I'm starting to change everything over to help for Hashimoto's. So yeah.

Bryan: 39:20 Awesome. And we'll have all the links for that and the show notes at summit for one at [inaudible] dot com slash [inaudible] 78. All right. Stephanie, thank you so much for coming on. We appreciate you and I'm glad that you're able to share this information with the world.

Stephanie: 39:34 Thanks for having me.

Bryan: 39:35 It's pretty amazing that 90% of a Hypo thyroidism ends up being hashimotos and that's a significant amount of people and the fact that it can take so long to get diagnosed with a hypothyroid is or Hashimoto's is a troubling because people can be suffering from these issues for a long time and not getting the help that they need. If you are interested in learning more, we've done a couple of other podcasts episodes talking about the thyroid, so you can go to summit for wellness.com/ 78 and see some of the resources there. If you liked this episode, then please go to apple podcasts and leave us a rating and review. Those ratings and reviews do make a difference and help out the podcast to be seen by other people. If you go to summit for wellness.com/itunes it's super simple and easy to leave a rating and review. It takes about 20 seconds. Keep on climbing to the peak of your health and we'll see you next time.