S2 E3 Q + A #2 – Undiagnosed, reintroduction issues, and how to make greens interesting

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Welcome to The Autoimmune Wellness Podcast Season 2! We’ve created this podcast as a free resource to accompany our book, The Autoimmune Wellness Handbook: A DIY Guide to Living Well with Chronic Illness.

Season 2 Episode 3 is our second Q + A episode where we answer questions submitted by AIPers just like you! Angie and Mickey answer eight reader-submitted questions and, as usual, they pack in a lot of information.

Topics discussed include what to do if you don’t receive a diagnosis, how long to wait before beginning reintroductions, determining what a “bad reaction” looks like, how to keep leafy greens interesting, and how to find a natural doctor. Scroll down for the full episode transcript.

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Full Transcript:

Mickey Trescott: Welcome to the Autoimmune Wellness podcast, a complimentary resource for those on the road to recovery. I’m Mickey Trescott, a nutritional therapy practitioner living well with autoimmune disease in Oregon. I’ve got both Hashimoto’s and Celiac disease.

Angie Alt: And I’m Angie Alt, a certified health coach and nutritional therapy consultant, also living well with autoimmune disease in Maryland. I have endometriosis, lichen sclerosis, and Celiac disease. After recovering our health by combining the best of conventional medicine with effective and natural dietary and lifestyle interventions, Mickey and I started blogging at www.Autimmune-Paleo.com where our collective mission is seeking wellness and building community.

Mickey Trescott: This podcast is sponsored by The Autoimmune Wellness Handbook; our co-authored guide to living well with chronic illness. We saw the need for a comprehensive resource that goes beyond nutrition to connect savvy patients, just like you, to the resources they need to achieve vibrant health. Through the use of self assessments, checklists, handy guides and templates, you get to experience the joy of discovery; finding out which areas to prioritize on your healing journey. Pick up a copy wherever books are sold.

Angie Alt: A quick disclaimer: The content in this podcast is intended as general information only, and is not to be substituted for medical advice, diagnosis, or treatment. Onto the podcast!

1. Mickey and Angie answer non-AIP related question [2:48]
2. No diagnosis despite blood work [6:38]
3. Continuing AIP without an exact diagnosis [12:00]
4. How long before reintroductions? [14:14]
5. Determining a detrimental reaction after reintroduction [17:31]
6. Mickey and Angie’s personal experience with elimination and reintroduction [20:44]
7. Adding more greens, keeping them interesting [26:49]
8. Getting in calcium [29:56]
9. Resource for finding natural doctors [32:09]

Mickey Trescott: Hey everyone! Mickey here, and welcome back to the Autoimmune Wellness podcast. We’re in the middle of our season two. Today we’ve got a great question and answer episode for you, and we realize that some of you guys might be new to the podcast, or even to AIP in general. So if some of the questions on these podcasts sound a little bit above your head; kind of gibberish to you, we recommend going way back to the beginning of season one where we take you through every step of living well with autoimmune disease, starting with informing yourself. There is a ton of information there; we don’t want you guys to miss it. Right Angie?

Angie Alt: Yeah, we did a podcast episode for every chapter of our book; both one sharing our personal stories on that particular topic; as well as in-depth interviews with various experts for each of the topics. Trust us, there is a ton of information. What was there; like 18 episodes or something, Mickey?

Mickey Trescott: Yeah, it was a very comprehensive and well-produced season. So if you guys are new, don’t be afraid to go back there and start. We cover a lot of information that we’re actually getting questions about that are in those episodes, so we wanted to send you guys a little reminder. Say, hey, start there if you’re kind of new to this. If you guys have been on the road for a while, then you’re in the right place.

1. Mickey and Angie answer non-AIP related question [2:48]

So before we get started with today’s episode, I actually kind of had a little idea. And I think it would be fun, Angie, to ask each other an AIP related question before our reader questions. What do you think?

Angie Alt: Um; well, thanks for springing this on me. {laughs}

Mickey Trescott: {laughs}

Angie Alt: And yeah, I’m into it. Let’s do it.

Mickey Trescott: Ok, cool. So, I want to ask you; what was the most non-AIP you ate or did this week?

Angie Alt: Non-AIP thing I ate or did this week. Well, so my birthday was on Saturday.

Mickey Trescott: Woot, woot!

Angie Alt: Yeah. {laughs} So I went out and had a glass of wine, that was very yummy.

Mickey Trescott: Oh my gosh.

Angie Alt: Yep. And then, yesterday I actually made the fish pie recipe from Russ Crandall’s first cookbook; The Ancestral Table. Russ Crandall goes by The Domestic Man on his blog and social media accounts. And that recipe includes heavy cream, butter, and white potatoes. So I super went into some reintro mode there with that delicious meal.

Mickey Trescott: How did you feel after eating it?

Angie Alt: Pretty good. You know, I’ve been pretty lucky in the dairy department in terms of reintroductions, and I seem to do pretty ok. I don’t eat dairy every single day, by any means. Not even every single week. But if I have it in small amounts; like, the last time I had any dairy was at Christmas time; I seem to do ok.

Mickey Trescott: Yeah, that would probably take it over the edge for me.

Angie Alt: I know; don’t worry, I won’t make it when you’re here. {laughs}

Mickey Trescott: Actually, thinking about it right now is maybe producing a reaction, so let’s move on.

Angie Alt: {laughs} Ok. Don’t start wheezing. Ok, so my question for you; you know, I think folks have the impression that we work a lot; and we do. But we also take breaks, and I’m wondering what kind of vacation plans you have this year.

Mickey Trescott: Yeah, so you know what kind of vacation plans I have this year.

Angie Alt: {laughs}

Mickey Trescott: Because; when we were on book tour in November…

Angie Alt: Oh my god.

Mickey Trescott: I stayed up; well I didn’t stay up. I set my alarm for 1:30 in the morning so that I could get up and buy Radiohead tickets in Europe. Because my husband and I have been trying to see them since I saw them 10 years ago without him, and he’s been kind of hurt and sad {laughs} ever since then that we haven’t been able to get tickets, which are kind of hard to come by. And they were going on a European tour, and I was like; well, if I can get tickets anywhere in Europe, I guess we’ll go there. {laughs}

Angie Alt: Yeah.

Mickey Trescott: So Sweden won; I won tickets in Sweden, so we’re going to go there in June. And I have nothing planned, except for a plane ticket and a Radiohead ticket. So if you guys know any cool things going on in Sweden, send me a message on Instagram or something.

Angie Alt: And I’m like a really cool partner, because even though this craziness was happening at 1:30 in the morning, while we were supposed to be on book tour; I was like, “Yeah, dude, I’m down with live music. Do what you gotta do!” {laughs}

Mickey Trescott: I’m like, I was in the bathroom because I didn’t want my computer screen to wake you up. And then I was trying to type in my credit card number, and the website was all in Swedish. I actually accidentally bought the Norwegian tickets; which I really. The date was wrong; anyways, I’m in the bathroom with my computer, in the dark, and the bright light is blinding me; and I’ve got Google Translate, and my credit card, and I’m like, “Angie is probably thinking I’m a crazy person right now!” {laughs}

Angie Alt: No. No. I was totally behind you.

2. No diagnosis despite blood work [6:38]

Mickey Trescott: Yep. That happened. So that was fun. So, now let’s get onto tackling some of your specific questions about AIP, because we know you guys have got a lot; you always send in a lot when we ask. So let’s start with some questions about diagnosis. Sound good Angie?

Angie Alt: Yeah.

Mickey Trescott: Alright. So, Good Eats Gal has a question about those who are undiagnosed despite heaps of blood work. She says she has a definite positive ANA, and symptoms but no confirmed diagnosis. She is worried about people like her who are put on a “wait and see” track, and that it would be great to hear in-depth about another way of how to find hope without those answers.

Angie Alt: So, the first thing I would say to Good Eats Gal is we actually are going to have an interviewee during this season who doesn’t have a diagnosis, and has been following the AIP for a long time despite that. She’s still working towards her answers, and it’s been a decade’s long process for her. So don’t give up hope, and definitely stay tuned to this series, because there are other folks out there just like you that don’t have confirmed diagnoses. Mickey, what else would you say to her?

Mickey Trescott: I would say a positive ANA; so for those of you who don’t know what that is, that’s anti-nuclear antibodies, and that’s an antibody that by itself is not indicative of an autoimmune disease. So when they test the healthy population, a certain percentage of people have a positive ANA without any symptoms or other autoimmune disease. So that by itself; this is probably why your symptoms might not fall into the category of diseases that go with ANA. Which doesn’t mean you don’t have an autoimmune disease, but it’s part of the reason why it’s unclear. Because ANA isn’t really one of those things that’s very obvious.

Usually, there are more of the mixed connective tissue types of diseases, so things like lupus or Sjogren’s or rheumatoid arthritis, which affect kind of the way connective tissue affects the body. So maybe the joint, and some of the organs, and that kind of thing. So those are usually the diseases that a good rheumatologist will kind of look into.

If you’re one of these people that’s been searching for a long time, you really do feel like you’ve been seeing high level doctors and they’ve been testing you thoroughly and they’re still not coming up with anything, it really is ok to try to work on your own stuff before you get answers; and maybe in the absence of any answers ever.

A lot of people have that experience; I know I had this experience when I was diagnosed with Hashimoto’s and Celiac; I went through a period after my diagnosis where I started developing more symptoms. So I started to develop neurological symptoms; I started to develop some of these connective tissue symptoms. I did not have positive ANA; but I actually had a lot of markers for illnesses like lupus, and I was actually told that I very well could have that, but I needed to wait for 6 more months before I got a formal diagnosis, and in that period of time I discovered the autoimmune protocol, and slowly some of those symptoms started to peel away, so that diagnosis was no longer obvious.

I think for the people who are kind of waiting in that; you know, their body is just starting to kind of express those symptoms, and that’s why we have, in our book, we present autoimmunity as a spectrum and not just black or white. A lot of the people that are kind of in the middle of that spectrum, not really ready for diagnosis yet but experiencing autoimmune symptoms, those are the best people to try and work on your own. Work with diet; maybe see a functional medicine practitioner to try to root out some underlying issues, and then prevent going down that road of being diagnosed with a clear illness because of your symptoms, if that makes sense.

Angie Alt: Right. Yeah, I mean it’s definitely ok to start doing what you can on your own. Many of the principles that are part of the autoimmune protocol are just great principles for living a fuller, healthier life anyway; so even if autoimmune disease doesn’t turn out to be an underlier for you, some of the principles of the process could be positive.

Mickey Trescott: Yeah, they could. You never really know until you try what level of success you’re going to see. So some people have been in that murky; like, how can I get diagnosed, I can’t really figure this out, and then they try the lifestyle and the diet changes, and they’re able to completely reverse whatever they’re symptoms were; and then that’s great. They know exactly what they put in, in order to get healthy, and they know how to avoid it for the future. And for some people, that’s best-case scenario, because then they never really have to deal with that mental part of getting a diagnosis and having to go through all that testing. It’s a lot.

3. Continuing AIP without an exact diagnosis [12:00]

Angie Alt: Right. So, the next question is kind of in this same category; it looks like Sue asked us. “Is it best, or do most people, continue on the autoimmune protocol diet for a long time, even without an exact diagnosis?”

Mickey Trescott: So, I think for people that don’t have a diagnosis, it’s the same. It doesn’t matter if you have a diagnosis or if you don’t. When you go onto the autoimmune protocol, the elimination diet; really the standard recommendation is 30 to 90 days. And that is to see if your body is responding; or basically to really see if there are any underlying issues. So you try the elimination diet for one to three months; and then if you have positive changes, it means that there were some food triggers in your diet that are affecting you. If you don’t have positive changes, then that’s time to go start working with a functional medicine practitioner, or a nutritional therapy practitioner, or someone who can really guide you on looking into those root causes. It doesn’t really matter if you have a diagnosis or not.

Of course, having a diagnosis might give you more information to be looking for clues about improvement. So, for instance. If you have Hashimoto’s disease, over time you might see your thyroid lab markers change. Or if you have Celiac disease, over time you might see your antibodies change. That’s where having a diagnosis, I think, helps you track; but it doesn’t really matter if you have a diagnosis or not when you go into the process, because the protocol is basically about feeling your own body and seeing how food affects you.

And this woman is talking about, “do most people continue it for a long time.” You know, we’ve reiterated this a lot. The autoimmune protocol; the elimination diet is not something that you do for a very long time without guidance. If you’re doing it for a very long time, expecting results and not getting results, that’s really a clear indicator that you need to bring in some outside support and trouble shoot a little bit.

Angie Alt: Right.

4. How long before reintroductions? [14:14]

Mickey Trescott: Alright. So Misha Cooks AIP; or it might be Misha, probably. Misha.

Angie Alt: Yeah, Misha.

Mickey Trescott: So she said she loved podcast season one.

Angie Alt: Thank you!

Mickey Trescott: “How long is it recommended to continue the strict phase of AIP before starting reintroductions after healing the gut. She says she has a program she’ll be starting from her functional medicine doctor.

Angie Alt: Well; there’s a couple of things here. First of all, the basic kind of guidance for everyone is that you need to stay for at least 30 days in the elimination phase of the autoimmune protocol. So, this is just to kind of give you a clean slate from which to be able to gauge reactions as you begin to reintroduce foods. And everybody does a minimum of 30 days there.

The reality is that for most of us with autoimmune diseases or other chronic illnesses that are using AIP to heal, a more ideal time frame is probably something like 60 to 90 days. You know; it takes time to reverse some of these health issues that have happened. Our autoimmune diseases didn’t develop overnight, and healing also doesn’t happen overnight. So you might need to dedicate a little more time.

Mickey Trescott: And also; it sounds like Misha has a functional medicine doctor; which is awesome that her doctor is involved. But you know; I would also add, too; if your doctor is giving you guidance that is a little bit different than ours, definitely go with what your doctor is saying, because we don’t really know anything about your history and your condition. And if you have a very long, deep history with autoimmune disease, your functional medicine doctor might actually say; you know, you need to do this for 6 months, or 9 months. They are the medical part of that equation. So it’s great that you’re working with someone, and that really applies to anyone who is working with a doctor. If their doctor says; you know what, you’re going to probably need a little more time here; that’s not something to be worried about, you know? That can happen.

Angie Alt: Right, exactly. And you know, that’s one thing I was going to add there. When you’re working with a doctor, and you’re going to be doing things like trying supplements or other kinds of treatments; you’re going to have a lot of variables happening, and a smart scientist always limits their variables, so they can better understand their outcome. So you might want to take it slow with reintroductions with a doctor guiding you in other areas.

Also; just as a rule of thumb, you know; again. If you have different guidance from your doctor, that applies. But if you get to 90 days and you’re not having any improvement, or you’re not seeing the improvement you would have expected to see, then it’s a good time to get somebody involved and helping you trouble shoot the process further to see if there are some underliers that are preventing progress. A lot of us have issues like gut dysbiosis; parasites; viral problems; things like that that might need treatment that isn’t going to happen with diet alone that can help you get further long with the protocol.

Mickey Trescott: We’re going to sound like a broken record after a while.

Angie Alt: Yep, we are.

Mickey Trescott: But we’re going to keep giving you guys the same answer no matter how many different ways you ask it.

5. Determining a detrimental reaction after reintroduction [17:31]

Angie Alt: {laughs} Let’s see; so Rochel asks, “How can you tell if a food that has been reintroduced after trying the AIP diet is having an adverse effect on you? For someone who suffers Graves’ disease, sometimes only the blood work will show whether there has been an adverse impact eating certain foods.”

Mickey Trescott: Yeah; so Rochel, this is kind of where you want to get into food journaling and really careful food and symptom journaling. Because with Graves’ I agree, it is kind of hard; and Hashi’s is actually kind of similar in some ways where a lot of people don’t have very immediate changes in their symptoms, but when they go to their doctor and they have their thyroid labs taken, there is clear improvement or adverse reaction in their blood work.

So you’re going to be looking for really subtle things. So these are things like how your food plan is affecting your mood; how you’re sleeping at night; your digestion; your skin. And not necessarily like any rashes or any skin things that haven’t really healed; but more the brightness, and quality, and texture of your skin. So a lot of people find that when they transition to the autoimmune protocol, maybe they’re having a bowel movement every day, where as they used to have one every other day. And maybe their eyes seem a little bit clearer, and their skin is a little bit brighter. Maybe their energy is just subtly a little more steady a little more there. Those are the things that you’re going to find by tracking your symptoms really carefully, and also going in and getting your blood work taken and try to see how things are affecting you.

But then when you reintroduce those foods one at a time, you can be on the lookout for those subtle things that improved when you kind of make a little backslide; say maybe you introduce fats and seeds and then that night you don’t sleep as well as you normally do. Those are going to be the things that you’re looking for; they’re a lot more subtle.

Angie Alt: Right. It’s always a little tough with the thyroid folks, isn’t it?

Mickey Trescott: Yeah, and there are; we’ve had some questions from people that have autoimmune disease that are very clear in the blood work, but aren’t as clear symptomatically; and for you, it might just mean how far you can expand your diet until it shows up in your blood work. That might be kind of a longer game that you’re working on with your practitioners. But really, you don’t need to eat a super restricted diet because you know that you have an autoimmune disease, but you don’t feel the effects of it yet; I would actually play with those boundaries and maybe open that up a little bit, try to include some egg yolks, and some nuts and seeds, and maybe some white rice. Just really expand it to where it makes it easier for you for a few months, and then get your lab work and see how going off the grains, and the gluten, the soy and all of that; how those foods that we know affect most of us are impacting you in a deep way. But that’s what I would do.

Angie Alt: Yeah.

6. Mickey and Angie’s personal experience with elimination and reintroduction [20:44]

Mickey Trescott: So the Copper Vase says, “How long did it take each of you to move through both the elimination and reintroduction phase of AIP? Any tips? I’m 4 months in and feeling overwhelmed because I seem to be triggered by everything.”

Angie Alt: Yeah, so for me the elimination phase was pretty long, actually. I tried after 6 months, sort of; I don’t know what the term is. Playfully the wrong word, but just not with a lot of careful scientific approach.

Mickey Trescott: Well there was no science back then.

Angie Alt: {laughs} Good point.

Mickey Trescott: Sometimes we have to remind people, it wasn’t like we were like, “Oh yeah, I think I’ll do this!” You know. Now, I wonder, people that follow our Instagram, I’ve heard of people that follow us for a year before actually trying it. Like it’s in the back of their mind. That wasn’t what it was like when we were at the beginning.

Angie Alt: Right. That’s a very good point, yeah. So The Copper Vase should know that; there wasn’t a lot of really super clear-cut guidance back then as there is now. You know, I tried after about 6 months a little bit with things like chocolate. But then I knew it really wasn’t working for me, so I waited longer. So I didn’t really get into concerted and careful reintroductions until after about a year.

Now, that’s not to say that I didn’t have improvement all along the process. I clearly knew within about 3 days that it was working, and by 6 weeks I had proof in my blood work that it was working. By the time that I got to about 2 to 3 months, I knew that there were probably some underliers that were preventing progress. I didn’t think it through in quite that eloquent way back then, but I knew that there was something still going on and I went through and did some testing with my doctors. And that’s when I discovered that I had SIBO; small intestine bacterial overgrowth. Which can’t be treated with diet alone; especially in adults. So I had to work through some of that before I could get to the reintro stage, too. Mickey, how long did it take you?

Mickey Trescott: Yeah; so I had the complexity of coming from a vegan diet, so that transitioned from vegan to AIP took a couple of months. And there were a lot of issues with, like; I hadn’t eaten meant in so long, so I had to kind of slowly get the meat into the diet, and then learn how to cook it and that kind of stuff. And then there were some things I was really in denial about; like tomatoes. I actually did pretty fully compliant AIP without omitting tomatoes for a few months, because I was growing them in my garden and I just really didn’t want to own {laughs} that I could be sensitive to them, and I am actually very sensitive to them still.

So you know; like Angie said, there wasn’t a community. There weren’t other people out there doing it. When you read a couple of paragraphs in a book, and you go, “Hmm, maybe I’ll try that.” And then you’ve never heard of anyone ever doing it before, they’re just; it’s hard to do it. It’s hard to do it fully compliant and have all the cooking and everything figured out. So for me, it took about 2 months before I started noticing any changes. So it took a little while for me to start noticing, but the changes were there, and I was improving.

At 3 months, I started to introduce some foods; and I didn’t get any reintroduction. So everything that I tried, even nuts and seeds, eggs; they just didn’t work for me. So I was like; ok, I’m in this for the long haul. And it wasn’t until about 9 months that I started to be able to make those early reintroductions. You know; we’ve talked about the reintroductions before, but I haven’t been able to do dairy or tomatoes ever. But you know, now over the past 5 or what; gosh, are we going on 6 years now?

Angie Alt: Yeah. {laughs}

Mickey Trescott: You know, I consider myself still in reintroduction. You know, I’m still figuring out almost every year, there’s a new nuance of; like nightshades that are, some of them I can do, some of them I can’t. So the reintroduction process is kind of like the rest of your life, you know. After doing AIP, and we’ve talked about the ebb and the flow; batten down the hatches, and unfurl the sails and just kind of going, expanding and contracting based on the situation. I think Angie and I have both done that a lot through our journeys.

And you know, for this woman it sounds like she is; “4 months in, feeling overwhelmed because they’re triggered by everything.” That was definitely me at 4 months, and I was kind of like; is this ever going to work, am I ever going to heal? Am I ever going to eat these foods again? Hang in there. As long as you’re not one of the people that’s literally seeing zero improvement, and probably has something underlying they need to handle and manage, that long-term; as long as you’re on that slow and steady, you’re probably still on the right track and it just needs a little more time, you know?

Angie Alt: Right, right. That would be my same exact advice. If you’re seeing good things starting to happen, don’t be overwhelmed by having trouble with the reintroductions. Just stay your course. And, on the flip side; if you’re not seeing anything good happen, there’s probably something underneath that probably needs a little more trouble shooting, and I would get some people on your team to help with that.

Mickey Trescott: And really track. You know; tracking is, we keep going back to it, but really learning how to track accurately can really help. Because even now, when I look back in my journals from back when I was recovering; I mean, some of the changes that I would see from month to month would be; “I can stand up without feeling like I’m going to pass out.” That was one month to the next, where I wrote that. I was like, “You know, I’m noticing that I just; my blood pressure is a little bit more normal.”

And it just seems like such a long time to go a whole month with just that change. But over time, those changes just magnify and they compound. You collect them, and then you just realize that; oh my gosh, I feel so much better than I did two years ago! And you don’t really know how you got there; you know. So that tracking is really valuable.

Angie Alt: Right.

7. Adding more greens, keeping them interesting [26:49]

Mickey Trescott: Let’s see; we have some other questions today. Kind of moving away from the reintroduction questions; Hey I’m Still There asks; oh no. Hey I’m Still Here asks, “How do I get more greens in my life and how do I make them interesting?”

Angie Alt: Well I just learned an awesome recipe from my friend Mary about how to cook greens. Which, you know; I think we can all kind of get in ruts with certain foods. It’s like greens, sweet potatoes; there’s a lot of those AIP foods that we eat over and over that’s kind of like; ok, let’s make this more fun.

Mickey Trescott: Right.

Angie Alt: So, what we’ve been doing. Well, what I’ve been doing at Mary’s recommendation is sautéing a little bit of kale, like in some coconut oil or some duck fat, and then adding a little bit of bone broth to kind of give them some moisture and let them simmer in that. And then add some sea salt; and actually you don’t even need much sea salt. Like an anchovy fillet, just kind of minced up in some garlic, it’s really, really flavorful. It’s a little bit more of like a cooked, more of a steamed-braised green, but the anchovies just add a really nice flavor. Anchovies are a cold water, fatty fish, so they’re really high in omega-3 fats. They also add a little more of an interesting flavor, so that’s how we’ve been cooking them. Do you have any good green’s ideas?

Mickey Trescott: You know, one of my favorite ways to eat greens is to take rainbow chard, or swiss chard, and cut it up real thin into ribbons, and then sauté in a little bit of, usually lard at my house. We’re pretty big fans of lard. Sautee in a little bit of lard, and season with just a little bit of salt, and just leave it there. Just like real simple; I find that chard is, to me, one of the most flavorful greens.

Another way to work in greens is to not forget the tops that come on things, like beets for instance. Beet greens are actually really great for you. They’re especially very supportive of gallbladder health; so finding greens in those ways can be a good way to get it in.
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Another thing we do in our house tends to be a lot of spinach, and spinach combined with citrus is a great way to make sure that you get the iron that’s in the spinach.

Mickey Trescott: Yeah, because that vitamin C is a cofactor.

Angie Alt: Cofactor; yep, exactly. So we’ll make a lemon or an orange dressing; just a little bit of olive oil, and some lemon juice or orange juice, and shake it up good in a jar and pour it over the spinach and enjoy a salad that way with a little bit of; you know, tangy citrus flavor.

8. Getting in calcium [29:56]

Angie Alt: Let’s see; Megan asks, “How do you get enough calcium without dairy products?” Interesting that we just talked about the greens, huh Mickey?

Mickey Trescott: I know. So actually the answer to that question is; greens are actually a really good source of calcium, so all of the things that we just talked about; kale, chard, beet greens, turnip greens, spinach, that kind of stuff; really great for the calcium.

Another thing to add, which you know, if you guys aren’t already; bone broth, hello? When you’re slow cooking those bones for a long time, it’s not like this super massive source of calcium, but you are simmering the bones, and putting a little acid, so that cider vinegar, a little lemon, helps extract the minerals out of the bones. So that’s another source of calcium. Also eating fish; like sardines, because you eat the whole fish, you’re eating the bones, so that has some calcium in it, too.

But generally, the Paleo Mom actually; Sarah Ballantyne, has a really great post on her site about calcium content in food and the autoimmune protocol if you guys want to get into the science, there’s a pretty great read on this topic. But really, dairy isn’t the greatest source of calcium. You know, it’s very hard to digest in dairy, and actually it doesn’t have a lot of the cofactors that we need to digest the calcium. So, with most people that are actually lacking in calcium, what they need in order to get the calcium into their bones is to make sure they’re getting enough fat soluble vitamins. So things like vitamin D, vitamin A, vitamin K2. So anyone with osteoporosis or dealing with tooth issues are just generally worried about their calcium. I would actually be more worried about those fat soluble vitamins, and either trying to find foods that have them, or trying to supplement with them if you’re trying to make some gains in the calcium department.

Angie Alt: Right. For most of us; even if we’re not eating dairy products, calcium isn’t about not getting enough of it in our diets, it’s about having the right cofactors in place for our body to use it.

9. Resource for finding natural doctors [32:09]

Angie Alt: Ok, we’ve got one more here Mickey.

Mickey Trescott: Let’s go for it.

Angie Alt: Chick With Taste says, “What’s the best resource to find doctors or naturopaths that can help with Hashimoto’s or other autoimmune diseases? I’m looking for someone who can help me heal and recover naturally, and test completely instead of just TSH.”

Mickey Trescott: Yeah; so the first place that I would look, I think we’ve talked on the podcast before about our community update. But if you guys haven’t heard of that before, we have a page on our site; www.autoimmunewellness.com. Just go to little search bar in the right-hand side bar, and type in “community update”, and you’ll get the latest one. And what that is is a post with listings of all the AIP support groups nationally and worldwide; there are a lot of them. I think there are over 80 of them. So we have groups broken up; Northern California, Southern California. We even have Kansas, and Florida, and Egypt, the most recent. So there are places all over the world, and I would start with the group that’s closest to your location, and I would just ask. “Hey, is anyone working with a good thyroid doctor in my area?” or whatever.

Getting a referral from someone that already eats this way, and already kind of is on this lifestyle, they might have a connection to a doctor that kind of knows about AIP, and that would be ideal. Second choice, for some people not everyone is going to find a doctor in their area through word of mouth, and that’s ok. There are a lot of online databases that have information about practitioners that are not just conventional. So some places that I would look are like www.paleophysiciansnetwork.com, so these are going to be kind of more paleo trained doctors. You could also go to www.primaldocs.com, which is in the same vein; primal, you know not trained, but doctors that have kind of an ancestral or primal philosophy. The institute for functional medicine; they certify and train a lot of practitioners. Some of them are doctors; some of them are conventionally trained, some of them are naturopaths. But they have a resource on your website where you can put in your zip code and you can find a doctor near you.

And then for thyroid specific people, finding thyroid specific support groups and asking is a good way. Also looking for thyroid advocacy organizations. So Hashimoto’s Awareness; I think they might have a running list. Thyroid Change I think has a list; so finding those doctors in your area. And then lastly; if all of those options, you can’t find a doctor, a way that I’ve used to find a local doctor is to call a local compounding pharmacy and ask them which doctors in the area are prescribing compounded thyroid medication. I know that sounds like; weird! That’s kind of a weird way to find a doctor; but actually it’s the doctors that are prescribing compounded medications are usually more open minded about testing and treatment. So of course, it’s no guarantees that you’re going to find an amazing doctor, but from there, if you get a list you can kind of call different offices, see what they charge, see what their training is like and see if that might fall into line with what you’re looking for. But I think those are some great options.

Angie Alt: Yeah. Those are very super sleuth ways to find a good doctor eventually.

Mickey Trescott: And sometimes you have to go through a couple. You know; how many doctors have you gone through for a particular issue just to find the right now?

Angie Alt: Right. Right; sometimes it takes a lot of commitment on our parts to find the collaborative person to be on your team.

So alright. I think our time is up for answering questions today. Thanks to everyone for submitting; we hope you learned a lot over the course of this episode. We try to give you guys as much info as we can. Have a great day everyone! We’ll see you next week with a personal interview.

Mickey Trescott: Bye guys!

Angie Alt: Bye!

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About Mickey Trescott

Mickey Trescott is a co-founder here at Autoimmune Wellness and a co-teacher of AIP Certified Coach. After recovering from her own struggle with both Celiac and Hashimoto’s disease, adrenal fatigue, and multiple vitamin deficiencies, Mickey started to write about her experience to share with others and help them realize they are not alone in their struggles. She has a Master's degree in Human Nutrition and Functional Nutrition, and is the author of three best-selling books--The Autoimmune Paleo Cookbook, The Autoimmune Wellness Handbook, and The Nutrient-Dense Kitchen. You can watch her AIP cooking demos by following her on Instagram.


  • Jessie says

    Great episode! I’ve listened several times now because the information and discussion is crazy relatable. I’m beginning to see why it could prove great benefit to find a community of people going through/having similar, uh adventures in autoimmunity. I have a question: Have you, or has anyone in the community witnessed an increase in the cost of compounded thyroid? I live in the southwest, and the cost has gone up over the past year. On my last refill, the only two compounding pharmacists within a 50 mile radius have said that they will no longer carry compounded thyroid because the cost has been raised astronomically. If memory serves it went from $30 bucks a bottle to $30 a pill. Is this happening across the country?

    Thanks for all you do ladies! You’re quite the pioneers!!!

    • Mickey Trescott says

      Hey Jessie – thanks for the feedback! I have been on compounded thyroid for 4 years now and have not experienced the increase you are describing. I think I pay $35/month for mine. $30 a pill sounds like highway robbery! I would call around to see what other pharmacies can offer you. I have mine made by a company about 2 hours from me and they mail it, which may be an option for you. Good luck!

  • JJ says

    What a great episode! It really resonated with me…I’ve been suffering from my chronic illness for 20 years, seeing so many doctors and specialists. Even going to Philadelphia for help–and still no diagnosis. I’ve basically given up on getting help from my doctors. I found a functional medicine doctor but since it’s not covered by insurance I’ll need to save up first.
    That’s how I found paleo…I was tired of being bedridden and depressed every time I had a flare. I’ve done (and still do) tons of research because I have to be my own advocate. Eating right and exercising consistently and mobility work is what keeps me going! Thanks for the podcast–I feel comforted to know I’m not alone:)

    • Mickey Trescott says

      Hey JJ! Thanks for being here and sharing some of your story! You are totally right, that digging in, informing yourself and being your best advocate are big ways you can positively affect your future. Don’t lose hope!

  • John says

    Hi! Thank you for the great resources that you provide. I’d like to submit two questions:

    1. I have post-infectious IBS and some issues with histamine intolerance and/or mast cell activation. I don’t do well with most of the fats, like coconut oil, olive oil, avocados, avocado oil, palm oil etc. I digest them well, fatigue and dermatitis are my main symptoms, but other symptoms are affected as well. Non-aip foods make me feel worse, so I can’t really just have white rice or potatoes instead. I’m trying to source grassfed tallow, but it’s not easy to find where I live. Non-grassfed tallow just makes me tired and foggy-headed. So I end up eating meat, root vegetables, a little fruit, and then some coconut oil or other fat that makes me feel bad, but it’s less bad than under eating.

    2. I’d love to hear some career advice for people with autoimmune conditions. I’m retraining to work as an economic assistant, as that might be a fairly well-paying, low-stress job that would allow me to work part-time and still be able to pay the rent.


    • Mickey Trescott says

      Hey John! These are great questions and we’ll keep them in mind for future episodes. One thought I have right now, is regarding your first question have you been tested for SIBO? Some of your symptoms here sound a lot like you might have that, or even a different gut infection that could produce some positive results if properly treated. Wishing you luck!

      • John says

        Hi Mickey! Thank you for getting back.

        I have done the hydrogen+methane lactulose breath test, it flatlined so I suspect H2S-SIBO, if any. I have done several rounds of treatment with different herbal formulas (incl. Candibactin AR+BR), elemental diet. Not sure if any of that helped. I do pretty well with starchy carbs like parsnips and butternut squash. Gut infections have been ruled out by at least three different stool samples, incl. GI Fx 3 day. Some dysbiosis/unbalanced gut flora though.

        Since first posting I have managed to source some prime quality grass fed goat suet and tallow that I have rendered. I do feel a lot better with it than with regular beef tallow, although I still experience some fatigue of unknown origin. Anyways, with goat tallow as a base I manage to sneak in a bit of the other fats to get more variety, and still get about enough calories.

        • Mickey Trescott says

          John, have you worked with a practitioner to treat your SIBO? I highly recommend a consult with Dr. Alison Siebecker if you are looking for someone to work with. Even if it isn’t pure SIBO, she should be able to make some suggestions to get you on the right track healing your gut. I suspect these underlying issues are at the root of the sensitivities you describe. I find your issue with fats intriguing – for many folks it is the other way around (they tolerate plant fats well but have issues with animal fats). Hoping you find some answers soon!

  • Kelly Alvarez says


    I am a mom with an 8 year old daughter that is suffering with an un-diagnosed autoimmune disease. I am wondering if you have heard about Low Dose Antigen Immunotherapy? Have you tried this? Do you recommend it?

    • Mickey Trescott says

      Hi Kelly, We haven’t tried it, and don’t have anything to say either way. I would say that treatments that proclaim to cure or fix autoimmune disease should be suspect – we’ve found a combination of conventional and natural treatments, diet, and lifestyle to be the best way to manage. Wishing you luck!

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