Why I'm not a skinny nutritionist

Why I’m not a skinny nutritionist

June 15 • 2018

Ok so this might be a bit of a long post, so please bear with me. If you have ever struggled with your weight then this may be worth a read.

My Journey
I used to be quite skinny, as a child and teenager anyway. Partly because I was extremely fussy about food, and then due to an untimely comment by a boy in my class about the size of my bum (I was a size 6), I started actively ‘dieting’ by skipping meals and generally having a fairly disordered eating pattern from the age of 14 – 19.

At 19 I went travelling and finally learnt to enjoy more food and tastes, and stopped punishing my body with restriction. I was about a 10. I started university, and then gained quite a bit of weight in my 2nd and 3rd years – I was driving and not walking as much, drinking a lot (student ways), and had got into a lovely relationship where we used to eat big pasta dinners and sweets. I got to about a size 16 and didn’t really notice until I saw some photos of myself and felt quite shocked and sad that I hadn’t really noticed such as dramatic increase. I got diagnosed with PCOS around this time due to the weight gain, acne, hair growth, and mood swings I had; a pelvic ultrasound also showed cystic ovaries. I was told “you’ll probably never get pregnant, and may always have weight issues. Here is a diet sheet to follow”. It was 1000 calories a day (seriously), with 6-8 portions of carbs from food like bread and pasta, and low fat foods like skimmed milk and margarine. Yes, margarine. I tried it for a week and felt awful. I figured there had to be a better way.

Starting my Nutrition Studies
At this point I had decided to pursue nutrition so off I went with boyfriend in tow to Perth in Australia, where I started learning and was instantly hooked, and making some changes to my diet. Over this year I gradually lost weight. When I came home I continued my studies, applying what I learnt and the weight steadily but gradually came off. In my 3rd year of study, in 2013, I decided to try a super low carb/ketogenic type diet, although I did this without guidance and not really knowing what I was doing- so I did it badly. I lost A LOT of weight and was down to about a size 8-10. My clothes were hanging off me, I felt awful and I lost a patch of hair (alopecia areata) for the first time which was very distressing. I started working with a wonderful nutritional therapist in January of 2012 for several months who helped me resolve a decade of IBS, poor skin and mood issues using a modified elimination diet, working on some gut flora and yeast imbalances, low iron and supporting my insulin levels. I got to a stable and healthy weight range which was around a size 10 and for me I was in the 9st 7lb – 10st 2lb bracket, and here I generally remained. Feeling great by the way with no health issues at all. NONE! Wahoo!

Then I qualified! I chugged along like this for the first couple of years of practice – if I was at the upper end of my weight bracket I would reign in my carb intake or desserts, and reduce alcohol intake which would shift things. I thought I had it nailed – good digestion, good skin, good mood, healthy weight. I thought I had mastered my PCOS – my ultra sound showed no cysts. ‘Bingo!’ I thought. I loved helping other people get better in clinic and figured I was on the right track.

Naivety
In hindsight it is somewhat naive to think you will never get ill or have health issues again. Bar the odd cold I assumed I was fine and would stay that way. Unfortunately life had other plans… In 2014 I had a considerable period of stress – I’ll spare you the details but I was so stressed I had chronic insomnia, daily panic attacks and my skin flared up (both acne on my neck and my psoriasis). My weight started to creep up. This stress wasn’t resolved for at least 12 – 18 months sadly, but did eventually end. By the end of it I was at least a stone heavier than I felt comfortable being. No biggie I thought, I’ll cut out alcohol and watch my food intake more closely. It didn’t work. I started tracking calories, carbs, everything. Everything I did wasn’t working. My weight was going up and up.

This became very distressing. I started taking part in a kettle bells class and regular strength training (lifting heavy weights) with HIIT intervals..…Still, weight went up. By the end of last year 2017 I was 40lb above my normal weight range and in total despair. I couldn’t fit in any of my clothes, looking in the mirror made me burst into tears and everything I did seemed to make it worse. I had been doing some blood testing along the way but nothing seemed particularly out. I felt like a complete failure. Why can’t I figure things out – I eat well, what the actual F is going on?!

More Symptoms
I started feeling awful. I wasn’t able to recover from my workouts. Instead of a little muscle fatigue, I didn’t recover my energy for several days after them. I couldn’t think straight, I couldn’t remember words (I spent 5 minutes trying to remember the word for fridge one day), my alopecia came back which was super distressing, and my hair became really dry and brittle. My once normal menstrual cycle became irregular. My mood was flat, and I was tearful all the time. I was SO tired. Often in bed at 7-8pm, sleeping 12-14 hours and still knackered in the morning. My lovely partner started to mention words like ‘chronic fatigue’, or tried to encourage me by saying “you just need to get out and do more, do more exercise that’ll help”. I used to sob, thinking I don’t have enough energy to get up the stairs or down to the shops let alone do a workout!

I saw my GP who said ‘it’s just stress” as I begged them to do more blood tests – ‘please check my thyroid, my iron levels, my blood glucose, everything you can. I don’t feel normal’. Normal no action was always the result. Although I certainly didn’t feel normal. Luckily I have access to more extensive blood tests and am more aware of the difference between ‘normal’ and ‘optimal’. So, I ran a few of my own.

Lab Tests
Now GP’s only measure TSH (thyroid stimulating hormone) as a general rule for thyroid health, if this is in their range (0.4 – 4.5 generally) then all is considered fine, ‘go on your way’. My results have always been fine – 2.51, 1.59, 2.24 as far as they are concerned nothing to worry about.

However, my private thyroid screen results showed lower than the range total T4 and free T4 (this the thyroid hormone made by the thyroid gland, in response to TSH). This is not something that is ever usually picked up on standard tests as they don’t routinely check these. They also don’t check T3 the actual active hormone which is what works on your cells. T4 converts to T3 and if you don’t convert this you may feel terrible. My T3 was in range, but very low in the range.

Finally I had some kind of answer. Between tears for symptoms there were a few tears of relief that I might be able to actually do something now. I also had low B12 which surprised me as I eat lots of B12 rich foods. Low thyroid function may reduce stomach acid production. Stomach acid is needed for B12 absorption – this could possibly explain it.

Changes
So I made some changes – supporting my thyroid health. After some consideration I tried the commonly prescribed medication levothyroxine for 6 weeks. By the way my GP was having none of it, as my TSH was normal so she wouldn’t even entertain the idea of a prescription so I went privately. I went from feeling about a 2/10 to 4/10 over 6 weeks of the medication but I knew I could feel better. As I have colleagues in this field, I managed to get hold of Natural Desiccated Thyroid (NDT) extract to try instead of thyroxine. This is not easy.

I started NDT at the beginning of May. Literally within days I started to feel better. I got some up and down days (if I increased to slow or fast I could end up in bed with fatigue, if I forgot a dose that day I would end up in bed). I got some sublingual B12, a thyroid support supplement with iodine, zinc, selenium and other nutrients. I prioritised sleep. I had stopped going to the gym (too shattered). Improvements! After slowly increasing my dose step by step I started sleeping better, feeling less fatigued. My memory came back and my mood improved. My hair grew back and stopped falling out (it’s still somewhat dry) and my weight STOPPED GOING UP. It hasn’t gone down yet, but I am finally hopeful it will start to in time.

Things I have learnt from this experience:

Never assume your thyroid is fine based on TSH alone. A full screen, plus someone knowledgeable in thyroid health, plus symptoms are much more useful.
I had to stop pushing myself. Temporarily not exercising as I was helped a lot. It’s super scary to stop exercising so much when you want to lose weight as it feels like the opposite of the ‘MOVE MORE’ advice that is shouted around everywhere.
Don’t go too low in calories or carbs with your diet when you fell unwell. Despite weight gain being a super distressing side effect, I feel the more I cut calories the worse my other symptoms got. It isn’t worth it; I had to eat at a higher level to start to get better.
I feel that eating under 1500kcal per day upsets the thyroid by ultimately lowering metabolic rate long term. It’s super easy to get into the trap of pushing harder, more exercise, eat less when you are focused on your weight but I feel I probably made things worse. Sure I had a couple of times where I lost about 7lbs being SUPER STRICT (against my better judgement), only to have my weight pile back on and then some. I was soooo desperate to lose weight, even I lost sight as to the end game, which is a sustainable way of eating that doesn’t hurt your health.
You can eat really well and still have hormone issues. Sometimes it’s not just about diet. You can micro manage your diet; calories, carbs, protein, gluten, dairy etc until you are blue in the face but sometimes there are bigger changes afoot that need identifying and dealing with.
I personally have had to really watch my alcohol intake. Whilst I don’t drink more than most people, I found that the bigger I was getting the more I relied on alcohol for confidence in social situations. That can be a really dangerous trap – I felt like a gin and tonic or white wine spritzer allowed me to let go and stop worrying about what I looked like which is absolutely not helpful.

So that is why I’m not skinny. I don’t think my body necessarily reflects my healthy choices. It does however reflect a body that has been struggling with a hormone imbalance for quite a while, probably since 2014. I am confident that in time my weight will come down – when I get to an optimal NDT level, when I nourish myself with the right food and right type of exercise not to stress my body out (back to yoga for me). The thing I have learnt out of all of this is that feeling well – having a good mood, not being super moody, sleeping well, not having my hair fall out, and having ENERGY are super important. I’d rather be this weight at the moment with good health, than risk losing all of that in my pursuit of getting back into a size 10.