Progress

A lot has happened in the month of August so far, and it’s still early in the month.  I have a lot to cover in this post.

Before I dive in, let me review the last few months.

In April I met my NP and discussed my health history and symptoms.  She ordered blood work which looked at everything: TSH, Free T-3 and T-4 and Reverse T-3, Iron, B12, Vitamin D. Pretty much a laundry list of things. I changed my diet by eliminating dairy, gluten and simple carbs from my diet, started a probiotic and Morinda Supreme as she diagnosed me with candida and “leaky gut”.  I know, that just sounds gross, and it really is. 

If there is one thing I learned quickly, it’s that your guts have A LOT to do with how you feel.

There was a delay at the lab and so my results took twice as long to get back. When I met with her in late May, at that time, my blood lab results were “relatively good” and she determined that I was not hypothyroid just really stressed and low in my Vitamin B’s and Vitamin D.  She did agree to start me on Lugol’s Iodine solution (6 drops, daily) to see if that would help my fatigue, anxiety, weight, etc when I pressed her for an explanation as to why I felt so drained and agitated all the time and my temperatures were low.  She also increased my B Complex, and Vitamin D3. 

Over the next few weeks, I did notice a subtle improvement in my energy (any improvement was noticeable) but I still struggled with nearly constant anxiety and all the fun stuff that comes with that: avoidance, irritability, exhaustion. 

It was a really discouraging couple of months.  I expected that my blood work would have bright flashing hazard lights indicating thyroid issues and it was a huge let down when that didn’t happen but my symptoms persisted.

I was encouraged by my husband to continue to look for help for my anxiety and depression and so I entered counseling to help me process everything that was going on: my grief from the pregnancy losses, my health, my vocation, the challenges I experience daily just getting out of bed.  All along I have said that I just want to be healthy and find out what the problem is. I am willing to recognize that the last few years certainly justify feeling depressed and I am not a stranger to the benefits of counseling as I have found great healing and renewal through this process in years past. 

It’s work, though!  Whew!

So far, counseling has brought me some great insight and my therapist  is a very kind and genuine woman.  Her office is my safe haven where it’s all about me and I can let out all my thoughts my complaints and frustrations. It’s also a place where I learn new ways of coping and looking at things. I am committed to working on my whole self: body, mind and spirit.

In July, my husband, who is also treated at the clinic I go to, had an opportunity to mention to my provider what he sees me struggle with and she told him that we should do a saliva test to check for Adrenal Fatigue.  I had an appointment with her the following week and we agreed to do the test. 

On August 1st I had an appointment to find out the results from the saliva test.  Before she started to explain she looked at me and said, “I don’t know how you get out of bed in the morning.” I chuckled and said, “Well, it’s not pretty.”

Trust me. It isn’t.

I have been reading a lot about adrenal function and cortisol.  As I understand it, cortisol is one of the hormones the adrenal glands release to prepare us for challenges, including “fight or flight” situations. Cortisol, also known as a “stress hormone,” works by increasing blood pressure and blood sugar (for energy). These are helpful physiological responses in the heat of a stressful situation, but if they continue throughout much of the day, weeks or years, the body will suffer. Sustained levels of cortisol can destroy healthy muscle and bone, slow down healing and cell regeneration, disrupt metabolism and digestion, and compromise your immune system.

To help me explain my results, I took a picture of the graph that shows my “Circadian Cortisol Profile:”

image

 

The light grey shadow you see is considered normal range.  As you can see, I start the morning out low and just keep crashing.  Even though I am considered normal range by 4pm and midnight, she explained that I am still so low for “normal”.  I struggle throughout the day with energy, my anxiety is highest in the morning and then I feel more fatigued through the afternoon and evening.  I wouldn’t consider the way I feel as normal, either.

The saliva test also tested my Cortisol-DHEA Correlation. My results are in the picture below:

  
image

In order to explain this accurately, I’m going to refer you to this link: DHEA and Adrenal Imbalance, by Marcelle Pick, OB/GYN NP

Results showed I am in what is considered “Zone- 4- Maladapted Phase II”.  I’m just going to quote directly from my lab paperwork: (this) “represents a marginal cortisol output with reduced DHEA levels reflecting a limited adrenal response…this suboptimal response is any response not consistent with a normal diurnal cortisol production pattern.  This condition is usually the outcome of chronic and protracted stress exposure.” 

Uh, yeah!

A surprising result from this test was that I was found to be positive for Gliadin Ab, or Gluten Intolerance.  Borderline range for this lab was 13-15 U/ml.

A positive result is anything greater than 15/mil. 

My result was 32 U/mil which was described to me as moderate to severe gluten intolerance. 

I was surprised to learn this, although it made a lot of sense as to why I felt better when I consistently eliminate gluten. 

I think that this has been the slowest realization to sink in because I am faced with challenges every day.  I find myself repeating “I am gluten intolerant. When I eat gluten, my intestines are inflamed and my body doesn’t absorb nutrients I need.” 

I have read a lot about gluten over the last 2 years, where it hides and how to cook most “normal” things without it, so I’m not completely at a loss.  My greatest challenges are being prepared and holding the boundary when others I am with don’t have this issue.  At least now I have a medically diagnosed reason to be gluten-free.

I guess it feels more “official” and helps me feel justified when I explain it to people.

Adrenal Treatment:

I already updated my treatment page a few days ago, but let me explain in detail. Our plan to strengthen the adrenals involves taking Hydrocort at specific times throughout the day. I am working up to 7.5 mg (5 mg am, 2.5 mg at noon).

My NP has not prescribed DHEA support at this time as she wanted to see how I respond to the Hydrocort.  She also prescribed a supplement called Ashwaganda, an adrenal adaptogen that I also take in the am and at noon.

I started this medication just over a week ago and I am still building up to the full dosage.  I still feel extremely tired, but I can say I have noticed a lot of improvement in my anxiety, especially in the morning.  I definitely still feel anxious, but it’s more subdued than a week ago.  I am hoping that my energy improves over the next few weeks too. 

I’ll leave it at that for now. 

I still want to talk about what I have to teach myself about adrenal fatigue, fertility and how to effectively treat myself but I will save that for another post. 

I also have some very important information about thyroidchange.org, but I want to give it my full attention so I’m saving that for my next post coming soon.

The “Worst Blogger” Award Goes to….

(boo, hiss, *throw rotten tomatoes*)

Oh, good grief.  It happened again, didn’t it?  Weeks Months have passed and I have neglected this little corner of the web. My only excuse is the truth.  I’m busy!  Work, husband, family, house, laundry, repeat. 

Allow me to share a few highlights of what I’ve been up to:

Wanderings:  Since the first week of February I have delved into the world of running and I love it.  I’m no marathoner (not sure I will ever be) and that’s okay because that’s not why I do it.  These days I average about 10 miles a week.  I would like that number to be higher, but a lingering left ankle injury in March keeps me from pushing myself too hard, so I’m taking my time and building strength at my own pace.  I enjoy the experience of running and the high that comes after a good run.  I track all of my miles this year and will add that to the miles I spend hiking.  As for hiking, I am gearing up for a backpacking trip later this month (August).

Projects: This is where most of my extra time has been spent since you heard from me last.  I have put together my plan to complete several home improvement projects around our house this year and I will enjoy sharing them when I am am finished.  I will post them here as I complete them.  Sewing, crafting and home decor projects coming soon! I do have a couple of pictures of a few things I am working on:

Food:  I have stumbled upon some really great recipes recently and have succesfully created some of my own.  I am maintaining gluten-free cooking at home. July marked one year since I began reducing (not quite eliminating) gluten from my diet. It also marks a year since I started using chemical free products (hygeine, cleaning). I’m not 100% by any means, but I have definitely changed my way of living and feel heathier for it!

Bookworm Chronicles: Not going to go there. Page 534. 3 Years and counting….

No flour was used in the making of this post about cookies

Quick post today before I head to the office:

Last night my husband and I had a craving for peanut butter cookies.  I did a little searching and found this recipe for gluten-free peanut butter cookies at Gluten-Free Girl and the Chef.  Twenty minutes later, we were enjoying these delicious little cookies.  Hard to believe they don’t have any flour in them!  Curl up with two (or three) of these and a cold cup of milk ( I drink rice or almond milk now) and enjoy!  My husband, who has accepted the job of being the official food taster gave them a 2 thumbs up and said (and I quote)  “Honey, these cookies are awesome.”

I’ll tell you how I made my cool picture above later.  I see a new banner for this page coming in the near future.

I’ll take The Easy Way for $200, Alex.

A few weeks ago I shared a little about my ongoing transition of reducing gluten from my diet.  I have grown to really enjoy cooking from scratch and eating real food.  One thing I do miss (and my husband too), since we started trying to eat gluten-free is bread.  As of last July (2010) there have been precious few sightings of bread in our home (expensive gluten-free bread mixes I made in my breadmaker). When we do have bread, it usually only lasts a day or two because my husband and I go on a French Toast eating binge. It doesn’t take long for there to be crumbs left of our $5 loaf of bread!

Until now, I haven’t ventured too far into making gluten-free bread from scratch.  Not because I didn’t have recipes to try.  Oh, no.  It’s because I’ve been too thrifty (or, CHEAP) to buy a necessary ingredient in making any type of gluten-free bread: xantham gum.  Xantham gum is an ingredient that replaces the gluten you are trying to eliminate.  You see, gluten is what makes bread, bread.  Basically, gluten is a protein contained in wheat, barley, rye, and oats.  It makes that doughy/elastic consistency to flour.  Xantham gum has the same binding, the trouble is that it is very expensive.  Like $10-12 for a cup of it!   Finally, at the urging of my husband, I broke down and bought some last week. 

This weekend, I tried a recipe for sandwich bread.  I made 3 loaves and was very happy to discover that laziness actually paid of.  Let me explain.  This is the recipe I used to make 3 loaves of bread.  You can find it and many others here at: Gluten-Free Cooking School.  I also mixed and used the Gluten-Free Flour Mix mentioned in the recipe.

Really Good Gluten Free Sandwich Bread

1 Tbsp. bread machine yeast
1 Tbsp. sugar
1 ½ c. water (105 degrees or a little less than hot)

2 ½ cups of my gluten free flour mix
2 tsp. xanthan gum
1tsp. salt

3 eggs (or 9 Tbsp. water and 3 Tbsp. ground flax seed)
1 ½ Tbsp. oil
1 tsp. cider vinegar

1. Start by combining the yeast and sugar in a small bowl (I use the smallest in my set of three nested mixing bowls). Add the water while gently stirring the yeast and sugar. Let this mixture sit while you mix the rest of the ingredients – bubbles and foam should form if the yeast is happy.

2. Combine the flour mix, xanthan gum and salt in the largest mixing bowl and stir well.

3. In a third bowl, whisk the eggs, oil and vinegar until the eggs are a bit frothy.

4. By this point the yeast mixture should be foamy, so you can pour the two liquid mixtures into the flour mixture. Blend the dough with a mixer for 4 minutes.

Bread Machine Directions:

Scoop your dough into the bread machine and smooth the top of the dough. I bake my bread using an 80 minute setting that allows for 20 minutes of kneading, 18 minutes of rise, and 42 minutes of baking. However, since I don’t use the paddle in by bread machine, I’m effectively doing a 38 minute rise and a 42 minute bake. (The advantage of not using the paddle is that you don’t end up with a hole in the bottom of your bread.)

Conventional Oven Directions:

Scoop the dough into a greased loaf pan. Allow the dough to rise in a warm area until is about 1 inch from the top of the pan. Then bake at 375 degrees for 50 – 60 minutes.

Other Notes:

  • The masa harina in the flour mix for this recipe is usually available in the Hispanic sections of most grocery stores. Due to the way it is processed, masa harina is very absorbent and you cannot substitute corn meal or corn flour. You can purchase masa harina on Amazon.com if it is not available locally.
  • If you are allergic to corn then you can make the following substitutions in the flour mix: use tapioca starch instead of corn starch and almond flour instead of masa harina
  • If you are allergic to soy, then you can substitute any of the following flours for the soy flour in the flour mix: sorghum flour, garfava flour, or quinoa flour.
  • If you are on a dairy-free diet, then you may use soy milk or rice milk. Just make sure that they are gluten-free.
  • If you are allergic to eggs, use the flax substitute listed in the recipe, or follow the instructions on your favorite egg replacement powder. When I use the flax eggs, the bread is usually slightly wetter than otherwise.

One thing you need to understand: I love my bread machine.  I love it so much, in fact, that I don’t want to steal it’s thunder and take any of the work away from it! For the first loaf, I decided to go off the recipe once I got to the “Bread Machine Directions.”  I threw all of the separate wet and dry ingredients into the breadmaker at once and set it on the “Basic” cycle which includes 2 rises and lasts almost 3 hours.  I really didn’t know what to expect.

I was very happy with the end result, but I wanted to know if I was missing something and decided to make the second loaf following all of the directions.  The result was very disappointing.  I don’t think my bread machine has the setting that the author of the recipe used.  It was flat, uncooked in the middle and weighed at leat 5 pounds.  It was like the ugly sister to the first loaf.  I kind of felt sorry for it.  I still took a picture, though. 

I’ll let you figure out which loaf is which:

Uh, are you two related?

 

Since the second loaf wasn’t edible (and I heard my husband mention he’d been craving French Toast again), I decided to make another loaf the easy way!   I also wanted to be sure it wasn’t just a fluke. Once again, I was very happy to discover the same result:

A happy loaf of bread

 

The End.

Revised: Man can’t live on bread alone, but I might get by on tortilla chips for a while.

I will be baking it up this weekend!  I’m looking forward to trying a couple of new recipes I found at Gluten Free Girl and the Chef this weekend as I am trying to broaden my gluten-free food options.  I’ve been semi gluten-free for 6 months now. I can’t say I am completely gluten-free because I know there are times I eat foods that have it, although I generally avoid all obvious breads, flours, and processed foods.   

I decided to try it after spending time with my Sister-in-Law who has suffered for years with debilitating migraines has had to eliminate gluten and many other foods from her diet. (Even lettuce!  Lettuce!)   It has been such a rough road for her I am so glad to see that she’s found some relief from her symptoms and can enjoy spending time with her husband and beautiful daughters.  Her journey intrigued me and I wondered if making some changes would help my husband (her brother) with his hiatal hernia and chronic acid reflux (GERD). 

What surprised me was how much better I felt when I eliminated gluten from my diet.  What was most noticeable was how much more energy I felt all day.  Especially at work.  I no longer needed a shot (or three) of caffeine at 1:30/2:00 because my eyelids felt like 10 pound weights and like I hadn’t slept soundly for 8 hours the night before.  It was remarkable.  Really.  My mind was clear and alert and I just felt better.  My husband also noticed this and commented that I hardly ever mentioned how exhausted I am anymore (which I realize I said a lot).  Another positive side effect (?) that has baffled and elated me is how my adult acne [shuffles feet awkwardly] is almost gone. I have changed all my hygiene and cosmetic products too, so that is also a likely factor.  At some point I’ll share that information here as well.

I started to read more about gluten and was surprised to learn there is a link between gluten and infertility/miscarriages.  This really got me wondering considering I have not been able to carry a pregnancy to term.  I miscarried twice at 8-9 weeks.  While I am hesitant to peg this as a factor because there may be no explanation, it really makes me wonder.

I have not been tested by a medical doctor to see if I actually have any level of intolerance to gluten.  I don’t have any of the other physical symptoms listed, although when I eat gluten foods I have noticed a severe drop in my moods and am unexplainably sluggish and tired the following day which can linger. I don’t know if that means anything or not, but it’s happened more than once.  I did speak with my Chiropractor about my diet changes and I appreciated his insight when he said: “if eliminating or reducing gluten makes you feel better, it sounds like that’s what you need to do.”  Simple, but true.  Does having an official “diagnosis” make what I know I feel somehow more credible?

Anyway, I will be trying the following breakfast-type recipes.  The first one can be found at Gluten Free Girl and the Chef:

Gluten Free Whole Grain Muffins

Gluten- Free Granola

Ingredients:

  • 5 cup oats (certified gluten-free)
  • 2 cups coarsely chopped almonds
  • 1 cup pumpkin seeds
  • 2/4 cup sesame seeds
  • 2 tsp cinnamon
  • 1 tsp ginger
  • 1 tsp salt
  • 1 ½ cups dried fruit (your choice)
  • ¾ cup maple syrup
  • 2 TBS canola or other vegetable oil

Use a large roasting pan to prevent spills (cookie sheet will make a mess)

  1. Preheat oven to 350*F
  2. Mix oats, almonds and seeds. Sprinkle with cinnamon, ginger and salt and mix well.
  3. Add at least 1 ½ cup bite sized pieces of dried fruit, you can add to your preference.  Stir well.
  4. Drizzle maple syrup over surface of oats mixture.  Repeat with the oil. 
  5. Stir until well coated not too stick or too dry.
  6. Place in 350*F oven for 12 minutes.  Stir and repeat 3 times.

Granola should be golden brown with a crunch (not wet).  Makes 10 cups.

One of the foods I miss (a lot) is doughnuts, so I will be trying these to see if they are an edible alternative.  I have tweaked the original recipe here, but you can find it at Food.com: Gluten- Free Doughnut Holes Recipe # 295554 (by Jubes at food.com)

Gluten Free Doughnuts (my version)

Ingredients:

  • 2 cup water
  • ½ cup butter 0r margarine
  • 1 1/2 cup rice flour
  • 3/4 cup potato starch
  • 2 TBS sugar
  • 1 tsp nutmeg (or less)
  • ¼ tsp salt
  • 4 eggs
  • Oil (for frying)
  • Cinnamon sugar, for dusting: 2 TBS sugar to ½ tsp cinnamon

Directions:

  1. Heat oil to 375*F.  You need at least 1-2 inch of oil.
  2. In a sauce pan, heat water and butter until boiling point is reached and remove  from heat.
  3. Add rice flour, potato starch, sugar, nutmeg and salt.  Stir until mixture forms a ball and pulls away from the sides of the sauce pan.
  4. Using an electric mixer, add eggs one at a time.  Mix well between adding each egg.
  5. Drop batter by small rounded teaspoons into hot oil a few at a time.  Turn them to brown evenly, approx 5 minutes to cook.
  6. Remove from heat and drain on paper towels and shake then in a plastic bag with cinnamon sugar.
  7. Best served warm.

My husband is a maple doughnut freak, so I may have to find a gluten-free maple glaze if these actually work.  We can stop whining that we can’t visit Pastry Perfection in our town anymore.

**Update 1/26/11: I was able to make 2 of the three recipes on my list:

Gluten Free Granola:  It is awesome. So much better than store bought. I used golden raisins, craisins and roughly chopped almonds and made 2 batches. I think the secret is the ginger. It has such great flavor! I keep it in an airtight container and have enjoyed it for breakfast for the last few mornings. I made GF french toast the other day sprinkled some on top with a little sliced banana. SO GOOD.

Gluten Free Doughnuts:  Oh, my. This was an adventure. I think it will work better after a little more tweaking, but they were certainly edible, just a little dense for a doughnut.  This will definitely test my coooking skills (I’m not that great at adjusting recipes).

Waiter, there is too much pepper on my paprikash

…but I would be proud to partake of your pecan pie.
 

Chicken (shown here) or Pork Paprikash - photo credit: ashleynutrition

It is always a good sign in my house when my husband barricades himself in the kitchen with a second helping and won’t share with me!  Last night I made Pork Paprikash and it was delicious!  A great cold weather meal. 

I’m going to post this recipe because it really is worth sharing.  A good quality paprika is key; I was excited to use my Hungarian Paprika I got as a gift last year from a friend who spent part of last summer there. 

Here is the recipe:

Pork (or Chicken) Paprikash

Ingredients:

• 4 thin cutlets pork (or chicken breasts)

• 1/2 tsp salt

• 1 TBS butter or oil

Paprika sauce:

• 2 large onions, chopped

• 4 tablespoons butter

• 2 red bell peppers, chopped

• ½ lb peeled, chopped fresh tomatoes

• 1 ½ tsp sweet Hungarian paprika

• 2 cups beef broth

• ¼ cup cream

• 3 TBS flour (I used white rice flour)

Directions:

1. Sauté onion in butter until tender

2. Add red peppers, tomatoes and paprika and sauté for about 3 minutes

3. Add beef broth and simmer for 30 minutes

4. Mix flour with a little water to make a thin paste and stir into sauce

5. Stir to thicken sauce for about 3 minutes

6. Add cream and stir (do not boil)

7. Meanwhile, salt the cutlets and brown on both sides in butter or oil

8. Add a little water and braise, turning once or twice, about 5- 10 minutes until tender

9. Remove from heat

10. When sauce is finished, add the cutlets and heat for a few minutes; don’t let it boil

Serve with boiled or mashed potatoes or rice and a vegetable.  While your at it, watch “When Harry Met Sally” while you eat!