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Hashimoto's

How can Vitamin D support your immune system?

While talking with some of my Functional Health Coach chums, I asked what their favourite vitamin was. After the initial shock, this question is a bit like asking who your favourite child is… more than 70% of those asked for my highly unscientific poll agreed on vitamin D. We then delved into minerals, but that’s a whole other story.

Unless you live under a very large rock with no access to the outside world you’ll have seen that vitamin D has been in the news recently. This is due to the first randomised controlled trial which showed that administering vitamin D almost completely removed the risk of needing admission to the ICU for patients who’d tested positive for Coronavirus. https://www.sciencedirect.com/science/article/pii/S0960076020302764?via%3Dihub This is obviously fantastic, although more research is needed as the study was small.

However, that’s not why this vitamin would always be top of my vitamin charts. Firstly, most people know of its role in supporting calcium absorption. It also helps to prevent rickets, osteoporosis and stress fractures. Vitamin D deficiency is linked to increased risk of heart disease, cancer, type 2 diabetes and death from all causes. While these are all great reasons to optimize your vitamin D levels, my interest lies in the immunomodulatory effects of the vitamin.

Immunomodulatory impact

Part of the conclusion from The Implication of Vitamin D and autoimmunity: A Comprehensive Review states:

“Due to its unique capability to bind to VDR* and serve as a transcriptional factor, vitamin D can regulate gene expression and further exert its immunomodulatory effects on immune cells.”

*Vitamin D receptor

It goes on to state that additional studies are required to fully understand the potential capacity of vitamin D to prevent and ameliorate autoimmunity. https://pubmed.ncbi.nlm.nih.gov/23359064/

So what does this mean for those of us who are living with an autoimmune disease? Anecdotally, I’ve noticed that clients report hair regrowth after the Summer when they’ve tended to be outside more, or been on holiday to a sunny place. That said given that vitamin D is toxic at high levels the answer isn’t just to  take a supplement. First you need to understand what your levels actually are, and retest after 3 to 4 months. You can ask your GP to run the test or use one of the private companies to get this information. I like Medichecks or Tiny Tests.

Sunshine is simplest

The easiest (and cheapest) way to obtain vitamin D is from sunlight, but in the UK that’s only possible between the end of March and September. I like the Dminder app which helps you to track depending on your location, your skin colour and amount of exposed skin. The image below is from September 22nd 2020 in North West England. We only have a few more weeks remaining after which time you’ll need to look for other sources until late March/early April 2021 when it becomes available from the sun again.

Snapshot from Dminder app

Food

Good sources are cod livers and cod liver oil. Other fatty fish include herring, fatty tuna, rainbow trout, salmon, sardines, and mackerel. Other good food sources are egg yolks with free range eggs containing more (approx 4-6 times more) than eggs produced by chickens without access to pasture.

Supplement

While you could argue that cod liver oil is a supplement. Here I’m talking about the ones which are not food-based. Ideally you’re looking for an over the counter supplement which also contains vitamin K2 as they work together synergistically.

Toxic

As stated earlier too much can be toxic so don’t start to supplement without first knowing what your personal level is. There’s a fair amount of debate regarding what optimal levels are. Generally in the Functional Medicine Community 50ng/ml is regarded as optimal, but that doesn’t mean that would be the perfect level for you.

To wrap up I make sure that I obtain vitamin D from sunlight in the first instance, and then food. Given the risk of toxicity I don’t think this is a supplement that you should take without medical advice. If you’re interested to find out more take a look at this article by Chris Kresser. https://chriskresser.com/vitamin-d-more-is-not-better/

How to improve your gut health

A key focus of mine as a Functional Medicine Health Coach is to support my clients to improve their gut health. We know that 70-80% of our immune system resides in the gut, and I work primarily with clients who are living with autoimmune diseases. It’s an area that fascinates me, so  I was delighted to catch up (in a socially distanced way) with Emma Cronin aka Wild Pickle to talk about all things related to gut health. Emma’s been running her fermenting business since 2015. She’s literally a walking-talking advert for fermenting because she herself looks so healthy!

The first time that you speak to Emma you are immediately struck by both her deep passion for fermenting, and her incredibly wide knowledge. Unlike some people who have spent years immersing themselves in a subject and live deep in the weeds of the technical details, Emma makes it easy for a first-time fermenter to understand the process. I attended two Wild Pickle workshops in 2019 and came away armed with huge amounts of knowledge, and perhaps more importantly the confidence that I wasn’t going to food poison myself!

What led you to first become interested in fermented foods?

My daughter was suffering from gluten and dairy intolerances from her early years. While I was fatigued and suffering from low mood and digestive problems. I started to look at our diet and lifestyle overall to improve our health and I was introduced to sauerkraut, milk kefir and kombucha. I started to work on cooking everything from scratch and eating the kind of food our great grandma ate  (no processed foods). Then I attended a sauerkraut making workshop. When you make everything from scratch, being able to make a fermented tomato ketchup that tasted amazing and lasted 2-3 months for a little one was like hitting the jackpot for me!

Foraged food ready to be fermented
Foraged from the hedgerow, ready to be fermented. Photo: Wild Pickle

What differences have you noticed in your own health since becoming a committed fermenter?

There’s been so many positive changes: social anxiety lessened; mental health improved; skin condition and colour improved; my hair stopped falling out as much as it was; stronger nails; digestive health recovered; hardly any colds in the winter; enhanced immunity and overall better gut health and I really appreciated feeling an increased vitality in everyday life.

What’s your favourite food/drink to make and why?

Kimchi has to be one of my favourite ferments to make. I enjoy the making process of chopping the vegetables, brining them and making the paste. It is therapeutic and I take my time. I love the Korean phrase “Son Mat” meaning the taste of one’s hands, in my case this translates as made by hand with love and awareness. It slows me down. Kimchi ferments in such a short time of 1-3 days. I then leave it for a couple of months in the cold and when it is brought out the depths of the flavours… are totally different from the beginning. They are complex and superb and I love that all the alchemy of the bacteria is working in kimchi to create the pungency and umami flavours that we love. Giving time and patience is worth it.

Fermented foods. Photo: Wild Pickle

If someone is completely new to fermented foods, where do you suggest they start?

I would recommend that with fermented foods you start with something you enjoy, whether it is gherkins, kimchi, sauerkraut or kombucha. In all cases I would recommend trying small amounts and paying attention to how your body reacts. I would then recommend trying a wide variety of live, unpasteurised fermented foods.

I think that the easiest introduction to making fermented foods is sauerkraut. It is simple and does not need much in the form of ingredients or utensils to get going. It’s great as you can control how tangy it gets and what ingredients go into it. It is a powerhouse of goodness for not very much outlay and effort.

That said, sauerkraut is not always everyone’s cup of tea. So sometimes Kombucha, a sweetened fermented tea is a good gateway into fermented foods and maybe try that first. I think that Kombucha was the first fermented food that we tried. Again, we had to get used to drinking it and had it in small quantities to begin with but we loved it!

What plans do you have for the future of Wild Pickle?

Wild Pickle is moving to online workshops. It’s exciting to be able to reach out and share the fermenting fun with many more people than I could reach locally. The workshops are teaching sauerkraut, kimchi, kombucha, milk kefir, condiments, salsas and looking at incorporating more wild foraged foods.

I’m starting with smaller workshops (less than 10 people) in order to give all attendees focused attention. In addition to the workshops I also teach groups of friends who are keen to host a kombucha/sauerkraut making virtual party. Plus, I’m also offering bespoke and tailored one to one sessions which will really explore the flavours that you particularly enjoy.

We have a small commercial test kitchen based on a farm in the heart of Staffordshire countryside. We’re also busy creating a workshop there which will provide additional teaching space, but given the current environment that will be ready in 2021.

Fermentation is an increasingly important part of supporting our gut health and immunity. But let’s not forget the other roles that it fills. It’s a tool to help in minimising waste, it focuses our attention to use what we have available, it helps us to get away from the use of plastic, it preserves seasonal food at its best, and makes it easier to store food without the relying on refrigeration.

Fermentation of food creates such complex and amazing flavours that cannot be achieved by other means. What’s incredible is that you can easily make this at home with no fancy equipment. It’s too exciting and too delicious not to share!

How can people get in touch with you?

I’m on both Facebook https://www.facebook.com/WildPickle/ and Instagram https://www.instagram.com/wild.pickle/ or you can email me at info@wildpickle.co.uk

How to make gluten free sourdough starter

There has literally never been a better time to start making sourdough bread. Literally. Never. After a couple of months of trying the keto diet, I could feel homemade carbs calling my name. I always keep a small stash of gluten free sourdough starter in the freezer to be used in case of emergencies. I feel that current times classify as such.

So why bother making your own sourdough? Well, you don’t have to go to the shops for bread, you don’t need to keep a stock of yeast, you’re saving yourself from all of the mystery ingredients in supermarket bread and let’s face it most of us are at home with extra time on our hands. (I’ve gained around three hours every day due to not having the school run and after school sports activities).

“Think of your starter as a low-maintenance pet…” Yes, I’m actually quoting myself. Who does that?! It’s from my book The Twice as Nice Guide: Gluten Free and Dairy Free Baking. https://www.amazon.co.uk/Twice-Nice-Guide-Winning-Recipes/dp/1912009978/ref=sr_1_1?keywords=twice+as+nice+guide+gluten+free&qid=1584978302&sr=8-1

There are many different ways to begin making a starter. This is an updated version from my book. Did I mention my book yet?

Ingredients:

500g millet/sorghum/teff/buckwheat flour (use whichever gluten free wholegrain flour you have to hand)

500g white and brown rice flour by Dove’s Farm

1 litre bottled water

Kit:

Freezer bags (the kind that close like Ziploc) Medium size

Large thermos flask (I like to use an Easiyo yoghurt making container)

Instructions – Day 1:

Measure 25g of the wholegrain flour and 25g of the rice flour into a freezer bag. Add 120g of water, and mix well. Seal the bag. Mix again. Open and release any air. Reseal.

Place this bag into a second bag, seal, release any air and reseal.

Fill your flask three quarters full with hand hot water, and place the double-bagged flour and water into it. Seal the flask. Check it every few hours and make sure that the water stays warm.

24 hours later:

Fish out your flour and water bag from the flask. There may be a few bubbles, and maybe some yeasty aromas. Carefully open the bag, add 25g of the wholegrain flour, 25g of the rice flour and 80g of bottled water.

Mix, seal the bag, mix some more. Let out any air. Reseal. Return to the second bag, seal, let out any excess air from the second bag.

Refill your flask with hand hot water. Place the double-bagged flour mix into the flask, and periodically check to make sure that it stays warm.

24 hours later:

Weigh the flour mix, discard half. Put the remaining half into a clean (not sanitised – it’s not jam) lidded container. I like to use a Kilner jar without the rubber seal.

Add 25g wholegrain flour, 25g rice flour and 50g bottled water mix using a wooden spoon.

Close the lid and leave on the kitchen counter for an additional 24 hours. Do not use the locking mechanism.

Your starter is now ready to bake with! If you’re going to be using it regularly it’s fine to leave it on the kitchen counter. Every day remove a tablespoon of starter, and add a tablespoon of flour and water each day. If you know that you won’t be using it for a while place it in the fridge with the lid loose. Each week discard a couple of spoonfuls of the starter and add a couple of flour and water.

Keep using the flour mix of 50% wholegrain and 50% rice flour. After about a month it’s okay to move to tap water.

I find it helpful to freeze a couple of tablespoonfuls of starter in case something happens to it. You can then just defrost it and two tablespoons of the flour mix, and two tablespoons of water to kick it off again.

You’re now ready to bake which is where the fun starts. Please do message me with any questions.

Which vitamins support your immune system?

I’m lucky enough to have two parents in their 70s. My Dad, in particular, is part of the at risk group for coronavirus, as he used to smoke 40+ a day for 40+ years and my Mum was exposed to all of that second-hand smoke. Right now no-one in my immediate family is taking an immunosuppressant which would increase their risk of picking up any cold or virus going. So which vitamins and minerals support your immune system?

This is how we’re staying as healthy as possible. In addition to the common sense steps recommended by the WHO (not THE WHO) https://www.who.int/news-room/q-a-detail/q-a-coronaviruses we’re taking the following vitamins. While ordinarily I’d recommend a food first approach, I’m using these vitamins as back-up in case of a lack of access to fresh food.

Vitamin A: Supports cell growth, it acts as an antioxidant and is critical in maintaining the structure of mucosal cells (like those which line your respiratory and GI tracts). A lack of this vitamin results in poor night vision, keratosis pilaris aka ‘chicken skin’ that appears on the back of arms, dry skin, dry eyes, eczema, psoriasis, hypothyroidism, autoimmune disease and infertility. 

Best food source: Liver (from cows, sheep, chickens, geese, turkeys or fish) followed by egg yolks, it’s a fat soluble compound so requires fat to be absorbed.

Note: Taking Vitamin A along with Vitamins D and K2 significantly reduces the potential risk of vitamin A toxicity.

Vitamin D: Increases intestinal absorption of calcium and is a known immune modulator. If your levels of Vitamin D are outside of the optimal range then your immunity can be compromised which increases your risk of infections. You can find this vitamin in food, sun and supplements. I like the dminder app which calculates how much Vitamin D you’re being exposed to depending on your skin type, location and clothes. This article by Chris Kresser will give you more info on Vitamin D https://chriskresser.com/vitamin-d-the-new-super-nutrient/.

Best food source: Cod liver oil, fish, shellfish, grass-fed meat.

Vitamin K2: Works in synergy with Vitamins A and D. It may prevent toxicity from these other two fat-soluble vitamins.

Best food source: Natto (Japanese fermented soy product), Gouda, Brie, Poultry liver

Vitamin C: Probably the best known vitamin for supporting the immune system. It’s an antioxidant and a cofactor for many enzymatic reactions like producing collagen and neurotransmitters. It’s not stored in the body so we have to obtain it from our diet or supplements as we can’t produce it ourselves. A deficiency results in poor wound healing and fatigue. Good levels of Vitamin C reduces all causes mortality risk. That said, there’s some controversial evidence that large doses of this vitamin can block the actions of anticoagulant drugs. I prefer to take liposomal Vitamin C, but given the cost of purchasing this form I’m choosing to alternate with other types.

Best food source: Red peppers, citrus fruits, kiwis, strawberries, grapefruit.

Vitamin E: Another fat soluble vitamin that’s needed to maintain proper immune function. Are you seeing a theme here?

Best food source: Avocados, olives, nuts and seeds.

Zinc: This mineral is necessary for both the development and function of immune cells. It functions as a cofactor for over 300 enzymes and chemical reactions. Like Vitamin C it can’t be stored in the body and so you need to make sure that you’re consuming it regularly or supplementing. Zinc is a cofactor that helps to convert Vitamin A to its active form.

Best food source: Oysters, red meat, cheese, crab, turkey.

While I would always prefer to obtain these vitamins from food which increases their bio-availability, I’m trying to cover my bases by having them on hand in case of drastic measures such as isolation. You can see that the majority of best food sources come from animal products, so veggies and vegans should be ready to start supplementation. These vitamins and minerals are necessary to support your immune system.

Gut friendly Paleo Pancakes

These gut friendly paleo pancakes are a great way to start your day! They pack almost 20g of protein per serving, along with good fat, zero added sweeteners and a hefty portion of Vitamin A, D and Selenium (>20% of your RDA).

One serving which is approximately 4 pancakes will give you a little over 5g of fibre. The combination of protein, fat and fibre will keep you full until lunch-time. They’re naturally gluten-free, and don’t feel like you’re eating ‘diet’ food.

If you have 10 minutes in the morning, then you have time to make these.

Serves 2

Ingredients:

100g ground almonds

25g dried, unsweetened coconut

1 tsp gluten free baking powder

0.5 tsp salt

0.5 tsp psyillium husk (optional, makes them a little easier to flip)

2 large eggs

125ml milk or mylk (I like Good Hemp, Creamy Seed Milk)

1T ghee or butter for frying pan

Optional add-ins to mixed batter:

1 tsp cinnamon or 1 tsp vanilla extract or 1 T dried blueberry powder

Method

Mix dry ingredients together. Then mix wet ingredients together. Or, throw caution to the wind and mix all in one bowl. Put frying pan on the stove with ghee on medium heat.

Spoon/pour the mixture into the pan. Leave undisturbed for 3 minutes, then flip and cook for another 2/3 minutes.

Keep first batch warm, while you repeat with remaining batter.

Serve with kefir, almond butter, berries and a sprinkle of flaxseed*.

*I’m currently using Waitrose’s Milled golden flaxseed with maca, cacao and chicory inulin. This is a gut friendly product as it contains prebiotics and insoluble fibre.

Thirty Day Paleo Reset

After embarking upon a rigorous course with the Kresser Institute to study and train to be an ADAPT Health Coach, I decided to put myself in my prospective client’s shoes and begin a Thirty Day Reset diet following a Paleo template (sometimes called ancestral health diet). Typically a client would be prescribed a diet protocol by a Functional Medicine doctor, a Registered Dietitian or Nutritionist to address their health concerns.

In fact, last year my family and I were placed on the Auto-Immune Protocol (AIP) by a Functional Medicine doctor and I found that to be very challenging. The Thirty Day Paleo Reset is quite similar in approach with some subtle differences, e.g. unlike AIP it includes nuts and seeds in moderation, and excludes natural sweeteners like maple syrup and honey completely.  I wanted to understand the challenges that clients would be dealing with when faced with a prescription or protocol that you can’t just hand in to the pharmacy to fill.

Let me start by saying that the Thirty Day Reset was a lot more straightforward than last year’s AIP. This was due at least in part to the fact that I’d already made so many lifestyle changes over the last 12 months. I felt overwhelmed by the AIP because it was a huge amount of food shopping, cooking and preparation. As soon as one meal was finished and I’d cleaned up, I’d start to prep the next as we’re a family of 5, with 3 of us battling auto-immune diseases. I remember walking into the supermarket and thinking ‘this will be quick!’ as only the first aisle had the fish, meat, vegetables and fruit that were part of our ‘new’ diet. I found the supermarket incredibly expensive and soon turned to my local butcher, fruit and veg stall, fish man and egg lady who not only provided a wider and better priced array of local produce, but could also vouch for the provenance.

A key difference with my AIP experience was that this time it was just me, and not my entire family. This meant that I didn’t have to spend time preparing food, then more time talking people into eating it, teenagers don’t tend to like hot smoked mackerel salad. Surprisingly I still had the caffeine withdrawal symptoms on Day 2, but this was less severe and more short-lived than before. One of the worst days was Day 5 which was the first Friday night. Typically my husband and I will have a glass of wine or a G&T to mark the start of the weekend. This ritual effectively disappeared as a glass of San Pellegrino with a slice doesn’t really cut it.

Another challenge was going out to dinner with friends. I was driving so not having an alcoholic drink wasn’t a problem. However, I became that person, you know the one who asks for the salad, but then proceeds to ask for half of the ingredients listed on the menu to be excluded. My three friends had ordered their complicated tapas dishes in the time that it took to figure out my amended salad.

How did it go? Well, I feel fantastic. My sleep has improved, my skin is clearer, my thoughts are sharper and I’m much less tired than before. I’m waiting on blood test results to see if my auto-immune disease has been pushed into remission. Was it easy? Yes, because this time around I knew what to expect and I had a far greater insight into the science behind the diet because of my Health Coach training. Was I hungry? No, although I did have some cravings for sweet food. Did I lose weight? Yes, I lost 3 kilos over the month which was an unintended benefit.

The most important thing is that I feel more like myself and have so much more energy. Now the fun starts with the food reintroductions, I’m going to take it slowly and carefully monitor any side-effects. By the time that I’m finished I’ll have created a personal paleo template that will be the perfect diet for me at this time in my life. For more info, take a look at The Paleo Cure by Chris Kresser or e info, take a look at The Paleo Cure by Chris Kresser or https://chriskresser.com/