Integrative Nutrition for Thyroid and Autoimmune Patients

A Q&A With Laurie Borenstein

Laurie Borenstein is an integrative nutritionist with expertise in working with thyroid, autoimmune and weight loss patients. Laurie Borenstein

“You are what you eat," goes the old saying. And more than ever before, scientists, physicians, and healthcare practitioners are echoing the old adage, recognizing the role that food and nutrition plays in health.

Many people with thyroid disease or other chronic diseases are also looking more carefully at the role of nutrition in triggering or reversing health problems and symptoms.

One of them most promising ways to approach the relationship between food and health is integrative nutrition.

To explore this cutting-edge discipline, I turned to New York City-based integrative nutritionist Laurie Borenstein for some thoughts on the topic.

Mary Shomon: What is "integrative nutrition" and what does and "integrative nutritionist" do? Can you explain how it differs from a traditional nutritionist?

Laurie Borenstein : Integrative nutrition – sometimes referred to as holistic nutrition is an all-encompassing practice that provides individualized and complete nutritional care and addresses important components of nutrition that are often overlooked. Unlike the traditional role nutritionists, an integrative nutritionist doesn't focus entirely on physical nutrition: diet, food, and exercise. Integrative nutrition includes the client’s physical, emotional, spiritual, mental, and social health. The integrative nutritionist and client work together to create balance in all these areas.

The integrative approach to nutrition acknowledges that food is just one piece of the puzzle, and there are often underlying issues affecting one’s health and wellbeing.

I find it extremely important to frequently work along with an integrative medical plan and practitioner for my clients who require additional intervention and support.

I received my training from the Institute for Integrative Nutrition in New York City, where I had the opportunity to explore leading health and wellness concepts, diets, and theories from some of the most well-known experts in the industry.

My clients often ask me which theory or diet works best. My answer is always the same: No person is identical to another, and in the same respect, no one diet or lifestyle change will work for everyone. This concept of bio-individuality is important to integrative nutrition, and I take it very seriously, working with my clients to create tailored programs that personally suit their needs and goals.

Mary Shomon: You personally faced the health challenge of polycystic ovary syndrome (PCOS) - which can cause weight gain and fertility problems. You've overcome that with nutritional changes -- and have gone on to lose weight, and have two children after that diagnosis. Can you tell us what you did to help heal your condition?

Laurie Borenstein: PCOS seems to have become an over-diagnosed condition that many conventional doctors currently use as an umbrella label for what often seems to be hormonal imbalances and insulin resistance-related issues. Many women diagnosed with PCOS do not even meet the key PCOS criteria of cysts on the ovaries.

In the face of hormonal imbalances, doctors are quick to diagnose PCOS, and quick to prescribe birth control pills (synthetic hormones). In my experience, synthetic hormones mask the issues, and can actually exacerbate the problem by contributing to yeast overgrowth, and worsening long-term hormone imbalances.

I have not worked with a single PCOS client whose doctor has explained the underlying issue of insulin resistance. In my own case, recognizing my own insulin resistance, I began treating my hormone imbalance issues by cleaning up my diet. I focused on eliminating processed foods, sugar and soy. I chose whole foods, increased my intake of greens and vegetables, and eliminated complex carbohydrates, and many grains. It worked wonders.

Another important component was physical activity, in particular those activities that increase muscle mass, since this aids in improving insulin resistance.

Mary Shomon: One of your areas of interest is in helping patients who have candidiasis / yeast overgrowth.

What are the most common signs and symptoms of this condition? Are there tests to diagnose it? What sorts of changes do you recommend to someone who is struggling with this health challenge?

Laurie Borenstein: The key risk factors for yeast overgrowth include prolonged use of antibiotics, birth control pills, and steroids. Candida problems can present themselves in different ways in each person. People with candida overgrowth or sensitivity often show signs of low immune function and general malaise. The most common symptoms include bloating, sugar cravings, sinus congestion, depression, allergies, chemical sensitivities, eczema, psoriasis, irritable bowel and other digestive issues, trouble losing weight, nausea and light-headedness.

Women are more predisposed to candida overgrowth due to the nature of their fluctuating hormones.

The diagnosis of candidiasis is made with a combination of a thorough analysis of the patient’s history and a comprehensive digestive stool analysis. The level of antibodies to candida can also be measured via a blood test.

For someone struggling with this health challenge, I typically recommend an integrative approach including dietary changes, natural and pharmaceutical anti-yeast agents, and supplements to promote a healthy gut.

Mary Shomon: Many thyroid patients are told that going "gluten-free" can help their health. What are your thoughts on this? Should all thyroid patients go gluten-free? Should everyone with an autoimmune disease be gluten-free?

Laurie Borenstein: In my opinion, going ‘gluten-free’, or at the very least eating gluten in substantial moderation, can benefit everyone. Gluten contributes to increased intestinal permeability, also known as “Leaky Gut." Leaky gut, or intestinal permeability, describes a situation where there are openings in the intestine that allow undigested proteins to pass through into the bloodstream. Leaky gut is a known risk factor for autoimmune diseases, malabsorption of nutrients, and unhealthy gut in general, which predisposes individual to a variety of diseases and symptoms.

I also believe that everyone with an autoimmune disease should choose a gluten-free diet. In fact, I would recommend taking it a step further, and reducing or eliminating most grains -- even those that are considered gluten-free, such as rice. Grains, in general, convert into sugar at a fast pace in the body. For some clients, I can recommend several grains that are considered safer in moderation, as they are slower to convert to sugar.

There is also a link between yeast overgrowth and autoimmune disease. Like gluten, candida often contributes to Leaky Gut, and of going gluten-free can be critical to helping eliminate candida overgrowth in the body.

Mary Shomon: Many thyroid patients struggle with excess weight, and difficulty losing that weight, even with low-calorie diets. What is the integrative nutritional perspective on how to help a thyroid patient lose weight?

Laurie Borenstein: I would say about 90 percent of my clients over the years have had a thyroid issue or a diagnosis of a thyroid-related disease. The majority of these individuals have struggled with weight loss challenges, despite their best efforts to follow specific diet and exercise programs.

Many of my clients with thyroid issues also have undetected candida overgrowth that they were either unaware of, or mismanaging. I’ve found it important to work with them on dietary changes that focus specifically on tackling candida.

I will, however, say that with thyroid patients, no one diet fits all! The key is trial and error coupled with and careful examination of what works for each individual. While a diet may seem healthy, there may be one or two foods in particular that don’t work with an individual’s body chemistry.

Another paradox that is particularly true for thyroid patients is that low-calorie is often not the key! I find more often that it is the absence of healthy fats in the diet that restricts weight loss.

Mary Shomon: Thyroid patients are cautioned about soy and goitrogenic (goiter-promoting) foods. As a thyroid patient yourself, what are your thoughts on these food controversies? Should thyroid patients avoid all soy, or just some? Can we eat all the goitrogens we want (as long as cooked/steamed) or should we limit consumption?

Laurie Borenstein: I am opposed to the consumption of soy in general. It is one of the top allergens, and among the first foods I ask clients to eliminate from their diet when beginning a detox. Soy can block thyroid function, and acts as phytoestrogen in both men and women, which contributes to hormone imbalances, autoimmune diseases, and has been linked to infertility and increased risk of cancer. Much of the soy foods available are also genetically modified.

Goitrogenic foods do have nutritional benefits, including many nutrients, alkaline properties, and fiber. Goitrogenic foods can make up a good portion of some people’s diets if they consume a large amount of vegetables. I have found that thyroid patients vary in how they tolerate goitrogenic foods. I often have them eliminate goitrogens from their diet and once their thyroid is managed, I sometime reintroduce them in cooked form, or juiced in moderation, and gauge the response.

Personally, I don’t have a problem with consuming goitrogens at all. On the other hand, I have had clients who can’t tolerate them at all. Once again, the approach of bio-individuality comes into play. I take a cautious approach with goitrogens, but I feel it is important to evaluate the situation with each client and manage their consumption accordingly.

Mary Shomon: What are the typical steps you take to get started working with someone who is interested in integrative nutrition? How can a client prepare for a consultation? Do patients need to do weekly calls, monthly calls, etc. -- how does it work?

Laurie Borenstein: The first thing I do with anyone interested in working with me is send them a detailed health history form. Their responses give me a clearer picture of their past and present health, as well as their health and wellness struggles and goals. I then schedule an initial consultation with them to go over their needs in detail. During this consult, I explain my program and approach and answer any questions they may have. If at that point it seems like a good fit, we can begin working together.

Typically, though, I work with clients in a customized six-month month program. I’ve found that it can take the body about three months to properly detox and adjust to changes, and then start to fine-tune the program. I also find that providing support, and asking for accountability, is an important part of an integrative nutritional practice.

Life changes and circumstances change, but when my clients move on after completing a program, I am confident that they are empowered with the knowledge and confidence to adjust to challenges and get back on track.

Laurie Borenstein is a Certified Health and Nutrition Coach, with certification from the Institute for Integrative Nutrition in New York City. She is the founder of Life Intake, an integrative nutrition practice where she works with clients by telephone to help create and implement an integrative nutritional plan for optimal health. She specializes in integrative nutrition treatments for a variety of health issues and disorders, including hormonal imbalance, thyroid issues, candida, adrenal fatigue, metabolic syndrome, irritable bowel syndrome, among others. Laurie also provides weight management counseling and wellness coaching in both individual and group settings.

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