Perimenopause is a significant journey in a woman’s life, bringing with it a variety of changes (and challenges) both physically and emotionally. These changes can feel overwhelming at times, but nutrition and lifestyle medicine can play a powerful role in helping you navigate this stage of life with greater ease. This isn’t a conversation about whether you should take HRT. That’s a conversation between you and your doctor. Regardless of whether you can, do or even want to take replacement hormones, the answer to hormone harmony lies in the food you eat and how well you look after your body.  In this newsletter, I’ll share five practical steps you can take right now to support your body during perimenopause. Before we start, there are some things to get straight. What is perimenopause and am I in it?  You don’t have to wait for hot flushes, brain fog or night sweats to take over to be in perimenopause. ‘Perimenopause’ is the transition to menopause (when you’ve not had a period for a year) and it can last five to ten years. That might not mean five to ten years of symptoms. Since the average age of menopause is 51, if you’re in your mid 40s, whether you’re experiencing severe symptoms or not, you will be in perimenopause. You do not have to wait for a doctor to ‘diagnose’ you with perimenopause to start making changes that will benefit you.  What comes after menopause? Menopause is a single day - the day you are 12 months since your last period. After menopause, you are postmenopausal. Many women will find their symptoms ease off at this point, while others will experience ‘menopausal symptoms’ for a little longer.   Is HRT the only way to manage menopause?  HRT involves replacing one or more of the hormones your body used to make in plentiful supply in your younger years. These are commonly oestrogen and progesterone together, sometimes only oestrogen, and sometimes you might be prescribed testosterone as well. While taking HRT is the only way you can actually replace lost hormones, many of the symptoms of menopause experienced at this time can be managed by changing your diet and tweaking your lifestyle. What are the main changes I need to know about?   Oestrogen, one of the main female hormones, provides you with protection from cardiovascular disease and osteoporosis, among other things. Lower oestrogen levels are also linked to insulin resistance and this, along with declining muscle mass as you age, has an impact on your body’s response to the food you eat. Declining oestrogen also impacts how your body handles stress. Essentially, you become less resilient to stress as you get older. What this means for you is that you will need to do things a little differently than you did before. But the message I want you to take from this newsletter is that, now knowing where you might be vulnerable, you are forearmed and can tweak what needs tweaking to minimise or improve any symptoms you might be having.    1. Balance your blood sugars Maintaining stable blood sugar levels is crucial during perimenopause. Fluctuating blood sugars can lead to energy crashes, mood swings, and increased cravings, all of which can make menopausal symptoms feel more intense. How to balance blood sugars: ●   Eat regularly:  aim for balanced meals with a mix of protein, healthy fats, and fibre to slow the release of sugars into your bloodstream. ●   Limit refined sugars:  reduce your intake of sugary snacks and drinks, which can cause spikes and drops in blood sugar levels. ●   Include complex carbs:  focus on whole grains, legumes, and vegetables, which provide sustained energy.   2. Choose a Mediterranean diet The Mediterranean diet is renowned for its health benefits for all kinds of ills and especially for women going through perimenopause. This diet emphasises whole foods that are rich in nutrients, antioxidants, and healthy fats, all of which can support hormonal balance and reduce inflammation (the latter also rises during this stage of your life). Key components of the Mediterranean diet ●   Fruits and vegetables:  these are backed with inflammation-quelling, disease-fighting antioxidants. Aim for a colourful variety to get a range of vitamins and minerals plus important phytonutrients.  ●   Healthy fats:  include sources like olive oil, nuts, seeds, and oily fish such as salmon, fresh tuna, mackerel and trout to support heart and brain health. ●   Whole grains and legumes:  provide fibre for digestive health and help regulate blood sugar levels.   3. Eat phytoestrogens Phytoestrogens are plant-based compounds that can mimic the effects of oestrogen in the body, helping to balance hormone levels naturally during menopause. Including these in your diet may help reduce hot flushes and other menopausal symptoms. Sources of phytoestrogens: ●   Soy products:  tofu, tempeh, and edamame are excellent sources. ●   Flaxseeds:  ground flaxseeds can be added to smoothies, salads, or yoghurt. ●   Legumes:  chickpeas, lentils, and beans are rich in phytoestrogens.   4. Prioritise stress relief Your body in perimenopause is less resistant to stress so you will need to ensure you make stress relief important in your daily life rather than something you will add to your list of chores and get to it if you have time. Stress can exacerbate perimenopausal symptoms, so it’s important to find ways to counteract its effect. Chronic stress can lead to hormone imbalances, sleep disturbances, and weight gain. When I say stress, this does not have to mean the ‘big stuff’ like bereavement, divorce or a house move. The relentlessness of day-to-day worries is just as important. Stress relief techniques: ●   Mindfulness and guided meditation:  incorporate deep breathing or mindfulness practices to calm the mind. These encourage slowing down your breathing while you do them which can have an impact on your heart rate variability (HRV). If you have wearable devices like a smart watch, or smart ring, or even use wellness apps that measure HRV, you will be able to see for yourself how the magic works by testing before and after meditation. ●   Physical activity:  regular exercise, like walking, yoga, or swimming, can reduce stress and improve mood. While running and high intensity training is good for your cardiovascular system, it does place additional stress on your system so this doesn’t count for the purposes of stress relief. ●   Connect with others:  social support is key; spend time with friends or join a community group. You might have heard the saying, it takes a village to raise a child. Consider, it takes a village to get through the transition to menopause, too.   5. Ensure you get quality sleep Sleep disturbances are common during perimenopause, but getting adequate rest is essential for overall health. Poor sleep can worsen symptoms like mood swings, fatigue, and weight gain. It’s not just the amount of time you spend in bed that matters but the sleep you’re getting and the quality of your sleep. The most restorative sleep is deep sleep, and you stand the greatest chance of getting more of this when you go to bed before midnight, according to The Sleep Foundation.  Tips for better sleep: ●   Create a sleep routine:  go to bed and wake up at the same time each day to regulate your body’s internal clock. ●   Limit caffeine and alcohol:  both can interfere with sleep quality, especially when consumed later in the day. ●   Relax before bed:  wind down with a relaxing activity like reading, stretching, or taking a warm bath. TV is not on this list as the blue light can impact how well you sleep. ●   Limit scrolling on your phone before bed:  this might seem a good way to wind down but the blue light from your phone may disrupt sleep hormones. Scrolling also provides a dopamine hit, and this keeps you scrolling longer. The reason this is important is that dopamine is a daytime hormone - the opposite of what you want when you’re trying to wind down. As you navigate perimenopause, remember that your body has unique needs, and small changes can make a big difference. Nutrition and lifestyle medicine can help support your body through this transition and improve your overall wellbeing. Just as a little reminder, I’m a nutrition practitioner dedicated to supporting women through perimenopause and beyond. If you’d like to discover how I can help you, I offer a free call where we can discuss your needs and explore the best ways I can support you on your journey.

Is it all in your head or is your body trying to tell you something? Some might dismiss a ‘wisdom of the body’ theory as quackery.  However, if you think about the biological processes happening within your body and the factors affecting these, the argument to substantiate a link becomes more compelling. Here’s why.  Food is so much more than just calories.  It’s information.  The body is a wonderful machine, constantly sending you signs and signals about the information (or nutrients) it needs to function at its best.  The trouble is, when you fall into unhealthy patterns, you unwittingly train your brain and body to think and crave certain foods.  Often these foods give you a quick fix. You feel great for 30 minutes, yet an hour later your energy levels are on the floor and you need another hit to keep you going. Sound familiar? This concept applies to everyone, not just women in pregnancy who are typically associated with an appetite for unusual or inedible substances such as clay, coal or dirt (this type of craving is referred to as ‘pica’ by the way). Are You Craving Sugar?   One of the most common and documented cravings is, of course, sugar.  In recent years, articles in the press have suggested sugar is as addictive as class A drugs.  How true is that really? Or, have you been simply making excuses for your lack of willpower? You’ll be glad to know there is more to it than meets the eye.   The brain needs glucose to function – sugar, which comes from carbohydrates.  When you’ve got a steady release of glucose into the blood stream throughout the day, this process works as it should. You’re productive, sharp, and full of energy.  However, too much of the wrong kinds of sugar can throw things off kilter.  Eating something high sugar and high in fat (like donuts, chocolate, cake, biscuits and sweets) triggers the release of dopamine, the neurotransmitter associated with feelings of reward and satisfaction.  By falling into this trap, you train your brain to think, ‘you need to eat this to help you feel better’.  You might use these foods to regulate your mood and lower your stress.  But in the long run, this sends you on a rollercoaster – with your energy, your mood, stress levels and sleep.   Over time, this rollercoaster can result in the development of chronic health conditions like diabetes, obesity, inflammation, immune suppression or chronic fatigue. So, what causes you to crave sugar in the first place? You’re more inclined to eat these kinds of foods when you’re stressed or tired, because your brain is looking for more fuel than it would be when you are relaxed and well nourished.    Sugar also stimulates the release of tryptophan, the precursor to serotonin, which in turn produces melatonin helping you get a good night’s sleep.  Similarly, woman can be more susceptible to sugar cravings around the time of their menstrual cycle. That might not come as a huge surprise to you…  Studies have shown that higher oestrogen levels are associated with greater levels of the hunger hormone, leptin, which triggers stronger cravings for sugary foods.  PMS also causes the stress hormone cortisol to increase and the feel-good hormone serotonin to dip, making you reach for chocolate, chips and sugary snacks to give you a feel-good boost at that time of the month.   Generally, the foods you choose to eat every day can help to regulate or trigger these cravings.  Try switching your white bread, pasta, sugary cereals, low fat products and processed foods for lower GL (glycaemic load) alternatives such as wholegrains, pulses, root vegetables and increasing your protein intake at each meal.  This can help to regulate the release of glucose into the blood stream.  Quality proteins such as eggs, turkey, salmon and nuts and seeds are also rich in tryptophan and tyrosine, which support production of serotonin and dopamine - a much better source than a packet of chocolate digestives or a bag of sweeties.  Making the switch to a more wholesome and nourishing alternative may be a much more sustainable approach to healthy weight loss than crazy diets you might be tempted to try.  Do You Crave Salty Snacks? Sugar doesn’t do it for you? Perhaps you are more inclined to reach for savoury, salty foods; crisps, salted nuts, cheese and biscuits.  Generally speaking, this may be a sign that your adrenal glands are under strain, and similar to sugar, that hankering for salt could be attributed to stress, fatigue or PMS.  You rely on your adrenals to produce the stress hormones cortisol and adrenaline whenever you need it. That might mean meeting that deadline at work, training for a marathon or gearing yourself up for a big presentation.   Like insulin, this is fine and necessary in the short term but chronic demand on the adrenals can result in fatigue and insufficient secretion of other hormones including aldosterone, renin and angiotensin, mineralcorticoids which regulates blood pressure by controlling fluid levels and electrolyte balance in the body.   When your adrenals are tired and don’t produce enough aldosterone, your blood pressure can become low and result in salt cravings and these might be accompanied with other symptoms such as fatigue, excessive thirst, headaches and nausea.  If you are experiencing a multitude of these symptoms, a trip to the doctor would be recommended for further investigation.   Don’t read this that I’m suggesting you need to be consuming salt by the bucket load.  Too much sodium (the key element in salt) should be avoided as it can tip the hormone balance in the other direction and contribute to high blood pressure and other cardiovascular issues.   Ultimately, it’s about tuning into your own body and how it’s feeling.  What signs is it giving you each day?  Working with a Nutritional Therapist can be a powerful way of tuning into your own body, equipping you with the knowledge to recognise these signs when they present themselves, and make positive changes to benefit your long-term health and wellbeing.

GLP-1 medications, known as glucagon-like peptide-1 receptor agonists, have transformed diabetes management and weight loss by offering a dual-action approach. These medications help regulate blood sugar levels by increasing insulin release and slowing digestion, making them powerful tools for improving health. However, their effectiveness and the reduction of side effects can be enhanced with the right dietary plan. Why Nutrition Matters with GLP-1s When using GLP-1 medications, side effects such as nausea, bloating, or reduced appetite are not uncommon. A nutrient-dense eating plan can alleviate these issues while supporting overall health goals. The focus is on providing your body with essential nutrients within a calorie deficit, optimising weight management and stabilising blood sugar levels. The Core Principles of a GLP-1-Supportive Diet A strategic nutrition plan tailored to GLP-1 medications centres on five key elements: 1. Protein Power Protein is the cornerstone of any GLP-1-friendly diet. It not only supports muscle maintenance and repair during weight loss but also helps stabilise blood sugar levels. Lean proteins such as chicken, turkey, fish, eggs, and plant-based options like tofu or legumes are excellent choices. Aim to include a protein source in every meal to ensure satiety and steady energy. 2. Healthy Fats for Balance While fats often get a bad reputation, healthy fats are vital for hormone regulation and cellular health. Incorporate sources such as avocados, nuts, seeds, olive oil, and fatty fish like salmon. These fats also help you feel full for longer, complementing the appetite-suppressing effects of GLP-1s. 3. Fibre for Digestion High-fibre foods play a crucial role in promoting digestive health and preventing side effects such as bloating. Vegetables, fruits, whole grains, and legumes not only provide fibre but also deliver essential vitamins and minerals. Aim for a variety of colours on your plate to maximise nutrient diversity. 4. Whole Foods The foundation of this plan lies in whole foods that are nutrient-dense. These foods offer more vitamins, minerals, and antioxidants than their processed counterparts, helping to support overall health and reduce inflammation. Think leafy greens, fresh fruits, whole grains, and unprocessed proteins. 5. Incorporating Allulose for Blood Sugar Management Allulose, a naturally occurring sweetener, can be a valuable addition to a GLP-1-supportive diet. Found in small amounts in foods like figs, raisins, and jackfruit, allulose tastes like sugar but has minimal impact on blood sugar levels. Unlike traditional sugar, it doesn’t cause spikes in glucose or insulin, making it an excellent choice for those managing diabetes or looking to maintain stable blood sugar. It can be used in baking, beverages, or as a sweetener for everyday foods, offering a way to satisfy sweet cravings without compromising health goals. Benefits Beyond GLP-1 Support Adopting this nutrient-dense eating plan offers benefits that extend beyond GLP-1 medications. It supports heart health, boosts energy levels, and promotes sustainable weight loss. By prioritising whole, nutrient-rich foods, you’re building a foundation for long-term health and wellness. Take the First Step Whether you’re managing diabetes, pursuing weight loss, or simply looking to enhance your health, aligning your diet with the principles of a GLP-1-supportive plan can make a significant difference. By focusing on protein, healthy fats, fibre, and whole foods, you can improve medication efficacy, reduce side effects, and achieve better overall health outcomes. Ready to start? Begin by incorporating these changes into your meals today, and experience the transformative power of strategic nutrition.

There’s nothing like a stack of pancakes to make breakfast feel extra special, but these pancakes take it a step further by blending indulgence with nutrition. Packed with fibre-rich oat bran, juicy bursts of blueberries, and just the right touch of natural sweetness, they’re a wholesome way to fuel your morning. 3 Servings Ingredients 6 Eggs 1 1/8 cups Plain Greek Yogurt (divided) 1 tbsp Cinnamon 3 tbsps Ground Flax Seed 1 1/2 tsps Stevia Powder 1 1/2 cups Oat Bran 2 1/4 cups Blueberries (divided) 1 tbsp Extra Virgin Olive Oil Method In a mixing bowl, whisk together the eggs, half of the yogurt, cinnamon, ground flax, and stevia. Add the oat bran and mix until a batter forms. Fold in 2/3 of the blueberries. Heat the oil in a pan over medium-high heat. Scoop 1/2 cup of batter at a time into the pan, and cook until bubbles start to form. Flip and cook for another one to two minutes. Repeat with the remaining batter. Plate the pancakes and top with the remaining blueberries and yogurt. Enjoy!

The festive season is a time to celebrate, connect, and, often, indulge. But it doesn’t have to mean putting your health on hold. Whether you're a committed healthy eater or more relaxed about your choices, these simple tips can help you stay balanced and feel your best this Christmas and New Year. 1. Set Realistic Goals Forget dieting over the holidays—it’s not the time for restrictive measures. Instead, focus on maintaining your current weight or habits. This approach takes the pressure off and allows you to enjoy the festivities without guilt. 2. Plan Your Meals With holiday routines often out the window, it’s easy to lose track of healthy eating. Take a little time to plan meals and stock up on balanced options, even during busy weeks. You’ll thank yourself when it’s easier to make nourishing choices. 3. Don’t Arrive Hungry Turning up to a party ravenous can lead to overindulging in sugary or less nutritious foods. Instead, eat a balanced snack or light meal beforehand, so you can focus on enjoying the company rather than battling cravings. Better yet, bring a healthy dish like a fresh fruit platter or vibrant salad to share with others. 4. Make Smart Alcohol Choices While creamy or sugary drinks are tempting, they can quickly add up. Opt for lighter beverages and enjoy them alongside food to stabilise blood sugar levels. Remember to sip water throughout to stay hydrated and keep festive hangovers at bay. 5. Stay Hydrated Water is a simple but powerful ally during the festive season. Drinking plenty of water not only helps curb overeating but also keeps you feeling refreshed and energised, no matter how hectic your schedule becomes. Extra Tips for the Table: Starters:  Swap bread and pastry-based dishes for options like melon and Parma ham, smoked salmon, or soups. Mains:  Choose lean proteins like turkey, paired with chestnuts (a fantastic stuffing alternative) and lots of steamed vegetables. Limit portions of roast potatoes and sugary sauces. Desserts:  Opt for lighter options like vanilla ice cream or small portions of oatcakes with cheese, or try a healthier take on a Christmas cake. This holiday season, you can enjoy all the cheer and delicious treats without sacrificing wellness. Here's to a balanced and joyful Christmas!

When winter sets in and the days get colder, there’s nothing better than a warm bowl of soup to keep the chill at bay. This parsnip, potato, and ginger soup is a true winter classic, combining the earthy sweetness of parsnips, the creamy comfort of potatoes, and the gentle warmth of ginger. 4 Servings Ingredients 4 1/4 cups Vegetable Broth (divided) 1 Yellow Onion (small, chopped 1 stalk Celery (chopped) Sea Salt & Black Pepper (to taste) 1 Garlic (clove, minced) 1 tsp Ginger (fresh, grated) 2 Parsnip (medium, peeled, chopped) 1 Yellow Potato (large, peeled, chopped) 1 1/2 tsps Dijon Mustard 1/4 cup Pumpkin Seeds (roasted, optional) Method Heat a splash of broth in a large pot over medium heat. Sauté the onions and celery until tender. Season with salt and pepper. Add the garlic and ginger, cooking for one minute while stirring. Add the parsnips, potatoes, and the remaining broth. Bring to a boil, then reduce the heat. Simmer for 12 to 15 minutes or until the vegetables are soft. Add the Dijon mustard and blend the soup with a stick blender until smooth. Alternatively, add the soup to a blender and blend in batches as needed. Divide evenly between bowls. Top with pumpkin seeds (optional) and enjoy!

This cosy winter dish pairs the natural sweetness of roasted butternut squash with a savoury sausage filling for a perfectly balanced meal. For a vegetarian twist, swap the sausage for lentils, mushrooms, or your favourite plant-based alternative - it's a versatile recipe that suits any table. Serves 2 Ingredients 1 Butternut Squash (small, halved, seeded) 1 tbsp Extra Virgin Olive Oil (divided) Sea Salt & Black Pepper (to taste) 1 Yellow Onion (medium, sliced) 1 Garlic (clove, chopped) 6 ozs Pork Sausage (casings removed) 1 cup Baby Kale Method Preheat the oven to 425ºF (220ºC). Line a baking sheet with parchment paper. Brush the squash halves with 1/3 of the oil and season with salt and pepper. Place cut side down on the prepared baking sheet and cook in the oven for 35 minutes. Carefully flip the squash cut side up. Add the onion wedges to the baking sheet around the squash. Drizzle with half of the remaining olive oil and season with salt and pepper. Cook in the oven for another 10 to 15 minutes or until the squash is fork tender and the onions start to brown. Heat the remaining oil in a pan. Add the garlic, then the sausage. Cook for four to six minutes or until cooked through, breaking the meat up as it cooks. Add the kale and cook for one minute or until wilted. Fill the squash halves with sausage stuffing. Top with onions and enjoy!

As the temperatures drop and the days grow shorter, our bodies face unique challenges. Winter can bring its fair share of colds, sluggishness, and a dip in mood. With a few intentional habits, you can strengthen your immune system, stay energised, and even thrive during the season. Here are my top winter wellness tips to help you feel your best. 1. Nourish Your Immune System The foundation of winter wellness is a strong immune system, and this starts with what’s on your plate. Focus on foods rich in vitamins and minerals, particularly: Vitamin C:  Found in citrus fruits, kiwi, bell peppers, and broccoli, vitamin C helps support immunity and combat seasonal colds. Vitamin D:  With less sunlight in winter, it’s important to get enough vitamin D through fatty fish, egg yolks, and fortified foods. A high-quality supplement may also be beneficial, particularly in the UK where sunshine is limited. Zinc:  Essential for immune function, zinc is found in seeds, nuts, shellfish, and legumes. Don’t forget the importance of a diverse diet. Fermented foods like kefir, sauerkraut, and miso support gut health, which is closely linked to overall immunity. 2. Stay Hydrated While it’s easy to sip on water in the summer, many of us forget to hydrate in winter. Dehydration can weaken your immune system and leave you feeling fatigued. Warm herbal teas, hot water with lemon, and broth-based soups are great ways to stay hydrated while also keeping cosy. 3. Prioritise Sleep Winter’s longer nights are a natural cue to optimise your sleep routine. Adequate sleep is essential for repairing your body and bolstering your immune defences. Aim for 7-9 hours of quality sleep each night, and create a relaxing bedtime ritual—perhaps a warm bath, chamomile tea, or a few pages of a good book. 4. Keep Moving Physical activity is just as important in winter as in summer, though it can feel harder to stay motivated. Exercise boosts circulation, enhances mood, and strengthens your body’s defences against illness. If outdoor activities like walking or running feel unappealing, try indoor workouts, yoga, or even a brisk dance session in your living room. 5. Support Your Mood Seasonal changes can affect mental health, leading to the winter blues or even seasonal affective disorder (SAD). To maintain a positive mood: Spend time outdoors during daylight hours to soak up natural light. Consider using a light therapy box to mimic sunlight if you’re indoors often. Incorporate mood-boosting foods like dark chocolate, nuts, seeds, and oily fish. Practise mindfulness or meditation to reduce stress and maintain emotional balance. 6. Practice Gratitude and Connection Finally, don’t underestimate the power of emotional wellbeing. Stay connected with loved ones, even if it’s through a quick phone call or video chat. Gratitude journaling can also help you focus on the positive and counteract the darker days of winter. By adopting these simple habits, you can support your body and mind through the colder months. Here’s to a healthy, happy winter!

Looking for a quick, healthy, and delicious meal? This Spinach and Artichoke Naan Pizza is a perfect choice. With nutrient-packed spinach, tender artichokes, and a creamy, cheesy topping, all served on a crispy naan base, it’s a recipe that’s as easy to make as it is satisfying. Whether you need a speedy midweek dinner or a tasty appetiser, this recipe delivers big on flavour without the fuss. Serves 2 Ingredients 2 tbsps Extra Virgin Olive Oil 1 Garlic (clove, minced) 4 cups Baby Spinach Sea Salt & Black Pepper (to taste) 3/4 cup Artichoke Hearts (from the jar, drained and coarsely chopped) 4 ozs Mozzarella Cheese (grated) 1/4 cup Cream Cheese, Regular (softened) 2 pieces Naan Method Preheat the oven to 400°F (205°C) and line a baking sheet with parchment paper. Heat the oil in a pan over medium heat. Add the garlic and cook for one to two minutes. Add the spinach and season with salt and pepper. Cook until wilted and remove from the pan. Add the spinach and artichokes to a bowl and mix to combine. In a separate bowl, combine the mozzarella cheese and cream cheese until well combined. Season with salt and pepper. Spread the cheese mixture evenly onto the naan. Top with the spinach and artichoke mixture. Place the pizzas on the prepared baking sheet. Cook in the oven for 12 to 14 minutes or until the cheese is melted and the naan is golden. Slice once slightly cooled and enjoy! Fill the squash halves with sausage stuffing. Top with onions and enjoy!

Your gut is more than just a part of your digestive system; it’s a cornerstone of your overall health. Often referred to as the 'second brain', the gut influences everything from your immune system to your mental wellbeing. But what exactly is gut health, and how can you support it? What is Gut Health? Gut health refers to the balance and function of microorganisms living in your gastrointestinal tract. These microbes, collectively known as the gut microbiome, play a crucial role in digesting food, absorbing nutrients, and protecting against harmful bacteria. A balanced microbiome contributes to a strong immune system, better mood regulation, and even clearer skin. When the balance of good and bad bacteria is disrupted, it can lead to issues such as bloating, fatigue, inflammation, or even chronic conditions like irritable bowel syndrome (IBS) and autoimmune diseases. Signs Your Gut May Need Attention How can you tell if your gut health needs a reset? Digestive issues:  bloating, gas, or constipation. Food intolerances:  difficulty digesting certain foods. Low energy:  persistent fatigue despite adequate rest. Mood swings:  anxiety or depression linked to gut-brain communication. Weakened immunity:  frequent colds or infections. If you’re experiencing any of these, it may be time to focus on your gut health. How to Support a Healthy Gut The good news is that you can take proactive steps to improve your gut health through diet and lifestyle changes. Here are some proven strategies: 1. Eat a Diverse Range of Foods A varied diet supports a diverse microbiome. Focus on whole, unprocessed foods like fruits, vegetables, legumes, and whole grains to nourish beneficial bacteria. 2. Incorporate Fermented Foods Probiotic-rich foods like yogurt, kefir, sauerkraut, and kimchi can boost the population of good bacteria in your gut. If fermented foods aren’t your thing, consider a high-quality probiotic supplement. 3. Prioritise Fibre Dietary fibre acts as fuel for gut bacteria, promoting their growth and activity. Include plenty of fibre-rich options like leafy greens, oats, and flaxseeds. 4. Stay Hydrated Proper hydration helps maintain the mucosal lining of your intestines and supports nutrient absorption. Aim for at least 2 litres of water a day. 5. Cut Back on Sugar and Processed Foods Excess sugar can feed harmful bacteria, disrupting the balance of your microbiome. Opt for natural sweeteners and minimally processed meals. 6. Manage Stress Chronic stress can negatively impact gut health. Practices like yoga, meditation, or even a daily walk can reduce stress and improve gut-brain communication. The Gut-Brain Connection Your gut and brain are in constant communication through the gut-brain axis, a bidirectional link between the nervous system and the digestive system. An imbalance in your gut can affect your mental health, contributing to conditions like anxiety or depression. Supporting your gut health doesn’t just improve digestion; it can also enhance mental clarity, mood, and resilience to stress. When to Seek Help While lifestyle changes can significantly improve gut health, some conditions require professional guidance. If you’re dealing with persistent digestive issues or suspect a more serious imbalance, consulting a nutritional therapist can help uncover root causes and tailor a plan to your unique needs. Conclusion Your gut health is the foundation of your wellbeing. By making conscious choices about what you eat and how you manage your lifestyle, you can cultivate a thriving microbiome that supports every aspect of your health. If you’re ready to take the next step in improving your gut health, book a consultation today. Together, we’ll create a personalised plan to restore balance and help you feel your best. Don’t wait to prioritise your gut health! Contact me to schedule your consultation and discover how a tailored nutrition plan can transform your wellbeing.

As we welcome a new year, many of us set goals to improve our health and well-being. While nutrition, sleep, and exercise often take centre stage, it’s crucial to focus on another pillar of health: managing stress. Stress is a common part of modern life, yet few truly grasp the toll it takes on our bodies and minds. The Healthy and Natural Journal  estimates that 70% to 80% of GP visits are for stress-related conditions - a staggering statistic that highlights its importance. What Is Stress? Stress can be categorised into two main types: acute stress  and chronic stress . At its core, stress is our body’s survival mechanism, triggering the “fight or flight” response when we perceive a threat. This reaction helped our ancestors survive by either fighting off danger or fleeing from it. Imagine being confronted by a predator like a lion; stress hormones such as cortisol and adrenaline would kick in, providing the energy and focus needed to escape. Acute Stress Acute stress is short-term and can even be beneficial. When your body enters “fight or flight” mode, your heart rate increases, breathing quickens, and glucose is released to provide fuel. Non-essential systems like digestion temporarily slow down, and your brain sharpens its focus. This heightened state helps us respond effectively to immediate challenges. However, once the threat passes, the body returns to balance. For our ancestors, that meant going back to gathering food and resuming normal activities. Today, acute stress might arise from a looming work deadline or a missed train but typically resolves once the situation is handled. Chronic Stress: The Modern-Day Dilemma In contrast, chronic stress  occurs when stressors persist without relief. Unfortunately, our bodies don’t differentiate between life-threatening dangers and modern pressures, such as work deadlines, financial concerns, or juggling family responsibilities. This constant activation of the stress response wreaks havoc on our health. Compounding the issue are modern lifestyle factors: inadequate sleep, diets high in processed foods and sugar, and the ever-present demands of technology. Over time, chronic stress can lead to burnout and serious health issues. Symptoms of Chronic Stress If stress becomes a long-term companion, elevated hormone levels can cause various physical symptoms, including: Digestive Issues:  Stress slows digestion, leading to bloating, cramps, and conditions such as GERD. Eating on the go or during stressful moments exacerbates these issues. High Blood Pressure:  Elevated stress hormones increase heart rate and blood pressure, which, over time, can raise the risk of heart disease and stroke. High Blood Sugar Levels:  Stress triggers glucose release to fuel the body. While this is useful in emergencies, it can lead to sugar cravings and excess glucose storage when you’re sedentary, potentially increasing the risk of diabetes. Starting the Year with Health in Mind This new year, consider making stress management a key part of your wellness plan. Simple changes such as mindful eating, prioritising sleep, and setting aside time for relaxation can make a significant difference. By managing stress effectively, you’ll not only feel better day to day but also set yourself up for a healthier, happier year ahead. Take the First Step If stress is taking a toll on your health, you don’t have to face it alone. Reach out to schedule a consultation with me today, and together we’ll create a personalised plan to help you manage stress and reclaim your well-being. Let’s make 2025 your healthiest year yet!

Bursting with vibrant flavours and nourishing ingredients, this Veggie Tom Yum & Green Curry Soup is the ultimate comfort in a bowl. Combining the zesty, citrusy tang of Tom Yum with the creamy, aromatic warmth of Green Curry, this dish is a delicious harmony of Thai-inspired flavours Serves 4 Ingredients 6 cups Vegetable Broth (divided) 1 Yellow Onion (small, thinly sliced) 1 1/2 tbsps Ginger (fresh, grated) 2 cups Shiitake Mushrooms (sliced) 4 Garlic (clove, minced) 1 tsp Chili Flakes 3 tbsps Green Curry Paste 1/2 cup Canned Coconut Milk 1/4 cup Lime Juice 2 cups Diced Tomatoes (from the can, drained) 2 tbsps Tamari 1/4 cup Cilantro (chopped) Method Heat a splash of broth in a large pot. Add the onion, ginger, mushrooms, garlic, and chili flakes for five to seven minutes or until tender. Stir in the curry paste and cook for one more minute. Add the remaining broth, coconut milk, lime juice, tomatoes, and tamari. Simmer for 10 to 15 minutes to warm through and thicken the soup. Divide evenly between bowls. Top with cilantro and enjoy!

As we welcome a new year, many of us are motivated to make changes that promote health and wellbeing. But resolutions can often feel overwhelming, especially if they’re too ambitious or lack a clear starting point. Instead, let’s focus on small, manageable habits that can have a big impact on your health in 2025. Here are some easy tips to help you feel your best this year. 1. Stay Hydrated Water plays a vital role in almost every bodily function, from digestion to energy production. Start your day with a glass of water and aim to drink regularly throughout the day. To make hydration easier, keep a reusable water bottle on hand and try adding slices of lemon, cucumber, or berries for a refreshing twist. 2. Prioritise Whole Foods Processed foods often contain added sugars, unhealthy fats, and preservatives that can leave you feeling sluggish. Focus on incorporating more whole foods like fruits, vegetables, whole grains, lean proteins, and healthy fats into your meals. Planning ahead with simple recipes can make this transition smoother. 3. Embrace Movement You don’t have to commit to a rigorous exercise routine to stay active. Whether it’s a brisk walk, a yoga session, or even dancing around the living room, finding enjoyable ways to move your body can improve both physical and mental health. Aim for at least 30 minutes of activity most days of the week. 4. Improve Sleep Hygiene Quality sleep is essential for overall wellbeing. Create a bedtime routine that encourages relaxation, such as reading a book, meditating, or practicing deep breathing. Reducing screen time an hour before bed and keeping your bedroom dark and cool can also support better sleep. 5. Practice Mindful Eating Instead of rushing through meals, take time to savour each bite. Mindful eating helps you tune into your body’s hunger and fullness cues, which can prevent overeating and improve digestion. Sit down at a table, avoid distractions like your phone or TV, and truly enjoy your food. 6. Connect with Loved Ones Strong social connections are a cornerstone of good health. Make time to nurture relationships with family and friends, whether it’s through regular phone calls, shared meals, or joining group activities. Feeling connected can reduce stress and boost your overall happiness. 7. Set Realistic Goals Big changes are best achieved through small, consistent steps. Rather than overhauling your entire lifestyle, set one or two specific, achievable goals. For example, commit to adding one extra vegetable to your dinner plate each night or walking 10 minutes daily. Once these habits are established, build from there. 8. Take Time for Self-Care Self-care is not selfish; it’s a necessity. Whether it’s a weekly bath, journaling, or exploring a hobby you love, prioritising time for yourself can reduce stress and recharge your energy levels. 9. Nourish Your Gut Your gut health is key to overall wellbeing, influencing everything from digestion to immune function. Incorporate foods rich in probiotics, like yoghurt and fermented vegetables, and prebiotics, such as onions, garlic, and bananas, into your diet. 10. Focus on Gratitude A positive mindset can do wonders for your health. Start a gratitude journal where you jot down three things you’re thankful for each day. This simple practice can improve your mood, reduce stress, and help you focus on the good in your life. By implementing these easy tips, you can create a foundation for a healthier and happier 2025. Remember, it’s not about perfection but progress. Celebrate your successes, no matter how small, and keep moving forward toward your goals. Here’s to your health and happiness in the year ahead!

This one-pan wonder combines creamy white beans, rich tomatoes, and a kick of spice for a quick, hearty meal. Perfect with crusty bread, rice, or as a baked potato topping, it’s a versatile, plant-powered dish that’s sure to become a favourite. Serves 4 Ingredients 2 tbsps Extra Virgin Olive Oil 2 Yellow Onion (small, diced) 1 cup Vegetable Broth (divided) 2 cups Cherry Tomatoes Sea Salt & Black Pepper (to taste) 2 Garlic (clove, minced) 2/3 cup Passata 3 cups Lima Beans (cooked) 3 cups Cannellini Beans (cooked) 6 cups Baby Spinach 2 tsps Chili Flakes Method Heat the oil in a pan over medium heat. Add the onions and sauté for three to four minutes. Add a splash of broth if needed. Add the tomatoes, salt, and pepper, and sauté for five to six minutes or until the tomatoes blister. Add the garlic and sauté for another 30 seconds. Stir in the remaining broth and passata. Bring to a boil then stir in the beans. Reduce to a simmer and cook for eight to ten minutes. Stir in the spinach and cook for another two to three minutes or until it has wilted. Top with chili flakes. Divide evenly between bowls and enjoy!

Say goodbye to starchy tortillas. These delicious burrito jars provide you with all the yummy fillings, just without the tortilla! (Serves 1) Ingredients 1 cup salsa 2 tbsp cooked guinoa 2 tbsp kidney beans, chick peas or cannellini beans 1 tbsp grated cheddar cheese 2 tbsp greek yoghurt Method Evenly spoon each ingredient into the jars. Add ingredients in the order listed. Keep in the fridge for up to two days. Eat straight from the jar!

Gluten is in a lot of things we eat, from bread and pasta, to cookies, pastries and even drinks like beer. It’s been a staple for thousands of years but, along with turning vegan, going gluten free has been one of the biggest health trends in the last decade and is almost as divisive. Some claim gluten is damaging their health. Others argue that we are at risk of nutritional deficiencies if we don’t eat it. So what’s the truth?  Like so many things these days, when there is a lot of information and opinion, the waters can become muddied and it’s not always easy to separate fact from fiction. I thought I’d explore the topic so you can decide whether going gluten free is best for you. What is gluten is and where you’ll find it Gluten is a collective noun that refers to a number of different proteins found in grains like wheat, barley, rye and anything made from them.  The main proteins found in wheat are glutenin and gliadin, which are very elastic and give bread its stretchy quality. Some products naturally contain gluten, but gluten is also added in extra quantities to foods to add protein and texture, and to bind processed foods together. You’ll find gluten in the following products (not an exhaustive list!) Wheat flour Durham wheat Kamut Semolina Bread and breaded or battered foods   Pasta   Noodles Soy sauce (Tamari soy sauce is gluten free) Worcestershire Sauce Many flavoured crisps Barley squashes Beer, lager, stout, ales Cous cous Bulgar wheat Pies and pastries Pizza Cakes and biscuits Dumplings and Yorkshire puddings Breakfast cereals Muesli Many packet sauces (powders and liquid sachets) OTHER INGREDIENTS Malt extract  Malt vinegar Barley malt flavouring  Brewer’s yeast Edible starch What’s the problem with eating gluten? The gluten proteins are very hard for your body to break down and, when they don’t break down completely, they cause inflammation in the digestive tract or leak through the wall of your small intestine into your bloodstream, creating an immune response.  Coeliac Disease  is the most well-known gluten-related problems. It’s an autoimmune disease triggered by gluten and it causes your body to attack the small intestine, resulting in damage to the lining of the intestine. Symptoms range from digestive distress like diarrhoea, cramping and nausea (among others) to anaemia, neurological disorders and skin diseases like psoriasis and dermatitis. Testing for coeliac disease is by intestinal biopsy, usually when the condition is very advanced. There are a few specialist tests not available on the NHS that I can offer clients and that can spot problems before you become very poorly. Email to ask me about this.  Wheat allergy  is an abnormal immune response to one or more proteins found in wheat. Like other true allergies, the body makes a specific inflammatory response and symptoms can be mild or severe, including anaphylaxis, which can cause breathing difficulties and death. Allergies are usually detected using blood or finger-prick testing for IgE antibodies. Non-coeliac gluten sensitivity  is a ‘catch-all’ phrase that covers everything else! Advanced testing for gluten-related disorders (I mentioned this above) can pick up if your body is making an unfavourable response to gluten. Or, quite simply, you might know that gluten causes you issues, which can mean anything from milder intestinal symptoms, headaches, joint pain and fatigue, as well as neurological symptoms. While not life threatening, these can still have a profound effect on your health and how you feel and should not be ignored.  Neurological symptoms, really? Yes. What we’ve come to understand about gluten is that it can cross the blood brain barrier in the same way the proteins slip through the normally tight junctions in the gut. If you’ve ever heard people talking about Leaky Brain, this is what they are referring to. Research has shown that gluten can cause central and peripheral nervous system and psychiatric disorders  I see a lot of autoimmune clients in my nutrition clinic, and one of the first things I ask them to do is cut out gluten due to the inflammation gluten creates in the body. Why is this a problem NOW? But - I hear you cry - bread and gluten-containing products have been around for thousands of years so why is this only a problem now?  Gluten-containing grains now form the backbone of the modern diet thanks to an over-reliance on convenience and snack foods, and bread and pasta making multiple daily appearances on family menus. It’s not uncommon for me to find clients grabbing cereal or toast in the morning for breakfast, a sandwich or soup and roll at lunch and a pasta dish or pie in the evening.  We’re just eating way too much. Add to that, the wheat we eat today is also markedly different from the historic versions that used to be grown thanks to industrial milling that brought us the almost entirely barren white flour and other highly processed foods that see today’s wheat stripped of many of its vital nutrients. Add to that, wheat is now grown very differently with fertilisers and pesticides to increase yields. Dr William Davis, author of Wheat Belly, had this to say: “This thing being sold to us called wheat – it ain’t wheat. It’s this stocky high-yield plan, a distant relative of the wheat our mothers used to make muffins – light years removed from the wheat of just 40 years ago.”  Is giving up gluten bad for me? You might have seen articles proclaiming that unless you are coeliac, you MUST eat gluten-containing products or all kinds of bad things that will happen, including nutrient deficiencies. This is not the case [or insert your own personal feelings]. Articles citing the supposed nutrient deficiencies when you remove gluten containing foods that have been fortified with B vitamins (ie they have had extra B vitamins added). You could just ensure you eat foods that naturally contain vitamins instead! As long as you focus on eating real food rather than relying on processed ‘gluten free alternatives’, there is really nothing to worry about. About ‘gluten free foods’ Don’t make the mistake of thinking gluten free foods are necessarily healthy. When you buy any processed foods like breads, pastries, cakes and biscuits, you are in for a long list of ingredients, some of which you may not have heard of before. The same is true of gluten free processed food.  Gluten free breads are a case in point. Because the gluten in regular flour gives bread it’s unique texture, it’s hard to recreate gluten free, which is why gluten free bread often contains corn starch, rice flour, tapioca starch and potato flour, which are more likely to spike your blood sugar levels, be lower in fibre and cost more than regular bread.  How to go gluten free If you suspect you have a problem with gluten, the answer is to eat no gluten at all. Don’t reduce it, don’t save it for treats. Because gluten intolerance provokes an immune response, there’s no halfway house. That means don’t eat any gluten-containing foods and try to minimise cross contamination with gluten products. The food industry has come a long way in the last few years, developing products and menus that contain no gluten, but you do need to be vigilant.  To start, you might find going zero gluten a struggle, but label checking and spotting cross contamination hazards will soon become second nature. Here are my biggest tips for following a zero gluten diet: 1. Become an avid reader of food labels. Get to know which food types and which brands contain gluten and, therefore, need to be avoided. 2. Don’t afraid to say you need to avoid gluten. Real friends will try to accommodate you, and restaurants have an obligation to point out any potential allergens (and remember you are paying for the meal!)  3. Carry an emergency snack (nuts, seeds, a protein bar) in case there really is nothing else to eat. Hidden gluten Hidden gluten is found in many processed foods, including sausages and beefburgers, sauces and gravies. Some products, while they contain no gluten-based ingredients, may have been produced in a factory that handles gluten. This means cross contamination is possible (imagine gluten free food surrounded by puffs of normal flour). These are also ideally avoided. This is why oats can be bought as gluten free or regular. Oats themselves contain no gluten but they are often packaged in an environment where other cereals like barley and wheat are processed. Eating out Most restaurants now offer a gluten free (GF) menu and, if not, can often advise on GF options on a standard menu. If something is not listed as being ‘gluten free’, always ask the waiting staff. If they don’t know, ask them to check with the chef. Sauces are one of the things you always need to check. Check chips are not fried in the same oil used for breaded products.  It’s a good idea to call ahead to find out what the GF options are. You’ll soon build up a bank of favourite destinations you know can cater for you. Pizza Express, Ask, Prezzo and Zizzi now offer a GF pizza base and pasta. Coeliac UK provides a pretty comprehensive listing.   Cross contamination This can happen very easily in any kitchen – including your own. Grills, pans, chopping boards and utensils may still have traces of gluten on them so wash them diligently. Take care if using normal flour as residues can remain in the air for up to 24 hours and settle on counters. Crumbs are another hazard – you’ll want a separate butter or spread you can designate GF. You’ll also want a new toaster or use toast bags to prevent the transfer of crumbs.   NOTES FOR PRACTITIONERS Other studies you might be interested in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711951/ Migraine - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213149/   Depression - https://journals.sagepub.com/doi/full/10.1177/0004867418796955   https://journals.sagepub.com/doi/full/10.1177/0004867418796955   Anxiety - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641836/ Autism - https://www.glutenfreesociety.org/does-gluten-affect-autism/

Introducing a delicious Ginger-Seared Tuna with Avocado, Pea and Mint Smash! Here all the goodness of tuna is paired with a gorgeously green and super addictive - not to mention super easy! - avocado, pea and mint mash. Serves 2 Ingredients 1 teaspoon sesame oil 2.5 cm 1 inch) knob of fresh ginger, peeled and cut into matchsticks 4 garlic cloves, thinly sliced 2 tuna steaks 1 tablespoon extra virgin olive oil, plus extra for drizzling 45 g (11 oz/3 cup) cooked shelled edamame beans 1 large handful of mint or coriander cilantro leaves, to serve 2 Tbsp sesame seeds, toasted, to serve (optional) AVOCADO, PEA AND MINT SMASH: 75 g fresh peas, or thawed frozen peas 1 handful of mint leaves finely grated zest and juice of 1 lime 1 ripe avocado, chopped 1 teaspoon apple cider vinegar pinch of chilli flakes (optional) Instructions Heat the sesame oil in a frying pan over medium heat. Sauté the ginger and garlic for a few minutes until golden, then remove to a small bowl. Brush the tuna steaks with the olive oil and season with sea salt and freshly ground black pepper. Add them to the pan and fry for 2-3 minutes on each side, until cooked to your liking. Meanwhile, to make the avocado, pea and mint smash, cook the peas until just tender, then place in a bowl, add the remaining ingredients, and roughly mash or crush with a fork. Season to taste. Serve the tuna steaks on a bed of the avocado and pea smash, drizzled with a little olive oil, garnished with the sauteed ginger and garlic, and topped with the edamame beans, herbs and sesame seeds. Bon appetit!

(Servings: makes 12) Start your day right with a bowl of vanilla and almond granola - a deliciously crunchy and naturally sweet way to kick off your morning. The warm notes of vanilla pair perfectly with the nutty crunch of toasted almonds, creating a breakfast that's both satisfying and full of flavour. Ingredients 2 tsp pure vanilla extract 1⁄4 tsp almond extract 1⁄2 cup pure maple syrup 1⁄2 tsp salt 1⁄2 cup coconut oil, melted or vegetable oil 4 cups old-fashioned oats 1⁄2 cup slivered almonds 1 tbsp sultanas Sprinkle of cinnamon   Instructions 1. Pre-heat oven to 325°F/160°C. 2. Mix liquid ingredients in a mixing bowl. Pour in 4 cups oats and stir well. 3. Pour on a baking sheet and spread in one layer. 4. Bake for 25-30 minutes, stirring twice during baking. 5. Cool thoroughly. Can be stored in an airtight container for up to 1 week.

This vibrant Detox Salad is packed with fresh, nutrient-dense ingredients to nourish your body and keep you feeling energised. With a mix of leafy greens, roasted sweet potato, avocado, and protein-rich grilled chicken or eggs, it’s a delicious way to support digestion and overall well-being. Drizzled with a light turmeric-lemon dressing, this salad is both refreshing and satisfying. Serves 1 Ingredients 2 cups mixed lettuce 1 handful of spinach, kale, or watercress 1-2 tablespoons chopped fresh herbs 75g Medium roasted sweet potato 1 cup mixed vegetables Grilled chicken OR boiled eggs (2 large) 1-2 tablespoons roasted nuts or seeds 50g Avocado 1 tablespoon pomegranate seeds Dressing: 1 tablespoon olive oil 1 teaspoon fresh lemon juice ¼ teaspoon turmeric powder Pinch of black pepper Method Combine lettuces, leafy greens, herbs, mixed vegetables, and roasted sweet potato in a bowl. Add your chosen protein, roasted nuts or seeds, avocado, and pomegranate seeds. Whisk olive oil, lemon juice, turmeric, and black pepper for the dressing. Drizzle, toss, and enjoy!

With winter approaching, it is the ideal time to reboot your system and commit to glowing health – and thinking about thyroid health is a good place to start. If you often feel you’re dragging yourself through the day or you've been struggling to lose weight for a long while despite eating all the right things, it might be worth considering whether your thyroid is doing the job it should.  The thyroid – a butterfly-shaped gland located in the neck – is the body’s internal motor, effectively setting the speed at which the body works. If it’s not up to scratch, you might experience a whole host of uncomfortable or annoying symptoms (see below).  The hormones it makes affect most cells in the body by increasing the basal metabolic rate, as well as augmenting heat production. That’s why people with an underactive thyroid often struggle to lose weight, feel the cold more easily and have low energy – imagine a record player playing a record at reduced speed. Do any of these sound familiar? I feel tired all the time My hands and feet are always cold I’m putting on weight for no reason I can’t seem to lose weight whatever I do I’m often constipated My muscles ache I get muscle cramps more often I feel irritable Generally, I’m feeling a bit low I’m struggling to fall pregnant My periods are heavier than usual My hair and skin feel so dry My sex drive is flagging or non-existent I’m losing hair at the outer edge of my eyebrow. If more than a few symptoms resonate with you, visit your GP to discuss symptoms and ask to get your thyroid tested.  GP Testing One of three things will happen after you have a blood test at the GP. The doctor may tell you your results look normal, in which case no further action will be taken. Or you might be sent for further testing. Make sure that you have tested more than simply TSH and T4. Often these can be normal, however T3 is the active hormone and if levels are low, you will have the symptoms of an under active thyroid. If the result looks a little off, either immediately or in a few months' time, go for a retest. It’s much more common to have an under active thyroid than an overactive one, and more common still for the under active thyroid to be an autoimmune condition called Hashimoto’s, where the immune system destroys the thyroid gland to the extent that it can no longer function normally. However, even with a diagnosis, many people still experience symptoms in spite of treatment.   What Actually Gets Tested?  In the UK, the first thing doctors test is Thyroid Stimulating Hormone (TSH) levels. TSH is the hormone that tells your body to produce the actual  thyroid hormones. If TSH is within range, your GP is unlikely to do any further tests on the assumption that the rest of the thyroid hormone-producing cascade is working correctly.  If TSH is raised, your body is working harder than necessary to produce the right levels of thyroid hormones. At this point, your doctor may repeat the TSH test in a few months in order to compare levels.  Alternatively, they might test your Thyroxine (T4) levels to determine whether or not you’re producing the right levels of this hormone. If this level is below range, you’ll likely be prescribed a synthetic form of thyroxine to supply the body with what it is not making itself. If the levels is above range, which suggests an overactive thyroid, you may be prescribed carbimazole and perhaps a beta-blocker. Still Feeling Tired and ‘Rubbish’ Despite Treatment? This a common problem. Initially, you may start to feel better, but many patients report sliding back into their previous pattern of symptoms. The reasons why you’re not feeling better can be complex. Supplementing with T4 might not work, as what’s going on in your body might be more complicated and involve several issues. Some people produce enough TSH and T4, but T4 isn’t actually the hormone that does the work. Triidothyronine (T3) is the ‘work horse’ that needs to be converted in the liver from T4. Some people, for various reasons, simply don’t convert it very well. Zinc and selenium, for example, are two essential minerals required for the conversion of T4 to T3, and it may simply be a question of a deficiency in one or both. In other cases, you might produce enough TSH, T4 and T3, but the body negates the effects of the usable T3 by making reverse T3 (rT3) –literally reversing the action of T3. Everything may ‘look normal’, but if you’re still dragging yourself through the day, you could have sub-clinical thyroid problems. GP ranges are quite broad, so it’s easy to fall outside the limits.  It’s worth knowing that regular GP testing does not cover T3 or rT3, so if you’re still feeling below par, it’s worth getting a full thyroid blood screen done privately. I work with all major private laboratories and can arrange this for you. Do You Have An Autoimmune Thyroid Problem? Another vital piece of information, which isn’t often covered by the standard GP test, is for the presence of autoimmune thyroid antibodies (thyroid peroxidase and thyroglobulin). This indicates your immune system is attacking your thyroid. The autoimmune disease Hashimoto’s Disease (a form of under active thyroid) is incredibly common but unless your GP tests for the antibodies, you won’t know that you have it. GPs generally don’t test for this as it doesn’t affect their clinical management of you – whatever the diagnosis, you’re still going to be prescribed thyroxine. However, this test is important to nutritional therapists, as the diagnosis requires an entirely different treatment protocol. You may have high levels of these antibodies, but no symptoms of an under active (or overactive) thyroid. The autoimmune element always comes first. Hashimoto’s (under active) and Graves’ (overactive) Disease affect the thyroid, but they are actually immune system disorders. According to Dr Alessio Fasano MD who lectures on autoimmunity at Harvard University, for an autoimmune disease to exist there are 3 requirements: a genetic predisposition, a trigger and a 'leaky gut.' Once you have been diagnosed with an autoimmune condition, we will delve deeper into these issues. Adrenal Stress - The Missing Link In Thyroid Treatment Thyroid health is closely connected with your adrenals (two walnut-shaped stress glands located on your kidneys). If you have had any significant stress, your adrenal glands may not be performing optimally – and this is very bad news for thyroid health. Adrenal stress disrupts the complex network of interactions needed to make the right amount of thyroid hormones, suppressing the thyroid function.There are tests available privately for this. Unfortunately, adrenal problems are not recognised by UK GPs. Addressing adrenal problems is important because the effects of stress affect energy production, fat storage (storing fat around the middle) and female hormone health.   The Importance of Iodine Did you know that the mineral iodine is essential for the manufacture of thyroid hormones triidothyronine (T3) and thyroxine (T4)? Thyroid hormones contain three or four iodine atoms respectively. If you’re serious about fixing your thyroid for once and for all, you could consider a urine test to determine whether or not you have sufficient levels of iodine.  Ready To Get That Thyroid Back Into Shape? There are a number of different tests, which we can use to measure your thyroid levels. These include a full blood draw, finger prick blood spot test and a urine test. I take a full medical history and evaluate my clients before deciding on the best option. If you have an under active thyroid and are feeling below par, despite medication, I can help. Medication is just a piece of the puzzle.