Katie: [00:00:00] Welcome to our monthly Speaker Series. My name is Katie and I am part of the team at Paloma Health. We are an online medical practice focused exclusively on hypothyroidism, and we host a monthly event on a specific topic related to hypothyroidism. Tonight's is a little bit different. We thought we would be relevant for the holidays upcoming.

I can't believe that Thanksgiving is already just next week. This is always a busy season, it's complicated this year with COVID,  and we want to talk about prioritizing thyroid health to make it through the holiday season successfully and without distraction, being able to focus on what matters most.

So we have three awesome speakers with us tonight, Dr. Sean Zager, Neeyaz Zolfaghari, and Kristina Cegla are all going to talk about, sleep, stress, movement, and nutrition, and how you can support your thyroid with those things this holiday season  The event will be about 75 minutes long. Each of our speakers will talk for 10 or 15 minutes, and then we're going to open it up to a live Q&A at the end.

You'll see a chat feature at the bottom of your screen. Go ahead and start dropping your questions in there. Let us know if you already have questions or what comes up as our speakers are talking, and a replay will be available after the event. I would like now to introduce my cohost, Mary Shomon.

Mary is a hormonal health and thyroid health patient advocate. She's been doing this for a long time. She has her own journey with thyroid conditions  and she's a wealth of knowledge. She is going to help moderate our speakers and then the Q&A at the end. So, I will stop talking and I'm going to pass them over to you, Mary, to introduce yourself and then introduce our speakers.

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Mary: [00:01:46] Great. Thanks, Katie. Happy to be here and, happy getting into the holiday season to everybody cause we've got  quite a stretch now of between Thanksgiving and then Christmas, Hanukkah, New Year's, Kwanzaa, Boxing Day. We've got all the holidays coming, lots of food, lots of stress, lots of cold weather, all sorts of adventures, and that can be a challenge to our thyroid health, our immune system health.

But luckily, we have these three amazing experts here today who were going to help us navigate the holidays, mind, body, and spirit, so that we can get through it all feeling great, looking great, and coming out into a 2021 that is hopefully going to be even happier and healthier than ever before. I know we're all praying for that and hoping for that.

So tonight we're going to start with one of our Paloma doctors who is one of the amazing providers that you might have a lucky opportunity to work with if you are working with Paloma for your thyroid care. Dr. Sean Zager is a board certified family physician, and wait until you see him, because he looks like he's not young old enough to even be a doctor, but I assure you, he has quite a lot of experience.

He has a passion for holistic approaches. This is his world. He wants to look at things from the patient oriented, more comprehensive approach. And to that end, he's our kind of guy, because he does not believe that hypothyroidism is a one-size-fits-all cookie cutter  condition. He brings both conventional and evidence-based alternative medicine into his diagnosis and treatment approach, which I think is really the best way because you're taking all of the smartest things that we've known for centuries and the most cutting edge, and you're putting it all together to get the best results for your patients.

Sean believes that effective approaches come from an understanding of each person's unique narrative. So this is a doctor who listens, and he is very interested in the cross-section between thyroid, and adrenal, immune, and gastrointestinal health and the importance of sleep and all of the other lifestyle issues. So I'm going to stop talking about him and I'm going to let him start talking to you. So I'd like you to welcome Dr. Sean Zager.

Dr. Zager: [00:04:24] Thank you, Mary. Really appreciate it. I used to get the Doogie Howser thing all the time. I get that much less now. I'm approaching my 41st birthday.  And, I am so happy to be here, guys.  I'm going to speak about hypothyroidism and sleep and, I believe sleep is one of the four pillars of health care.

I would consider the four pillars being sleep, stress management, and exercise, which you're going to hear about from Neeyaz after me, and the fourth being nutrition, which you're gonna hear about from Kristina after that. And these are all obviously very interrelated and very much related with our hormonal balance, including hormone, of course.

Now, of course, getting good sleep, good quality sleep, enough quality sleep is important for everybody  but if you're a person who struggles with hypothyroidism, it is all the more important to work with your healthcare provider, both to optimize your thyroid care, but also to make sure that you're tending to your sleep hygiene. The two often go very much hand-in-hand. Both your thyroid health and your sleep hygiene.

So the hallmark challenge of hypothyroidism is that involves the slowing down of your metabolism. The most common symptom of hypothyroidism is fatigue. And a lot of people know that, but what's lesser known is that hypothyroid patients really struggle with poor sleep quality. And there's an increased risk for sleep disorders, such as obstructive sleep apnea and others.

So why does this happen? Why is there this connection between hypothyroidism and decreased sleep quality? Now, there are many factors that contribute to this link, but to name a few, one that people know a lot about is of course this increased intolerance of the cold, that, of course, in these winter months that are now upon us, at least in most of this country, we are dealing with this and it's cold at night and this can keep people up, especially if their thyroid is not well managed and well controlled.

Also there's an increased tendency for joint and muscle pain that can keep people up at night. In addition, people who suffer from hypothyroidism have an increased risk for low mood depression, and even seasonal affective disorder, which is known as SAD. And of course that is really an illness of the winter months and including this holiday season.

People with mood, depression, and SAD often have increased difficulty falling and staying asleep, or  both. So one other thing I want to talk about that really does connect  hypothyroidism to challenges with sleep is changes in other hormones that are related to thyroid dysfunction.

And of course there are many hormones out there. They're all very much interrelated, but I'll talk about two that I think are central. One being melatonin. melatonin is a hormone that is produced in the pineal gland in the brain. It follows a diurnal rhythm, so it's meant to really increase as we get ready for bad and peaks around midnight in the middle of the night.

And then it comes down to allow us, in the morning, to wake up and feel ready for our day. In patients with hypothyroidism, there's increased tendency for a disorder of melatonin secrete. And we see this in patients who struggle with seasonal affective disorder as well.

Now another hormone, cortisol is produced in the adrenal glands. And, it also follows a diurnal rhythm that's pretty much inverse to  melatonin. Cortisol is meant to well, melatonin really helps support our sleep. Cortisol really helps us be wakeful helps give us energy, helps us manage stress during the day.

So cortisol really peaks in the morning hours about six to 8:00 AM and then falls throughout the day. And eventually it comes down at night to help us get ready for bed. As melatonin starts to increase, If you're a person with hypothyroidism, then your increased risk for disorder of cortisol production.

And most often it's really elevations in cortisol secretion. And when this occurs at night, in particular, it leads to sleep disturbance, increased irritability, increased anxiety, decreased mood, decreased capacity to manage stress. So these are all ways that thyroid dysfunction can be tied to sleep difficulty.

And it really is a bilateral  relationship you really need to have. I should say, having your thyroid well managed and in balance helps your sleep quality and really tending to your...

How can I optimize my sleep and my thyroid function?  So first it's really important to work with your healthcare provider to ensure that you're getting the right kind of thyroid support. And I can't stress this enough because there are so many ways of assessing thyroid function beyond even what is done conventionally. And there are so many ways, so many options for thyroid support also beyond what is done conventionally.

And so really talking with someone who is aware of these different options can be so important to lead you in your healing path and your thyroid care. but also to work with your healthcare provider to optimize your sleep hygiene. So let's talk about that.

First, and this is what I do with all of my patients. I always start by talking about these four pillars of health care: sleep, which I'm going to wax on more here, but as it relates to exercise and good nutrition and stress management. It's just so important. And I know that during the holidays, it can be especially difficult, and then the holidays with COVID, on top of it can be especially difficult.

And, so all the more important to really focus on this and work with your healthcare provider and make it a priority so that you can. Go through these, this holiday season, this winter season as healthy as you possibly can.

One thing I'll start with is just that so many of us struggle with is really avoiding being with your screens and devices at least an hour before bed, right? Ideally two to three. I know we're all guilty of not doing that, but when you don't, it really can mess with your sleep. In general, I think it's helpful to have lights dimmed in the hours before bed and then allow for really good darkness and quiet during nighttime hours while you're sleeping.

This helps to support that melatonin production that I was talking about. That's so important for sleep and so important for thyroid health. You want the temperature in the room to be cool, not too cold, probably like 65 to 70 degrees, something like that.

You want to avoid being too full or too hungry when you go to sleep. Usually a good rule of thumb is allowing for about three hours at least between your last meal and the time you go to bed, avoiding caffeine after lunch, and limiting alcohol consumption before bad. I know people say, Oh, that glass of wine or two or three really helps me sleep. I  helps toput me right to bed.

And it is true that alcohol does help people fall asleep, but the studies are very clear that it causes disruptions of sleep through the night and more nighttime awakenings, which obviously it doesn't let you get into that deeper sleep that you need to be feel restorative. And again, I know during the holiday season, this can be hard, but all the more important to increase your mindfulness around not overeating, not eating too much, too late and not consuming too much alcohol before bed. In addition, just want to say really helpful to have a set sleep schedule and stick with it. ideally allowing for about 30 minutes, at least some people can do more, to allow your mind and body to relax before bed.

The way you do this is personal, there's a lot of different ways to do this. It can be a hot bath with Epsom salts before bad. It's the holidays, treat yourself, enjoy. I think it feels good and certainly support sleep, relaxes muscles, reduces worry. It's an incredible thing to do. Reading, playing soft music, for some people it's prayer, for others it's quieting practices like deep breathing or meditation, or one of my favorites is guided imagery for sleep support that I do on my own and with my patient . All of these help to decrease cortisol production at night, which is what we want. Again, coming back to that hormone, we want to help to that cortisol level to come down so that we can sleep soundly.

Finally, there's a host of herbs and supplements that can be used for sleep support. I'm not going to go into incredible detail about this. I'll just say it can range from having lavender essential oil in a diffuser in your bedroom to a melatonin supplement for some people before bed, to sedative herbal teas that might include chamomile or lemon balm or a passion flower valerian, right?

These are all really good options to help support sleep from  a natural vantage point in the end. I really encourage all the viewers out there to really work with your healthcare provider, to support the ins and outs, both your thyroid care and your sleep hygiene,  to find out what's right for you to move forward and enjoy the holiday season and beyond in health.

Thanks a lot, guys. Appreciate it.

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Mary: [00:14:19] Thank you, Sean. That was really interesting with some really great advice. Before we move on, we have one question. Erica,  one of our viewers wanted to know, you'd mentioned about alcohol, and she wanted to know if there's a suggested time limit or cutoff point before bed to stop drinking. Is there a timeframe or a recommendation on that as far as, bedtime?

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Dr. Zager: [00:14:48] I think it's a great question. I would say, I think it's likely to some degree personal, depending on people's body weight and the way that they metabolize alcohol and probably what kinds of alcohol you're consuming and that kind of thing.

But I think it'd be a good rule of thumb to stop drinking and turn to, water and really good hydration before bed. Couple of hours before bed, at least. I'd say two to three, ideally, to allow your body to reset before bed.

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Mary: [00:15:13] Okay, great. So around the same amount of time, as we probably want to stop  heavy eating, we want to probably stop drinking, as well.

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Dr. Zager: [00:15:22] Yes, I would say so.

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Mary: [00:15:23] Okay, great. One other question, and then we're going to go on to Neeyaz. Penelope wants to know if CBD oil is helpful for sleep, and if there are any contraindications or problems for people with thyroid using CBD for relaxation.

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Dr. Zager: [00:15:40] No,  I know of no contraindications. I think that CBD can be very helpful to support sleep, to reduce anxiety levels. If that's something that for given people who seem to have interrupted sleep, I think CBD can be a great natural herbal option for sleep support.

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Mary: [00:16:00] Okay, great. We've got a couple more questions, but we're going to go ahead and hold those till we get an opportunity to hear from our other speakers.

And so keep them coming, folks. We will have a chance to try to get to all of them as we go. But right now I would like to introduce you to Neeyaz Zolfghari. She is a nutritional and lifestyle coach. So she is a one of those smart people who tells us what to eat, how to eat, and how to put it all together in our lives.

She's the founder of, I love the name of her business, Unspoken Nutrition. I think that's a great name. And her philosophy is based and built on the concept of an inner home that helps transform our outer home. So maybe she'll tell us some more about that. Cause that's a really interesting concept.

She herself had a journey with autoimmune thyroid disease and now is trying to help other people by helping them take their own healing journey as much as she did. And she is all about nourishment, whether it's through positive affirmations, nutrient dense food, good routines, lifestyle, breathwork, movement, all the good things, that we put into our body, mind, and soul.

So I am going to turn it over now to Neeyaz to share some additional thoughts on how to survive the holidays.

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Neeyaz: [00:17:32] Thank you, Mary. And thank you, Dr. Zager for kicking us off. Hopefully you can hear me okay.  I want to piggyback a little bit off what Dr. Zager was talking about too, in regards to the holidays kicking up a lot of different emotions and how we really need to tap into what is coming up and how can we best support it with those four pillars that he did mention.

So I want to say one thing that might be a little discomforting to hear first, but the point of me saying it is that I'm going to give you tools and guidance that will help to address my initial points.

So the holiday season often is a trigger for autoimmune symptom flare up. And the reason for this is because there's a change of season. There's darker days. It's darker earlier in the day. So we have a little bit less vitamin D exposure and it impacts our vitamin D as well to our moods, like Dr. Zager was talking about SAD, seasonal depression disorder is a legitimate thing.

As well, too, the holiday season comes with stress. It comes with us overdoing things. It comes with us being a little bit overwhelmed by things and add on COVID, add on everything else that's been going on this year, it's a lot to really handle and to deal with.

And I just want to mention that if you are experiencing any flares, any symptoms, any imbalances-I definitely have this year for sure.  I've been fairly symptom-free for the past maybe six or seven years, but this year I started to notice a couple of my residual symptoms from autoimmune thyroid disease  creep up a little bit andI know it because I've been doing this work for a long period of time. And I've been on this journey for a long time too, but I actually really think my body when these symptoms or these signals start to come through.

So I want anybody who is experiencing anything, whether it's a small flare or a symptom to just drop into being really thankful for it because it's your body, giving you a really clear message that, hey, something doesn't feel right. Can you pay a little bit of attention to me? I need you to nurture what's going on underneath here.

The symptoms are just the body's way of really communicating with us and telling us when something is not aligned or when something is not totally balanced. So when we look at the list of symptoms for hypothyroid or Hashimoto', they're not usual symptoms that you should be experiencing. And that's because when you're experiencing these symptoms, your body has fallen out of homeostasis and it's putting its efforts into getting your attention by signaling through your physical body.

And that's where these sensations are then coming from. The most powerful way to really understand your stressors, your reactions to certain stimuli, or just certain experiences is to reconnect back to your vessel, your body, your inner home. And there are two really tactical ways to do this one being movement and one being breath, which is also a form of movement and both of these also help to facilitate and lower stress reactions.

Something that I actually see and hear time and time again, whether it's through clients or through just my community, is that the added stress that somebody has with Hashimoto's or with hypothyroidism, it puts them on a do more, be more active, push themselves beyond what's more comfortable because they want to see a tactical physical results coming off of it. And that's all right. It's appropriate setting. But I actually say to do something that I call pause, observe, and provide.

So the first step is to pause. Anytime you're feeling overwhelmed, you're feeling stressed, you're feeling anxious or any other emotion that might come up holidays. It might be stress, it might be exhaustion, it might be  irritability, anytime something below the midline comes up. I want you to first pause. And ask yourself, how am I feeling right now? It helps even just close your eyes and really drop into your body. How am I feeling right now? And what just triggered this feeling to come up for me right now?

Was it a conversation I had with a family member? Did your Aunt Whoever asked you if you were married and have children yet? I don't know, that might be a question that comes up at the table, but what was that thing? What was that circumstance? That situation that triggered and turned on this reaction and this feeling, and then you started to experience.

You know your symptoms. For me, one of my symptoms that was so prevalent was excessive sweating. Anytime something triggered me, my body would just get so hot and bothered. I would just start sweating and felt really uncomfortable. And I knew over time that. My excessive sweating was really linked to irritability.

Anytime that something started to bother me and create a bit of discomfort, that was the symptom that would, that was like the exact direct line. So really dropping in and understanding what does that symptom telling me? What is that emotion attached to? It is a good way to take a pause and then I want you to observe yourself, observe your surroundings. Where and in your body, do I feel this emotion?

Some people, they feel, anxiety in their chest. They might feel it in their throat. I definitely feel it in my throat. They may feel it in their stomach. So where are you feeling this emotion? And is there something in your environment right now that is a catalyst to that emotion?

Something, maybe in your home setting, something maybe in the setting that you have set up for the holiday, whatever it might be, what is it in your environment that acted as a catalyst of that emotion and then ask yourself, what do I need right now to lift me out of this space? So it might be one of the few things that I'll then talk about in the next step: provide.

So you've paused, you've asked yourself what's going on. You observe to see what exactly is in your surroundings is causing that emotion, causing this trigger to come up, and then you're going to provide, providing yourself with what you need whenever you need to bring you back into arrested calm state.

So do you need to practice some deep breathing? And there's two methods of breath that I can share right now. They're fairly quick and simple. One is called the box breath, the box breathing. Traditionally, I've heard that you do four breaths, four breaths all the way through the box, but I actually like to do five because five breaths brings your body back into homeostasis. It's been shown in research and everything that I've read so far.

So you imagine a box. I can't really do it with my hands, but you imagine a box and you inhale on a count of five, hold your breath for a count of five, exhale for a count of five, and then hold your breath empty for a count of five.

So if we want all try it right now, everybody close your eyes. Get comfortable. So go ahead and take a deep breath from your belly for a count of five, four, three, two. One hold it for five, four, three, two, one, exhale for five, four, three, two, one, and stay empty for five, four, three, two, one.

And you'll repeat the cycle until you feel calmer again. And you can do it as many times as you want. You can do it with your eyes open. I do it when I'm driving sometimes. Obviously eyes are open. So anytime you feel like you need to drop into a breathing, there's another method of breath that I also love called alternate nostril breathing, which balances the two hemispheres of the brain.

And you can do this with your eyes open. You'll close one nostril. So you can take, I usually take my ring finger, but you'll close one side of your nostril. You'll inhale from the other side. Close it with your thumb, exhale out of the other side and it's all out of your nose. So you inhale, close it, exhale, and you go back and forth.

I love to do alternate nostril breathing before I go to bed. It's one of the best ways to really calm the mind down, bring your body into a state of balance. So that way you can get yourself into a deep rested sleep and then follow the tips that Dr. Z talked  about, too

So breathing. Do you need to maybe journal? I personally do what I call a brain dump every night. For whatever reason. My mind is racing at night with all of my things, to do my to-do list, my creative ideas that people I need to call the next day. So before I go to bed, I pull out a piece of paper and I do a brain dump. I just write everything down onto paper.

And then that way I don't have to lay in bed and be like, Ooh, I got to do that. Okay. I'll remember in the morning when I wake up, I'm not going to remember in the morning when I wake up just doing a journaling exercise, whether it's a brain dump or following some sort of prompt is really helpful as well too, to get all of the chatter, the monkey mind out and putting it onto paper as well, or.

Do you possibly need movement to really get your energetic body moving freely? I always talk about how we're made up of four body types, our physical, mental, emotional, and energetic or spiritual body. We're mostly made up of energy when we're all of us right now, we're sitting in our spaces possibly still we're creating 500 Watts of power just by sitting still.

If you feel like you have this pent up energy in you, I say dance. I say, just shake it out. getting that energy out. Moving the energetic body is a really great way to release a lot of the stress too. And maybe you don't have too much energy. You really just want something that's really soothing and really comforting.

Restorative yoga is a really beautiful practice. Are you in yoga? Or thyroid yoga, which I'm going to plug as something that I teach. I'm also really supportive as well, too. walking or hiking. So grounding into earth into mother nature through movement is another really beautiful way to reconnect back into your body and help to really lower those stress responses.

So truthfully, the most important component is really what's happening internally through the dialogue that you have with yourself. That's why I gave you the pause. Observe and then provide because our thoughts create our realities. So if we're staying within the same thought pattern, if you start to storytell, "Ooh, I have to go to this person's house for the holidays.

Oh my gosh. But last year this happened, they're going to ask me this question and then I have to answer it this way." I'm creating. I haven't even gotten to the house yet, the day hasn't even come in and I'm already assuming what's going to happen a week from today. So if you keep going into this cycle and you get stuck into the cycle, it's going to create a stress response in your body.

You start to physically create that stress and then your body physically starts to manifest it into symptoms. And so on and so forth. So being really mindful of also the languaging that you're giving yourself, too. There's an experiment that I love talking about. It's by a man named Dr. Emoto.

And he did this study where it shows a correlation between our thoughts or the messages and the formation of water crystals. I think the study is called the science of water, but it could be mistaken. But the hypothesis of the study was that human vibrational energy, our thoughts, our words, it all had an effect on the molecular structure of water and being that water makes up give or take 80% of the human body.

This study was really fascinating to look into because it gave an exact kind of look as to what happens when we ourselves are giving ourselves these kinds of thoughts and languaging, and what's happening to our internal landscape. He basically had these like beakers or containers of water that were just filled with regular stillwater.

And he noticed that the containers of water that were spoken kind and loving and gentle languaging to, they form beautiful water crystals like snowflakes. And then the ones that were spoken to with hatred and anger and just a lot of self-sabotage languaging, those formed into what, or actually looked like virus cells.

Cause he did like microscope on both of them, it was beautiful snowflake. And then a ball with spikes on it looked like the COVID cell, but it was a lot of like vibrancy, really ugly looking water crystals. So that already shows that the choice of language has a direct physical impact on the status of matter.

And we ourselves are made up of matter too. So again, the words that you speak to yourself, have a direct impact on the state of your physical being and the state of your physical body. So whether it's utilizing practices like a positive affirmation or mantra, a gratitude practice, which significantly improves stress and mood imbalances, or doing something like the movement or the breath work practices, those are all really important, tangible, free, easy, accessible ways that you can help to really lower and mitigate your stress reactions.

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Mary: [00:30:49] Thank you so much. That is really incredible information Neeyaz, and I was thrilled that you mentioned breathwork in particular because that is one of my go tos and especially the alternate nostril breathing, because I want to put in an extra pitch for the fact that there've been a number of studies that have shown that it also increases metabolism. Have you seen some of those studies?

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Neeyaz: [00:31:14] I don't remember if I have, but I believe it's one of my favorite breaths.

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Mary: [00:31:19] It's absolutely incredible. Not only does it give you energy, but it actually increases metabolic activity to a really measurable level. So a lot of folks find it helpful for weight loss and energy and oxygenation.

So I just had to put it in my pitch cause I'm a big breathwork fan. So I hope that, was as fascinating to everyone else as it was for me, because that was some really great information, from Neeyaz. And we're going to, we had a couple of questions, but we're going to hold onto those until we get finished.

And because we have Miss Kristina Cegla up next and Christina is a certified holistic health and nutrition coach, and she's the founder of Mindful Thyroid. I love the name of that business. She's got more than two decades of personal experience with Hashimoto's and she has created something called the Mindful Thyroid eight pillars to creating health, focusing on a holistic approach to bring together all of these factors to create a healthy life for yourself.

She's working with clients for weight, loss, energy, and regaining trust in their bodies, and a practical approach to both nutrition and mindfulness with thyroid disease. So she's going to talk to us a little bit about how to stay on track with our thyroid healthy diet, or at least as close as we can get to it, during the holiday season.

And I'm not missing out on the fun of the holidays. So I am going to turn it over to Christina.

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Kristina: [00:32:53] Thank you. Can everyone hear me? Okay? Yep. All right. Thank you for joining us tonight. So I know the holidays are a fun and exciting time, and I want you to be able to enjoy them as much as possible. So I do have some simple and practical tips I'm going to share tonight to help you stick with your healthy eating plan that could look like whether you're eating gluten and dairy free, maybe you're Paleo AIP, or really any other diet.

So to help reduce symptoms of Hashimoto's, it's important to follow an anti-inflammatory diet, and most people are going to see benefits from going gluten-free and dairy-free as well as reducing sugar. Those are some of the more problematic foods. So the goal of doing that is to reduce the attack on the thyroid and reduce symptoms of inflammation, such as brain fog, joint pain, bloating and fatigue.

A lot of the tips I'm going to share with you tonight, come from my own experience navigating diet changes with Hashimoto's. When I first went gluten-free, many years ago, I was learning how to cook at that time. And I thought it was just easier to stay home, avoid parties because I felt left out and frustrated that I couldn't eat foods I was used to.

And I couldn't enjoy where everyone else would be enjoying. So over the years I've had experience with Paleo, AIP, low-FODMAP and I've discovered some tips that really helped me stick with my diet. So I'm excited to share those with you tonight. but first let's dive into some easy ways to get more anti-inflammatory meals into your diet.

As we transition into the fall and winter, we of course have colder days. Which means we're naturally going to crave more warming foods that feel comforting and grounding to us. So that means you'll most likely crave less smoothie salads and other cold foods. But I want you to continue to eat dark leafy greens and veggies, which should of course be a staple in your diet already.

Dark leafy greens are great sources of calcium, zinc, folate, and other nutrients, and they help with liver detoxification. So going through the colder months, try adding more soups, stews, casseroles, and Crock-Pot meals to your weekly menu because, there are four key benefits to these types of meals.

So the number one, they make large batches, you can cook once and get several meals out of it. They're quick to throw together. That way you can spend more time socializing with your family or doing your online holiday shopping.

Number two, you can add a ton of vegetables and greens. So spinach, bok choy, kale, and cabbage, and other greens are great additions to soups. You can throw a variety of different vegetables together in Crock-Pot meals and casseroles. This is a great way to get a lot of nutrients with minimal work in the kitchen. One of my favorite winter meals is a Crock-Pot. Chuck roast with beef broth carrots, sweet potato and onion. It's really filling and it's perfect for these rainy cold nights and benefit numbers.

Three, you can add gut healing nutrients, so things like bone broth and chicken stocks, you can add those two soups and stews. Also add collagen powder, turmeric and ginger to your casseroles and other recipes. I'll often add collagen powder  to my soups for additional protein and the gut healing benefits.

Bone broth and collagen contain glutamine which helps to repair the gut lining. Turmeric and ginger have anti-inflammatory properties. And these are all helpful to reduce the inflammation that comes with Hashimoto's.

And number four, soups, stews, casseroles, and Crock-Pot meals are typically easier to digest. As the fibers from vegetables get cooked down for a longer period of time.

So if you're someone who has a hard time digesting vegetables, or even eating raw vegetables, then Crock-Pot meals and suits might be a good way for you to get more vegetables into your diet and be able to tolerate them better. Just to give you an example. I like to make a homemade chicken noodle soup, and instead pile on just a ton of vegetables and greens in there.

You can definitely add lentil noodles, brown rice, or sweet potato, if you want a hardier soup. But spinach and bok choy add great flavor and you can pile on a ton because it cooks down quite a bit. So I also like to add frozen butternut squash, peas, carrots, salary, green onions, and zucchini. When it's done simmering and I'll just put some baked chicken and then just add collagen powder to each individual bowl.

And this makes a huge batch and only takes about 40 minutes altogether. And for me, it'll last, maybe four days. If you have more people you're feeding, maybe it'll last a little bit less, but to help make things quicker in the kitchen, try using frozen organic vegetables as often as you can, if you're short on time.

Just put some frozen vegetables in a bowl and microwave them. For me, I like to do  that when I'm using vegetables that are time consuming to cut. So if I'm doing butternut squash, I'll just get a frozen version. It's less time to have to cut it. Even carrots and broccoli, I'll do the same thing.

And you can find this recipe on my website, mindfulthyroid.com and, Paloma Health just released an app for AIP friendly recipes. And so you can find lots of great recipe ideas in there as well and it was just  released. And so it's usually easy to eat healthy when we're at home, especially right now.

We're not really not going out to eat as often. But you might be wondering how are you going to stick with your diet while you're out at a holiday party or any gatherings. So I have a few tips for you that I think will help you enjoy your time while you're out without feeling guilty. If you indulge just a little, there are some challenges that come up this time of year, especially if you're following any type of restricted diet or just trying to eat healthier.

So a lot of the challenges I faced, I'm sure many of you face, they aren't necessarily around what to eat, but more center on the emotions surrounding food and our food choices. So the first challenge is you might not know what you'll be able to eat at a party. This can cause some tension or anxiety.

You might even think it's easier if you just don't go and just stay home instead. Or maybe you feel like you're being judged by others for eating differently, or you even feel the last hour I've been there and I've avoided parties to basically avoid those feelings, but it honestly doesn't feel very good missing out on the fun either.

So challenge number two you might face is  feeling stressed and short on time for cooking. So if you're hosting a party, maybe you just don't have the energy or you feel overwhelmed. Some thoughts that might come up are, will others want to eat the foods you compare that are gluten and dairy free or will you even have enough energy or feel well enough on the day of the party and challenge number three, probably the biggest challenge that we all face is all of the temptations.

So alcohol, sugar, cookies, cakes, you name it, can be hard to say no at times. And if you overindulge, feelings of guilt and shame might come up. So those are some pretty big challenges. One key takeaway from tonight I'd like you to remember is that holiday parties are about celebrating with your friends and family and the connections and memories that we're going to make.

So when you look back in a couple of months or years, you really, aren't going to remember what you ate, but you will remember the memories that you made. So if you're on the fence this year, you're feeling stressed about going to a party or even hosting a party. I hope you remember that food is a tool to connect us.

I'm going to share with you five simple tips, I think will help you navigate these challenges. That way you can enjoy your time with your friends and family this year. So tip number one, eat before you go to a party, seems simple, but they're simple for  a reason so that way you have a success doing them.

So when you don't know if there's going  to be food you can eat or not at the party, I recommend just a small meal before going. So if you're less hungry, once they get there, because you ate something you're less likely to overindulge on any sugary foods or be tempted to try something off your diet. You can spend more time socializing and less time worrying about what you can eat at the party.

Okay. Tip number two, bring a meal or a dish to share. So in addition to eating a small meal before you go, bring something to share. If you do get hungry, you have a backup, something you feel comfortable eating and that you can easily share with others, depending on the type of party you might want to bring, say gluten-free muffins, a veggie or hummus tray, or meatballs and marinara sauce, which is really easy and quick to make.

Think of this as an opportunity to share your favorite healthy recipe with others. Most people are going to be surprised how good your homemade meals or desserts taste. for a long time, I was honestly afraid to make any of my recipes for others. And I thought they wouldn't like them. And so I just really didn't like to host parties or, have to cook for others.

And what changed my mind on that was I began to change my perspective on cooking. So instead of looking at healthy meals is different or subpar, then you know what my family and friends were used to. I started thinking about how I was eating healthy and why I was doing it. And that the nourishing foods were full of nutrients, energy, and  life and it made me feel better. So I wanted that for my family as well. And of course my friends, and so I found more joy then and cooking for them and sharing my recipes and feeling really good about that.

So tip number three, if you're hosting a party, delegate out the food. Offer to make your main course, maybe one or two side dishes, but then delegate the rest of the food, the beverages, desserts, appetizers, delegate that to your friends and family, have each person bring their favorite holiday dish.

Or it can have a theme say if you're going to do like an Italian food or finger foods, and then just, assign those out to each person or family person that's coming. So this can cut down on your stress a lot and your food budget and that way, you can enjoy the party without having to spend all the time cooking.

So if you're comfortable making a Turkey or roast, go for it. If you're new to cooking, start with something more simple, say like baked chicken, seasonings, a clap, a casserole, or even gluten-free spaghetti, which is very easy and you can't really mess that up. But pick a food theme that you feel comfortable cooking around and then have others bring dishes that will then support that meal.

Okay, so tip number four, this is a big one. Don't fight the temptations, but do eat mindfully. So if you spend all night fighting against yourself, when you really want to have a treat, you're not going to have much fun at this party. So allow yourself to choose one or maybe two items that you really want to eat and then eat them mindfully to be present and enjoy them.

So place them on a napkin or plate whatever's available at the party. Visually seeing them is important. So you're aware of what you're eating. If you just grab items off the table and eat them throughout the party, it's really hard to keep track of how much you had by the end of the night. So next, take a moment to release any judgment or feelings of guilt, your choosing to enjoy this treat.

And that's an important component there. So to thoroughly and eat it slowly. So you really get to taste all the flavors, to give you an example, I threw a New Year's Eve party several years ago. I made a ton of gluten free, healthy foods for everyone but I didn't allow myself to have any cupcakes or treats that I had made.

So by the end of the night, I was so tired of saying no, all night long to myself. And I just ended up eating so many sweets. I got sick and I was sick the rest of the night and took me about a week to really recover and feel better. My body just did not do well with even one night of overindulging.

So from then on, I learned it's easier just emotionally and physically to have a small amount, rather than fight with yourself all night over not having something. And when it comes to alcohol, have a small glass if you choose to, and then switch to putting water in the wine glass. Or just start with water in the wine glass and forego wine and alcohol altogether, if that's your preference, but this way it does feel more festive and you don't feel as left out a s you're walking around the party.

And finally tip number five, have a sensible sugar craving backup. So even if you followed all of the tips, maybe indulge just a little, maybe you made it all the way through the party. There might be a sugar craving waiting when you get home. So whether it's hunger because it's the end of the night, or you've just seen and smelled all of the yummy treats all night long, you're really gonna want to have something ready and waiting for you that we have something to look forward to.

And if you need it, great, you have it. But if you don't, that's fine too. So a few healthy examples would be some strawberries with coconut whipped cream, maybe a gluten free muffin or cupcake, some homemade applesauce, paleo brownies, which you can always freeze and take out maybe one or two to have waiting for you or try some fresh berries and just drizzle some warm coconut butter on top.

Those are all really good choices that are sensible and you can have your sweets and sugar now, giving in a little bit to the sugar craving, but you're eating them in a really sensible and healthy way. And as you go through the holiday season, it's important not to label foods as good or bad foods.

So if you're constantly pointing out to yourself that I can't eat this or shouldn't have that. Really puts a lot of negative energy and negative thoughts in your mind that makes it more difficult to actually stick with your diet. You'll almost instinctively want to rebel and eat something that's forbidden.

So instead try changing your thoughts from, I can't have this food or shouldn't eat that too. I don't want this food because it doesn't make me feel well, or that's not the right food for me right now. These positive thoughts put you back in control. Rather than allowing the diet to control you. And this allows you to have those foods down the road again, if or when the time is right for you.

So I hope you'll try out some of these tips at your next holiday gathering. And if you do want to learn more about mindful eating and tips for sticking with your diet, I do have a guide available on my website. It's mindfulthyroid.com. And I thank you all again for joining us tonight.

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Mary: [00:47:24] Thank you, Kristina. Those were some incredible, ideas and advice. And I love your tip about having something waiting at home for yourself  because that's something that I started to do when I was going out to parties at the holidays, because I'm a pumpkin pie fanatic. I could eat pumpkin pie all the time  What I've started to do is I make is pumpkin chia pudding. And it tastes just like pumpkin pie, but it's super healthy. And, so I always have a little bit of that at home, so that even if I turned away the pumpkin pie with the big pile of whipped cream on top of it, I know that I've got my pumpkin treat waiting at home. And I loved all of your ideas.

I think those are really great and about not denying yourself, but being reasonable and keeping things in moderation. It's not about deprivation, but it's about trying to keep it in balance. And if you're eating all those healthy soups that you were talking about, the rest of the week, you can afford to have a treat on the weekend or at a party.

But you made me hungry too. Now I'm thinking about soup. So I have to start planning my soup recipes for the rest of the week. Thank you, Kristina. That was fantastic. And we've had questions pouring in, throughout all three of the presentations. So I think we're gonna move on to some of our viewer questions.

And I want to go back to a question that I think, Sean, Dr. Zager, this is going to be one that maybe you can start out with. And then if any, if we have any other advice coming in from Kristina and from Neeyaz, I would welcome that too, but Davey wanted to know, he has Hashimoto's, vitamin D levels that are always on the low range in the fall and winter, and always borderline or below normal, uses a sad lamp, a seasonal affective disorder lamp, and takes 5,000 IUs of vitamin D every fall and winter, but cannot get that vitamin D level up, sleeps well ,eats well, doing everything right.

But the D levels are just really dragging. Do you have any thoughts on what might be going on there and what somebody can do to get those D levels up and fight that seasonal depression and get the immune system  ready to go?

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Dr. Zager: [00:49:45] Absolutely. There's a lot of questions there but they're all related really.

So of course, there's good study showing at least correlations between  having low vitamin D levels and increased risk for autoimmune problems like Hashimoto's. So getting your vitamin D levels up, I think is important, especially if you're a person with Hashimoto's.

Some people need even higher doses than 5,000. I use daily in the winter time so that it could just be an issue of dose  I have a few patients who they don't seem to respond to certain supplements. And sometimes even if you up that dosage of vitamin D or even, or other supplements that does, they don't respond. And it makes me want to look at their GI function and make sure that they're absorbing supplements and nutrients that they ingest.

Of course  use of a lightbox is really helpful and well proven to help with seasonal affective disorder. So I completely support that on a regular basis. along with getting vitamin D levels up one way or the other is, you know, what I just talked about. I think I touched on those questions, but yeah.

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Mary: [00:50:56] Yeah, absolutely. And I would add one thing, which is that every, all of the information I see always says that we should take our vitamin D with the fattiest meal of the day which oftentimes, I guess, is dinner. Cause some people think of, Oh, they take all their vitamins in the morning, but, a variety of sources and research I've seen says, no, really you should take it with whatever meal is fattiest, which is often dinner for a lot of people. What are your thoughts about that?

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Dr. Zager: [00:51:23] Yeah, I've seen that for sure. Vitamin D is a fat soluble vitamin and, in some people more than others, it needs to be taken with a fatty meal, so that it's absorbed, optimally.

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Mary: [00:51:33] Okay. Alright. So make sure we're taking our D correctly, taking enough of it and, get out those lightboxes. And how about outdoors? Is it helpful to get outside and get a little bit of natural light exposure to, for seasonal effective issues?

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Dr. Zager: [00:51:48] Oh, yeah. Tons of study on that. And, yeah, we're made to be outdoors, right?

Our genes, the way that we're built is to be outdoors, and it's all the more important during the winter months when there's less sunlight available, again, to support the diurnal rhythms that I talked about in our hormonal balance, talking about melatonin and cortisol and, thyroid hormones. So a big resounding yes.

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Mary: [00:52:15] Okay, great. I'm wondering if, Neeyaz or Kristina, do you have any, thoughts about that vitamin D level in the winter and, seasonal effective issues? Or shall we go on to some additional questions?

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Kristina: [00:52:30] Just to second what you were saying about having it with a fatty meal since it is a fat-soluble vitamin. And then, just, not always in the morning, like you're saying sometimes with lunch or in the afternoon that I found it helpful to do that way as well.

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Mary: [00:52:44] Okay, great. Thank you all. We have a question. I think Neeyaz, this is for you. We have, let's see, Diane wanted to know a little bit more about the thyroid yoga.

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Neeyaz: [00:52:56] Okay. Amazing. So thyroid yoga is essentially created to support the full endocrine system and lymphatic system, the digestive system  The postures that are practiced in thyroid yoga all really helped to benefit the throat chakra and to open up the thyroid and to bring a lot of energetic healing to the thyroid gland itself, as well as the other glands that also have a direct in terplay with the thyroid function, like the liver and the stomach and the heart and all those different Meridian points too. So it's a combination of yoga asana, which is  movement, breathwork.  Breath of fire is a really popular breath that I love to practice with thyroid yoga. And of course, Meditation mantra work, affirmation, all of that is really intertwined to create a very unique yoga experience.

That's not like anything you would see in a class because it's so tailored to be specifically for thyroid and you don't have to necessarily have a thyroid disease or ailment in order to benefit from it. Because like I said, it helps to benefit all the different systems as well, too.

So it's really beneficial for anybody,  whether you have Hashimoto's, hypo, hyper Graves, whatever it might be. It's a really powerful practice.

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Mary: [00:54:09] Okay, great. Thank you. And where can people find out more about the thyroid yoga?

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Neeyaz: [00:54:15] Definitely. So if you go to my website, unspokennutrition.com or my Instagram @unspokennutrition, I talk about it quite frequently, but there's information there more about the practice and if you'd like to practice it with me.

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Mary: [00:54:27] Okay. Great. Thank you. Kristina, I think this question is for you. Kimberly has tried the collagen powder and said that it's making her feel bloated, giving her indigestion, and wants to know if including it in a soup reduces those side effects, or maybe you have some recommendations on other forms or other ways to get the benefits or nutrients that we're getting in that collagen that may not cause those kinds of side effects.

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Kristina: [00:55:00] Yeah. So that's a great question. There's a lot of different brands and types of collagen powders out there. So the first  thought would be to try a different brand. Some of the brands might be bothersome. I've myself tried two or three different brands and one made me bloated, the other one didn't for whatever reason.

So that could be one suggestion is just try a different brand. As far as putting it in the soup, when you're making your soup, don't include it in the whole batch of the soup. So do it like, your individual bowl, like for whatever meal you're eating that night. Just put a little bit in your bowl that way.

If you do notice that you're not ruining your entire soup that you just made, and start with a very small amount. So typically if it's a big scoop or two scoops for a serving size, just do a half a scape, just do a little bit and see how you react. And that goes for any supplement or anything you're doing.

I always like to start with just a very small amount, and just see how you're going to react with that. If you find that  no collagen powder is really working for you. That's okay too. stick with, those, the bone broths or chicken stocks. Those also have glutamine in 'em. And those are also going to be beneficial for gut healing.

You don't have to do the collagen powder. And instead, maybe look for, just start adding a lot more vitamin C rich foods to your diet. Vitamin C is a precursor to collagen production , in the body, which helps with connective tissue and gut healing, things like that. So you can start increasing vitamin C foods, or even try taking a little bit of a vitamin C powder.

And stick with the bone broths and chicken stocks for your soups. But again, if you want to try to collegen powder, just start with a very small amount and put it in your individual super bowl. Don't put it in the huge batch that way you don't own your receive. If it does still make you bloated.

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Mary: [00:56:48] Okay. Great. Thank you. That's a that's good advice and gives us some strategies to get the benefits of that collegen and without any side effects. Okay  I'm going to go back to Dr. Sean and we're getting a lot of questions about melatonin, which is one of my near and dear favorite supplements.

I've been taking it regularly, religiously for over 10 years. So we've got questions. Number one, people want to know, is it dangerous for my thyroid? What's the maximum dosage? Is it bad to take? Is it good to take and what do I do if I'm still waking up in the middle of the night and can't go back to sleep?

So that's a multi-part question, but it sort of centers in on the concept of melatonin.

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Dr. Zager: [00:57:36] Absolutely. Okay. Yeah. I could probably spend an hour answering those different questions, but in a nutshell, no supplement is right for everybody, first of all. So that includes melatonin. But, and I know that some people are worried and that it can cause dependence and start to inhibit the body's natural ability to create melatonin.

I actually have never seen that be a problem in my practice. It's easy to put people on melatonin, take people off melatonin. I don't see withdrawal or difficulty. And as I said, there's a host of different, herbs and natural supplements that can help with sleep beyond melatonin. You can play with that.

In terms of dosing melatonin, it's very interesting. The dose range is quite large, probably 0.5 milligrams to 10 milligrams. Some people do better with less, some people do better with more, I don't see much downside to melatonin supplementation, except that the only thing that I would see that are the most of those common things that I see it, which is still rare is that people might feel a little groggy if the melatonin works too well, that in the morning they feel a little bit groggy.

And then you pull back on the dose or find a different dose or find a different way to support sleep all together. And okay, the last question, Mary, that you said about if you like nighttime awakenings, what to do. So I think the first thing is really try to keep the mind calm.

And Neeyaz spoke of so many ways, so many techniques of doing this. And, because it's so easy in that middle of the night and those strange, wee hours of the morning for the mind to start racing and thoughts from the day that can come into your head or thoughts for the upcoming day and different anxieties and worries.

And then once that takes hold it's really is hard to fall back asleep sometimes. So really trying to stay calm, remember that even just being restful in bed, even if you're not fully sleeping is still about half as good as sleeping. And so remembering that if you're able to be restful in bed, maybe doing some deep breathing, if you're not fully asleep yet, it's okay.

I am a big fan of deep breathing exercises, guided imagery to help support sleep, and really, again, help to decrease that cortisol level, increase the parasympathetic system where your relaxation system, so that you can actually be in a place to rest, to sleep, or at least be in a restful state.

I'll leave it. There. There's a lot to say about that, but, and Neeyaz, of course, if you want to chime in or anybody, please feel free.

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Neeyaz: [01:00:14] Yeah, definitely. Definitely what you do before you go to bed makes a big difference too. So like I mentioned, doing something like a brain dump, journal brain dump for me is super helpful because my mind is racing.

Otherwise, if I'm laying on my pillow and I'm just going through my to-do list of what I need to do, I'm not going to get the quality sleep that I want to get. So doing these practices before you go to bed, maybe doing some restorative yoga before you go to bed. One of my favorite ways is to actually throw my legs up on the wall.

Close my eyes and practice deep breathing for even just five minutes before you go to sleep that can really help to calm the nervous system and allow you to really drop into a deeper sleep. But Dr. Z said too, when it does happen, just still stay in bed because it encourages and it teaches your body that

we're supposed to be resting now because if you get up and you try to do something, if you look at your phone, that exposure to blue light, Is not helpful. Every time you glance at your blue light, whether it's the computer screen or a phone, you lose 10 minutes of sleep every single time you stare at it.

So you really wanted to limit the exposure to blue light that you have, especially if you're waking up in the middle of the night, keep everything really dark. Wearing an eye mask is really helpful. Closing the blinds, diffusing some lavender essential oil just before you go to bed. All of these little practices over time will really help to support a deeper sleep.

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Mary: [01:01:38] Great. Thank you. Okay. I'd like to, I'm going to go back to Dr. Sean for a moment, but I do want all three of our experts to have a chance to weigh in on this question because, one of our viewers  really is talking about the elephant in the room:  COVID. She's nervous about COVID through the holidays.

We've got people that are, everybody's got a varying degree of risk tolerance, but some people are going to have big family get togethers for Thanksgiving, with masks, without masks, people are getting on trains, planes, automobiles, traveling, getting together, having parties, et cetera.

What can we do beyond the standard, wear your mask, wash your hands, all of the business, what can we do to keep our immune system healthier? We'll start with Dr. Sean, have you got any recommendations for us besides staying home and hiding in the closet wearin' a mask, for what we can do for the holidays?

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Dr. Zager: [01:02:36] Absolutely. Again, almost every health challenge that patients ask me about, I always start with those four pillars, right? That we've all spoken about. You just can't leave that behind. Speaking of, trying to get your sleep really optimized. Sleeping ,  we know that's really good for our immune systems. Eating well.

Kristina talked about stress management. Like Neeyaz mentioned, regular exercise, right? Those are just basic bedrock ways of helping to support our immune systems. And so if we do come in contact with the coronavirus that we may not contract, or we may not be as susceptible of becoming sick by it.

Beyond that,  I would think about other, natural remedies for care. Of course you hear about vitamin D supplementation, which we talked about is being talked about for immune health. And that is, I think that is really important. again, probably, especially for patients with Hashimoto's, but really all of us, but certainly with autoimmune, challenges, it's really important.

Zinc, vitamin C. I'm a big fan of, herbs, like echineca and elderberry and astragalus for immune health. I could talk about specific brands, but maybe I'll just leave it there and open it up. I know you want all three of us to talk about it, but that's what I got to say.

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Mary: [01:03:51] Sure. Kristina, did you have any, specific tips about, keeping the immune system and tip top shape as we venture out into the land of COVID?

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Kristina: [01:04:03] Yeah. And I think Dr. Zager touched on some of them already, but, it's the little things that you're going to be doing every day to improve your health. So just overall eating a healthy diet, eating that anti-inflammatory diet that we talked about, that's going to be  a huge step ahead to stay healthy, and hopefully not get sick, whether it's COVID or any other illness. But vitamin D zinc and vitamin C are very important.

So I would say, make sure, those dark leafy greens are a staple in your diet because they are full of zinc and vitamin C. And of course, bell peppers and, oranges and different fruits. Strawberries are another good one. And so for vitamin C and so including those in your diet every day and making, if you do a smoothie, great.

If you don't want to do smoothies, cause it's cold out, do the soups and just get as much leafy greens in as you can. That's going to be very beneficial and then just avoiding sugar is another big one. Like I know it's hard going the holidays. So just  minimize the sugar, making when you do have it, very small amounts. You can still enjoy it, but you're not overindulging in it.

Doing all those things are gonna be really important. The other thing I like to do is if I feel myself coming down with something, I'll do a little bit of apple cider vinegar, mixed in water. And just drink a little bit of that usually helps. And then gargling with saltwater. That's like an old, old habit or tale t hat really works to just clear out the throat, any germs and things that are in there.

So a little bit apple cider vinegar and water. I'm gargling with saltwater, at the onset of feeling sick or trying to, feeling anything in your throat. I find that's really beneficial and helpful.

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Mary: [01:05:43] Great ideas. Neeyaz, do you have anything to add to, how to, COVID-proof our holidays?

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Neeyaz: [01:05:50] Both of them have already really touched on so many of it, especially the four pillars. But what I really wanted to mention also is there's so much of the things that we have to do or not to do in the midst of all this, whether it's COVID, whether it's not catching the flu, whether it's a cold, I also want to drive the message of doing something that brings you a lot of joy, and that helps you to forget what's happening.

And the outside environment of what you can't control. So I personally know that the media and the news is a trigger for me, so I don't watch the news. I don't read any of the news or anything like that, because I know it's triggering for me. If I am in a really grounded space where I'm ready to read, okay, what are the statistics in my county, or what's going on?

I have to be really mentally sound to then go in and read those  kinds of numbers. Otherwise, what I'm doing outside of all that is doing things that bring me joy. So of course, cooking and doing all these other practices that really make up the four pillars. Bring me a lot of joy, but also I love painting.

I love going on long walks. I love hiking. I love dancing around. I don't dance. I'm not a dancer, but I love to just throw music on and dance. I love to play with my dog. So doing other things that are outside of just my day to day routine. Also helps to instill a lot of happy, good, healthy hormones and endorphins that will really help to strengthen the immune system.

That way in the case comes that I do contract COVID or anything like that. My mental state is in a healthy, balanced, mindset. That way I can, come out of COVID or whatever might be, without really weighing too heavily on the do's and the don'ts you're saying that if you're not having any fun and finding joy and you're anxious all the time that COVID is getting you one way or the other.

Even if you don't come down with it, it's no fun. So we've got to, we've got to put it aside and realize that we've got the moment now and live it. Enjoy it. Paint, dance, cook, have fun. Because we can't control the future. We don't know. We've never known what the future was gonna hold.

It's always been unpredictable. You can only control right now. So what do you want to do right now to paint that picture for yourself?

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Mary: [01:08:02] Exactly. I think that's very good advice. So we're balancing it, that we're doing healthy things. We're being protective. We're taking good care of ourselves, giving ourselves a good baseline and keeping our minds and spirits, happy and resilient as well.

One, one more question. I think we have a question from one of our viewers, this one, back to Dr. Sean, wants to know if we are at greater risk for COVID or with COVID given having hypothyroidism and I'm, that's an interesting question and it may, we may need to even break it down to hypothyroidism versus Hashimoto's. But, what are your thoughts Dr. Sean, about, the thyroid-COVID crossover  risk issue

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Dr. Zager: [01:08:49] Yeah. I think it's a good question. And, first of all, I think it has all to do with it's one thing to have those conditions, but it's another, I think what is even more important is how well is it managed, right? If you're a person with hypothyroidism, or Hashimoto's, and it's really well managed and your numbers are just where they need to be.

And your thyroid is supported, where needs to be, I think your risk is really no more than the average population or it is minimally more. But if  it really is, if your thyroid is really, not in balance that I, then I believe that, due to a array of mechanisms through hormones and neurochemicals and ultimately to immune function, your immune function is impaired.

And you can be at an increased risk for contracting infections. Like COVID.

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Mary: [01:09:41] So the take home message. And I keep hearing this, cause I've talked with, epidemiologists and doctors all along the way, rheumatologists, gastroenterologists, and every one of them has had the same message, which is yeah,

having an autoimmune disease or being diabetic, as I am as well, or any of these conditions can put you at a higher risk. But if you are carefully controlled, well-treated, optimally, feeling well and doing everything possible to support your immune system. You are on the low end of that risk scale, of the higher risk.

If you're an uncontrolled diabetic, if you're super hyperthyroid and forgetting to take your medicine, if you are a heart disease patient, who's not taking your high blood pressure pill, whatever, all of those things. Yeah. You're going to be at much higher risk, but if you are doing everything you can to stay in good control.

You're going to be in, it may be a little bit higher risk, but not to the extent that we should be worried or neurotic about it. Correct?

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Dr. Zager: [01:10:46] Oh, there we go. I think you're muted. If you hear me, you're back. You're back. Yeah. I just want to say that. Yeah, I've been thinking, you're saying Mary is right on and that's, I agree with everything that you're saying it, I work besides doing, integrative, thyroid care and integrative primary care.

I work urgent care as well. and so I'm exposed to infections all over the place and I'm working. I work COVID clinics, I'm working the Saturday 10 hours doing COVID testing and treatment. So I find that in general, my immune system is so my own immune defense is so much more decided by how well I take care of myself through if I'm exercising and sleeping well and eating well and managing my stress.

if I'm doing those things, I can be exposed to infections and not get sick. But if I'm not taking care of myself, then I'm much more at risk. And so it really does come down to those roots of the tree.

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Mary: [01:11:47] Good advice. Good advice. I think, Katie, is it time for us to, start wrapping things up? What do you think?

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Katie: [01:11:55] Yeah, I think we'll probably start to wrap it up here. Thank you so much. This event was a little bit longer than our usual events. We wanted to give enough time to all of our speakers, to share what they know about specific topics and get to a lot of questions. because we know the holidays can be stressful and they can be a lot of fun.

And we hope that you have taken some tips and tools, for your health, for your family's health. I really liked, Kristina's mention about wanting health for our friends and family as well.

Someone also mentioned a tool that Paloma Health recently launched. We launched a mobile health app, to help you with the AIP diet and inside of the app, there is symptom tracker.

There's a recipe library that has recipes from some of our favorite health coaches, including Neeyaz and Kristina. There's a food journal in there. There's an article database. There's a lot in there, even if you are not. doing the AIP diet. So you can download that for free, on both Apple and Android.

And you can find that on our website, if you want to find a link there or just go to your app store and search. It is getting late. So I want to say thank you to all of our speakers for joining us tonight. I want to say thank you to you, Mary, for moderating our Q and A and introducing our speakers.

We hope that everyone has a really fun holiday season, without the stress of coronavirus, without the stress of family. And when you experienced those stressors, we hope you have some tips from tonight to take with you. So thank you all very much. We will send out the repla  hy opefully tomorrow, if not the next day.

And we will make sure to include where to find each of our speakers so that you can learn more from them if you would like to. I also saw a note that we want Mary's pumpkin chia seed pudding recipe.

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Mary: [01:13:37] I will send you my pumpkin chia pudding recipe because it's really delicious. And it's so much fun. Even my kids like it, if you can believe it. yes, I will send that in.

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Katie: [01:13:46] Perfect. awesome. Thank you everyone so much. We hope you have a good night.

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Mary: [01:13:51] Thank you everybody. Happy Thanksgiving.