Can Hashimoto's be reversed?

Hashimoto's is a chronic autoimmune condition, but antibody levels and symptoms can often be significantly improved when the underlying drivers are addressed. Many people are able to reduce antibodies, feel substantially better, and in some cases lower their medication needs in partnership with their physician.

Do I still need thyroid medication?

Often yes, at least initially. Functional nutrition is not a replacement for thyroid medication. It works alongside your medical care to address the immune and lifestyle factors that medication alone does not. Any medication changes should always be made with your prescribing provider.

Do I have to go gluten-free with Hashimoto's?

Not necessarily for everyone, though many people with Hashimoto's do notice improvement when removing gluten, particularly if they have gluten sensitivity or celiac disease. The right approach is individualized rather than universal.

Is weight gain in perimenopause inevitable?

No. While the metabolic changes of perimenopause make weight management harder, they are not insurmountable. Addressing blood sugar, protein, muscle, sleep, and stress can meaningfully shift how your body responds, even when previous approaches have stopped working.

Can nutrition really help my perimenopause symptoms?

Yes. Nutrition and lifestyle won't stop the hormonal transition itself, but they powerfully influence how you experience it, affecting energy, mood, sleep, weight, and inflammation.

Do I need hormone replacement therapy for perimenopause?

That's a decision to make with your physician. Hormone therapy is appropriate and helpful for many women, and functional nutrition works alongside it rather than replacing it.

When Your Body Lets You Down: A Gentler Approach to Autoimmune Disease

When your body hurts and fatigue has set in, it’s easy to feel discouraged about taking
any action toward health and healing.
For most of us, avoiding the problem only makes things worse. The longer we feel bad,
the more likely our mood will shift downward, and we may find ourselves asking,
“what’s the point of doing anything?”
When you live with an autoimmune disease, your energy and pain levels are often
unpredictable.
For some of us, not knowing how our bodies will perform leads to feeling powerless.
These experiences bring up a lot of unpleasant emotions, from frustration to
disappointment. While we cannot always control how our bodies feel, we do have
influence over what we do and how we respond, both of which are important ways of
taking care of ourselves.
Nutrition, exercise, rest, and the way you talk to yourself are important ways of caring
for yourself and supporting your well-being.
How we think about our situation impacts what we do, and when we feel sluggish it’s
easier to swim in thoughts of “I can’t do this” and “things will always be this way.”

Taking a stance of indecision and passivity can contribute to feeling worse, creating a
cycle that’s hard to break.
When it comes to facing health issues, if we don’t think we’ll be successful, or we are
feeling inadequate because our bodies are not performing the way we want them to,
it’s natural to check out, lay low, and do nothing. This holding pattern can turn into a
kind of freeze response, where fear of uncertainty keeps us stuck.
Our mind is great at spinning postponement stories for our future selves such as,
“When I feel better then I’ll start to walk, lift weights, and eat healthily.” Procrastination
helps us avoid uncomfortable feelings, but it keeps us away from our goals around
feeling better.
When we cross the bridge into a routine of wellbeing, starting at a sustainable pace,
without focusing on the outcomes, life starts to feel different.
In a society crazed with wellness, for some the beliefs go something like, “if I’m sick,
it’s my fault.” For many of us, taking a harsh critical stance isn’t motivating; it’s more
like stepping on our neck when we are already down.
In our hyper-productive society it’s not surprising that some people with autoimmune
disease carry a quiet but persistent sense of shame about their struggles.
Shame is a self-conscious emotion, it has us thinking about what others may be
thinking of us. It also shows up because our desire to be connected and feel a sense of
belonging is strong. The antidote to shame isn’t more willpower or discipline. It’s
compassion.
What helps is tenderness, acknowledging the difficulty, the wish for things to be
different, and speaking to yourself with an open-hearted, kind tone.
Research on self-compassion suggests that a harshly self-critical inner voice can
contribute to depression and avoidance, while a compassionate approach is
associated with greater well-being.
When you have an autoimmune disease, accepting your situation can be difficult. But
not accepting reality makes life exponentially harder. When we fight against what is
happening, we often create additional suffering rather than making room for
perspective-taking, problem-solving, and a gentler approach.
Assumptions around how long a flare-up will last, how unfair it is to have an illness, and
whether you’ll be able to handle what you are dealing with all contribute to additional
suffering. While it's understandable that these thoughts pop up—in many ways they
are an attempt to gain certainty over an uncertain situation—it's important not to get

stuck here. We are better off getting into the habit of shifting our attention toward what
we can do to support our well-being.
When our bodies act in unwanted ways, it can be scary. Chronic health issues remind
us of the fragility of life, but that doesn’t mean we are weak. Feeling fearful doesn’t
have to lead to feeling helpless or powerless. Even in difficult moments, there are
opportunities to bring a gentle touch to what we are experiencing. It’s not many
people’s first response, but why not open your heart to your struggles rather than
criticizing something that is not in your control?
And you don’t have to navigate this alone. Working with a nutritionist who understands
autoimmune conditions can help you identify what your body needs right now. Having
a compassionate professional in your corner, whether a coach or therapist, to help you
manage the unpleasant emotions of a chronic illness can make the journey less
isolating and more hopeful. You are dealing with something hard. You deserve support
that meets you where you are.

Aviva Kamander, LCSW is a licensed clinical social worker, therapist, and life coach with
over 20 years of experience helping adults with anxiety, chronic illness, relationship
stress, and the particular complexity of midlife. She has had a personal mindfulness
practice since 1998, which deeply informs her work. Aviva offers psychotherapy
through Authentic Vida and coaching through Aviva Coaching. She offers both
in-person and virtual appointments from her office in Mamaroneck, NY.
authenticvida.com | avivacoaching.com