s5 e13: Thyroid Case Study

thyroid and Hashimoto's

Thyroid Case Study

We have our first case study this week and joining me to break it all down for you is one of my clinical nutritionists, Erin. We will be covering a thyroid case this week since that’s what my patrons wanted the most and then next week we will dig into a digestive/gut health case. We will wrap up the case study series with a final review of a client that struggled with fatigue and energy issues. 

Our first case is of a previous course student and 1:1 client, Tina. I reached out to her to ask if we could share her story since I think many people will relate. We did change her name, but all other details are accurate.

Tina’s main concern was thyroid health and specifically, Hashimoto’s. She did an HTMA through the course and noticed her calcium was really high. When she got 1:1 support we worked on rebalancing calcium through her nutrition and lifestyle primarily, as stress was a big part of her high calcium. This gave her the energy she was looking for and greatly reduced her thyroid antibodies since high calcium can slow down our metabolism and impact all systems in the body. 

This episode covers:

  • Tina’s main concerns and symptoms, including what she had previously tried
  • Create her stress timeline and determine foundational interventions
  • Her HTMA lab testing results
  • Additional interventions based on her HTMA results
  • Tina’s healing ups and downs

Thyroid Mineral Training

Master Your Minerals Course

Free Resources:

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Mineral Imbalance Quiz
Mineral Training
Feminine Periodical (monthly newsletter)


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Amanda Montalvo [00:00:01]:

Welcome to the are you menstrual? Podcast, where we dive deep into all things women’s health to support you on your healing journey. I’m Amanda Montalvo functional and integrative dietitian, also known as the hormone healing Rd. If you enjoyed this podcast and you want to keep learning, check out the podcast Patreon, where I share a bonus episode with additional downloadable resources each week. You can go to Patreon.com forward slash Hormone Healing Rd or check out the link in the show notes. This week’s episode of the Are You Menstrual podcast is brought to you by Paleo Valley. They’re sponsoring us again this week. A couple weeks ago, I talked about beef stix because that’s definitely my most utilized product that they have. It’s one of my favorites.

Amanda Montalvo [00:00:44]:

It’s a staple in our home. But I also love their organ complex. So this is a really good one. If you are trying to incorporate more organ meats, maybe you haven’t quite adjusted your taste buds yet. You don’t want to eat them as often, or you’re just like, I don’t know if I can do this through food. They have a great whole food supplement that’s actually a blend. It has beef liver, beef kidney, and then it has beef heart. And kidney is great, great source of selenium, really helpful for histamine issues.

Amanda Montalvo [00:01:12]:

And I think a lot of us know how nutrient dense their organ meats are. Very rich in vitamins and minerals, but if you didn’t grow up eating them, it can be a hard adjustment. I remember the first time I had beef liver, I was like, I don’t know if I can do this. To this day, I still have to, very much so, hide it in my food. My daughter loves it, but it’s because she’s been eating it since she was like, seven months. So her taste buds are very adapted. So if you’re trying to get it in or if you want something that’s easy to travel with, it’s not even necessarily something that I think people absolutely have to take every single day. But it is a great form of like, a whole food multivitamin.

Amanda Montalvo [00:01:47]:

And I love all of their products, but especially their organ complex. I highly recommend it. A lot of people ask me about beef liver supplements. I’m like, if you can do the Paleo Valley one, I think it’s the best one out there for sure. So you can go to Paleovalley.com slash Hormonehealingrd, check out the organ complex, along with all my other favorite products from Paleo Valley, we have our first case study this week. I’m doing a little case study series. You guys all request case studies. I know you love them.

Amanda Montalvo [00:02:18]:

I know. Especially inside Patreon. My patrons love case studies, and I decided to do a little series. So we’re going to have three total this week. I’m talking about thyroid because that was the most heavily requested inside Patreon. And then we’re going to have a digestion gut health case and then we’re going to wrap it up with a fatigue energy concern case study. So we’ll be talking about hair tests, clients history, lots of fun stuff. And joining me for these case studies is my clinical nutritionist, Erin, who’s been with me for over two years now.

Amanda Montalvo [00:02:55]:

And yeah, erin, do you want to give a little bit of your background and what you do at Hormone Healing RV?

Erin [00:03:01]:

Yes. Hello, everyone. Super excited to be here. It’s wild to be on the podcast, even crazier that I’ve been working with Amanda for a couple of years because it feels like two weeks and also, like, two decades. But you might recognize me from Kajabi questions or doing results reviews. Just doing a few different things on the Hormone Healing Rd team. And then I also take one on one clients. So super excited just to talk through.

Amanda Montalvo [00:03:33]:

This case study with yeah, so and Erin’s also a horse trainer. She’s very cool and interesting outside of all of the nutrition stuff. Whenever I tell people that, they’re like, really? That is amazing. I’m like, yeah, she’s pretty big deal in the horse training world, which is just like, random.

Erin [00:03:53]:

And I have a bunny. Those are my two claims to fame.

Amanda Montalvo [00:03:56]:

She’s a very cute bunny that my daughter loves. But yeah, I’m excited to have her here today. She works primarily one on one with our clients and supports people inside the course. So, quick summary of this thyroid case. We’re going to cover her main concerns that she came to me with Tina. Her real name is not Tina. She gave us permission to share everything, but she was like, Just change my name. So, Tina, her main concern was thyroid health and specifically Hashimoto’s.

Amanda Montalvo [00:04:26]:

So she did have a Hashimoto’s diagnosis. She had very elevated antibodies, and she did a hair mineral test through the Master Minerals course, very high calcium. And she made a bunch of changes, but she was like, I’m still not where I want to be. I need some support. So she did some results reviews and one on one work. And we worked on rebalancing her calcium mostly through nutrition and lifestyle because stress was like, a big one for her, which we’ll get into. And then that really helped with her energy, and that was a big part of it. We eventually did gut stuff, which we’ll talk about, and that all helped bring her thyroid antibodies down and just support her metabolism in general, because that high calcium was definitely really weighing on her metabolism.

Amanda Montalvo [00:05:10]:

And so even though she was like, I feel like I’m doing all the right things, she experimented with a lot, which we’ll talk about. I think a lot of people will relate to this. It was just like a few smaller Tweaks and then really was digging in to that gut health, because when you have that autoimmune condition present, that’s huge. But stress is too. And her antibodies produced even with working on stress and nutrition and then just working on that gut health piece took it a big step further. So that’s what we’re going to dig into first. Her main concerns outside of the Hashimoto’s were that she had to continue to increase her thyroid medication. That was a big one for her.

Amanda Montalvo [00:05:51]:

And she’s like, and I’m still not feeling like that really messed with her. She’s like, I feel like it’s not working. But she was way too scared to reduce the dose with her doctor because then she was afraid she’d feel worse. Her cycle had continued to shorten and shorten. I mean, she was in her 40s early, like late 30s, early 40s over this time span. So, I mean, that really shouldn’t have been a big concern around this time. Definitely thyroid related. She had no libido, no libido, which was like, that can really affect your life, and very low testosterone levels.

Amanda Montalvo [00:06:25]:

And it’s interesting because the low testosterone had been happening for way previous to the Hashimoto’s diagnosis. And a common root cause of low testosterone, especially in women, is hypothyroid. So those were like her big things. Again, she felt like she was doing everything right. She experimented with a lot, but she just kept seeing that shortening cycle antibodies kept creeping up no matter how much she increased her medication. And then joint pain, her joints were really starting to bother her. And she’s young. I’m like, this is not you getting older, which is really what the message, unfortunately, that her doctor conveyed.

Amanda Montalvo [00:07:02]:

Do you want to talk about some of the things that she experimented with previous the course and working one and 101?

Erin [00:07:09]:

Yes. And this is something we see with so many of our clients, is that they continue to try to increase their thyroid meds. They keep going after certain supplements or after certain protocols and not really addressing the root cause of what’s causing the hypothyroidism or Hashimoto’s in the first place. So that’s one of the big things. Just talking through Tina’s case and how we approach things on this team is really going from a root perspective rather than doing like, okay, try this diet and then try this supplement. While those sometimes have a place, of course food is very supportive. Supplements can be supportive. We don’t want to mask anything by doing either of those things.

Erin [00:07:52]:

So a few things that Tina tried, she did an autoimmune paleo diet, which is something that we see very often in thyroid cases, especially if there is a piece with elevated antibodies and then also low carb and keto, which it’s pretty common in our clients. People will do keto and they will be like, oh my gosh, I feel awesome for six to twelve, even maybe 18 months. And then they sometimes crash and burn. And typically we see people or women feeling better when doing keto because you often are running on stress hormones and cortisol feels great until it doesn’t. And then she also tried intermittent fasting, which can result in similar outcomes from doing something like low carb or keto. Welcome to Just a lot. She was an athlete.

Amanda Montalvo [00:08:46]:

She was like a very active person, like strength and conditioning. CrossFit took her dog, like, hiking constantly. So I’m like, ma’am, these are not things that we want to do.

Erin [00:08:57]:

Yes, please don’t do fasted workouts. Please don’t fast. But also fasting workouts is just like pouring gasoline on a fire already and then already mentioned a little bit about supplements. But a laundry list of supplements probably now has a supplement graveyard, and many of them were to reduce stress, which we’re not automatically against supplements to help with stress responses. If you are in an acute stressful season of life and you just need a little bit of additional support. But our concern comes in when you have to continue to use supplements in order to have an appropriate stress response. And it’s a chronic thing. So like, oh, I’ve been taking ashwagandha for two years or else I don’t sleep.

Erin [00:09:43]:

Because then we want to start to discuss, okay, well, why is your stress response not working in the right way? And we’ll talk more about things to consider when it comes to those. Amanda and I have been very big into circadian rhythm stuff, so we’ll jump into that dive a little bit deeper in a second. And then she did also try bioidentical hormones as well. So again, many of the listeners probably recognize a lot of these things that she tried, but as Amanda said earlier, she just wasn’t feeling better. She continued to try to increase her thyroid dose and it just wasn’t getting her to where she wanted to be. She was still fatigued, still had gut issues, and just wasn’t thriving. So when she came to the team and started doing results, reviews, went through the course and then started working one on one, one of the first things she did and one of the first things that we do with every client that we work with that we see one on one and encourage everyone who goes through the course to do is to work on the stress timeline. And the goal of the stress timeline is just to highlight stressful events in your life and see how they may correlate to some of the health concerns that have come up.

Erin [00:11:02]:

This isn’t meant for you to put everything stressful on a piece of paper and then get stressed about all the things that have happened to you, but instead to make connections between, oh, hey, I went through a really stressful season and then I noticed that I was having a little bit more hair loss. Or wow, I had a really hard loss a few years ago and that’s when my digestive symptoms popped up. Because many times physical symptoms are going to be related to emotional things that happen or mental things that happen. So it’s really powerful to be able to say, hey, these symptoms didn’t necessarily come from nowhere. They probably have a root in something that I was experiencing in my life. And Amanda talks about this a lot in the Master minerals course. But some things to consider when it comes to the stress timeline are not necessarily things we will think about right off the bat. Like, what was your birth experience like? Did you have a C section or were you naturally born? What was your childhood like? What were your teen years like? How was it even applying to college or going to college? How was your transition out of college? Did you feel like you were able to transition well into your adult years? How are your relationships through all of those seasons? So those are things, like, I’ve noticed in my clients that big transition phases in life are often when it’s easier for us to neglect certain health aspects.

Erin [00:12:26]:

And even I see a big piece of that when it comes to college into adult years, because you’re like, oh, yeah, I was living at home and I had food available to me all the time. And then you get to college and it’s like, oh, yeah, I stopped eating consistently because I was so busy and I was in sports and I was doing all these things. And then that just carried through the adult years. And then, of course, other things to think about are illnesses either for you or family members, living situations, good or bad, family dynamics, school, your home environment, and then relationships like divorce or breakups. And then, I mean, the list is endless. But pregnancy, postpartum kids, all of those things, and really just giving yourself time and space to think through that, because not many of us do. And again, this is meant to be done in a way that’s empowering and not like, oh, my gosh, look at all the bad things that have happened. Because the work that we do with our one on one clients, the biggest thing is that our bodies are resilient.

Erin [00:13:28]:

We are able to respond to stress if we support it in a way that our body has the energy and the nutrients that it needs to respond to that stress. But sometimes the first step is being aware of the stress that yeah.

Amanda Montalvo [00:13:41]:

And like, for Tina, I think about when I was going through her stress timeline when she did her first results, very we see this a lot. Very common response. Part of why I chose her case, she was very like, I didn’t even really think I was stressed. And she wasn’t in her current day to day. Right? She had done so many things to reduce her stress and worked on relationships and stuff like that, but she’s like, I really just completely forgot about everything from her past. And she had a lot of big past stressors, like divorce. It happened when she was much younger. So she’s like, I mean, it had been ten years, so I didn’t really think anything of it now.

Amanda Montalvo [00:14:27]:

Right? Moving. She was previously moving a lot before she got settled in her current home, job changes, a sick family member that she was not full time caring for. But between her and other siblings, they’re all managing and caring for this family member. And when she looked at that timeline, and she’s like, that’s like right around when I was diagnosed with Hashimoto’s, and she was able to see okay, because even when she was diagnosed, if you saw her, you’d say, oh, she’s healthy, she’s thin, fit. What society tells us is the picture of health. Right? That definitely would have been her. So it was one of those things where she was in complete shock, and it really threw a for a loop. That’s why she immediately started researching and trying to figure out what was going on.

Amanda Montalvo [00:15:14]:

But when we looked at her current stressors, it was more of like, okay, definitely wasn’t eating enough. Very consistent eater, but not eating enough food. Over exercising, for sure. She was addicted to intense workouts. It was like she could not take a rest day. I was like, this is and it’s okay. Right? It’s important to recognize. And it was one of those things where that was one of the last things that she changed.

Amanda Montalvo [00:15:38]:

Because if you think about the nervous system, and if you have not listened to my episode with Irene Lyon, run, Don’t Walk, listen to that episode. It’s so good.

Erin [00:15:46]:

Agreed. You got to do it.

Amanda Montalvo [00:15:48]:

It’s so good. I’m like, I need to have her on 90,000 more times. But if we think about the nervous system and I knew for her, I knew it was going to be very difficult because her body’s used to being in that fight or flight, right? So for her to take a rest day and not have that intensity, it’s uncomfortable. She would take a rest day from the gym, but then she’d go for like a super long run with her dog and be exhausted after that. But if she didn’t do that, she didn’t have those endorphins, those stress hormones. She felt very uncomfortable. And so that was like a really big thing for her. So we could see a lot of stress in her day to day.

Amanda Montalvo [00:16:21]:

She had some light stuff going on, but she had a lot of things that were good. And this is what we always like to highlight first, because I feel like people are always wanting to change things, like, what should I do differently? I’m like, yes, we will get there. But also, let’s talk about what you’re already doing really well and that we do not have to worry about. But I like to make sure people know so that there’s just so much health information out there. It’s very easy to not recognize that something you’re doing is really good. For yourself to see something that’s like the opposite online and then to be like, oh, I’m going to switch to that because that’s better. Whereas for her, for example, she was a very great, consistent eater. She didn’t eat enough food, but she never skipped meals.

Amanda Montalvo [00:17:02]:

Food was a priority for her. She enjoys food. It just wasn’t enough overall. So I was like, this is very important. Do not stop doing this. Because she had experimented with intermittent fasting. She felt terrible. But what, her doctor recommended it.

Amanda Montalvo [00:17:15]:

I was like, really? For the low testosterone? I was like, what? This makes no sense. And she knew that about herself. And she was good at listening to her body once she really tuned in. So that was it. She goes outside every day with her dog, right? That was a huge priority. Outside time. She spent a ton of time outside in the weekends. She loved it.

Amanda Montalvo [00:17:37]:

She’s like, if I didn’t have to work all day, I’d be outside all the time. So that was easy because she enjoyed it. She made time for friends and family. She had good close relationships and supportive people in her life. And I’ll tell you what, this is, I think, a really big one for a lot of people that makes them struggle with their and this is something I talked about with Irene in that episode, about how we are wired for connection. Humans are made for connection. It’s incredibly healing being within a community. And so that’s something know, if that’s something that someone’s really lacking, it’s like that can have a huge impact on your health if you’re never connecting with others.

Amanda Montalvo [00:18:14]:

So that was really good. I highlighted that. And she had a job she enjoyed. I remember at one point, it got really stressful because they changed some things. And I’m like, Why don’t you just talk to your boss? Because I’m like you’ve been there forever. You should have a conversation and just see. And it all worked out. But it can be really hard to do that.

Amanda Montalvo [00:18:32]:

But that’s like a very easy thing for me to say versus her actually doing it. But I was like, you love this job. You used to love it. So I think that obviously makes a big difference. I used to hate my job when I worked in the clinical setting, and it was a struggle to get through school because it was like conventional Rd school, and I was already working on functional medicine stuff. So that was very difficult and draining mentally. And I think that took a toll on my health. We’ve had clients where they’ve hated their jobs, and it’s like a big stressor.

Erin [00:19:01]:

It’s so hard when we have clients and it’s not I mean, we don’t want to come on this podcast and be like, quit your job. Because we’re also realistic. And I say that from having clients who I’m like, oh, my gosh, quit your job. But I can’t say that, but it is a reality of like, if you are spending 8 hours of your day just stressed, it’s like, okay, what shifts can you make within that job? Does it require you to have a tough conversation, but you’re able to work something out? Or is it to the point where you’re like, oh, wow, I didn’t realize the toll this really was taking on my health, and maybe look for something different or even just changing within the job that you have. And one thing that I like that you mentioned Amanda, about Tina is that she was good at listening to her body. And that’s just one thing. Whenever we start to work with someone and start to make lifestyle adjustments or supplement adjustments, but we start with the lifestyle stuff first. Is it’s pretty common for us to see someone who’s like, okay, give me the protocol.

Erin [00:20:00]:

And we’re like, okay, well, we’ll have things for you to implement, but what happens if you try this and let’s see how you feel. Even just making a small adjustment, especially with someone like in Tina’s case, who’s been running on these stress hormones, who’s addicted to these hard workouts, who’s go, go, we can’t take a rest day. It’s not sustainable. And it’s not fair to her or to her nervous system to be like, hey, we’re going to change everything at once. Because that can be just as damaging sometimes, especially if you’re stuck in a certain nervous system state, which, again, just go listen to the Irene podcast and it’ll all make sense.

Amanda Montalvo [00:20:37]:

And the one I do with Alyssa Chang, we talked about that a lot, too, and about how, yeah, do we want to be out of the fight or flight state or supporting our body into a more relaxed state? Yes, but if you’re never in that relaxed state and it’s incredibly uncomfortable for you, that’s not going to be know.

Erin [00:20:53]:

Yeah, definitely. So Amanda touched on the things that she was already doing well, and then to talk about just a couple of the things that we wanted to work on again, from a foundational perspective, are very simple. Many times free things to implement from a day to day, which, when we recommend these to clients, they’ll be like, but wait, this is so simple. Which doesn’t necessarily mean they’re easy. But one of the first things was really addressing light hygiene when it came to Tina’s schedule. So it was pretty common for her to stay up late watching TV, which, we’ve all been there, we’re binging something on Netflix. But it was pretty just chronic for so, especially given just her overall stress levels and then low hormone levels. So getting light first thing in the morning was one of our very first recommendations.

Erin [00:21:48]:

And I mentioned earlier that Amanda and I are really into just circadian rhythm and getting light first thing in the morning and how many downstream advantages and benefits it has to so many things in our health. We could talk for 3 hours about all the things.

Amanda Montalvo [00:22:04]:

We’re going to do a podcast on it, we’re going to do one on it because it’s like people don’t understand for hormone health especially, you literally need that light to start that pregnant alone, which is like our parent hormone conversion. So it’s a big deal. Light hygiene is a very big deal.

Erin [00:22:21]:

It’s everything. Yeah, we can argue it’s everything. So getting light first thing in the morning is especially important. And some of you listening to this might be like, yeah, but I work or this happens, or I get kids to school, and it can be the best that you can do. So it’s like, okay, ideally around sunrise, there’s a great app called Circadian that Amanda told me about, which you put in your location. It can tell you when an ideal time is to get out in the morning for those UVA rays, which are really what kick starts that pregnant alone, everything downstream effect. And if you can only get out for five minutes in the morning, that’s great. Start eating breakfast outside, something super small, or like, try not to go on your phone right away in the morning and instead sit in front of a window.

Erin [00:23:09]:

Little things like that can make a huge difference in all of your hormone pathways throughout the whole day. And again, this is just deceivingly simple because it’s so easy, but it really does make a massive difference in energy levels. So that was the first thing, again, just getting light first thing in the morning, making sure she was eating more and reducing restrictions around food, especially given the history of just trying all different diets. She did intermittent fasting for a little bit, but Amanda already said she just did not feel super great on that. So she was good at eating consistently, but just needed a little bit more meal density. And then the other big one was lots of time scrolling on her phone, especially right after waking, which I touched on a little bit when I was talking about getting outside, not going on your phone right away, but instead of when we work with clients, instead of us just saying, like, hey, don’t do this, don’t do this, don’t do this. We really like to approach things of like, okay, this is what you’re filling your time with. Maybe scrolling on your phone, is there something that we can replace it with? So no one in all my days of working one on one, no one’s like, yeah, you know what really fulfills me? Spending 45 minutes on instagram mindlessly.

Erin [00:24:29]:

No one’s like, wow, I’m really happy I did that.

Amanda Montalvo [00:24:33]:

Thyroid health is essential for healthy hormones, digestion energy, and more. Our thyroid is so important because it sets the metabolic pace of our body, which controls how every single system functions. Whether you think you may have some thyroid dysfunction going on based on symptoms you may have or have a confirmed diagnosis, chances are you haven’t been given the best tools to address your thyroid health. I’ve been there. Thyroid is a big part of my health journey and something I’ve been optimizing for the last decade. I’m very passionate about this topic, which is why I created a free thyroid training that walks you through how to assess thyroid health. All the labs I do cover blood work and what the optimal ranges are. I just want to say that I think we have to look beyond blood work when it comes to assessing our thyroid health.

Amanda Montalvo [00:25:16]:

That’s why I also cover hair mineral testing, urine testing, and then basal body temperature, which is a measurement you can do at home to assess your thyroid health. I’ve had so many people reach out and say they can’t believe that this training is free. I promise you won’t be disappointed. I also cover nutrition tips for optimizing thyroid health. You can head to the link in the show Notes or to my website Hormonehealingrd.com to watch the training. There’s just so much lacking when it comes to helpful info on thyroid health. So I’m really hoping that this training helps you and fills that gap.

Erin [00:25:52]:

So it’s like, okay, let’s kind of reverse psychology and be like, what do you want to make more time for? Do you want to read more books? Do you want to listen to more podcasts? Do you want to spend more time with your husband? Do you want to talk to your best friend more? So think of the things that you want to do and then say and all those things that you think like, hey, I don’t have time to do that. Like, oh, I’m a busy mom or I run a business, or all these things. But then you can be like, okay, maybe I would have time to read for 15 minutes every morning if I didn’t grab my phone or I can go to bed and read rather than scroll on my phone. So for Tina, she did want to read and then do a few other Hobies things that she enjoyed. And so she decreased her phone time by waiting until after she had gone outside, so got UVA rays right in the morning light outside, and then she had breakfast and then she was able to use her phone. And for me personally, when I wait to use my phone, I’m so less grabby for my phone throughout the day, even if it’s just those 1st 15 minutes and then otherwise. Amanda mentioned this was one of the last things for her to change, which is fine. Again, we want to do this in a stepwise, gentle, sustainable way, but really working on implementing rest days and then reducing exercise intensity just to see if it helped with her hormones in general, because a lot of times she would work out fasted, which was very stressful.

Erin [00:27:23]:

So. She started just by having a snack outside or by a window, depending on the time of the year, to get that morning light, then would eat a fuller breakfast after the workout. So, again, that was just a slow implementation. We did all of these things at once. You have to be picture perfect habits, but it’s like, what can you implement slowly in a sustainable way that’s going to be supportive for a long time?

Amanda Montalvo [00:27:50]:

And the funny thing is, we haven’t even talked about her hair test yet, right? So we are going to talk about her hair test next, but I think it’s very easy to see. This is why I want to do these case study ones, because a lot of times people are like, what do you mean when you talk about the foundations? The beginning of this podcast season, I think it’s season five. Yeah, that’s terrible. Yeah, it’s season five. It’s just been a long season. So I think that’s why it’s confusing in my head. But at the beginning of this season, I’m like, I’m going to go back to the foundations. I have the episode on how to eat for your hormones.

Amanda Montalvo [00:28:24]:

I had the episode on Cortisol, we have the episode on Digestion, we had episodes on supporting gut health. We talked so many foundational things. This is what I mean, looking at someone’s day to day, like how they live every day, making small changes. You don’t have to do testing to do that. And I think you should do this before you do testing, ideally. Right? So this happened over like three to four months. Now. She did have her initial hair test from when she first joined the course, so she was working on some stuff, but we didn’t retest right away.

Amanda Montalvo [00:28:57]:

We went through her initial hair test and that’s what I’ll dig into now. But even before we went through the hair test with her, but it was like, I’m like, we’re not going to do anything based on these test results because we already have so many things for you to work on without even seeing your hair test. So I like to do that first, because, again, if we’re going to implement things like supplements and you don’t have the foundations in place, I just feel like it’s like throwing out your money. And for some people, I know they can be very helpful regardless. I know that I know that from a personal experience for myself, but it makes far more sense for me, for someone’s long term health, to work on the foundations first and just to be less stressed and see results. So her initial hair test looked like she was very stressed was the theme, right? She had very high calcium. Her magnesium was also high, showing a loss, showing that she is definitely stressed. She’s burning through a lot of magnesium, very low sodium and potassium.

Amanda Montalvo [00:29:57]:

This is a very common pattern that we see, too. Those are like the macro minerals, calcium, magnesium, sodium, potassium. And those are the minerals we want to focus on first. When we’re thinking about, how can I optimize my minerals? Those are the ones that are going to have the greatest effect on others. So when she was a slow metabolic type, having this high calcium, low sodium potassium, this is not surprising because she’s in that more, like, depleted stage of stress. Her metabolism has slowed down, and we saw that with all of her symptoms, right. The energy piece, the feeling like sluggish, not recovering from workouts well, low sex hormones. Her cycle changes.

Amanda Montalvo [00:30:35]:

No libido. She did not handle stress well. She was definitely more in that exhaustive stage versus actively dealing with stress. So she had active stress, but her body’s, like, past that point. It’s like, we’ve been dealing this for so long that we’re more depleted now, which that’s what happens with minerals. It makes sense. So we wanted to work on those things with her first, sodium. Potassium.

Amanda Montalvo [00:31:00]:

Very easy ones to implement. We focused on potassium rich foods, which is like a ton of animal plant foods. You can get it everywhere. Potassium. You can get potassium in red meat, salmon, pork, chicken. I mean, it is in pretty much all foods in some amount, but it’s in higher amounts in like, salmon, beef, stuff like that, dairy products, and then things like root vegetables, fruit, cooked greens, like certain cooked greens. Beans are another great source. And then, of course, things like coconut water, aloe vera juice.

Amanda Montalvo [00:31:30]:

So that was really our first focus, which was helpful for her because she was struggling with constipation, which she didn’t even have as a main complaint at first because she thought it was normal to not use the bathroom every day. And we see that a lot too, right? So potassium is so helpful for constipation, so upping that she’s like, man, I’m having a bowel movement every day. I feel good. And I’m like, you’re supposed to be having bowel movement every day, so that’s good, right? Normal. So that was like a big one, and that was like a quicker win. And then we looked at the rest of her test. We were focusing for that. Calcium.

Amanda Montalvo [00:32:06]:

A lot of people are like, how do we get calcium down? We were primarily focusing on stress for that because I truly think that a lot of her increases in minerals were related to stress. She also had very high zinc, so we knew and very high cobalt. And those are signs of, like, gut liver. Right. We knew that she was not taking a zinc supplement, so it definitely wasn’t from that. And she has the autoimmune hashimoto’s history, so there’s pretty much always a gut component with that. I’ve never had a client that hasn’t had, like, where we worked on gut stuff, and it has not that was we knew, like, okay, that’s a big red flag. I always want to work on that with someone that has an autoimmune condition anyways.

Amanda Montalvo [00:32:47]:

But when I saw that zinc, I was like, okay, we’re doing a stool test. And then the high cobalt, which is a sign of liver stress, also can be a sign of poor digestive capacity. Like, she’s not making enough stomach acid. She was taking some b. Twelve. She was taking a million supplements. I think there was a B complex in there because that was the other thing where I’m like, well, that could also be raising your cobalt as well, if you’re not breaking it down well. So those were kind of like the major things.

Amanda Montalvo [00:33:17]:

And then her iron, her iron was high, and she had also high chromium. The high zinc is a sign of inflammation with iron. And then, of course, the liver stress, right? Because we store excess iron in our liver. So it was basically like, stress is number one. We knew we were going to have to work on iron because she had gut stuff, we’re assuming, right before we did any testing. And elevated iron is a huge issue if you have autoimmune disease. I recently was going back with an older client who I saw again, just to check in and stuff, and I saw her iron because we had her iron tested. I saw her iron previously from 2015, before we worked together.

Amanda Montalvo [00:33:59]:

And it was so high. And I was like, oh my gosh. And she was like, yeah, that’s when I got diagnosed with Graves. And I was like, oh, okay, that makes sense. So she was like, opposite on the spectrum. She’s hyperthyroid with Graves, but still very interesting case. I should do a Graves case study. I get a lot of questions about that.

Amanda Montalvo [00:34:20]:

But iron can play a huge role in pathogenic growth in the gut, inflammation in the body, and of course, that can contribute to autoimmune stuff. But those were her very big things. She did have some low phosphorus, which is signs of not enough protein undereating, things like that. But those were the big things that we were like, okay, we absolutely have to work on these. But again, we had to work on the stress stuff first, eating more, all that kind of stuff. We had to do that first in order to make anything else effective.

Erin [00:34:50]:

Yeah, all that lifestyle stuff before doing the sexy stuff of like, hey, do this and this and this, and then otherwise for additional interventions based, again, on her hair test, which I do find it funny. We talked like 30 minutes before we even got into the hair test, but welcome to the team of like, when I prep for results, reviews, or like one on ones, I go through intake forms first, and then I have like, ten recommendations. And then I’m like, oh yeah, we have testing to look at too. So again, really big on lifestyle changes that we can make first. So then whatever food or supplement changes you make, you get more bang for your buck, pretty much. So for Tina, Amanda already talked about just increasing potassium, and we can do this very easily from whole food sources. So that was one of the big focuses for Tina, just given her hair test results with that lower potassium. And then we did recommend she stop pretty much all of her current supplements.

Erin [00:35:52]:

Again, we aren’t anti supplements here, but we do want to be really intentional about the supplements that we use, because everything we put into our body, our body has to process. So if you’re taking ten supplements, one, it’s expensive, it’s a lot to just manage, and it’s a lot for your body to process so many times that’s one of the first things we do with a lot of people is try to just decrease the amount of supplements they’re on and be really intentional about the ones that we do recommend they take. And then liver support, which, when we were prepping for this podcast, I was trying to think, I was like, I don’t know if there is a single client that I have had that we have not done. Liver support. I know in some way, shape or form, the liver is the unsung hero of our body. I think it just does not get enough airtime. So shout out to all that it does. But for specifically Tina, we do a lot of thyroid hormone conversion in our liver.

Erin [00:36:50]:

So that was important given her health history, her main concerns, as well as the fact that on her HtMa, there were a lot of signs of that liver stress. So we recommended some liver support. And when Amanda and I talk about liver support and Amanda has a whole podcast, is that in this season?

Amanda Montalvo [00:37:09]:

Season five, yeah, because I have an older episode, but like, redid it and it’s much more like, yeah, okay, so.

Erin [00:37:18]:

Like, if you want to learn all about the liver, you can go there. But it’s nothing crazy. We’re not doing some crazy liver detox where you only drink juice or something for three days, but it can be like doing milk thistle, for example. Again, Amanda goes more in depth on.

Amanda Montalvo [00:37:33]:

How I just made a note. I’ll link it in the show notes so you guys can listen.

Erin [00:37:39]:

So liver support for Tina. And then even though we did decrease a lot of her supplements, one supplement that was recommended was Mega IgG 2000 just to support her immune system since she likely had gut issues. Given again, her health history, where she was like, oh, wow, I’m having a bowel movement every day, which was not normal for her to have a bowel movement. She struggled with constipation for a long time. So the Mega IgG was able to support her gut health and her immune system because most of our immune system does live in our gut. And that also helped prep her and just give her a good foundation because she knew that she wanted to eventually do a stool test given her gut health history. And then another specific supplement was using boron for joint pain, which is something that I don’t want to say we use a lot, but if someone does come to us with joint pain and it’s reflected on their hair test, that can be really helpful for giving them symptom relief from their joint pain. And then boron is also important for keeping calcium and magnesium inside the cell.

Erin [00:38:47]:

Amanda has a whole boron podcast, so you can give that a listen if you want to learn all about boron. And then overall, again, increasing protein intake, just making sure she’s eating enough, and then supporting her digestion with using digestive support. So most commonly, we will recommend either doing digestive bitters or even apple cider vinegar. Those are our most commonly used digestive support additions, which are pretty easy to get, and a lot of people tolerate them. And those are designed just to support your body’s digestion. They’re not meant to replace your body’s digestion, which sometimes we will utilize something like digestive enzymes in particular cases. But we do prefer to start just a little bit lower and do digestive bitters.

Amanda Montalvo [00:39:39]:

Yeah. And for the boron, she had none. It was so low that it wasn’t detectable on her hair test. So that’s one where it made sense. I was like, we’ll just see, because her joint pain was really bad. It’s also really important for iron as well. And I knew we hadn’t done the blood work yet, but I’m like, I know that her iron is going to come back very high, and it did. So that’s like a little more on that.

Amanda Montalvo [00:40:02]:

You know, someone on my comment on my YouTube on the Boron episode and said it was like, boring and I’m not a good host and all this stuff. And I’m like, Man, YouTube. I’m like, funny because people love that episode, but thanks.

Erin [00:40:15]:

Also funny because wasn’t the title of the episode, like, nothing boring about boron.

Amanda Montalvo [00:40:20]:

I know. I was like, okay, thanks, sir. I was a guy. I’m like, okay, I’m boring. I’m like, it’s packed with research, but okay. So that was like her first hair test. Those are interventions we made. Again, nothing too crazy.

Amanda Montalvo [00:40:36]:

So we did do some other testing from here, but even just from this. So from making her foundational changes that we went through before, like eating more, all that stuff, light exposure, making changes in exercise, all those things. Most of that reducing her stress, right? Like slowly shifting that nervous system. And then we added some stuff for gut support and everything that Erin just went through. The next session is highlighted. Is healing ups and downs? Because I just feel like people only highlight the ups and I’m like, that’s not usually how it goes on the healing journey. There’s always some frustration. So she saw a ton of improvements right away.

Amanda Montalvo [00:41:16]:

Very common. Right? So she saw a lot of improvements in energy. We talked about her bowel movements. That was, like, night and day for her and her mood. And I think the mood was a lot of the light exposure. She got addicted to going outside more in the morning because she loved it in the afternoon. She’s like, I honestly never thought she’s like, I thought I spent plenty of time outside, but she’s like, I was really missing out in the morning, so that was funny. And then working on the phone stuff, I just think that really helped with her mood and everything, which, when that shifts, it’s like, it’s a lot easier to see improvements in other areas, like having better digestion, being able to sleep better, you’re less stressed.

Amanda Montalvo [00:41:52]:

So that was huge. She improved her relationship around food. She didn’t realize she had so much fear around food because we’d talk about introducing new foods from this restrictive history, and it would really stress her out. And I’m like, that’s okay, whatever you feel comfortable with. We don’t have to go crazy. And she was like, I had no idea how much food is stressing me out. So that was, like, a huge eye opener. Kind of a hard one at first, but ultimately, she’s like, she doesn’t even blink an eye at food now.

Amanda Montalvo [00:42:22]:

She doesn’t freak out over anything. She did have some reduction in her joint pain. It did take two months. So, again, while I can say that now, it’s like, when we were in it, it was hard for her because she’s like, I don’t know if the boron is working. I don’t know if the changes are working. Like, I’m in a lot of pain. So that’s just, like, a good reminder. Her antibodies went from over 700 to below 200 in six months.

Amanda Montalvo [00:42:47]:

That was huge. They were undetectable by the time we finished working together. So once we got all the stools test stuff going on and her cycles, they were still short for a while, right? That was another main complaint. And we’re always trying to check in, like, okay, what are we working on? Are we seeing progress there? If not, what are we going to change? And for the first three months, it did not change. One of them was even shorter. She had one of her shortest cycles. And I’m like, take a deep breath. It is okay.

Amanda Montalvo [00:43:15]:

And then once she got to that four month mark of working on foundations, we hadn’t even added in, I don’t think, any Mega IgG or anything yet. Then she was like, okay, I had, like, a 23 day cycle. That was better. She rounded out. Like, she finished with us at a 27 day cycle, which is a huge win for her. I mean, she was, like, 20 days or less, and I think that was having a huge impact on her hormones and her mood. So that was big, but I would say it’s not like a down, but like a struggle. Was the libido same thing as joint pain, but it took even longer and it took her really making changes in exercise because remember that’s that fight or flight, that’s like her burning the candle at both ends and it’s going to have a huge impact in her adrenals.

Amanda Montalvo [00:44:02]:

And her body fat increased a little bit, which she was okay with it, but she’s like, how much is it going to increase? It’s interesting because her weight didn’t change, like an insane amount, but it was like, that was hard for her. Clothes fit differently, but she was like, I actually have a libido, which was huge, but that took like almost a year. But everyone has to go at their own pace. That’s why some people make changes really quickly. Maybe they gain more weight in the beginning, but they feel better for her. I was like, we should really do this slowly. I can tell by your personality this is going to be better if we do this slowly and that it wouldn’t. I also think it’s less stressful on the body personally when you make changes slower, but everyone’s on their own journey.

Amanda Montalvo [00:44:50]:

You have to do what works for you. And those were kind of like some of the bigger ups and downs from working on hair tests, foundations, those sorts of things. Anything you want to add before I talk about the other things that we did after?

Erin [00:45:04]:

Yeah, I think the big one was just that cycle piece of how it did take some time for it to shift. And if we had a dollar for every time we said this, but the last 100 days impacts your cycle. And once you kind of start to get in this space and you start to realize, like, wow, my cycle does communicate a lot about how my overall health is doing, like cycle length and just period pain and all those things, it can turn into like, wow, I’m empowered because I know all these things about my cycle. And then it can pretty quickly shift to like, oh my gosh, I had a really short cycle. What’s going on? What’s wrong? And then you might have a series of short cycles and then it can just lead to more stress. So that’s just one thing that we see a lot with our clients, is it can take time for it to adjust, especially because it is going to respond to things that you are changing and it might not necessarily respond in the way that you expect it to. So if someone starts to get outside in the morning and they start to have better moods and better bowel movements and overall things are getting a lot better, they might be like, oh, great, all my period concerns and my cycle length and all these things are going to improve as well. But it can take time for our hormones to balance out and for our cycle to just normalize, too.

Erin [00:46:21]:

So that’s one thing that if you do start on your healing journey or you’ve been on it for a while and your cycle starts to get a little wonky, sometimes, that’s a good sign. And it can also be like, okay, let’s look at this with curiosity rather than criticism and then just really getting stressed about it. So that’s something I see a lot in my clients. And we always say, like, okay, let’s take a deep breath and let’s look at what happened these last 100 days. And 99% of the time, someone does that and they’re like, oh, yeah, this happened. And that was only two months ago.

Amanda Montalvo [00:46:55]:

Yeah, that’s like, a very important thing to highlight. And I think curiosity is so important on the healing journey. I have a video on this inside the course, because I’m like, this is something where it can really help you versus constantly being in a state of fear around healing and questioning. Is this going to work? Is that going to work? I’ve tried all these things. Or if you have a weird response to something, it’s like, okay, let’s take a step back and let’s try to see what is my body trying to tell me? Is it getting what it needs? Does it like the changes that I made? Is there something I can do differently? But not living in fear while healing, I just think that puts us in that chronic state of stress, and I think it makes it pretty much impossible to heal.

Erin [00:47:42]:

Impossible to heal. And like you said, Amanda, too, I don’t think enough, which welcome to the Instagram highlight reel of our lives of if you are in the healing space or you’re following pages, people don’t talk about the, oh, hey, I didn’t have a good reaction to this. It’s only like, oh, I’m on my healing journey and everything is perfect now. So it’s like, no, we are going to expect or like, I got this.

Amanda Montalvo [00:48:04]:

Result in this much time. And it’s like, okay, that’s amazing, but also you’re not hearing about all the other things that happened while they were on the journey of getting that result or what other aspects of their health are like. So it’s hard. It’s like, I’ll see all these things about, like, my client healed this in 30 days, and it makes me want to vomit because I’m just like I don’t know, I just feel like it’s not ethical.

Erin [00:48:31]:

So many things that just go into it. I read an interesting article once of treating our health like a meritocracy, of like, if I do this, I’ll get this, and that’s impossible. If it were that easy, we would not have jobs where it’s like, there’s so many things that go into health, and that’s also too we’re literally on a health podcast. But it’s also like, okay, well, what are you focusing on outside of your health because you don’t want to get.

Amanda Montalvo [00:48:58]:

Obsessive either, because a lot with people.

Erin [00:49:02]:

A lot. My favorite question is, what are you doing for fun? What brings you joy every single day? And if it’s five minutes listening to your favorite song, cool. If you can’t even think about what you do for fun, just take a second to reflect on that question because that’s not discussed enough either.

Amanda Montalvo [00:49:21]:

In the house space, 100%. Okay, so then after this, we did an iron panel with her because we knew her iron. There was markers on her hair test that showed it was high. And then the GI map, I’m going to cover those inside the bonus episode for Patreon because we are at 46 minutes now, which is I try to cap these, but really quick, we talked about all the positive changes and stuff. We also did see this reflected in her hair, which sometimes doesn’t always happen. I see it more like if you’re retesting too soon, if you’re not waiting, like, a good chunk of time. Because, remember, it took her like three to four months to make the foundational changes. And then we started working on iron and gut stuff.

Amanda Montalvo [00:50:05]:

And so I didn’t have her retest her hair until the nine month mark because I was just like, it’s literally pointless because you’re probably not going to see what you want to see. And we already have plenty of information from these other tests. Like, we have to address iron, we have to address your gut health, so we don’t need you to also do another hair test. Was kind of like the way that I looked at it. And when she retested her hair at that mark, she already worked on supporting iron, supporting gut. So I’m like, this will let us really see where you’re at now and kind of give us a plan, of course, matching up with how do you feel going back to those main complaints? Have we accomplished everything that we need to accomplish? But it was really cool because her calcium, pretty much all the high minerals came down. And so that’s what we want to see, right? Less mineral loss, more bioavailability of those minerals, meaning that her body can actually use them. Everything came down.

Amanda Montalvo [00:50:57]:

Her cobalt that was sky high, her zinc that was sky high. Both of those came down to optimal. Her sodium potassium increased a ton, which is not easy to do. To me, that truly shows that’s how I know that someone has really addressed the stress lifestyle, how they’re living every single day piece. She did have a lot more heavy metals on her retest. This is very common. Her liver was very bogged down before, so she wasn’t really processing much on her retest. She was still a slow one, metabolic type, which is not bad.

Amanda Montalvo [00:51:33]:

Everything was slow versus everything being fast. But she was eliminating a lot of heavy metals, which is likely because she had that liver support, right? Her liver is no longer overloaded with these endotoxins and things from overgrowth and stuff in her gut. So I think you just had more of an ability to handle the heavy metals. Her magnesium was still high, which is a sign of stress still, but I’m personally not worried about it. You’ve made so many changes, and your body doesn’t just like you don’t just finish a protocol and you’re just like, okay, I’m good now. It’s like your body’s still processing things, especially, like, I think, of a gut protocol. We’re supporting liver digestion immune system. Sometimes we’re eradicating getting rid of pathogens, parasites, whatever it might be.

Amanda Montalvo [00:52:18]:

When you stop, the protocol doesn’t just end. You’ve repopulated your beneficial gut bacteria. Everything shifts. So that’s, like, one thing we always try to have people keep in mind, too. But it was really cool to see everything reflected on her retest for her hair. And again, I’m going to go through the iron panel and the GI map inside. Patreon, you can go to healingrd if you want to watch that bonus episode, but I hope this case was helpful. I hope everyone enjoyed it.

Amanda Montalvo [00:52:46]:

Anything you want to add, Erin?

Erin [00:52:49]:

I think the biggest thing is just trying to highlight and empower anyone who’s listening that there are so many simple lifestyle things that you can do that are most of the time free. And it’s not, I mean, as hokey as it sounds, but you’re trying to get somewhere, but it’s like, how can you approach your health and implement little things day to day so that you can thrive and feel your best? And I think that’s also one thing, too, is we can get so entrenched in our healing journey that we kind of forget to look up and be like, wait, what am I actually going after anyway? Like, oh, do you want more energy? So then pay attention to one thing at a time rather than trying to reach this perfect health goal or perfect mineral test or GI map or whatever you’re going after, because I have yet to see one. So that’s not the goal.

Amanda Montalvo [00:53:41]:

It’s not the point. And if you don’t feel good and you haven’t addressed those things, or if you’re so feeling like you have to be so type A and neurotic in order to maintain it, I mean, that’s not ideal, right? So case study number one. The next case study we’re going to go through is gut digestion case, and then we’ll wrap it up with a fatigue case. But I hope you enjoyed this episode and we will see you next week. Thank you for listening to this episode of the Are You Menstrual? Podcast. If you want to support my work, please leave a review and let me know how you like the episode. This lets me know what you guys want more of, less of. I read every single one, and I appreciate.

Amanda Montalvo [00:54:20]:

Them more than you know. If you want to keep learning, you can get access to the bonus episode and additional resources on Patreon.com hormonehealingrd. I’d love to have you in there. Thanks again and I will see you in the next episode.

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

Master Your Minerals

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Hormone Healing RD