Thyroid Disorders and Habit Change with Dr. Emily Parke, DO and Maya Nahra, RD

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Maya:                  Perfect!

Alright, we are live. Good morning, everybody.

Emily Parke:       Good morning!

Maya:                  Here’s Dr. Emily Parke and I decided to jump on a Facebook Live this morning and everything’s being recorded, so if you’re a work, or on the road, or checking your Facebook, it’s all recorded, and it will go into both of our websites and both of our blogs. We would love the attention. We would love to start doing more of these together, but we wanted to pop on today and have a chat on thyroid disorders. And Dr. Parke can certainly go into more of thyroid disorders, some autoimmune disorders, and we can give you some habit tips today, and some nutrition tips, and some medical tips, and everything that you could do to get started.

And just to give you a background, of course, my name is Maya. I’m the founder of [inaudible 00:00:56], formerly Healthy Habit Solutions, and the creator of the Habit and Behavior Change Health Coaching Program, which is now an integral part in Arizona Wellness Medicine, which is by, of course, Dr. Emily Parke.

So, yeah. Dr. Emily, welcome! Thanks for being here!

Emily Parke:       Yeah, of course! Thanks for having me. This is great!

Maya:                  Yeah, totally. Let’s … Well, why don’t you … I gave a quick background. This is on my Facebook page this morning.

Emily Parke:       Sure.

Maya:                  So, why don’t you give a quick introduction to everybody on who you are?

Emily Parke:       Sure. So, as Maya said, I’m Dr. Emily. I’m the owner and founder of Arizona Wellness Medicine. It is a functional medicine and acupuncture practice. So, those of you joining, if you’ve been following Maya, you kind of know what functional medicine is, but just in case you don’t, functional medicine is a type of integrative medicine that’s all about finding and treating the root causes of whatever signs and symptoms are going on.

So, it varies a little bit from traditional medicine because although we don’t forget about traditional medicine things … Because I did go to regular medical school, internship, residency, fellowship, then got trained in functional medicine and certified in functional medicine after that … It really is doing the deep detective work, digging in and figuring out how you got where you are today, instead of just, “Oh, you have this symptom. Here’s this pill or this procedure,” and you may feel better temporarily, but you didn’t really fix the why. You didn’t really fix how you got there to begin with. And so, you’re likely to get either temporary results or no results, but at some point your disease is gonna keep progressing, and you’ll get further symptoms down the road.

So, this type of medicine’s really all about getting to the bottom of it, so you’re better not only for the immediate future, but you’re also preventing yourself from getting sicker with the current disease you have or current symptoms you have, and prevent yourself from getting diseases down the line in the future. So, that’s what this type of medicine is all about.

Maya:                  Yeah, yeah. And if I may add, I was actually just talking about this. All this week, cause we’re rolling the Habit and Behavior Change Health Coaching Program to quite a few city of Phoenix employees, and the point is that this is the last … Well, for them it was weight-loss based. So, I said to them, “It’s the last weight-loss that you’ll ever need in your life. This is the last weight-loss program you’re ever gonna engage in in your life,” and same way with Dr. Emily. This is not something … You don’t see her or I for the rest of your life. This is something that … You see us, and we don’t ever wanna see you again.

Emily Parke:       Right. I say that to patients all the time. It’s like, “It’s lovely to see you, but I don’t wanna see you too much, because that means that you’re not where you need to be.” So, the ultimate goal is to get patients to a point where they’re coming in once or twice a year, we’re doing their big lab work panel beforehand, we’re checking in with all of their factors, how they’re doing with nutrition, sleep, exercise, stress-management, their supplement plan, and sending them on their way. And that’s another really important piece.

Functional medicine is the lifestyle factors that … They are the foundation to health, and I’m not just talking about nutrition as in … Maya, what you say all the time is, “We all know we should be choosing an apple over a cookie,” right? To use your example, but it’s very much more detailed than that. So, for instance, patients that have auto-immune diseases … There’s maybe a certain nutrition plan I’m gonna put them on versus a patient who is coming in with cognitive decline or Alzheimer’s. That may be a slightly different food plan versus someone who has mitochondrial disorder. That might be a different food plan versus someone who has specific gut issues. And so, there’s a lot of personalization that happens in functional medicine, and that is true for sleep, exercise and movement, and stress-management too. There’s nothing cookie-cutter about functional medicine.

And so, while I can create these amazing plans for people, where the hiccups come, is people filing through on the plan, not just in the short-term, but the long-term also. And that is one of the reasons why I decided to pair with Maya and have health coaching as an integral part of the practice, because without follow-through and creation of the permanent behavior changes, in health, the plan is for naught.

Maya:                  Absolutely, yeah. And we’ll … This is the last thing I’ll say before we get into thyroid disorders. It is. It’s an integral piece in the … That’s the combination of … So, habit behavior change health coaching, for those of you that don’t know who we are and what we do, in a nutshell, we know what to do. We’re just not doing it.

And so, when it comes to our health, now there’s … There’s quite literally … Yes, there is a nutrition piece, there is a medical piece, but there’s also the habits piece behind. It’s not just the physical habit and behaviors, but the thought habits that we change too. It’s … We know what to do. Dr. Parke gives patients a plan, but we have to stay on it through vacations, and holidays, and family visits, really integrate this into our life and make it a lifelong, integral part of what we do. We often put ourselves on the front-burner when we have to focus on something with our health, and the moment we get stressed out or the holidays hit, we go back on the back-burner, and then we feel like we’re always having to start and stop, start and stop.

So, yeah. It’s quite literally the next level of nutrition, health, and medicine on all levels, which is really exciting. So, let’s dive in, and … So, we’re talking about thyroid disorders, and you’re obviously the medical expert here. Give us a background … When we say thyroid disorders, what is that? What is that?

Emily Parke:       Sure, sure. So, just to start with a little bit of anatomy … So, the thyroid is a gland that’s located in your neck right about here, and sometimes it’s difficult to feel, but either your primary care doctor or of course, if you come to a functional medicine doctor, we’re always doing a thyroid exam, and checking to see if we can feel the size of it, and feel if there’s any nodules or cysts, anything there that we need to further investigate. So, your thyroid gland is located here, on your neck, and it produces thyroid hormones. And I’ll go over some of the lab tests, and some of the thyroid hormones specific.

But so, your thyroid produces thyroid hormones, which control so much about your life. It controls your entire metabolism. There is a receptor for T3, which is one of the main thyroid hormones, it’s the active thyroid hormone, in every single cell of the body. So, that’s how important the thyroid is, and you can get symptoms of thyroid disfunction that you would not necessarily even link directly to the thyroid, but it really has to do with most metabolic functions of your body on a cellular level.

And hypo-thyroidism is one of the most common diagnoses out there. Actually, Synthroid, or levothyroxine, is always in the top four medications prescribed in the United States, so hypo-thyroidism is a very, very common disorder, generally speaking. And hypo-thyroid means low thyroid function. Your thyroid’s not producing enough thyroid hormone. And then, there’s hyper-thyroid, which means the thyroid’s over-active. So, you can have either one. Hypo-thyroidism, low-active thyroid is a lot more common.

Maya:                  Hmm, got it. Why? Why does this happen?

Emily Parke:       Yeah. So, there are tons … Well, let me back up for a second and kind of describe how the thyroid works a little bit. So, one of the main … And I’ll try to keep it super not [inaudible 00:08:20].

Maya:                  I’ll ask questions on my level.

Emily Parke:       [inaudible 00:08:23]. Yeah. Because I’m doing it all day every day, but … So, the thyroid … In very simple terms, there is a thyroid-stimulating hormone that comes from the brain, so that’s TSH, and that TSH is very commonly measured by most doctors. But one of the issues is that that becomes the only measurement that most doctors look at for thyroid function. It does not tell the whole story because TSH is what the brain is telling the thyroid to do. It’s not what the thyroid’s actually doing. It’s just the signal. Thyroid-stimulating hormone, it’s what the brain’s telling the thyroid to do.

So, once that signals makes it there, then the thyroid puts out thyroid hormone. And there’s two main thyroid hormones. There’s T4 and T3. And T4 gets converted into T3, which is the active form of the thyroid hormone. And so, there’s a lot of different factors that come into play with how well the TSH signal gets to the thyroid. There’s things that can block that signal from happening really well, like stress, like inflammation, like infections, like toxins, like nutrient deficiencies. There’s all kinds of things that can interfere with the TSH signal getting there, and there’s also a set of factors that can interfere with the thyroid converting T4 into T3, the active form of the thyroid hormone.

Maya:                  I see. I see. So, there’s multiple places where things could go wrong.

Emily Parke:       Correct.

Maya:                  TSH, of course, could not be signaling. And then, the conversion T3 to T4 … So, if you have hyper- or hypo-thyroidism, how would that show up in the numbers.

Emily Parke:       Yes, great! So, labs. So, because the thyroid-stimulating hormone is what the brain’s telling the thyroid to do, if you have hypo-thyroidism, meaning a low-functioning thyroid, typically that TSH, the thyroid-stimulating hormone number is high. And that’s because … If you think about it logically, it’s because the brain is spitting out the hormone saying, “Hey thyroid, wake up. Give me more, give me more, give me more,” and because of the other factors I just mentioned earlier, it’s not doing it appropriately. So then, there’s a feedback mechanism that goes right back to the brain saying, “Okay, I need to put out more thyroid-stimulating hormone cause the thyroid’s still not giving the body what it needs.” So, hypo-thyroidism tends to have a high TSH.

Hyper-thyroidism is the opposite, will tend to have a low TSH because that signal feeds back as well. So, if thyroid’s over-active, what’ll happen is the signal will feed back to the brain, and the brain will go, “Oh, I don’t need to put out as much of this thyroid-stimulating hormone. I’m good.” There’s lot’s of thyroid hormone floating around.

So, one of the big glitches and things that I come into in this practice is patients will be told by their primary care doctors that, “My thyroid numbers … My thyroid’s normal,” and they’ve only checked the TSH, and one of the problems is the lab ranges for normal are huge for TSH. Most labs go from about point-five to four-point-five. Well, that’s a –

Maya:                  Wow.

Emily Parke:       A, that’s a giant range. And when they decided these ranges many years ago when they first started doing the labs, they didn’t decide the ranges by checking labs on just healthy patients. They decided the ranges on checking labs on everybody. So, there were people that had awful hypo-thyroidism, for example, and they were included in the group, and then, they just came up with the normal ranges. So, there’s a big concept in functional medicine. There’s normal versus optimal, and optimal TSH is more like point-five to two-point-five, something like that. And you can start to have some thyroid disfunction and thyroid symptoms when you start getting outside of that range. And that’s also why it’s really important to check the free thyroid hormones, and the free T3, and the free T4.

Maya:                  Free … Tell me more. What’s the free?

Emily Parke:       So, free … There’s … When checking a full thyroid panel, you want to check a TSH, you want to check a free T4, and a free T3. So, free means that the hormone is free, not bound to anything and can be biologically active and interactive with the cells. Remember I said there’s a receptor for T3 in every single cell of the body. So, if you want to check a full, full thyroid panel, what you would be looking at is a TSH, a free T3, a free T4, a total T4, a total T3, and reverse T3.

Now, the reverse T3 is an interesting lab value because reverse T3 … It looks very similar to regular T3, except it’s not as biologically active as T3. So, what happens is you have this one … For example, you have this one cell, and you have a receptor for thyroid hormone on this cell, let’s say. And so, reverse T3 and regular T3 compete for that receptor site. So then, what happens is, if the reverse T3 level is high, which can go high from a lot of the things I mentioned earlier, like inflammation, stress, toxins, chronic infection, nutrient deficiencies, things like that … Then, we will get … There’s competition there, and then there’s no cellular action, so the reverse T3 takes up the good site for the active T3. And so, even though there’s a lot of T3 floating around, it’s starving. It’s not actually getting to the cells.

Maya:                  And so, the reverse T3 is not … That’s not usable even if it [inaudible 00:13:59] on to the –

Emily Parke:       Correct.

Maya:                  To the receptor site.

Emily Parke:       Correct, correct. And I see that happen all the time. And so, that … If you want to check a full, full thyroid panel, it would be a TSH, a total T4, a total T3, free T3, free T4, reverse T3, and then, you also want to check to see if you have thyroid antibodies.

And so, this is really important because one of the … The most common cause of hypo-thyroidism is an auto-immune disease called Hashimoto’s Thyroiditis. It’s also … The other medical name for it … The old medical name for it is a chronic lymphocytic thyroiditis. “Itis,” right? So, anything with an “itis” at the end means there’s an inflammation. So, in the case of Hashimoto’s, what happens is your own body starts attacking your thyroid. So, your own body starts putting out these thyroid antibodies. So, what that means is your body is actually sending out chemicals, these anti-bodies, these immune system cells, that are actually attacking and eating the thyroid gland, which eventually will cause the thyroid function to go low, right? Because if there’s not enough of the actual gland there to put out the thyroid hormone, the function’s gonna go down.

And so, knowing that … If you have Hashimoto’s … And so, those two antibodies, by the way … The names are TPO, which stands for thyroperoxidase antibody, and then there’s thyroglobulin antibodies. And you can have either one or both of those antibodies present in Hashimoto’s Thyroiditis. But it’s important to check to see if that is your root cause of hypo-thyroidism, because knowing that you have Hashimoto’s, that’s a great place to be able to intervene because there’s great things to do with nutrition, sleep, exercise and movement, stress management, as well as some advanced laboratory testing that we can do to figure out how that auto-immune disease got triggered.

Because it just doesn’t happen in a vacuum. It’s not like, “Oh, I’m so sorry. You’re unlucky. You have Hashimoto’s,” or any auto-immune disease, for that matter. This is true for Celiac disease and Crohn’s disease, [inaudible 00:16:11] colitis, Rheumatoid arthritis, Lupus, multiple sclerosis, you name it. There’s a reason, or reasons more commonly, factors that add up to trigger that auto-immune disease to get started in your body. And so, by knowing what those factors are, that’s how we get to the root of it and treat it, so gut disfunction is very, very common, right? Because 80 percent of the immune system is located inside the gut.

Maya:                  Mm-hmm (affirmative). Gut dysfunction … So, I’m gonna back up for two seconds. Hashimoto’s … I’m simplifying. Hashimoto’s and hypo-thyroidism, same thing or not?

Emily Parke:       Not the same thing. Not the same thing at all. So, hypo-thyroidism is just a general term for low thyroid function.

Maya:                  Hmm.

Emily Parke:       Correct. Right. So, Hashimoto’s is one of the causes of hypo-thyroidism. So, for example, if you … So, Hashimoto’s again, is the antibody to your body’s own immune system attacking the thyroid gland, which will then create low thyroid function. But completely separate from that … So, let’s say someone has low thyroid function on labs, but they don’t have Hashimoto’s. This is common also. Well, it could totally be related to nutrient deficiencies, for example, if the patient doesn’t have enough iodine. There are other really important nutrients that contribute as well, like vitamin D, vitamin A, magnesium, zinc, selenium … There’s a huge list of nutrient-deficiencies that can create thyroid dysfunction, and it’s because … Iodine’s one of the key ones, but it’s really hard to get iodine-deficient in our current world because our traditional table salt is all iodized salt, so these days you really have to try to become iodine-deficient.

But iodine is part of the thyroid molecule. T3, for example is triiodothyronine, so there’s three iodine molecules. And T4 is four iodine molecules. And there’s enzyme systems that come into play with creation, with how the body makes the thyroid hormone. And so, again, if there’s nutrients, stresses, toxins, infections, inflammation, the laundry list of things that we mentioned before.

Maya:                  Completely.

Emily Parke:       Your body’s not gonna produce thyroid hormone adequately.

Maya:                  So, some of the common reasons that some of these would exist … We’ve got the gut dysfunction, nutrient deficiencies, anything … You said the toxic materials of question are environmental toxins, things like that?

Emily Parke:       Yep.

Maya:                  Anything else?

Emily Parke:       And the gut is … And honestly just stresses … And that’s stress of any kind. So, with the term stress, we all think of mental, emotional stress, which absolutely is not to be forgotten, and is a huge trigger. And I have seen it in my practice many times. Just stress by itself … Like, someone will be going along really great with their plan, labs are looking good, they’re feeling great, and then a huge life-stressor will happen, and that’s enough to throw those thyroid antibodies, or antibodies from any auto-immune disease into … Increasing them into a tizzy there. So, it’s really important. It’s really important. Stress-management is a crucial part of the plan. I think it’s one part that gets placed on the back-burner and blown off a lot, with sleep too. Right?

Maya:                  Yeah.

Emily Parke:       Not getting enough good-quality sleep is one of the biggest stressors on the body. But yeah. So, I’m gonna show … Cause I think this will help. I’m gonna show … This shows up great. This is a graph about factors that affect thyroid function. So, it’s just really some of the things that we’ve been talking about here. And so, the picture does a really good job showing the reverse T3, T3 thing, competing for that receptor site on the cell, but there’s also a list of factors like I was mentioning, that play a role in the conversion T4 to T3, and other factors that play a role in production of thyroid hormones. And so, there’s all kinds of … It’s complex, but there’s all kinds of reasons, which is …

One of the reasons to get to a functional medicine doctor if you can at all is because we are thinking about all those factors, and we’re checking them. We want the thyroid to function as great as possible. We want to optimize everything that we possibly can, and when we do that, we find that patients need less thyroid medication, or they may even be able to come off thyroid medication, or if they have Hashimoto’s, then awesome, because we can actually watch those antibodies come down in the lab results, and that correlates with patients feeling better.

Maya:                  Love it. Love it. Absolutely. That was perfect to put up. That was really helpful. So, if anybody wants to, you can always pause the video, screenshot it, go back … This is all recorded everywhere, so you can … I saw it perfectly, so you can screenshot that.

So, Dr. Emily, let’s talk about … And I want to definitely incorporate some habit stuff in there too, because there’s the knowledge, and then there’s the integration. I always joke sometimes in this work because we have a lot of knowledge in this world, and so, it’s kind of like … If I were to show someone. I want Dr. Emily to give us some tips and things that we can do. It’s almost as if I were to show you the treadmill … I heard this example. It was perfect. But I show you to the treadmill, and all the benefits on the treadmill, and you got really excited about the treadmill, but you never got on. That’s the difference between knowledge and integration.

Emily Parke:       Totally!

Maya:                  So, what are some … We know kind of where it comes from. We have gut dysfunction, nutrient deficiencies, environmental toxins, stress-management … What would … And I realize that this is kind of a broad paint stroke here.

Emily Parke:       Sure.

Maya:                  So, we’re talking hypo-thyroidism, Hashimoto’s, hyper-thyroidism … What would be some … If anyone’s watching that has any of these, what are some things that people can do right now?

Emily Parke:       Right. Awesome. Awesome. Actionable steps.

Maya:                  Yes.

Emily Parke:       So, one of the biggest contributors to thyroid dysfunction is really the SAD diet, right? The Standard American Diet that’s high in processed, packaged foot items with high sugars, and carbohydrates, and packaged with all kinds of preservatives, and colorings, and additives, chemicals that are toxic to the body. So, one of the biggest things you can do for yourself and for your thyroid is to start eating organic. So, start eating organic. Start adding more vegetables into your diet, into your life. So, you kind of wanna approach it by eating the foods of the color of the rainbow, and it doesn’t have to be a lot of each of the different types of colors, but you do wanna get a lot of the variation of colors in, and that’s because the colored vegetables and fruits have all kinds of vital nutrients and antioxidants in them that are really important for your health of every single cell in the body, including the thyroid.

So, one of the biggest things you can do for yourself is work towards getting that eight to ten servings of plant foods in per day. And by serving size, I mean half a cup of cooked vegetables, or if it’s leafy greens, it would be a cup, or a piece of medium fruit. That’s one of the biggest things you can do for yourself, is to get more plant foods in the diet.

I would say the second-biggest factor is to take out the food groups that are known to be really inflammatory. And so, of course, sugars are very inflammatory to the body, and so are the grain family. And so, these are grains of all kinds, but specifically for thyroid function, we know that gluten is one of the top triggers of antibody dysfunction, and that’s because there’s a little bit of what’s called molecular mimickery going on, and that’s a fancy term for … Basically, when you eat gluten, it looks structurally similar to the thyroid, and so, if you have thyroid antibodies floating around, your body’s gonna go, “Oh, I see more enemy. I need to create more antibodies.” And so, just eating the gluten by itself can trigger that.

Plus, eating gluten … Gluten is a very large protein, and it’s kind of difficult for the body to digest. And if it doesn’t get digested properly when it makes it into the small intestine, it can create a host of inflammation, which then can secondarily thin the lining of the gut and create leaky-gut, or intestinal permeability, which is the gateway to all auto-immune diseases, right? Cause 80 percent of the immune system’s located inside the gut.

So, the biggest nutritional things you can do for yourself are of course, make sure you’re getting good hydration, right? Half your body weight in ounces of water per day. We wanna make sure that you’re getting as close to the ten servings of plant food as you can per day. We want to ideally, take out definitely gluten, and then, the second most-common trigger is dairy. So, the top triggers are gluten, dairy, corn, soy. And those are the top triggers, and of course sugar. Yeah. So, those are the biggest things you can do for yourself and your thyroid nutrition-wise.

Maya:                  Got it. And you mentioned water too, right?

Emily Parke:       Yes, yep.

Maya:                  Water? Okay.

Emily Parke:       Getting at least half of your body weight in ounces of water per day, more if it’s hot, more if you’re working out or exercising, cause obviously our bodies are made mostly of water, and so we need them for all of our metabolic functions.

Maya:                  Love it. Love it. Love it. So, those three recommendations. That’s the first actionable steps.

Emily Parke:       Yes, and then, of course, not ignoring getting enough good-quality sleep, as we mentioned, right?

Maya:                  Yeah, yeah.

Emily Parke:       And that’s huge. Having a regular bedtime and a regular wake time, creating a rhythmic routine for your body is really important, because not getting enough quality sleep is a big stress on your body. And then, of course, there’s the big, huge category of stress-management, right?

Maya:                  Mm-hmm (affirmative).

Emily Parke:       So, that’s where … I know all of my patients get recommended a daily relaxation practice of some kind. Meditation is particularly helpful and useful, but meditation, deep breathing, if you’re doing yoga, tai chi, chi gong, there’s all kinds of … Epsom salt bath with lavender oil … It doesn’t matter to me what the daily relaxation practice is, but having one is really important because it balances the nervous system. It brings down that sympathetic side, that fight-or-flight side. It brings that down, and it raises the para-sympathetic side, which is the rest, relax, digest side of the nervous system.

Maya:                  Mm-hmm (affirmative).

Emily Parke:       So, now we’ve got nutrition, sleep, stress-management, and then, of course, exercise. Getting your daily movement in is really important to. And so, the initial goal of getting 10,000 steps a day in is what we want. And then, of course, on top of that, depending on where the patient’s at with their ability to tolerate exercise. And if they’ve been really sedentary before, I’m not gonna tell them to go start running three miles every day, or start lifting heavy weights every day. This is different for everyone, but making sure you’re getting your daily movement in is also really important.

Maya:                  Awesome, awesome. So, this is perfect, because this is … Let me recap this, but we have the plant … And all … Anywhere that we put this, of course I’ll make sure that I put a recap and how to contact us both, but we have increasing plant foods of course, anti-inflammatory, but outing the biggies, the sugar, gluten, dairy, corn, and soy, upping your water, stress-relief, exercise … So, those are six main pieces. And if I may add, really, the habit and behavior change component. So, this is quite frankly, the …

Thank you, Dr. Emily. She’s given us … Right? This, “Here’s the treadmill,” right? “And here’s what we have to do.” Getting on the treadmill actually requires … That’s where the habit change comes in, because so many of us, when it comes to real, lasting, permanent change in our lives, often times … And this may or may not be you if you’re watching, but we hear these, “Duh, Maya. I know that’s simple. We can do those kinds of things. I’ve heard those things before.” And often times, if we haven’t been consistent … Consistency is often one of the biggest downfalls, so to speak, or where we fall of the wagon. But in our mind, our mind tells us … Because our mind can only tell us based upon past experience what will work and what won’t work. If we haven’t experienced something different before, it’s hard for us to know how that is actually gonna work.

So, it is this simple. I do wanna drill that in here. These small changes … It is actually this simple, and you can see changes. It’s rather, the consistency that might have been lacking in your past. So, if your brain right now is saying to you, “I’ve done these things and nothing’s really helped, nothing ever worked,” there’s a component of integration and consistency that’s required on your part. And so, habit behavior change comes in to simply say … I joke with people a lot, but it’s not really a joke. It’s, “All-or-nothing is a very common thought habit,” because in this work there are thought habits or perfections, and all-or-nothing thinking, catastrophic thinking, over-thinking, obsessive thinking.

Those types of thinking … They create our physical habits and behaviors, and so, if we go into a change … If I have hypo-thyroidism, and I want to create a change in my life, we can take on these six recommendations that Dr. Emily is going to give to you, but if we take them on, do them consistently and really strong, go all-in for six weeks and feel great, and then the holidays hit, and next thing you know, I’m completely off and starting at square one. This is very … Someone who eats fast food three times a day isn’t going to stick with kale, beans, and quinoa tomorrow. Sometimes we change 998 things about our life, and we fall on Monday, and we fall into chocolate cake high Friday. It’s not because people aren’t strong enough. It’s not because we don’t have enough willpower, although our brain tells us that. It’s simply because we have not used willpower strategically.

So, for example, take these recommendations now and integrate what Dr. Emily’s given us very, very simply. Plants … So, one of the things you learn in habit behavior change is, we work with a stepping-stone routine. That’s … One of the very first things our dieticians do with you is, we work with a stepping-stone routine. If you are eating zero plant-foods a day and your physician wants you up to ten, right? Then, going up to ten for the next five days every single day … You may be able to do it, but you’re not going to be able to do it long-term. Stepping-stones are, quite frankly, do this. That’s all a stepping-stone is.

And so, stepping-stones meet two requirements. It says, “Can I do this with little to no resistance?” And “Can I do this for the rest of my life?” So, if we were to sit down with you and say, “Okay, I’m at zero plant foods. I need to be at ten servings of vegetables a day, so to speak, or eight. And how can I … So, for the next seven days of my life, can I incorporate two vegetables a day, or three vegetables a day?” And when you meet that, you wanna ask those questions of, “Okay, does that feel simple to me?” The moment you start to resist, the moment I start to say, “Okay, you have to eat ten vegetables every single day for the rest of your life,” there’s a lot of resistance in that, right?

Emily Parke:       Totally.

Maya:                  Yeah, so we wanna find that little sweet spot. We wanna find that spot that says, “I can do this, and there’s little to no resistance there, and I can do it for the rest of my life.” If you’re … For example, Dr. Emily, you just mentioned the walking. If I’m not up to 10,000 steps, someone who doesn’t exercise at all or goes on walks every single day, walking or exercising two hours a day seven days a week is slightly ridiculous, and that’s obviously not where anybody would wanna go cause we burn ourselves out.

Emily Parke:       Right. Yeah!

Maya:                  But we have this all-or-nothing mentality, that’s what we do. So, when you’re integrating these steps, we wanna think about, “How can I do this? What’s the next-easiest step I can do for the rest of my life with little to no resistance?” That is, by far, the key with these stepping-stones of getting on the treadmill and staying on the treadmill consistently.

Emily Parke:       Yeah, awesome. Awesome. Yeah, that’s so true because at follow-up visits after a prescribe my plan, we go through what everyone’s been doing for nutrition, sleep, exercise, and stress-management. And what’s really funny to me is, most of the time, that all-or-nothing thinking shows up. And so, I’m like, “Okay, well how is nutrition going for you?” And they’ll give me an answer like, “I didn’t start my 30-day reset yet!” Like, they can’t even look at me, and I’m like, “Okay, well what did you do?” And, “Oh. Well, I added more water, and I’m having at least three vegetables a day,” and I’m usually super excited, same as you. Like, you get super excited about that. Like, “Yay! You have made a change. You’re doing something.” But again, it’s that …

What Maya … If you guys don’t know Maya, what she’s masterful at is, breaking that thought-pattern habit of a hundred percent or nothing, and the middle ground is okay, and life-stressors are gonna happen, and if you don’t eat your ten servings that day, it’s okay. You just get back to doing the best that you can the very next day. So, this is why health coaching has become an integral part of my practice. It’s really creating those lifelong behavior changes, as Maya described, in a very low-resistance way. You almost feel like not much is happening, but a lot is happening, and over time it builds, and next thing you know, you’re like, “Wow. I totally got where I needed to go.”

Maya:                  Yeah, absolutely. You’re completely right, and we are wired in that way. We see a lot of … A lot of patients and clients who are very wired for … We are very wired to only see a … Fear of failure is a common thought-habit that drives how we think, feel, and do. And so, it’s very common that we only see what doesn’t work. One of the first things that we do with patients a lot of the time and asking them about where they wanna go, we ask them what they don’t want first to achieve what it is that we do want. We’re just wired in that way, because the brain is wired for safety and survival, so a lot of the thought-patterns … When we break the thought-patterns or you learn to think differently, because that’s the key here. The key isn’t learning to do differently, it’s in learning to think differently.

And so, we use a lot of evidence-based practices and neuroplasticity, where you quite literally learn how to think differently, because when you learn how to think differently, you’re thinking balanced thoughts, you’re feeling good … It’s easier to reach for a vegetable when you’re feeling good as opposed to when you’re stressed out, or anxious, or depressed.

Emily Parke:       Yes.

Maya:                  And just looking at the time, I know you have a patient at 9:45, so let’s wrap us up here. So, what I’ll do is make sure, around this video, that there is contact information for both myself, the Habit and Behavior Change Health Coaching Program, Arizona Wellness Medicine, and Dr. Emily Parke. And so, we are … Of course, there’s two ways you can go about this: health coaching, and the Habit and Behavior Change Health Coaching Program is an integral part in Dr. Parke’s medicine, and packages, and everything like that. So, if there’s a medical to what it is that you’re looking at, thyroid, hypo-thyroid, any thyroid disorders in general, auto-immune, then you can reach us through Dr. Parke. If you’re just looking for Habit and Behavior Change Health Coaching, of course you can go through us as well.

So, all of that information will be there. Any last words, Dr. Emily?

Emily Parke:       No, this was great. I think we covered all the bases, and yeah. Love to … We’ll get together and do more of these in the future, and so, if you guys are listening just shoot Maya or I a little quick message and let us know what kind of topics you’d like to hear about, and we’ll get together on it.

Maya:                  Perfect! Perfect! I love it, and we didn’t … My intention was to take a few questions, but we will certainly do that next time. We’ll do more Facebook Lives, so … And the last words of wisdom I’ll leave you with too is that if you’ve been … We see a lot of patients and clients that have been there, done that, and so, I just need you to know and I want you to hear that your habits aren’t your destiny, and that real change is possible, and there are people … Whether it’s Dr. Parke or myself or not, it doesn’t matter. There are people that are rooting for your real change, for your permanent change, where you don’t have to go back and be on medication your whole life, and see doctors your whole life. That change is real and possible, so don’t ever think otherwise, because it is real and it is available to you.

So, thank you guys so much for watching today. We’ll make sure that we send this out with all of our information, and if you do have any questions on anything we’ve talked about today, I’ll be sure to put our info there as well, so you can reach out to the both of us and get your questions answered. So thanks, Dr. Emily.

Emily Parke:       Thanks, Maya! Have a great day!

Maya:                  You too! Enjoy! Be well.

Emily Parke:       Alright, thanks.

Maya:                  Bye.

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