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Sara Gottfried MD
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Sara Gottfried MD
  • Home
  • About Dr Sara
    • Media
    • Contact
  • Books
    • Women, Food, and Hormones
    • Younger
    • Brain Body Diet
    • Hormone Reset Diet
    • The Hormone Cure
  • Upcoming Events
  • Blog
    • Recipes
    • Women’s Health
    • Hormones
    • Weight Loss
    • Cleanse
    • Stress Management

Hormonal Replacement Therapy

Detox Friendly Recipes – A Sample Menu from the Hormone Reset Detox

By Sara Gottfried, MD | August 19, 2014
Detox Recipe Tips

One of the biggest questions I get during the Hormone Reset Detox is “What do I eat?!” Perhaps the better question would be, what can’t you eat? That list is much shorter, and easier to remember.…

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Too Young for Menopause and Feeling a Little Crazy? Symptoms and Solutions for Perimenopausal Women

By Sara Gottfried, MD | March 13, 2014
Too Young for Menopause and Feeling A Little Crazy_ Symptoms and Solutions for Perimenopausal Women

I talk to countless women who find themselves feeling more than a little off balance as they move into their 30s and 40s, and they’re not sure why. If you…

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PRAISE

“For the first time in my adult life I feel that I have gained control over food. I feel healthier, look better and have gained an interest in making sure that what I am putting into my body is the best it can be. And I lost 10 pounds in all the right places.”

– Janice Lunde, Dr. Sara’s Detox Challenge Participant

“Dr. Sara is the height of excellence! She is incredibly knowledgeable and gives very generously of her time. I feel so blessed to have been able to work with her.”

– Yvonne Varah

“You don’t have to settle for being stressed out, binging on sugar and chocolate, and aging prematurely. Stop blaming yourself and step into sacred action. It’s your birthright. You can have the joyous, mission-driven life you want, and Dr. Sara is here to show us how.”

– Marci Shimoff, New York Times Bestselling Author of Happy for No Reason and Love for No Reason

“Dr. Gottfried offers powerful and effective tools for addressing the most difficult health issues facing women and men today. She is warm and kind and has so much experience to draw upon, it’s inspiring. Thank you Dr. S!”

– Cassandra Mick

“Dr. Sara Gottfried is a modern-day healer goddess if ever there was one, and she also happens to be a Harvard Medical School graduate and rigorous physician-scientist.”

– Christiane Northrup MD, author of Women’s Bodies, Women’s Wisdom

“Dr. Gottfried’s book and detox came at a time when I was ready to give in to old age. Hot flashes, low energy and libido, weight gain, increasing blood pressure and cholesterol levels were unacceptable to me. I now know that hormone levels and what I eat are a huge influence on how I feel and look. To now be able to control something that was out of control is empowering…”

Cheryl V., Dr. Sara’s Detox Challenge Participant

“My health coach told me about your book and I took the [hormone] test, and lo and behold, I found I was a mess, hormonally speaking. Now I’m getting on track and I love your videos and your book. I feel like I’m getting my life back again, when not long ago I truly thought I was losing it!”

-Tracy, Registered Nurse

“You don’t have to accept the hormonal hell of being tired, stressed, overweight, and never in the mood for sex as you grow older. In her fabulous new book, the brilliant Dr. Gottfried gives you an effective, easy-to-follow plan to balance your hormones and become lean, energetic, and loving life again. Stop settling and reclaim your sexy!”

–JJ Virgin, Author of Six Weeks to Sleeveless and Sexy and The Virgin Diet

“I lost 10 lbs., reset my hormones and metabolism and eliminated my sugar cravings! I have also found that I respond to stress much differently, I feel it, notice it and move on from it. Stress no longer has a grip on me. Dr. Sara’s conference calls and detox information was invaluable. I am so grateful for this program. Thank you Dr. Sara!”

–Sophia, Dr. Sara’s Detox Challenge Participant

“The Hormone Cure is the playbook for your mojo, your mind, and your bootie. With every chapter I thought, ‘So THAT’s how that works.’ I wanted to call every girlfriend and give them the goods on how to glow… now and always.”

-Danielle LaPorte, Author of The Fire Starter Sessions and The Desire Map

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Today I’m in the winter wonderland of Tahoe, sur Today I’m in the winter wonderland of Tahoe, surrounded by a blizzard. Not quite a white out, but close. I grew up in Alaska and the conditions feel so cozy, perfect for working on book #6 on autoimmunity, trauma, and novel therapies like psychedelic-assisted therapy. The wound is the way I want to live in and from my soul, not ego or fear, not conditioned patterns, and to do that we need to wake up from the family trance. Old defensive structures. That’s the writing topic today. Feel me? XO Dr. G 🗻 #mountains #yoga #autoimmunity #autoimmunedisease #autoimmune #trauma #adversechildhoodexperiences #psychedelicmedicine #psychedelictherapy
Celiac disease is a permanent intolerance to eatin Celiac disease is a permanent intolerance to eating gluten, and it triples your risk of problems with low thyroid function. 1% of Americans have celiac disease, although many more—an estimated 6 out of 100—suffer from gluten sensitivity. Many people don’t know they suffer from gluten intolerance, because they have no symptoms at all. They don’t know they aren’t absorbing crucial nutrients until they start to develop symptoms of hypothyroidism. If you’re interested in testing for celiac disease, the main gene to look for is DQ2 - about 90% of celiac patients are positive for DQ2. Additionally, around 7% have DQ8. Too often, doctors don’t think of celiac as a root cause for such vague and nonspecific symptoms as fatigue and bloating. If you have celiac disease, you may be missing out on key nutrients, such as the fat-soluble vitamins A, D, E, and K. You may not be absorbing iron, vitamin B12, and folate, and some of these nutrients impact your thyroid function as well. People with a sensitivity to gluten develop something known as leaky-gut syndrome, or increased intestinal permeability, when the tight junctions between the cells lining the small intestine become disrupted. We also see increased intestinal permeability in the healthy relatives of celiacs, which is not surprising given that celiac disease is genetically transmitted. Symptoms of leaky gut include bloating, food sensitivity, and weight gain. If you have autoimmune thyroiditis, consider testing for leaky-gut syndrome with a blood or urine test ordered through your doctor. Celiacs are much more likely to have antibodies against the thyroid. It’s not definitive whether a gluten-free diet can slow progression of the auto-attack, but the best data show that eating gluten-free normalizes hypothyroidism and prevents progression. I believe that since celiac patients are more likely to have hypothyroidism, the corollary is true as well: all patients with hypothyroidism should be tested for celiac and gluten sensitivity, particularly since removing gluten may reverse the thyroid problem. Do you have thyroid issues? Have you been tested for celiac and gluten sensitivity? #thehormonecure
There are more than 5 factors that make your thyro There are more than 5 factors that make your thyroid sluggish, including gene variants (DIO2), hormones (estrogen, progesterone and cortisol), and gluten. But I will dive deeper into these five here. 1️⃣Hashimoto’s thyroiditis (HT) is a chronic disease in which the body interprets the thyroid as a threat, and as a result produces antibodies that target the thyroid's cells, thereby destroying them. HT is the most common cause of hypothyroidism in the US and is 5-10X more common in women than men. Despite conventional medical management with thyroid hormone replacement (usually T4), many women with HT continue to experience symptoms and impaired quality of life. 2️⃣After giving birth, about 7% of women develop what’s called postpartum thyroiditis. Women with baseline thyroid antibodies before pregnancy are much more likely to develop postpartum thyroiditis. 3️⃣As our exposure to endocrine disruptors has increased, so has the incidence of thyroid disease in the United States, particularly for thyroid cancer and thyroid autoimmune disease. The most common exposure to thyroid disruptors is flame retardants, and the worst offender is your home and office furniture. Bisphenol A (BPA) is another major endocrine disruptor that blocks thyroid receptors and keeps your thyroid hormone from exerting its biological destiny. 4️⃣Selenium deficiency can also lead to low thyroid function. I believe selenium is the most important mineral for your thyroid health and it’s difficult to get enough from your food as many areas around the globe have soil depleted in selenium. If you don’t get enough, you are less able to convert T4 into T3. 5️⃣If you don’t have enough iodine in your diet, you can develop low thyroid function. If you’re not sure about your iodine consumption, check your urine in a home test. But those of you with Hashis, beware. Iodine stimulates thyroid peroxidase, which can lead to a dramatic increase in antibodies against thyroid peroxidase (TPO), resulting in an autoimmune “flare.” The therapeutic range of iodine is remarkably narrow, so don’t get too little or too much. Check vit D levels as deficiency is more common in people with autoimmune thyroiditis.
I want to help you understand your thyroid and the I want to help you understand your thyroid and the numbers. TSH stands for Thyroid Stimulating Hormone and when you have low thyroid function, you make more TSH. TSH is not made in your thyroid, it’s made in your pituitary, the manager of your thyroid. When your thyroid gland is not making enough thyroid hormone, your brain senses it. Your hypothalamus tells the pituitary to crank out more TSH and whip that thyroid into shape by stimulating greater production of thyroid hormones. As a result, the hormone factory in the thyroid manufactures more thyroid hormones, which are then sensed by the brain. Often the thyroid will adjust sufficiently, and TSH settles back down to normal. If not, your TSH levels will climb correlating with the severity of the problem. Mainstream medicine usually defines thyroid problems as: 👉Overt hypothyroidism: TSH levels are high, but total and free T3 and T4 are below normal or 👉Subclinical hypothyroidism: TSH levels are high, above 2.5, but total and free T3 and T4 are in the normal range. In my years of practice, I’ve observed gradations of thyroid IMBALANCE. More people, particularly women, brave thyroid imbalance because of old reference ranges for the thyroid. That’s a lot of sluggish, uncomfortable, and unhappy people. I recommend a full hormone panel to my patients, including: ▪TSH ▪free T3 ▪free T4 ▪reverse T3 ▪thyroid peroxidase antibodies ▪anti-thyroglobulin antibodies Your mainstream doc will probably only check TSH, maybe free T4. In 2002, the AACC lowered the normal range for TSH to 0.3-2.5 mIU/L. Your doc may not know this and still use the old range. Save this post to refer back to as we continue with the thyroid. #womenfoodhormones #thehormonecure #thyroidhealth #thyropause #hormonebalance #hormoneimbalance
Let’s talk about reverse T3. Reverse T3 (rT3) i Let’s talk about reverse T3. Reverse T3 (rT3) is an inactive metabolite of T4, and provides a mechanism to slow down metabolism in order to save energy. Generally, if you are healthy, T4 gets made into T3, and a small portion of T4 gets converted into reverse T3. Put another way, reverse T3 provides a feedback system to keep you in balance under normal conditions. But occasionally this plan backfires, and what was designed to be adaptive for your body becomes disadvantageous. Here’s why: if your body is stressed or on a calorie-restricted diet, a signal is sent to change the ratio, and you produce more reverse T3. One of the common issues in patients on a ketogenic diet is that they may have increased reverse T3. This is one of the things I check with patients who tell me they have tried keto and it didn’t work for them. Part of the reason I wrote my book WOMEN, FOOD, AND HORMONES (link in bio @saragottfriedmd) was to find a better-formulated plan for these patients, where we still work with ketosis for weight loss or whatever their health goal is but we modify the plan. One element of this modified ketogenic diet plan is adding back prebiotic carbohydrates and exploring what their carbohydrate tolerance is as a way of helping with their thyroid function. Aside from stress, and a low carb diet, other factors that can increase the conversion of T4 to RT3 include: ▪Trauma ▪Inflammation ▪Infections ▪Kidney/liver dysfunction ▪Toxins The toxins that I see the most in my patients who have high reverse T3 are bromide and fluoride. This could be in the toothpaste or mouthwash they are using, or in their water supply. Have you had your reverse T3 checked? #womenfoodhormones #thehormonecure #thyroidhealth #thyropause #hormonebalance #hormoneimbalance
We know that hypothyroidism is the second most com We know that hypothyroidism is the second most common endocrine disorder affecting women of reproductive age. (PCOS is #1) 60-70% of people with thyroid disease are unaware of their condition. Now, this is one of those things that makes me slightly crazy because what I find routinely in my practice is that many of my patients who've been talking to their well-meaning primary care doctor about their symptoms of hypothyroidism often get dismissed. Occasionally, they'll get a TSH but often they don't get more than that. In fact, I'll tell you a quick story about what first got me motivated to learn more about thyroid dysregulation and dysfunction. When I finished residency in 1998, I went to work at a large health maintenance organization and I was trying to be careful about stepping on other doctors' toes. However, I had a patient who came to see me for a Pap smear who had classic symptoms of hypothyroidism. She had constipation, cold intolerance, hair loss, weight gain. She also had fatigue that lasted all day, which in my mind is one of those cardinal signs of hypothyroidism. I checked her TSH (4.2) and she had a low free T4. She had TPO antibodies that no one bothered to check in the past. I thought she should be treated so I called her primary care doctor to discuss it—he refused to offer her treatment. I remember him saying, “Here at the HMO, we don't treat TSH until it's greater than 5 and in some cases, we don't treat until it's greater than 10 depending on other circumstances.” I disagreed completely. So I checked her micronutrients, recommended an elimination diet, and wrote her a prescription for thyroid medication. This experience made me realize very early in my career that there are so many patients, especially women, who are not getting adequately screened and treated for their symptoms of hypothyroidism. I’ve been on a mission to change this ever since. Btw, this clip is from my lecture for Integrative Psychiatry Institute If you purchased my book Women, Food, and Hormones, this thyroid lecture is part of the BONUS content that you can access through the link in my bio. Enter your purchase details to gain immediate access to the content.
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DR. SARA'S Guide to Tracking Your Blood Sugar

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