Written by Sophie Getliff 
MSc Health Psychology student at the University Of Derby

My research looked into the lived experiences of people living with a thyroid condition. This report focuses on a small subsection of the data which focuses on young adults. 

This research aimed to gain a comprehensive understanding of the healthcare experiences of young individuals living with thyroid conditions. Hypothyroidism and hyperthyroidism are chronic health issues caused by the dysregulation of the thyroid gland, leading to either an underproduction (hypothyroidism) or overproduction (hyperthyroidism) of essential hormones, triiodothyronine (T3) and thyroxine (T4).

These hormonal imbalances result in various symptoms, such as severe fatigue, weight management difficulties, and depression. The number of people diagnosed with these conditions is gradually increasing in the UK. Therefore, it is crucial to understand how these conditions are managed and their impact on patients, particularly younger adults. In light of the rising incidence of thyroid disorders and risk factors for earlier onset, this study explores the diagnostic experiences and healthcare needs of younger adults aged 18-40.

​The research employed a cross-sectional online questionnaire survey composed of eight open-ended questions focusing on different aspects of the participants' lives, including their healthcare experiences. Out of the 250 participants who completed the survey, data from 56 respondents who fell within the target demographic of younger adults aged 18-40 were analysed. The mean age of this sample was 32.3 years, with 52 biological females and 4 biological males. The ethnic composition of the sample included 73.2% white individuals and 26.8% from ethnically diverse backgrounds.

The data were analysed using reflective thematic analysis, which revealed three prominent themes: feelings of dismissal by healthcare providers, condition management, and the role of support. Many participants reported feeling dismissed by their primary healthcare services, describing experiences where they had to advocate for their diagnosis strongly. Even after receiving a diagnosis, participants often felt they were not provided with adequate information to understand and manage their condition effectively. This lack of support and information led to feelings of frustration and isolation, negatively impacting their physical and mental health.

Additionally, the participants highlighted issues with condition management, noting that insufficient guidance from healthcare providers resulted in poor management of their symptoms. The lack of effective communication and support from healthcare professionals contributed to these challenges, exacerbating frustration and isolation among the participants.

The role of support was another critical theme identified in the study. Participants expressed a need for more comprehensive support from their healthcare providers, as well as a desire for a more patient-centred approach to care. The absence of adequate support systems and resources left many feeling isolated and struggling to manage their conditions effectively.
​
This study underscores the urgent need for improved education and support from healthcare services, emphasizing the importance of quality, patient-centred care. The findings suggest that to enhance the quality of care for young adults with thyroid conditions, there is a need to design evidence-based educational programs and performance improvement interventions. Such initiatives should aim to better inform healthcare practices and provide comprehensive support to this population. By addressing these gaps, healthcare providers can help reduce the feelings of dismissal and isolation experienced by young adults with thyroid conditions, ultimately improving their overall health and well-being.

Written by Verity Chester
Thyroid Patient & NHS Researcher
 
I was diagnosed with hypothyroidism in 2019 after two years of ill health, including weight gain, muscle pain, and exhaustion. I struggled to keep up with the demands of my job as a researcher, and my activity levels and quality of life declined. I didn’t know anything about hypothyroidism at that time, and I struggled to understand my diagnosis.

In my role as a researcher, I work with people with learning disabilities. Having a learning disability is defined by “significant limitations in both intellectual functioning and adaptive behaviour”. People with learning disabilities have a below average IQ, and difficulties reading, communicating verbally, and advocating for themselves. They often are dependent on family members or paid carers to support their everyday tasks, including navigating healthcare, and experience a poorer service within medical services. 

Following my own experiences, I began to wonder about hypothyroidism diagnosis and management with the patients I work with. I thought they might struggle to obtain the diagnosis, and to manage their condition. For example, I found understanding my blood test results difficult, and learned the most about hypothyroidism from my own online research, including information and resources from the Thyroid Trust. Many people with learning disabilities do not access the internet and are less able to access these kinds of resources. 

I tried to undertake some background research on hypothyroidism and learning disabilities. I have completed projects on lots of physical health conditions and how they affect the patients I work with. When I am doing background research for a project, it is very rare that I find absolutely no articles. However, that is what happened when I typed “learning disability” and “hypothyroidism” into my search engine.

​So this year, with my colleagues, we were able to investigate hypothyroidism among 463 patients with learning disabilities using NHS healthcare records. I expected hypothyroidism to be under recognised in this group, due to the lack of research, and I thought people with learning disabilities might struggle to communicate their symptoms for diagnosis. However, among the 463 patients, 43 (9%) had hypothyroidism, which is considerably higher than the general population (2%). 

While this was a preliminary study, with several limitations, the results suggest hypothyroidism in intellectual disability should be the focus of future research. We need to understand whether: 

• hypothyroidism is more prevalent in this population, in larger, more representative samples,
• those with learning disabilities, and their carers, understand the diagnosis, and how best to manage it,
• hypothyroidism is being effectively managed in this patient group, e.g. how many patients are accessing regular reviews of their bloods, are on optimal levels of medication, and are satisfied with their treatment.

Finally, there is a need to raise awareness of hypothyroidism and learning disabilities among healthcare professionals, and stakeholders such as thyroid charities, to ensure the needs of this group are being considered and advocated for at the national level. 

Bio: Verity Chester is a researcher in the NHS focused on people with learning disabilities and autism. She has authored over 75 peer reviewed publications alongside undertaking her PhD at the University of East Anglia. Verity is also an advocate for patients with hypothyroidism following her diagnosis of the condition in 2019

Written by Natalie Guy
​
Taken from our monthly ‘Talk Thyroid’ column in Health Triangle Magazine, where we discuss a wide range of subjects relating to Thyroid health. Currently 1 in 20 people in the UK have a thyroid disorder, which may be temporary or permanent.

This is Natalie's personal account of her own lived experience and she hopes that by candidly sharing her story it will help others feel less alone. The Thyroid Trust would like to add that whilst all views are the author's own,  from the thyroid patient community they help support stories of patients not feeling listened to and challenges around accessing T3 or Liothyronine are sadly commonplace. These patient stories just highlight that thyroid patient voices have been overlooked for too long and why there is such a desperate need for change. 

My journey to taking liothyronine medication has  been on a steep’ learning curve’ to find what works on an individual level for me and I couldn’t access them at all via the NHS.

Like  so many thyroid patients, I do not fit neatly into everything being great with just a daily dose of levothyroxine only treatment.  I have been told that old chestnut of a thyroid saying -  ‘you’re in range’.  That one ‘phase’ that covers everything and has some thyroid patients shaking their head with total frustration and the lack of being able to access a full thyroid function  blood test panel, including T3 levels, to show the full picture of thyroid health.

My quality of life wasn’t and still isn’t perfect. I am a shell of who I used to be; it’s a lifelong journey to being back to the  joy of great personal well being and gaining my full life back. 

 My thyroid story has been a long road, with a lot of medical gaslighting along the way.  I  was finally diagnosed with widespread papillary thyroid cancer after a long struggle to get a second option, the cancer was found after my total thyroidectomy in histology in every single layer of that biopsy.   Bye, bye butterfly gland and hello to a new world trying to navigate critical medication to support my ‘system’ to feel well again. I never knew what my thyroid controlled and had influence over. 

For  the past couple of years  my dosage  was  levothyroxine treatment only  and it  has been adjusted and monitored with blood tests.  The brain fog, the mood swings to name a few,  the quality of life hasn’t been good, not much of a life at all if I’m honest  and I have been brushed off by my traditional professionals and not been taken seriously. Navigating thyroid symptoms has sometimes  felt like walking through treacle with a blindfold, in the dark, alone. 

For example,  my one and only  NHS endocrine consultant appointment, ( My follow up at has been cancelled) the discussion about talking about T3 meds, told over quite a lot of that appointment I had waited so long for,  that I shouldn’t be taking them and that they are not prescribed on the NHS in Dorset. 

I have been prescribed a low dose of liothyronine by a private doctor based on symptoms, blood tests, tight monitoring and even within a week when I first started taking them, I  started to notice a difference. 

For instance  some of my symptoms  such as my brain fog, woolliness, feeling wobbly on my feet, forgetting words and not being able to express a comprehensive conservation, my mental ability was so much clearer,  I felt so much brighter, my roller coaster  of hormone instability of crying one moment and being semi okay then next, has been so much settled, my friends and family have noticed a big difference ( and said so!).

It was after a really considered decision to start taking private medication, as the financial impact, the regular private testing, monitoring is a big step to take and  not taken lightly. 

I found the honest conversations on forums to be so helpful; reading trusted research, information and not to feel completely alone. It will be a lifelong quest for great thyroid health; especially with the barriers traditional medicine has put up,  the insatiable costs the pharmaceutical  companies are raking in; the constraints of the current NHS system  including the costs of prescribing T3 meds and navigating a mainly old dated system. Awareness, education and being my own advocate is key. 
That saying, If you do the same old, you get the same old seems very apt. 

Bio: Natalie Guy lives on the South coast in Bournemouth after moving 15 years ago from London. She was diagnosed with widespread thyroid cancer in October 2020 and is still on her healing journey. Natalie was self employed  mosaicist prior to the diagnosis and due to the glass dust and grout, is currently pursuing other creative avenues. 

Determined to simplify the process, I turned to the basics. I realised that there's a certain beauty in simplicity, especially when navigating through challenging times. Thus began my culinary experiment, where I crafted recipes using correct ingredients, ensuring they align perfectly with the requirements of a Low Iodine Diet.

"Thyroid Triumph" is not just a cookbook; it's a testament to resilience and creativity. Each recipe is a result of trial, error, and a passion for making the LID journey not just bearable but enjoyable. While these dishes are curated to last for two days, they are designed with flexibility in mind. If the thought of eating the same thing back-to-back doesn't appeal to you, feel free to mix and match. The kitchen is your sanctuary, and "Thyroid Triumph" is your guide to turning it into a place of joy, even amid dietary restrictions.

Beyond practicality, this cookbook encourages creativity. Create notes dedicated to creating your own recipes, a canvas for your culinary imagination. Substitute ingredients, experiment with flavours – make it your own. As you hold this cookbook in your hands, know that it's a labour of love. A desire to share not just recipes but a roadmap for a smoother LID journey. It's my way of reaching out to those who might be feeling lost and saying, "You're not alone, and you can make this delicious."

To those embarking on their thyroid journey, "Thyroid Triumph" wishes you strength, resilience, and, above all, a cancer-free destination. May this cookbook be a companion, a source of inspiration, and a reminder that through the joy of cooking, we can triumph over adversity. Let's savour the journey, one delicious recipe at a time, and together, let's kick cancer in the butt!​

Written by David Christopher,

​I was diagnosed hypothyroid about 20 years ago, by chance, via a ‘well man’ test. It was a real shock. Not to worry, I was told, you just need to take a tablet every day and it will be fine. And so, it began.

I wasn’t fine, my thyroid hormone levels didn’t stabilise, my dose of levothyroxine kept on going up and my GP couldn’t work out what was wrong. I saw an endocrinologist who said I was hashitoxic, i.e., my thyroid problem was an auto immune condition. Originally, I had been hyperthyroid, had Graves disease and thyroid eye disease, which weren’t diagnosed and treated, but went away when I became underactive. This left me with some double vision on my left-hand side.

My levothyroxine was set at 275 mcg and settled down. I was told, almost in passing, that once you have one autoimmune condition, you can develop others, but didn’t really think about it. For about 15 years all was relatively ok. I never felt quite the same, had energy than previously and become more moody. I also had about 4 years of allergic reaction to the sun, which was a pain, but settled down.
​
About four years ago I developed sore feet follow a walking holiday. It was very painful and didn’t go away, so I saw a doctor and was told I had plantar fasciitis. I had to wear insert in shoes, and it lasted about 6 months. It recurred a few times, but has settled down. Three years ago, I had pain in my left arm, and it was kind of numb. Ever melodramatic, I thought it was a heart-attack, so saw a doctor, and was told I had carpal tunnel syndrome – which is linked to hypothyroidism. I had to wear a wrist splint, this still comes and goes.

All the time, my levothyroxine kept on going up, I think it got to a maximum of 300mcg a day. About a year ago, I noticed in cold weather that my fingers stinging, going white and numb. I assumed it was due to the cold. One morning, I woke up with numb hands and feet, which was very disconcerting. I went to hospital, and they were flummoxed, did blood tests, and pumped me with B12. It turned out I was coeliac, confirmed after gastroscopy, which is an autoimmune condition. So, I had to go gluten free, a disaster for someone who likes bread and pastries!

I assumed undiagnosed coeliac disease had affected my hands and feet and would calm down, but it didn’t. I’ve had brain scans, and nerve conductivity tests to try and find the underlying cause. It turns out my white fingers were due to Raynaud’s disease, another autoimmune condition, I may also have rheumatoid arthritis, again autoimmune related. To date, the best thing that has happened is that I’ve had physio, which really helped my hands and feet. The numbness has lessened, but a certain stiffness and low-level pain remain. My dose of levothyroxine has come down, undiagnosed coeliac disease may cause malabsorption of levothyroxine.

When first diagnosed, I was rather blasé, not realising how my illness would affect me or my family. I also discounted the autoimmune element, thinking it wouldn’t happen to me. My journey continues, things are better and hopefully I’ll get resolution re the arthritis and be able to move forward. However, at the back of my mind I always wonder what next?

My advice for anyone with similar conditions is, listen to your body, you know best how you feel. Don’t letter doctors fob you off, and remember that lots of apparently random and unconnected issues, could all be down to your immune system and linked. So, don’t discount things, seek answers, and never give up, oh, and good luck!

"David was diagnosed as hypothyroid (Hashimoto's) in 2003 and developed coeliac disease and Raynaud's syndrome in 2023.  He has been a regulator, mainly education and healthcare, most of his professional life, and lives in west London, with his wife, two kids and cat."

Written by Mina, The Graves' Disease Chef

The last time I wrote for Thyroid Trust, I shared my Dutch Oven Pumpkin Spiced Chili recipe. Think all plant-based chili with tons of aromatics, flavour and yum. Everyone loves a generous bowl of chili with all the fun toppings.

Thought I’d share a different type of recipe today given that the weather is getting even colder here in Northern California and I’m thinking more comfort food would be a nice welcome. Rather different from the dishes I used to prepare when I lived on an island.

It’s wild to think that a little over one year ago. Life was very different. I was living on a remote island in the heart of the Philippines and so much was going on in my little part of the world. We had just moved back to the U.S., after island living for almost two years. Going from warm and balmy tropical days of paradise living, to the wintry cold and stormy weather in the States was quite a shock to the system. As you can probably imagine. 

​Gone were my “we wear short shorts,” crop tops, bikinis and flip flops. Incoming were winter coats, bulky sweaters and fleece lined boots, hats and gloves. Bye-Bye to A/C on high nonstop and hello to central heating - round the clock. I didn’t care though because I knew I was finally home safe and sound and exactly where I belonged - near our boys - sharing meals, love and laughter again. And… life was just as it should be.  The freezing temps were intense to say the least but one of the first comfort food dishes I created upon return was that very spiced chili that I last shared on the Thyroid Trust blog. Did you try it? It’s quite the colourful comfort food dish. If you didn’t catch it, let me know and I’ll send over the recipe. 

In keeping with tradition to share yet another wintry recipe, I thought, why not a seasonal inspired dish because I love sharing the delights of plant-based dining and using local, fresh ingredients for each dish. There’s that and because I get weak in the knees for Thai food. I’ve come to discover, traveling the world and experimenting with international flavours, near everyone seems to love Thai food. Why not share something you might not expect you can do with Brussels Sprouts and give it a Thai twist. Brussels Sprouts? Hah! Yes. Thai influenced. Why not?!

Since Brussels are in abundance here, I developed this Roasted Brussels Sprouts with Cannellini Beans and Thai Peanut sauce dish. The peanut sauce is featured in The Graves’ Disease Chef Cookbook, “How to Master Simple to Gourmet Plant-based Flavours from Around the World” in the Sauces, Drizzles and Marinades Chapter. I thought it might be fun to give you a little sneak peek tasting of what you’ll find in the Cookbook.

This Thai Peanut sauce is beloved and one of our all-time family favourite Asian sauces. If you ask any of our four sons, they’ll tell you it rivals any Mom and Pop or high end Thai restaurant because it’s as authentic as it gets. The major difference being that the ingredients in my recipe are much healthier and cleaner and all organic and yes, all plant-based. You’ll be hard pressed to find that in most any Thai restaurant from the peanut butter and “fish” sauce to the coconut cream and red curry base. Pairing it with Cannellini Beans and Brussels Sprouts topped with toasted almonds and gluten-free breadcrumbs takes it to a whole different level of yum when you think of Brussels or Thai cuisine for that matter. It’s quite the winter party in your mouth.

If you ask me, I have to admit, I was never a fan of Brussels Sprouts. Frankly, I’m not a big fan of most any boiled veggie unless I’m under the weather and need something bland and boring but even then, Brussels never made it on my “gotta have it” list. In fact, I never chose to cook with Brussels during my years of recipe developing for Graves’ Disease until one day, I happened to taste them as an appetizer – roasted, slightly charred, nutty and perfectly crispy. Oh. My. Yum. There wasn’t that distinctive, familiar, overwhelming sulphur odour and bitterness. I was hooked on what I once thought to be an utterly boring, tasteless, smelly green cruciferous vegetable. The secret I discovered is in how you prepare those little round balls of Brussels.

I don’t know if you fancy Thai dining or Brussels and Beans but I do think you’ll enjoy this one. I had quite a bit of fun developing this dish to share with you so I hope you’ll give it a go in your own kitchen. Introducing my Roasted Brussels Sprouts + Cannellini Beans generously smothered in Thai Peanut Sauce - topped with scallions, fresh mint, Serrano slices and toasted almond and sourdough breadcrumbs. Served with a side of freshly steamed Thai Jasmine rice – it’s delish. I couldn’t decide if I wanted to enjoy it with plain Jasmine rice or fancy it up even more with Thai Fried Rice, so I tried it both ways and both ways did not disappoint. The Thai Fried Rice recipe is also featured in the Cookbook along with 76 other plant-based international gourmet flavours from around the world – not just Thailand. 

For those who may not know, I came out of retirement to share my story about living with Graves’ Disease, ditching the dyes and embracing my silvers and the beauty of aging. Learning along the way how to find wellness and healthy again. These days, you can usually find me on social media under the moniker, The Graves’ Disease Chef, sharing cooking demos and things you didn’t know you could do for a healthier, happier you especially if you suffer from Hyperthyroidism, Graves’ Disease. 

May you have an amazing New Year filled with love, peace and healthy eats. Remember, if you’re not having fun embracing a more whole foods, clean organic lifestyle the way nature intended, you’re not doing it right. Have some fun and try making this dish, especially if you’re not a fan of Brussels, this’ll change your mind.

​Here's the recipe:

Written by A.R Arthur

​Having any Thyroid condition typically implies a slew of mental and other health implications that ultimately impact both quality of life and literal physical health. In this November's blog piece, I will be exploring the ways in which mental health impacts alongside Thyroid illnesses impact men. 

As a man going into my eighth year of having Hashimoto’s, I have often found myself fighting from the very lowest ground level to gain some form of understanding and empathy. Speaking for myself, I don’t want to be victimised or made to feel inadequate, faulty or to have rogue sympathy lobbed at me. Instead, I yearn for simple understanding for men like me who have faced all manner of mental health suffering as a result of a condition that can arise in anyone at any given time. 

​Despite increasing levels of diagnosis, it is estimated that women are ten times more likely to be affected by a thyroid condition within their life. However, due to this difference in levels of diagnosis, men often go unheard and excluded in many discussions of Thyroid illness and mental health.

From intrusive thoughts to depression and chronic anxiety to not wanting to leave the house. These are just a spattering of the many mental health trials and tribulations that can arise with Thyroid illnesses. More specifically with men, many feel inadequate, lose libido, are tired all the time or lack a general zest for life that often sticks out more than the pin-pointed definitions that have emerged for many forms of mental health conditions. This is to say that Thyroid illnesses have a slew of mental health conditions that are just inherently part of them. 

However, especially in younger men, this can lead to more impacts on livelihood and the ability to maintain relationships due to the simultaneous strain of both the Thyroid condition itself and any of its consequences. These ramifications take their toll on all aspects and processes of the body from insomnia to brittle nails and hair. 

Like many men who have Thyroid Illnesses, I have found ways to cope through mindfulness activities that emphasise a sense of calm in the dark and tense. Something that is so quintessentially English, is the belief that one should ‘get on with it’. This can be negative as someone who has experienced this mentality being transposed onto myself and my condition. However, this way of thinking has also been extremely beneficial to my ability to work and see through the illness and naturally, the anxiety and other mental health impacts that exist with it. 

Despite these challenges we continue to persevere and find common ground amongst each other as we come to terms with our Thyroid illnesses and how we can cope and grow despite their far-reaching impacts. If you have a Thyroid condition, be gentle with yourself today and if you know someone who is struggling, reach out and make them feel less alone. 

Written by Mina, The Graves' Disease Chef

Hello my beautiful Butterfly Warriors. Happy Autumn and Happy World Vegetarian Day! Can you believe Fall has finally arrived?! It has here in California. Swoon!

I don’t know about your neck of the woods but it was a very long and hot Summer here in Cali so you can only imagine that the cooler mornings and chillier nights have received quite the welcome from me.  

It's officially “sweatah weatha” and you know what that means for The Graves’ Disease Chef and my kitchen?

Not only is it time to change the menu, it’s also time to change out all the brightly coloured Summer dish towels, potholders and aprons and bring out the colours of Autumn. Time to start recipe developing again and creating new, fun and fancy Fall inspired dishes with the season’s freshest organic produce and flavours.

Time to add to my plant-based library of recipes that I’ve created through the years that now topple well over 700+ recipes from soups, salads, sides and sauces to rice, pasta and noodles along with simple to gourmet main dishes. And, now that Fall has arrived, the top of my list always includes comfort foods like soups, stews and Chili because c’mon, who doesn’t love a nice bowl of Chili?! 

I grew up loving Chili! The entire house would always smell of amazingness while the big pot of chili would slowly simmer on the stovetop. Chili was just one of those memorable comfort food bowls of goodness that I always looked forward to whenever we’d have it. By the time I “grew up” I learned to experiment with many versions of it (long before I had embraced a plant-based lifestyle).
You name it, I’ve probably experimented with it.

Chile con Carne (with meat) – TexMex version. Chile con Pollo (with chicken). Chili con Pavo (with turkey). Chili con Porotos de Soja fermentado (with fermented tempeh) that's a mouthful just to try and pronounce.  And now, as a plant-based Chef and foodie, I created the tempeh version and then passed GO, skipped tofu completely and made the next ultimate healthy vegetarian version of Chili and I'm sharing it with you! Are you ready?

All beans and all plants.
My homemade, Autumn inspired, Pumpkin Spiced Chili featured to celebrate Vegetarian Day has a cozy little twist though. Instead of letting it slow simmer on the range, this Chili will cook slowly in the oven, using a good-size Dutch oven. If you don’t have a Dutch oven, not to worry because a large heavy bottomed sauce pot with a lid will do the trick.

Why the oven though?
Here’s my WHY. When you “bake beans and tomatoes” together, it changes their flavour and texture. You get treated to a creamier, thicker consistency with a richer umami sweetness from the tomatoes, and the beans unleash a more savoury and caramelized deliciousness. Add pumpkin puree to the pot and you suddenly have a warm Autumn hug for your taste buds and tummy – served up in a bowl and piled high with all the fun mix and match garnishes.
​
What’s not to love? We could all use a warm Autumn hug. Right?!
I hope you’ll join me in celebrating World Vegetarian Day, along with World Vegetarian Month and give this a spin in your own kitchen this Fall and if you do, I’d love to know what you think. Love you big. Thank you for your continued support of this long-term healing journey. 

You can usually find me sharing cooking demos and healthy lifestyle tips @thegravesdiseasechef on Instagram or my newly launched website: www.thegravesdiseasechef.com It has been a wild, beautiful and magical ride! I'm thrilled to be on it with you - living our best life - despite the challenges of thyroid disease! Giggles and Swoon, Mina "The Graves' Disease Chef" 

PUMPKIN SPICED – DUTCH OVEN BAKED CHILI

INGREDIENTS

3 TBSP – Avocado Oil, divided
13 oz – Field Roast (*) Chipotle Sausages, crumbled
1 Purple Onion – chopped
2 Red Bell Peppers – chopped
2 TBSP – Chili Powder
1 TBSP – Ground Cumin
1 TBSP – Pumpkin spice
1 tsp – Smoked Paprika
1 tsp – Cinnamon
1 tsp – Sea Salt
¾ tsp – freshly cracked peppercorns
6 Garlic Cloves – minced
1 Serrano Pepper – minced (for less spicy heat, remove white pithy membrane and seeds)
4 - 14 oz cans fire roasted tomatoes
2 – 15 oz cans, Black Beans, drained & rinsed
2 – 15 oz can, Red Kidney Beans, drained & rinsed
2 – 15 oz can, Great Northern Beans, drained & rinsed
1 – 15 oz can, Pumpkin Puree
3 ½ cup – Vegetable Broth, divided
1 – 7 oz can, chipotle peppers in adobo sauce, roughly chopped (optional, use only if you fancy spicy heat)
1 tsp – Worcestershire sauce
2 fresh Bay leaves
2 TBSP – Unsalted butter (Vegan option, use Non-dairy butter)
1 tsp – Coconut Sugar
 
Garnishes:
Corn or Flour tortillas, flame charred to warm up
Toasted Pecans, chopped or Pumpkin seeds
Crema, Crème fraiche or Sour Cream
Shredded Cheddar cheese
Chopped Sweet Onions
Cilantro sprigs
Fresh lime wedges
 
(* Field Roast brand sausages are Vegan; feel free to substitute with any of your favorite vegetarian sausages).

DIRECTIONS
Preheat oven to 180C/350F degrees.
In a large Dutch oven, heat 1 TBSP oil over medium until shimmering. 
Add crumbled sausages and cook until browned, 5 to 7 minutes. 
Using a slotted spoon, transfer the cooked sausages to a plate. Set aside.

Add remaining 2 TBSP oil to Dutch oven, add onions and red bell peppers.
Cook over medium low heat until translucent and caramelized, 10 to 12 minutes. 
Stir in spices – chili powder, cumin, pumpkin spice, smoked paprika, cinnamon, salt and pepper – to toast and release the flavours, 2 to 3 minutes until paste like consistency.
Add garlic and serrano peppers. Sauté an additional minute until aromatic.
Using a silicone spatula, gently stir in tomatoes, black beans, kidney beans, white beans, pumpkin puree, 2½ cups broth, chipotle peppers with adobo sauce (if using), Worcestershire sauce and Bay leaves. Stir to combine.
Bring to a quick boil over high heat.

Cover and transfer Dutch oven to the preheated oven.
Cook for 1½ hours, stirring every half hour or so. Sauce will continue to thicken. Add a few splashes of broth, each time and stir to combine.
Remove from oven, add butter and coconut sugar, stir gently. Keep covered and allow Chili to rest at least 20 minutes before enjoying.

Serve over flame charred fresh corn or flour tortillas and top generously with toasted Pecans or Pumpkin seeds, crema, cheddar cheese, finely chopped sweet onions, cilantro sprigs, and a squeeze of fresh lime.
Eat your “Hearty” out and feel that warm Autumn hug.
 
SIDEBAR: To make this an even heartier meal, serve with rice. Chili tastes delicious with a side of freshly steamed rice or with my MexiCali fried rice (if you already purchased the Cookbook, you’ll know that both recipes can be found in the Rice Chapter of “The Graves’ Disease Chef – How to Master Simple to Gourmet Plant-Based Flavours from Around the World” Cookbook.)

Email me at ExecutiveChefMina@thegravesdiseasechef.com or send me a message on Instagram, if you’d like to receive the freebie "Sneak Peek Preview" of the Cookbook and I'll send you the link. 

P.S. In the off chance you have leftovers, Chili tastes even more indulgent the next evening after all the flavours have had a chance to marry and mingle overnight in the pot. 
​
I can't wait for you to try this Chili! 

Written by Ahmad Alsharrah

​Ahmad Alsharrah is a striving Arab doctor who is currently studying his fourth year of Medicine at the Queen Mary University of London. With a recent diagnosis of Hashimoto’s thyroiditis, Ahmad has been living with autoimmune hypothyroidism while finishing up his final years as a medical student. Ahmad has a particular interest in medical writing and overall wellbeing, with multiple articles published online in Fahmidan Journal. 

Impact of overworking for the guardians of health 
Healthcare providers work tirelessly to deliver the highest quality of healthcare to their patients and continue to do so on a day-to-day basis. 

​This umbrella of workers can include doctors, nurses, psychiatrists, and occupational therapists. Their responsibilities typically involve heavy workloads under immense stress, often over long working hours to provide adequate healthcare to their patients. Considering this, healthcare workers and their physical, mental, and emotional wellbeing are often overlooked in their profession, as one must display immense resilience and determination to complete their duties to a high standard. When talking about healthcare workers, the term “burn-out” becomes highly prevalent and is often experienced by a large majority of workers that push through their limits and capabilities without a thought of their own health. While some may have incorporated healthy habits into their routine to mitigate this exhaustion, what about those that struggle to do so? Even more so, what about those that suffer from chronic illnesses and autoimmune conditions?

The double-edged sword of being labelled a “hero” 
It is easy to think of healthcare workers as superheroes; strong, invincible, and selfless when it comes to treating those who are sick and in need of assistance. This has created an illusion masking the underlying truth which is: healthcare workers are human, just human. They also struggle, get sick and make mistakes just as any other person would, so why are they viewed under a different lens? As a medical student recently diagnosed with Hashimoto’s thyroiditis, I inadvertently found myself experiencing a glimpse of this harsh reality by constantly pushing through my limits just to cover my responsibilities and the sheer content that comes with being a medical student. Weeks of somnolence and feeling down would go by without a reasonable explanation, and prior to seeking answers which eventually led to a definitive diagnosis, I always put it down as, “Medical school is taxing so just keep pushing through, as all students and doctors have.” I kept finding myself glued to my bed due to excessive tiredness, but it did not matter to me as long as I completed the tasks set out to me. Overtime I found that I was highly self-critical for not having enough resilience or drive to soldier through tough times such as these, as how can one expect rainbows without a shower of rain? It took me quite some time to gain this realisation but how can we expect doctors to improve our health at their highest performance when they’re actively neglecting their own?

A message put forth to improve our health
To begin breaking down this illusion, healthcare workers must work to adopt better self-care practises for themselves. We must always check up on our own health and ensure we are functioning at our best. Our limitations are not set by what chronic condition we suffer from, but by how willing we are to understand and work with it to achieve the best possible outcome for ourselves. You may have been dealt a bad set of cards, so use it the best way you possibly can.

Can you take birth control with thyroid problems?

You can still take birth control if you have thyroid problems. However, your healthcare provider may take the opportunity to monitor your thyroid function to check for any changes around 6 weeks after you commence the birth control pills.
In a study Qiu et al  (2021) demonstrated a significant association between history of taking birth control pills for more than 10 years and hypothyroidism.
Google searches suggest that thyroid medication and oral contraception should not be taken simultaneously suggesting a 4 hour window between the two drugs  but I have been unable to trace any reference source that confirms this. 

Thyroid and the menopause
In the same way it is suggested that oestrogen in HRT can affect thyroid management. 

Menopausal diagnosis can be problematic as every woman tends to experience slightly differently. Women with pre-existing hypothyroidism treated with thyroxine may require an increase in their thyroxine dose after starting HRT. It is useful for thyroid function tests to be re-checked around 6 weeks after starting HRT.

Soya and thyroid 
There is also evidence to suggest that soy foods may inhibit the absorption of thyroxine and increase the dose of thyroid hormone required by hypothyroid patients. Generally, it's best to wait four hours after taking thyroid medication to consume any products that contain soy. The same guidelines apply to other products that may impair the body's ability to absorb thyroid medication, including concentrated iron and calcium supplements, and antacids that contain calcium or aluminium hydroxide (Messina 2006).

References
● Qiu Y, Hu Y, Xing Z, et alBirth control pills and risk of hypothyroidism: a cross-sectional study of the National Health and Nutrition Examination Survey, 2007–2012BMJ Open 2021;11:e046607

● Messina M, Redmond G. Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature. Thyroid. 2006 Mar;16(3):249-58. doi: 10.1089/thy.2006.16.249. PMID: 16571087.