"You're a Tough Nut to Crack..."

Posted by Healthful Elements Staff

Almost every client that Jill and I work with comes to us after having tried many different healing strategies. 

Most have tried a Paleo or AIP diet; many have given up gluten or dairy or both; the majority have seen an endocrinologist and a holistic practitioner (or three), including chiropractors, naturopaths, and nutrition coaches. 

I recently had a client who’d been a patient of one of the biggest names in functional medicine. 

Many of our clients already take high quality supplements — vitamin D, fish oil, and probiotics are the top ones I see — and I’d put the percentage of them who exercise regularly at 95 percent or higher. 

In other words, we see some of the smartest, most committed people around (which makes our jobs an absolute joy). 

But the sticky question remains: if they’ve done everything “right,” why do they still feel so badly? 

Why are they fatigued and weight loss resistant? Why do they still have digestive issues? Why are their antibodies stagnant — or increasing

Most of our clients have put this question to their previous providers. Many times, they get some version of: “I don’t know. Your case has me stumped!” Or, “You’re a tough nut to crack.” 

I talked with someone yesterday, and someone again this morning, both with versions of the same story: “My doctors were baffled. They said I was the exception to the rule.” 

Then there’s the all-too-common response (and one that’s rampant in the conventional medicine community around autoimmunity): “I have nothing else for you.”

One woman I worked with recently had not one but TWO previous practitioners refund her money after she tried their protocol and it didn’t work.

Let me be clear that Jill and I aren’t wizards. 

After seeing some of the shenanigans that go on in the world of online health and wellness, I’d venture to say that we’re quite humble, if we do say so ourselves. We certainly know our professional limitations — we know what we don’t know.

We can’t be sure what has previously worked for our clients and what hasn’t and we would never say, “Hey, we have all the answers!” We’ll be the first to tell a potential client that we’re not the right coach for them and to go work with so and so. It’s in no one’s best interest to work with someone whose issues are outside of our wheelhouse.

Anyway, during our program together, the woman who’d had her money refunded twice started to make progress for the first time in a decade. 

Most of our clients report feeling better quickly (and, for many of them, for the first time) as they move through immune modulation, a gut healing protocol, and hormonal balancing, all of which is our wheelhouse.

Again, I would never suggest that Jill and I know more than other practitioners. Besides, it’s not all about the knowing.

I also want to emphatically point out that we’re not doctors, so we can’t prescribe, diagnose, or treat, nor do we use the words “cure” or “heal” in our work with clients.

Instead, Jill and I educate, inform, and support. And in the process, I’ve developed some theories about why many of our clients haven’t been successful in the past.

Here are my top hunches about why people get dismissed with shoulder shrugs. And how they can — and often do — get better.

Previous protocols ignored sequence.
So many of the interventions our clients have undertaken in the past are great — and critical for healing — but they’re largely ineffective when they’re done out of order. Sequencing makes all the difference. Suggest interventions and recommendations in the right way, and some degree of symptom relief almost always follows — in pretty short order. [See the final point in this post for more details on hormonal sequencing.]

Practitioners want to be liked, so they back-pedal on the non-negotiables.
If you have an autoimmune condition, avoiding gluten is a non-negotiable. But it’s hard to be the one to break the news that a favorite food is now off limits. There are more (and less) effective ways to tell someone that gluten is off the table, but it has to be established — bottom line. Some would call it tough love. A practitioner can’t skip over this (or soft pedal it) to curry favor or avoid someone getting mad. Far better for someone to get upset, but ultimately get better, than for them to like you and stay sick.

Lack of ongoing support.
When a client hires us, they’re stuck with us for a set period of time. So if they know that doing an elimination/provocation diet will help them, but it’s getting challenging and they’re thinking of “taking a short break,” we’re there to remind them of the life-changing value of sticking with it. Significant lifestyle changes are next to impossible when you go it totally alone, or when your extremely wonderful, but extremely busy, functional MD can only see you once every six months.

Prioritizing supplements above everything else.
Supplements can be powerful tools in the healing arsenal, but they are far too easy to rely on at the exclusion of other interventions. Some of the most foundational healing strategies are more challenging to do — changing diet, changing work/life patterns, carving out time for radical self-care. By comparison, popping this week’s new “miracle pill,” whether it’s phosphatidylcholine or nicotinamide riboside, seems way easier. Note: I have nothing against these supplements and have taken both of them. My only point is that neither of them — nor any other supplement — can substitute for other changes. People need both.

Misunderstandings about hormonal sequencing.
If you’ll allow me to geek out and get a little more specific about sequencing, perhaps one of the single biggest reasons that people still struggle is that they’ve worked with other practitioners who don’t fully understand how our hormonal house is built.

This is fodder for a whole other post (or more like a book), but most clients come to us with little prior education about blood sugar balancing and true adrenal support. Insulin, which regulates blood sugar, and cortisol, the bossy, independent adrenal hormone that has such a profound ripple effect throughout our endocrine/hormonal and immune system, are foundational to everything.

All roads lead back to blood sugar management and adrenal restoration.

Perhaps you have Hashimoto’s. You can’t just focus on TSH, T3, and T4. Or thyroid hormone replacement.

Maybe you’re estrogen dominant. You can’t simply work on detoxing estrogen.

Perhaps you have PCOS. You can’t just worry about insulin resistance. (Or simply take the birth control pill or Metformin, which is what the conventional medicine community is quick to suggest.)

Maybe you’re struggling to get pregnant. Focusing on progesterone, estrogen, lutenizing hormone (LH), and follicle stimulating hormone (FSH) doesn’t always help. (I would suggest that it rarely helps.)

Perhaps you’re perimenopausal. Simply taking HRT (hormone replacement therapy) doesn’t get to the root cause of your weight gain, moodiness, and hot flashes and night sweats.

If you’re struggling to lose weight, you’ve probably noticed that eating less and exercising more isn’t a long-term solution (and ultimately makes weight loss resistance worse).

Maybe you don’t get quality sleep. Prescription medication doesn’t fix the problem. Instead, it paves over the root causes that only get worse the longer they’re ignored. 

In short, if your adrenals are shot and you’re dysglycemic, all bets are off. You’ll never see true relief from any of these conditions without first balancing insulin and cortisol.

Again, they’re foundational. As Jill has said a hundred times, “You can’t put the roof on the house without a foundation.” (She has a background in architecture, so this is her form of geek speak.)

I could go on and on about this, but for today, I’ll leave you with this…

The reason that our clients feel better within a few days is because to start, we focus on these two short-cycle hormones.

Insulin can be managed from meal to meal.

Cortisol has a 24-hour diurnal cycle.

Hence, it doesn’t take weeks and months to get these hormones working for you vs. against you. And people can feel remarkably better — sometimes within the day. Yes, the day.

Sequencing is everything.

Posted by Healthful Elements Staff


i was diognosed with Adrenal insiffiency and Hashimoto, 1 1/2 ago, my doctor and endroconologist prescribed me steriods. And thyroid medicine, I've gained 30 pounds since than. I still don't feel good, I try to exercise regurlaly but it seems I can't because I'm always tired, I'm so depressed over all this, and think there must be something different I can do!

Wow! Well done! I love reading your posts, so succinct and true :-). I am now gluten & dairy free, cut out sugar/alcohol for a while & did lots of lifestyle changes to aid my adrenal recovery. Now a year later I feel great, am more balanced and am starting to exercise. One more stone to lose!! (I have hashimotos). Also swopped my levo pill for another lower levo dose and importantly without lactose too! Thanks for your informative and brilliant posts. So spot on xx 

Way to go, Esther! Lifestyle medicine is so powerful. I’m thrilled to know that you’re reaping the benefits!

This is such a great post and is great affirmation of what I do. It all seems so complicated, but I find as a practitioner that most of my work circles around stress management and blood sugar management (which of course are fraternal twins). Thank you for writing.

Thank you for commenting and keep up the good work. The world needs practitioners who really understand those fraternal twins!

I have hypothyroidism. So I am wondering should I address my adrenal first. If so, where can I find more info on addressing my adrenals.  Thank you

Yes, you can find more information in our Restore Your Adrenals chapbook, which we linked to in the post. 

I feel like I'm doing everything I can to get better and reading all the posts and I'm almost there but I'm having weekly migraines when before I started taking thyroid hormone I had them once a year. My functional doc is taking things slowly .. . first trying estrogen and now trying progesterone and both give me more headaches. . . .I have Hashimoto's. I truely feel like the hard to crack nut.

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