Also available on the market are combination medications that contain both synthetic T4 and T3 hormones, but such medications aren’t usually recommended. For one thing, most patients see their condition improve with synthetic T4 alone because of the ability of the thyroid to convert these hormones to T3 when needed. Also, synthetic T3-T4 combination drugs can cause anxiety — if you have a preexisting mental health disability, such side effects may be even greater. (3)
Nature Throid or WPThyroid: This is a great alternative to Armour as it’s gluten-free (and as we discussed in the diet section, people with hypothyroidism are often gluten sensitive, intolerant or Celiac). I prefer this to Synthroid, too, because it’s not made in a lab and instead is a natural supplement (though it’s made from animal thyroids, the thyroid hormones are biologically similar to that found in humans.). Both Synthroid and Armour contain controversial inactive ingredients, including gluten, sugar, and colorants, whereas Nature Throid and WPThyroid do not contain any artificial colors or flavors, corn, peanut, rice, gluten, soy, yeast, egg, fish or shellfish.
On the flip side, there are certain foods that people with underactive thyroids should minimize or avoid altogether, like cruciferous vegetables, particular raw Brassica vegetables like broccoli, cauliflower, cabbage, kale, soy, and Brussels sprouts. While these are healthy foods for most people, they contain a compound called goitrogens, which might impact thyroid function by impairing thyroid peroxidase. Gluten, conventional dairy, refined sugar and refined flour, caffeine and alcohol (which stress your adrenals) are also contraindicated for hypothyroid patients.
Characteristic symptoms and physical signs, which can be detected by a physician, can signal hypothyroidism. However, the condition may develop so slowly that many patients do not realize that their body has changed, so it is critically important to perform diagnostic laboratory tests to confirm the diagnosis and to determine the cause of hypothyroidism. A primary care physician may make the diagnosis of hypothyroidism, but assistance is often needed from an endocrinologist, a physician who is a specialist in thyroid diseases.
Zinc is critical to thyroid health and is required for the synthesis of thyroid hormones. In fact, deficiencies of this mineral can lead to hypothyroidism. (Additionally, thyroid hormones are essential for zinc absorption, so hypothyroidism can lead to zinc deficiency.) Pumpkin seeds are a rich source of zinc; other good sources include oysters, crab, lobster, legumes, nuts, and sunflower seeds.
Ancient Nutrition Bone Broth Protein is an all-natural, Paleo-friendly protein supplement that I’ve created that helps anyone who loves bone broth enjoy the benefits of real, homemade bone broth without spending hours cooking bones in your kitchen. For as long as humans have been cooking food over fire, bone broths — chicken, beef, turkey, fish and more — were staples in the traditional diets of every culture. And for good reason. The long cooking process allows easier digestibility and assimilation of key nutrients.
But determining the correct dosage isn’t a quick process — you will need a blood test between six and eight weeks after you first start taking your medicine to see if your hormone levels are normalizing. If your doctor thinks you need a dosage adjustment, he or she will do so and recheck your hormone levels after another six to eight weeks. Once your thyroid hormone levels stabilize, you won’t need another thyroid check for six months. (5) Controlled hypothyroidism requires only an annual checkup. (3)

As mentioned above, most thyroid conditions are auto-immune diseases. There are tons of lymphocytes and other immune cells in the gut, which protect the body from viruses, bacteria, and other invaders. This is why most people with thyroid conditions also experience frequent bloating, gas, constipation or diarrhea. A diet change will help your gut tremendously. “All disease begins in the gut“, said Hippocrates, the father of modern medicine. I’m not sure why this is not taught in schools today, but it’s an important part of the thyroid diet plan.

Iodine supplements should not be taken with Hashimoto’s disease because getting too much iodine over the longterm increases the risk of developing an overactive thyroid. While it’s nearly impossible to get too much from eating a variety of healthy foods alone, sometimes people taking supplements or eating very high amounts of dried algae and seaweed can exceed the recommended upper limit of 500 milligrams per day.

The problematic compound in soy (for your thyroid) are the isoflavones. In fact, a study in the Journal of Clinical Endocrinology and Metabolism reported that researchers fed some subjects 16 mg of soy isoflavones, which is the amount found in the typical vegetarian's diet,  and others 2 mg soy isoflavones, which is the amount found in most omnivore's diets.


Levothyroxine tablets come in 12 different strengths, and it is essential to take them in a consistent manner every day. A dose of thyroid hormone that is too low may fail to prevent enlargement of the thyroid gland, allow symptoms of hypothyroidism to persist, and be associated with increased serum cholesterol levels, which may increase the risk for atherosclerosis and heart disease. A dose that is too high can cause symptoms of hyperthyroidism, create excessive strain on the heart, and lead to an increased risk of developing osteoporosis.
Goitrogen Foods — People with hypothyroidism may want to stay away from eating large amounts of raw Brassica vegetables like broccoli, cauliflower, cabbage, kale, soy and Brussels sprouts. These vegetables might impact thyroid function because they contain goitrogens, molecules which impair thyroid perioxidase. (11) When consuming these cruciferous vegetables, it’s best to steam them for 30 minutes before consuming and keep portions moderate in size. These pose more of a risk for people with iodine deficiencies.
Refined Flour Products – Any food made with refined carbohydrates, like enriched wheat flour, for example, negatively impacts hormone levels and can contribute to weight gain. Refined flour products include bread, cereals, pastas and all baked goods. If possible, remove most grains from your diet all together, or at least try to greatly limit the amount of products you eat that are made with any flour by choosing 100 percent whole, ancient grains instead (like quinoa, buckwheat, etc.)

Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.


Medications that are used to treat an overactive thyroid (hyperthyroidism) may cause hypothyroidism. These drugs include methimazole (Tapazole) and propylthiouracil (PTU). The psychiatric medication, lithium (Eskalith, Lithobid), is also known to alter thyroid function and cause hypothyroidism. Interestingly, drugs containing a large amount of iodine such as amiodarone (Cordarone), potassium iodide (SSKI, Pima), and Lugol's solution can cause changes in thyroid function, which may result in low blood levels of thyroid hormone.
One of the most powerful things you can do to help your health and metabolism is to drink enough water. Water helps your metabolism function more efficiently and can help reduce your appetite, get rid of water retention and bloating, improve your digestion and elimination, and combat constipation. Some experts even say that we should drink one ounce of water per pound of scale weight.
It is extremely important that women planning to become pregnant are kept well adjusted, since hypothyroidism can affect the development of the baby. During pregnancy, thyroid hormone replacement requirements often change, so more frequent monitoring is necessary. Various medications and supplements (particularly iron) may affect the absorption of thyroid hormone; therefore, the levels may need more frequent monitoring during illness or change in medication and supplements.
** Medications** - Some medications can contribute to hypothyroidism. Medicines such as lithium, amiodarone, interleukin-2 and interferon alpha can prevent the thyroid gland from producing its hormones normally. These medicines are most likely to affect the thyroid’s functionality in patients who have a genetic susceptibility to autoimmune thyroid disease.
Radioimmunoassays for measurement of serum T3 (48) and T4 (49) were soon developed, and it was observed that l-thyroxine monotherapy could normalize both T4 and T3 levels at the expense of a high T4:T3 ratio. In contrast, l-triiodothyronine, desiccated thyroid, thyroglobulin, and l-thyroxine/l-triiodothyronine combination all typically resulted in low or low-normal serum T4 values with usually elevated serum T3 levels, and thus a low T4:T3 ratio (28). Desiccated thyroid resulted in a T3 peak about 2 to 5 hours after administration that corresponded to thyrotoxic symptoms in some patients (50). That a single daily dose of l-thyroxine resulted in stable blood levels of T4 and T3 throughout the day (48) was understood to result from a steady rate of conversion of T4 to T3 (51).
The tendency to put on weight if you have hypothyroidism can cause people to starve themselves or eat an extremely low-calorie diet. This can cause more harm than good and lead to several other health complications. Instead of fad or crash dieting, learn to eat a healthy balanced meal that provides you with all the necessary nutrients, vitamins and minerals required to function optimally. In addition to this add at least an hour of exercise thrice a week and you can boost your metabolism and reduce symptoms such as fatigue as well.
The goal of natural remedies or alternative medicine is to fix the root cause of the thyroid problem. Thyroid problems sometimes start as the result of poor diet, stress, or missing nutrients in your body. Changing your diet and taking an herbal supplement are two ways you can help your thyroid condition. These options may have fewer side effects than taking thyroid medicine. Also, using an herbal supplement for treatment of a low or underactive thyroid may be helpful for people who aren’t responding well to medicines.

Once again, if you look to the anatomy, you find the thyroid gland located in the throat, the center of our communication with the world. Andrea has found in her practice that people with hypothyroid tend to “swallow down” what they really want to say. It’s been very healing for them to learn to speak their truth. On the flip side, she has found that people with hyperthyroid are talking too much, and can benefit by listening more.


“A teaspoon of iodine is all a person requires in a lifetime, but because iodine cannot be stored for long periods by the body, tiny amounts are needed regularly. In areas of endemic iodine deficiency, where soil and therefore crops and grazing animals do not provide sufficient dietary iodine to the populace, food fortification and supplementation have proven highly successful and sustainable interventions.” [Brahmbhatt 2001].
Making dietary changes is your first line of defense in treating hypothyroidism. Many people with hypothyroidism experience crippling fatigue and brain fog, which prompts reaching for non-nutritional forms of energy like sugar and caffeine. I’ve dubbed these rascals the terrible twosome, as they can burn out your thyroid (and destabilize blood sugar).
An unhealthy gut environment can contribute to nutrient deficiencies and raise autoimmune activity in the body. Food sensitivities or allergies, including those to gluten and dairy, can trigger gut inflammation. Other causes of a damaged gut are high stress levels, toxin overload from diet and the environment and bacterial imbalances. When leaky gut occurs, small particles that are normally trapped inside the gut start to leak out into the bloodstream through tiny openings in the gut lining, which creates an autoimmune cascade and a series of negative symptoms.

It is hard for me to tell you what to do without a thorough health history…but I would start by following my anti-inflammatory nutrition plan as mentioned in this article. A natural thyroid hormone replacement like Armour is typically cleaner (levo and synthroid contain GMO corn in the coloring dies) so that would be a good idea. If you would want to consult so I could learn more about your case and customize an appropriate plan for you we could arrange that. Blessings!

Ancient Nutrition Bone Broth Protein is an all-natural, Paleo-friendly protein supplement that I’ve created that helps anyone who loves bone broth enjoy the benefits of real, homemade bone broth without spending hours cooking bones in your kitchen. For as long as humans have been cooking food over fire, bone broths — chicken, beef, turkey, fish and more — were staples in the traditional diets of every culture. And for good reason. The long cooking process allows easier digestibility and assimilation of key nutrients.
The thyroid peroxidase test measures the level of an antibody that is directed against thyroid peroxidase (TPO). A presence of TPOAb in the blood reflects a prior attack by the body's immune system on thyroid tissue. A positive thyroid peroxidase test may signal chronic thyroiditis. Other autoimmune disorders, however, may have a positive TPOAb test.
Central or pituitary hypothyroidism: TSH (Thyroid-stimulating hormone) is produced by the pituitary gland, which is located behind the nose at the base of the brain. Any destructive disease of the pituitary gland or hypothalamus, which sits just above the pituitary gland, may cause damage to the cells that secrete TSH, which stimulates the thyroid to produce normal amounts of thyroid hormone. This is a very rare cause of hypothyroidism.

High-fat fried foods, like mozzarella sticks, jalapeno poppers and um…fried chicken and French fries can contribute to inflammation in the body, says Blum. Inflammation from Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, often leads to an underactive thyroid gland. Hypothyroidism primarily affects middle-aged women, according to the Mayo Clinic, but it can target anyone at any age.

Your thyroid is the little butterfly-shaped gland at the front base of your neck. It regulates the release of hormones and regulates your metabolism. The most common issue is hypothyroidism, an underactive thyroid condition that leads to extreme fatigue, depression, forgetfulness, and weight gain. It can also increase your risk for heart disease, diabetes, and some cancers.
To ensure that you remain as healthy as possible it is important to eat the right variety of foods in the correct proportions. For example, choose low fat, low calorie spread rather than butter or ordinary margarines, avoid high salt intake and cut down on hidden fats & sugars (cakes, biscuits, chocolate). More information is available from NHS guidance.

In the 1995 American Thyroid Association (ATA) guidelines, biological and synthetic thyroid hormone preparations containing T4 plus T3 were not recommended out of concern for fluctuating and often elevated serum T3 concentrations (71). In conjunction with the American Association of Clinical Endocrinologists in 2012, the ATA continued to recommend l-thyroxine monotherapy and noted that evidence does not support using synthetic combination therapies; in addition, they stated that “desiccated thyroid hormone should not be used for the treatment of hypothyroidism” (72). In 2014, the ATA recommendations evolved with the recognition that 1) serum T3 levels might not be normalized in all l-thyroxine–treated hypothyroid patients and 2) some patients remain symptomatic while receiving l-thyroxine monotherapy. Titration of l-thyroxine dose to achieve normal TSH concentrations remains a first-line approach, but trials with combination therapy can be considered. In addition, the guidelines recognize that although superiority data are lacking, some patients do experience a clinical response with desiccated thyroid preparations or combination therapy with l-thyroxine plus l-triiodothyronine (1). The European Thyroid Association has similar recommendations (2).


According to some estimates, 40 percent of the population suffers with some form of low thyroid function. Women, especially older women, are the most susceptible group for developing hypothyroidism. People who are elderly or who have other existing autoimmune diseases – like type 1 diabetes, rheumatoid arthritis and celiac disease, for example – are also at a higher risk.
Is there anything suggestion on eliminating the hydrogen peroxide? I read that an over growth of it can cause gray hair and hair loss..so maybe that is what needs to be addresses.. Will mention it to my DC.. This is a new discovery for me…only heard it mentioned recently by Suzy Cohen…. Any suggestions on how to combat it ? In your program or anything nutritionally to eat?

Lifeworks Wellness Center is long recognized as one of the foremost natural health clinics in the US. At our Tampa Bay, Florida alternative medicine office we have been offering treatment for underactive thyroid for a long time and many of our patients have benefitted from it. The patients fly in from all over the world because they simply can’t find clinics offering natural treatments for underactive thyroid and natural medicine for low thyroid where they live.
Limit or eliminate junk foods and highly processed products: This plan focuses on whole, unrefined foods as they are fundamental to a healthy diet. Realistically it’s very difficult to eliminate all highly processed (often pre-packaged) foods, but just be mindful of cutting down. Likewise, snacks listed are optional depending on your regular eating habits, and there are bonus snack recipe ideas if you scroll to the bottom.
Unless a food is fortified with iodine, the Food and Drug Administration doesn't require manufacturers to list it on their products. That's just one of the reasons why it's hard to know how much of this nutrient is in certain foods, says Ilic. But as a general rule, shellfish like lobster and shrimp are good sources of iodine, she says. In fact, just 3 ounces of shrimp (about 4 or 5 pieces) contains more than 20% of your recommended intake. Bonus: shellfish can also be a good source of zinc, too. Three ounces of Alaskan crab and lobster contain 6.5 and 3.4 milligrams of zinc, respectively.

The first step in natural treatment of hypothyroidism is to eliminate the causes of thyroid dysfunction, such as inflammation, overuse of medications, nutrient deficiencies and changes in hormones due to stress. The hypothyroidism diet eliminates foods that can cause inflammation and immune reactions and instead focuses on foods that help heal the GI tract, balance hormones and reduce inflammation.
Mild hypothyroidism is usually the early stage. It can progress to hypothyroidism if a hypothyroidism diet isn’t adopted and lifestyle changes aren’t made. When the condition isn’t corrected, more severe autoimmune reactions can occur — this can cause worsened problems like impaired brain function, infertility, unhealthy pregnancy, obesity, heart complications and joint pain.
When the hypothalmus decides we need more thyroid hormone in circulation (cold weather or increased activity level for example) it sends a chemical messenger called thyrotropin-releasing hormone (TRH) which goes to the pituitary gland.  The pituitary than sends thyroid stimulating hormone (TSH) over to the thyroid.  TSH activates the production of a protein called thyroglobulin.
In fact, more and more people with hypothyroidism are turning to holistic care, as many people are simply sick and tired of covering up their symptoms by taking thyroid hormone medication. While there are some great endocrinologists and medical doctors out there who are trying to help their patients the best that they can, just about all of these healthcare professionals are trained to treat conditions through the use of drugs and surgery. And while this sometimes is necessary, many times there are other options. Although symptom management is without question important, just think about how great it would feel if you were able to fully restore your thyroid health back to normal through a natural hypothyroid treatment protocol, and not have to rely on taking synthetic or natural thyroid hormone for the rest of your life.
The content on this website is made available for educational purposes only, and is not to be used for medical advice, diagnosis, or treatment. To get a medical diagnosis for your condition, book an appointment with a PlushCare doctor or your own primary care physician. This blog and all contents herein are the intellectual property of PlushCare and may not be used or copied without written permission.
According to some estimates, 40 percent of the population suffers with some form of low thyroid function. Women, especially older women, are the most susceptible group for developing hypothyroidism. People who are elderly or who have other existing autoimmune diseases – like type 1 diabetes, rheumatoid arthritis and celiac disease, for example – are also at a higher risk.
Zinc is critical to thyroid health and is required for the synthesis of thyroid hormones. In fact, deficiencies of this mineral can lead to hypothyroidism. (Additionally, thyroid hormones are essential for zinc absorption, so hypothyroidism can lead to zinc deficiency.) Pumpkin seeds are a rich source of zinc; other good sources include oysters, crab, lobster, legumes, nuts, and sunflower seeds.

An early symptom of hypothyroidism is weight gain. Low-calorie, high-density foods such as fresh produce are the cornerstone of every successful weight loss program. Include either fresh fruits or veggies at each meal, if possible. Specific foods such as blueberries, cherries, sweet potatoes, and green peppers are also rich in antioxidants, nutrients that are known to lower risk for heart disease.
The thyroid peroxidase test measures the level of an antibody that is directed against thyroid peroxidase (TPO). A presence of TPOAb in the blood reflects a prior attack by the body's immune system on thyroid tissue. A positive thyroid peroxidase test may signal chronic thyroiditis. Other autoimmune disorders, however, may have a positive TPOAb test.
The disease process for Hashimoto’s is a spectrum, and not all patients require treatment. Some patients have autoimmune antibodies but retain enough thyroid function without the need for intervention for years. Generally, once the body can no longer produce an adequate amount of thyroid hormone for necessary physiological functions, thyroid replacement medication is necessary to correct the hormonal imbalances associated with hypothyroidism.

The content on this website is made available for educational purposes only, and is not to be used for medical advice, diagnosis, or treatment. To get a medical diagnosis for your condition, book an appointment with a PlushCare doctor or your own primary care physician. This blog and all contents herein are the intellectual property of PlushCare and may not be used or copied without written permission.
There is an association between vitamin D deficiency and Hashimoto's disease, the most common cause of hypothyroidism, according to a study in the issue of August 2011 issue of the journal "Thyroid". Fortified milk not only has added vitamin D, but also significant amounts of calcium, protein, and iodine. Because Hashimoto's may also lead to changes that contribute to gut issues like heartburn, foods such as yogurt with good bacteria may help regulate other bacteria, Dodell says.
Try this: Make a lassi, a traditional Indian beverage: purée yogurt, frozen mango chunks, and lime juice, then pour into glasses and garnish with slices of lime. Purée yogurt with blackberries, honey, and grated ginger; stir in vanilla yogurt to make swirls and then spoon into Popsicle molds and freeze. Dump a container of yogurt into a cheesecloth-lined strainer and refrigerate overnight; stir in your favorite herbs and seasonings, and use as a substitute for sour cream.
I’m Kate, and I'm here to inspire you to live a more non-toxic life. Expect real food that tastes as good as it makes you feel. Deep dive into natural + holistic wellness topics, with a focus on hormones, gut + thyroid health. No restrictive diets, no products that don't work, no unrealistic lifestyle changes, no sacrifice. Here, we strike the balance between good + good for you. I'm living proof this natural lifestyle and healthy food heals!

Clinicians noted several differences in the ability of l-thyroxine monotherapy to normalize markers of hypothyroidism at doses that normalized serum TSH (45). For instance, in many l-thyroxine-treated patients with a normal serum TSH, the BMR remained at about 10% less than that of normal controls even after 3 months of therapy (53). At the same time, doses of l-thyroxine that normalize the BMR can suppress serum TSH and cause iatrogenic thyrotoxicosis (28, 45, 46). The clinical significance of this was not fully understood because many patients appeared clinically euthyroid with a BMR between −20% and −10% (36, 37).

People with celiac disease who can’t tolerate the gluten found in many baked goods, pasta and cereals often have Hashimoto’s thyroiditis, and vice versa. Hashimoto’s disease is an autoimmune condition in which your immune system attacks your thyroid. Once rare, Hashimoto’s is now the most common autoimmune disease, according to the May 2017 study in the journal Endocrine Connections.


In the developed world, where protein is plentiful and many countries add iodine to salt and processed foods, we don’t typically need to worry about protein malnutrition or iodine deficiency.  However, the rest of the world is not so lucky. More than 2 billion people around the world suffer from hypothyroidism due to iodine deficiency.  2 billion!  We are told that the reason for this planetary epidemic is that iodine comes from the ocean, and that the soil of inland areas has had most of its iodine washed away over time by erosion:
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In other words, taking supplements and herbs alone is usually not the solution. Plus, while nutritional supplements can help, one must remember that different people will need to take different types of supplements, take different dosages, etc. Plus the quality of the supplements you take is important, and the truth is, many supplements are of low quality. So just taking a general thyroid support formula is usually not the answer to restoring your health back to normal. Doing so not only can worsen your symptoms, but often times taking this approach will be a complete waste of money. In most cases it takes a combination of different factors to restore one’s health back to normal. This includes eating well, doing a good job of managing stress, getting sufficient sleep, improving the health of the gut, minimizing your exposure to environmental toxins, etc.


It’s imperative dietitians have a good understanding of the metabolic changes associated with thyroid disease so they can set realistic goals and expectations for clients. Most people with hypothyroidism tend to experience abnormal weight gain and difficulty losing weight until hormone levels stabilize. Moreover, it’s common for patients with Graves’ disease to experience periods of high and low thyroid hormone levels, so it may take several months to achieve a balance. During this time, it’s essential clients focus on healthful behaviors such as eating nutritious foods, exercising regularly, managing stress, and sleeping adequately rather than focus on the numbers on the scale.

Unlike conventional medical treatments, a natural hypothyroid treatment approach tries to get to the underlying cause of your disorder. In other words, upon seeing a competent natural healthcare professional who focuses on endocrine conditions, they will try to determine what is actually causing your thyroid gland to malfunction. In addition to looking at the typical thyroid blood tests, they might also evaluate your adrenal glands, digestive system, hormone levels, and other areas of the body which can be causing your thyroid gland to malfunction. Then assuming this natural healthcare professional feels they can help you, they will recommend a natural hypothyroid treatment protocol that won’t just manage your symptoms, but will also attempt to restore your health back to normal.

Subclinical hypothyroidism refers to a state in which people do not have symptoms of hypothyroidism and have a normal amount of thyroid hormone in their blood. The only abnormality is an increased TSH on the person’s blood work. This implies that the pituitary gland is working extra hard to maintain a normal circulating thyroid hormone level and that the thyroid gland requires extra stimulation by the pituitary to produce adequate hormones. Most people with subclinical hypothyroidism can expect the disease to progress to obvious hypothyroidism, in which symptoms and signs occur.


In areas of the world where there is an iodine deficiency in the diet, severe hypothyroidism occurs in about 5% to 15% of the population. Examples of these areas include Zaire, Ecuador, India, and Chile. Severe iodine deficiency occurs in remote mountain areas such as the Andes and the Himalayas. Since the addition of iodine to table salt and to bread, iodine deficiency is rare in the United States.

The thyroid controls how your body's cells use energy from food, a process called metabolism. Among other things, your metabolism affects your body’s temperature, your heartbeat, and how well you burn calories. If you don't have enough thyroid hormone, your body processes slow down. That means your body makes less energy, and your metabolism becomes sluggish.
Remember that there is no magic answer, single supplement, or sole dietary change that will miraculously cause you to lose weight. Likewise, medication alone may not be enough to help you feel your best with thyroid disease, whether you have weight to lose or not. Ensuring optimal thyroid function and focusing on diet, movement, and nutritional and lifestyle changes can all help you achieve greater success.

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Please Note: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any diet or exercise program.

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