Autoimmune Response: Doing it "Right" Was Wrong

My non-plan to get better and avoid cancer.

After I burned out and left my demanding career, I thought my physical and mental health would improve effortlessly. This ended up being true…ish. My cortisol definitely lowered, but something still felt wrong. I couldn’t work out like I used to (my body broke down when I tried to get back into distance running) and I was frequently sick. I fell asleep in the afternoon with such regularity that I set a recurrent 2 pm alarm to avoid napping through school pick-up.

What rest often looks like with small children.

Something wasn’t right. So, I did the usual things one does when feeling unwell - researched, rested, visited my primary care provider, etc. But my overwhelmed doctor didn’t have the time to deep dive with me. She took a quick glance at my out-of-range labs and suggested I return when my symptoms became “acute and unbearable”.

Unsatisfied with this directive, I channeled my obnoxious type-A-elder-sister-energy into figuring things out on my own. As a start, I ordered cash labs (easy and fairly inexpensive, yet still a privilege to have the time and resources required to do this). Was I celiac and reacting to all the sourdough I had recently become obsessed with? Were my iron levels too low? Vitamin D out whack in the PNW gloom? What was going on?!

Finally, after a few rounds of labs, I got an answer: my thyroid was malfunctioning. In a weird way it was almost relieving to see these results - I wasn’t just making it up or being lazy, I had a legitimate health issue that needed attention.

And this information led to a more-focused look at family history, which confirmed that I needed to take this health issue seriously. Three generations of people on my dad’s side have all had significant thyroid issues, including cancer. So, I decided to concentrate my type-A energy into fix-it mode.

One of the first things I did was hire an out-of-network ARNP focused on women’s health and thyroid issues (again, so many resources required… but shouldn’t be?!). She took the time to review labs with me, engaged in lengthy conversation about my concerns, and helped me formulate a plan to heal. Ultimately, she also diagnosed an autoimmune disorder alongside the thyroid malfunction. For the first time, I felt like I didn’t have to vigorously advocate for myself in order to receive proper care. I left the first appointment validated, armed information, and determined to solve ALL the things.

I also pestered my primary care doctor into ordering a thyroid ultrasound. Which - no surprise - came back showing unusual growths and areas of concern. At that time, the collection of growths were too small to biopsy but deemed worthy of frequent monitoring. (Again - validation - I wasn’t just being whiny and it would’ve been a bad idea to just sit around waiting for these things to get bigger/make me sicker.)

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Now, before going any further, I should remind everyone that I freaking love a gold star. And no matter how much I’ve evolved, I still fall way too easily into the pattern of “set goal, blindly dedicate self to goal, achieve goal, get awarded gold star, burn out”.

Even though I am aware of this tendency and know that extremes are not sustainable I still fall victim to it. I mean, I’ve even written a whole post about how strict approaches to wellness don’t work - yet, the siren call to “follow this plan exactly and you will feel better” is tempting and cannot always be resisted.

And boy did I fall victim to the call - becoming hyperfocused on “healing”. I took my ARNP’s gentle, reasonable suggestions and ran with them - creating a much more intense version of her plan. I was going to HEAL and be the BEST AT IT!

I immediately decided that I needed to follow the Autoimmune Protocol Diet (look it up - very limiting). My confused husband Nate watched as I pilfered our pantry, boxing up every single item that contained any hint of an ingredient that may potentially bother me (gluten, soy, dairy, sesame, nightshades, etc, etc, etc). I pivoted from a reasonable “everything in moderation, even moderation” diet to a severely restrictive one - scouring labels and menus in order to comply (God Bless Nate and his supportive patience with me during this journey).

Early 2025 - enjoying an AIP friendly burger… or at least trying to.

I went ham in other areas of my life, too - cutting out alcohol, limiting coffee, adhering strictly to my new medication routine, and reducing the intensity of my workouts from marathon and strength training to the occasional, short walk. This lasted for months and, eventually, my labs looked a bit better! I was doing it all right!

GOLD STAR FOR ME!

But… I was mentally exhausted and grouchy. It turns out that completely (and often unnecessarily) sacrificing things that otherwise brought me joy stressed me out. Big time. The pressure I put on myself to diet and rest “perfectly” became a significant strain. I no longer derived social happiness from group dinners (what if everyone wants to split ice cream???!!!!) and cooking for my family became a miserable chore (one thing for me, one for my husband, and something else the kids would eat). Just a few examples.

Ironically, my labs started to look grouchy, too. The mental stress of following my restrictive plan began to nullify any physical benefits I was experiencing.

So, per usual, I careened off my gold star platform and plunged into burn out. I flipped to the other diet/activity extreme, devouring all of the things that made me feel horrible, indulging in one too many glasses of wine, and amping up the workouts. I didn’t even have to justify this behavior to myself - I was so exhausted from being “perfect” that it felt good to be “bad”.

Ah yes, a Moscow Mule as big as our heads.

As you can guess, that wasn’t the solution, either. Once again, I started to feel pretty terrible, pretty fast. My labs got even grouchier and it became clear that, again, I needed a change.

But this time, I wanted to find sustainable healing. I didn’t want to live in a land of extreme restriction, stress, and miserable “perfection”. I also couldn’t live in lala land where Carly gets to consume unlimited irritating food/beverage and feel dandy. My black and white approach wasn’t working - I needed to find a flattering shade of gray.

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And that’s where I currently sit. I’m writing this post in part to hold myself publicly accountable. I don’t want to slip into “perfection or nothing” but I also can’t really fudge it anymore. Quite frankly, I want to do everything I can to avoid getting cancer. I also want to give myself grace.

So, I need to embrace the discomfort of the middle ground. I need to accept that having a glass of wine or the occasional gluten-y, cheesy snack doesn’t mean I’m a failure. It is embarrassingly difficult for me to subsist within this gray zone, without clear black and white boundaries that force strict guidelines and goals. I struggle constantly - always questioning whether I should work out harder, skip that flour-based dessert or lean into rest - but ultimately believe (and desperately hope!?) that this mindset will lead to growth.

December might seen like kind of an odd time to focus on healthy living, but in many ways it makes sense for me. In order to be the most-present, peaceful version of myself during this busy season, I need to feel good - even in the midst of heavy holiday food, cocktail parties, and delicious desserts. And, like, I want to enjoy those things! When it’s right.

Along those lines, I’m not aiming for a gold star, but rather a passing grade. I’m willing to accept some wellness “demerits” in the name of joy. So, I’ll mostly be eating gluten/dairy free, avoiding alcohol, tinkering with supplements and prioritizing rest/recovery.

But if you see me in the wild - and I happen to be consuming a creamy espresso martini while munching on a slice of pizza dripping with cheese - I hope you’ll come on over, raise a glass, and celebrate living in the gray alongside me.

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Over the next few months, I’ll document this journey - sharing updates about progress and challenges. I hope to hold myself accountable, share things that are working, and connect with others.

And even if you don’t have an autoimmune issue, I think my experience is universal to anyone who, like me, is approaching middle age. We just can’t get away with what we could in our 20s. But I don’t think we are ready to live like we are in our 120s, either.

So, here’s to being somewhere in the middle!