It’s bad enough feeling cold when the weather really is cold, but if you are someone who feels cold even when it’s hot, you may have poor circulation.

Cold hands and feet, when accompanied by weight gain, constipation and a sense of apathy or even depression may be a sign of an underactive thyroid gland. This gland governs metabolism, producing hormones – thyroxine (T4) and triiodothyronine (T3), known together as thyroid hormone. T4 has to be converted to T3, and when this conversion fails to happen adequately, thyroid issues arise.

Thyroid hormone oversees your basic metabolic rate. Metabolism creates heat, which is why coldness is a symptom of hypothyroidism, or underactive thyroid. This condition more commonly affects women, especially those over the age of 35.

If you suspect you have an underactive thyroid your first step should be to see your GP for testing. You may have to start taking the hormone thyroxine. If however tests prove negative, you could still have mild hypothyroidism which may not be detected by tests, especially if your results fall just outside the ‘normal’ parameters. Mild hypothyroidism can go on to become overt hypothyroidism, so you will need to have your thyroid hormone levels regularly monitored. Be sure that you have an adequate dietary intake of the nutrients required for thyroid function, in particular selenium and iodine. Deficiency of these two nutrients is not uncommon, as I discuss in I Wish I Hadn’t Eaten That. Selenium is found in nuts, especially Brazil nuts, meat and fish. Iodine is found in seafood, seaweed and dairy produce.

There is of course also the possibility that your poor circulation is due to lack of exercise … and if that’s the case you already know what to do.

You might expect parts of you to dry up as you get older, but when you’re still fairly young it seems a bit unreasonable.

Dry skin and eyes are symptoms often experienced as part of the ageing process. Dry eye syndrome is also known as keratoconjunctivitis sicca, a condition which can cause inflammation and blurred vision and lead to complications including conjunctivitis and scarring of the cornea. People over 60 are more likely to be affected by this condition.

Dry eyes – and skin – are not unique to older people. A common complaint I hear, from people in their 20s and 30s, is that their skin is lizard-like, and that they have to moisturise all over, every day. They may also complain that their eyes feel gritty. If you’re not ageing and creaking yet still have dry skin and eyes, you have a problem which may be diet related.

More specifically, you may have a fatty acid deficiency. Many people are now fat phobic, thanks to utterly misinformed and misguided nutrition advice from so-called experts who exhort us to cut out fat at every conceivable opportunity. In chapter four of I Wish I Hadn’t EatenThatI explain how fat is essential, and how deficiency of certain fatty acids can lead to a wide number of symptoms, including dry eyes and dry skin. Other symptoms of fatty acid deficiency include poor memory and concentration, mild depression, fatigue, PMS, infertility and period pain.

The fatty acid people are most likely to lack are EPA and DHA, which are part of the omega-3 family. The best source of these fatty acids is oily fish, so if you do have dry skin and eyes, and aren’t yet old and wrinkled, try upping your intake of salmon, trout, sardines, mackerel, herring, anchovies. If you really don’t like that sort of fish, fish oil capsules might also help.

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Clinical depression is a debilitating condition that can be so severe that pharmaceutical management is sometimes the best if not only treatment option. Mild depression, on the other hand, may not require intervention, but the dark cloud that it creates can cast a shadow over every aspect of your life.

It can also be baffling if you can think of no reason at all to feel so down. Relationships and home life are great, job and finances not a worry. So why do you feel so glum? The answer may have something to do with your diet, and as ever this is an option worth exploring.

In symptom number 16 I briefly discuss six possible causes of poor memory and concentration. Have a look at these, as they may also be the same health issues underpinning mild depression. Food intolerance, blood sugar imbalance, adrenal fatigue, fatty acid deficiency, mild hypothyroidism and leaky gut syndrome can all affect brain function and be implicated in mild depression.

If you are a woman suffering from mild depression you could also add oestrogen dominance to that list. I devote a chapter to this in I Wish I Hadn’t Eaten That, and describe how an imbalance of female hormones can cause a number of nervous symptoms, including irritability, mood swings, headache and of course depression. In women of menstruating age these symptoms manifest as part of premenstrual syndrome (PMS), which in some cases can last for around two weeks. In menopausal or perimenopausal women depression, as a result of oestrogen dominance, can be a month-long constant.

As I describe in chapter 5, oestrogen is a natural hormone but we are exposed to so many chemicals in the environment and in our food which have an oestrogenic effect that we can end up with oestrogen overload. Often referred to as xenoestrogens, pesticides, dioxins, PCBs, plastics and detergents, together with HRT and the contraceptive pill, combine to form quite an oestrogenic load. These chemical oestrogens are stored in the body, usually in fat. Your best self defence is to lower your oestrogenic load by eating a high fibre diet, and in particular lots of beans and lentils, nuts and seeds. Fibre helps excrete excess oestrogen and also feeds the friendly bacteria which help metabolise phytoestrogens – plant chemicals which balance oestrogen levels in the body.

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Some symptoms are so non-specific that trying to work out what’s causing them can be quite a challenge. You always know when your memory and concentration are not what they should be, and when functioning below par the problem can cause enormous frustration. Poor memory and concentration can be attributed to a host of possible causes which, on the plus side, are often diet-related. This means that there is plenty of scope for self-help.

In I Wish I Hadn’t Eaten That I list six possible diet-related causes, so if you want to improve your less than razor-sharp memory and concentration you might want to embark on a process of elimination. First, consider the possibility that you may have a food intolerance. Food intolerances can affect your brain just as much as the rest of you. Your next approach might be to balance blood sugar, or glucose, levels. I’ve talked a lot about blood sugar levels and how an imbalance can result in symptoms of cognitive dysfunction, including poor memory and concentration, irritability, and even mild depression. If you are stressed out, and have been for a long time, you should research a condition called adrenal fatigue – too much or too little of the hormone cortisol, often called the stress hormone, and create all sorts of symptoms which affect brain function. On the other hand, your problems may be related to the levels of fatty acids in your diet, in particular omega-3. Oily fish is very much linked to cognitive function, and for good reason, as the fatty acids it contains affects mental agility as well as mood. If, as well as poor memory and concentration you also experience easy weight gain, constipation and fatigue, and have a history of dieting, you might have an underactive thyroid. Then again, if you suffer digestive problems and as well as poor memory and concentration you also have aching joints, bad skin and a history of taking non-steroidal anti inflammatory drugs you may have leaky gut syndrome.

It’s a conundrum! As you can see, there are lots of issues to consider, but the process can be highly empowering. If nothing else, you may find the journey illuminating as you notice other subtle but significant changes to your health.

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You can delude yourself that craving a certain food is your body’s way of telling you that you need that food. Dream on! It’s an argument I’ve heard many a time but sadly not the case. Nobody needs nicotine but an addict will crave a cigarette. Nobody needs sugar or chocolate but the craving you might feel for those foods can easily persuade you that you are satisfying a physiological need by succumbing to it.

I’ve noticed that cravings can be caused by two dietary issues: blood sugar imbalance and food intolerance. I write about these in I Wish I Hadn’t Eaten That. If you have a blood sugar imbalance, you are more likely to crave sugary or other carbohydrate foods. Other symptoms include low energy, poor memory and/or concentration, difficulty waking up in the morning and often an inability to go several hours without food without either keeling over or wanting to kill someone.

Eating sugar and refined carbohydrates can cause a spike in blood glucose levels. This in turn causes a spike in insulin. The more glucose, the more insulin. A sudden drop in blood sugar will leave you craving something to raise those sugar levels again, and temporarily feel normal. That something will be food which causes a blood sugar high: muffins, biscuits, chocolate, crisps, tortillas …. add your own suggestion here. But the high is always followed by the low. You need to avoid those peaks and troughs and instead aim for steady glucose levels, without all the drama of the ups and downs. Slow releasing carbohydrates – fruit, vegetables, beans and lentils, together with protein and fat with each meal, will help restore equilibrium, and therefore eliminate cravings. 

It is a cruel irony that we often crave the very foods which cause us trouble – digestive symptoms, headaches, low energy and so on. I have always found that people who are sensitive to, say, wheat, tend to eat a great deal of it: toast for breakfast, sandwich for lunch, pasta for dinner. By avoiding the foods you crave you might just find that you also eliminate the very symptoms that have been plaguing you. Worth a try.

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Constipation is one of those symptoms which you might not notice at first, as it can creep up on you gradually until one day you realise you can’t remember the last time you went. But as we all know you have to go, and you have to go regularly – that is, once a day. What’s more, if a bowel movement is really hard work (literally, hard) then that’s still constipation, even if it’s a daily occurrence.

Constipation is a condition of the ‘developed’, industrialised world that often, ironically, eats too much but doesn’t excrete enough. The effect of this can be to make you feel a bit bunged up, toxic even, and not in optimal health. I always say that if you want to be healthy all over you have to start with digestion.

Healthy bowels are about what you eat, and equally about what you don’t eat. If you are not regular, ask yourself why. In I Wish I Hadn’t Eaten That I describe a number of possible causes. These include food intolerance, mild hypothyroidism, dysbiosis and leaky gut syndrome. Being sensitive to a food, especially dairy foods, can, as I know only too well, cause constipation. So too can an imbalance between pathogenic bacteria (bacteroides) and friendly bacteria. Those friendly bacteria such as L.acidophilus and bifidobacteria in your gut do a lot of work to promote your health, including encouraging peristalsis – the wave-like muscular movements which sweep everything along and out. They also keep hostile microorganisms and yeasts, such as Candida albicans, in check. Overgrowth of this yeast can result in many symptoms, including constipation.

Fibre is important because it not only keeps you regular, it also feeds those friendly bacteria. Insoluble fibre is indigestible and passes unabsorbed through the body, taking toxins, carcinogens and other waste products with it. Refined foods have the opposite effect – white bread and rice, for example, and all those carbohydrate-rich snacks so beloved of the western world. Not only do they delay healthy bowel movements, they also feed the pathogenic bacteria which can do so much harm.

Finally, if you have a history of calorie-restrictive dieting it is worth considering the possibility that you may have an underactive thyroid. This impacts on metabolism and makes everything slow, including gut transit time. Fatigue, feeling cold, apathy and weight gain are other symptoms of hypothyroidism which should convince you to see your GP for testing.

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A one-off bout of diarrhoea is one thing, and lord knows we’ve all been there. However it’s quite another when it’s a regular occurrence. If it is, and you’ve had all sorts of tests which tell you there’s nothing wrong, there’s one area you might not have considered, and that is parasitic infection.

Not a nice thought, I know. When we think of parasites in the gut we tend to imagine bug-eyed beasts trawling their way through the contents of our bowels. Eww. In reality, most parasites are microscopic, which is why you haven’t spotted them. They may be invisible, but they are becoming increasingly common.

Here are some questions to give you food for thought. Do you regularly get pain in the abdominal area? Do you often urgently need to use the toilet? Did this pain and diarrhoea come on quite suddenly, perhaps after a trip abroad? Perhaps you also suffer from fatigue, bloating and even weight loss. You might want to think about the possibility of parasites. I’m not talking about life-threatening pathogens such as Salmonella or E.coli 0157; rather, common infections which can affect your daily health but not necessarily your daily life. 

As I discuss in I Wish I Hadn’t Eaten That, one of the most common parasites is Blastocystis hominis. In the UK it is rare to get tested for this (unless you do so privately) but in the US, a 2000 study found that of 2,896 patients tested for intestinal parasites, 23 per cent were infected with Blastocystis hominis. These diseases easily make their way around the world: with globalisation of our lifestyles has come globalisation of diseases. If you’re starting to think you’re part of the globalisation process, seek professional help. See your GP, and consider a visit to a nutritional therapist with experience in dealing with digestive disorders. For a list of local practitioners, go to www.bant.org.uk

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If you’re getting on a bit, and you don’t exercise much, aching joints are almost par for the course. Even more so if you are overweight. But aching joints are not an inevitable fate, and if in addition you have an aching gut, there is very possibly a connection worth exploring.

There is a digestive condition which can affect any part of the body, and in particular joints. Leaky gut syndrome, also known as intestinal permeability, occurs when the protective lining of the gut becomes damaged. This lining normally prevents all sorts of undesirable particles in the gut from entering the blood, but if it’s damaged in any way that protection is compromised.

In chapter 8 of I describe how certain medications, in particular non-steroidal anti-inflammatory drugs (NSAIDs), as well as alcohol, stress, free radicals and parasitic infection can cause damage that creates microscopic holes in the gut lining. As a result, undigested food particles and toxins can enter the blood and travel all around the body. Arthritis has long been associated with abnormalities of the gut, and because arthritic symptoms  often improve when the digestive disorder is treated, it is thought that these two conditions are related. This is hardly surprising as the toxins and particles in the blood often end up in connective tissue, joints and muscles. Three types of arthritis – ankylosing spondylitis, reactive arthritis and psoriatic arthritis – belong to a group of arthritic conditions called the spondyloarthropathy group. Up to two-thirds of patients with one of this group of conditions have been found to have gut inflammation, one of the outcomes of leaky gut. To heal the gut, you must remove whatever it is that is causing your gut to become leaky.

Also worth considering  if you have aching joints is the possibility of food intolerance and fatty acid deficiency – especially omega-3 fatty acids as found in oily fish such as mackerel, salmon, sardines, trout and herring.

Period pain can vary enormously in its intensity, from mild discomfort to sheer agony. Periods may be normal, but extreme period pain – known as dysmenorrhoea – is not. This condition is not only painful, it can also be utterly debilitating. When you know what to expect, every month, it can really make life a misery.

As well as pain, you might also experience headache, nausea, vomiting, diarrhoea and fainting. Obviously you need to see your GP to make sure you do not have endometriosis or any other underlying condition which will cause your symptoms. Where this exists, the condition is known as secondary dysmenorrhea.

Primary dysmenorrhea is where there is no known underlying cause – which is good news. I have never known this condition not to improve enormously just by making dietary changes.

Painkillers are usually prescribed to treat primary dysmenorrhea. Taking non-steroidal anti-inflammatory drugs (NSAIDs) is very effective, precisely because the condition is called by inflammation. Specifically, inflammatory chemicals made in the body called prostaglandins. Where do these prostaglandins come from? Diet, of course.

In I Wish I Hadn’t Eaten That I discuss how excessive inflammatory prostaglandins are created from omega-6 fatty acids. These fatty acids are found in vegetable oils, including soya, corn and sunflower oils. Most processed meals and snacks are cooked in these vegetable oils. Although some omega-6 is essential, it is generally acknowledged that we now consume far too much, especially in relation to omega-3 fatty acids. Omega-3 are the anti-inflammatory oils which balance the excesses of omega-6. We should ideally consume equal amounts of these fatty acids, but research suggests that on average we now consume 15 times more omega-6 than omega-3. That’s a recipe for inflammation, and therefore pain.

So, as well as avoiding foods cooked in the omega-6 oils, up your intake of omega-3. The best source is oily fish: mackerel, salmon, sardines, herring, anchovies. Just don’t cook them, or anything else for that matter, in omega-6 vegetable oil – instead use butter or extra virgin olive oil.

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Here’s a non-specific symptom that everyone is familiar with. It would be unusual for anyone to get through a lifetime without ever experiencing a headache, but some people barely get through a day. That’s obviously not normal, and if you are one of those people, you’ve got to find out what’s causing your headaches if you want them to go away without having to resort to painkillers.

The thing with headaches is that there are so many possible causes, not all of them diet-related. You may have frequent headaches as a result of an accident, or bad posture. Then again, you might be straining your eyes without knowing it. Stress is an obvious candidate: chronic, unremitting stress can lead to an excess of the stress hormone cortisol, and one of the symptoms of this is frequent headache. There are lots of possibilities, but if you’ve already explored them it may now be time to consider your diet.

Firstly, are you drinking enough water? That one is easy enough to remedy. It might seem a bit obvious but I have met people who had no idea that drinking only tea and coffee (which of course are diuretics) was not enough to stay hydrated. The next most obvious consideration is blood sugar. Blood sugar imbalance is surprisingly common which is why I devote a chapter to it in I Wish I Hadn’t Eaten That. Symptoms of an inability to maintain even blood sugar levels include low energy, poor memory and concentration, food cravings (usually for something sweet) and of course regular headaches. What causes blood sugar imbalance? Lack of protein and too many carbohydrate-rich meals and snacks. Cereal for breakfast, sandwich for lunch, pasta for dinner… that sort of thing. Once you know the cause, the answer is obvious, and the great thing about this possibility is how quickly and easily you can eliminate symptoms.

Another possibility worth considering is food intolerance. In I Wish I Hadn’t Eaten That I describe how to work out what food item might be causing your symptoms. This basically involves keeping a food diary, looking at what you eat rather a lot of and then eliminating it for around a week. If your symptoms disappear, then you know to stay away from that food. Simple!

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