In recent times, talks around functional medicine have increased. It serves as a means to provide not just medical care, but holistic health care. Doctors practicing functional medicine focus on providing tailored, individual care. The patient and practitioner both focus on better lifestyle practices to treat complex diseases.

## What is Functional Medicine?
Most patients with any chronic disease will definitely have heard one or more of the following:

- This disease has no specific cause. It can happen to anyone.
- You have to continue taking medication lifelong.
- We can only control the symptoms. There is no cure.

Sounds familiar right? 

[Functional Medicine](https://my.clevelandclinic.org/departments/functional-medicine/about) provides an alternative to this conventional approach. Functional Medicine doctors undertake a complete understanding of your body. This is not limited to physical illnesses alone. It also includes emotional well-being and mental health, all factors which can directly impact your health. 

![Why Functional Medicine matters](/blogs/functional-medicine/1.png)

The principles of this approach were first put forward by the [Institute for Functional Medicine](https://www.ifm.org/) close to three decades ago. They explained how every person's genetic makeup is different. As a result, the way they respond to the environment also varies. It advocated a biology based approach to understand all these connections.

To treat any chronic disease, it is necessary to explore the root cause. That is the only way to address the real problem. Focusing on symptoms is a temporary solution of sorts. 

This is why health is in itself a positive state. It cannot simply be defined as an absence of disease.

Consider a situation where you have back pain. You apply a balm over it. It produces a cooling effect and your pain reduces. Next time it happens, you take a painkiller tablet. 

Will these prevent it from happening yet again? Most likely not. Unless you identify all the factors putting strain on your back and address them, it is likely to recur. 

The same parallel can be drawn with other medical conditions. This does not mean that the use of medications can be skipped completely. They are a necessary part of the treatment. However, they should not be the only component of your road to recovery.

## What does a functional medicine doctor do?
You may be wondering what a visit to a functional medicine doctor looks like. Let us walk through what you might find new.  

Any given disease can occur due to a variety of causes. Of these, most are not addressed by conventional therapy. Therefore, a few additional steps taken in a [functional medicine](https://drhyman.com/blog/2019/11/05/a-big-win-for-functional-medicine/) set up include:

- Assessment of nutritional deficiencies 
    Most chronic diseases are related to micronutrient or protein deficiencies. These can be corrected by diet improvements and additional supplements. The specific requirement of these is assessed. 

- [Gut Health](https://thyroidpharmacist.com/articles/importance-gut-health/)
    A leaky gut is not linked only with digestive problems. It can contribute to hormonal imbalances, mood disorders, skin conditions and several [autoimmune conditions](https://www.jeevamhealth.com/post/autoimmune-disease-treatment). 

- Stress management 
    Although [stress](https://www.jeevamhealth.com/post/healthy-sleep-habits) is universal, it can be managed. This requires in depth analysis to identify how you are coping with stress currently. Following this, more effective options can be suggested.

- Active lifestyle
    Exercise can be a very effective source of relaxation. However, it requires a balance to avoid overdoing it and causing stress. 

- Food as medicine 
    Our expert nutritionist can guide you to adopt a diet which reduces [inflammation](https://www.jeevamhealth.com/post/anti-inflammatory-food-1). We harness the medicinal properties of food to improve your daily habits.

The final treatment plan includes a combination of medications and these therapies. This is reviewed over time to assess the response. The plan is constantly modified to best suit the needs at the time. Eventually, the aim is to wean the patient off medication or maintain the lowest possible dose. 

A [functional medicine](https://www.ifm.org/functional-medicine/) plan requires much more active participation by the patient. They have to be involved at every step. Optimal results are seen when they consistently follow the lifestyle changes suggested. Visits to a doctor may also last longer.

## The Functional Medicine Model
![The Functional Medicine Approach](/blogs/functional-medicine/2.png)

The fundamental principle of functional medicine is to focus on the cause, not just the symptom. Any given disease is a culmination of many triggering factors as we have seen above. 

Conversely, the above mentioned factors can individually be a risk factor for various conditions. What do we mean by this? A single cause such as inflammation can cause depression, heart disease, cancer, [diabetes](https://www.jeevamhealth.com/post/diabetes-blood-glucose-level-is-symptom-know-why-should-doctor-advice-for-blood-insulin-test) and other illnesses. This means that directly addressing this factor can offer you protection against other diseases as well.

Hence, the focus should be on tackling that root cause itself, not limiting oneself to controlling the resultant disease. [The field of functional medicine](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217393/) achieves this by modifying the conventional medical approach.

## Why choose functional medicine?
Simply treating symptoms does not treat a disease. Even if you feel the medications make you feel comfortable, the underlying disease process continues. This means that despite feeling better, you might be getting worse. 

Thus, the [functional medicine practitioner](https://www.jeevamhealth.com/our-doctors) adopts an integrated approach. The conventional science based approach uses medications for short term control. The alternative medicine component works towards long term health care. 

[The functional medicine model](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312741/) is ideal for patients with chronic disease. These include diabetes, [thyroid disease](https://www.jeevamhealth.com/post/thyroid-disease-treatment), [polycystic ovarian disease](https://www.jeevamhealth.com/post/pcod-polycystic-ovarian-disorder-functional-medicine-approach), [psoriasis](https://www.jeevamhealth.com/post/how-i-reversed-my-psoriasis-autoimmune-disease), nerve disorders and many others. 

In India, the incidence of these conditions is on the rise. Functional medicine provides individualized treatments which target specific concerns. This includes an assessment of medical history and present lifestyle. It brings to light some habits which the patient may not even associate with the present disease.

These diseases are a source of economic burden as well. The proactive approach of functional medicine can reduce this as it improves overall health status. Integrative medicine makes your entire body healthy. 

Hence, choosing functional medicine can help you gain a deeper understanding of how your body works. It can help you feel more energetic and reduce dependence on tablets. It also takes into consideration genetic factors, toxins and microbial makeup. These significant factors are sometimes missed by some doctors practicing medicine. 

## Conclusion
Every individual is unique. The occurrence of a disease in the human body involves multiple variables. 
Functional medicine helps break down this complex process and answer one simple question: why did I get this disease? By shifting focus to the patient, functional medicine aims to restore balance to the body. This means not only will you get treated, you will become healthy from the inside out.


**We’re here to help. Please get in touch with us and we can help address your concerns and assist you in your journey to better health.
[Book a call with Jeevam Health Team NOW!](/join)**



Functional Medicine: A Key to Transform Your Life


The thyroid gland is one of the most important parts of the entire endocrine system and our entire body.  
The thyroid is a butterfly-shaped gland that releases certain hormones which balance the overall functioning of the body.  
When this thyroid gland starts to produce too much or too little of its hormones, it is termed thyroid disease.  
When this is too much it is hyperthyroidism and when it is too less it is hypothyroidism.  

![Thyroid and Parathyroid Glands](/blogs/thyroid-disease-treatment/1.png)

## What thyroid and thyroid hormones actually do?

The most crucial job of our [thyroid gland](https://www.ncbi.nlm.nih.gov/books/NBK279388/) is to control and release the right amount of [thyroid hormone](https://drhyman.com/blog/2015/06/05/when-this-master-metabolism-hormone-malfunctions-you-become-fat-tired-and-inflamed/), which ultimately maintains the body's metabolism.  
Metabolism is a process in which the food you consume is transformed in the form of energy which is then used by the body to execute a range of functions.  
T4 (Thyroxine) and T3 (Triiodothyronine) are the key hormones secreted by the thyroid gland that regulates the body's metabolism by directing how much energy each cell should consume.  
The thyroid is analogous to the central gear in a complicated engine: if that gear fails, the entire engine fails.  

All this is controlled with the help of the master gland of the body, which is the “Pituitary gland”.  

![Thyroid Stimulating Hormone (TSH)](/blogs/thyroid-disease-treatment/2.png)

When the pituitary gland detects a decrease or increase in thyroid hormone levels, it secretes [Thyroid-Stimulating Hormone (TSH)](https://www.jeevamhealth.com/post/new-guideline-for-tsh-thyroid-stimulating-hormone), which stimulates the thyroid gland's receptor cells.  
This hormone regulates thyroid hormone production by either increasing or decreasing T3 and T4 production based on the body's needs.  

## What happens in thyroid disease?  

Thyroid disease is a condition in which the body stops producing the right amount of thyroid hormone.  
In [Hyperthyroidism](https://www.jeevamhealth.com/post/hyperthyroidism-novel-approach-to-cure), the body produces more thyroid hormone than required.  
As a result, your metabolism accelerates and your body consumes more and more energy, leaving you exhausted and your heart rate skyrocketing.  
Another condition is when the body produces lesser thyroid hormone than required. This condition is called [hypothyroidism](https://drhyman.com/blog/2010/04/20/thyroid-disease-are-you-sick-tired-overweight).  
Weight gain, Fatigue, dry skinning, thin hair, and intolerance to cold temperatures are accompanied by hypothyroidism.  
Most of the hypothyroidism symptoms resemble other diseases and vary from person to person. As a result, almost [60% of the people are unaware](https://www.thyroid.org/media-main/press-room/) of the fact that they are suffering from hypothyroidism.  

![Factors Affecting Thyroid Function](/blogs/thyroid-disease-treatment/3.png)

## What are the causes of thyroid disease?
There are a variety of reasons why thyroid disease can be caused and is different for both hypothyroidism and hyperthyroidism.

The conditions which can cause hypothyroidism are:

- **Nutritional Deficiency:**                     
[Iodine](https://thyroidpharmacist.com/articles/iodine-hashimotos/) deficiency is a major cause of hypothyroidism. The thyroid gland requires iodine for producing thyroid hormones. An iodine deficiency can result in the reduction of these thyroid hormones.  
Other nutritional deficiency includes deficiency of [selenium](https://thyroidpharmacist.com/articles/selenium-deficiency-and-hashimotos/) and that of [zinc](https://thyroidpharmacist.com/articles/hashimotos-and-zinc-deficiency/). 

- **A non-functional thyroid gland:**  
Almost in every [1 out of 4000 newborns](https://medlineplus.gov/genetics/condition/congenital-hypothyroidism/#frequency), the thyroid gland is non-functional. This results in hypothyroidism.  
A blood test of all the newborns is done in order to check the amount of thyroid hormone in their blood. 

- **[Hashimoto’s Disease:](https://www.jeevamhealth.com/post/hashimoto-thyroid-issue-an-autoimmune-hypothyroid-condition)**  
It is an autoimmune disease in which the body cells attack the thyroid gland and reduces its capacity to produce thyroid hormones to a large extent. 

- **Postpartum Thyroiditis:**  
It is an uncommon condition in which women get their thyroid gland dysfunctional within 1 year of their child’s birth.  

Conditions that can lead to hyperthyroidism are:

- **Graves’s Disease:**  
It is an autoimmune disease that enlarges our thyroid gland and makes it overactive, resulting in the production of a large number of thyroid hormones.

- **Nodules:**  
Sometimes the nodules present within the thyroid gland becomes superactive resulting in a condition of hyperthyroidism. 

- **Excess of iodine:**  
A person who over consumes iodine on a regular basis has a high chance can get affected by hyperthyroidism.

## Symptoms of Thyroid Disease
Symptoms for [thyroid disease](https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease) are mostly misunderstood by the patients as they are quite similar to those of other diseases and general to so many people.  
Symptoms of thyroid disease can be classified into two categories.  

Symptoms for hypothyroidism are:  
- Feeling tired
- Increase in weight
- Forgetfulness
- Intolerance to cold temperature
- Hoarseness of voice
- Rough hair   

Symptoms for hyperthyroidism are:
- Sensitive to heat
- Irritation in the eye
- Insomnia
- Anxiety and nervousness
- Disturbance in the menstrual cycle
- Loss of weight  

## How can thyroid disease be treated?
The goal for the thyroid disease treatment is quite obvious, that is bringing your hormone level to normal.  
If the condition is serious, this can be done with some of the extreme treatment options like:

When it comes to hyperthyroidism the treatments include:

- **Anti-thyroid drugs**: These are medications that help in decreasing the thyroid hormone count.

- **Radioactive iodine**: This damages the thyroid cells which prevents the increasing hormonal count.

- **Surgery**: Surgery is another extreme treatment option. Your thyroid is surgically removed and you have to take thyroid replacement hormones for the rest of your life.   

When it comes to hypothyroidism, the treatment includes:

- **Thyroid replacement medication**: Drugs like levothyroxine, can help you live a normal life by acting as a man-made thyroid hormone.  

## How can Jeevam Health ease your pain?

![Thyroid Disease Treatment using Functional Medicine by Dr. Anish Musa](https://www.youtube.com/embed/zYwx7ZH3Xm0)

Misdiagnosis has been seen as one of the major concerns when it comes to Hypothyroidism.  
The majority of times, the patient is simply treated with hormonal replacement if his/her reports are not normal.  
In case the reports are normal, the patient is usually told that they are fine or given an anti-depressant.  
Thyroid physiology is a complex matter. Many stages are involved in the production, conversion, and uptake of thyroid hormone.  
It is actually inappropriate to treat all the cases in the same or neglect the other causes.  
A blunder in any of the procedures can result in hypothyroidism, which may or may not be detected in test results.  
But not all doctors treat the same way...  
And as far as your problem is concerned, we have got your back.  

At **Jeevam Health**, we follow the [Functional Medicine](https://www.jeevamhealth.com/post/what-is-functional-medicine) Approach for Thyroid disease treatment. To assist people to regain their health, our treatment focuses on [lifestyle changes, nutritional diet, and supplements.](https://drhyman.com/blog/2015/06/10/a-comprehensive-6-step-strategy-to-heal-your-thyroid/)    

Here's everything you need to know:  
- If autoimmunity is causing thyroid problems, balancing and regulating the [immune system](https://www.jeevamhealth.com/post/build-immunity-during-covid) —and thus slowing or stopping its attack against the thyroid gland—should be a primary goal of treatment.  
In conditions like [Hashimoto’s disease](https://my.clevelandclinic.org/health/diseases/17665-hashimotos-disease) when not caught up in the early stages, hormone replacement will come into play to normalize the thyroid function.  
But addressing the immune imbalance is important to stop further destruction of thyroid tissue. In cases, Hashimoto’s is detected early enough, it may prevent hypothyroidism from developing in the first place.  
- Similarly, restoring healthy iodine and/or selenium levels is the most reasonable first action to take if iodine and/or selenium shortage is causing the patient's thyroid condition.  
Again, this does not eliminate the need for thyroid hormone replacement, but it can often significantly reduce the dose required to regulate thyroid function.

Here is the catch for you: We have developed a program with some top-notch doctors and medical experts to help you with your thyroid problem.  
**Features of Our Program**
- History and Medical record analysis from Functional Medicine perspective
- Elimination of Goitrogens from Diet
- Identification of Nutrition deficiency and Target supplementation
- Complete [Lab testing](https://www.jeevamhealth.com/post/thyroid-blood-tests-details-how-much-is-the-normal)
- Lifestyle Management
- GUT ( Digestive System) Healing
- Detoxification
- Bioidentical Hormone Replacement
- Thyroxine (T4) and Liothyronine (T3) Hormone Replacement

Our approach helps to address the underlying causes of thyroid disorders rather than simply medicating with thyroid hormone supplementation. We will understand the symptoms of thyroid disease and explain how to cure it. We would design a nutritional, lifestyle, and supplement regimen for the treatment of thyroid disease.  

**We’re here to help. Please get in touch with us and we can help address your concerns and assist you in your journey to better health.  
[Book a call with Jeevam Health Team NOW!](/join)**




Thyroid disease causes symptoms and treatment.

Thyroid Disease: Causes, Symptoms, and Treatment

 

With over 23.5 million individuals suffering from autoimmune diseases, this epidemic deserves a second look at the root cause and the reason for the rising symptoms and incidence all over the world.

It’s important to note that most autoimmune conditions tend to overlap one another. According to the National Institute of Health, 25% of autoimmune patients have a tendency to develop multiple autoimmune conditions.  

![A  trio of causes](/blogs/autoimmune-disease/image1.png)

Now in India, We observe the rise of all kinds of autoimmune diseases. It makes more sense to me to focus on the root cause of the pathology than just focus on symptomatic treatment. The conventional approach to “autoimmune disease” in general fails to address the body as a whole system, and we fall prey to mitigating the “symptoms” by adding toxic medications that potentially set off other unintended consequences. We know and understand that our body struggles when homeostasis is disturbed by its innate compensatory mechanism to keep our body from harm. Once the body is taxed and burdened to its threshold is when we end up with a host of symptoms. Symptoms tell us that our bodies need help, that they’re burdened.  

## The Autoimmune Triad
Thanks to the work of Dr. Alessio Fasano, a physician, and researcher at the University of Maryland, he and his team have discovered interesting findings on celiac disease, which is relevant to all autoimmune conditions.

This is exciting because of the possibility that treatment approaches to celiac disease may benefit other autoimmune conditions as well.

Dr. Fasano found that for patients with celiac disease, which is an autoimmune condition, 3 factors must be present for the disease to manifest: trigger, genetic susceptibility, and a permeable gut (leaky gut).

## Trigger
A trigger can be an event, much like the straw that broke the camel’s back. It can be a cold, flu, trauma, or an emotional turmoil that does you in.

When you think of the trigger though, I think it’s important to understand that it’s never one episodic moment or event. A cumulative burden usually exists in the way of emotional stress, physical stress, or psychological stress.

As a graduate student, I wasn’t eating the best of foods, had terrible sleeping habits, and was constantly stressed by many course load.

## Genetic Susceptibility
Life deals you a deck of cards in the way of your genes. It’s how you play your hand that determines your gene expression. If the autoimmune disease runs in your family make you prone to develop autoimmune disease. 

## Gut Permeability
Also known as leaky gut. Lupus patients and all autoimmune patients have leaky gut.
As a result, we have mitochondrial dysfunction which leads to a host of systemic inflammation and immune imbalances. The good news is that since we know the root cause of our issues, we can work on fixing our issues once and for all.

Gut permeability exists due to any type of stress, antibiotic use, and toxic load. Most people have gut permeability issues to some extent.

## Functional Medicine: Treating Causes, Not Symptoms
It is clear that we can prevent and reverse autoimmune disease. Functional medicine is a hidden movement sweeping across the globe, and it is based on a different method of diagnosing and treating disease—one that focuses on causes not symptoms, one that is based on an understanding of the dynamic way our genes interact with the environment, one that goes beyond simply treating diseases based on their label.
This approach is a fundamentally different way of solving medical problems, one that allows us to decipher the origins of illness and identify the disturbances in biology that lead to symptoms.



Autoimmune Disease


Some fats and oils can be used when cooking over high temperatures, while some are better suited for use over low or no heat. The following guide lists preferred cooking oils, their smoke points, and their best uses. 

![AltText for image 1](/blogs/cooking-with-fats-and-oils/image1.png)

The smoke point of a fat or oil is the temperature at which the oil will burn and become damaged. Smoke points for fat or oil can vary depending on the quality and variety of the source ingredients, and on whether the fat or oil has been refined. It’s important to not exceed a fat or oil’s smoke point when cooking.  

![AltText for image 2](/blogs/cooking-with-fats-and-oils/image2.png)

## What About Other Fats and Oils?  
Most of the fats and oils listed below have high smoke points and seem safe for cooking, but these fats and oils undergo heavy processing. These processing methods counteract any potential health benefits. These fats and oils are also high in omega-6 fatty acids, which can cause chronic inflammation in the body. Because of this, regularly consuming fats and oils from this list is not recommended. If you do consume these fats and oils, be sure to choose brands that are certified organic and made from non-GMO crops. 

- Canola oil (rapeseed oil) 
- Corn (મકાઇ)oil 
- Sunflower oil 
- Vegetable (વનસ્પતિ) oil 
- Safflower oil 
- Soybean oil 
- Cottonseed(કપાસિયા) oil 
- Grapeseed oil

What Does It All Mean? There are many different ways to describe oils, and deciphering food labels with these different words can be confusing. Some common descriptors found on packaging include the following: 

![AltText for image 3](/blogs/cooking-with-fats-and-oils/image3.png)
![AltText for image 4](/blogs/cooking-with-fats-and-oils/image4.png)

## Tips for Buying and Storing Cooking Fats and Oils 
Fats and oils can become damaged by contact with light, heat, air, or thin plastics. Many fats and oils sold in grocery stores are poorly packaged, which increases the risk that the fat will be damaged before you consume it. In order to maximize the health benefits of fats and oils, and help you make sure you’re consuming high-quality products, follow the list of tips below.  

![AltText for image 5](/blogs/cooking-with-fats-and-oils/image5.png)








A guide to Cooking with Fats and Oils


Food reactions of any type can trigger low-grade inflammatory reactions in the gut, making the intestinal wall more porous and exposed to the influx of large, undigested food particles into the blood (a condition referred to as “leaky gut”). This breakdown of the intestinal barrier can allow other substances like bacteria, chemicals, and yeast to leak from the intestine into the bloodstream, further stimulating the immune system and causing more inflammation. Just as food reactions can lead to a leaky gut, the reverse is also true; leaky gut can significantly increase the development of food sensitivities. Removing problem foods decreases inflammation and helps calm the immune response. The Elimination Diet helps to reduce inflammation by promoting the ingestion of anti-inflammatory foods. Over time, these foods, combined with the elimination of common trigger foods, cause inflammation to subside and helps the gut to heal.  
The intestinal lining is made of cells that replace themselves approximately every two to four days. This means that, in the span of a single week, every cell in the intestinal lining is broken down or sloughed off and a new cell grows to take its place. Removing from the diet potentially harmful foods and those that cause inflammation, while at the same time supplying the body with healthy, anti-inflammatory whole foods (especially those containing healthy fats, fiber, and an array of phytonutrients) makes this newly-formed gut tissue stronger and healthier.  
Much of one’s overall health is determined by the health of the gut.  

![Table for what to eat and what not to eat](/blogs/elimination-food-guide/image1.png)

More than 70% of the immune system is clustered around the digestive tract. The gut immune system is constantly assessing things that are ingested or inhaled into the digestive tract. The way the immune system responds is impacted by the flora that inhabits the gut. The normal flora also referred to as the microbiome, helps regulate the immune response. When the gut is inflamed, the balance of beneficial versus non-beneficial microbes is thrown off. This results in improper stimulation of the immune response and can cause adverse symptoms. Providing essential nutrients for healing is a critical factor in creating a healthy microbiome as well as a healthy immune response. Eliminating certain foods decreases inflammation, which allows the gut, and ultimately the immune system, to heal. Additionally, a healthy gut microbiome can be rebuilt by eating healthy whole foods, especially those high in protein, phytonutrients, probiotics, and prebiotics. These foods are the basis of the Elimination Diet.  
In order to achieve the therapeutic effects of the Elimination Diet, it is important to know which foods to avoid and which foods are okay to eat. The table below provides a summary.

## Touring Through the Food Plan

1. **Protein:**  Protein is an essential cornerstone of optimal nutrition. It performs multiple functions in the body, such as helping to stabilize blood sugar levels, which in turn keeps hunger and cravings at bay. Additionally, the human body cannot effectively eliminate toxins without amino acids—the building blocks of protein—that bind transformed toxins in the liver and help the body excrete them. Thus, it is extremely important to include some protein in every meal or snack. The Elimination Diet offers different sources of animal and plant proteins from which to choose. As with the other food categories, quality is of utmost importance. High-quality proteins include lean, pasture-raised, grass-fed, organic, and non-genetically modified (GMO) sources. Options include low-mercury fish like halibut, herring, mackerel, salmon, sardines, and tuna. Wild-caught, sustainable fish choices are preferred, as some farmed fish may contain hormones and harmful chemicals. Other protein options include the wild game (buffalo, elk, lamb, venison) and poultry (chicken, Cornish hen, turkey). Vegetarian protein choices include spirulina, legumes, lentils, peas, and select protein powders (hemp, pea, and rice).  
2. **Legumes** are a perfect source of quality protein and complex carbohydrates, which give a sense of fullness and stabilize blood sugar. At least one serving of legumes on a daily basis in soup or as cooked beans, dips, or hummus is recommended.  
3. **Dairy Alternatives** Dairy products are not included in the Elimination Diet, as dairy is often a culprit in gastrointestinal symptoms. Additionally, the risk of toxin and hormone contamination is high with many commercially available dairy products. There are several dairy alternatives available in this food plan, mostly in the form of milk made from nuts. Dairy substitutes like coconut (boxed variety), almond, flaxseed, or hazelnut milk often contain added sweeteners or gums, so it is important to read food labels before purchasing. Unsweetened coconut kefir is included in the food plan because of its prebiotic and probiotic potential, which may help improve gut health and aid in toxin removal.
4. **Nuts & Seeds** A variety of nuts and seeds are included in the Elimination Diet. They can be added to meals for a nutrient and flavor boost—perhaps sprinkled on top of salads or vegetable dishes—and make a great snack choice. Eating a handful of nuts each day has been shown to reduce the risk of chronic disease. It is recommended that at least 1 to 2 servings of nuts be eaten every day. Raw, unsalted nuts instead of nuts roasted in oil are preferred. Flaxseeds and hemp seeds can be ground and stirred into smoothies or sprinkled on salads. Additionally, nut butter like almond butter, cashew butter, and tahini (sesame seed butter) can be used as condiments, spread on fruit, or drizzled over vegetables.
5. **Fats & Oils** A large selection of fats and oils can be used for salad dressings and cooking while following the Elimination Diet. Approved choices are minimally refined, cold-pressed, organic, non-GMO fats and liquid oils, as these will be the best quality. Consuming these high-quality fats on a daily basis is recommended for reducing inflammation, stabilizing blood sugar levels, and minimizing sugar cravings. Extra-virgin olive oil is associated with healthy cholesterol levels. Research suggests that consuming minimally processed extra-virgin olive oil provides the greatest health benefits by increasing HDL (healthy cholesterol) and decreasing oxidative damage. The health benefits of olive oil are also found in whole olives, which are included in this category. Coconut-based fats, particularly coconut oil, are rich in medium-chain fatty acids (MCFAs) that help restore gut health. MCFAs are absorbed directly into the lining of the small intestine and sent straight to the liver for energy production, or are converted into ketone bodies, an important source of energy for the brain. 
6. **Ghee, or clarified butter**, is also included in this category. While ghee is technically a dairy product, all milk proteins are removed in the process of making it. Ghee is primarily composed of short-chain fatty acids (SCFAs), which are easily digested by the body and are thought to stimulate the secretion of stomach acids to help with digestion. Ghee also has a high concentration of butyric acid, which contains antiviral properties and helps break down food for energy.
7. **Non-Starchy and Starchy Vegetables** The Elimination Diet emphasizes eating plenty of vegetables. Ideally, it is best to get 10–12 servings of vegetables per day. (A serving is ½ cup of most vegetables or 1 cup of raw leafy greens.) Green vegetables, especially members of the cabbage family, are particularly nutritious for those on the Elimination Diet. However it is important to eat a “rainbow of colors” in addition to greens; such foods include red beets, red peppers, and radishes; orange carrots, orange pepper, yams, sweet potatoes, and winter squash; yellow summer squash and yellow peppers; and white onions and garlic. To promote good health, it is important to eat a variety of colors each day. While darker-colored plants are generally higher in phytonutrients, even vegetables from the white family have potent contributions to make.
8. **Fruits** phytonutrient-rich fruits offer antioxidant protection, which helps reduce inflammation. Eating a piece of fruit may be helpful when the desire for something sweet arises. It’s always better to eat fruit with a little bit of protein, such as nuts or nut butter, to offset any blood sugar spikes. Fruit can be fresh or frozen but must contain no added sugars or sweeteners. The Elimination Diet includes fruits that offer a wide range of health benefits, including blackberries, blueberries, kiwi, pomegranate seeds, and raspberries. Pomegranate seeds are recommended because they support detoxification pathways. In addition to improving memory and cognition, blueberries contain one of the highest antioxidant levels of all fruits. Apples contain phytonutrients that suppress inflammation. They may be eaten raw or stewed with cinnamon for added benefits. Small amounts of dried fruit are acceptable on occasion; you can make your own dehydrated, non-sweetened fruit to eat. As with vegetables, it is important to purchase organic fruit whenever possible. While citrus fruits are included.
9. **Gluten-Free Grains** Gluten and gluten-containing grain products (bread, cereals, crackers, pasta, etc.) are omitted from the Elimination Diet. Removing the gluten-containing grains is just the first step, however, as gluten is also commonly found in prepared sauces, dressings, seasonings, and many other foods. Gluten-free whole grains, those with an intact bran outer coat, are allowed on the Elimination Diet as they provide an excellent source of fiber and other phytonutrients to assist with detoxification. These grains include amaranth, buckwheat, kasha, millet, oats, quinoa, rice, and teff. Cross-contamination is an issue with oats and perhaps other gluten-free grains when those grains are grown near wheat, rye, or barley. It is also an issue when gluten-free and gluten-containing grains are processed using the same machinery. When purchasing oats, look for the certified gluten-free seal on the package. Patients with celiac disease need to ensure that gluten has been entirely omitted from daily eating. 
10. **Beverages** Hydration helps rid the body of toxins, builds resilience to stress, enhances metabolism, and promotes satiety. It is important to drink plenty of clean, filtered water throughout the day. Individual recommendations for fluid intake will depend upon a number of factors. To determine an individual’s baseline hydration needs, use this equation Bodyweight(KG) ÷ 30 = Fluid intake (L). So 60 Kg man required 2L of water daily to maintain normal functions. In addition to filtered water, broths (vegetable, bone), meat stocks, and other decaffeinated beverages like fresh, raw, cold-pressed vegetable juices are also good liquid choices. Decaffeinated teas are also recommended on the Elimination Diet. Omitted from the Elimination Diet are coffee, alcohol, soft drinks, and non-dairy creamer. Coffee, while not high on the list of potential allergens, can have a significant effect on blood sugar and stress hormones. Eliminating coffee might lead to having headaches for a few days. One strategy to try is to slowly lower caffeine intake over several days to minimize the headaches, fatigue, or other unpleasant withdrawal symptoms that are often associated with caffeine withdrawal.
11. **Alcohol** is avoided because of its inflammatory effects and its interference with liver function. The liver breaks down most of the alcohol a person consumes, but the process of breaking down alcohol creates toxins that promote inflammation and weaken the immune system. Both artificially sweetened and regular soft drinks should be eliminated for the duration of the Elimination Diet. Try substituting seltzer water with lemon or lime wedges, or a splash of coconut water. It is important to avoid non-dairy creamer, as it contains refined sugars and unhealthy hydrogenated fats. Instead, use one of the non-dairy milk substitutes like almond or coconut milk in place of milk and creamer. 
12. **Spices and Condiments** All herbs and spices are included in the Elimination Diet. Some of these can reduce pain and inflammation, particularly in cases of a gastrointestinal upset: cayenne pepper, chili powder, cilantro, ginger, nutmeg, and paprika. Turmeric is also known for its anti-inflammatory and pain-relieving properties. Digestive health is further enhanced by several others, including cinnamon, cumin, and dill. Other herbs and spices selected for detoxification and for their overall antioxidant and antimicrobial effects include cloves, oregano, rosemary, and thyme. Most condiments available on store shelves are not permitted on the Elimination Diet, as they can contain added sweeteners and preservatives. However, homemade versions of many condiments—including ketchup and barbeque sauce—can be easily made using few approved ingredients. Vinegar is permitted in the diet.

## Inflammatory Foods to Exclude: 
Focusing on anti-inflammatory foods in the diet is just the first step. What is not eaten is as important as what is eaten. During the Elimination Diet, and even afterward, reduce or eliminate the following: 
1. **Trans-fats:** Found in processed foods like cakes, cookies, bagels, and crackers. 
2. **Refined sugars:** Added refined sugars are pervasive in processed foods. Read the labels very carefully for sugars such as HFCS, corn sugar, corn syrup, and sucrose. 
3. **Foods with a high glycemic response:** High-glycemic foods create blood sugar spikes after eating; these can stress the body to overproduce insulin, which is not healthy. Over time, the body becomes less equipped to handle high-sugar foods, and inflammation increases from the excess sugar and insulin produced. Examples of foods with a high-glycemic response are refined grains and bread, desserts, sweetened beverages, and highly processed prepared foods.
4. **High omega-6 oils such as corn or soy:** Most people eat high amounts of refined vegetable oils in their diet if they eat lots of processed foods. These oils have high amounts of omega-6 fats and too few omega-3 fats. When the omega-6 fat level in the diet is too high compared with the omega-3 level, enzymes involved in inflammation can be activated. The goal is to balance those two types of fats. 
5. **Gluten-containing foods** (wheat, rye, barley, spelt, Kamut): More people are learning that they have gluten intolerance. While it is unknown why this is happening, one theory is that the genetic modification of these grains in the modern era of agriculture has led to changes in how most people digest them in the gut. For some people, wheat may be more of an issue; for others, all of these grains could provoke inflammatory-related symptoms. Another theory about the recent surge of gluten intolerance is that the reaction isn’t caused by the grains themselves, but rather by the pesticides and herbicides the grains are treated with. Yet another theory is that treating grains with enzymes or acid to make flour that is more easily mixed with liquids (a process called deamidation), may be affecting the body’s ability to handle them.
6. **Saturated animal fats from grain-fed red meats:** Dietary fat has had a bad reputation for a long time. However, there are many types of fats and they are not all inflammatory; too much poor quality fat is the real problem. New research suggests that a high-fat meal of animal foods could lead to inflammation in the body. Adding vegetables to the meal can help to offset the inflammation. This finding does not mean that one should not eat animal foods, but that if they are eaten, vegetables should be included with the meal.
7. **Dairy-containing foods:** Foods that contain dairy products such as milk, yogurt, cheeses, and butter, when eaten in large amounts, may be inflammatory in certain individuals. This effect may be due to the milk itself or to the contaminants in the milk, such as growth hormones and antibiotics that were given to the cow. 
8. **High-temperature cooking with fats:** The process of cooking can lead to the formation of inflammatory compounds in foods. Foods that take on a brown color with cooking have high levels of these compounds (e.g., fried potatoes; fried, broiled, grilled, and roasted meats, especially bacon, and fish; pastries or pizza crust). Both during and after the Elimination Diet use slow-cook methods, as well as poaching and steaming, instead of grilling, broiling, and Deep frying.


Elimination Food Guide


Food is information, not just calories. Food influences gene function, hormones, your immune system, and even your gut flora. Literally, food controls every function within your body. This is especially true with the omega-3 fatty acids.  
Omega-3 comes from both animal and plant sources. The primary animal sources are krill oil and fish oil. The primary plant sources are flaxseed, chia and hemp, and walnut.  
When it comes to omega-3 benefits, there are rarely nutrients that pack this many positive health outcomes into one compound. The most commonly known benefit of omega-3s is a reduced risk of heart disease, but that’s not the only studied plus of getting lots of omega-3s in your diet. In fact, omega-3 benefits everything from fetal development to retinal function, weight management, and a lot more in between. These acids support and promote optimal health for anyone.  

## Types of Omega-3 Fats
![Omega 3](/blogs/essential-guide-for-omega-3-fatty-acid/image1.png)

Marine animals such as fish and krill provide eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are mostly promoted for their protective effects on your heart. Flaxseed, chia, hemp, and a few other foods, on the other hand, offer alpha-linoleic acid (ALA).  
Furthermore, ALA is converted into EPA and DHA in your body at a very low ratio. What this means is that even if you consume large amounts of ALA, your body can only convert a relatively small amount into EPA and DHA, and only when there are sufficient enzymes.
**YOU NEED ALL 3 TYPES OF OMEGA 3 IN YOUR DIET OR SUPPLEMENTS.**

## Why Omega-3 Fats are Important
Simply put these extraordinary fats affect every part of your biochemistry. They control gene function, regulate your immune system, impact the speed and efficacy of your metabolism, and they are a vital component of the cell membrane that covers every one of the 100 trillion cells in your body.
This means when you don’t get enough omega-3 fats, messages can’t properly communicate from one cell to another. If you’re not getting enough omega-3s, your body — including your brain — just can’t work to its optimum potential!

## Dietary Sources for Omega-3 Fats
Today the only real sources of omega-3 fats are:
- Wild fish 
- Grass-fed and finished animals and animal products
- Seaweed
- Algae
- Omega-3 eggs
- Flaxseed
- Walnut
- Chia seed 

## Finding a High-quality Omega-3 Supplement
The limited sources for omega-3 fats and the fact that most people don’t eat enough foods that contain them leads me to recommend a high-quality fish oil supplement as part of a daily workhorse team of vitamins and minerals needed to help you optimize your health.
However, finding quality fish oil is key. You want to locate something that is free of mercury and other contaminants. Look for reputable companies that certify their products are free from heavy metals and pesticides.
I typically recommend taking 1000 mg of omega-3 twice a day. There are some good sources of fish oil on the market. You can compare yourself.  




An essential guide for Omega 3 Fatty Acid


Eating a healthy diet has never been as important as it has become during the COVID-19 pandemic. What we eat and drink can affect our body’s ability to prevent, fight and recover from infections. The first step towards building our immunity is what we consume on a daily basis. 

Here is the list of the seven things anyone must include in their diet to increase immunity during these unprecedented times: 

1. Include omega 3 fatty acids like Flaxseed oil (Flaxseed oil is a source of polyunsaturated fatty acids such as alpha-linolenic acid). The alpha-linolenic acid and related chemicals in flaxseed oil seem to decrease inflammation. That is why flaxseed oil is useful for rheumatoid arthritis and other inflammatory (swelling) diseases.

![Omega 3](/blogs/right-food-to-build-immunity/image1.png)

2. Eat fresh and unprocessed food every day (Unprocessed food quickly reduces weight, increases your stamina, effectively fights heart disease). Add a minimum amount of 5 to 6 cups of seasonal vegetables to increase antioxidants. Also add in a wide variety of seasonal vegetables like carrots, leafy greens, cruciferous vegetables like cabbage, broccoli, cauliflower. These are Sulphur rich vegetables, which help the body to detox.

![Balance the proportions](/blogs/right-food-to-build-immunity/image2.png)

3. Add in good fats in the form of pure bilona ghee (Desi Cow’s Bilona Ghee is full of nutrients, fatty acids, antibacterial, antifungal, antioxidant, and antiviral properties. It is cool, sweet and a kind of saturated fat which we can add in our cooked food daily during lunch or dinner), cold-pressed extra virgin olive oils (there are many benefits of cold-pressed extra virgin olive oil--- it's high in nutrients. Olive oil also boosts vitamin E and K. Vitamin E is a powerful antioxidant involved in immune function, while vitamin K plays a key role in blood clotting and bone health.), avocados, nuts, and seeds, fatty fish.

![Good fats and ghee](/blogs/right-food-to-build-immunity/image3.png)

4. Include protein and complex sources of carbohydrates in the form of legumes, dals, vegetables, and whole grains. Legumes are a rich source of fibers that have various beneficial health effects. Legumes improve blood pressure, reduces cholesterol, lowers heart disease risk, and promote weight loss in long term.

![Protein and complex sources of carbohydrates](/blogs/right-food-to-build-immunity/image4.png)

5. Avoid all refined flours, refined oils, simple processed sugars in all forms including sugar replacements like honey and jaggery. Refined flours cause an acid-alkaline imbalance. Regular consumption of refined flour affects the body’s pH level. It also increases your blood sugar and causes weight gain. It also affects your digestive health and causes inflammation. This kind of food should be avoided if you have been diagnosed with inflammatory diseases.

![Avoid Refined and processed items](/blogs/right-food-to-build-immunity/image5.png)

6. Avoid all bakery items like bread, biscuits, cookies, etc. Replace with whole grains like millet, amaranth, buckwheat, sattu. ( Millets should be added to your daily menu as they have an abundance of vitamin B, calcium, iron, potassium, copper, manganese, magnesium, and zinc. Since millets have their outer cover and they are rich in fiber too).

![Avoid Bakery Items](/blogs/right-food-to-build-immunity/image6.png)

7. Vegetable juices are easy to digest and are also high in their nutritional value. Add in a simple green vegetable juice. Green vegetables and their juices are the best sources of essential vitamins, minerals, and beneficial plant compounds. Eating green leafy vegetables may help in reducing inflammation. Avoid fruit juices in all forms because it's high in sugar and high in calories which is unhealthy for your health. Fruits to be taken in limited quantities once a day only. 

![Green Vegetable Juice](/blogs/right-food-to-build-immunity/image7.png)

A balanced diet with an anti-inflammatory protocol is important to follow during and post-recovery from Covid-19. These food items may not help in the prevention of the virus but they shall help prepare your body to fight it and come out stronger. 

![Balanced Diet](/blogs/right-food-to-build-immunity/image8.png)



What's the right food to build immunity during Covid?



Have you been feeling tired or lethargic and put on some weight? It might not just mean you are lazy. It could indicate that your thyroid gland is not as active as it should be. In this case, your doctor would advise you to get a thyroid panel or thyroid function test done. The main components of this are serum Thyroid Stimulating Hormone (TSH), triiodothyronine (T3) and thyroxine (T4).  

Let us see what these tests mean and how to interpret them. And how we at Jeevam Health go one step beyond to take better care of you.
 
## How thyroid tests are performed?  
Typically, fasting is not necessary for thyroid testing. Mornings are the best time for optimal assessment.  
A blood sample is required which is drawn from a vein in your arm. One sharp prick is required. In experienced hands, the process is virtually painless and only takes a few seconds.  
 
## Who needs to get a thyroid test done?
The two main groups of people
- Those having symptoms- The thyroid gland affects virtually every part of the body. Symptoms could be related to the heart, gut, immune system, bone, nervous system or reproductive organs in women.
- Those diagnosed with thyroid disease who need monitoring.  

Having a thyroid disease means your thyroid gland is producing either too much or too little of the hormones T3 and T4. These perform various vital functions in the body.
 
![Thyroid-Stimulating Hormone (TSH)](/blogs/thyroid-blood-test/1.png)

Then what is [TSH](https://www.jeevamhealth.com/post/new-guideline-for-tsh-thyroid-stimulating-hormone) for? It is a hormone produced by the [pituitary gland](https://my.clevelandclinic.org/health/articles/21459-pituitary-gland). It controls the function of the thyroid gland. The levels of TSH get affected earliest when there is any thyroid disease. This is why some doctors advise getting only TSH levels done.
 
This may, however, not be the best idea. TSH levels may be difficult to interpret and need to be considered in the context of clinical findings. Not only this, there has been much debate over what level should be considered a cutoff.
  
## How thyroid tests are interpreted?
TSH levels are an indicator of level of activity of the thyroid gland. When the thyroid gland is not functioning optimally, T3 and T4 levels in the bloodstream are below normal levels. When this message is conveyed to the brain, it increases the stimulation to the thyroid gland. This results in an increase in levels of TSH, which will mediate this action. Hence, a level of TSH higher than normal indicates [hypothyroidism](https://youtu.be/Pq5-JGq3NNY).
 
A similar mechanism occurs in case of an overactive thyroid. Higher levels of T3 and T4 will cause a decrease in levels of TSH. Hence, a level of TSH lower than normal indicates [hyperthyroidism](https://www.jeevamhealth.com/post/hyperthyroidism-novel-approach-to-cure). The most common forms of this are [Graves' disease](https://my.clevelandclinic.org/health/diseases/15244-graves-disease) and [thyroid nodules](https://my.clevelandclinic.org/health/diseases/13121-thyroid-nodule).
 
![Thyroid Blood Test Range](/blogs/thyroid-blood-test/2.png)

Traditionally, TSH levels from 0.4-4.5 mIU/L have been considered normal. Levels from 4.6-8.0 mIU/L suggest subclinical hypothyroidism. It is important to remember that these values cannot be considered absolute.  
 
Many experts consider the cutoff for normal TSH levels to be 2.5 mIU/L. Patients with levels above 2.5 can have insulin resistance, higher blood pressure, elevated triglycerides and a higher body mass index. These increase the chances of metabolic syndrome, a major risk to your [cardiovascular health](https://www.jeevamhealth.com/post/cardiovascular-risk-to-prevent-heart-attack-and-stroke-monitor-10-risk-indicators-not-cholesterol). So, any level higher than 2.5 can put you at risk.  
 
**What does this mean?**  
Simply put, it means that a TSH level between 2.5 to 4.5 does not definitively mean that a patient does not have a thyroid disease. Therefore, always trust your doctor to evaluate the blood tests and your symptoms together. He can best assess what care you need going forward.  
 
The same holds true for hyperthyroidism where TSH levels are typically below 0.4 mIU/L. However, scientific evidence suggests levels above 1.0 are optimal.
 
**TSH levels can be affected by many factors, such as:**
- Taking other medications. Metformin, one of the most commonly prescribed treatments for [diabetes](https://www.jeevamhealth.com/post/diabetes-blood-glucose-level-is-symptom-know-why-should-doctor-advice-for-blood-insulin-test), can also cause a false reduction in TSH levels.
- Women who are pregnant or on birth control pills
- Presence of other [autoimmune diseases](https://www.jeevamhealth.com/post/autoimmune-disease-treatment)
- Age and gender of the patient, levels being higher in older females
- Taking biotin supplements
- Time at which the test is done, levels being most accurate in the morning  

The next set includes T3 tests and T4 test. T3 is the active form which performs all the biological actions in the body. Hence, for the body to function normally, T4 has to be converted to T3.  

T3 circulates in the bloodstream, both bound and not bound to protein. The free (unbound) T3 is the only form which is able to enter and affect the body tissues. A total T3 test measures all the T3 in your body. This includes the inactive bound form as well. Free T3 a crucial test which only measures the amount of T3 which performs essential functions.  
 
**The conversion of T4 to T3 can also be affected by various factors such as:**
- Imbalance in gut microbiome
- Stress
- Improper liver function
- Extreme calorie restriction  

In these situations, TSH level may be normal as the feedback effect of thyroid hormones is maintained. Nevertheless, symptoms are present too as the hormone is not the active form.  
 
Keeping all these factors in mind, it is suggested to go a little deeper to evaluate the root cause of thyroid illness.  
 
## Antibody testing for the thyroid gland
There are certain people who have thyroid problems but their TSH test, T3 levels and T4 levels are all normal. That is because the disease process acts beyond these test measures. Such a person may have elevated antibody levels. This may occur in early stages of disease.  
 
There are two main antibodies implicated in the causation of hypothyroidism. These are:
- Anti-thyroid peroxidase (anti-TPO)
- Thyroglobulin Antibodies (TgAb)

Thyroid peroxidase is an enzyme required in the synthesis of T3 and T4. Antibodies against this directly hampers the ability of the thyroid gland to produce hormones. Presence of either one of these autoantibodies implies presence of autoimmune thyroid disease.  This is known as [Hashimoto's](https://www.jeevamhealth.com/post/hashimoto-thyroid-issue-an-autoimmune-hypothyroid-condition) autoimmune hypothyroidism.
 
One factor to keep in mind is that thyroid disease does not develop abruptly. The disease process is gradual, which is why it is often missed by conventional blood tests. This is where the relevance of antibodies is highlighted.
 
Consider a person having symptoms of fatigue, weakness, dry skin and hair fall. Despite normal hormone levels, in the presence of antibodies, it means the person has a disease which the regular thyroid panel missed.
 
## How to approach thyroid testing?
Standard protocols in India generally use serum TSH to screen for presence of thyroid disease. Only those with derangement are advised free T3 or T4 levels. This results in missing out of several cases.  
 
Hence, our first step at Jeevam Health is to perform a complete profile, without cutting any corners. This includes testing for TSH, T3, T4, free T3, free T4, and thyroid antibodies.  
 
A key component of our treatment approach is not just resolution of symptoms, but working towards treating the disease itself. We choose to adopt a personalised approach for optimal results. This helps us understand what are the specific factors in your history and lifestyle that can be modified. This includes:
- Assessing micronutrient levels to address specific deficiencies
- Identify the presence of goitrogens in your diet and eliminate them
- Find the triggers such as stress present in your lifestyle pattern and manage them
- Heal from within by restoring [gut health](https://thyroidpharmacist.com/articles/importance-gut-health/)
- Detoxification with diets directed towards reducing [inflammation](https://www.jeevamhealth.com/post/anti-inflammatory-food-1)
- Hormone replacement therapy

Many nutrients such as iron, [iodine](https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/), [zinc](https://thyroidpharmacist.com/articles/selenium-deficiency-and-hashimotos/) , selenium, vitamin E and other B complex vitamins are needed for the thyroid gland to function. Stress and inflammation cause inactivation of T4 hormone such that it does not convert to T3.  
 
Conversely, nutrients such as vitamin A and practices such as exercise can improve the response of the body to thyroid hormones. All of this means that the gland itself is only one part of the problem. Hence, a few additional tests are required to treat it best.  
 
## How knowing all of this can help you?
Thyroid disease does not occur in isolation. Much like other autoimmune diseases, it is an indicator of deep seated problems which need to be understood. [Functional Medicine](https://www.jeevamhealth.com/post/functional-medicine) helps address these modifiable factors to identify the root cause. This means adopting a holistic approach to make you healthy from inside out. In the long term, this implies healing without relying only on medications and potentially reversing the disease itself.

**We’re here to help. Please get in touch with us and we can help address your concerns and assist you in your journey to better health.
[Book a call with Jeevam Health Team NOW!](/join)**

Thyroid Blood Tests: All you need to know