Are you under stress and feel as though your metabolism is slowing down?

Your thyroid may be affected as a response to chronic stress.

By Delina Rahmate- Clinical Nutritionist Image-1(1)

When we are under prolonged levels of stress we will begin to experience multiple system issues, one of these is a change in our metabolism and consequent weight gain particularly around our midsection. We may also begin to feel puffy and fatigued. Due to the complexity of the thyroid I have only looked at a snap shot on what may be happening to your thyroid as a result of chronic stress.

Essentially under the stress response, fight or flight, our thyroid hormone conversion is going to be down- regulated to peripheral tissues. This is a normal response to threat. It should only be short lived. When the stress response becomes chronic and we are experiencing high levels of stress daily we begin to experience more dysfunction in the body leading to various symptoms, inflammation, disorders, and disease.

Often this is when you may begin to expect something is wrong with your metabolism, you may be gaining weight and feeling tired without changing your diet. You may visit the Doctor and have blood tests done.  In the earlier stages of dysfunction you may be symptomatic however your pathology does not reflect a thyroid issue, your blood test may show a normal TSH (thyroid stimulating hormone) and T4. This can leave you feeling confused about what is really going on with your body as the bloods appear to be normal. Testing TSH, however, does not represent the thyroid hormone status of all the peripheral cells, it represents T3 in the pituitary. In stress situations T3 is upregulated to pituitary and downregulated to peripheral cells.

Due to the lack of supporting evidence you may be told to eat less and exercise more as a way of controlling your symptoms. This may increase the stress response/Cell Danger Response (CDR). If the stressful state continues then a weight struggle persists, often for years, before the next phase happens and you start to develop an autoimmune attack on your thyroid. Regular blood tests do not detect thyroid antibodies so this can go undetected as bloods will still appear to be normal. You once again may be told the same thing- to eat less, exercise more and look at managing stress through referral, stress management techniques and possible medication.

Eventually if stress remains unresolved phase III kicks in. This is when the autoimmune / immune response creates so much damage to the thyroid that the gland can no longer make enough hormone to support the pituitary gland, TSH will rise and T4 will drop below lab range. Pathology tests will now show that there is a thyroid issue. Unfortunately it is now a chronic problem.

Due to the complexity of the chronic stress response and how it effects other body systems it is important that you seek good advice on managing your return to optimal health. As a Clinical Nutritionist I can work with you and your Doctor to find out the best approach that will work for you. Metabolism testing is also an excellent tool in helping understand what is going on with your body.

Image-1(2)If you feel like some further very technical reading you can search “Cell Danger Response”, and you will find an amazing paper that explains the CDR.


Nutrition to support the thyroid

To support the thyroid we should choose a diet rich in tyrosine, iodine, selenium, zinc, vitamin E, vitamin A and antioxidants.

The following is a list of healthy foods to base your diet around to support your thyroid.

  • Grains and legumes: Always choose wholegrains: amaranth, brown rice, millet and quinoa. Chickpeas, lentils, kidney beans, black beans, lima beans
  • Vegetables: Organic where possible (particularly when you eat the skin such as tomatoes), cooked cruciferous vegetables such as broccoli, cauliflower, cabbage and kale. All seasonal and local vegetables.
  • Fermented vegetables.
  • Seaweed such as dulse, kelp and wakame
  • Brightly coloured fruits such as berries, kiwi fruit, pineapple, papaya and other seasonal fruits
  • Fats and oils: Cold pressed oils, coconut oil, ghee
  • Pot set yoghurt and kefir
  • Fish: Alaskan fish, pacific ocean fish, farmed oysters and mussels, oily fish such as mackerel
  • Grass fed meat, bone broth and liver
  • Free-range chicken
  • Free-range eggs
  • Salt such as Celtic or Himalayan
  • Turmeric, onions and garlic
  • FlaxseedBrazil nuts
  • Sunflower seeds


Daily exercise stimulates thyroid hormone secretion and increases tissue sensitivity to thyroid hormone.

Recipe to support the thyroid

What is lovely about this dish is its simplicity and diversity. You can use a wide variety of veggies here — there is no right or wrong as long as the veggie can survive the roasting!  You can easily use sweet potatoes, beets, asparagus, cauliflower, broccoli, parsnips, radishes, onions, garlic cloves, leeks, peppers, zucchinis, fennel, carrots or eggplant. These Veggies can be prepared ahead of time and added to salads to boost the flavour and interest. A great recipe for your balancing your hormones.

Roasted Vegetables and Moroccan Spice by Magdalena Wszelaki

Prep time:15 mins | Cook time: 45 mins | Serves: 4-6


  • Vegetables of your choice (see the list above). Pictured are: asparagus, parsnip, carrots and leeks
  • 2 tablespoons coconut oil, warm it if needed so it’s liquid
  • sea salt
  • Moroccan spice blend


  1. Preheat the oven to 220C.
  2. Toss the veggies with coconut oil, sea salt and the Moroccan blend.
  3. Lay them out on parchment paper so they don’t touch each other too much.
  4. Bake for 45 minutes.
  5. Serve with your favourite protein and a green leafy salad sprinkled with sunflower seeds.



New and existing patients we are offering a NO GAP Initial Consultation for treatment of;

– a new condition or

– a new area of your body

Private health members will not pay an out of pocket gap. Non insured patients you can take advantage also for only $49 *

In this session you will receive;

– a complete assessment of you condition
– diagnosis of your problem
– treatment of your condition
– treatment plan ongoing to get you the outcome you want

All of this normally valued at over $100

IMG_3298Take advantage of this offer to use your health fund  benefits before they run out

Call on 5578-7155 or  CLICK HERE  to book online.

Must mention offer to book

* Conditions apply
– Bookings with Tim and Kelly only
– Appointments only available Tuesday-Friday 9:30am-2:30pm
– Offer only for NEW clients or Existing clients with a NEW condition

3 Weight loss friendly foods that are low cost and highly nutritious!!

Not all calories are created equal!

Different foods go through different metabolic pathways in the body. They can have very different effects on hunger, hormones and the amount of calories that we burn off.

In this article we have a look at foods that can be included in your diet that have been scientifically proven to be weight loss friendly without breaking the bank.

1. Chia seeds- are highly nutritious little seeds that contain 12g of carbohydrate per gram however 11 of the 12 grams are fibre making them a low carb friendly addition to the diet. The amounts of fibre means that chia seeds can absorb up to 12 times their weight you can see this effect when you put chia seeds in water they will expand and form a gel. This swelling of the seeds will occur in your stomach making you feel fuller and consume less calories.

2. Cruciferous vegetables- these are vegetables like broccoli, cauliflower, cabbage, kale and Brussel sprouts. They are very high in fibre and tend to be very filling. Along with their high levels of fibre they also contain decent amounts of protein higher than most other vegetables. A combination of fibre, protein and low energy density are a perfect addition to a weight loss diet. They are also high in antioxidants and indole-3 carbinol to assist in repairing the damage caused by oxidation, decrease the risk of cancer and assist in the management of hormonal pathways. These vegetables are best consumed cooked if you are at risk of thyroid issues.

3. Soups – foods with a low energy density tend to help people consume less food overall, these foods are usually high in water content like the cruciferous vegetables and many fruits. We can also create this ourselves by adding water to foods like soups. As winter approaches heart-warming soups become a perfect addition to our diets as starters or as a meal in themselves. Studies have shown that when the same food is consumed as a soup we often eat less as we feel more satisfied and fuller quicker and therefore decreasing the amount of overall calories that we consume. Studies have also shown that eating soup prior to a meal decreases the amount of calories consumed at that meal as well as later in the day.

Here are a few simple recipes to help you include these weight loss friendly foods into your daily diet;


Raspberry Chia Seed Parfait [Vegan friendly/Gluten Free/Dairy Free] Chia has 5 grams of protein per 2 tablespoons and is also a complete protein source.

For the Pudding:IMG_6559
– 6 tablespoons chia seeds
– 2 cups of almond milk
– 2 tablespoons pure maple syrup
– 1/4 teaspoon vanilla extract
– 1/4 teaspoon cinnamon
– 1/8 teaspoon ground cloves

For the Raspberry Purée:
– 2 cups frozen raspberries (or other berries)
– 1/2 cup water
– 1 tablespoon pure maple syrup (or drops of stevia until the right sweetness)

For the Topping:
– Apples and pomegranate seeds (or whatever you like! Such as coconut yoghurt , berries
and a sprinkle of seeds/ muesli)

Recipe thanks to chia-seed- parfait/


Potassium Balance Broth (Makes 4 serves) (Vegan friendly/Gluten Free/Dairy Free): Low in calories and high in nutrients.

Ingredients IMG_6560
– 4 Cups of filtered water;
– 4 medium zucchini finely chopped;
– 425 grams green beans roughly chopped; 1 small bunch of parsley;
– 3 tomatoes finely chopped;
– 2 cloves of garlic,
– 2 stalks of celery, finely chopped,
– 1 tsp sea salt.

– Put all ingredients in a pot. Bring to a gentle boil, lower heat and simmer for 30 mins with the lid on. Serve as is or blend for a creamier soup.

Recipe thanks to broth-recipe


Creamy Cauliflower Soup (Vegan friendly contains nuts/Gluten Free/Dairy Free) serves 6-8

– 2 tablespoons grapeseed or coconut oil
– 2 teaspoons minced garlic (2 cloves)
– 2 cups (200g) thinly sliced leeks (white parts only)IMG_6561
– 1 teaspoon Celtic sea salt, plus more to taste
– 1 large head cauliflower, chopped
– 7 cups (1.65L) vegetable broth (Massell stock powder works well)
– 1/4 cup (35g) raw unsalted cashews or 1/4 cup (35g) blanched slivered almonds
– 3 tablespoons chopped chives, to serve

1. In a large saucepan, heat the oil over medium heat and sauté the garlic, leeks, and 1/4 teaspoon of salt for about 3 minutes, until the vegetables are soft. Add the cauliflower and sauté for another minute.
2. Add the vegetable broth, increase the heat to high, and bring just to a boil. Reduce the heat to medium and simmer for 20 to 30 minutes, until the cauliflower is completely tender.
3. Remove the saucepan from the heat and allow the soup to cool slightly; stir in the nuts.
4. Pour the soup into your blender in batches and blast on high for about 1 minute, until smooth and creamy.
5. Return the soup to the saucepan and warm it over low heat. Stir in salt to taste.
6. To serve, ladle the soup into bowls and garnish with either chopped chives or grated nutmeg.

Recipe thanks to

Blog by Delina Rahmate- Clinical Nutritionist

The forgotten calf muscle

With the winter sports season fast approaching it is essential to make sure we are doing everything to minimise injury risk and rehabilitate our injuries correctly. Too often do I see running related sports participants come into the clinic with persistent calf tightness, calf muscle tears, achilles tendon pain or even shin “splints” who have weak and poor calf function that is driving a lot of their pain.

A major risk factor for these types of injuries is lack of calf strength, capacity and power.

Due to the demands of their chosen activity – whether it be walking , running or football – the calf needs to have to ability to tolerate the stress going through the lower leg. The calf propels us forwards during walking / running and jumping and acts as a shock absorber for bones and other connective tissue in the lower leg.

The calf complex is made up two portions;

  1. the gastrocnemius (the thicker and bulkier muscle)
  2. the soleus (the deeper calf muscle)

The gastrocnemius can take around 1-2 x your body weight during running and is normally simply trained by a straight legged calf raise ( heel raise). However the soleus can take up to 8 x your body weight!! .. and can be trained simply by bending the knee during the calf raise (see video below).

Too often do I see people neglecting the soleus in rehab and prehab exercise programs, when it is arguably the most important muscle in running related sports! Exercises to strengthen the soleus muscle should be included in all strength routines by the everyday population , runners and sporting teams to reduce the likelihood of foot, ankle and calf related pain. It also needs to stress the calf adequately so the amount of load going through it is enough to mimic the demands of your activity.

For further guidance on how you can reduce the likelihood of calf or any lower limb pain let us know at Physiologic – Call now 55787155.

by Tim Rigby, Associate Physiotherapist

Shaking it up – with meal replacement shakes

Are meal replacement shakes a healthy option for us?

By Delina Rahmate- Clinical Nutritionist

Often when we struggle with our weight we look for quick fix options on how to lose weight. Meal replacement shakes come at a high price and promise great results so are they worth the price we pay? In today’s article we’ll delve into the ingredients added to meal replacement shakes that may be doing your body more harm than good.

Image-1(1)Meal replacement shakes are usually processed products that people drink in place of eating one of their main meals. Dieters, the elderly, busy people on the go with little time to cook or those with digestive complaints are most likely to use meal replacement shakes. In the short term people often get weight loss results by replacing 1, 2 or even 3 meals with a meal replacement shake due to the drastic reduction in daily calories, however over the longer term we may start to see nutrient deficiencies, a lack of fibre, effects on digestion and a drop in metabolic rate.
Some of the cons associated with meal replacement products is that they’re high in sugar, sodium, artificial ingredients and synthetic vitamins/minerals.

The following is a list of some meal replacement ingredients that may be harmful to your health:

  • Soy Lecithin: While lecithin is naturally found in foods that we eat, such as eggs, soy lecithin is a highly processed soy product that is added to products to serve as an emulsifier. Soy lecithin is often made from genetically modified soy, and unfermented soy has been connected to several health risks including immune system malfunction, digestive upset, fertility problems, and loss of libido.
  • Vitamin and Minerals over the Recommended Amount: Some meal replacement products contain important vitamins and minerals that are needed on a daily basis, although food-sourced vitamins are always more readily-absorbed by the body. However, it should be noted that if some “weight loss” protocols are followed to exactly, consumers will receive an overdose of several vitamins including B12, Vitamin C, selenium, and zinc. Vitamin and mineral overdose, especially when it occurs on a regular basis such as with a meal replacement program, can cause a whole host of symptoms including digestive upset, nerve damage, brain fog, fatigue, and hair loss. Again, check the ingredient list to determine if you are receiving the right amount of vitamins and minerals for your size. Image-1(2)
  • Synthetic Vitamins: Meal replacement shakes love to brag about how many vitamins and minerals are in their products. What they don’t tell you is the kind of vitamins they contain. The vitamins in meal replacement shakes don’t come from a food source so your body doesn’t recognise them. These lab-created synthetics can cause inflammation, allergies, digestive disturbances, and autoimmune dysfunction.
  • Fructose: Processed sugar, such as in the form of fructose, can greatly affect health. Excess fructose can lead to obesity, liver toxicity, insulin resistance, hypertension, and pancreatitis. The standard western diet already contains an excess of sugar, and it seems that when replacing a meal, sugar, in the form of fructose, maltodextrin or any other type of sugar should not be an included ingredient especially when it appears as one of the first ingredients on the list. It is being discovered that more and more health issues are connected with a high sugar diet and that lowering one’s sugar intake can improve gut health and enhance immune system function.
  • Canola Oil: Canola oil is an extremely unhealthy choice, yet is often added to “natural” products. Canola oil is used as a cheap cost-cutting alternative oil, it is partially hydrogenated, and sometimes genetically modified product that is reported to cause inflammation, neurological health issues, and kidney problems. It is best to avoid using any partially hydrogenated oils in the diet.
  • Maltodextrin (1400): Maltodextrin is an affordable, low-quality sweetener made from corn, rice, or potato starch that often sneaks and creeps its way into processed foods. Maltodextrin is often made from made from genetically-modified corn. Genetically-modified corn contains pesticides that do damage to your digestive, endocrine, neurological, and immune system. This sweetener depletes your body of natural vitamins and minerals while causing side effects such as weight gain, bloating, flatulence, and breathing difficulties. Check ingredient lists carefully – a lot of alternative sweeteners are combined with maltodextrin.
  • Tricalcium Phosphate (E341(iii)): One of the synthetic ingredients utilised in many meal replacement products, ingesting tricalcium phosphate on a regular basis, such as in a protein shake, can cause issues. Tricalcium phosphate has been linked to nervous system dysfunction, skin irritation, abdominal pain, difficulty breathing, nausea, constipation, and intestinal obstruction. These are not things to mess around with!
  • Natural Flavours: Unfortunately, the label “natural flavours” provides a great deal of wiggle room. The only requirement is that the ingredient must be extracted from natural plant or animal matter. However, this leaves the door wide open. You have no idea the level of processing said plant or animal matter has undergone, or any indication of quality and actual ingredients.
  • Aspartame (E951): Aspartame is one of the deadliest sugar lies on the planet. It is often an additive in diet foods and drinks to replace table sugar. Aspartame is a deadly neurotoxin that has been linked to the development of muscle twitches, spasms, cognitive impairment, migraine headaches, irritability, mood swings, and more. This happens because aspartame interferes with the proper function of your hypothalamus. The hypothalamus is a region of the forebrain that connects to the pituitary, endocrine system, hippocampus, striatum, and brain stem. Scientific studies have shown that aspartame causes lesions on the hypothalamus, which interferes with proper brain and endocrine function.
  • Acesulfame Potassium (E950): As if aspartame wasn’t bad enough, drink manufacturers have been slowly replaced with a new and more dangerous sweetener, Acesulfame Potassium or “Ace K”. This calorie-free sweetener is not only neurotoxic, it also “turns off” the part of your brain that tells you when you’ve had enough to eat. This means each time you drink a meal replacement shake or eat anything that contains this sweetener, you’re drinking something that encourages you to eat more!
  • Concentrated Milk Product: Concentrated milk product may seem harmless enough but it can cause problems with your health. This is because the concentrated milk product contained in meal replacement shakes contain hormones, steroids, antibiotics, and pesticides that interfere with proper digestion and assimilation of nutrients. These growth hormones and pesticides fuel the development of cancer.
  • Cellulose Gel (E460i): This thickening agent is used to keep synthetic sugar from crystallizing and “freezing” in the can. It has been linked to digestive distress and allergic reaction.
  • Soy Fibre: It is estimated that 90% of soy is genetically-modified. Any genetically-modified food or product contains pesticides. When you ingest pesticides, you interfere with the proper functioning of your nervous, digestive, and immune system.
  • Xanthan Gum (451): Xanthan gum is a thickening agent made from bacteria and has been linked to gas, bloating, and allergic reaction.
  • Carrageenan (E407): Carrageenan is often listed as a natural ingredient in meal replacement shakes and some yogurts. This sneaky little additive has been quietly causing chronic health problems for forty years. It has been linked to colon cancer, chronic inflammation, and digestive disorders.
  • Sodium Phosphate (E339): Sodium phosphate is a popular diet food additive because it acts as a laxative. If you’re going more often than usual or are suffering from diarrhoea, this is your culprit. Too much of this additive could cause permanent damage to the lower intestine, leading to uncontrollable bowel movements.

Healthy alternatives to meal replacement shakes are making homemade smoothies, natural protein powders with no added nasties and preparing healthy meals in advance.

If you are busy and on the run or just love a delicious smoothie for breakfast here are some ingredients you can consider to create a nutritious and well balanced smoothie.

  • A healthy protein: you can obtain this from raw nuts and seeds such as pumpkin seeds, cashew nuts, almonds, almond meal or a protein powder – my key tip when choosing a protein powder is to make sure it is a clean as possible with limited added ingredients such as a 100% protein powder (you can then add natural flavouring as you wish)
  • A healthy fat: Such as coconut milk, almond milk, dairy (if tolerated), yoghurt, avocado, coconut oil, chia seeds, hemps seeds, flaxseeds or the nuts and seeds mentioned above
  • A healthy carbohydrate: this will generally come from the fruit you add which can include banana, berries of any kind, pineapple, mango (whatever combinations you like really). Don’t overdo the fruit limit it to one healthy serve for example ½ frozen banana with ½ cup of frozen berries.

Once these have been chosen it’s always great to add a little extra nutritional punch:

  • A handful of leafy greens such as baby spinach or kale (kale is best pre-blanched), you can start small and as you become accustomed to the flavour you can increase
  • A sprinkle of cinnamon – great anti-inflammatory and also supports blood sugar balance
  • A spoon of mineral rich cacao for that chocolatey flavour – if you like chocolate.
  • You can also use greens powders or other “super foods” if you have them.

The 2 recipes I’m giving you today are real crowd pleasers – they are super tasty and nutritious!


1- The Coco Berry Smoothie (by Natural Vitality Nutrition)


  • 1 frozen banana
  • 1 tablespoon blueberries frozen or fresh
  • 3 large or 4 small strawberries frozen or fresh
  • 1 large tablespoon of coconut or natural dairy yoghurt
  • 1 handful of baby spinach
  • 1 tbsp raw cashews
  • 1 tbsp pepitas (pumpkin seeds)
  • ½ cup coconut milk
  • ½ cup coconut water

Instructions: Simply add all ingredients to the blender and blend on high until all fully blended, serve and best of all ENJOY!!


2- Green Smoothie (great for thyroid hormones as well as other autoimmune conditions) Serves 2


  • 1 cup leafy greens of choice
  • 2 large carrots
  • 1 ripe avocado
  • 1 stick of celery
  • 1 cucumber
  • 1 bunch of basil leaves
  • 1 cup coconut milk
  • 1-2 scoops Vegan Protein (30g per person)
  • Sea salt
  • Extra water or ice (to taste)
  • Optional: you can add other things to give you a boost such as Camu powder -vitamin -C; Maca powder – increase body temp and stabilises hormones; Turmeric- anti-inflammatory: Green powders – omega 3’s, energy, blood oxygenation

Directions: Blend together in a blender and enjoy as low glycaemic breakfast, lunch or snack.

Bike Fit Q & A

Tim Rigby answers some good questions in this Q & A about our new bike fit program:  RPM Cycling Injury and Performance Program!!


1. Why would someone come to see a physiotherapist to have their bike fitted and not the bike shop? 

The interaction between to body and the bike is very complex , and includes many individual variables. To achieve the perfect bike fit , we need to take into account these variables.
The major difference is that physiotherapists have the skill to perform a detailed body screening prior to actually fitting them people on the bike to flag these individual variations. These can include;

  • Spinal mobilityBF 1
  • Neural mobility
  • Lower limb flexibility
  • Muscular strength / control
  • Pedal efficiency

We use this information in conjunction with optimal biomechanical, geometry and sizing to ensure the perfect fit for YOU. Essentially – We are really looking at not just the bike .. but the body and the bike in the one picture.


2. Do I need to be injured to get a bike fit by a physio?

No. A Physio bike fit can also be used to make sure you are;

  • Getting the best out of their body / pedal stroke
  • Comfortable
  • Confident in your set up
  • Performing at your peak

We will ask carefully what your goals on initial consultation to clarify this, from there we will tailor the program / consult to meet your goals.


3. How long will it take to achieve to “fix” my bike set up and make sure Im performing at the best or out of injury?

Bike fitting with a physio is a dynamic process and requires adjustment and adaptions to new positions. For this reason it may take a sometime and over some sessions to fine tune any set up issues to ensure the perfect fit for YOU. Also the interaction between the body and the bikes takes into A LOT of individual factors- we may identify areas of weakness / mobility which you may have exercises to work on.

rpm bike - tim

These are important to reduce your pain , minimize injury risk, or maximize performance . We have different treatment \packages available , also a more accurate time frame will be given to you on initial consult to give you an idea of you path to injury free cycling of optimal performance.


4. What do I receive after an initial consult for a bike fit?   

After you initial bike fit and screening process you will be given the following;

  • individual summary of results including pictures / videos
  • a detailed pathway of treatment needed to achieve your goals
  • immediate things to work on / address
  • summary of your overall fit
  • the ability to email any bike fit Q during the week


5. Which program is right for me?

We offer a number of packages to suit everyone’s cycling goals. These packages will range from a single bike fit and follow up results session, to a comprehensive 6- week program that will include:

  • Bike fit consult and follow up session
  • Physiotherapy sessions
  • Physical screening assessment
  • Individualized cycling strength and conditioning program

Each of these packages will be recommended depending on the results of the initial consult and the patients goals.

Click here to view our package options


Tim blog