Sudden Onset Pouting

Recent research has shown that in the case of Hashimoto’s Autoimmune Thyroiditis, there is a high prevalence of a condition called Sudden Onset Pouting, also known as SOP. Generally experienced by Hashimoto’s patients at the beginning of any one of a variety of specialized eating programs (AIP, GAPS, SCD, FODMAPs, DrK, Paleo, etc.) aimed at eliminating allergens and determining food sensitivities, the condition is a response to sudden changes in diet that deny the patient access to formerly allowed foods of choice.

Symptoms of SOP include the following:

  • Pronounced extension of the lower and sometimes upper lip
  • General downward curve of the corners of the mouth
  • A look of sadness in the eyes
  • Complaints of food cravings
  • Intermittent sighing
  • Frequent verbal expressions such as “Why me?”
  • Whimsical mutterings about the virtues of prohibited foods
  • Staring longingly at the candy aisle at the grocery store… or the pastries
  • Furtively picking up and setting down prohibited food products when grocery shopping
  • Coveting your coworker’s pizza

Extended periods of SOP can result in the following:

  • Deep wrinkles in the skin of the face
  • A reduction in the need for Botox procedures on the lips
  • Chapped lips
  • Addiction to lip balm
  • Excessive spending on colorful lipstick
  • Invitation to Hollywood parties and red carpet events
  • A tendency to wear glamorous evening gowns
  • Photo-bombing at photo shoots
  • Excessive requests for Zoolander “Magnum” impressions

Causative Factors of SOP include denial of access to the following substances:

High-Glycemic Fruits and Vegetables
Processed Foods
Goitrogenic Foods
Salicylate Foods
All Added Sugars
Synthetic sweeteners
– and more –

Diagnosis of SOP:

After thorough examination by a medical professional, positive diagnosis may be made. Based on visible signs and reported symptoms, diagnosis is generally considered reason to warrant treatment.

What To Expect From Your Doctor:

When visiting your doctor about SOP, come prepared and keep in mind that you may not hear what you hope to hear. Recently many doctors have been banned from medical practice for statements such as the following. If you hear any of these statements, take your pouty-lipped self and run the other way:

  • “Diet has nothing to do with autoimmune conditions.”
  • “Your TSH is in range, come back when your thyroid is dead and we’ll remove it. Here’s more Synthroid.”
  • “Unless you have Celiac Disease, gluten is not a concern for you.”

If you are lucky, you might hear,

  • “You’ve gone on an allergy elimination diet? Fabulous! Here’s a really good probiotic to help recolonize gut flora.”
  • “Ooh! I specialize in autoimmunity. Have you been tested for H. Pylori yet?”
  • “We sell Chapstick.”

In any case, when you see your doctor, come prepared. Be honest about your cravings and whether or not you have broken down and raided the pasta shelf while everyone else was asleep. Write down all your symptoms at home and bring the paper with you. Do your research. Know your goals. If you have had the condition for a time and lost your self control, tell your doctor; signs of regression will help your doctor help you to prevent unnecessary recurrences. Your doctor needs all the facts to make a certain diagnosis and get you the treatment you need. Sudden Onset Pouting can be very uncomfortable, and in research has even been shown to ruin friendships and first dates. If you are concerned about being seen in public with the condition, wear a big floppy hat and sunglasses. Everyone will think you are Julia Roberts.

Treatment of SOP:

Although the unenlightened may assume that treatment for Sudden Onset Pouting would be the reintroduction of the recently disallowed substances, this method has been proven to lead to recurrence of the disorder, upon the inevitable reentry into the above-mentioned allergy-determination diet protocols.

Recommended treatment includes:

  • Application of large amounts of sympathy
  • Distraction by staying busy with preferred activities other than consuming the offending substances
  • Generous consumption of allowed substances such as bone broth, quality vitamins and minerals, digestive enzymes, non-offending vegetables, minimal non-offending fruits, quality fatty acids and not a small amount of quality, natural, free-range, organically grown, humanely-raised, grass-fed and hormone-free sources of protein
  • Commiseration with fellow Hashimoto’s patients
  • Generous application of lip balm

The recommended form of treatment allows the body to heal from systemic inflammation, promoting a greater state of health in the digestive tract, leading to a reduction in the occurrence of leaky gut, the reduction of which helps quell the promotion of autoimmune cross-reactions to protein chains in the suspected foods. Once treatment is complete, cravings for the offending foods are eliminated, thus eliminating the necessity for pouting. Treatment is considered complete when symptoms subside.

Prognosis for SOP:

When a positive diagnosis is made, prognosis is generally good. Symptoms may last for up to a week, rarely longer. In addition to the above-mentioned symptoms, a patient may experience annoyed housemates, children, house guests, coworkers, pets and life partners. In sunny locales, sunburn may be a concern. If you are the outdoorsy type, be aware of flocks of low-flying birds. If the patient is able to refrain from losing self-control and falling back into old, bad, dietary habits, the symptoms will subside, one’s perspective shifts and a feeling of general well-being and dietary bliss will commence.

Recurrence of Sudden Onset Pouting is possible when a return is made to the above-listed offending foods, either by loss of self control, or while following the provocation phase of one of the autoimmune elimination/provocation diet protocols. With these protocols, periodic reintroduction of some foods may occur, sometimes resulting in an unfavorable reaction which may lead to the decision that the food must be avoided for life; this may lead to a recurrence of SOP. In the case that this leads to a final determination of food sensitivity and subsequent autoimmune response, recurrence of SOP is considered acceptable on a temporary basis.

A Personal Note From The Author:

Sudden Onset Pouting is a difficult condition to live with, but remember, it is temporary and you are not alone. Though studies have yet to be done to show the statistics, it is believed that an overwhelming percentage of Hashimoto’s patients experience it at least once, and sometimes recurrently. The stigma is a burden, but as a community, we can pull together and put a strong face up to an non-compassionate and under-educated public. Talk to other Hashi’s about SOP. You might be surprised at how many admit they have suffered from it. Next time your best Hashi bud cancels for a “Girls Night Out” or a workout, call her and just ask: “Are you having a bout with SOP? I’ve been there…” Open the door, and she will thank you for it. If you have nobody to talk to about it, seek out a SOP support group in your region. Remember, most of all, you are beautiful. Your beauty comes from inside, and shines on the outside. Stand proud, stand strong, and remember to love yourself no matter what.

For more information, please visit these links: