Thyroid Mystery Solved: Hashimoto's and Hypothyroidism Revealed

The Case: 

• Alexandra’s everyday was determined by the state of her stomach
• She was often bloated, gassy, and struggled to keep her weight healthy
• She tried restrictive diets, tried over the counter gas remedies, digestive enzymes, and various probiotics but nothing gave her long-term relief

The Investigation

It was clear that there was something going on with her gut and it seemed likely that dysbiosis was at play. I knew her microbiome needed support but, I also suspected that with everything she’d tried, we needed to approach the solution methodically as there was likely more than one thing going on. 

Gut issues and the state of our microbiome plays a huge role in how we feel physically but it can also seriously impact our mental health, organ health, immune system, and our ability to lose or maintain a healthy weight. 

Wheat Belly Author’s Latest Book

When it comes to understanding gut health and addressing Alexandra’s problem, I knew that one of the best people to talk to would be the author of the best selling book, Wheat Belly. Dr. William Davis has a new book out called Super Gut where he addresses exactly what Alexandra is going through. The book also shares a ‘4-week place to reprogram your microbiome, restore health, and lose weight’. 

Symptoms of a Disrupted Gut Microbiome

There are many symptoms that could point to a disruption in the microbiome balance. Most people think of the symptoms that Alexandra was experiencing because they are related to the gut itself (bloating, gas, cramping, diarrhea, constipation, etc) but there are many other issues that can be traced back to microbiome disruption. Dr. Davis points to a myriad of issues including, weight gain, skin rashes and eczema, arthritis, pain, inflammation, wrinkles and healthy skin, and sleep health. He also believes that just about every human disease needs to be reconsidered in light of the microbiome.

What Causes the Microbiome to be out of Balance?

There are many reasons that the microbiome may be out of balance including use of antibiotics as well as other drugs like stomach acid blocking drugs, nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen diclofenac), synthetic sweeteners (Aspartame, sucralose and saccharin),  emulsifying agents (Sorbate 80, carboxymethyl, and cellulose), and even something as common as stress can disrupt microbiome. 

One condition that is directly related to microbiome health is the silent epidemic of SIBO. 

What is SIBO

SIBO stands for Small Intestine Bacterial Overgrowth. Dr. Davis says that many people have SIBO but go undiagnosed (which can lead to long-term health issues). There is now a breath test that people can do to better understand SIBO and where the bacteria overgrowth is happening, specifically, in the digestive pathway. 

Microbes belong in the colon which has a protective barrier against microbes. When there is an imbalance or overgrowth, microbes can end in the small bowel where the mucus barrier is thinner and can be easily damaged by these misplaced microbes. 

Exposure to antibiotics and emulsifying agents can further erode the lining as well as disrupt the balance of stool microbes like E coli, and citrobacter. These proliferate and offset the balance. And then, these microbes die (within a few hours) and release a lot of byproducts that break down and make it into the bloodstream. This process results in something called endotoxemia which is extremely toxic to humans. With all of this going on internally, it can be difficult to detect but may show up as depression, brain issues, joint swelling or intestinal issues. 

Dr. Davis estimates that 1 in 3 people are dealing with SIBO which can lead to Endotoxemia when untreated. 

Testing for SIBO

Conventional doctors can conduct a test for SIBO but Dr. Davis says the method they use does not identify all forms of SIBO. 

One of the early signs of SIBO is the presence of hydrogen gas (produced by the bacteria) within 90 minutes of consuming food. The quicker it shows up, the further up the GI tract the imbalance is occurring. 

Signs we often attribute to food intolerances may in fact be related to SIBO. For example, if you eat black beans and experience bloating, gas, and/or diarrhea in about 30 minutes then it is virtually 100% reliable that you have SIBO. 

Another sign of SIBO is fat malabsorption. If you look in the toilet, you see fat droplets or staining of the toilet where water meets porcelain, this is a sign that you are not absorbing fat and that SIBO may be present.

Dr. Davis says that many diseases can be seen as a symptom of SIBO. For example, he says 84% of people with irritable bowel syndrome have SIBO. People with autoimmune diseases, like Hashimoto's, Crohn’s, UlcerativeColitis, and rheumatoid arthritis, as well as those with neurodegenerative disorders, like Parkinson's disease, Lou Gehrig's disease, Alzheimer's, dementia, cognitive decline, or multiple sclerosis have a high probability of having SIBO. 

What is SIFO

It is also possible to have small intestinal fungal overgrowth (SIFO). The trick is that sometimes SIFO looks like SIBO and as a result, they are misdiagnosed. There are about 200 different fungal species that can proliferate in the small intestine. The symptoms of SIFO are tough to distinguish from SIBO but it's typically bloating, diarrhea, skin rashes, eczema, and sugar cravings. 

SIFO can take months to treat. 

The SIBO and Endotoxemia Connection to Depression

Dr. Davis says that people who are depressed may get temporary relief from antidepressants but he doesn’t believe this is the long term solution because the real cause may be SIBO endotoxemia. A German research group performed two studies in which they injected endotoxin into the bloodstreams of non-depressed people. The result was profound depression which was identifiable through MRI brain scans. 

Dr. Davis believes that, for many people, depression is a disease of the microbiome.

How to Support SIBO

If you talk to your regular doctor or a gastroenterologist, they’ll likely prescribe a course of conventional antibiotics. This is about 40 - 60% effective and can be very expensive. Plus, you run the risk of perpetuating the problem because of the damage the drug may do to the intestinal lining.

There are many herbal remedies that can work as well as the antibiotics and after that,  but Dr. Davis recommends high-potency probiotics that are best delivered through home-made yogurt or fermented foods. 

When supported properly, SIBO can be eradicated and it does not have to take many months.

Supporting SIBO with Home-made Probiotic Yogurt

In his book, Super Gut, he has recipes on how to ferment your own yogurt at home using specific bacterial strains. These recipes use the microbes like Lactobacillus Gasseri,  Lactobacillus Reuteri, and Bifidobacterium Infantis (commercially available under the name EVIVO). 

When Dr. Davis makes his own yogurt, he finds he’s getting upwards of two hundred sixty billion counts of bacteria, per half cup serving which is significantly higher than what you might buy as a supplement.

The benefit of this is that the right bacteria (in the yogurt) colonize in the upper GI tract which then releases oxytocin which can improve mood and sleep. 

Another benefit to ingesting these home-made yogurts, according to Dr. Davis is that you may see a reduction in wrinkles (especially when combined with collagen hydrolysates and hyaluronic acid). 

But, the biggest benefit is the oxytocin effect as this can preserve bone health, boost libido and improve sleep (including supporting longer REM sleep periods). 

Dr. Davis provides recipes in his book, Super Gut for various types of home-fermented yogurt and an apple cider drink. 

Histamine Intolerance and SIBO

While Dr. Davis recommends

The Investigation

Thyroid issues are not a one-size-fits-all. If you’ve been listening to my podcast for a while, then you know I talk a lot about hypothyroidism and Hashimoto’s because I see so many people struggling with these issues. 

One of the main reasons they struggle is because traditional medicine tends to treat hypothyroidism one way - by measuring TSH and then medicating to get TSH back into range. 

There is so much more to optimizing the thyroid and the key is to take a more individual approach. 

The best news is that you can balance your thyroid and your immune system and you CAN feel good again. You can feel like the old you, the pre-war you as I call it, when your body was not battling itself every day.

Yes, it is possible to be:

• Full of energy
• Reach and maintain your ideal weigh
• Sleep well every night
• Have great skin and hair
• Think clearly (no more brain fog)

But this can only happen when you look at your thyroid not from the perspective that it is slow, but more about what type of slow down you have.

There are several types of slow downs.  I call these “Thyroid Types”. Knowing your Thyroid Type will allow you to properly balance it, not just reverse the speed of it. When you balance your thyroid, you can actually deal with the symptoms that are hanging around even though your doctor says your thyroid tests show the medication is working and you are in range. 

That’s right, you do not have to put up with those symptoms anymore once you understand your Thyroid Type! 

This is also true if you have Hashimoto’s but the support needs to be twofold to make sure that you aren’t just addressing the thyroid issue but also balancing the immune system. 

In order to identify your Thyroid Type you will need to have a full panel of thyroid tests. Having just the TSH is not enough. You also need all the other markers. A full thyroid panel includes TSH, Total T4, Free T4, Total T3, Free T3, Reverse T3, T3 Uptake and TPO and TG Antibodies. 

Let’s look at these different Thyroid Types.

Type 1: High TSH

This is what many doctors will diagnose and prescribe medication for (such as Synthroid). The lab range on this is pretty wide, so I like to look at the optimal range which is 1.8 - 3 if you are not on medication and .5-2.5 if you are on medication. The typical lab range is .5-4.5. 

This High TSH is just one type and most people who have issues that do not seem to be resolved by their initial approach would typically fall into the other types.

Type 2: Low T3 

This is very common and is easily missed if you are not looking at the full thyroid panel. T3 is converted from T4 and is needed for cellular health but just boosting T4 doesn’t always solve the issue. In this case, it’s important to find out why T3 is not converting. 

Type 3: Unavailable Hormones Type 

You are this Type if you have a normal TSH and a normal total T4 and T3. In other words, most doctors would not diagnose you as having a thyroid issue. But, you have symptoms that scream thyroid issue. We determine this Thyroid Type by looking more closely at Free T4 and Free T3 to see that while they may be in the wider range, they are not in optimal range. I call this Unavailable because the hormones are there but they are not available to your cells. There is a specific underlying reason for this and unless that is supported, those hormones will continue to be unavailable and cause symptoms. 

Type 4: Understimulated Hormone Type

This is you if you have a low TSH and a low T4. It can be hard to catch because the TSH is fine so doctors never look deeper but with a low T4,  there is not enough stimulation happening. 

All of these types can come with or without Hashimoto’s. The last Type is for those who have Hashimoto’s

Type 5: Normal Type (with Hashimoto’s)

This one is when your thyroid is not low - it’s actually in range. But, you do have Hashimoto’s. I’m including it because it can be super deceiving and so often, people are told that nothing can be done and they just have to wait it out. Basically, they are told to wait until their Hashimoto’s destroys the thyroid enough to trigger an elevated  TSH to warrant starting on medication. However the symptoms you are experiencing can be there from the inflammation even if thyroid is completely normal. 

But, you CAN start supporting the immune system to prevent more destruction. 

Understanding your Thyroid Type is the key to understanding why you still have symptoms even if you are getting good labs or taking your medication. 

Now that you know your Thyroid Type you can find the right solution for you. 

For this, I use my Thyroid Trifecta approach.

The thyroid trifecta has 3 steps.

1. Identify your Thyroid Type
2. Properly address the underlying cause (why this thyroid type happened)
3. Support the thyroid AND if you have Hashimoto’s, balance the immune system with a comprehensive plan that is specifically for you. 

This last step is key because a general approach would not typically work  because we all have different thyroid types.

I have been using this approach in my practice for years and it really works! The problem is, I’ve been so booked up with clients in the last few years, the number of people I’ve been able to help has been limited. 

Until now. 

My approach in designing a custom thyroid action plan is now accessible to you through my brand new online course called “Thyroid Mystery Solved”.

I am so excited to put these tools in your hands so you can get back to feeling good again. 

This course is actually personalized so that you get the support for you! Including:

• Labs 
• Diet 
• Medications 
• Supplements 
• Cleansing
• Mindset

Basically, everything you ever wanted to know (and a few things you didn’t know you should know) put in a step by step comprehensive plan customized to get your thyroid back on track. 

Just imagine finally creating balance so that you can have better energy, less brain fog, improved sleep, more balanced digestion, less bloating, less PMS, decreased moodiness, better body composition, more strength and vitality and start to actually enjoy your life. 

Imagine feeling in control of your body and your health. 

I am so excited to share This Course with you and to watch you finally get answers and reclaim your power. 

Eliminating Health Mysteries

If you are dealing with hypothyroidism or Hashimoto’s (or both) this program is for you. And, if you know someone with hypothyroidism or Hashimoto’s (and you like them) make sure you share this link because it has the potential to be life changing! www.thyroidMysterySolved.com. 

Links:

Resources mentioned

www.thyroidMysterySolved.com

PLEASE NOTE

All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical trea

The Investigation

Women experience a range of physical and emotional changes when they enter the perimenopause stage. These symptoms vary greatly from person to person and may include: 

• Hot flashes
• Night sweats
• Low libido
• Increased anxiety
• Not sleeping well
• Low energy
• Weight gain
• Menstrual cycle irregularities
• Cyclical headaches or migraines
• Mood swings
• Memory loss 
• Brain fog
• Vaginal dryness
• Urinary tract infections 
• Hair thinning

For a lot of women, they hold the false belief that this is something they have to suffer through. There are treatment options out there but with conflicting reports and information, it can be a challenge to figure out the right one. This confusion and fear is another reason that so many women resign themselves to just suffering through this period of their life. 

In episode 96 of Health Mysteries Solved, we spoke with Dr. Jim Hrncir about this issue. The response I got from that episode was fantastic but I could see that there were more questions too. So, I decided to invite Dr. Hrncir back to dive deeper into these questions around the safety and efficacy of compounding bioidentical hormones for treating the symptoms of perimenopause and menopause. 

An Advocate and Expert in Compounding Bioidentical Hormones

Dr. Jim Hrncir is a hormone expert and compounding pharmacist. In fact, he’s one of the pioneers of modern pharmaceutical compounding. Jim is responsible for the formulation of many bioidentical hormones, as well as dermatological, nutritional, and anti-aging compounds available throughout the US. And, he’s one of the driving forces taking on big pharma (and congress) to clear the path for the use of bioidentical hormones in the US. 

He’s passionate about what bioidentical hormones can do for women’s health; not just in reducing symptoms but in supporting optimal health. 

The Benefits of Compounded Bioidentical Hormones (Beyond Reducing Menopause Symptoms)

While most women turn to bioidentical hormones to help them deal with the symptoms of perimenopause and menopause, Jim says that there are additional health benefits to bioidentical hormone replacement therapy (BHRT) that often get overlooked. 

He claims that his bioidentical hormone replacement therapy patients experience better health as well as a higher quality of life. 

According to Dr. Hrncir, women who are on bioidentical hormone treatments will have a reduced risk of heart attack and stroke (which, he explains, is the number one killer of women with 400,000 female deaths related to heart attack and stroke each year). He also says that bioidentical hormones help reduce osteoporosis. 

Breast cancer is often a concern for women and those on bioidentical hormones can see a decreased risk here too, according to Dr. Hrncir.

He also says that these hormones can help with anti-aging, colon health, brain health, and sexual health. 

In this episode, he shared some unbelievable statistics about the degree of risk reduction. Dr. Hrncir says that women who use these hormones “are going to have a 50% decreased risk of heart disease and stroke. A 50% decreased risk of osteoporosis. Twenty percent decreased risk in breast cancer risks… also 78% decreased risk in dementia. And, what about colon cancer? Reduce risk 50%. Longevity and antiaging, you know, none of us want to age faster than we have to. Plus, isn't it nice to know that these hormones, not only are they sex hormones, but they're also anti-inflammatory hormones, which means they're going to be reducing inflammation, not only in your body and your joints and your muscles, but also in your brain, you know brain inflammation leads to all kinds of disturbances including dementia.”

When Can Women Start Using Bioidentical Hormone Replacement Therapy

Dr. Hrncir says that women don’t need to wait to have symptoms of perimenopause before starting on bioidentical hormone therapy since the health benefits are reason enough to start. He feels that even women who are pre-perimenopause and who are post menopause can enjoy the health benefits of hormone therapy. He has his 84-year-old mother on bioidentical hormones. 

While some feel that they shouldn’t mess with nature because menopause is a natural process, Jim points out that our bodies are still operating on a much shorter life expectancy than we currently have. So, he feels there is no need to suffer through a reduced quality of life and with an increased risk of disease given that we are living much longer these days. 

Testing hormone levels early on can help to establish a baseline and track how well hormones are balanced. A baseline test might look at estrogen, progesterone, testosterone, adrenals, DHEA, DHEA sulfate, and cortisol. 

How Long Can Women be on Bioidentical Hormone Replacement Therapy

Women can start thinking about bioidentical hormone therapy when they reach the age of perimenopause and can stay on it for as long as they like, according to Dr. Hrncir. There have been studies that point to the health risks of staying on BHRT for more than five years, but in recent years the study that is often cited has reversed its findings, points out Dr. Hrncir. 

He believes that some people may still be hanging on to these old findings and he encourages his patients to look at the upsides and research that shows reduced risk instead.  

What’s in Bioidentical Hormone Treatments?

The treatment is to replace what a woman’s body is no longer making. After menopause, a woman's body makes estrone own automatically. The adrenals make DHEA which is then converted into estrone. Women also get estrone from fat tissues. So, there is no need to give extra estrone (plus estrone has three metabolites, two of which are risky). As women age, they stop making estradiol and estriol, for the most part. For this reason, most treatments are a combination of estradiol (the most potent estrogen in supporting the brain, heart and bones) and estriol (a protective estrogen). 

Dr. Hrncir loves something called Biest, which is a combination of estriol and estradiol. The ratio is up to the doctor. Some give 50/50 each while others might go with 80% estriol and 20% estradiol. 

How is Bioidentical Hormone Replacement Therapy Delivered? Pill or Patch?

Dr. Hrncir prefers transdermal applications although he doesn’t love the patch because he says many women are allergic to the adhesive. He also warms about estrogen being taken orally because, as he says, it goes from the stomach, right to the liver. This can induce clotting factors in the liver, which then go to a higher level and could increase the risk of forming a clot, like a DVT or Deep Vein Thrombosis.

Topically applied hormone replacement creams do not have the same risk of clots. This might be cream applied to the skin but there is also the option of getting a lower dose to apply to the labia. 

The labial application works quickly and effectively because the membrane absorbs the hormones easily. In his practice, he says about 90% of his patients are on transdermal hormones with the other 10% using the labial application. 

The Case: 

• Sarah is struggling to lose weight and has been for years
• Every year she makes resolutions and goals but she never sticks to them
• She wonders if she hasn’t found the right diet protocol or supplement

As the new year dawns, many people will be like Sarah - vowing that this is the year they eat better, get fit, commit to self-care… but then the new year's resolve dissolves before the end of January. 

The Investigation

To better understand why our goals and resolutions fail, I invited Tanya Dalton on the show. Tanya is a best-selling author, speaker, and productivity expert. She’s the CEO of inkWELL Press Productivity Co. They provide tools that work as a catalyst in helping people do less while achieving more. 

She shared that about 81% of people don't follow through on their New Year's resolutions and 23% drop off in the first week alone. 

Why Do New Year’s Resolutions Fail?

Tanya says that one of the main reasons New Year’s resolutions fail is because we do them in a hurry to meet the deadline of the changing calendar and we don’t spend enough time making sure these goals are aligned with what we want, what we desire in our lives; aligned with your big, bright, beautiful future. 

Instead, these goals are a knee-jerk reaction to the time of the year and can often be influenced by what other people are suggesting or doing. 

Additionally, we focus on the numbers instead of what those numbers will lead to. For example, with Sarah, she was focusing on the number on her scale instead of focusing on what a healthy lifestyle will afford her in the future. The numbers on the scale this week start to mean a lot less (and create less stress) when you focus on the long term vision of years and decades to come. 

Words Matter: Use Empowered Language

All too often when someone is trying to create a new habit, they think of the negative impact of that change. And, their language follows suit. This can contribute to the failure. 

For example, dieters might focus on all the food they can’t eat instead of the good food they can eat. Or, they might say, “I can’t eat that” which makes them feel deprived, restricted, and like they have no choice. They no longer own their decision. If they say “I don’t eat that” instead, it empowers them and keeps things positive. Tanya says that our success rate more than doubles when we make this kind of adjustment to our language. 

Set Goals with IMPACT

You’ve likely heard of SMART goals. Tanya uses the acronym IMPACT to create powerful goals.

Inspirational

Measurable

Purpose-driven

Adaptable

Challenging

Timed

Inspirational

Write goals in the positive (as mentioned above). Be sure to ‘order up’ the results you want to get as your goal. When you really start identifying with what it is you want, it builds endorphins which serve to motivate you. And, the positivity you put out, comes back to you. 

Measurable

Even though Tanya suggests not focusing on the numbers day to day, you do want your goals to be measurable. You can pick whatever measurement you want. It could be something like eating healthy three days out of the week. Or, exercising twice a week. But ,Tanya encourages you to give yourself some grace. Create measurements that allow for an average. This might mean that if you have a goal of drinking 2 liters of water 4 out of seven days of the week. One week you might do it 3 days and the next week it might be 5. Instead of seeing this as having failed one week, see it as being on track for the month, on average. Having measurable goals in this way creates a pattern for yourself and generates a feeling of success. 

If you’re going to measure your goals, Tanya suggests using a habit tracker app so you can see your progress. 

Purpose-Driven

This goes hand in hand with what Tanya shared earlier about aligning your goals to your big, bright, beautiful future. We want our goals to be bigger than just what we're doing here today. For example, if your goal is weight loss. You will measure it with pounds but if it’s purpose driven, you focus more on the new habits that set you up for the future you envisioned. 

(By the way, if you’re struggling to figure out your purpose, or envisioning your big, bright, beautiful future, have a listen to this episode where Tanya shares her tips on how to tap into this).

Adaptable & Challenging

Tanya likes to talk about these two things together because as we build new habits, we will face challenges. And these challenges require us to adapt. This removes the black and white nature of goals where you’ve either succeeded or failed. When your goals are challenging but with the room for adaptation, you set yourself up for success because you have the flexibility. 

Another way to make your goals adaptable but also challenging is to use the MTO methods of setting goals. MTO stands for Minimum, Target, Outrageous. So, when you create your goals, you set the minimum you will accept in executing the goal. And, you also set the target - this is the actual goal - and the outrageous goal when you are shooting for the moon. This method helps keep the perspective that your goals can be met by staying in the MTO range. 

Timed

Having a deadline with a goal is so incredibly important. Even when goals are ongoing, Tanya suggests setting check in dates. These check-ins can either motivate us because we are on track (and possibly allow us to push the boundaries a bit more by adjusting those goals), or remind us of the importance of the goal and give us a chance to get back on board or realign the goal. 

These check-in dates provide a pause in our busy lives. It gives us time to ask:

• How am I doing? 
• Do I like where I am? 
• What do I think I want? 
• How am I doing emotionally, physically, and mentally?

Stay Focused on the Priorities

Life gets busy and we can sometimes say yes to things that make us even busier (often out of fear that the opportunity will disappear). But, if you want to succeed with your goals, you have to really question what you say yes to and assess what will slip on the priorities list if you add new things in. So, it’s important to do a gut check - really listen to what your body is telling you about the opportunity and the shift in your goals. 

Make Time for the Things that Matter

Our tasks tend to fill the time we allow them. If we don’t make or find the time for the things that matter to us, the time will be used elsewhere. So, Tanya says we need to block off the time and count it as sacred. She also reminds us of the power of words, so avoid saying ‘I don’t have time’ because you’ll start to believe it and it will become the truth. Instead, when someone asks for your time, say something like ‘it’s not a priority for me right now,’ or ‘I have committed that time to my family’ (or whatever you’ve committed to).

Build Your Own Support Team

Make sure the people around you understand the importance of your goals so that they grant you the time you need. Ask them to support you by being a team member. Tanya says this is especially important to do if you have a family. And finally, let go of perfectionism so that you can truly accept the help and support that is offered without any limitations. 

Mystery Solved

In Sarah's case, we discovered that the work was really more in mindset than the actual plan. So to start, I helped Sarah work on being mindful about replacing words like ‘can’t’ with ‘don’t’ when it came to things like gluten and sugar. We also worked on phrases like ‘have to’, ‘must’ and ‘should' as they can be very negative and instead focused on using word

The Case: 

• Pam is dealing with brain fog, poor concentration, and fatigue.
• Tests revealed that she was low in Folate and Vitamin B12.
• Weeks of taking Vitamin B Complex didn’t help her symptoms at all.

A little more research helped Pam understand that not all B vitamins are the same - some are synthetic while other options are natural and in methylated forms. Inspecting the B Complex vitamin she’d been taking, she discovered that the B12 was in the cyanocobalamin form and the folic acid was also synthetic.

You might think the mystery was solved at this point, but after finding a methylated B Complex at the local health food store, and taking it for several weeks, her symptoms persisted. She increased her dosage, but after several weeks, she felt even worse. 

Her labs showed that she was deficient in B vitamins, so why weren’t her supplements working?

The Investigation

This is something I commonly see and while B vitamins are wonderful, they come in many forms but they are not ‘one size fits all.’

And there is another misconception - people believe that because B vitamins are water soluble, they can’t hurt anyone because the body will expel what it doesn’t use. This isn’t the whole story. 

How Methylation Works

The body has a process called methylation. This is a biochemical process where there is a transfer of four atoms - one carbon atom and three hydrogen atoms (CH3) from one substance to another.

This process happens all the time, every second. When its optimal it has a significant positive impact on many biochemical reactions in the body that regulate all types of activities. Methylation is needed for neurotransmitter production, detoxification, histamine metabolism, estrogen metabolism, fat metabolism, cellular energy, eye health, and immune balancing.

Essentially, if you think of the body as a machine, then methylation (and demethylation) are the gears that trigger the different systems in the body. 

Two important methyl donors (nutrients that keep methylation moving) are methylated folate (also known as methyltetrahydrofolate or 5 MTHF) and methylcobalamin (methylated B12).

It’s worth noting that there is a gene called the MTHFR gene (which we’ve talked about in Episode 34) which makes it harder to convert folic acid from foods or supplements into active form. 

Understanding the Role of the MTHFR Gene in Methylation

The process of methylation is quite complex. We have about 30 enzymes that are part of the methylation cycle pathway. The MTHFR gene is only one piece of the puzzle. And, while the MTHFR being off can cause issues with methylation, those other enzymes can also be a factor (sometimes a major factor).

Balancing Methylation

You may have heard that methylation is all about taking methyl folate or methyl B12 but there is so much more to it. 

Think of methylation (and methyl donors, specifically) as a bell shaped curve. You want to be somewhere at the top of the curve to be in balance.

If you are lower on the left side of the curve, that is considered less methylation or being an under methylator. If you are lower on the right side of the curve, that would be considered too much methylation or being an over methylator. So many doctors don’t realize this and think more is better. More is not always better, balanced is what you want to aim for.

Symptoms of Unbalanced Methylation

When you are not in balance (in either over methylation or under methylation) you can experience symptoms. And, taking more B vitamins (especially the wrong kind) may make things worse - even if you’re taking methyl folate and methyl B12 (considered to be the best). There are tons of issues with sub optimal methylation and some can actually be the same when you are an over or an under methylator

• Anxiety
• Itchy skin
• Brain fog
• Mood changes
• Fatigue
• Jitteriness
• Allergies
• Immune challenges
• Environmental sensitivities 
• And many more…

How to know if you are an over or an under methylator?

Looking at genetics can help but genetics don’t actually show what is expressing and how it's affecting metabolism itself. I like to look at specific biomarkers to see what the body is doing rather than just looking at the genetics which can be a bit deceiving. For example, someone with MTHFR may not actually need more methyl folate.

The good news is that there is a simple blood test. It's called the Histamine Determination Whole Blood Test. This lab test can be done at Labcorp. It is really helpful in determining if you are an under or over methylator. If the level is high, you are an under-methylator. If it’s low, you’re an over-methylator. This test is done at many labs but from everything that I have learned about it, it's something that is only accurate at Labcorp and needs to be sent there.

As with most tests, there is a lab range and an optimal range.I made a handout on how you can check your methylation status. Please  CLICK HERE to access this handout where I give the exact LabCorp test number so you can easily order or ask your doctor to order the test along with the optimal ranges. Based on those results, I detail which B Vitamins would be best for you. 

Supporting Overmethylation and Under-methylation

Once you find out your levels, if you are an under-methylator, take more methyl donors such as:

• Methylated Folate
• Methylcobalamin

If you are an over-methylator, take less methyl donors and look for ingredients such as:

• Folinic acid
• Hydroxocobalamin
• Adenosylcobalamin

Mystery Solved

If you are taking B vitamins and feel off, perhaps you are not taking the right ones. This can also happen with multivitamins. If you feel upregulated or like there is something under your skin that may be a sign of being over methylated. If you are very sensitive to chemicals, while there can be many things related here, methylation also plays a large role so please take a look at this.

This was the case for Pam. We ran her labs and she was very low indicating that she is an over-methylator. We changed her B vitamins and she felt a huge difference in her energy and brain fog.

Eliminating Health Mysteries

For Pam we were able to find that missing piece of the health puzzle and help her regain her health. Could methylation be the missing clue for you or someone in your life? 

Links:

Related Podcast Episodes:

The Case of Unrelenting Depression and Anxiety w/ Dr. Loren Marks

The Underlying Causes of ADD and the 10 Things You Can Do to Improve Concentration

Demystifying Annual Check-ups & Why They Fall Short

Thanks for Listening

If you like what you heard, please rate and review this podcast. Every piece of

The Case: 

• Jenny went on the pill as a teenager to regulate her irregular and heavy periods.
• After 20 years on the pill, she decided to start a family.
• Going off the pill led to fatigue, insomnia, hair loss, acne, and when her periods returned after 3 months, they were painful, heavy and irregular.
• Her symptoms led her to suspect hypothyroidism but her levels came back normal.

The Investigation

The first thing I did when I started working with Jenny was to run a full thyroid panel. While her TSH was normal, as her doctor had said, her free hormones were off. I knew that there had to be a connection between Jenny’s long history with birth control pills, her menstrual issues, and her thyroid but was the thyroid causing the issue or did the pill create a thyroid problem?

To discuss this further, I reached out to Emily Sadri. She’s a board-certified women’s health nurse practitioner and midwife who runs a functional medicine practice for women in Cleveland, Ohio. She specializes in abnormal bleeding, perimenopause, menopause, and fertility so I knew she would be a great resource for this episode.

How the Birth Control Pill Became So Popular

Most people are familiar with the birth control pill and yet, most of the time this medication is prescribed it is not specifically for family planning as it was designed. Instead, women often turn to the birth control pill to help them deal with other issues. For example, it is common for young women to turn to the birth control pill to lessen heavy and/or painful periods. They may also start taking the pill to help them deal with acne or irregular bleeding. This will often happen soon after a woman starts her menses.

Emily says this is a bit of an issue because a woman’s cycle takes time to find it’s rhythm and if a medication is used to regulate that early on, it may never find its own rhythm because the feedback loop between all of the hormones is interrupted.

How Menstruation Works

To fully understand why this is an issue, we needed to go back for an anatomy lesson and reconsider what is going on in a girl’s body as she starts to cycle. The average age of onset of menses is around 11 years old. Prior to that, the young woman's pituitary gland and hypothalamus (in the brain) start to send out little signals to her ovaries. This feedback look is called HPO access or hypothalamic pituitary ovarian access. It's like the feedback loop. So, the hypothalamus talks to the anterior pituitary. The pituitary gland sends out hormones to stimulate the ovaries and release estrogen. That estrogen is released in little bursts over the years leading up to a young girl's first cycle and may still be firing irregularly during the first year or so of menstruation.

The estrogen builds up in the uterine lining which starts to thicken the endometrium (lining of the uterus).  The hormones from the anterior pituitary stimulate the release of a follicle (aka an egg) from the ovary. That first follicle is released prior to the first bleed. The follicle has a lining around it called the corpus luteum which releases progesterone. The progesterone stabilizes that thickened endometrium. When that egg is not fertilized, the body picks up on that and then the endometrium sheds and that is when you get a menses. All of these hormones have to rise and fall in the cycle and find their rhythm in those first few years of menses.

And remember, often at this time in a woman’s life, she is dealing with other things that can impact the release of these hormones including stress and/or not getting enough sleep.

How the Birth Control Pill Works

The birth control pill interrupts the natural feedback loop by introducing hormones that weren’t called for or stimulated by the system. The pituitary hormones, the hypothalamus calibrating hormones, that normally communicate with the ovaries, sense the circulating estrogen and progesterone so there’s no stimulation required. This quiets the whole system and the body either stops producing or produces very little of its own estrogen and the endometrium doesn’t build up as much as it might without the pill.  In a traditional birth control pill, there would be 3 weeks of active pills and a week of sugar pills. The absence of the hormones causes a withdrawal bleed. This is different from actually menstruating. This is one of the biggest myths about being on the pill – it does not regulate your period; it eliminates it and triggers a monthly withdrawal bleed. So, any of the problems that existed before going on the pill haven’t been fixed by going on the pill, only paused. Often, women will discover that the pill has only masked the problem.

The Menstrual Cycle is Not Steady

It's also important to note that certain birth control pills deliver consistent levels of hormones each day. This is not how the body naturally produces hormones. Progesterone and estrogen ebb and flow throughout the natural cycle.

These natural ups and downs are responsible for creating variety in our mood and feelings. Hormones around ovulation can provide feelings of passion or happiness. It may also be a time of creativity and productivity. Whereas later in the cycle, you might be feeling more introspective. Understanding the natural cycles can be a gift, says Emily.

Having a steady state of hormones that do not fluctuate as they naturally should can actually lead to even more mood swings and even things like depression, and a lower libido.

Birth Control Pills, Hypothyroidism and Autoimmune Diseases

While Emily believes that women should embrace the ups and downs of their natural cycle, she does note that these hormone fluctuations can be problematic for those with autoimmune disease. And while fluctuations can cause flare ups, she still feels that it’s important to dig deeper because these responses or flare ups could be a clue to what’s really causing the issue.

When it comes to the effects the pill might have on hypothyroidism, lab tests may show lower circulating free hormones (even if TSH is fine). This is what we saw with Jenny.

Progestin-Only Birth Control Pills

The progestin-only pill is popular for women postpartum for a few reasons. The first is that they already have such high circulating levels of estrogen. The second is that estrogen dramatically increases a woman's risk for blood clots.

This option is also preferred by those who are at higher risk of complications.

Progestin-only birth control pills work differently than the more common estrogen/progesterone. It doesn’t always fully suppress ovulation however, it really suppresses the development of the uterine lining. So over the course of your cycle, your estrogen develops the endometrium and makes it thick and rich (perfect for an egg to implant). Because this birth control pill limits the development of the endometrium, it is not sufficient for an egg to implant.

Possible side effects include irregular spotting, depression, mood swings, and mood abnormalities.

Long Term Birth Control Usage

Women who are on the pill from an early age to their mid thirties (when things naturally start to change) can develop issues that are hard to diagnose because they never developed a natural HPO access. As women age, they experience hormonal shifts that, when combined with continued use of birth control pills can lead to a variety of issues. These include:

• Headaches
• Migraines with aura
• Thromboembolism
• Spotting
• Sore Breasts
• Constipation
• Digestive Changes (bloating)
• Yeast Infections
• Leaky Gut
• Nutritional Deficiencies (specifically vitamins C, E, B2, B6, B12, and folic acid)
• Metabolic Issues (and weight gain)
• Low Libido

These can be exacerbated by poor diet, poor gut function, slow transit times in their colon, as well as the potential for estrogen dominance.

Preventing Hormone Imbalances

Any conversation about balancing hormones or starting on birth control pills, according to Emily, should also address nutrition. Estrogen recirculation

The Investigation

Thyroid issues can be so frustrating because often doctors will say there is nothing to be done other than taking medication.

We talk a lot about hypothyroidism and Hashimoto’s Disease (an autoimmune disease that attacks the thyroid resulting in not enough thyroid hormone) but there is another side to thyroid issues. 

It is also possible for there to be too much thyroid hormone being produced. This is called hyperthyroidism and the autoimmune disease that can cause this is Graves' Disease. 

But it is also possible for those with Hashimoto’s disease to experience periods of hyperthyroidism - which just adds to the thyroid mystery. 

In this episode of Health Mysteries Solved, we’re exploring hyperthyroid symptoms in Graves' as well as in Hashimoto’s. To help with this discussion, I invited fellow clinical nutritionist, Juli Keene, on the show. She’s based in Los Angeles and has been in practice for over 25 years often helping professional athletes and high-functioning folks with complicated health issues. She’s also a real expert on Graves' Disease. 

What is Graves' Disease?

Graves' Disease is an autoimmune disease affecting the thyroid. What’s happening with Graves' is that there is an immune attack and antibodies get created. These antibodies attack the thyroid and stimulate the hormone receptors. This results in an overproduction of thyroid hormones and a hyperactive thyroid.

It can be very dangerous to have too much thyroid hormone and needs to be addressed right away.

The Difference Between Graves' Disease and Hashimoto’s Disease

With Hashimoto’s, the immune system is attacking the thyroid resulting in reduced hormone production (hypothyroidism) and with Graves' it’s the opposite. However, the nuances between the two autoimmune diseases are more complex, especially if you have Hashimoto’s. With Graves', the levels continuously escalate. However, with Hashimoto’s, there can be flare ups that present like Graves' where the thyroid swings from not producing enough to overproducing. So, someone with Hashimoto’s might have a flare up and suddenly have hyperthyroid symptoms.

It’s also worth noting that someone with Hashimoto’s can also have Graves' disease too (although it’s not common). It’s all in how and when the immune system produces the different antibodies and how these antibodies succeed in destroying the thyroid.

Symptoms of Graves' Disease

Unlike the symptom of Hashimoto’s where people feel sluggish (when not in a flareup that is), people with Graves' might report feeling great. They have lots of energy, their weight is good, and they are often in a good mood. But soon, this can slide into feelings of anxiety, sometimes a sense of feeling manic, and even experiencing heart palpitations. Soon, they may also swing into weight loss, and brain fog.

With Graves', the symptoms can go up and down but generally progress.

The most common symptoms include:

• Irregular & rapid heartbeat
• Heart palpitations
• Hand and finger tremors
• Anxiety and irritability
• Unexplained weight loss paired with insatiable hunger
• Heat sensitivity (sweating and hot flashes)
• Muscle weakness
• Hair loss.
• Visibly enlarged thyroid gland (sometimes it can develop into a goiter)
• Menstrual cycle irregularities
• Low or no sex drive
• Diarrhea or IBS
• Insomnia
• Decreased bone density and low calcium levels

Diagnosing Graves' Disease

Graves' disease can be diagnosed with a blood test. Generally, this includes a full thyroid panel and TSI Antibodies. 

If you are talking with a conventional doctor because you have symptoms that might indicate Graves' it’s important to ask for the full thyroid panel and look specifically at the TSI antibodies.

Conventional Treatment for Graves' Disease

Graves' is a dangerous condition. Doctors usually put the patient on thyroid suppressing hormone medication. They may also add a beta blocker to slow down heart palpitations.

Many conventional doctors will also recommend a treatment that destroys the thyroid and requires the patient to be on thyroid replacement medication after the procedure to have a better handle on thyroid hormone levels. 

Contributing Factors to Graves' Disease From An Integrative Perspective

As mentioned, Graves' disease or symptoms and labs that suggest Graves' need to be taken seriously. Ideally, you would see an endocrinologist as well as an integrative doctor or nutritionist who understands Graves' and can look at some of the underlying issues that conventional doctors may miss that could be contributing to the severity of your condition.

Potential contributing factors could include:

• Infections or viruses (like H. Pylori or Epstein Barr)
• Gut pathogens (yeast, SIBO)
• Intestinal permeability (leaky gut)
• Stress
• Environmental toxin exposure like mold, mercury, glyphosate, and copper.
• Hormonal shifts

You may be noticing that many of these potential contributing factors are very similar to the ones we speak about in Hashimoto’s triggers because the issue here is the immune system that is confused.

Integrative Support for Graves' Disease

Some integrative doctors will recommend supplements aimed at supporting the slowing down of the thyroid. They may also recommend supplements to reduce the risk of worsening health issues caused by the symptoms of Graves' disease like depleted calcium.

In addition, testing for and supporting underlying issues may reduce Graves' symptoms. Juli shared an example of a patient who was taking excessive amounts of spirulina believing increased amounts of a health product would result in increased health benefits. Instead, the high doses of spirulina resulted in an overload of iodine which even further increased thyroid function. This is why it’s important to look at the whole picture.

Additionally, patients typically see that dealing with dysbiosis, adrenal imbalances, H. Pylori infections, or removing toxins from their day to day environment reduce their symptoms and help calm the immune response.

These are positive steps to take and getting to the root cause of what is creating the immune response my be able to reduce the chances that the thyroid will need to be removed or destroyed. These options however should be considered with the guidance of an endocrinologist and (ideally) also a functional medicine doctor.

Testing for Triggers and Contributing Issues

Finding what may have triggered a symptom or lead to Graves' disease can be a real health mystery. Juli likes to test for viruses when she is on the hunt for a root cause. She will run a variety of tests looking for antibodies to see if there is an active virus. This viral panel will also reveal if Epstein Barr Virus might be at play.

Treating Triggers and Potential Root Causes of Graves' Disease

Treating triggers and dealing with potential root causes may require a combination of integrative health and conventional medicine solutions. For example, Juli explains that antiviral medication sometimes just works faster including valacyclovir and acyclovir.

Additionally, correcting any mineral deficiencies or excesses can be very helpful in decreasing symptoms and supporting the immune system.

Having said that, Graves' is not the kind of disease where you can get symptoms under control and just forget about it. It’s important to regularly test your thyroid levels as well as monitor oth

• Jessica has Hashimoto’s Disease and can’t seem to balance her thyroid
• Her doctors say her levels are fine but she’s experiencing bloating, fatigue, hair loss, GI issues, and brain fog.
• She met with several doctors but none were able to address her concerns. 

The Investigation

When I met Jessica, I knew that we had to go beyond supporting the thyroid, we had to slow or stop the attack on her immune system. There are many triggers and Jessica had already cut out gluten. This was great but that told me we had to dig deeper. 

I noticed that Jessica came from a family of farmers and had quite a bit of exposure. Figuring out her specific triggers was how we were going to solve her autoimmune mystery. 

Autoimmune Triggers and Glyphosate

I talk a lot about the four most common triggers for autoimmune disease and they are: stress, toxins, infections and foods. There is one thing that intersects with all four of these triggers - glyphosate. To explain it fully, I invited Jeffrey Smith on the show. He is the Founder and Executive Director of the Institute for Responsible Technology and Protect Nature Now. He’s also a bestselling author, award-winning filmmaker, and an in-demand speaker. I could think of nobody better to explain what’s going on for those with autoimmune disease and even for those who do not have an autoimmune disease. 

What is Glyphosate?

Glyphosate is the main ingredient found in Roundup (a herbicide) created by Monsanto which is now owned by Bayer. This chemical has been found (in a US lawsuit) to have contributed to Non-Hodgkins Lymphoma and cancer. It has also been linked to more than 30 diseases. It was originally patented as a descaler for industrial builders because it chelates minerals. When it gets into the human body, it also grabs minerals from our system and prevents these minerals from doing their work in keeping us healthy. 

How are we Exposed to Roundup and Glyphosate?

Since the late 1990’s, Roundup has been used on human food including genetically modified crops such as soy, corn, cotton, canola, sugar beets, and alfalfa. These GMO crops are engineered to be Roundup-ready which means they can withstand it. Other crops that are often sprayed are oats, wheat, mung beans, lentils, chickpeas, and even orchard fruits and grapes used for wine. It is found throughout the food chain. 

Effects of Glyphosate Exposure

There are many ways that glyphosate exposure can affect the body, including: 

• Mineral deficiencies (which can cause metabolic pathways to shut down)
• Acts as an antibiotic that kills off the beneficial bacteria in our microbiome. 
• Can break down the cellular walls of our gut, brain, kidneys, or other organs in the body
• Can damage and mutate the DNA which can lead to cancer. 
• Can damage the mitochondria which has been linked to chronic fatigue, cancer, aging, and several other diseases.
• Interferes with intercellular communication causing gap junctions (also linked to cancer).
• Blocks the production of good gut bacteria.
• Can throw off hormonal balance between estrogen and testosterone. 
• Acts as an endocrine disruptor. 
• Can cause epigenetic changes in gene expression in future generations.
• Suppresses cellular detoxification pathways and downgrades Nrf2.

How Can Glyphosate Trigger Autoimmune Disease?

Several of the effects listed above can then contribute to the development of an autoimmune disease. Jeffrey points to GMOs and BT toxin. BT toxin works by creating tiny holes in the insects and that is how it acts as an insecticide. While this can help grow those plans, it can also have the same effect on human cells. This is why he believes that leaky gut can be directly related to BT toxins and that leaky gut can lead to a variety of autoimmune diseases because the gut is now allowing bigger proteins that don’t below in the bloodstream, directly into the bloodstream and the immune system starts to see these as an invader and attacks them. The thing is that when the  immune system attacks them, it can also by accident attack our other tissues.  For example, in the case of Hashimoto’s, the immune system is attacking the thyroid because it’s mistaking it as an intruder.

Because the gap junctions are permanently open due to leaky gut, more and more proteins get into the bloodstream and this creates a lot of inflammation.  Scientific studies have found that lab animals fed GMOs will develop inflammation and issues with the immune system, leaky gut, and the destruction of the good bacteria in the gut.

Diseases That May Be Linked to Glyphosate and GMO Foods

Jeffrey shares that correlational charts show a rise of specific diseases in parallel with the increased use of glyphosate on soy and corn in the US as well as the increased prevalence of genetically modified soy and corn. The specific diseases that appear in the correlation include:

• Inflammatory Bowel Disease 
• Deaths from intestinal infection
• Liver disease
• Various cancers (liver, bile duct, kidney, breast)
• Autism
• ADHD 
• Deaths from Alzheimer's
• Deaths from Senile Dementia
• Deaths from Parkinson's 
• Anxiety
• Suicide by overdosing 
• Schizophrenia
• Celiac disease
• Insomnia and other Sleep Disorders
• Skin problems
• Birth defects
• Eye problems
• Diabetes
• Obesity 
• Stroke and Hypertension
• Anemia

While of course correlation does not prove causation, Jeffery says that he’s seen the correlations first hand. He recently surveyed 3256 people who switched to an organic diet and they reported that they felt better. In fact, 85.2% said their digestive issues were resolved. They also reported improvements in fatigue, weight problems, brain fog, anxiety, depression, food sensitivities and allergies. In addition, 21.4% of respondents reported improvements with their autoimmune diseases. 

Additional Threats from Engineered Microbes

We often focus on the microbes in our gut but the atmosphere is full of microbes. And, all of these different microbes belong to microbiomes. For example, there is a microbiome in the dirt, in trees, in other organisms, and in the atmosphere. The threat to these microbiomes (and our own) comes from genetically engineered microbes. Microbes can mutate, swap genetic material, and travel around the world. This is how an engineered microbe created for one purpose could end up inside the DNA of hundreds or thousands of other types of microbes and enter the ecosystems with unknown effect.  Jeffrey is trying to stop the release of engineered microbes and has created a film about the threat. You can watch “Don’t Let the Gene Out of the Bottle” on his website protectnaturenow.com

How to Avoid Glyphosate, BT and GMO Foods

Jeffrey gets asked all the time about how to avoid these harmful chemicals. Is going organic enough given the exposure so many of us have already experienced? Jeffrey says it is possible to heal from GMO and Glyphosate exposure but it’s more than just switching to organic. You will likely need to remineralize, restore your leaky gut, heal the mitochondria and rebalance hormones (especially if there are sleep issues causing anxiety or depression). The good news is that reducing the GMO and Glyphosate burden has helped people regain their health. He suggests tracking how you feel before you switch to organic and then each day on a clean diet. 

If going organic feels like a financial challenge, he outlines a few areas to focus and a few ways to reconsider your

The Investigation

As we head into cold and flu season during the second year of the pandemic, it’s important to provide support for your immune system - especially if you have an autoimmune disease like Hashimoto’s, Lupus, MS, Rheumatoid Arthritis, Type 1 Diabetes, Addison’s, Grave’s, and Celiac disease. 

As someone with Hashimoto’s and who works with a lot of people with Hashimoto’s I’ve created a protocol that I have been updating month after month and here is my latest version. This protocol is great for overall immunity and best of all, it is absolutely safe and recommended if you have an autoimmune disease as well. 

Herbs & Supplements to Avoid with Autoimmunity

I always need to remind those with autoimmunity that the supplements you often hear about for supporting the immune system can do real damage if you have an autoimmune disease. These supplements stimulate the immune system. For those with autoimmunity, an overstimulated immune system can lead to flare ups. 

Here are the commonly suggested supplements to avoid:

• Echinacea 
• Astragalus 
• Reishi (or other immune supporting mushrooms)
• Elderberry

My Autoimmune-safe Immune Support Protocol

Here are the things that I take to give me the best chance for avoiding the flu, colds and other viruses as well as how I use them to decrease symptoms if I do get sick. These are my go-to recommendations: 

Vitamin C

For general immune support, I usually recommend for an average, 150lb adult, a dosage of 1000 - 2000 mg of vitamin C per day. I personally use C+Biofizz from Designs for Health which you plop in water for a fizzy drink (if you prefer capsules, try their Stellar C). Please note that if you experience loose stools when taking vitamin C, you may want to try liposomal vitamin C because it helps the body absorb through the mucous membranes in your mouth first (just remember to keep it refrigerated.) 

If you are already sick, vitamin C can be very helpful in decreasing recovery time from infections, cold, flu or other viruses. You can increase your daily dosage but make sure you divide it and take it over the course of the day. That might mean taking 500 to 1000 mg of C (it can be powder, liposomal or capsules) every 30-60 min to bowel-tolerance (until you get diarrhea which is when your body says it's saturated and had enough). You would then restart it later in the day or next day. Do this for a few days when you are sick. There is a ton of research about high dose vitamin C in helping fight infections. 
Alternatively, you could look at getting a vitamin C infusion through an IV for prevention or treatment. 

Vitamin D

Vitamin D is imperative for many different things but specifically supporting your immune health. Many people have low vitamin D and it tends to decrease during our shorter winter days here in the Northern Hemisphere. 

You can determine how much vitamin D you need by checking your levels through a blood test. Ideally, you want to be in the range of 50-80 on that test (the lab range is wider, typically 30-100). 

If you don't know your vitamin D levels (and you're not regularly supplementing) the typically recommended daily dose is 5,000, IU. 

If you are already sick, you will want to make sure that you are also taking vitamin K with your vitamin D to prevent calcification of tissues and organs. You can either take a vitamin K supplement or a multivitamin with vitamin K. 

I use Vitamin D Supreme which is a capsule but if you have issues with fat soluble vitamins, you could try a liquid form of vitamin D or, if you also struggle with energy issues, you could try Hi-Po Emulsi D3 from Designs for Health. 

Zinc & Quercetin

There has been a lot of talk about Zinc online and in the media lately as a great way to boost your immune system during the COVID pandemic and into cold and flu season. What many people don’t realize is that Zinc mainly stays outside the cell and you want it inside the cell for optimal immune support. One natural way to do that is by taking it alongside Quercetin. I take Designs for Health’s Quercetin and Nettles blend and I recommend 250 milligrams to about 500 milligrams daily. 

Quercetin is something that I've added to my protocol a bit more recently because I'm seeing such great results. When combined with zinc, it’s great for both prevention and also healing from infection. Please keep in mind that extended use of zinc can cause a copper deficiency so you want to make sure you are balancing these two minerals. If you are taking zinc for a long time, consider supplementing with copper or a multivitamin that contains copper. To be extra sure that you aren’t deficient in copper (which can have serious health repercussions), a hair analysis will reveal both your copper and zinc levels. If you already have recent hair test results, you would want to look at, not just the individual zinc or the copper level, but actually, the ratio of the two. Ideally, the zinc to copper ratio should be right around 8. If your levels are lower than 8, then you can use more zinc. If you are above 8, you would need to supplement with copper.

Garlic (Allicin)

This one is a favorite because it really works and I typically don’t see any side effects. Garlic has both antiviral and antimicrobial properties which means it can work on bacteria, yeast and other bugs in addition to viruses. 

For general immune support, I don’t recommend it long-term (unless your practitioner has you on a specific protocol). 

Instead, consider garlic for immune support when you’ve been around someone who’s sick, you’ve been exposed to a virus or when you feel like you’re coming down with something.

It can be difficult to get enough garlic in food form so supplementing is best. There are many on the market but my absolute favorite is Allimax. It’s a potent (and patented) allicin extract which has all the benefit with way way less of that garlic odor.  I recommend 4-6 capsules a day for the duration of illness or for a few days if exposed or feeling off. I also give this to my kids when they come home with a runny nose or they’ve been exposed to a virus and it's really fantastic. 

SPM’s and Liposomal Glutathione

Two things I’ve added recently to my immune support protocol are SPM’s and liposomal glutathione. 

SPM’s stands for Pro Resolving Mediators and they literally go in and resolve inflammation. I think it's one of my most favor

The Case: 

• Denise has Hashimoto’s and hypothyroidism and has been trying to balance her thyroid for years.
• She tried Synthroid, Levothyoxine and Armour but these left her feeling ‘off’.
• It seemed impossible to find something that would get her T4, T3 and TSH levels into range and give her ample energy. 

I knew that while she was on the right track, we needed a slightly different type of approach to solve her health mystery. When the standard solutions don’t work, you might need to go custom. 

The Investigation

I immediately thought of the work that Jim Hrncir has been doing with compounding thyroid medication. This is something he is incredibly passionate about ever since his own wife had challenges similar to Denise’s. 

You may recall that Jim was on a previous episode talking about compounding hormones for treating menopause and perimenopause. It’s episode 96 if you missed it. 

Typical Thyroid Treatment

I talk a lot about Hashimoto’s and hypothyroidism on this show. When we talk about treating the thyroid, the most common option is Synthroid. Synthroid is levothyroxine sodium which is synthetic levothyroxine. Tirosint is another brand of this same synthetic hormone but with no fillers. Synthroid is mostly prescribed by conventional doctors. While it replaces the T4 that the thyroid is not producing or producing enough of, the body still has to convert that T4 into T3. That’s why it’s important to test T3 levels to make sure that the T4 you are getting from Synthroid is being converted.  Some people may be under converting which is why they are not getting full resolution of symptoms with T4 only medications. 

Going Beyond Synthroid

Some patients aren’t happy with the synthetic hormone options either because they are looking for a more natural solution or they aren’t getting results from the synthetic hormone. This brings them to desiccated thyroid which comes under several brand names including Westhroid, Armour Thyroid, and Nature-Throid. Each option has different additional ingredients beyond the porcine desiccated thyroid and these fillers can sometimes be an issue. 

Supply of these options can sometimes be threatened because of supply chain issues and heavy regulations from the FDA. 

Sensitivity to Synthroid and other Thyroid Treatments

The thyroid plays a very big role in how the body functions so it’s important to pay attention to how well it is working by testing all the thyroid hormones - T4 and T3. 

It is important to have enough but at the same time, not too much. 

Getting too much thyroid hormone poses its own issues which include:

• Heart palpitations
• Nervousness 
• Tachycardia (racing heart)
• Hot flashes
• Insomnia
• Brain fog
• Feeling wired 

Jim points out that before concluding that these issues are related to the thyroid medication, it’s important to check thyroid levels and also check for other deficiencies, in particular low iron. 

The Compounding Option

Compounding thyroid is the practice of combining various thyroid treatments in a custom way. Jim was a pioneer in this field. The process allows for highly customized dosages based on patient and lab test responses to micro-tweaking the dose. This dose then comes in a natural base with no toxic fillers. Also, once the correct custom formula is found, the compound can even be provided in a time release capsule that gives you just the right amount of thyroid, all day long, especially when T3 is involved. 

Accessing Compounded Thyroid Medication

Jim’s pharmacy is in Texas and he only serves his state. There are however 7000+ other compounding pharmacies across the country, but when you look for one in your area,  you want to look for quality. If you are interested in finding a compounding pharmacy that can help you with a custom thyroid solution, Jim suggests you look for a compounding pharmacy that is PCAB (The Pharmacy Compounding Accreditation Board) accredited.

Compounding as a practice can have so many advantages as so much customization is available in natural forms. Unfortunately, compounding is under fire right now. Please check out  compounding.com for suggestions on what you can do and how you can support the continued availability of compounded medications. 

Mystery Solved

It was clear that Denise needed a custom solution to her thyroid issue. Based on the history of her blood work, it seemed that Denise needed both the T4 and T3. It also seemed like she might be reacting to some of the fillers in the commercially available T4. And, the desiccated thyroid she tried left her feeling wired and didn’t sufficiently lower her TSH. 

When I looked at her labs after she took dessiccated thyroid, I could see that her T3 was high (which would explain the ‘wired’ feeling). This made it clear that she needed more T4 and less T3 than the fixed ratio in DTE’s and she would benefit from getting the T3 in a time release capsule so that it would be less jarring to her system. For her, compounding was going to be the best option. 

Conclusion

We worked with her doctor to prescribe a synthetic T3 at a lower dosage and we got it in a time-released form. 

She started with 5 mcg which worked well but her T3 was still a bit low. We bumped it up to 10 mcg and that brought her T3 into range and she felt better. Now she was on a combination of Tirosint 75 mcg and 10 mcg of compounded time released synthetic T3 and it is working very well.

Happy Ending

On a combination of Tirosint 75 mcg and 10 mcg of compounded, time-released synthetic T3 Denise is managing her thyroid levels.  Denise was very happy to have an answer and to be feeling better. 

Eliminating Health Mysteries

For Denise we were able to find that missing piece of the health puzzle and help her regain her health. Could this be the missing clue for you or someone in your life? 

Links:

Resources mentioned

Thanks to my guest Dr. Jim Hrncir. You can learn more about the movement to ensure women continue to have access to compounded bioidentical hormones, visit compounding.com. 

Related Podcast Episodes:

096 Demystifying Hormones for Perimenopause and Menopause

[Ask Inna] Answers to Your Questions about Hypothyroidism and Hashimoto’s

Are you Missing this Important Evaluation Method for Thyroid Assessment?

Navigating the Thyroid Treatment Mystery with Inna Topiler

Solving the Thyroid Mystery w/ Inna Topiler

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