The Thyroid Connection: Why You Feel Tired, Brain-Fogged, and Overweight (& How to Get Your Life...

Oh, hello, it's Ben Greenfield. And if today's audio sounds a little funky, it's because I'm in the Bahamas. You might hear children in the swimming.

Pool behind me playing Marco Polo.

The rush of wind over the microphone, fish leaping. I hope I'm painting a very good picture for you. And the sunset setting over the. I believe it's the Atlantic Ocean that.

I'm looking over right now. I just emerged from the water.

I'm still shivering from having spearfished three big tasty fish that I am going to proceed to grill after recording this wonderful podcast introduction for you. I'm down here doing a lot of cool things, working on building the new business that I'm going to be revealing to you quite soon. Working a bit on my book of fiction, which you can read for free over@BenGreenfieldFitness.com TheForest and of course planning on how I am going to continue to get out amazing podcasts like the one you're about to listen to on Thyroid. It's called why you Feel Tired, Brain Fogged and Overweight and how to get yout Life Back.

My apologies, by the way, for the.

Fact that today's audio is not pristine. Super duper high quality, at least in this introduction. But in the actual interview itself, I promised pure audio. Liquid gold. But before we jump into this show, let's talk shockwave therapy, shall we? Because what podcast is complete without a discussion of shockwave therapy? This has been used in Europe for about 15 years and it's been used on people's crotch. I'm not kidding. Viagra Cialis. They give you things like blurred vision and priapasm, which is basically an erection.

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Fitness for 20% off the sun in youn Pocketses. As Gollum from Lord of the Rings would say. So let's go ahead and jump into the thyroid, shall we?

In this episode of the Ben Greenfield Fitness Show.

And that's a whole nother controversy about where are safe places to be getting iodine. Right. With the radioactive situation in Japan, just what you know, where is there a safe source of co? Everybody should get testing because really you want to prevent having a problem. Don't want to wa until you have the problem to deal with it. You want to prevent the problem from happening in the first place. What's the secondary effect? I have candida in my gut that creates leaky gut. Now I have a leaky gut and now I have autoimmune thyroid dysfunction.

He's an expert in human performance and nutrition. Voted America's top personal trainer and one of the globe's most influential people in health and fitness. His show provides you with everything you need need to optimize physical and mental performance. He is Ben Greenfield.

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All the information you need in one place right here, right now on the Ben Greenfield Fitness Podcast.

Hey, folks, it's Ben Greenfield. And I know that a lot of you out there get exhausted. Sometimes you get plagued by brain fog. Sometimes you find yourself unable to shed a little bit of fat, or maybe you struggle with insomnia or panic attacks or even things like tremors. And in many cases, your doctor tells you that your labs are normal and that maybe you just need to eat less or exercise more. And frankly, that can be frustrating, it can be stressful, and it can be emotionally draining. My guest on today's show gets into a lot of these issues in her new book and highlights how a lot of these issues can be tied directly to your thyroid. And her book is called the Thyroid Connection. I got it a few weeks ago and thumbed through it. She had already written a book I'd read before called the Autoimmune Solution, a New York Times bestseller that I got.

A lot out of.

And this book is just as good. Her name is Dr. Amy Myers, and Amy is a pretty well known leader in the functional medicine community. She's the founder and the medical director of something called Austin Ultrahealth, which is a functional medicine clinic in Austin that treats people from all over the world who are dealing with issues like this, you know, thyroid and other forms of chronic illness. She's been all over the place like Dr. Oz show and the New York Post and Women's Health magazine, the Huffington Post. And she's got a lot of really cool resources, including this new book. So I have some things that I've circled and highlighted in this book as I do. I love to damage books as I read them, and I've certainly done some damage to this one and have some questions to ask you, Amy. So welcome to the show.

Thanks for having me, Ben. Really appreciate it.

Yeah. And for those of you listening in, by the way, everything Amy and I talk about I'll link to over@BenGreenfieldFitness.com ThyroidConnection, which is also the name of the book. So BenGreenfieldFitness.com thyroidconnection now I just want to if you're game, Amy, I want to dive right into the deep science here. So T4 and T3 I've talked about on the show before. I even talked about how I have low amounts of T3 despite having adequate amounts of T4. And so this is a question near and dear to my heart. Can you go into how T4 actually gets converted into T3 and how we could enhance that process somehow?

Sure. So as you mentioned, T4. Well, first of all, we say T4, but there's T4 total free T4. So total hormones are usually bound to proteins, and the free hormones are what we really care about. So free T4 or T4 gets converted into T3 partly in the liver and in the gut. And we need a certain amount of nutrients in order to make that happen. And then T3 can do one of two things. It can become free T3 or reverse T3. And for your listeners, if this is new to them, the free T3 I like to think of kind of as the gas and the reverse T3 as the break. And so when you say you had low T3, I don't know if you just genuinely have low T3 or if you even look to see if it's low in free T3 and high in reverse T3 or low in both, because there are a lot of different things.

For me, it was basically like low free T3. And frankly, I talked about this on a podcast episode a few weeks ago with L. Russ, who wrote a book about the thyroid. And, you know, we discussed how, you know, a big, big part of that for me was related to extreme amounts of physical activity and running around in the forest half naked, throwing spears while not eating enough carbohydrates. But yeah, for. For me personally, it was low free T3 levels.

Yeah. So that certainly. So when, you know, when we are stressed, whether that's physical stress, like what you were saying in the forest, not getting enough food, I mean, the physical demands can be stressful. Then not having enough carbs, not having enough food can also be stressful. Or if you're just stressed, like psychological stress, or there can be, of course, like trauma or abuse type stress. Any of these things, or even a stress like a toxin on your system can cause that to happen. Basically, when you're stressed, the body is trying to conserve its energy and so it converts more. Typically, sometimes you can see it just. Just as the low free T3, but often what you'll see is a low free T3 and a high reverse T3. So it's not that people aren't making enough T3, they're just making it more into the break because the body's stressed and it's saying, stop, stop. We don't want to be making energy, we want to be conserving. It because we're starving or we're in a trauma situation or we're super stressed out. Occasionally they'll also be like completely normal free T3 levels, but still have a high reverse T3. I like to see a 10 to 1 ratio between those. So there are people that frequently they'll come in with labs and they have even a normal or optimal TSH, free T4 and free T3, but then nobody checked their reverse T3. And so they're having a lot of symptoms. Their hair's falling out, they feel cold, they have a lot of symptoms of thyroid, but they've been told, even by integrative or functional doctors that don't really fully understand this, that their labs are normal and they just didn't check that reverse T3. It is really important that you get that full panel and that you're not only looking at what is normal, what is optimal, but also what are these ratios looking like to one another.

Yeah, I want to ask you about that full panel there in a second. And also, what would make the body produce more reverse T3, but really quickly returning to that whole enzymatic process for converting T4 into T3.

One of the things that, of course, seems like a horse that gets kicked to death these days is you're not eating enough food, or perhaps you're not eating enough carbohydrates, you're combining too much ketosis with too much activity, things along those lines. But sometimes this can come down to simple micronutrient status.

You talk in the book about an enzyme called diodinase. Am I pronouncing that correctly? Okay, so deiodinase actually needs specific micronutrients to function in the right way, doesn't it?

Yeah. So, you know, zinc, selenium, iron, in order to, you know, basically what you have is you have four iodine molecules creating the T4, and then you're dropping one off to get to the T3. And so you need that enzyme to be working properly. And, you know, I see this, of course, frequently with people who are just not eating the right diet. But after, as you mentioned, I have two books out there. And so now I'm really kind of seeing the sickest of the sick. And most people have read the books and done the programs and possibly even seen. Of course, they've been everywhere, but they might have even seen another functional medicine doctor before they get to me.

And so they're already eating what one would consider a good diet, or like many of your listeners, a paleo diet that they think is full of nutrients, and it may be, but a lot of things that I see are that, you know, like yourself, maybe you were burning through them. So even though you might have had adequate amounts, you might have been, you know, overexerting yourself, so you were burning through them or. What I typically see is that people's guts are so messed up. And, you know, about. I think it's about 60 to 70% of the thyroid hormone is converted in the gut. And so, you know, A, that's part of it, that their gut's messed up, so they're not making that conversion, or B, they're not digesting and absorbing their nutrients properly. So they might be eating a great diet, but then they don't have enough stomach acid or digestive enzymes or, you know, they have small bowel bacterial overgrowth, and so they're not absorbing their nutrients. So I like to say it's, you know, you're not. You are what you eat, but you're what you digest and absorb, because that's really. Clearly, it's important what you eat, but you got to make sure your gut is working optimally as well, so you can extract all those nutrients from your food and absorb them.

So deiodinase is basically stripping all the outside iodine atoms off of T4, and that's what turns the T4 into free T3. And that deiodinase enzyme, which I'm trying to spit out, it needs selenium, zinc, and iron. So that's kind of like one part of the equation you'd want to make sure that you cover is testing and making sure you get enough of the selenium and the zinc and the iron. But in the book, you go on to explain how even if you have.

Enough free T3, it might not be able to actually get into or pass through the membrane of the cell. And there's something you talk about in the book that actually helps it get through the cell that I found surprising. You know, something that gets kicked under the bus a lot of the time. But can you talk about the hormone that helps T3 actually get into the cell, Assuming we make enough of it.

So cortisol? Is that what you're talking about?

Yeah.

Yeah. Okay. I'm just like. You got so specific in the book. I'm like, all right. I remember my first book, the first time with the autoimmune solution. And I talk about these eight myths about autoimmunity. And of course, I mean, I don't know if you've written a book, but like, you write a book, and then they come out, like, a year later. So somebody's like, yes, I went over these eight myths, and they're like, tell us about myth number four. And I'm like, okay, like, could you tell me which myth it is? Like, I definitely. But I don't remember, like, what order I put those things in.

I run into that quite a bit. I've written 13 books, and, yeah, they tend to blend together after a while. Sometimes people will ask me about what I wrote on page 183, and I'm trying to remember which book even had a page 183. Yeah, I hear you. But you talk about cortisol. Why is it that cortisol is something we need so much for thyroid? Because a lot of times you'll hear like, stress will inhibit your. Your thyroid capabilities or give you hypothyroid or something like that. But what is it cortisol is doing on a membrane level, on a cell membrane level that's helping T3 move in?

Yeah. So, I mean, I think it's like everything. And I talk about this in the book, too. It's like Goldilocks, right? You know, with the immune system, with cortisol, you know, with our hormones in general. And as you know, I mean, no, Even though we often are sitting here talking about the thyroid, it is never one hormone. I mean, you and I are on Skype, and it's not, you know, I'm bouncing one signal to you, and you're bouncing one back. There are all kinds of signals that are going out across the Internet in order for you and I to talk to one another. So that's really what's happening with all our hormones in general.

Which is that our sugar hormones, insulin, and what we consider stress hormones with cortisol to our female or male hormones to our sleep hormones. All of these things are acting in concert with one another. And so, yes, as you mentioned, having too much of cortisol is, you know, can certainly inhibit, you know, create an inflammatory process and actually can slow down the thyroid and make you convert to more reverse T3 than free T3. So too much cortisol is going to inhibit our thyroid, not production necessarily, but at least the conversion. And you need, you know, just, you know, the right amount in order to get it into the cell where it can, you know, do its job. And including, you know, we need to make sure that we have enough fats in that cell so that that membrane and porous and fluffy instead of rigid for the hormone to get in. I mean free T3, there are receptors, you know, on and inside every cell, which is, once it's in there, it's where it's going to do its job. So it's very important that the, you know, it's very important that the free T3 can actually get into the cell.

Yeah, that, that's one of the things I think is super important for people to realize is that your cell membranes, which are going to allow free T3 to into your cells, assuming enough cortisol is present, those are made up of the fats that you're consuming. And so if you happen to be grabbing too many, say, bags of sweet potato chips off the shelf of whole foods with some heated oxidized fats in them, that's what your body is going to make its cell membranes out of versus say like the avocado or the extra virgin olive oil or the wild caught fish. And so, yeah, I think that, that cell membranes are something that certainly get.

Underplayed quite a bit there. And honestly, you know, potato chips for you?

No, absolutely not. Nor my wife.

Potato chips cooked in coconut oil. You were not talking to me, right? You didn't been talking to my staff or something?

No, no. I walk into my own pantry and a lot of times, let's just say that there are certain people in the household that have a craving for crunchy foods coated in heated oils. And I try and avoid those quite a bit for some of the reasons that you just highlighted. You know, one of the things you.

Brought up, if you're gonna grab a potato chip, getting one that is a sweet potato and it's cooked in coconut oil is better than a lay something.

It is much better than a canola oil. Absolutely.

We all have our. We all have our. We are human living, you know, living in 2017 after all.

That's right. And for me these days, it is fruition dark chocolate that is my sinful food of choice.

I have a little secret stash. I'm a fan too.

You gotta try this fruition brown. I interviewed a guy named Kevin Rose in a podcast episode a few weeks ago and I ordered 25 bars of the custom extreme dark raw chocolate fruition bars. So, yeah, amazing anyways though, so reverse T3, you mentioned about how that kind of puts on the brakes. You have a section in the book where you talk about what would actually stimulate the body's production of reverse T3. You highlighted some things there that I thought were quite interesting. Like some things you definitely want to avoid, if you wanted to avoid stimulating the production of reverse T3. What are some of those things that really amp up reverse T3?

So yeah, I think we hit on them to some degree. Which is, as you mentioned, you were. Well, probably having. There were about four main things that I think of and then within those, lots of. Of things can sort of subcategories. But I think your experience in the wilderness there kind of hit on three out of the four which was over exercising, you know, starvation, so you weren't eating enough carbs and you probably, I don't know if you were living on, you know what, you could forage out there, but starvation and then.

Oh, I didn't want to give you the wrong impression. When I say running around in the forest, what I mean by that is like I'm actually, I'm surrounded by. I live out in the forest and so it's not like I can't wander into the house and have a chocolate bar or some of those coconut oil coated potato chips. But. But I do do quite a bit of masochistic exercise, you know, grueling exertion. So you're saying that's one thing that could, that can amp up the production of reverse T3?

Yeah, yeah. I mean for some people, CrossFit, I mean, I see, you know, I think, I think in general, I mean, we could probably have a whole conversation about this. I mean, I think that there are people who really, you know, I mean there are athletes out there that are excelling, but the average person, that's really not good for them. I mean, I definitely see a fair amount of women coming, you know, burned out from CrossFit. And I'm not kn CrossFit at all. But you know, their adrenals and their thyroid, their adrenals get burned out, then their thyroid gets burned out. So, you know, I mean, doing Ironmans marathons, I mean when you complete a marathon, you're. They've done studies, you know, of checking people's white blood cell count before a marathon and then after and they end up with a suppressed white blood cell count. So your immune system's getting suppressed while you're doing.

Yeah, for actually about, about. It's actually like two and a half weeks that it's suppressed. I thought it was interesting. I think this was a study on Iron man triathletes. It's 19 days before your, your cytokine production kind of ramps back down and your white blood cell count returns to normal. So I mean, it's like almost a month that your body is, to use the highly scientific term, effed up after you do one of those.

Yeah. And imagine, you know, the training that had to go into that. And then, you know a lot. I mean, there are people who do kind of a one off, right. You know, a marathon a year, a marathon in your lifetime. But there are other people that are, I mean, I'm sure you know them. I know them kind of in this world that are, you know, do three or four iron men a year and you know, that means that most of the year it's sort of like eating gluten. You know, eat gluten once and it can suppress your immune system for up to three months if you have a gluten issue. And so that means you get four times that you're eating it a year and you never gave your immune system a break. So you do three, four iron men a year and you're really not giving yourself a break between the, you know, training, the ramp up period, the ramp down period.

Yeah, it's a very good way to amp up as you go into, in the book reverse T3. I think the other interesting part is despite anything else you're doing to remain healthy, it's one of the fastest ways to age the body and increase the rate at which telomeres shorten. I recently did a test with telomere length. It was a salivary telomere test. And although I'm 35 years old and I do a great deal of techniques now to assist with anti aging and I don't do Ironman triathlons anymore, although I've done done 12 of them and a whole host of other brutal events, my, my biological age is actually about 36, despite my chronological age being 35. And I'm convinced that a great deal of that has to do with the years and years of endurance based exercise. So.

Yeah, but that's actually probably pretty good. I mean, you know, there I'm trying five year olds that are, you know, 45.

Yeah, absolutely. You know, and I think I'm reversing a lot of damage these days now that I've kind of.

Yeah, you're probably, probably would have been higher before and it's probably gotten better with everything else you're doing.

Yeah, exactly. Now you go into how things like extremely low calorie weight loss plans can stimulate production of reverse T3. You also go into, you know, no surprises here, physical and mental and emotional stress. But then you also mention, you mentioned heavy metals.

That was the first round too. Yeah. We were talking about you and how you in your scenario might have had three out of the four. And maybe you have heavy metals as well, but heavy metals as well.

Tend to inhibit that conversion. And I think it's probably. I don't know if anybody really knows how or why, but I think that that's, you know, considered a stressor on the body.

Yeah, it is kind of interesting. You know, you go into like arsenic and lead and mercury. And one that you mentioned is cadmium. This is something that, because I have some clients who I work with who will do some metal testing on, people are testing really high in. And I started to dig into this because a lot of the people I work with now they're kind of getting into like plant based medic and stuff like that. You know what's extremely, extremely high in cadmium is marijuana. And a lot of marijuana these days, like they don't test for heavy metals. It's kind of like the wild, wild west as far as whether or not it actually is tested or whether it comes from organic sources. Marijuana, especially when you're vaporizing, it tends to be mainlining heavy metals into the bloodstream if you're not careful.

Well, I mean, in general, I mean, we have cadmium in the soil and then certainly, you know, places, you know, we have to be very careful about herbs and spices and teas and things like from Asia and China, because they can be very high in. I mean, we have arsenic and cadmium in our soil. I don't know what testing you're using, but I certainly use some testing in my office, an ion panel. And it's looking at the blood levels and I mean most people do have high levels of both of these. So it's, you know, I mean even eating organic fruits and vegetables are going to have it. Because it's about the soil. I mean, not necessarily, but unless somebody's really cognizant of that in their soil and getting it tested, these things are getting picked up in the environment and then it comes out in the rain to floating in the air.

Yeah, and green tea. And also this was based on a study done a couple of years ago, whey protein. Those are two notoriously high sources of a lot of these metals. And you find these in a lot of healthy people's diets.

Inclusion of things like matcha, green tea and green teas and of course whey protein in the morning smoothie. And you do have to be careful. I think anybody who has thyroid issues should probably go out and do something like you mentioned, like an ion panel or a urinary analysis or something that actually looks at levels of arsenal and cadmium and some of these other metals. Because, again, this. This is one of those things that. That's kind of. Kind of surprisingly detrimental to the thyroid. Almost like cortisol in adequate amounts can be surprisingly helpful to the thyroid.

So, yeah, I mean, I would say everybody should get testing because, you know, it's really. You want to prevent having a problem, Right. I mean, you. You don't want to wait till you have the problem to deal with it. You want to prevent the problem from happening in the first place. So if you can identify that, you have high levels of these things. And it's not just thyroid. I mean, I wrote about these in my book, the autoimmune Solution, as well. I mean, anybody with any type of autoimmune condition. So, I mean, you know, I consider these things toxins. And I think that, you know, as I talk about in this book, as well as the autoimmune solution, that there are really five factors that are creating all chronic disease. And that's the diet. We're eating, our leaky gut. That's toxins, infections, and stress. And so these are toxins. So I think no matter what you have, either if you're looking at it from a prevention standpoint or from a reversal of some sort of chronic disease.

Yeah. And you go into more than just something like heavy metal testing. In the book, you, of course, talk about how it's important to get a full thyroid panel where you're testing TSH and free T4, free T3, reverse T3, your thyroid antibodies, and then your thyroglobulin antibodies. But then you also mentioned, like, some other nutrients that you look at that wouldn't be on necessarily, like, a full thyroid panel, but that you've in your practice found to be really important in terms of assessing overall thyroid health. Can you go into some of the other blood work that you look at for the nutrients necessary for optimal thyroid function?

Yeah. So you can get a selenium level. I mean, if you can get a red blood cell. Anytime that you can get a red blood cell level of a nutrient, it's not always available. But that's helpful because that's inside your cell rather than in your. What's called your serum, just kind of all your blood there, because, you know, particularly those of us that are. I don't know about you, but I certainly take supplements. And so if you're taking a supplement, I mean, something floating around in your blood, you kind of hope it's there, but it's like, what are you doing with it and can it get in your cell, which is where a lot of these reactions take place, particularly, you know, conversions and, you know, where the thyroid needs to get. So you want to make sure that, you know, it's in the cell and able to get in the cell, and then there's whether you're able to utilize it or not. And that's a whole different story with genetic SNPs and stuff like that.

But, yeah, but that's important because a lot of labs will only test, like they spin the blood in a centrifuge, they separate the red blood cells, and then they work with just the serum. Right?

Yeah.

And so you don't actually get a look at the red blood cell levels.

Right. And for some things they don'. You know, you may have to request. I mean, there's a magnesium, red blood cell, there's a selenium, there's a zinc. So you do want to get those if you can. If not, I mean, having a serum is better than nothing, you know, because if you're low, then you're low and a lot of people will be low. But so certainly, you know, testing zinc levels, testing selenium levels. I do a different type of test, or at least I want to know. Somebody's mthfr, sort of looking at their B vitamin status and iron. You want somebody's ferritin. You actually want a ferritin level to look for iron storage. A lot of people that are, you know, anemic, it doesn't really show up on what's called an H and H, a hemoglobin and hematocrit. You know, iodine is the one that's quite controversial. There is a blood test for iodine, but again, it's just going to tell you, you know, a level, and that really doesn't tell you functionally what your body's doing with it. So some people use what's called a patch test, where they put some iodine on the skin and see how quickly it absorbs. The quicker it absorbs, the more you need. Other people do a challenge test where you take 25 to 50 milligrams and then collect your urine. And again, the less that comes out, the more your body took up, which means it needed more. I don't use those in my clinic. There's a lot of debate about them and about really because you, you know, people absorb things at different rates. They filter through their kidneys at different rates. You know, I'm more. And I know one of your questions, you wanted to get into the iodine controversy. So we can certainly get into that at some point. But, you know, I just pretty much assume that if you're having thyroid issues, you know, based on the fact that, you know, we're not eating an iodine rich diet like we used to. And then more importantly, we're being bombarded with the other halides, the bromides, chlorides and fluorides that are really displacing what iodine you do have. So I pretty much just take the universal thought that everybody's iodine deficient to some degree, and I replace it in micrograms, not milligrams. There's a whole controversy, which is why I called it the iodine controversy in my book. But about these super high dosages of iodine and being a clinician, being a doctor and seeing people coming in from things they've read on the Internet or other programs they've done, or even other doctors or, you know, chiropractors or people that have prescribed this to them, I've had probably 50% of the people who've been on it come in and swear it solved their thyroid problem being on these mega dosages. And I've had 50% of the people come in and swear it's what caused their thyroid problem. So I think the jury is really out about those, you know, milligram dosages.

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Okay, so, so your take on iodine then to highlight this iodine controversy, is that what you're saying is that a lot of these other things that we're getting like, like halides and bromides and even like, you know, chlorine in swimming pools and then water and fluoride that displaces the iodine that our thyroid is dependent upon. However, when it comes to like supplementing with extra iodine, iodine, it's kind of an issue because there's no reliable way to test the body's iodine levels. And you don't quite know exactly how much iodine to take, but what you're saying is you're just making that assumption that most people are deficient in iodine and should supplement with small amounts of iodine.

Yeah. So I mean, unless they're eating a super iodine rich diet, which then that's a whole nother controversy about where are safe places to be getting iodine. Right. With the radioactive situation in Japan, just what, you know, where is there a safe source of kelp? And, and there are some, but you just, you know, unfortunately this day and age, you really have to, with everything in our diet, look at risk benefit because there's nothing perfect left anymore.

So where should we get our iodine.

Well, I mean, you know, you can get it from kelp sources, you know, seaweed. You just need to make sure that you're getting it from a reliable source, fish sources. Again, you just need to make sure to the best of your ability that you're getting it from as clean a source as you can get it. What I was saying about the iodine. Yes, your summary is correct. And just to explain a bit further, you know, I've created a multivitamin, a formulated one to go along with the book just because, you know, there are so many nutrients that are vital to having your thyroid work optimally and or to help reverse a situation. And I couldn't find one out there that kind of had everything. So I ended up formulating one because in my first book people were like, oh, you have so many supplements. This is, you know, overwhelming. So I was like, okay, let me just like formulate one thing for them to take. So I included 300 micrograms of iodine. Now what people, when they're advocating large dosages or what I would say are large dosages of iodine, something called iodorol, that comes in 25 milligrams. And so some people are taking one to two pills. So that would be 50 milligrams. So that's over a thousand fold what I'm recommending. So yeah, So I mean, 300 micrograms versus, you know, 50 milligrams. So.

That'S. To me, I mean, one would say there's an iodine controversy as it is, because you might go to your regular doctor. This is probably the number one email that we get is, well, wait, I'm confused about iodine. What should I do? So I would say even at the low level, there's some controversy, but the real controversy is surrounding these mega dosages of it. In my opinion. I mean, in my opinion there's really not a controversy. I mean, if you think about it, you know, I mean, breast cancer, thyroid issues are much lower in Japan. And you know, is that because they're eating a more plant based diet, the soy in their diet, or is it that they eat a bunch of seaweed and they have a much higher concentration of iodine in their body? So we are not, you know, we used to, one, I don't think we ate a whole lot of iodine to begin with, our iodine rich foods. Then two, we used to have it in our salt and that got taken away. And then again, the most important thing about all of this to me is that what we have in our Environment is everywhere you look. Your sofa, your rug, your computers, your mattress. There's flame retardants with bromides in them. There's chlorine in our water, there's fluoride in our water. I mean, we are being bombarded by these other halides, which are right next to iodine on the periodic table and are in our body.

That ion looks exactly the same and our body gets confused. And so.

It'S a relative iodine deficiency because of these other halides. So, you know, I'm kind of replacing back to what we should be or used to be getting, and we're no longer getting. I mean, that's not even necessarily counting for, you know, all these other halides in our system. And there are people who I put on higher dosages, but I mean, I couldn't do that blanketly. You know, when tens of thousands of people are reading a book, I had to stay on the more cautious side.

Yeah. So basically the idea here is microdosing with iodine is probably a good idea, especially if you got exposure to a lot of, like, fluorides and chlorides and bromides and things like that. And then also including preferably safer sources of iodine in your diet that would be like, you know, seaweed from an area that doesn't have a lot of heavy metals in it, or wild caught fish that maybe wasn't caught right off the Japanese coast, things like that. And that's. That's kind of like your recommendation when it comes to this iodine controversy. Okay, got it. Now, you also, in addition to iodine, another thing that you mention in the book as a potential treatment is something called low dose naltrexone. Can you go into why that's something that you've found to be helpful in low doses?

Yeah, so naltrexone is something that I used to be an ER doctor, and we would give that to block opioid receptors. So when somebody came in an overdose of heroin and we give them a big dose of that and knock them out, somewhere along the line, somebody realized in very, very small microdosages.

It enhances but also blocks receptors. And so there's this theory that people with autoimmune disease and most thyroid dysfunction is autoimmune in nature, people with cancer, people with depression, that they have low endorphins. And so what happens is when you take a small dose of what they call it low dose naltrexone, ldn, when you take a small dose. So the dose we used to give was, I don't honestly remember 50 to 100 milligrams in the ER and this is like taking 1 to 4 milligrams. So they realized that if you, particularly if you take it at night, about 9 o' clock at night, your receptors are the highest about I think it's like three or four in the morning. And so what happens is the. And you have to get this compounded by a special pharmacy and it's with a special thing to where it basically gets released right around three or four in the morning when the receptors are the highest. And it blocks the receptors just for a quick second. And so it's basically kind of floods your system. So it blocks the receptors and then they kind of like. There's almost like a rebound effect. So it's supposed to increase your endorphins ultimately. And so by increasing the endorphins, that's supposed to modulate your immune system and enhance your immune system, which then is supposed to help people with autoimmunity. Now I write about this in the book because again, it's like it's out there and there are people. There's a website, I think it's Lowdonaltrexone.org that there are thousands of people writing how this has dramatically changed their lives. I have certainly used it in my clinic. Now, I don't use it as a first line. I want to work through all the principles of my program because otherwise you're just putting on another band aid. It's just a more natural or out of the box band aid, but you're just putting on a band aid. So I still like to work through all the principles. And if people are getting stuck or have reached a plateau, then we'll certainly give low dose naltrexone a try. That I've had some people have good results. I've had other people not really notice anything. I've taken it before, I don't notice anything. But there are, you know, lots of people out there that swear by this stuff. I'm not saying it doesn't work, I just personally have to be honest, I haven't personally had amazing results and I haven't personally had.

Amazing results in my clinic, but there are people out there who have. So I would have been remiss by not writing about it in the book.

But the idea behind it is that when you look at someone with an autoimmune issue, which would be somebody potentially who has thyroid issues, they have really, really low levels of endorphins and what low dose naltrexone does is it kickstarts some of that endorphin production.

Yes.

Okay, cool. Interesting. Yeah, I've heard quite a bit about low dose naltrexone used for a variety of things like Lyme disease, autoimmune, Epstein Barr. So it's really interesting. And that's a total prescription based drug, right? That's not an over the counter.

Yes, that is a prescription based drug that needs to come from a compounding pharmacy. Now. I mean, I have no idea if that's something people can get from Canada or something like that.

Yeah, you could order it online along with your generic Viagra, I'm sure from somewhere not recommended.

And I would recommend that people do that properly just because there seems to be an art. Although I hosted Thyroid Connection Summit and I can't remember who it was.

I can't remember who, but I interviewed 35 different people and somebody I was talking to, I was talking to about low dose naltrexone and they were telling me that they, you know, the standard is to take it at 9 o' clock at night. And he was telling me that in his clinic they were using it at all hours of the day and they were not finding that there was any difference between using it during the day or using it at night. And they had better compliance during the day. So, so that's why he started doing that. But in general, what one is taught is to do it at 9 o' clock at night.

It seems like doing it during the day might have the added benefit of the euphoria produced with that little bit of endorphin release. If you wanted to experience some of the, well, some of the euphoric like symptoms I've used during the day. I don't know if you've heard of this herb before. Kratom. Kratom is an opioid like painkiller. I've used it in the past for injuries, more specifically recently for a back injury just to allow me to function during the day. But you get this intense feeling of euphoria that actually seems to improve productivity and relationships and enjoyment throughout the day. And so I would imagine if low dose naltrexone can produce similar feelings of euphoria, it might be something that patients would prefer to take during the day rather than at night.

Yeah, I mean, maybe I don't know that it's that noticeable.

Simple.

But you know, perhaps what, tell me what you were doing. Just, I was just curious about that and have some.

Yeah. Kratom K R A T O M.

It comes in different strains. You can chew on the leave. You can put the powder into a tea. And it's mostly broken into three different varieties, white, green, and red. And the white is a little bit more kind of like uplifting, euphoric, energetic, kind of similar to coffee, but with an opioid like. Like painkilling effect. Whereas the red is something you take at night that really does knock you out, helps you sleep. And I do a lot of sleep quantification, and I found that I always test things to see if they disrupt, say, like rapid eye movement sleep or deep sleep or elongate sleep latency or something like that. And this seems to give one an extremely nice night of sleep without producing any symptoms. And then they also have a green version, which is kind of like in between the. The euphoric energetic one and the sleepy time one. And so it's really interesting, Herb. The FDA recently tried to schedule it as a Class 1 controlled substance.

I was just about to say I'm Googling it. And here in Austin, they trying to make it illegal.

Yeah. But as of right now, still legal. And I found it to be useful. And it's a nice tea to drink during the day and also to drink at night is like a nightcap, especially if, you know, in a situation like mine where I had to. Some. Some low back pain from a gymnastics injury that was. That was keeping me up at night. I mean, that was a game changer for me. So.

Yeah. So just anybody listening, you would not want to do that along with the low dose naltrexone, because probably not.

Yeah, that'd be a. That'd be a bad one two combo.

Yeah, well, because you're basically you. Well, not. No, just in the sense that it would be, you know, the Lotus. Naltrexone will be blocking that receptor. So it would be making the Kratom basically an act.

Yeah, exactly. You'd be wasting some of your hard earned money because it's not cheap stuff. It's like 20 bucks for an ounce.

Yeah, I just didn't want anybody to be like, oh, what she said was cool and what he said was cool. Let me go out and get them both. And then, you know, then you're kind of negating them.

Right.

Don't do that.

Exactly. And. And then you can throw a little like, weed and Nori and Wild caught fish into the mix and just see what happens to your thyroid then. Yeah. Don't do everything you hear on a show all at once, boys and girls. Okay. So you talk A little bit about detoxification too in this book and specifically you delve into SNPs, you know, these types of common genetic mutations. And I'm curious why it is that you talk about SNPs in a book on thyroid. What's the link there?

Well, you know, in part of my thyroid summit that I did, thyroid connection summit, you know, I interviewed somebody about SNPs and you know, there are not any that he nor I seem to be aware of that are directly related to the thyroid. But I like to look at things as like, what's the one to one correlation? You know, I do this like I don't have enough selenium. I'm, you know, might not make enough T4 or T3. Or I could have high thyroid antibodies versus like what's the secondary effect? I have candida in my gut that creates leaky gut. Now I have a leaky gut and now I have autoimmune thyroid dysfunction. So I think the SNPs are really more that I have MTHFR. So I can't clear heavy metals like mercury. I have mercury buildup that's affecting my thyroid. I need a higher amount of B vitamins than the average person and I need B vitamins in order to have my thyroid function properly. So there's not something that I see as a one to one correlation with the SNPs, at least not yet. I mean they are discovering every day new information about SNPs, but there wasn't anything that I could find as a one to one. It was more these secondary. I'm GSTM1 negative, meaning I don't make glutathione well, so I don't detoxify well. So I keep heavy metals and the heavy metals interfere with my thyroid.

Okay, got it. So are you actually doing like a 23andMe genetic analysis on people who, who have thyroid issues? And if so, are you like looking for, for specific snips?

So I have done 23 on me and my family and we recommend it. So it's not something, I mean that's, you know, anybody can get that off the Internet, 100 bucks, 200 bucks, whatever it is.

And then they'll need to stick that in some sort of software. And I'm familiar with probably about 10 of what I would call the main that I'm aware of. And I can go over that with patients. I would by no means call myself a 23andMe expert. In all 1000 gene SNPs that come back. I know exactly what they're doing. So I look at methylation pathways, I look at things like comt, which is clearing estrogen and caffeine and catecholamines. So there's a handful that I look at that I'm aware of that mostly have to do with detoxification either of hormones or of toxins.

Okay, got it. So the main ones that you would tend toto want to take into consideration would be that MTHFR bar snp, which would be one that, that would show that you would need to take like a full spectrum vitamin B complex, like a pre methylated vitamin B complex. And then the other one that you look at is, is this GSTM1 SNP which could indicate that you need to be taking some form of glutathione. And then those are, those are kind of like the biggies.

Yeah. And COMT is another one. So that's your catecholamine clear through that. So when you don't clear your catecholamines well, you're gonna have high, you know, cortisol, potentially from stress. You're gonna have high estrogens. When you have high estrogens, that binds. Remember when I talked about the bound thyroid is inactive and it's the free that we care about. So when we have higher estrogens, the proteins, there are more proteins and they tend to bind up the thyroid. When you have catecholamines it's gonna compete. And A, you're not going to clear your estrogens. Like everything in the body is interconnected. It's never just one thing. But when you don't clear your catecholamines well then you're going to. And that same COMT clears your estrogens as well. When those are elevated, then you're going to have.

Then you're going to have more or you know, more. Thyroid is bad.

Right? Right. Yeah. And one of the things that I found to be really useful for actually taking your 23andMe genetic test results and exporting the raw data into is another website called. And I don't know if you've heard of this Dr. Amy 23 and you.com and that, yeah, 23 and you.com is fascinating because it, it's like this resource list of all the different websites out there that allow you to import your 23andMe raw data and take a look at some of the SNPs that you've just talked about. Talked about as well as a, a host of other helpful information. You know, probably one of the one of the more well known websites for analyzing your DNA data is Genetic Genie, for example, which actually Genetic Genie, I believe, for all three of the things you just talked about comt. And then the, the glutathione gene and then the MTHFR gene. I think Genetic Genie will look at, at, at your, your status for each one of those and it gives you some really, really cool practical takeaway results too. But there are other websites out there as well, like Prometheus. Prometheus is another common one. But yeah, 23andMe combined with 23 and you, I think is a really cool one, two combo. And frankly, I found it to be almost intuitive enough to where someone can get their 23andMe test, download the results. It's not rocket science, and then upload it to Genetic Genie and you can get some really good actionable information based off of this stuff that you lay out in the book. Yeah, and speaking of actionable stuff, I want to actually kind of turn from some of this nitty gritty science into some of the practical takeaways because you have this thing called the Myers Way, which is kind of like your method, so to speak, for implementing a lot of your recommendations to optimize the thyroid. And I was wondering if you, you could, because you've got specific days of what a Myers Way protocol would look like. Could you walk us through what a typical day would look like? Because in the book you go into what your meals would look like, what kind of your morning habits would look like, what your evening habits would look like. And I think this is really good practical stuff that people could use, especially if they have thyroid issues or really just health issues in general. So can we go through a typical day?

Yeah, so yeah, so I call the program the Myers Way. And you know, we did that. Not, you know, honestly, we were just trying to come up with something. But really I like the name Way because it's really about a way of life rather than it being quick fix. And I'm sure probably most of your followers have already bought into that idea of, you know, this being a lifestyle rather than some 30 day program. I mean, the book is a 30 day program, but my goal is that they really learn something from this. You know, what are the foods that are really become their. No, no foods. What are foods they can add back in? So it's really a tool to learn and then to take on with you for the rest of your life. And so as part of that, I spent a whole chapter talking about stress. I actually went through a toxic Mold exposure. As I was writing this and was super stressed and kind of just talked about all the things that I did to kind of get through that, to kind of keep my sanity and my calm while writing a book and being basically homeless and super sick on top of it. So the morning is kind of getting up and doing something that gets you settled for the day. And that can be anything from if you're a person that is in prayer or likes to do meditation, or you're somebody who likes gadgets and apps and wants to do something like Muse or heart math, and five minutes, if that's all you can do, 10, 20 if you can do that. But really, really starting your day off in a kind of mindful, relaxed way. And then, you know, of course, if you take any supplemental thyroid hormone or something like that, you know, taking that. And then we like to start the day off with some kind of gut healing, either tea or bone broth, because so much of sickness is from, you know, having a messed up gut, frankly. And again, most autoimmune, I mean, most thyroid is autoimmune in nature. And if you have autoimmune, then you likely have, have a leaky gut. So, you know, we move into breakfast and we have, you know, each day is laid out for all 30 days and there are recipes to go with that, you know, at a basis. It's. It's very similar to a paleo autoimmune protocol. I mean, I've tweaked it based on, you know, what I've seen in my clinic, worked for people. So I mean, if you need me to go into details about that, I can. And lunch.

And yeah, we've actually done entire podcasts on the paleo autoimmune protocol, so we don't need to delve into that. But what I will do over in the shownotes, if you go to BenGreenfieldFitness.com ThyroidConnection I'll put a link to some of the more helpful podcasts we've done on the Paleo autoimmune protocol because I certainly recommend it quite a bit to folks, even if it's just for a short stint, four to eight weeks. I'm a huge fan of it because it's pretty easy to follow too. There's a little paleo autoimmune book out there that exists that I really like. I interviewed who was. I interviewed Eileen. Eileen. I forget. Eileen Laird. I interviewed her recently about it. So you work this paleoautoimmune protocol in.

Yeah, and so I Mean my book or you can, you know, either the thyroid connection or the autoimmune solution. I mean, the program's already there. So, I mean, oh, yeah, you have it in your book.

But it's also here in both books. I'm just, you know, giving people a reference point because people seem to understand that I didn't want to pigeon my hole in myself into some autoimmune paleo, you know, place. I want to be agnostic and open to all people. So, you know, I don't tout it as that, but to give your listeners, you know, a reference point, that's kind of what it is. But you don't need to go get a. I mean, if you want to get a separate book, that's totally fine. I don't mind that.

But yeah, you actually do have it all, all in here, the Myers way, step by step. That's a good point. But I do have a podcast of people.

Recipes are here and, you know, everything you need, but probably what you're, you know, so there's breakfast, lunch and dinner and dessert. And then really, you know, here's the next part of it is, you know, as the sun is setting. And I know this is big in the paleo world as well, but I mean, this has been life changing for me is, you know, getting that, you know, a doing something that brings you joy, you know, engaging with your community, your family, whatever that is. And as the sun's beginning to set, you know, beginning to set. Get your melatonin set. This is all about sleep. You know, when we sleep, we detox. Our cortisol goes down, hopefully our melatonin goes up. And so, you know, we have amber light bulbs in our house. I use amber glasses. So that's another part of it is just kind of after dinner is, you know, beginning that wind down. And then if you can, something else relaxing, a hot bath again, meditation, prayer, whether it's muse, whether it's. Whether it's heart math, or if you want to explore even further, float tanks or neurofeedback. I mean, these are not things you have to do, but I just throw them out as, you know, once a week, once a month kind of thing.

So they can be super helpful, though. I mean, I like that how, you know, you go like, for example, I'm looking at day seven in your book, and at the beginning of the day you have a recommendation to relax with heart math, which, by the way, for those of you listening in, that's like, like neurofeedback based on heart Rate variability. I've got plenty of information on it. If you go to BenGreenfeldFitness.com and you do a search for heart math, plenty on there about that Muse, which is almost like a form of guided meditation, you talk about another. Another option would be like binaural beats, brainwave entrainment, meditation, prayer, or breath work. I frankly do kind of like a little variation of almost all those in the morning, and then you have, have, you know, kind of the same thing in the evening before bed. I, I love that. Now you also talk, you, you say, you say to start the day with one cup of the Myers Way spa water. What's the spa water?

Oh, so that's just, you know, lemon water. And it was just trying to make things sound a little better.

Just like, just like an alkalinic beverage to start off the day.

Yeah. And so just. So my first book, I kind of was like, here's a sample day, now go do it. And somehow that was confusing to people. So, you know, as you've written lots of books, you kind of improve upon the process. So in this book, we literally spelled out every day, but just so people aren't getting overwhelmed, you know, that sort of morning routine and the evening routine are the same each day with, again, you can pick something you want to do. If you do all six, great. You don't have to pick any of them or, you know, you can pick one of them to do. So I don't want people to feel overwhelmed. And I also gave sort of, when I talked about stress, I gave things that were free, I gave things that you might want to do every day. And then I gave things that like, you know, probably people are not going to go get acupuncture every single day. I mean, somebody might do that once a week or somebody might only be able to do that once a month.

Right.

And so it, you know, I just want people to know that there's no set tool. I mean, this book should be a standalone book. If you want to get supplements, you can, you don't have to. If you want to get any kind of gadget to track things, you can, but you don't have to. So I really. And also, this book is meant to take to your primary care or endocrinologist, not necessarily a functional medicine doctor. So it was very, you know, my first book was like, you need to do this and you need to see this person and, you know, don't take these meds and, you know, do this program. And this is very much like, hey, you Know if you're somebody on supplemental thyroid hormone. I mean, we didn't even get into my story, which is totally fine. It's actually the first interview I've ever done that nobody has asked me my own.

I know I don't care about the people. I just want to get straight into the science.

But the point is, I've had my own story, which is Graves disease, and I had my thyroid ablated. So I don't have a thyroid. I didn't know me. I mean, I've since helped literally hundreds of people with Graves disease reverse their Graves disease. So, you know, the point of that is, is that, you know, I've been there, and if I don't take my supplemental thyroid hormone, I would literally die. So there are going to be people who need supplemental thyroid hormone. The idea that, oh, you can just completely reverse it and get off of it, if you've had this disease for 20 years. No. Does it mean you don't do the book? No. I mean, it means that you might be able to reduce it. You can at least fix your gut and prevent something else from happening to you.

So the point of that is that this was really. This affects so many people. And everybody does not have access to a functional medicine doctor. And you need to work with a doctor if you're on supplementation supplemental thyroid hormone to get testing. So the book explains what tests, what are optimal levels. There's a letter to your doctor. It tells you your choices for supplemental thyroid hormone.

Yeah, there's a lot in there. And if I could interrupt you because I know folks are. I'll put a link in the show notes over at BenGreenfieldFitness.com ThyroidConnection where you can get the book. But just to give you an idea so you could wrap your head around this, breakfast is, for example, sweet potato and greens breakfast hash with cinnamon apple breakfast sausages. Lunch, I'm looking at day one, actually. Citrus shrimp over red leaf lettuce salad. And then dinner, you've got apricot chicken with some gut healing bone broth. Snack, for example, is some cucumber seaweed salad. I mean, it's good stuff. I can get on this bandwagon that's not necessarily cardboard that you're eating, but it is kind of cool how you walk people through it.

Yeah. And I mean, I would say besides people telling us that their symptoms have resolved and their autoimmunity has gone away, the next biggest compliment we get is how good the food is. So my registered dietitian helped me with this, we eat like this. This isn't just something I threw out there. And, you know, I don't really eat this myself, so. We do. And it is actually good food. Food.

Right. And then you just toss a few of those coconut oil potato chips in there for good measure, just in case.

Yeah, on occasion.

Cool. Well, it's a great book and I enjoyed it immensely. I know for those of you listening in, it seems like about once a month I do some kind of an episode that has something to do with the thyroid. That's for two reasons. One, it's a topic near and dear to my heart with, you know, issues that I've had in the past with thyroid. And two, I wouldn't, I wouldn't keep focusing on thyroid if I didn't see on the blood and biomarkers of so many folks in the crossfitting and the triathlon and the marathoning and the exercise enthusiast community that I look at thyroid issues related to everything you learn about on the show. Selenium, zinc, iron, the T3, T4, reverse T3, all that tends to be dysregulated in a lot of folks these days. And so this is important stuff for you to know because a lot of these things like being tight, tired, being brain fogged, being overweight, having low performance, insomnia, many cases, it really is related to this really, really important part of your system, your thyroid. So the book is called the Thyroid Connection. Amy's other book is called the Autoimmune Solution. They're both really good reads. I like the actionable, practical information. And again, I'll link to some of the stuff we talked about. I'll also link to some of the own little things I've found like the 23andMe and 23and you genetic testing and some of the seaweed sources I've found that are lower in heavy metal. There's a little ebook on Amazon about that Kratom that I talked about that I'll link to if you guys want to delve into that a little bit and everything. I'll put over at BenGreenfieldFitness.com ThyroidConnection so that all being said, Amy, thanks for coming on the show today and sharing all this stuff with us.

Yeah, thanks for an interesting interview. It was great to talk to you.

I specialize in the weird ones. Well.

Cool. So for those of you listening, until next time, I'm Ben Greenfield along with Dr. Amy Myers signing out from BenGreenfieldFitness.com have a healthy week.

You've been listening to the Ben Greenfield Fitness Podcast.

Go to BenGreenfield Fitness.com for even more cutting edge fitness and performance advice.

Sam.