RPM Facebook Live: Thyroid. Todays is all about hypothyroidism in dogs

And it's time for RPM, full of frolics, full of hypothyroidism. And Brendan, Dr. Brendan Clarke, how are you, my friend?

Here as always, enjoying a nice respite from the downpours that we've had for the last 4 days, wrecking my hay crop at the moment. But there we go, just, hey ho, it's always the challenges. So Hi guys, hi Rach Mac and Jane's on as well, so nice to see you all.

Good evening, lovely to see everybody there. Bianca and Deb and actually great to see you.

We've still got a following. Yeah, I thought nobody would turn up because I thought they're out taking photos of our good friend.

They are. I've heard that Brady's been prancing around in his budgie smugglers.

No way.

Seriously, this is what I've heard.

And he's been— and all his fans, and he's got a lot, have been taking pictures. But an intrepid Raw Pet Medics— Brendan, a Raw Pet Medic agent has actually managed to snap him. So if you can just take off the hypothyroidism there for a second. And this is the photo that our intrepid Raw Pet Medic—

there he is!

There he is.

Oh, look guys, you know, and we thought he would be soaking in the south of Ireland and what it looks like he's soaking up something.

Yeah, look at those little white legs.

Oh, bless him.

So there you go, that's, that's Brady.

Oh, that's enough of that. I'm sorry, we're gonna, we're gonna turn the ladies off. They're not gonna be wanting to see that sort of image. If you wondered what we're just talking about, you'll have to rewind and look all over again.

That was, that was Brady on his holidays, but I'm on my holidays next week and the week after, so, uh, God knows what photos we might have. I dread to think what these two have got in store. So, uh, Brendan, have you come across anything interesting in the last week at all?

I've been reviewing some of these books that are being referenced in a lot of the books that we're reading, um, and I had that interesting one that you sent, um, on The— ah, the— let's have a look in Audible because that was, um, you've kindly sent it. And then yet another book that we asked you, um, just go through. This Primal Blueprint.

Ah yes, it's, it's a really good, uh, resume. It doesn't go into a lot of depth, no, but it's basically talking about, um, how and why we should be eating like Our cave person ancestors. Yeah, can you say cave person? It's all caveman, seems a bit, a bit— no, our primal ancestors basically. And this is the reason why we do it. And, and how did you find it? Did you, did you, did you—

no, that's one I think we, we share loads of books, don't we? I mean, just so many books between us, and you know, it's just going through some of those. But they're ref— he's referenced also by, um, Gary Taubes in one of his books. Um, so not the calories one, it's, uh, Keto Diet. Yes, he references him in there as well.

And that's why, that's why I read it. I thought if it's good enough for Gary Taubes, it's good enough for me. Can you just show us that reference again so we can see who it is? It's called the, the Primal What's it called?

The Primal Blueprint.

The Primal Blueprint.

Can you see that there?

And he's called Mark Sisson. The Primal Blueprint by Mark Sisson. And it's just about 6 hours on Audible, so it's quite a slim volume if you read it. And it's a really good just roundup of very simple ways to eat, to exercise. His exercise regimes are fantastic. Basically, you don't really need to break— you I sweat very much at all. You can give up going to the gym. So if you don't like going to the gym, he's your man. Really amazing. Fantastic guy to come across.

And that was referenced in this book by Gary Taubes.

The Case for Keto, which is wonderful. It's Gary Taubes doing what Gary Taubes does best.

Yeah, I think his more recent one, The, which is a bit more comprehensive, was the Good Calories, Bad Calories by Gary Taubes.

Okay. I think he hasn't written anything since about— oh no, he did that one about 2008, was it?

The keto one was about 2008 or 2012. Yes, something like that. And then, yeah.

And then he did Case for Keto, which was what, about 2016, '17? Yeah, and no, not Case for Keto, Case Against Sugar.

Yeah, and that one's after that.

Okay, I can never remember the, the, the sequence, but they're all—

he talks about— even talks about the pandemic in the end of this one as well, I think.

Good calories, bad calories.

Yeah. All right, okay, well, yeah, reference things in there. Anyway, it's really interesting, you know, all of these. So, um, it's brilliant, it's brilliant.

I've got one here. Did you see this, Brendan? This is from our It's nice having lots of room, isn't it? Because when Brady's here, we're all squished. It's absolutely great. I could show you— I couldn't show you this all if Brady was here. So it's by our friend Mike Davis, your friend of mine.

Oh yeah.

Okay. And that was in the, uh, um, the Vet Times. Yeah, well worth reading. And you see, I have a few points that I disagree with him on it.

Just a few?

Yeah, just a few.

So are the green ones you agree and the red ones you disagree? What's going on there?

The, the, the, the, the bluey green is for references that I need to chase, and the pink is where I need to chase him, but I don't know whether I can be bothered because he's just, he's just doing the same old thing. And what, what, what I wanted to share was that in a nutshell, he said, he's basically saying Raw is dangerous and it's incomplete, and you know, all these tired old, uh, unscientific observations. And, and yet he says, uh, you know, there's lots of bacteria in it and you've got to be careful and you should wear full PPE if you're consulting a raw-fed dog, like anybody would do that. And, uh, he doesn't quote one instance of where a dog or a human has been injured through feeding raw food And yet he lists loads of incidents where dogs are being injured, as they are at the moment, through processed food. Um, you know, hundreds and hundreds of dogs he actually references. So, so the ratio is hundreds to one, and so therefore he's shooting himself in the foot. But I don't know whether I'm going to be bothered to write a reply because I'm just about to go on holiday and I'm trying to get everything organized, and I'll get really riled if I write it, and I won't be able to sleep until it's done. And yeah, what do you think?

You know what, all of these guys, all of us, we're all behind you. You don't need to worry about it. You know, leave it to one of us to take him on again. It happens. We do it all the time.

We do it all the time.

You know, it's just one of those— just leave it. You know, we've got other articles out there talking about RawSafe and safety and things like that. We've got You know, so many things that we're dealing with with all of those inquiries about processed foods at the moment. I would take this opportunity, guys, just if you haven't come across it, there is a withdrawal out there on a line of foods from Natural Instincts, just with a salmonella recall on a couple of lines. Please look out for that. If you do use Natural Instincts, just contact them, take a picture, and they give you a full refund. You need to dispose of it. Nothing serious has happened from it.

No injuries.

Unlike the processed foods. However, what we do is as a precaution, we like to just share that and make sure that nobody comes to any harm either. So that's fine.

That's a precautionary recall, unlike the recalls which have killed so far, getting on for 300 cats with pancytopenia. 300 versus zero with the raw food recall. Okay, so I think we should really, really get that in some kind of proportion. So fear not, do your duty, and off you go. And watch for the cats and pancytopenia, and that recall, very, very important, guys.

I would also like to just thank all of the guys that are joining us on Patreon. Uh, thanks so much. Um, you know, it's absolutely brilliant to see you all. I will keep, um, sharing stuff. So that's a very quick one. Some people have been asking me as they come into the surgery how they find it without going through Facebook. That's all you need to do is just go straight online to patreon.com/roadpetmedics. You'll find that we are shortly going to start moving our videos because Facebook is doing some jiggery-pokery with some of them, so they will be moved to there so that you can quick reference them in future. Just, they are not all easy to view at the moment through Facebook, so some are coming up on YouTube as well, which is absolutely fine. And just to reassure you also, guys, lots of people commented on the post about thyroid that we were going to— I wanted to know more about cats, and I want to absolutely reassure you, we are going to do cats. But between me and Nick, we could probably fill 3 hours on hypothyroidism in dogs, and therefore we thought that we should really do justice to hypothyroidism. Whilst our man is off sunning himself somewhere, okay, and whilst he's doing that, we'll talk to you about some real clinical stuff and see if we can at all get through at least hypothyroidism, so a lack of thyroid in dogs, and we'll talk about why there is that lack. But we are absolutely, definitely going to be talking about hyperthyroidism in cats in future. Okay, so please keep an eye out for that. It's not going to be many weeks away, and so we will make sure that we get that done for you guys as well.

Next time Brady's away on holiday sunning himself in his budgie smugglers, we will steal another session to do hyperthyroid, because dogs get hypo, cats get hyper.

And please remember, for all of you guys out following in with cameras, No frontal views, it's not necessary.

It wouldn't be nice.

Okay, grand. Okay, let's get serious. Let's start talking about thyroid. So, Nick, you know, oh, I was gonna let you kick off. Yeah, I'm just gonna ask you a very simple question here. Do you want to just take us through what your view of hypothyroidism in dogs is?

A broad view? Yeah, yeah, good. This is really good because I was wasn't that okay with thyroid disease in dogs because it's— you're taught at college, I was taught at vet college, that hypothyroid dogs are fat and chilly and apathetic, lazy. Okay, that's the classic, those three archetypal. Okay, and if they're not those, then it's not likely to be hypothyroidism. And I went through looking for these dogs and I couldn't see that many. And then I read— sorry guys, another book— I read this wonderful book about 10 years ago, read this wonderful book, The Canine Thyroid Epidemic by Jean Dodds, our friend Jean Dodds, and completely revolutionized my thoughts on hypothyroidism. She talks about something like 40% of aggressive, i.e., not lazy, aggressive dogs in the States are hypothyroid. Thyroid, which goes against everything you're taught. She talks about hypothyroid manifesting in every tissue in your body, from your respiratory system to your eyes to your skin to your liver to your anything. Basically, if it's connected to your body, it can be affected by hypothyroidism, and that revolutionized my thoughts on thyroid disease, and I found that was a real eye-opener.

And how much do you think that was down to the immune-mediated link here? Because that's really what we're talking about.

Well, the immune-mediated link because of vaccination or because of autoimmune disease or, you know, viral disease or something like that. Gene Dodds thinks it's quite significant, but I send off loads and loads and loads of bloods and not very often do we get an autoantibody, thyroglobulin autoantibody. How about you? What's your experience? And give me your, your, your relationship with hypothyroidism as well. I'd be interested. Yeah.

So, well, we've, we've actually, you know, as a practice, you know, the history to our practice is, you know, a long-standing practice that's done holistic medicine. And we've actually had quite a lot of people that have come to us for, for that for many, many years, and we've had some great clients with huskies particularly that we learned quite early on. You know, my first husky that I came across was hypothyroid, hypothyroid, probably 20 years ago, that, you know, and immediately David and Sue, the senior partners at the time in the practice, actually sort of said, this is an odd one, you'll never get this again. Oh, sorry, you'll never get this as to what it is. And I had this really thin, slightly aggressive husky stuck in front of me that was jittery, you know, on edge, had had longstanding behavioral problems. And obviously my interest at that point was actually quite a lot of canine behavior and stuff and feline behavior. And I was looking into all of those things. So I'm looking at this dog and you're sort of like thinking that, well, that's, you know, what's, what's going on here? And sure enough, they bring out the blood test results and, you know, it's hypothyroid and you just blows that image totally out of the thing. So if you've got a dog with behavioral issues, if they're just not quite right and you've done all of the training, you've been through so many other things with your behaviorist and it's just not, you know, coming to, you know, testing that thyroid can be really, really useful. In fact, actually, you know, one of my clients, Lynn, will not be afraid of me talking about a case that we were talking about just last week where, you know, we've got a Labrador that's actually presented in a very similar way. And I wonder over the years how many of those cases of hypothyroid have been missed for this whole thing that we've been— you know, it's almost ingrained into us at university that they're, as you say, the Labrador ladies, lethargic, overweight, you know, just so readily putting on weight even though they're not eating very much, all of that side of things. But Really, you know, looking at Gene Dodson and understanding a little bit more about that, because we have had some positive thyroglobulins, and it is actually— does seem to be only in a very early phase that you see significant amounts of this. And as you miss that phase and you go into longer term, it seems harder to pick up those cases of active thyroglobulins, um, in the system. But to me it is an autoimmune disease against something that is normal within the body. And therefore it fits around all of those immune-mediated diseases from IMHA, so immune-mediated hemolytic anemia, IMTP, you know, the thrombocytopenias, you know, all of those diseases where the body is recognizing something that is normal, creating an antibody to it and actually then attacking it and destroying it. And so, and this can be because of infections, surgery, vaccines we've talked about. All of these are noted, you know, if you look at Michael Day's book on immunology, you know, one of those main books that conventionally we look at immunology.

Professor Michael Day, God rest his soul.

Absolutely. All of these are noted as, you know, in that book as inciting causes to autoimmune disease. So it's not a case of, oh, it can't possibly be, you know, there's so many things that all it takes is something to glue on or be associated with an existing structure within your system and the body can start to recognize it as foreign, especially if there's a protein around that structure.

Yeah. Jean Dodds, when she's looking at— just before we get into a little bit further in the thought process, what I do, because I really like the idiot's guide to everything, and for me, the idiot's guide to thyroid disease is if the disease process that you're looking at doesn't make sense, test for thyroid. Okay, if you've been back to the vets and they're kind of scratching their heads and thinking, crumbs, we don't know what is going on here, and they haven't tested the thyroid, I think that's a very good place to start. It's probably bad medicine, but actually in the practical world, it's a very good idea. And the other thing is epilepsy. Epilepsy can be a very early manifestation of hypothyroidism, so you must get some blood to Jean Dodds because she has a testing regime where she tests 5 parameters including the autoantibodies whereas in this country we only test TSH, thyroid stimulating hormone, and T4. Do you want to just take us through why that might not be as ideal as, as possible? Yeah, I'll chip in.

Yeah, I mean, should we just show what the structures are? Because we've got, you know, let's, let's do a little bit of this. And sorry guys, if we're taking you a little bit sciencey while good old Conor's not here, but What we're going to do is just show you that there are several elements that, you know, tyrosine is effectively an amino acid that is, you know, part of the precursor, and a couple of those molecules together then adorned with iodine, okay, creates your T4 structure. So that's one of the things in GeneDODDS. Now, how this is bound and protein-bound will mean that there's free T4 and there's protein-bound, so a total T4 levels that you will look at.

Okay, when it's bound, it's bound to a protein and that's basically it's being delivered and it's not active. Yeah, uh, the free T4 is where, where it actually leaves the delivery truck and actually gets active. There's only about a thousandth of that, the active stuff, but that's really, really important and that's, that is relevant, guys, bear with us.

And then the other parts is going to be a T3 and 3T3. So again, that's in the Gene Dodds survey. Now these don't get measured in the UK. Now ridiculously, for the same cost as it takes to cost to, to do the bloods for a TSH and a T4, you can send these bloods to the States and get them run. Okay, that's, that really is where it's at, which is why we generally will send, unless it's just an initial screen with all of the other blood parameters, and people are looking at, and we're going to touch on that in a moment as to why that can be misleading. Then we sort of like, if we want to be specific about the thyroid, we will send it to GeneDots and they also then add in the immunoglobulins against the thyroid hormones in this array. And that usually gives an absolute that this is an immune-mediated thyroiditis that's dealing with it, that we're dealing with here. So that gives you a rough idea of what the structure is.

Okay, let's close that because the way I look at that, guys, just again from a simple point of view, is the, the, the 4-iodine form, T4, they call it T4, 4 iodines is the, is kind of the precursor, but it only really, really gets going when it gets to T3 with 3 iodines.

Yeah.

And that's so that's as much as you need to know. There is protein, there's certain things in there. Remember iodine, because if we're going to be supplementing, we'll talk about that later. Sometimes adding in iodine can be useful. There is also the amino acids and you might want to think about supplementing in some tyrosine, etc. Those are things that we would consider there. But that's enough of that science. Let's talk a little bit more diagnostics.

Can we just go, just make sure the diagnostics, just to say why? Because if you, if, if we, because of what we're talking about, you're going, oh my God, that's my dog, um, maybe sudden aggression for no good reason in a youngish dog, 2-year-old, 3-year-old, 4-year-old, something like that, that then, then I would very much be thinking about, uh, hypothyroidism needs to be ruled out. But you go to your vet and they'll say Well, why am I going to send some blood to California? I can do the test, I can measure TSH and T4 and we're good to go.

You can do free T4 as well in the UK. And I think there is a lab just starting up on the antibody in the UK, but it's really hard to get hold of that. And actually, you know, it's not just about the results, it's also about the people behind it that can give you the information on reading those.

So if you go to your vet in the UK, they'll say, we'll do TSH and we'll do T4. Now, for many reasons, and I'm not going to go into them, I always say just measuring T4. Yeah, Gene Dodds does T4, free T4, T3, free T3, okay? And in the UK, we just do T4, and I think that's like checking one wheel on your car for the inflation pressure, and then assuming you know what the inflation pressure is on the other 3 tyres on your car. Okay, it doesn't work. It doesn't actually work like that, but it's a great way of thinking about it. T4 on its own is not that helpful. And TSH, thyroid stimulating hormone from your pituitary, hits your this. In the UK, that's what we use. And in humans, which is where most of this information comes from for our pathologists, who are generally brilliant, in humans it's a really accurate test. TSH tells you exactly where you are with your thyroid. But with dogs, that's— there's a 30% chance it's not going to accurately reflect what the, what the, the state of the thyroid function is because TSH in humans has a really long half-life, about 5 days, but in the dog it has a half-life of about 12 hours, so it can go like this. Okay, so that's why we send them to, to, to, to Jean Dodds. The other reason that we send them to Jean Dodds is that she's been measuring all these bloods from every breed from a Chihuahua to a Great Dane to a, to a Saint Bernard and everything in between.

And every, you know, males, females, neutered of, of both sides, and on, and every age within those breeds. So she has this mega, mega, mega database that she can, for whatever breed you send, whatever sex and whatever age she will have 300 normals and abnormals against which she can judge your dog's particular age, breed, sex, blood. I think that's really— that is invaluable. That is astronomical. So yes, in the UK you can measure T4, maybe you can measure free T4, you can perhaps measure thyroglobulin autoantibodies, but you haven't got a million data points on your reference library to compare them against. So for me, it's a no-brainer, and if it's the same price, then why wouldn't you?

But where do you stand on all that?

So I think the other thing that, you know, we've seen a few comments going up in the comments line about T3 and why, why bother with that. Um, that there is a condition which, especially when you've had chronic illnesses called euthyroid, okay, where the T4 levels can dip, okay. And, you know, remember the range, let's say in the UK, the range generally will be between 13 and 53, I think it is 55.

Yeah, yeah.

And anything that actually is in that lower third of the range becomes suspicious if there's other symptoms that you think, well, actually it could be considered there. Now, especially if they're off the bottom end of that range, then obviously it becomes even more likely that there is a hypothyroidism. However, we also see a decrease in those— that, that T4 level where there is chronic sickness. And so determining whether it's a primary hypothyroidism or a secondary issue to long-term illness becomes more of an issue. And that's the beauty of having a T3 level, because if you look at certain ratios, if there is a— I believe it's 25:1 ratio— you can determine that actually above that you have got hypothyroidism rather than a euthyroid. So there is that ratio that they, they actually stay on their results for you to determine.

It's very in-depth analysis because what happens is if you get ill, your thyroid can go, oh blimey, let's just calm things down so that we're not putting fuel on the fire of the disease process, if you like. That's a pretty simplistic way of looking at it. But basically the body can slow down and make it look like you're hypothyroid, but you're not. It's just because you've got changes because of— you've got skin disease or liver disease or whatever it might be. So interesting stuff, really interesting stuff.

It looks like— bear with us, guys, it does look like Nick goes a bit muffled occasionally. I think there's waterworks between me and him in the cables, but I'm sure he comes forward, he speaks clearly, he's fine. I could understand what you're saying, Nick.

Okay, sorry.

I think they just love seeing you in Technicolor and hearing the crispness of your voice.

Of course they do, absolutely they do. Jane Johnson, yeah, I've gone muffled. I'm at the office. It's the best broadband I've got. I'm not at home. I have to come here.

Just imagine if he was at home.

Yeah, yeah, you wouldn't be able to see, hear, or anything, me. You might get the smoke signals perhaps in about an hour. So let's have a look. What about any cases come to mind apart from your initial husky, which is really interesting? Because that broke all the rules, and yet it was a hypothyroid case which would have gone undetected if you were just using the normal parameters. Any cases come to mind? I've got one that just, just that's come to my mind.

Yeah, I mean, it is so chronic skins, you know, this is another thing that we look at here. So, you know, if you've got a dog that has been suffering with alopecia, so hair loss, okay, but actually probably you've taken it because it started to itch and it's had a bit of a rash and pustules, and then you treat that and then it comes back, and you've assumed the hair loss is because of the chronic skin problem, and it's been dragging on for, you know, months, and it may be aseasonal, so it's not happening, you know, it seems to be chronically coming back through the year, and you've been thinking about allergies, and, you know, you've been ruling everything out And actually those are the cases that we're often looking at in these circumstances, poor skin health, poor general health that I would, I would definitely say are ingrained in us to look at and anything out of that ordinary. You know, there's a lot of vets that will think of a lot of other differentials before they'll jump to thyroid. So you do need to bear with them a little bit on that. And You know, if they happen to be doing bloods for anything else, that's a perfect opportunity to just say, whilst you're there, could you ask them to run a— even if they just run a basic T4, but ask them to reserve enough serum that if it comes back low, there's another test that could be done.

Jane Dodd says if your T4 is even in the bottom third, so if the range is between 13 and 52 and you are in the bottom third, whatever that would be between 13 and 25. She says that is grounds enough.

30, I think.

13 and 30, I think.

There you go. Is that the bottom third? Okay, I'll leave that. Yeah, okay. So dermatologically, in the book— and I would say everybody who's got a dog should get this book because it's, it's so valuable, because, uh, you will know an awful lot about thyroid disease— these are, these are the symptoms she talks about. She says dry, scaly skin and dandruff, but that could be any any disease, any skin disease known to man. Chronic offensive skin odour, that could just be Malassezia, but it could be hypothyroidism. Coarse dull coat, could be anything, could be bilateral alopecia, so losing hair equally on two patches either side of the spine. A rat tail, now that is a cracker. There aren't many things that would give you a rat tail, a puppy coat in a mature dog. There's not many things that would do that. So these are, these are— we're getting into the real nitty-gritty here. Um, greasy coat for no good reason. If you've got a Westie, then it might be because they're a Westie. Um, uh, grease and dry coat. Now that is a bit bizarre. And as soon as you start getting into bizarre symptom territory, for me that's thyroid. Yeah, that's when you think, wow, this doesn't make sense. Ah, let's check the thyroid. Hyperpigmentation for no good reason. Obviously, if they're scratching like mad, they will get hyperpigmentation, which is basically you get this deep, deep, deep black dark kind of suntan effect where the skin has been inflamed over a long period. And infection. I've had a case where before I really knew any better, I I had this case, she was, she was, she had recurrent, it was a lab, and she was having recurrent infections. We just couldn't get rid of it. We're trying homeopathics, we were trying, we were trying herbs, we were trying diet, the works. And yet she kept on coming back with this. And eventually, we worked out that it was, and I probably read the book around that time. And it was a really obvious hypothyroid case.

So, and I think, you know, those things like poor healing, uh, as you say, but I mean, one of the major differentials, you know, we'll be talking about Cushing's disease, which is an excess of corticosteroids.

Yeah.

But, you know, one of the major reasons that hypothyroidism, a lack of thyroid hormone, can give such a varied and wide-ranging effect is actually, you know, it's a big controller for our metabolic rates, our metabolism. And if we put that out of kilter, I think that actually, you know, is why we start to listen out for slow heart rates and all of those aspects. Yeah, we've got loads of questions in about, um, you know, these other commonly linked things to other endocrine diseases. Um, you know, I think a lot of people have asked why that might be. Now, in my mind, I've got— I'll go back to— because I think once you've started to link inflammatory disease and immune-mediated disease together, the immune system's heightened and active against all of the things that inflammation will be aggravating it to, and that's all of your own tissues. So I could understand why you're starting to get things like the seizure activity. You know, I see that as an immune-mediated disease in quite a number of dogs. If I give them treatments to treat that, I see a lot of those cases reduce without the need for drugs, etc. So I don't see why that it's necessarily a direct link to the lack of thyroid hormone. It may be a link to the underlying predisposition to disease that's going on for that.

On a very, really practical note for a second here, Bren, people are going to say, How can we get our— how can we get bloods to Gene Dodds? We've got 10 minutes left until we knock off, so I'm just thinking let's get into some real practicalities. So either you're there— if you— I would suggest get the book. You can get it on Kindle, so you can get it this evening.

If you're not a big reader, then at the end of every chapter, she does a really key points, okay? So you can, you can get this book in your head before you go to bed tonight, okay? Really amazing. If you're, if you're suspicious and talk to your vet, obviously, um, there are several ways you can do it. If you look online, she will say this is how you get blood to me, or this is how your vet can get blood to me, but it's a pain because, um, US customs is a pain because they're biological samples and blah blah blah. So what I say to people is if they say, can you help me with this? I'll say, if you send— if you'll get your vet to send me 2 milliliters of serum, I will send it off to GeneDOS because we're sending bloods off to GeneDOS probably every week or so. I'm not sure whether you offer that too.

We do, yeah, you know, absolutely, because we're sending it off, you know, on a weekly basis. Pretty much, I think the US Customs, you just need to make sure it goes by airmail. It needs to be fresh. You don't want, you know, stuff that's been transported around for 2 or 3 weeks. Okay. And it must go airmail. It must be marked appropriately as a non-pathological specimen.

Okay.

She will guide you with all of that.

Yeah. So that's all in there. You must get the serum spun down and separated. You don't want the red cells breaking down and leaking into that serum. So we do actually have quite a number of clients that come for referral that will get their local vet to draw the blood, spin it down, separate it, and then they send the serum to us because that takes 24, 48 hours tops. Okay. And then we literally send it airmail and it arrives at Jean's door, you know, within the next 24, 48 hours. And she's happy to run those. So it is, you know, it is a service that we run, but I guess there are ways for you to do it through the book. Have a look at that and, you know, work it out. But if you are going to post it yourself, do go to the post office, do make sure it goes airmail and registered.

So you've got 4 methods: your vet follows the instructions and sends it to Gene Dodds. Absolutely great, fantastic. Your vet takes the blood, gives it, gives the serum, the spun juice from the blood to you, and you put it in a package, take it to the post office and send it off to Gene Dodds. Absolutely fine. Or you can send, you'll be in communication with Brendan and Brendan's team and send him the serum. Make sure you get enough. Or you can send it to me and we can send it. However, I'm away on holiday for the next 2 weeks, which will actually give you 2 weeks to read the book. And if you want to ask more questions, then come join us on Patreon, and we're very happy to go further with the whole—

maybe we'll put a protocol of how to send the bloods and stuff on there so that people can understand that, you know, that method.

Yeah, okay, yeah, from, from the Hemopet website. Oh, Hemopet is the lab. H-E-M-O, because they're Americans, H-E-M-O-P-E-T, Hemopet. Yeah, and Jean Dodds is a real magnificent person. She's, as well as, you know, she was in on the ground floor of, of AIDS and that immunodeficiency virus in the '80s, you know, she was one of the lead researchers with that. So she really knows her stuff, and she does a lot of work with, with greyhounds and doing blood transfusions, hence Hemopet, for, for that. She really is a star, and she's, she's, she's not the youngest person in the world, but her energy is unbelievable. She still answers all her own emails.

And I think this is a, this is a good Aria, if I can just then draw you on to this, Nick, because I know we were going to talk a little bit about this. So, uh, Lynn's sort of talked about a few things that we wanted to touch on, which is, are there other options, um, uh, to helping the thyroid? Because the classic is that we're going to substitute for these cases a false thyroid hormone, okay? We're going to effectively supplement them to bring their thyroid levels back into the normal range. And that's why we monitor those levels so we get that level right, because every dog's an individual. And so we would be looking at monitoring those with following bloods. And that's certainly what Jean advocates, is actually using the thyphorons or the, you know, those thyroxine supplementations. So there are some other things that we've come across, and Lynn's highlighted a couple here, using iodine-rich foods. Theory around that, Nick, as to why that might be a good thing to do?

Well, if you're for some strange reason you've got a problem with iodine metabolism and you overwhelm the supply, your thyroid then goes, oh, thanks very much. I can now make some T4, which then can knock off the iodine to make into T3. And thank you very much. We can, we can move forward. I think that's— it's as simple as that. You know, if there's some strange quirk, then you just—

building a pathway, isn't it? It's a load of ingredients, then it's more likely to form an end product than push, push, push it down through.

I have had one or two where we've been able to gradually reduce the thyroxine treatment, and, uh, and but I always say, listen, let's get stability, let's clear that skin up, let's get that heart rate up, and let's get the whatever the fits, the behavior, let's get that under control and then we can worry about coming off the thyroxine with a stable patient as opposed to having an unstable patient and going, oh my God, I don't want to give thyroxine, I want to give herbs instead because thyroxine is a known quantity. And if you, if you dose like Jean Dodd says, which is dead easy, it's just an hour before or 3 hours after food, i.e., an empty stomach. Every 12 hours, away from food and away from soya products. That's it. In this country, I still know vets who— and we're probably taught at vet college— that you just chuck it in the food and off you go. That doesn't work because food will differentially absorb onto and into the thyroxine, will change. So it means that every day you're getting a different dose of thyroxine, whereas if you do the Gene Dodds method, 1 hour before breakfast, then you get the same dose every single day and the body says, thank you very much. I understand. I know what to expect and I know what to do with it.

Yeah. And I would say those— that's another really important— people, people, for everybody out there, people forget when you're taking the monitor service bloods as well, you know, 5 to 6 hours post-tableting, please don't give them loads of food because if they're really lipemic samples, okay, we do have some issues. Okay, fatty samples, they do have some issues reading those. So we just prefer, yeah, as with all bloods, you know, so many people we see have gone to vets and they've had bloods run and they haven't standardized things like starving the dog for 12 hours prior to the bloods, taking them in the morning, because that's what the standard curves generally are run on, and so if you fall out of that with how you're sampling your dog, then, you know, there's a lot of other variables that start to come in. So we would say that if you're going to have your dog's blood tested for anything, remember that the key things generally, unless there's another condition that contravenes this, I would just say, or is contraindicated by this, starve for 12 hours, get the appointment for the morning. Okay. And then when it's thyroid, when it's tableting, there's a couple of medications and this is one of them where it should be 5 to 6 hours post the medication that you're testing the system.

Yeah. So if you dose at 7:00 in the morning, you want your appointment for about 4 and a bit, 4 and a half hours later. Okay. Because you've got this window because in the blood, the thyroxine goes up and then goes down and you want to hit it right at the peak every single time, same every time, because then you're measuring oranges against oranges, not oranges against apples or oranges against apples when it's on a different point on the peak. Okay. So the easy way to say it is like if you dose at 7 in the morning, an hour before breakfast at 8, then 7 minutes, so it'll be an 11 o'clock appointment. Yeah, because then that gives the practice 2 hours in case there's emergencies or something. They've got 2 hours grace period to take the blood.

Yeah, so there was one last thing because we're right at the end, guys, and it's been really great to see all of you supporting us and coming along to listen. There is one question around ducks' necks And, you know, is that a problem? Is that a cause? Is that a solution to hypothyroidism? So here we go.

It's— you want to get into that?

Well, I think, look, so many in, in the UK, we don't generally see thyroid tissue remaining in the neck material. It is effectively stripped out. Okay, and because this is exactly where Nick is pointing is where the thyroid gland sits for all animals, okay, including bird life. And those two thyroid glands, and we talk about this a little bit more in cats when we talk about hyperthyroid, okay. You're now worried that you've got a goiter, is it?

The Adam's apple, mate.

The thyroid actually develops in the embryo within the chest and moves its way up. Now, for cats, that's, you know, something that we will talk about in hyperthyroidism. And so do join us again when we talk about that. And that's where feeding excess thyroid hormone or excess iodine could certainly be a consideration of a problem if they've got a tumor of that gland. When we're talking about hypothyroidism, okay, then really in this country, certainly feeding duck necks is really not going to be a problem. I mean, feeding raw is great because you're reducing generalized inflammation, you're reducing generalized disease, you're improving health. You are therefore helping your dog manage the situation. I think when you've got— if you're trying to supplement, we've talked a bit about organotherapy where you treat a condition with organs. Yeah, we've done this with pancreas for dogs which have lack of pancreas enzyme. Okay. We've talked about it for in diabetes cases. Is that going to help? But I think that's more about the fact that you're giving a good keto diet rather than necessarily that you're supplementing insulin into the diet. And we've talked a little bit. This comes along. Yes, you are. Just like you're giving a false thyroid hormone if you get hold of a thyroid glandula. Yes. And it's fresh. Yes, you will be supplementing an amount of thyroid, but it's too unpredictable as to how much you're giving. And because the thyroid gland from one duck could be totally different to the thyroid from the next stuck and therefore you are not able to know exactly how much you're supplementing. So it's a bit of a fly-by-the-seat-of-your-pants approach if you do go down that route of using glandulars to try and treat hypothyroidism.

And in the UK, yeah, in the UK, ever since BSE, it's been a no-no to feed glands to any, any animal. Yeah. So basically they make a beeline in the abattoir to remove that from beef animals and pork and sheep and what have you. So you might get a tiny little bit with duck necks possibly, but not really that much. And you know, one neck will have it, one neck won't because it was cut a little bit lower. So a bit unpredictable. There was a case about 20 years ago in Germany or Poland where there was a dog with hyperthyroidism, and because it was eating non- he was eating lots of thyroid tissue, loads of trachea which had the thyroid still on. But it's really rare. They removed the thyroid tissue and it got better. And I've seen one or two like that where somehow they've got hold of thyroid tissue and the dog is hyperthyroid, which is like hen's teeth, really, really, really rare.

And I'm guessing, yeah, that the other option here is if people are getting whole animals, so rabbit, duck, that'll happen in those circumstances, or stuck, you know, pheasant from the shoots and things like that, and they're feeding particular parts of the— maybe the shoot is taking the breast and the main part of the bird, and then they're giving you the remnants like the necks. Then there is a possibility, and you're absolutely right to highlight that those could force a normal dog into hyperthyroid. Yeah, but you'd have to be, you know, feeding quite a lot of that very specific material to really sustain sustain that for any length of time.

Yeah, very much so. And, um, and it's dead easy to treat. You just withdraw the thyroid tissue and off you go. They will just—

they'll—

within 6 weeks they'll probably be right. Yeah, right. Fantastic. Great. So, um, I'm not around next week, uh, so what are you guys doing? No doubt going to be putting up rude and derogatory pictures of me.

Well, I'm sure we'll find something, Nick. Yeah, um, okay, but, uh, we'll try and keep it reasonably clean. Uh, but for all of you guys, I look forward to seeing you next week. And I, you know, again, thanks to all of the guys on Patreon for this.

Thank you, Patreon people.

We'll be answering as many of these queries as we can over this coming week and getting back to you about that. I look forward to, uh, picking Conor's brains on something nutritionally succinct next week and we'll take you through that. He doesn't do anal glands. I think, I think we were going to do anal glands whilst you were away and the picture will be of a butt and anal glands between us.

Very nice.

But there we go, that's fine. We will have a little look at that. I look forward to speaking to you all next week. Look forward to your questions. Take care, see you soon.

Brilliant, brilliant. Thanks guys, be good. Look forward to seeing you in 3 weeks after