The ROOT CAUSES Of Autoimmune Disease You NEED TO KNOW! (How To Prevent It) | Izabella Wentz

Hashimoto's and hypothyroidism can affect brain health in various types of ways. One of the most severe consequences of Hashimoto's on the brain is known as Hashimoto's encephalopathy. Autoimmune conditions occur when the immune system starts recognizing a part of the body as a foreign invader, much as it would a virus or some sort of a bacteria, and then an immune system attack is geared toward that part of our body. There are various types of autoimmune conditions out there. The one I specialize in is known as Hashimoto's thyroiditis. It's the most common autoimmune condition worldwide, and it results in an underactive thyroid, or hypothyroidism, because the immune system launches an attack against the thyroid gland. Hashimoto's and hypothyroidism can affect brain health in Various types of ways. We know that there could be an autoimmune response against the thyroid gland with Hashimoto's that can cross-react potentially with some brain antigens, and we may end up with an autoimmune response against the brain. One of the most severe consequences of Hashimoto's on the brain is known as Hashimoto's encephalopathy. Now, this could be a life-threatening situation, and people are oftentimes gonna present to an emergency room with this kind of situation, pretty some severe neurological symptoms. There are also more subtle consequences that may occur with Hashimoto's and the brain. What we commonly see in most people with Hashimoto's is that they'll have brain fog, where their brain activity is just not as quick as it once was. So they'll have a slowing down of their thought process. They'll have trouble finding words. They'll walk into rooms and forget why they got there. We also might see other types of effects where a person might be depressed. They might become more sluggish in the way that they act and the way that they move. We also might see people having symptoms of anxiety, panic attacks. I've seen people with being diagnosed and misdiagnosed with depression, with bipolar disorder. And I've even seen some people being misdiagnosed with psychotic disorders when in fact they actually had Hashimoto's. What happens with Hashimoto's is we have this autoimmune attack against the thyroid gland which then causes a fluctuation in our thyroid hormone levels. Thyroid hormone levels impact everything, whether that's our brain function or our energy or our digestion. And sometimes these fluctuations can cause anxiety, they can cause mania, they can cause withdrawal, they can cause depression. And in the most severe cases, we'll also see that some of these thyroid antibodies may cross-react with brain antibodies, and this can manifest as Hashimoto's encephalopathy. Hashimoto's is much more common in women. Different studies will say that for every man diagnosed, there will be about seven women who are diagnosed. And hormones, especially female hormones, are thought to play a role in that. So viruses are thought to contribute to autoimmunity in a couple of different ways. One of the most relevant autoimmune theories to how viruses can trigger autoimmune disease is known as the bystander effect. And basically what that means is that the immune system will attack the virus and whoever is an innocent bystander. So in the case of autoimmune thyroid disease, there may be a virus that's infecting the thyroid gland. The immune system will go after the virus, but it'll also go after the home of the virus. And that happens to be the thyroid gland, which in this situation is this innocent bystander that gets attacked because of the virus that's in there. And so what we can do to help autoimmune thyroid disease and what we can do to help other types of autoimmune conditions is we can treat the viral condition. With conventional medicine, there are not a lot of options for many of the different viruses out there. There are some antiviral drugs that can be helpful for specific viruses and they can suppress the viral replication. most of the cases they're not able to eradicate the virus from the body. There's also some herbal antivirals that can be utilized. I've had really good results with antiviral known as Lomatium. And this is something that has shown a lot of benefit in people with herpes type viruses, including the Epstein-Barr virus. Another way that we can target viruses is by supporting our immune system. And some of my favorite strategies for that are going to be utilizing vitamin D, getting plenty of sunshine, getting plenty of rest, as well as using immune supporting mushrooms. With autoimmunity, the theory is that the immune system is over responsive, and that's why it attacks our own cells. In reality, my theory is that it's doing its job. It's doing what it's supposed to be doing. and that it may have some messages, whether that message is coming from an infection, like a virus through the bystander effect or some other mechanism, where the immune system for whatever reason is meaning to attack something that's foreign to us, but instead ends up attacking a part of our own body. With low immune function, when we suppress our immune system, and a lot of times this can be done through immune suppressing drugs or the monoclonal antibody type drugs, our body and our immune system is no longer able to fight infections as effectively. The standard approach to autoimmune thyroid conditions and all autoimmune conditions in general is severely lacking. With the standard approach to thyroid disease, for example, people will go for as long as 10 years of not being properly diagnosed because Unless it's a functional medicine practitioner that's doing the testing, the physician generally doesn't do the right tests. With thyroid disease, with Hashimoto's, which is the number one cause of thyroid disease affecting 95% of those who have hypothyroidism or an underactive thyroid, the earliest tests that are gonna be elevated are gonna be known as thyroid antibody tests. When these are elevated, this means that there's an autoimmune response against the thyroid gland. After a while, these antibodies will start attacking the thyroid gland, leading to a breakdown of thyroid tissue, and over time, the thyroid gland will no longer be able to produce enough thyroid hormone. And this can take one year up to 10 years, depending on how aggressive the condition is. for some people it might be even longer. With the conventional medical approach, the approaches to test TSH, which is the thyroid stimulating hormone, which is a hormone that's released when there are low levels of circulating thyroid hormones. Now, this happens after the thyroid gland has been under attack for many, many years, is no longer able to compensate and produce enough thyroid hormone. And so a lot of times people will have symptoms for 10 years before they're diagnosed. I was one of these people and they'll go to their doctor and they'll say, Hey, I think there's something going on with my thyroid. Or, I think there's something going on with me. Can we do some testing? The doctor will run the TSH test, thyroid-stimulating hormone, and this result will be normal. This will come out normal because the thyroid gland is still compensating, yet the person will have many symptoms and had the doctor just ran the thyroid antibody profile, they would have been able to find that the person's thyroid gland was under attack. Proper treatment at that point would help eliminate symptoms, prevent the progression of the condition, and potentially reverse the condition and even prevent the need for lifelong medications. The other issue with the conventional medical approach is that there's only one drug used to treat thyroid conditions, and that is thyroid hormone. So imagine if you have something attacking your thyroid gland and the response is, well, it's under attack, so once it burns out, we'll just give it some of the hormone that it's no longer able to make. But what about addressing why the gland is under attack, right? And so a big part of the root cause approach is trying to figure out why is the immune system attacking the thyroid gland? and what are some of the consequences of autoimmunity and this inflammation in the body? A lot of times we'll find that there are numerous things going on as well that can help the person feel better and reduce this autoimmune response. In my area, I look at nutrient deficiencies, food sensitivities, an impaired ability to handle stress, impaired ability to handle toxins, chronic infections, as well as gut issues. Another piece of the puzzle with thyroid conditions specifically is thyroid hormones. Most conventionally practicing physicians will just utilize levothyroxine or T4. This is just one of the thyroid hormones and it's not the most active thyroid hormone. T3 is the more active thyroid hormone that needs to be converted from T4. On paper, this happens perfectly every time. you give a person T4 and that should get converted to T3, but this doesn't always happen. What we found is that giving people T3 directly can help significantly with symptoms. So we'll see people who will have better brain function. They'll say, finally I feel like my brain is attached to my body. They will finally be able to lose the weight that they had they were carrying that was extra. And a lot of times they'll be able to grow their hair back when T4 medications alone couldn't do that. Some of the medications that can be helpful include T3 only medications that could be added to a T4 medication like levothyroxine or synthroid, as well as natural desiccated thyroid medications or compounded T4, T3 compounds. In full disclosure, I was never interested in thyroid health during pharmacy school. In fact, I thought thyroid conditions were very boring because if you had an overactive thyroid, you just took a medication to suppress that, and if you had an underactive thyroid, you could take a medication that would provide you with the thyroid hormone you were missing. And I really thought that was all there was to it. It wasn't until I became diagnosed with a thyroid condition myself after almost 10 years of some sometimes debilitating and oftentimes very confusing symptoms is when I really became interested in thyroid health. And that's actually how I became a Hashimoto's expert. birth slash human guinea pig was through trying to take my own health back because doctors weren't able to help me and every year I just kept having more and more symptoms and I felt like I was really losing myself. It started during my first year in undergrad when all of a sudden I found myself struggling with debilitating fatigue. I used to be this really type A student and I was always bright-eyed and bushy-tailed kind of teacher's pet getting All really good grades. And then all of a sudden, I was missing my classes because I was too tired. And I would come home from class and I would say, I'm gonna study all day. But first I'm just gonna take a little nap, right? And I would take a nap at 1 o'clock or 2 o'clock, whatever time class got out. And then I'd wake up the following morning. And one of these times, my exam had already started. and I was late to my exam and I hadn't even studied for it. And this was just not me. And I was very confused with what was happening with me. I just was tired all the time. I required like 12 to 14 hours to really feel like myself. I wasn't really the person that I used to be. I used to be really bright-eyed and bushy-tailed and energetic and all of a sudden I had a hard time getting out of bed. I had a hard time being motivated. I felt depressed. I felt confused. I felt conflicted all of the time. I felt anxious. And this sort of went on and there was nothing wrong with me according to the doctors and the clinics that I saw. And eventually I just learned to deal with it and I started to change my life around to really fit my condition and my health struggles. So instead of going out with friends, I would sleep more and find times to study instead of doing fun activities. I became really efficient at studying, I guess, and eventually I got into pharmacy school. And then during my first year of pharmacy school, I ended up with irritable bowel syndrome. I used to have to run out of class to go to the bathroom. It was quite embarrassing, right? Then as time went on, I became a pharmacist and I developed more issues. I had acid reflux, I had carpal tunnel in both arms, I started to have panic attacks, I started to have hair loss, allergies, and it was ridiculous because I just felt like my body was breaking itself apart. And I kept going to doctors and I was a good girl. I was eating healthy foods, right? I was eating whole grains and low-fat dairy and I was trying to exercise yet I felt like crap. I would wake up in the morning, go to work, come back home exhausted, eat something, fall asleep on the couch, and repeat that every day. I had all these dreams and goals and passions, but I was too tired to follow them all. Any of them, really. And my hope for other people with any kind of health challenges, mystery symptoms, mystery illnesses, I want you to know that it's not in your head, that there are oftentimes root causes that we can find through functional medicine to optimize your health and give you your life back. And really, really invest in yourself, really trust in yourself. If somebody, I know a lot of times people are told that they're hypochondriacs or that it's all in their head. and this is the disempowering message they get from conventional medicine, whereas in functional medicine we realize that the patient often is the first one that knows what's going on and they feel it within their bodies. Anxiety is often a sign that something is off in your body. I chose a career in pharmacy because I wanted to help people and I was hoping that one day I'd be able to find a cure for for some condition or disease out there. Now, I personally didn't have any health conditions when I chose that career. And even during pharmacy school, I wasn't interested in a thyroid. It wasn't until I graduated from pharmacy school is when I became really interested in thyroid conditions, and this was as a result of my own health journey. I was struggling with symptoms for many, many years, and it wasn't until I took charge of my own health and started utilizing functional medicine was when I was able to take my health back. Various nutrients are required for thyroid function. Zinc, selenium, iron, and the B vitamins are just some of them. Some of the more common nutrients that I find are deficient in people with Hashimoto's are going to include vitamin D. This is very helpful for immune regulation. We'll oftentimes recommend to keep vitamin D levels between 60 and 80 for most people who want to optimize their thyroid function and immune system function. B vitamins, specifically B12 and thiamine, have been found to be deficient in people with thyroid conditions very frequently. Oftentimes, I'll see people's neurological issues resolve once they get on a B12 vitamin. We'll see, I have seen people who unfortunately had seizures because of a B12 deficiency. I've had people with severe fatigue because of B12 deficiency. Thiamine is another vitamin known as B1, one of the B vitamins that can be incredibly helpful for people with thyroid conditions and other types of autoimmune conditions. Around 600 milligrams per day has been found to help thyroid fatigue as well as thyroid related brain fog. I've seen really incredible results in people with Hashimoto's who started taking B1 or thiamine at about 600 milligrams a day within three days or so they'll say that their brain function starts to come back once more. Selenium is an incredibly helpful nutrient for Hashimoto's. Selenium deficiency has been identified as a risk factor for autoimmune thyroid disease. We'll see that around 200 micrograms of selenium per day can be incredibly helpful with anxiety, with thyroid antibodies, as well as with some of the thyroid symptoms like hair loss. Some of the other common nutrient deficiencies are going to include magnesium. A lot of times we'll see people whose anxiety resolves when they start utilizing a magnesium supplement. Another really, really important nutrient that is going to be deficient in thyroid disease that can have a profound impact on brain function is going to be iron. Now most people, when they get tested for iron deficiency, they don't get the right test done. I recommend doing the ferritin test that looks for stored iron. When this is low, this can be contributing to a whole host of various symptoms, including anxiety, panic attacks, restless leg syndrome, insomnia. And we find that people, once they restore their iron levels, will feel significantly better. When we talk about some of the foods that are going to be beneficial to people with Hashimoto's and people with thyroid conditions, I often think about what people are deficient in. Carnitine is a amino acid derivative that it has been found to be deficient in people with autoimmune thyroid conditions. And this is something that we get from red meat. In my experience with people with thyroid disease, many of them actually go into remission when they switch from a vegan or vegetarian-like diet into a diet that contains some sources of red meat. I think part of that could be because of carnitine deficiency. Now this is something that clinically has been found to be helpful for thyroid fatigue when taken as a supplement. Some of the other types of foods that are going to be incredibly helpful for thyroid conditions are going to be bone broth and green smoothies. I really love bone broth because it's a rich source of glutamine, which is something that's helpful for restoring the gut lining. And we know that every autoimmune condition has a gut component. And whatever we can do to help seal that gut, we're gonna see improvements in the autoimmune condition. Another really incredible power food that I love to utilize for people with thyroid conditions is gonna be a green smoothie. So green smoothies are gonna be providing us with our nutrients. that are sort of pre-digested because we're gonna blend them up really nicely. This does two things. One, it frees up our energy and our resources and our enzymes to work on the body rather than working on our food. What we have with autoimmune conditions is we have a buildup of something known as circulating immune complexes. And these complexes are gonna be contributing to some of the inflammation within our body. Whenever we are eating, our body sends its enzymes to the foods that we're eating. People with autoimmune conditions, one, are oftentimes going to be deficient in enzymes. Whenever we're eating a green smoothie, that can help free up some of that energy for other types of processes such as breaking down these immune complexes. The other wonderful thing about green smoothies is that the nutrients are going to be really easy to absorb. And so we're going to be addressing some of these nutritional deficiencies that are going to be present in autoimmune disease. Gluten, dairy, and soy are three of the most commonly reactive foods in autoimmune conditions. We oftentimes will see that people feel significantly better off of these foods. One of my clients in particular had about 16 different issues that I counted when I was initially starting to work with her. She had autoimmune thyroid disease, she had polycystic ovarian syndrome, She had anxiety, depression, panic attacks, she had fertility challenges, she had vitiligo, she had psoriasis and eczema. And one of her biggest triggers was gluten. When she got off of gluten, all of these things began to resolve. So her skin condition started to clear up. She started to have more energy and her mood improved. Sure enough, her thyroid antibodies improved as well. And one of the theories is that gluten molecules cross-react with parts of our own anatomy. And so the body may recognize gluten as a foreign molecule and may attack the gluten as well as the part of the body. Or another kind of, another theory is that the gluten can cause this intestinal permeability that predisposes us to autoimmune disease. With autoimmune thyroid disease, I found that about 88% of people feel better off of gluten, about 80% of people feel better off of dairy, and another 60 or so percent feel better off of soy. And they'll say that they have more energy, that they no longer have stomach aches, that they no longer feel anxious, and specifically with removal of dairy, they'll see a lot of their skin issues clear up too. Food sensitivities can be contributing to the overall inflammatory load in our bodies. And what I've seen specifically is that people will oftentimes have an increase in thyroid antibodies with specific foods, and they'll also have an increase in thyroid symptoms. So they'll find that one food will make them anxious, another food will give them a stomach ache, another food will cause a skin breakout, other foods will be contributing to a whole host of these mystery symptoms. They'll have migraines that can be triggered by specific foods. What I really love to do is help people figure out which foods work for them in their own bodies and which foods don't work for them. One of the best ways to do this, and this is actually the gold standard, is through an elimination diet. So you get off of the most common reactive foods for three weeks. and see what happens. You keep a journal, you see does anything go away? Are there symptoms that I have that seem to be better? In my case, I got off of gluten and dairy and within three days, the acid reflux that I had for almost three years disappeared. I was on numerous medications for this and it still wasn't better and all of a sudden, I got off of dairy, got off of gluten, and the acid reflux was gone, never to come back again. So you eliminate these foods for three weeks and see what happens. And then you start reintroducing them. One food every four days or so is going to be incredibly helpful for you to figure out and dial in which specific food is causing the reaction. I recommend doing a food introduction journal where you introduce one food every four days, and then you write down what happens within those four days. What's interesting is that food sensitivities, as opposed to food allergies, which are immediate and life-threatening, food sensitivities tend to be more subtle and they can take some time to develop. So you might see symptoms within minutes, but sometimes it takes a few days to have symptoms. For example, you might have your migraine triggering food on Monday, but the migraine might not come until Wednesday. that's why it's really important to spend four days tracking your symptoms before you add in another food. The foods that I generally will recommend eliminating are going to be gluten, dairy, soy, grains such as corn being a very significant trigger, nightshade foods. These are going to include tomatoes and peppers and potatoes. Don't forget about potatoes, the white kind, and then nuts and seeds. We eliminate those for three weeks and then we start reintroducing them every four days. Now, it's incredible to see when people figure out their food triggers how different they feel and how they feel brand new again. They're able to lose those extra few pounds. They're able to have more energy. They are no longer anxious. They don't have migraines. Their, you know, their brain starts to work better when they eliminate of these reactive foods. Another way to test for food sensitivities is through doing a food sensitivity test. The test I like to use is Ollitess, A-L-L-E-T-E-S-S, and I like to utilize the IgG food sensitivity panel. This test has been really helpful for many of my clients in trying to figure out what their food sensitivities may be. Many years ago, thyroid conditions were primarily caused by an iodine deficiency and Our public health officials, they're always trying to help us, right? And they said, wow, look at that. Iodine deficiency results in so many cases of thyroid disease. What are we going to do to fix this? And so one of the solutions was to start putting iodine in the salt supply. People love salt, so let's add iodine to the salt supply and then everybody will have enough iodine. Now, this is a beautiful idea in theory, right? And thanks to this, we no longer have this prominent iodine deficiency everywhere. However, what we ended up causing is higher rates of autoimmune thyroid disease, higher rates of Graves' disease and higher rates of Hashimoto's with this iodine in the salt. Now, this is very, very frustrating because we solved one problem but created more problems. Iodine seems to be a narrow therapeutic index nutrient, which basically means it's a Goldilocks nutrient where you need to have the levels to be just right in order for it to do its good work, right? If you don't have enough of it, we're gonna have problems, but also if we have too much of it, it becomes toxic. And as a pharmacologist, this is one of the keys to pharmacology, right? And toxicology is whether it's a poison or a remedy is determined by its dose. In the case of iodine, doses above 300 micrograms, have been found to potentially exacerbate Hashimoto's or even trigger new onset Hashimoto's. We, in some countries, have studied rates of Hashimoto's before adding iodine to the salt supply, before, and then 10 years after. And we've seen the rates of Hashimoto's going double, triple, and sometimes even quadruple once iodine was added to the salt supply. Now, It is a Goldilocks nutrient. We do need some of it for proper thyroid function, but we don't need that much. Generally for people with Hashimoto's, I recommend what's in a multivitamin, 150 micrograms to anywhere upwards to 300 micrograms. But any more than that can be problematic. The small amounts are very helpful. They help with thyroid symptoms and improving thyroid health outcomes. But anytime we get too much of it, it can be a problem. With salt, it's a challenge because we can't really manage our intake. We can't really regulate our intake that we can with a medication or a supplement. I treat iodine like a drug. I don't think we should put drugs in our salt. Another public health initiative that didn't quite turn out as well as we hoped it would was adding fluoride to our water supply. Now, public health officials realized that people were having this higher level of cavities, and they found that fluoride could suppress cavities. Now, what's interesting is that the reason for the cavities is often due to having excess sugar. My cousin, who's now a dentist in Poland, when she was a dental student a few years back, she asked me, she said, Isabella, is it true that in the United States, they add fluoride to the water supply rather than just telling people to eat less sugar to prevent cavities. And I was like, yeah, yeah, fortunately that's true. So we know that sugar in excess, and this includes grains and a lot of these starches, can cause cavities, and fluoride seems to suppress that. That doesn't necessarily mean that we should take fluoride. A better approach would be to manage the amount of sugar that we eat and take care of our teeth. We know that the rates of tooth decay have gone down since fluoride was introduced to the water supply in the United States. However, countries that do not add fluoride to the water supply still have these improvements in dental health. And we believe that it's because of improved dental treatments and better brushing of the teeth, right? And better access to dentists. and cleaning teeth isn't necessarily due to fluoride in the water supply. What's very unfortunate is fluoride can suppress thyroid function and can potentially cause, trigger, or exacerbate thyroid disease. So in communities that have higher levels of fluoride in the water supply, they've seen higher levels of thyroid disease. Communities with lower levels of fluoride or no fluoride in the water supply have seen lower levels of thyroid disease. One of the ways that I help people change their habits is by making it easy on themselves. And so one of the things you do is you figure out 10 recipes that are gonna be to your liking that remove some of these reactive foods. And you just learn these 10 simple recipes. I have a cookbook coming out called Food Pharmacology. It's a cookbook and nutrition guide that will teach you how to be your own nutrition guru so that you can cook really delicious, easy, tasty, healing recipes for yourself. And really just getting prepared. So understanding which specific foods may be reactive for you is the right, one of the right key steps. The other thing is knowing which foods may have secret added ingredients in them that could be reactive. So a lot of the processed foods, for example, may contain dairy, gluten, or soy, but they might have some different names that are hidden. Really, once you start doing it, you do it for 10, 20, 30 days, you'll realize how amazing you feel. Just give it a chance. You can always go back to the way that you were eating before. This will become a habit. This will be second nature to you. The hardest thing is just getting started. Some of the best ways for caring for our immune system are really being kind to yourself. Lotta self-care. So sunshine, making sure you're getting outside and doing things that you enjoy. This is gonna help you feel better on a whole body level. Whenever we do things that stress us out, our immune system shuts down. So we wanna incorporate some de-stressing activities such as yoga, meditation, sowing whatever, whatever, right? And I also recommend getting plenty of sleep whenever possible, getting as much rest as you can. That's when our body really regenerates. Giving yourself the foods that really nourish you and avoiding the foods that cause you harm. Supplements, I love utilizing supplements to support your body, utilizing appropriate supplements for you. This might be vitamin D for a lot of people or immune boosting mushrooms can be incredibly helpful. And I really think that knowing your value, knowing your worth and being kind to yourself yourself is the root cause of having great health.

In an autoimmune condition, the body starts to fight itself off, right? So it starts to, it looks at the thyroid gland and says, okay, I'm gonna fight you off. I'm gonna attack you. And when it attacks the thyroid gland, the thyroid gland doesn't work as well. And so then you get low, well, in many cases you get a low thyroid. So what causes the autoimmune disease is the big question we always ask in functional medicine. That's it. Why?

Right.

And everybody's different, right? For one person it may be gluten. We know gluten is associated with a lot of Hashimoto's thyroiditis. Not all, but some.

My experience, you look at thyroid antibodies and you compare it with the gluten antibodies in that patient, and it's about 30% of the time it could be related to gluten. What do you think?

Yeah, I think it could be. It could be. It might even be a little higher. It depends because of the patients we're seeing. So we might be seeing more patients who have a lot of different digestive issues going on. And so I might see it even.

A little more frequently. We call that selection bias.

People who are sick select to come see us, so they have more stuff for sure. But we always think about the digestive system, right? You've got autoimmunity, you've got to think about what's going on in the digestive system. But then you think about could there be an overgrowth of bacteria, certain bacteria in either the digestive system or other parts of the body, have been shown to trigger autoimmunity in some people.

We know that. We're going to talk about that in another podcast. So stay tuned. We're going to talk about the gut and leaky gut.

Okay, we'll do that. We know that imbalances in iodine, actually excessive amounts of iodine.

You can shut down the thyroid.

Yeah.

So, Hashimoto's, because it was found first in Japan where they have lots of iodine. So we know iodine is important for the thyroid, But too little is not good, but too much is also not good. So we pay attention to that. And toxins, of course, right? Toxins can be triggers for autoimmune disease in some people.

Yeah, some people say that the thyroid is a yellow canary of our body. That the yellow canary was the coal miners used to bring the yellow canary into the mine, and if it dropped dead, they knew the air was bad, they had to get out. So it was an early warning sign. And the thyroid is like that, and it seems to be extremely sensitive to disruption from heavy metals, from pesticides, the plastics and everything. They have fluoride.

Fluoride.

Yeah. So, yeah, fluoride in the water, all these things can disrupt our thyroid function and often your doctor never even looks for them.

Absolutely, right? They say, okay, you know, we're just gonna look at the TSH and if it's in the normal range, you're fine or we're gonna give you medication to get it in the normal range, but.

Not really look a lot deeper. Yeah, so what is the difference in the testing that, oh, there's one other thing I wanted to bring up, which I remember reading about the New England Journal of Medicine, was a lady who thought that bok choy was healthy, and she ate like two pounds of raw bok choy a day, and she went into a hypothyroid coma. And people are having kale juice.

Talking about goitrogens.

Yeah, there's a whole kale craze.

It's a great point.

And people are juicing it and it's raw and raw cruciferous vegetables can be a problem. If you're eating a lot of raw broccoli and cabbage and if you're having raw Brussels sprouts or raw bok choy, kale.

Eating it in a level that's beyond just like a normal food portion. But as you mentioned, if you cook it, if you cook it, you get rid of a lot of that goitrogenic potential, the part that's going to interfere with thyroid function. So you don't have to be concerned when you have Cooked cruciferous vegetables, but.

It'S that, like you said, should I.

Worry about having a kale juice every day? It's a good question. Depends how much kale you put in it, right? Well, I'd like to drink green juices and most of them have kale. I think a little bit of kale is fine. I'm careful about it.

And it depends on the person, of course, right?

Right? You're an expert. What about soy? So, you know, that's a good question too.

You know, I think that if... Because a lot of people are like, soy is really bad, it interrupts your thoroughly. It's dangerous. You shouldn't eat it.

I think if we're going with, you know, non-GMO organic soy as a whole food, like edamame and tofu, then I'm not concerned. Yeah, tempeh. I'm not concerned.

Traditional soy foods that have been used for centuries, right?

Yes.

Miso, tempeh, tofu, fermented soy too, right?

Yep.

You know, soy sauce. I mean, those are fine. It's It's when we're drinking a quart of soy milk a day, that's a problem. Or when you're having all these fake soy foods that are processed or soy burgers and you're eating stuff that's sort of weird Frankenfoods.

Or like the texturized soy protein that they put in cereals and bars just to get that protein content up. We don't, that's stuff I tell people to stay away from.

Okay, so you're someone who comes in, you feel tired, constipated, depressed, your skin's dry, your hair's falling out, you don't have a sex drive anymore, you can't concentrate. And you go to a traditional doctor, they'll just test one thing.

What do they test? Right, so they typically test your TSH. Okay, so what is that? Your TSH is your thyroid stimulating hormone. And there's a feedback loop in the body. So if your thyroid level is low, then the body will get triggered to make more TSH. And that comes from your brain, from your pituitary gland. Yes, yeah. And then that TSH will say, okay, make more thyroid. So if the TSH is high, then the doctor says, okay, your thyroid is underactive and we need to treat it.

That's the only thing they test?

Often.

And I think you have your functional medicine doctor, a very different approach.

So what kind of way are you looking? We always start with a full thyroid panel, where you look at TSH, but you look at free T3 and free T4. So free T4 is one thyroid, that hormone that's floating around in your body, but then the T3 is the active form that your body needs for all the thyroid functions to occur. So we look at both, we look at all three of those at least. And then we often look at thyroid antibodies. And sometimes we'll even do things like reverse T3 and the reverse T3 to total T3 ratio.

So what does reverse T3 tell you?

So the reverse T3 is a thyroid hormone hormone that the body, when the body is, I always think of it almost as the brake that the body puts on itself. So when the body is saying, okay, I've got to slow myself down, it takes some of its T3, which is your active thyroid hormone, and it converts it to reverse T3, almost in a way to slow down our metabolism. It's a protective mechanism, I think of, right? And it makes sense that we have that in times of stress.

Well, a lot of times we trigger that, are not actually good, right?

That's very true. So like if there's a, you know, if there was a major stress going on, you'd wanna have that mechanism in place. So you didn't starve to death. But with a lot of chronic stress, which we see a lot these days, we can sometimes see high reverse T3. And the other thing we see a lot that causes that high reverse T3 is sometimes toxins. So it can be a sign that we've gotta look deeper and say, okay, is this person under a lot of chronic stress? how is their adrenal gland functioning? How are they working to activate that parasympathetic nervous system, that calming nervous system, which helps the body heal? And then we look for toxins. Yeah. In the gluten issues, we look for.

Everything that is imbalancing the thyroid. So we look for nutritional deficiencies, selenium deficiency, iodine deficiency, are you low in zinc, do you have low omega-3 fats, do you have yeast in your gut, do you have heavy metals, do you pesticide exposure, toxin exposures. So we take a very detailed history that your traditional doctor would not do.

Right.

To really look at the broad spectrum of what's causing it, because we could just treat the symptoms of the thyroid, but maybe we may not need to do that. And I've seen many patients where you fix these other things and their thyroid gets better.

Absolutely. And it's so powerful when you see.

That, it's like, oh, I don't need to do thyroid. I can actually fix the upstream cause. Yeah. And it's pretty impressive when you see that.

It is.

And the last thing you were talking about was antibodies.

So Can you tell us about what antibodies are and why we should look at them and why traditional doctors don't look at them?

I'm not sure why they don't look at them enough, but the antibodies are giving us a signal that the body is attacking its own thyroid and it's a sign that there's autoimmune disease going on in the body. And we've got to figure out that question, you know, why is that? Why is that going on? And, you know, so I had a woman who came in to see me and she was She was 40 and she had been struggling with all those symptoms we talked about with low thyroid. You know, she was cold all the time, you know, her hands were cold, she was gaining weight, she was tired, she was constipated, she was losing hair, her eyebrows were thinning.

Sound familiar to anybody?

I know, right? So I'm like, okay, but then her primary doctor did her TSH and it was normal. So we then went deeper. Can I stop you for a sec?

So when I was trained, and I'm sure you were trained the same way, was you only check TSH. if that's normal, then you don't do anything else. And what's normal is a range of like 0.5 to 5.

Often, yeah.

Which is a massive range that actually doesn't reflect even our current understanding on most reference ranges on the lab tests that even the American College of Endocrinologists says if it's over three and a half, we should be worried.

Right, and many, many studies are saying people between one and two feel the best.

Right? Right, and I remember, you know, because I always do all the tests. I don't do reverse T3, but I do TSH, T3, T4, and the thyroid antibodies. Because what I've learned is that even if all those are normal, TSH, T3, T4, you can have elevated antibodies.

Yes.

And people who have those feel better when they get on thyroid.

Very true.

And I went to a conference years ago at Harvard, and I, you know, it was a traditional medicine conference, and the endocrinologist was talking about thyroid. And he said, look, if your antibodies are elevated, they should be treated because they're probably symptomatic and you treat the patient, not the lab test. But in traditional medicine now we're more.

Treating the lab test, not the patient. And I think that's really important. And the physician sometimes thinks, well, I'll just wait until these antibodies damage the thyroid enough and then I'll treat. Right. That's like the way they, you know. It's like once the TSH starts to go up. I'm gonna wait until, but we say.

Okay, no, there's so much we can do. 100%. There's so much we can do right away. Yeah, I remember this patient came in once with blood sugar like 115 and 126 is diabetes, 100 is pre-diabetes. And I'm like, God, did your doctor say anything about your high blood sugars? Oh yeah, he checked it out. Well, what did he say? He said, well, when it gets to.

Like 126, we'll treat it with medication. Yeah.

But I'm like, no, this is the perfect time to treat you.

So tell us about this case. So she came in and she wasn't feeling good at all, but her TSH was normal. So we did the full panel. and we saw that her thyroid antibodies were elevated. And so then we had-: well, was.

Her TSH and the rest abnormal or not really?

No, her TSH was pretty normal. I can't remember exactly, might have been a little on the high side, but I don't even know if it was. I think everything looked really normal, but she had those thyroid antibodies. And so I had to ask that question, why? Why do you have these thyroid antibodies? And then it brought us down this whole pathway of what's going on with what's going on with her digestive system, what's going on with food sensitivities, was there any signs of increased intestinal permeability? And so we pulled her off of gluten and we measured things like her iodine level and her selenium level just to get the right balance. And we actually, we gave her some thyroid hormone. We gave her some glandular thyroid hormone. I used Armour thyroid on her, which is a combination of T4 and T3. And she started, she really responded well. She felt better. She noticed her hair starting to come back in, her skin starting to be less dry, her bowel movement's improving. And so, I think it's important that we take that step and go a little deeper.

And people don't often realize how bad they're feeling until they start feeling better on this stuff. And I think just to back up a little bit, you did something which was kind of unusual, controversial, and most traditional endocrinologists would scoff at, which is you used a combination of T3 and T4 in a hormone that comes from pig that is the entire thyroid combination of hormones, including T2, which we don't even talk about, that is actually really important to replace your own because you make a complex array of hormones and often the T4 can't get converted to the T3 in your body, which is the active hormone. So even if you're taking T4, which is what most doctors recommend like Synthroid or levoxyl or any of these. And they're not terrible, but they're just challenging because you actually may not be giving the person the T3 that they really need because their body's not able to make it as well. Right.

So then we ask that. So some people, as you mentioned earlier, feel fine on T4 thyroid hormone. That's like synthroid or, you know, so they do okay with it, but a large percentage of people don't. And that might be because They have deficiencies in nutrients that help the body go from T4 to T3, right? So they might be deficient in iodine or selenium, as we mentioned, in vitamin A, or iron, and zinc. We talked about that earlier, that they can't make that conversion as easily, and so the medicine doesn't work as well for them. Or it may be because they have a variation in a gene we know there's this gene, it's kind of a really, I mean, you know, really interesting low impact type of gene. So what that means is that it, you know, it can't kill you.

It's not going to kill you.

Right, thank you. It's not going to kill you, but it can make you not feel so good. And it helps us know how to treat people. So the gene is the dio2 gene that encodes for this enzyme, the dio2 enzyme, which helps the body convert T4 to T3, especially in the brain, but also all throughout the body and make that active T3 thyroid hormone. And what we're learning is that some people have this gene variation. And so when you give them just T4, thyroid hormone, they don't get the benefit. And studies have shown even when lab work looks normal, So even if their T3 looks normal, even if their TSH looks normal, that they do better when you give them some T3, which could be like a glandular thyroid hormone, like Armour, which is a combination of T4 and T3, or it could be a synthetic T3. We sometimes use like Cytomel and we'll add that to Synthroid, for example, or a T4. And so sometimes we see those people, who just start to feel better in terms of especially mentally, energy-wise, mood-wise, they really start to feel better finally.

I don't realize that depression is really linked to thyroid and that often psychiatrists in treatment-resistant depression, when drugs don't work, they'll give them T3 as a treatment for depression.

They've been doing that for a long time. It's not anything new.

Right, right, right. It's weird for them. the rest. And also, you know, the T4 thyroid replacements, there are challenges with that because there's often fillers, things like lactose and gluten even.

Right, could be other reasons why people don't feel well on those.

Yeah, so those are important to recognize. And a lot of the traditional doctors really scoff at the use of glandulars like Westroid, Nature-Throid, Armour thyroid. Why is that and should we be worried?

You know, I don't think so. I think maybe it's maybe during their training or many years ago, there was a question of of regulation of those or the dosage, but I don't find that to be a problem at all that we can definitely regulate dose with our patients. It's very reproducible in terms of the medication. And I mean, a good portion of our patients, I think we've talked about this before, right? We'll say like maybe it was 80% of our patients or a good portion of our patients do really well when we use a glandular. I mean, there are some that don't. There are some where that might actually cause more autoimmunity, maybe, for some, or they just don't feel good on them. And we use synthetic, but for a good portion it works really well.

And you can combine T3 and T4. We'll talk about the next case that are separate, not as a glandular, but just as a prescription drug. And I think the other problem with the glandulars and the things like Armour, Westhroid, Doctors can misinterpret the lab tests because the thyroid, the TSH goes really low because the T3 suppresses the feedback loop. But you have to look at the T4 and T3 separately and also the symptoms of a patient.

Absolutely.

So tell us about that.

Well, sometimes when you give T3, then you might see a low T4, and like you said, TSH, but definitely a low T4. T4 on the lab test because you're giving some of your thyroid in T3 and with the feedback loop, it causes that your body doesn't make as much T4.

And the TSH goes down, which worries doctors that you're taking too much or you're treated. And actually, it's not true, so.

It's really important to pay attention to the patient's symptoms. And I find that everybody's different. I have patients who are so sensitive to thyroid that if their TSH gets a little too low, they feel awful. They get palpitations, they get anxious, they have trouble with sleep. But then other people, you know, if you don't get their TSH low enough or if you don't give them enough thyroid, then they're feeling all those signs of low thyroid. So what I think the takeaway is, is paying attention to your patient and their symptoms and getting that feedback and listening to them and-- so like what.

William Wolfer said, treat the person who has the disease, not the disease that the person has. Right?

Absolutely. Right. That's what we, that's what we're working together.

It reminded me of a case I had years ago where this woman was so symptomatic on hypothyroid and her TSH or T4 or T3 were totally normal. And her thyroid antibodies were off the chart.

Yeah.

And I treated her, and it was like a miracle. And she lost like 21 pounds in six weeks. She had all her symptoms get better. She had fibromyalgia. She had all these, quote, things that were symptoms of low thyroid that weren't being treated. So it's really powerful. So tell us about the second case of your patient who'd actually been on thyroid for 15 years and really struggled.

Right. So she was a 35-year-old woman who came to see us who had been hypothyroid since her late teens, 20s, and she had been on thyroid medication. She had been on Synthroid.

And antidepressants.

Well, they wanted her to be on antidepressants. So she was on the thyroid medication for a long time, but always sort of dealt with this low-level depression. Not a major depressive episode, but enough where sometimes she would stay in bed all day, she would sleep too many hours, she would sleep 14 hours sometimes, she just had loss of interest in things. And so when she went to her primary doctor about that, you know, they were saying, okay, maybe we should try an antidepressant, right? Maybe this is interfering so much with your life at this point now that you're 35 that we should try this, try an antidepressant. And she came to see me because she wanted to look at it a different way. And so we did a bunch of different tests, and included in that is we did that DIO2 gene test. and what was interesting is her thyroid levels looked fine, right? Her TSH, her T4, T3, it looked fine, but she did have a homozygous variation in that DIO2 gene, which is associated with depression and that people who need thyroid hormone and get T3 in addition to T4 feels so much better in terms of mood and energy when they have that gene variation. So we actually with her, she was feeling fine on her synthroid, she'd been on it for many years, so we added the cytomel to it and it really helped. It helped a lot with her energy and her mood.

Yeah, that's amazing. So these cases are not atypical. We see this all the time at.

The Ultra Wellness Center.

And we help people when no one else could help them because we look at things differently through the lens of functional medicine, which is about root causes, about treating the whole system. Like when you come in with thyroid to your regular doctor, they don't ask you if you have been eating tuna fish every day for 30 years or if you worked in a pesticide factory or if your stomach's upset. They don't care if you have, maybe you're constipated, that's a symptom, but they don't care if you have bacterial overgrowth or yeast overgrowth or or leaky gut or any of this stuff. And so at the Ultra Wellness Center, we tend to look at all of that. And we really dive deep into each person's story because everybody's different. If you've seen one person with thyroid, you've seen one person with thyroid. And everybody has to be treated a little bit differently in personalized care. And that's really what the future of medicine is. It's personalized precision medicine and also precision health. And functional medicine is more about how do we create health. And so just to recap what Dr. Bubba and I have talked about, I think it's important to recognize if you have any symptoms, if you're tired in the morning, if you have dry skin, fluid retention, muscle aches, cramps, constipation, depression, low sex drive, low concentration, flaky skin, whatever, that it might be worth checking with a functional medicine doctor. And at the UltraWellness Center, we take care of patients from all over the world. And then when we do that, we look at different kinds of testing. So yes, we'll look at your TSH, we'll look at T3, T4, the thyroid antibodies, we might look at reverse T3, we might look at genes that are involved with thyroid function. But we'll also look at things like your gut and we'll look at heavy metals and we'll look at your experience. Your other hormones. Your diet, we'll look at nutritional deficiencies. We want to check selenium or zinc or iodine, things that are really important, vitamin D and omega-3s all these things are play a huge role in our thyroid function and then we'll talk about what foods you can eat, right? So what do you eat? I mean, so selenium is in Brazil nuts, iodine is in fish, Zinc is in pumpkin seeds. You can get Omega-3s in sardines. So you can actually use food to help optimize your thyroid function. Maybe you're having kale juice every day. You don't want to do that. So we'll sort of adjust things. And then by doing that, we really get a holistic view of what's going on and we can really optimize people's health. If you love that last video, you should check out the next one for sure on getting to the root cause of all disease.

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