14. The Anxiety Thyroid Connection (As Explained by an Integrative Doctor)

The knock on the door to my office jarred me out of my work and I looked up to see a beautiful blue eyed red haired woman standing in the doorway. It was Alicia, a colleague who had graduated from medical school a year after me and she looked troubled. You okay? I asked. She shook her head and put her finger to the pulse in her throat. I've been having palpitations and hot flashes since last night. I didn't sleep at all and I'm getting more anxious by the minute. I thought I'd stop by to see if you were in the office and could check my blood pressure. Her blood pressure read 160 over 100, which is high. Her skin was hot to the touch and her Pulse was over 100 beats per minute. Typical for her is more like 60. Funny thing is, I saw my PCP last week for anxiety and she wrote me a script for Xanax. I didn't want to take it but I've been so stressed lately I gave in, but it doesn't seem to be helping. Did she run any labs? I asked. She shook her head. My insurance only covers annual labs and she said if I started feeling worse to give her a call. Alicia, like many, went to her doctor for a mental health symptom and was sent away with a prescription and a Call me if you feel worse today. You're going to learn about the relationship between anxiety and your thyroid. Stick around to the end and I'll share with you what was going on with Alicia and what we did about it. Welcome to my podcast. I'm Dr. Nicole Cain, a naturopathic doctor with a master's in Clinical psychology and a former anxiety sufferer turned Anxiety Freedom Rebel. If you struggle with anxiety, I want you to know there is another solution. You don't have to feel like this with every symptom. It is absolutely essential to consider the root cause. Without investigating the root cause, we cannot find comfort in a cure. Just like if you kick the dresser and stub your toe every morning, no matter how much aspirin you take, you will never enjoy a pain free toe. That is unless you stop kicking the dresser. Similarly, if you do not look for the root cause of your anxiety, you may never enjoy the possibility of freedom until you investigate the cause. While causes vary from person to person, for example Trauma, medications, side effects, stress in the home, workplace, genetic, environmental, biological, getting to the root cause is possible. Today we're going to talk about one important biological cause of anxiety and that's imbalances in your thyroid health. Can thyroid problems cause Anxiety. There are two main types of thyroid hypothyroidism and hyperthyroidism. Hypothyroidism is when your thyroid is hypo underactive or under functioning. In contrast, hyperthyroidism is where your thyroid is hyper overactive and over functioning. There are also thyroid conditions caused by your immune system called autoimmune disorders. The main two autoimmune disorders we're going to talk about today are Hashimoto's thyroiditis and Graves disease. Anxiety can be seen in both hypo and hyperthyroid states, and testing the thyroid is an important component of your annual basic blood work. But if symptoms pop up, looking at the thyroid is a smart thing to do. Let's talk about how the thyroid works. Thyroid Basics. Your thyroid gland is the command center for metabolism in your body. Located at the base of your neck, the thyroid releases hormones that control many important processes in almost every cell of your body. When your body needs more thyroid hormone, your brain releases a hormone called thyroid stimulating hormone, which is abbreviated tsh. TSH leaves your brain and when it reaches your thyroid gland, it stimulates the thyroid to release thyroid hormones. The two types of thyroid hormones released by your thyroid gland are T4 thyroid and T3 thyroid. 99% of your total T4 thyroid is bound quite tightly to a protein and it is not very metabolically active. And so your body has to convert T4 into into T3 thyroid. It gets even trickier than this. If your body does not have the right nutrients. Instead of going to T4 going into usable T3, whether it's free or bound to a protein, that T4 will actually get converted into something called reverse T3 instead. Reverse T3 looks like standard T3 in testing, but it's an inactive form of T3 thyroid and therefore, unless we test them separately, we do not actually know if you have enough active thyroid hormone to be healthy. And this means that your T3 thyroid test can look perfectly normal and you could actually have a thyroid problem. Thyroid testing. A thorough thyroid panel should include the following tsh. Remember, this is thyroid stimulating hormone which is released by your brain and it triggers your thyroid gland to release thyroid hormone. Free T4 released by your thyroid gland. T4 is mostly inactive and it's bound to a protein and it gets peripherally converted Into Active Free T3 Thyroid for your body to use in a healthy state. Free T3 also released by your thyroid gland or made by converting T4 into T3. This is usable and active form of thyroid. And finally, the panel should include reverse T3. Because remember, reverse thyroid or inactive thyroid hormone can be made from T4. If you don't have the right nutrients or if your cortisol stress hormone is really high, the nutrients that your body needs in order to make regular T3 especially include iodine, selenium and zinc. And if you don't have enough of this, you're going to end up with high reverse T3. Many doctors only order TSH when doing general labs, and if TSH is abnormal, they will do what is called a reflex to T4. The problem with this, as you're probably gathering, is that you can have normal tsh, but all of the symptoms of hypothyroidism. This is seen in a condition called euthyroid 6 syndrome, abbreviated ESS. In ESS, we see normal TSH from the brain, normal T4 and either normal or low T3. Many doctors will stop there and tell you your thyroid is fine, but if they went a step further, they would see that your reverse T3 is elevated. So what's happening is that your body is making T4, but it is getting converted into reverse T3 instead of active T3. And that leaves you feeling exhausted, depressed, lethargic, and suffering from many other symptoms of hypothyroidism. Here's an analogy. Let's say that you have two kids with very messy bedrooms. You're the brain, and you send out TSH that tells the kids, who in this analogy are the thyroid hormones, to clean their room. Your TSH says clean your rooms, and the doctors only test tsh, and they, like you are assuming that as a parent, if you tell your kids to clean the rooms, that it's probably done. But as you know, that's like a 50, 50 chance. And if you want to know if the rooms are clean, you need to go ch. Because if you've ever been a kid or if you have kids yourself, you know that the room may not be clean and you have to go in and look at the bedrooms and you have to actually look under the bed for reverse T3 in order to ensure everything is as it should be. Test results in hyperthyroidism. If you're anxious, and if you're wondering if your thyroid is the culprit, get your thyroid tested by your doctor. If your symptoms are due to hyperthyroidism, you will see low TSH and high T4 and or T3 on your blood test. As mentioned, symptoms of hyperthyroidism include anxiety, difficulty sleeping, racing heart, diarrhea, heat intolerance, bulging of the eyes from the sockets, feeling a suffocation or congestion in your throat, hair loss and this can become severe and life threatening if not treated. Test Results in Hypothyroidism Hypothyroidism is much more common in this country, and this is especially so after people switched from iodized salt to sea salt. Hypothyroidism tests will show a high TSH and low T4 or T3 or both on your blood test. Symptoms of hypothyroidism include depression, fatigue, low endurance, low motivation, low blood pressure, as well as chilliness, constipation, and a whole lot more Autoimmune Thyroid There are two main autoimmune diseases associated with the thyroid gland that we're going to talk about today. An autoimmune disease is a condition where the cells of your immune system attack your own cells. In particular, the two thyroid autoimmune diseases we're going to discuss are Hashimoto's and Graves disease. Hashimoto's thyroiditis is an autoimmune disease that can cause the thyroid to alternate between hypothyroid and hyperthyroid states. As the thyroid hormones spike and drop, your symptoms may change from feeling wired and anxious in a racing heart to exhausted, depleted and depressed. The test that we run for this is antithyroid paroxidase, or TPO antibodies and antithyroglobulin, or TG antibodies. Graves disease is the most common cause of elevated thyroid hormone production. The antibody test for Graves disease is called thyrotropin receptor antibodies or trob. The other name is thyroid stimulating immunoglobulin. If your thyroid is out of balance, it is important to identify why it is out of balance. Running antibody tests gives us data on exactly what is wrong so that we can work on addressing the root cause. There are five main root causes of autoimmune thyroid diseases and they are vitamin D deficiency, heavy metal exposure, gluten sensitivity even if you're not celiac imbalances in your gut, microflora, a condition called dysbiosis and innocent bystanders where you may have another autoimmune disease like lupus that can be associated with thyroid issues. Steps to get to the bottom of your thyroid imbalance if you are struggling with anxiety, the first step is to get your thyroid tested. Include TSH Free T4, Free T3 and Reverse T3. If there are significant findings on this test, run thyroid antibodies and if you have elevated antibodies, Getting to the root cause of why your body is producing the antibodies against your thyroid gland is key and that's by running the autoimmune test we talked about. The good news is that this is very treatable and oftentimes you can get to feeling better quickly with safe and natural alternatives. Here are eight steps to ask your doctor about for addressing autoimmune Thyroid Number one is to rule out celiac disease by doing a celiac blood panel. Number two is to run food sensitivity IGG blood testing. Even if you don't have celiac inflammation as a result of a wheat or another, food sensitivity in your diet can increase your risk of autoimmunity. Number three is to test for candida and other gut pathogens which are important in impacting and regulating your body's immune system. Number four is test your vitamin D. If your vitamin D is low, then supplementing with vitamin D in addition to its companion nutrients like vitamin A, K E, calcium and magnesium is incredibly important. Number five is to test for metals and non metal toxicants. These can have a strong impact on your immune health and can promote autoimmunity. Number six is to test your red blood cells for selenium, zinc and iodine levels. If they're low, start to replace that. Number seven is to take immunomodulating herbs as prescribed by your specialist, your naturopathic doctor, your botanist, your physician, your treatment team. Herbs that I like to use are ashwagandha, curcumin, aloe and there are a few that we'll talk about later. Immunomodulators modulate the immune system. If the immune system is overactive, it'll bring it down and if your immune system is underactive, that will bring them up. Number eight is to take appropriate supplements based on your body's particular needs. Replenish deficiencies Give your body what it needs for thyroid health. In particular also replenish what might be missing for anxiety. Look at what's going on with your gaba. Look at what's going on with cortisol. Make sure that you're treating your entire body, your whole person approach what can you do to improve the health of your thyroid? A happy thyroid equals a healthy life. In order to optimize the health of your thyroid gland, we need to be mindful of what is health promoting and what is health robbing. Here are some herbs and supplements that your thyroid Selenium, zinc, magnesium, vitamin B12 antioxidants, withania, gugul, Ginseng, Bacopa, Curcumin and Ashwagandha. These are the top herbs and supplements that your thyroid adores. Thyroid nourishing treats Your thyroid loves oats and kelp, seaweed, artichokes, onions, garlic, Swiss chard, egg yolks, lecithin, sesame seed butter, turnip greens. Your thyroid loves probiotics. They're happiness for your bodies. Eat fermented foods like sauerkraut, coconut yogurt and kimchi. And then avoid thyroid food foes. Avoid foods with artificial ingredients, preservatives, avoid simple carbs and sugars, avoid corn syrup, high fructose corn syrup, and all the other synonym names. They came up for that. And tip. If you look at the ingredients on your label and you cannot pronounce a word, it's probably not good for you. Do you remember Alicia from the beginning of this podcast? Let me tell you what happened. We ran a TSH, a free T4, free T3, and a reverse T3. Because of the severity of her symptoms, and for speed's sake, we also threw in her thyroid antibodies. Her results came back showing her TSH was extremely low. Her free T4 was high, and her free T3 and reverse T3 were also elevated. She also had extremely high thyrotropin receptor antibodies, and she was diagnosed with Graves autoimmune thyroiditis. The typical treatment for Graves hyperthyroidism is radioactive iodine or surgical removal of the thyroid gland. But Alicia opted to try an alternative approach. First, she promised her endocrinologist that if her symptoms were not improving in 48 hours and if her blood tests were not 30% improved in two weeks, that she would consider more invasive treatments. Reluctantly, her doctor agreed with her proposal. Alicia followed a protocol that included nutrient support. She cleaned up her diet, took immunomodulating botanicals, a homeopathic remedy, and did daily hydrotherapy treatments. Within 24 hours, her palpitations had stopped. She got a good night's sleep. Within 48 hours, her anxiety was 50% better, and within a week, the heat, intolerance and hot flashes had stopped. She went back to her endocrinologist who retested her antibodies and they found that they had dropped by 80%. Her blood pressure was 120 over 70. Much better. And her pulse was back to 70 beats per minute. Much better. Pleased with her progress, her endocrinologist told her to keep up what she was doing and to schedule a follow up for six months out. Your body is designed to heal. If you fall off your bicycle and scrape your knee without you even thinking about it, your body will heal that scrape by setting off a complex cascade of events involving your platelets, your immune system cells, and other clotting factors. Why then would we assume that your immune system cannot re regulate itself? Why would we assume that your neurotransmitters, your hormones, your body, your brain and your anxiety cannot heal itself? Of course you can heal from anxiety. Of course you can get your life back. Alicia, a physician herself, worked as a team with her specialists and she used the wisdom of conventional and integrative wisdom and she got her life back. Had she accepted the Pill for nil model and just taken the Xanax and called if she felt worse, she would be in a seriously different place right now. What have you been accepting as status quo? Is there any root cause digging that you need to pursue? Sometimes it can be incredibly overwhelming and you don't know where to start. And that's why we're here. Our mission is to empower you with wisdom, hope and resources to get your life back. To get started, follow these three initial steps. The first step is to assemble a team of clinicians that you trust who will work together. The second step is to find the root cause of your symptoms. And the third step is to follow the laws of nature in creating a treatment plan that removes obstacles to health and gives your body what it needs for healing. It is important to remember to avoid the allure of dogmatism. While philosophy told Alicia's endocrinologist that she would unlikely recover from her autoimmune state without aggressive pharmacological or surgical treatment, he met her in the middle with a compromise. And while Alicia believed that her integrative methods would work, she met her endocrinologist in the middle too. Both paradigms were honored without dishonoring the other. They were willing to say yes and you deserve a comma at the end of your sentence. Too often we are told you have anxiety. Take this. Come back if you feel worse or you have hypothyroidism. Take this. See you in a year or you have Graves disease. We're going to take your thyroid out. Period. But we can do better than that. We can change the status quo of mental health and health treatment in this country and you can write a new chapter in your story. Hey everyone, thanks for listening. This has been Dr. Nicole Cain. If you want more free information on how to get your life back, check out my website at www.drnicolecane.com. you can send questions, learn about consulting with me directly, and even preview our online courses. We also have a free and private Facebook membership group, so go check it out. Search for Anxiety Freedom One Week Challenge. Also, if this information is valuable for you, please hit the subscribe button. We'd love to meet you and learn more about how to support you in getting your life back.

The recording you just listened to consists of the personal opinions of Dr. Nicole Caine, a naturopathic doctor with a master's in clinical psychology. While these opinions are based upon literature, her counseling education, medical training, and clinical experience, this content should not be viewed as the definitive opinion on these subjects. Listening to this podcast is not a substitute for any sort of medical, psychological, or other form of treatment. If you are in a Crisis, please call 911-OR call the National Suicide Prevention Line at 1-800-273-8255. If you're in need of counseling, don't hesitate to make an appointment with a counselor in your area. Dr. Nicole Cain is so passionate about people Life back. If this resonates with you and you think this podcast would help someone you love, please share it with them. Stay in the conversation with Dr. Nicole Caine about writing the next chapter of your life so that it plays out just the way you want it. Explore your options for working with her at www. Dr. Nicolecane.com that's Dr. R Nicole N I C O L E Kane C A I N.com when you're there, be sure to take advantage of the Free Anxiety Freedom One week challenge. We look forward to seeing you on the next episode of the get your life Back podcast. Here's to your next chapter.

Sam.