Thyroid 101

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Hey, it's JJ Virgin. And welcome to the JJ Virgin lifestyle show where I talk nutrition, exercise, mindset and lifestyle with some of the coolest people in the world. And the tips that you can put into fast action to up level your health so that you can go out there and live the big life you're meant to live. Now, today's show is all about the thyroid. And I know I've talked about this a bunch, but I gotta tell you, I have some mind blowing information today, some important information on lab testing that is gonna blow you away. Because if you are not taking these tests, which your doctor probably is not ordering, you could misdiagnose thyroid disease by a decade. Also, if you are on thyroid medication, we're gonna share what some key nutrients you may be missing that could make your thyroid medication not work. So I have with me today the amazing Dr. Isabella Wentz. Now, Dr. Isabella Wentz is a pharmacist who has dedicated herself to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto's Thyroiditis in 2009. She's the author of the New York Times best selling patient guide, Hashimoto's Thyroiditis Lifestyle Interventions for Finding and Treating the Root Cause and is an ardent champion of incorporating lifestyle change and functional medicine into the treatment of autoimmune disease. All right. And I think I know you are going to be blown away by some of the information she is going to share with you today. So let's do it. I've got Isabella Wentz. Isabella, welcome to the show. I am so glad you're here with me today.

Hey, jj, it's so great to be here with you. Thank you for having me.

Well, this is such a hot topic and I love your take on it because, you know, I've been working in weight loss for years and years and years and, and most of my clients now are in their 40s and 50s and man, it's hard to find someone that isn't being hit with some kind of thyroid condition. So I know, we're gonna talk about overcoming thyroid conditions and taking this root cause approach. And this really seems to be, I mean, whenever I think of you and think of thyroid, it's you two go hand in hand. So I'd love to know how you got so interested in the thyroid, you.

Know, so jj, your readers might not know, but I'm a pharmacist by training. And so I was actually never interested in the thyroid during pharmacy school. And after I graduated, I was working in psych and I used to work with really complicated patients and help them optimize their medications. And so I actually did not become interested in the thyroid until I became diagnosed myself in 2009 after almost a decade of some pretty debilitating symptoms. And conventional medicine, which I'm trained in, didn't really have a lot of options and a lot of answers for me. So I really started to take the methods that I was using to help my patients with rare conditions to get myself better. So it wasn't until I became diagnosed with Hashimoto's myself with a thyroid condition that I became a thyroid expert, slash human guinea pig.

And so often it starts with ourselves. And you just said, did I hear you right? Like you had a decade of struggle before you were diagnosed.

I did. So it started in my freshman year of college. So I went from this bright eyed and bushy tailed go getter in high school and starting off college, wanting to take on the world. And this was my pre pharmacy in undergrad. And within the first year I ended up with mono. And then after that I was never quite right. So I was exhausted all the time. I went from sleeping for six to eight hours, jumping out of bed, to just being too tired to get out of bed for my 10am classes. I missed exams. There were times when I slept for 12 to 14 hours and this kind of got worse. I eventually learned to study really effectively and still had somehow a bit of a life in college. And then I got accepted into pharmacy school and I ended up then developing irritable bowel syndrome. And it was like every other year I started to have new symptoms. So then I started getting acid reflux, carpal tunnel hair loss, panic attacks, and it was like every year I was breaking down little by little and I never fully recovered my energy levels that I had before starting college.

So it seems like thyroid is so common and so under diagnosed, and I'm wondering if a lot of that's just because people are missing the symptoms. So what are some of the most common symptoms of hypothyroidism?

You know, jj, that's a really great point, because symptoms of hypothyroidism are pretty nonspecific. Thyroid hormone receptors are present in every cell of the body. And it's very easy for a woman to come into her doctor's office and be told that she's just getting older or that everybody feels stressed out and that that's causing her symptoms, or that's just a part of being a normal mom. But, you know, the biggest symptoms that people will complain about are going to be, first and foremost, fatigue. So you're going to be so tired, and, you know, your family members, your friends might think you're lazy, but you're just tired all the time. And normal everyday demands like going to work and doing things are just going to wear you out. The second biggest symptom that people complain about is weight gain. So. Or an inability to lose weight. So women will eat the same kind of diet that they've been eating for a while and do the same exact level of exercise that they've been doing, and they'll just continually find themselves putting on more and more weight month after month. And then the other things that people complain about are going to be things like depression, any kind of mood disorder, lack of motivation, as well as the infamous brain fog where you just can't remember anything. So you'll walk into a room and then you'll forget why, or you won't be able to think of a common word like the word dog or cat. That's something I used to struggle with. And then the other symptoms that really let me know that a person is struggling with thyroid condition are going to be cold intolerant. So if you're the woman in your office that is wearing a sweater and everybody else is in a T shirt, that could be an indication that you may have a thyroid condition. And some of the other things are going to be hair loss, joint pains, loss of the third eyebrow, any kind of digestive disorders, and just an overall feeling of just feeling unwell or anxious.

It seems so common. I've got a thyroid condition, too. And I still remember over the course of a month, just the shift, and it was amazing. Fortunately, I've been teaching all the symptoms of thyroid disease for years. So I was like, oh, I know what this is. Okay, but what do you think is the most common cause of hypothyroidism, and why is it so common now?

You know, one of the main causes of hypothyroidism in the Western world and in countries that add iodine to the salt supply like the United States or Europe, Most of western Europe is actually Hashimoto's thyroiditis. So this is an autoimmune attack that happens to impact the thyroid gland. And what's happening in Hashimoto's is basically our immune system begins to recognize the thyroid gland as a foreign invader and starts to attack it. So many times, people will be told that they have a sluggish thyroid, but that's actually the furthest thing from the truth. Most of our thyroids are actually trying to work over time, and they're just not able to keep up with the demand because our immune system is at war with them. And so 90 to 97% of cases of hypothyroid or low thyroid are actually going to be due to Hashimoto's. So your immune system fighting against your thyroid gland, and looking at what is causing these higher rates of Hashimoto's, one of them is going to be nutrient depletions or nutrient excess. So we know that iodine is a goldilocks nutrient, so you need to have levels of it that are just in the right amount to prevent having iodine deficiency. Thyroid problems, which used to be the primary cause in, like, the 50s, and then just a tiny bit more of the iodine can cause excess rates of Hashimoto's, because having too much iodine on board actually makes our thyroid gland work harder and produce all kinds of reactive oxygen species that causes damage to the surrounding tissue, and then things like toxins in our food and our environment, infections, they all contribute to the immune system imbalance that eventually leads to the attack on our thyroid gland.

Well, I'm glad you brought up the iodine story, because there was, for a couple years there, it seemed like such a heavy loading on iodine that was frightening out in the functional medicine community. So I don't know what kind of damage we did with that. So what are the tests? Because I see so often someone walks in and goes, well, my labs were normal. Right. Or they were in the range. What are the tests that are essential and what are the tests that are not being ordered that really need to be ordered?

That's such a great question. And I'll see so many people that will say, oh, well, my thyroid's just fine. My doctor tested me, and I was going through that myself, jj. So when I was in pharmacy school, I was getting tested year after year and was told that everything was perfect, everything was normal. And then I went back and ordered my lab tests and said, oh, wow. These were definitely not normal. So one of the screening tests for thyroid disease that is really great for advanced cases of thyroid disease is the TSH test. And this is the thyroid stimulating hormone. And it's actually a hormone that's not released by the thyroid, but it's a hormone that's released when the pituitary senses that our body has low levels of thyroid circulating. And so this is one of the things that will change and will be elevated when we don't have enough thyroid hormone levels on board. The problem with this test is one, when doctors first established the normal reference range for this test, they actually put a bunch of people's blood tested a bunch of people's blood, and some of these people actually had unknown thyroid disease. So this reference range was very lax where they were saying, if your TSH is up to 10, you're considered normal, when in fact a normal person without thyroid disease should have a TSH somewhere right around one. And the other issue with this test is for the first 10 to 20 years that a person has Hashimoto's, this TSH number might be still within the quote, unquote, normal reference range. And this may not change. So one of the earliest ways to test for thyroid dysfunction is to do testing on thyroid antibodies. So we talked about how the immune system is at war with our thyroid gland and Hashimoto's. When we test for these antibodies, we'll be able to tell whether that's the case or not. These antibodies may be detected for a decade before we see a change in the TSH screening test. And just having these antibodies on board is going to give us a lot of the symptoms, like the fatigue, like the weight gain and like the anxiety palpitations and some of the other mood kind of shifts that we see with Hashimoto's.

Well, this is an important one to bring up because I got to tell you, one of the things I've heard because I can't order labs, so I would have my clients go to their doctor to order the labs, and I'd ask for him to get a thyroid panel plus antibodies. And the doctors wouldn't get the antibody test if their thyroid panel was normal. So what you just.

Right. And that's so silly.

Yeah, it's like, well, wait a minute, this is the one you really need to be looking at. Now, the other thing that I've seen is clients getting on thyroid medication, but they still don't feel right. So what's going on there?

You know, and that's a very, very Common thing I see as a pharmacist, too. You know, in 2014 and 2013, Synthroid, or synthetic thyroid, was the number one prescribed medication in the entire United States. So that was the number one drug that was prescribed. And, you know, some people, just some people do great on this medication. It's actually the identical version of one of the thyroid hormones we make known as T4. You know, most people, they're able to take this T4 and convert it to T3, which is the more active thyroid hormone. And this is what I, you know, I think of it as our beautiful hair hormone, as our helping us lose weight hormone, helping us keep a good mood hormone. And that's going to be four times more active in the body than the T4. Now, on paper, this conversion should take place without any problems, but when we get into the real world, some people just don't convert that T4 from the Synthroid medication to into the active T3 in their own bodies. So we often will find that those people will actually do better, like old school medications that have been around for a really long time and that were first isolated from the thyroid glands of animals. So these are gonna be identical to the own thyroid hormones that we produce in our bodies, and they're gonna have a combination of the T4 as well as the T3, which is our active, beautiful hair, helping me lose weight and helping me have great energy hormones.

I know those are the ones that I take, and they made a major difference. And what about, besides taking thyroid medication, if you've got a thyroid condition, what are some of the other things that you could do to take an integrated approach to making yourself better?

And, jj, this is why I love your work so much, because one of the biggest triggers in people with Hashimoto's and thyroid conditions is going to be food. So looking at balancing their blood sugar, and I know that you preach this all the time, but balancing blood sugar is going to be one of the very first things you can do to help yourself feel better. So making sure that you're getting enough proteins and fats within your day and that you're not doing a lot of carbohydrates, even things like excess fruit, can be problematic whenever we have blood sugar swings. This actually weakens the thyroid gland and it weakens the immune system and results in more of an attack on the thyroid gland. And so that's one of the very first things I recommend. And so the other thing is looking at food sensitivities. And I know this is really big for you. In the virgin diet as well. So gluten free diet can make a tremendous difference in how a woman with Hashimoto's with a thyroid condition feels. I surveyed 2,232 of my readers, and 88% of them said that they felt better gluten free. So the results that we saw with that was better mood, losing weight, reducing the antibodies which measure how aggressive the attack is on the thyroid gland. And I've even seen some people, people who actually will get into remission from their thyroid condition by going off of gluten. So then they don't attack their thyroid anymore and they don't even have to take medications anymore.

It makes so much sense with the role of gluten in autoimmune disease. And I'll tell you, I'm right there with the same numbers. It's right around 90% of people feel better when gluten's out of their diet. So I don't really understand why we do tests for gluten. Just pull the gluten out. That's the best test. Right. And if you've got autoimmune disease, gluten has no place in your diet.

Absolutely. And then some of the other food triggers are going to be dairy, soy, grains. Some people will react to eggs, nightshades, as well as seeds and nuts in some cases. And the biggest ones I have people start with are going to be gluten, dairy, and soy. And for some people, that's a complete game changer. I had acid reflux for three years, and then within three days of getting off of gluten and dairy, that was gone. And I was like, wow, this, it could be that easy. And I had been on medications, three different medications for the acid reflux, and it would not budge.

I know sometimes you hear this and you're like, it's. You're so excited and so angry at the same time because it's like, are you kidding? You know, all these years and changed in a matter of days. And that's what I've seen when people pull those foods out that are hurting them. So both those things you just brought up, I love especially the.

The little.

The little saying about fruit, because I find so many people seem to think, fruit, some free food. I don't know where we've gotten that urban legend from, but, man, it can wreak havoc on your blood sugar.

Absolutely. And then the other thing that I have, people start with is looking at their nutrient deficiencies. So thyroid conditions are going to be a combination. If you're Looking at the root cause approach and trying to figure out what's causing the condition and trying to potentially reverse the condition or slow it down or just live your best life with it is looking at nutrient deficiencies, food sensitivities, your gut function, looking at whether or not you have infections, whether you have impaired ability to handle stress, or impaired ability to get rid of toxins. And nutrient depletions are a very, very important part of that. So making sure that you have enough of selenium on board is going to be very, very helpful. I found clients with thyroid conditions, they do really, really well on about 200 micrograms of selenium methionine per day. This has shown to clinically reduce thyroid antibodies, it reduces anxiety. A lot of times women will say their hair will grow back, they'll feel more calm, it'll help them lose weight. And that's one of the first things I always start them with. And then also looking at getting their vitamin D levels tested, getting their B12 levels tested, as well as getting their ferritin tested. So ferritin is an iron storage protein and this is oftentimes going to be depleted in thyroid conditions. And we actually need ferritin to properly activate and utilize our thyroid hormone. So you could be on medications, but if your ferritin is low, you're not going to be using them correctly. And then the vitamin D is very, very important in immune system regulation. So if you have very low levels of vitamin D, your immune system is not going to be working properly. And so we often will get people on these nutrients. In addition to that, we'll do B vitamins and then people will just start feeling better. So they'll be on the same, even the same diet, the same dosage of medications, and we'll put them on a B vitamin that has B12 and then thiamine in and they'll start seeing their fatigue levels improve and they'll start seeing a lot of their symptoms get better. So this is one of the first things that people can start doing and they can do this within their own doctor. So it doesn't, you don't have to work with a functional medicine doctor Usually these things are going to be covered on insurance, these types of tests. And then you would just have to get supplements and you can do that usually on your own.

I love that you brought up the ferritin one too, because that's an interesting one that we don't think about much. And you might even be eating grass fed beef and taking vitamin C to help with the uptake but still have to supplement with additional iron if you've got thyroid conditions. So that was one that I wasn't aware of until I found it out myself. So I was like, where'd that come from? And I never had that problem until I had a thyroid condition. So sort of interesting. So I love that take. Now I know that you have something cool for everybody. So I'm going to Send everybody to thyroidpharmacist.com gift, right? That's where they go, right? Thyroidpharmacist.com gift Tell everybody, Isabella, what the gift is that you've put together for them.

So the gift actually has a digestion and depletions chapter. So it'll go over all of the nutrient depletions that people with thyroid conditions will have. One of the big ones and one of the reasons why people with thyroid conditions will have a depletion in their ferritin levels could be due to low stomach acid. So I'll also talk about using a supplement known as betaine with pepsin to give you more stomach acid that can really help boost those iron levels. And even more so, it makes a dramatic difference in your fatigue levels. So I went from sleeping like 11 hours a night on thyroid meds to 8 hours a night after starting this supplement.

So that's going to be a huge one. I'm so glad you mentioned that. Gosh. Yeah. That was a life changer too.

It's such a game changer. And I've got information on how to use that. Then we have the Thyroid Diet Quick start guide. So if you're just trying to get started on eating the right way for thyroid, you talked about things that you learned the hard way. And I've learned a lot of things the hard way, too. So when I first started with my thyroid diet, I was doing all kinds of foods that were sending my blood sugar on a roller coaster because I was doing gluten free junk food. So this quick starter guide has information on how you can get started on this diet without making all the same mistakes that I made when I was first getting started. And then we have 10 nutrient dense recipes to get you started on your healing diet.

Awesome. I love that. And I just so appreciate you joining me here today, Isabella. And again, I want to remind everyone listening that if you go to thyroidpharmacist.com gift you can pick all of that information up. And I know we've had Dr. Alan Christensen on too. You two work together. You complement each other so, so well, and you've given us some new information that I have not gotten out into my community ever before. So I hugely appreciate that. And just to let everyone know after the break, I'm going to be answering a listener's question, so stay with me.

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Welcome back. This is the time where I answer a listener's question. And today's question is is so important. And it comes from Jessica.

Hi, my name is Jessica Field. I just bought your book, the virgin diet. I'm 36 years old and I have about 150 pounds to lose. I was wondering if you could offer me any advice on how to be successful on your program. To be honest, I failed so many times before that. I just really don't want to fail again. And I really want this to be my year. Obviously, I feel very embarrassed about myself. Going to work is very hard. I work as a nurse in the nicu and I just lack confidence. And I know a lot of it is based on my appearance, and I don't want to be that person anymore. So any words of advice, words of wisdom, I would really appreciate. Thank you so much.

So how do you ensure your success on a program? You know, it really comes down to, and I heard this early on in my career, and I thought that is the greatest statement. It's not the how, it's the why. Sure, it's important how you do this, of course, but behind that is your big why. Why, Jessica? Now, why are you doing this? You say you've tried this so many times and you've failed so many times. So what can we do to make this different? I mean, obviously the important thing is that you're following a program that really works. You're following the right set of rules, but that's only a piece of it. The biggest piece of it is really what's going on, not so much the end of the fork, but between your ears. And really, where are you coming from? That's going to motivate you through the tough times. Because there will always be tough times, whether it's what you're choosing to eat or how you exercise or your sleep or how you're living your life. So the first step of this is really getting to this point of view.

Believing of knowing that you right now, Jessica, are awesome.

You're fantastic in everything that you do. Because you said, you know, I don't feel confident, I don't feel good about myself. Well, when you don't feel confident, you don't feel good about yourself. It's really a catch 22. Then you don't take great care of yourself. Then you don't take great care of yourself and you feel less confident and it becomes this really bad downward spiral. Let's start now knowing, look who you are. You're an ICU nurse. My son was in the icu. I bowed down to you. So first off, you are good enough. You're amazing right now. Now all we're going to do is help you get even more. So have more energy, have confidence, have more confidence. So start knowing that you're worthy, that you are worth it. And then let's get this big goal. Let's start taking you from where you are now to where you want to be. What does that look like for you, Jessica? What is your life going to be like when you've dropped the 150 pounds? And anyone listening, whether it's 10 pounds, 20 pounds or you're in pain or low energy, what does this life look like where you're going? Because you're very clear about what it feels like to be where you are right now. But I want to take you to where you want to go and I want you to live there. Be there now. What does that feel like? Get so clear on what that looks like. You, you know, being able to work a 12 hour shift with Boundless energy and then come off and be fine. Having an amazing partner who you feel totally comfortable with going out and pursuing a higher level in your career, being able to run around with your kids, whatever those things are.

What do those look like for you?

Lock them in, make them real to yourself. Visualize them. This is what you need to hold on to. And then you set your very specific goals of how much weight do you want to lose? And then you take it down to your action steps. Okay, so what does that mean? So let's say whether you're starting with the Sugar Impact diet or the Virgin diet, you're dialing that in right now and you're going to work that program, you're going to start with your assessment, you're going to go through the reset part, that you're going to figure out your personal discovery process to design the diet that works for you. You're going to make sure that you're getting your sleep, you're going to make sure you're getting your water step by step. What are those things that you do? And a couple things will help really.

Lock in that success.

Number one journal commit to this. This is something that I do every single day without fail is that I get up and I intention in my journal. Not just the whys and the big dreams, but also those action steps, those very specifics of what I'm going to do to make that happen. Hugely important. And then get an accountability partner. Get someone who's going to support you to be your best self in a very positive, kind, loving way. But tough love, they're not going to let you off the hook if you go, I went and lost it. You know, I cookies, they're gonna pull you back in. So find a great accountability partners or support community and start that journaling. And then please, please, please share your success with us at my Facebook community at JJ Virgin fanclub. This is why me and my team do what we do. When I heard your story I was like ah. Just wanted to reach through the computer and just give you a big hug and tell you you can do this. But again, it starts with knowing that you right now, Jessica, are awesome. You're worth it, you're worthy. Now if you'd like to submit a question, just go to jjvirgin.com ask and you can leave me a voicemail. And I love hearing from you. And one more way I'd love to hear from you. I would hugely appreciate it if you could jump on Stitcher or iTunes and leave a review for me. It helps a bunch and be sure to subscribe. Subscribe and share the show with your friends. This is JJ Virgin signing off and reminding you that you are worthy. Dare to live a life that matters.

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