Catch Thyroid Disease Early, with Dr. Eric Osansky

There's no single diet that fits everyone perfectly. So for my Graves patients and Hashimoto's patients, I do like autoimmune paleo. Admittedly it is restrictive and some people maybe standard paleo is a better option. I think the most important thing is eating whole healthy foods, plenty of plant based foods, vegetables.

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Hello and welcome to another episode of the Five Journeys podcast. Live Live like youe Matter. I'm Dr. Wendy Trubo and Dr. Levitan couldn't be here today, so it's just me with our guest, Dr. Eric Osansky. He is a chiropractor, clinical nutritionist and certified functional medicine practitioner who helps people recover from thyroid and autoimmune thyroid concerns. He's author of the books Natural Treatment Solutions for Hyperthyroidism and Graves Disease and Hashimoto's triggers. Dr. Osansky was personally diagnosed in 2008 with Graves disease and after using a natural treatment approach, has been in remission since 2009. Eric, welcome to the show. Thanks for being here.

Yeah, thanks for having me, Wendy. I'm excited to be here.

Me too. So can you tell the audience start to distinguish the differences between hyper and hypothyroidism?

Sure. So what? Most hyperthyroid cases are Graves, which is autoimmune. And most hypothyroid conditions are Hashimoto's. And so with hyperthyroidism you get an elevation of the thyroid hormones, free T3, free T4, the main thyroid hormones. And with Hashimoto's hypothyroidism, you get lower thyroid hormones. Sometimes it's subclinical, as you know with you could have Hashimoto's and it could be on the lower side of the reference range. Other times they could be overtly low. And then you have a hormone, tsh, which is actually a pituitary hormone, thyroid stimulating hormone. And that's kind of like a signal. So you know when someone has hyperthyroidism and they're having too much thyroid hormone, you don't want the pituitary gland to. You want the opposite. You want the pituitary gland to stop the thyroid gland from making thyroid hormone. So you usually see that TSH low and many times undetectable, like less than 0.001, for example. And then what? Thyroid hypothyroidism, it's the opposite. When the thyroid hormone levels gets too low, pituitary gland says, hey, we need more thyroid hormone. So it tells the thyroid hormone to produce more, I mean, tells the thyroid glands to produce more thyroid hormone. And as a result, with hypothyroidism, a lot of times you'll see that TSH elevate. And so those, as far as a blood test, those are the main differences as far as symptoms. When I dealt with hyperthyroidism, I had weight loss, I had increased appetite, I had, I had palpitations, I had tremors, I had some loose stools. Some people have also thyroid eye disease, which is associated with graves, where the immune system attacks the tissues of the eyes and you might get bulging and eye pressure and other symptoms. So I didn't have that. About 50% of people with grave disease experience that. With hypothyroidism, it's the opposite. You get again, lowered metabolism. So you're getting weight gain, you get brain fog, you get coldness, coldness in the hands and the feet, you get constipation. And you know, I mean, there could be other, like hair loss. I see with both, I see a lot with hyperthyroidism, insomnia. Actually, I didn't mention that. Anxiety insomnia, also common with, you know, more so with hyperthyroidism. So again, just think with hyperthyroidism, everything's revved up. And again, what hypothyroidism, it slowed down. With that being said, there could be sometimes overlap in symptoms. Sometimes people with hypothyroidism could get transient hyperthyroidism due to damage of the thyroid gland and the immune, the thyroid hormone being released in the bloodstream. But in a nutshell, those are some of the main differences between hyper and hypo.

Can you talk a little about what causes the thyroid to go off the cliff in the first place? Like what do you see in terms of triggers that throw the thyroid off?

Sure. So when we talk about triggers, where, I mean, there's autoimmune conditions and non autoimmune conditions. So again, most hyperthyroidism and most hypothyroidism is autoimmune. You know, Graves, these Hashimoto's, we do have, you know, some, some non autoimmune thyroid conditions as well. But as far as triggers, I like to talk about four main categories of triggers. So there's one is food. And I'm sure a lot of your listeners are familiar with the havoc that gluten can cause in many people and celiac disease. And a person with one autoimmune condition is more likely to have other autoimmune conditions. So in the research, it shows that someone with Graves or Hashimoto's is more likely to have celiac disease.

Let's talk about that. It's the same gene, actually. So the gene for celiac, there's two, the DQ2 and the DQ8. And on DQ8 is a gene that messes with your thyroid. So you are more likely to have Hashimoto's, which is low thyroid autoimmune condition. But it is genetic and it all. I mean, that's partly why it goes together because it's on the same loci of a gene. It's kind of crazy.

Yeah, it is. And that's why. Probably a good idea. The challenge is a lot of people work with me, they've already gone gluten free. But if you haven't gone gluten free, probably not a bad idea to test for celiac disease just to make sure, because once you eliminate gluten, as you know, especially if it's like for a few months, then you're not going to form the antibodies and those tests are going to be worthless. But so there's gluten. And even if someone doesn't have celiac disease, as you know, there's non celiac gluten sensitivity. I mean, people still should really avoid gluten. I can't say it's a trigger with everybody, even though there is research that shows it can cause an increase in intestinal permeability with everybody, which is a medical term for leaky gut. But there's gluten, there's dairy. Corn in the research has shown to cause a leaky gut, and even salt, too much salt. I do recommend sea salt to my patients, but there's evidence that Salt can increase TH17 cells, which are a factor in driving autoimmunity.

You mentioned diet just now. Is there a particular way of eating outside of gluten that you recommend for people with hyperthyroidism? Adopt?

Yeah, I wouldn't say a secret sauce. There's, you know, again, something I'm sure you know is that there's no single diet that fits everyone perfectly. So, you know, I would say for my Graves patients and Hashimoto's patients, I might. I do like autoimmune paleo. Admittedly, it is restrictive and some people maybe Standard Paleo is a better option. So I never force AIP autoimmune Paleo on people. I think the most important thing is eating whole, healthy foods, trying to eat. I do encourage plenty of plant based foods, vegetables and I mean there are some foods besides the obvious. Again, gluten free, I would say dairy free, no unhealthy oils. Usually I recommend grain free, which is also part of just regular paleo, not just autoimmune paleo. And legumes gets a little bit tricky some, you know, like if you're following AIP or Paleo that'll say no legumes. But then there are some other diets where they say if you properly prepare the legumes and if someone's vegan, vegetarian, you know that it might be difficult to follow just a strict AIP or a strict Paleo diet. So honestly, with any diet I look at it as a starting point. So whether it's autoimmune paleo or regular Paleo or modified Paleo, it's a starting point. We see how the person progresses and then we could always make variations in the future depending on again how they're progressing. Second stress, the second main trigger. And I think it's safe to say that especially over these last few years, stress has been extremely high. For a lot of us, if not all of us, it's always been a factor.

Well, how many people do you see where it's an acute event, they had something really noticeable happen versus what I'll call the water torture of it, where it's just constant and unremitting. Is there any way that you suss that out and see it's more about the constant unremitting versus the single event or is it both?

Well, I think more times than not it's more of the chronic stress. I mean, without question there's people that I work with and they had a trauma right around the time that they were diagnosed. And that could definitely have been a factor, at least a contributing factor, if not a main trigger. But what I see most of the time it's more of the chronic stress. Just the day in, day out stress, whether it's their job or just the relationship they're in my case, I definitely think more of a chronic stress was a factor. And when we think of stress, it's not only emotional stressors. So one thing, while I was losing weight, detoxifying, dieting, I was also exercising, but I'm pretty sure I was over training. And that is a stressor in the body as well. And I'm pretty sure that was at least a contributing factor in the development of my gravesee's condition.

Let's talk about stress for a minute. Because I only see women and they all say to me, oh, it's not that bad. And I'm like, what your brain thinks and what your body experiences are completely different. So it's in your mind you've sort of minimized the stress, like, oh, I can deal with it. It's not as bad as. And then you fill in the blank of that terrible experience you had. But the experience in our bodies, I always say to my patients, is when you're stressed, your adrenals are super primitive. So if they get turned on, they're not grading like, oh, this stress isn't as bad. All they know is, a lion's gonna eat ya. And you need to shut down detox, shut down digestion and absorption, get sugar to put it to the big muscles so you can run, and most of the time, disrupt your hormonal patterns, because that's not a priority right now. So I always say to patients, if you have a thyroid issue, you have an adrenal issue by definition, because the adrenals are gonna be much more powerful at turning on or turning off the thyroid if they're out of whack because of all those things that happen. So I think, I mean, you just really hit on a brilliant thing about what do you need to do is even if you don't think it's a lot of stress, you need to quiet it down, get enough rest, exercise, meditate, resolve your toxic relationships, stop eating, all of that. Right. It's just huge.

Yeah. And one thing I'll also say is that I definitely overestimated my stress handling skills when I dealt with. With graves too.

I think we all do. Right?

Yeah, you're right. So again, definitely, I think everybody should block out time on a daily basis for stress management. So I'll leave it at that before going into this third trigger. So the third trigger relates to your amazing book, Ditch the toxins, Reduce our toxic load. We have so many different chemicals out there. And again, people, I'm sure most of the listeners have read your amazing book and just xenoestrogens, the heavy metals, I mean, it's again, the fluoride, the flame retardant, but it's accumulation of everything. It's not just focusing on the flame retardants, but again, just trying not to drink out of plastic bottles on a regular basis, even if they're BPA free and trying to again, even the. Another conversation we had is fish. Just trying to maybe not eat fish every day or not eating larger swordfish.

High mercury fish. Yeah, don't eat that more than once every three months if you're a bad detoxer like me. I mean, I was on your podcast where we talked all about toxins, and that really scratched the surface. I feel like we really work hard to clean up our life. And I'll just put the plug in for go systematically and go slowly and you won't do it in a day. This is like a lifelong process. I mean, I'm sure you're still cleaning. I know I'm still cleaning it up and making mistakes. Sometimes I'm like, oh, that wasn't a clean product. How did I get greenwashed?

Yeah, yeah. It's always a work in progress. And yeah, so I'll leave it at that because again, they could just refer to your book, which if anybody listening hasn't read it, definitely check out Dr. Wendy's book. So it's relevant. I'm not just saying not to plug your book, but it's relevant to the conversation. It is a trigger. And when we think about over the years, what has changed? I mean, the next trigger that I'm going to talk about is infections. But we've had Epstein Barr and these other infections around for a long time. There's always been stressors with food. We could argue the chemicals in the food, too. So there's overlap between that first trigger, but that's the main factor, the chemicals over the last few days. So arguably, even though I started with food, and I could say food is the most important because that's what we put in our body every day, we could say that number three on my list of triggers could be pushed to the top.

Yeah, I'm all about. I mean, I always think it's toxins, but I do agree with you. You eat three times a day or more, and so you're going to want something that you're constantly doing to be optimized. But the food and toxins go together. Right? Because don't eat artificial colors, artificial flavors, artificial sweeteners, don't drink coffee that's moldy. Don't eat a lot of sugar, and then make sure your food's organic. If you do that, you're pretty darn good. Right? That's a great start. Okay, tell me about the infections.

So, yeah, so infections also could be a potential trigger. Again, there's viruses such as Epstein Barr, and again, this is in the literature, too. There are some that just throw out different infections. And not everything's in the research. I'm sure there are infections that we're not aware of that could trigger Graves and Hashimoto's, but in the research, there's again, Epstein Barr. There's H. Pylori, which is in the gut, and Yersinia entercolytica, which is another one in the gut. Borrelia burgdorferi, which is the pathogen associated with Lyme disease. Parasites, a little bit tricky. There's not a lot of research with parasites and autoimmunity. I certainly have seen it in my practice, but there's only some case studies, and those relate to Hashimoto's. I don't know what you've seen as far as, like, your experience, but I.

Was just laughing when you mentioned the Lyme, because it's just amazing to me how pervasive it is and how many sort of. It's like an octopus disease because it's got its tentacles in every other system. So it's not just like strep, where you have a sore throat and a fever, and then you take antibiotics for a couple days, you're better. It's really impacting every system.

Yeah, I agree. I dealt with Lyme. Lyme wasn't a trigger in my case, but 10 years after I was diagnosed with Graves, I dealt with chronic Lyme. So it's definitely not fun to deal with. But one more thing on the Lyme topic is, you know, and this is really the case, probably not just with Lyme, but other infections. But, you know, you could have an infection and not know it. When people think of infection, they think, you know, I'm going to have a fever. I'm going to just, you know, feel really fatigued. And, you know, you know, with Lyme, those are classic symptoms, especially like the debilitating fatigue and migrating muscle and joint pain. My symptoms are more neurological, and I'm sure I had chronic Lyme for at least a few months, maybe a few years before I developed symptoms. I'm not trying to, you know, like, scare everybody listening to say, yeah, you probably have Lyme, but just, you know, there. Some people are easily dismissive, Oh, I don't have this. I don't have that because I don't have this set of symptoms. Same thing with gut. You could have H. Pylori, but not have heartburn or not have reflux. So again, you can't always go by the symptoms.

All right, so to recap that, we have food, stress, toxins, infection, correct?

Yep.

What are some non immune reasons other than the parasites. I feel like we might have covered this, but I'd like to sort of put it all in a basket for people. What are some of the non immune things that can cause hyperthyroidism?

Well, again, there's the stress, which I mean everything kind of, I guess stress also affects immune system. So again, I don't even know if we could say stress. With the case of toxic multinodule goiter, there's the problems with estrogen metabolism, there's again insulin resistance and not that we can't tie those into the immune system somehow, but those. As far as non autoimmune thyroid conditions, there's also subacute thyroiditis, which subacute thyroiditis is another example of a non autoimmune thyroid condition now commonly caused by a virus. And virus. Of course there is that relationship between immune system and viruses because I always look at viruses more of an immune system problem. So it's not autoimmune like Graves disease or Hashimoto's, but if someone has any type of virus, I think it's important to optimize the health of your immune system. I mean you could take antiviral supplements and things or herbs and things like that. But I think number one priority is optimizing immune system health.

It's really a holistic view of the health. Right. What's happening in there? Because I didn't mean to interrupt you because you were about to say something, but you're sort of highlighting the whole system is involved in what happens.

Yeah, yeah, definitely. I mean, you know this, we need to look at the entire body. I mean just the gut, the adrenals, the liver. Um, yeah, I mean it all, it all goes together. So with all these conditions, even if someone comes in with toxic multinodular goiter and assuming they also don't have an autoimmune component, because again, people could also have both. They could have toxic multinodule goiter and they could have autoimmunity. But you know, we're still going to do things like estrogen metabolism. The importance not. You mentioned environmental toxins. But the gut, you need to have healthy, you know, healthy gut in order to have healthy estrogen. So really it does all, all relate together. One other thing I didn't mention is subclinical hyperthyroidism. So that's another type that's not autoimmune. And you could have subclinical Graves which is autoimmune, but you could have a non autoimmune component where you have low tsh, but then thyroid hormone levels are looking good. And that gets a little bit tricky because, again, I can't say there's a definitive cause when it comes to all cases of subclinical hyperthyroidism. So I tend to focus on the basics. Again, diet, lifestyle, adrenals, healthy gut. And a lot of times that'll resolve it. I can't say all the time, but those are, I would say, the different types of hyperthyroidism.

Let's talk a little bit more about the different types of hyperthyroidism. How can you tell the difference between them?

Sure. So again, most types of hyperthyroidism are graves, which is autoimmune. And so how did I know that I had graves? So I went to a regular medical doctor first and I got my thyroid hormone levels tested, but that didn't confirm I had graves. That just confirmed I had hyperthyroidism. And that was due to the elevated thyroid hormone levels of depressed tsh. And so I went to an endocrinologist, and so they did the antibodies test on me. So there's other ways, which I'll talk about in a minute, but the elevation in thyroid antibodies. Specifically for graves, it's the thyroid stimulating immunoglobulins, which is a type of TSH receptor antibody. I mentioned TPO or thyroid peroxidase antibodies, but we see those with both GRAVES and Hashimoto's. So in my case, I have the elevated thyroid stimulating immunoglobulins. And so that itself is diagnostic of Graves disease. Another way, if someone again has the symptoms of thyroid eye disease, that also is usually indicative of graves. And then they also do something called the radioactive iodine uptake test, where they administer a small amount of radioactive iodine. And. And the thyroid, pretty much, it goes to the thyroid. And if it's elevated, that could also be a diagnosis of graves. I'm not a huge fan of that test.

Put a toxin in you to diagnose the disease.

Exactly. But surprisingly, a lot of endocrinologists recommend that. And I mean, if a patient already has gotten that test, which actually happens a lot, a person will see me, they already got the test, and, you know, I won't make a big deal of it. They got it. And the thing is, if you have the elevated antibodies for graves, then, you know, you have graves, you don't really need the uptake test. And arguably you don't need it even if you don't have the antibodies for graves. But so if GRAVES let's say the antibodies are negative. Well, a thyroid ultrasound may be performed or even if you have graves. I had graves and honestly, my endocrinologist didn't want to perform a thyroid ultrasound. She just palpated my thyroid and she said, yeah, I think everything feels, feels okay. But I talked her into having an ultrasound just because I wanted to see were there any nodules and it was clean.

For the listeners, what would be the relevance of having a nodule or some kind of growth? Because if you simply have alterations, what difference would it make? It sounds like there's something driving that that would say, okay, you want to make sure that there's not X because of Y. What is that?

Correct. So if someone, if. Well, if you ask an endocrinologist, for example, many times they'll be dismissive of thyroid nodules because they are very common and most of the time they are small. And, you know, we could make the argument they're not causing problems. But the answer I always want to ask, or the question I always want to ask is why, why does someone have the thyroid nodule then? You know, the research shows problems with estrogen metabolism and insulin resistance. You know, those are two of the more common causes. So those are obviously areas that I would look into. And so, yeah, so regardless of whether if, obviously if the thyroid nodule is larger, it's more increased risk of thyroid cancer and, you know, causing other problems. But, but even if it's small, again, not that I make a huge deal out of it, but I still want to try to address the cause of the problem.

Sure. Okay. So you really want to make sure there's no other issue going on that might be life threatening, should we say?

Correct? Yeah, exactly. And with the ultrasound, it will show. It's not going to determine if someone. It won't confirm if someone has thyroid cancer, but it'll give certain characteristics. And if someone has those characteristics, then they might need to get a biopsy. And, and then, you know, that could sometimes confirm that that's not perfect either. But, but there. Another type of hyperthyroidism is. Speaking of nodules is toxic multinodule goiter. And so a lot of people have just what's called multinodule goiter without the toxic component. So multinodule goiter, as the name suggests, is when you have multiple thyroid nodules in the presence of a goiter. And a goiter is an enlargement of the thyroid gland. And so a toxic multinodule is when you have hyperthyroidism in the Presence of that multinodule goiter. And sometimes it could be because the nodule itself is causing the hyperthyroidism, Other times it's just coincidental. But either way, you want to try to address the cause of the problem, which most endocrinologists, of course they don't do. They just either recommend the anti thyroid medication, or many times we'll recommend surgery or radioactive iodine as a solution. But if the problem is estrogen, you know, issues with estrogen metabolism, insulin resistance, again, we want to address those factors. And a lot of times by addressing those factors, we'll see the problem resolve.

It's really interesting because just thinking about when you look at issues with estrogen metabolism and issues with estrogen, insulin and estrogen, both of those track back to toxins. Also, it all comes full circle, right? Because what are the things that throw off insulin? It's toxins. What are things that throw off estrogen? Either toxins like xenoestrogens or a gut dysfunction. Because if your gut's out of whack, your hormones are gonna be out of whack. Cause that's how you get rid of your toxins that you're trying to excrete after you've processed them. All right, it all comes full circle. So have you had patients where you really needed to drill into specific testing in order to distinguish between what they had? Do you use stool to look at any parasites or any inappropriate bacteria to distinguish what's going on for them and say, hey, your risk is higher because of this?

Yeah, I do recommend testing to determine, as we spoke, about the triggers, underlying imbalances. So I can't say I do stool testing with everybody. I know some functional medicine practitioners do, and maybe I should. I do adrenal testing with most of my patients, either saliva testing or dried urine testing. And then with the stool testing, I have a story to tell. With the stool testing, as far as, you know, again, you can't always go by symptoms. So with stool testing, yeah, I do like stool testing to look at things like H. Pylori to look at parasites. Again, I can't say I recommend it to everybody, but I learned years ago that you can't always go by symptoms. Because I did have a patient who just wasn't progressing as expected. And at the time, I didn't do a stool panel. I was thinking about it, but he had no digestive symptoms. He had regular bowel movements. I just didn't suspect anything going on from a digestive standpoint. And so I told him I Think if we did a stool panel, probably would come back negative. You'd just be wasting your money. And long story short, he saw another practitioner, and sure enough, the other practitioner did a stool panel. And the only reason I knew, I followed up with him a few months later, and he told me the story through email, and he said that another practitioner did the stool panel, found a parasite, which really surprised me because I always associated, at least at the time, loose stools, diarrhea, gastrointestinal symptoms, but found a parasite, and he got into remission by getting rid of the parasite. And it was a learning lesson for me, just because you can't always go by symptoms. So even though I can't say I recommend stool testing for everyone, it's something at least many times I'll give as an option. And if someone's not progressing with initial recommendations, it's something I'll look into. And of course, if someone is having overt gastrointestinal symptoms, if I am suspecting something, I'll recommend a stool panel. But it's a lesson. Yeah, you can't always rely on symptoms when it comes to testing.

Got it, Eric. Thank you. I mean, you've given a ton of awesome data. I know people are probably wondering how they can get in touch with you. How can people find out more about you, get in touch with you? Buy your books.

All right, sure. So my main website is naturalenzocrine solutions.com and then also they could check out my podcast, which is Save My Thyroid. And you could, of course, find that on Apple and Spotify and anywhere podcasts are found. And then on my books, Natural Treatment Solutions for Hyperthyroidism and Graves Disease. And Hashimoto's Triggers you can find on Amazon. And those are the main ways. I also have a checklist, the Thyroid. If they visit thyroidchecklist.com, they could also access a checklist where I discuss the different triggers of Graves and Hashimoto's. And so that I think will be helpful for anyone dealing with an autoimmune thyroid condition.

Awesome. We'll put everything in the show notes. Okay. And so they can find everything on how to get to you. This has been fantastic. I'm super grateful you came on our show, and I know my partner's gonna be really bummed he missed this conversation. So thanks for joining us for another episode of the Five Journeys podcast Live like youe Matter. Our guest today was Dr. Eric Osanski. Don't go it alone.

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