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How To Optimize Detoxification: Part 1

Most people reading this are aware that the liver is involved in detoxification.  However, many don’t realize how complex of a system this is, as there are many different factors that can affect the detoxification pathways.  And if any one of these factors are negatively impacted then you very well might have problems with detoxification.  Plus, remember that detoxification isn’t just about removing harmful chemicals, but hormones as well, including thyroid hormone, estrogen, etc.  There is so much to discuss that I’ve decided to split this up into two different blog posts, as in this post I will talk about how to optimize phase one detoxification, and in the next post I will focus on how to optimize phase two detoxification.

One thing I do want to point out is that while most detoxification takes place in the liver, keep in mind that the gut, lungs, kidney, and skin also play a role in detoxification.  As a result, if one or more of these other areas are compromised then this can affect detoxification.  For example, I’ll be talking about the CYP enzymes, which play a role in phase one detoxification.  And while these enzymes are primarily located in the liver, they are also located in the gut as well.  And this is one reason why having a healthy gut is important for optimal detoxification.

Understanding The Basics of Detoxification

Phase one detoxification is all about the transformation of fat soluble compounds into reactive intermediates.  I’ll explain what this means in a minute, but I first want to mention that this transformation requires the help of the CYP enzymes I briefly mentioned earlier, which I’ll expand on shortly.  While I’ll be focusing on phase two during the next blog post, I did want to mention here how this phase is involved in conjugation with the reactive intermediate to form a water soluble metabolite that will get excreted.

In order to better understand this let’s look at an example.  If someone uses a skincare product that includes a xenobiotic (a foreign chemical substance), as part of the phase one detoxification process the liver will use certain enzymes to transform this chemical, which in turn will become water soluble after the phase two reactions.  The same concept applies when someone is eating a vegetable with pesticides, as the body will transform the chemicals that are in the pesticide, and eventually these chemicals will become water soluble.

This is a simplified example, as in phase one what frequently happens is that the transformation process turns the environmental toxin into a more harmful reactive intermediate.  This in turn can form free radicals and cause damage to your DNA, RNA, and proteins.  And while a properly functioning phase two system is important for the detoxification of these chemicals, you need an abundance of antioxidants to help minimize the damage caused by these reactive intermediates produced in phase one.

So for example, if someone doesn’t eat a good amount of fresh vegetables and fruits, which are filled with antioxidants, then this will lead to increased damage during phase one detoxification.  Taking antioxidant supplements such as vitamin C, vitamin E, and glutathione can also help to some extent, but you need to eat a healthy diet in order to minimize any negative reactions from phase one detoxification.  In addition, certain factors can induce phase one activity.  In other words, certain factors can speed up the transformation that takes place in phase one.  This might sound like a good thing, but if someone doesn’t have sufficient antioxidants, or if there are problems with their phase two detoxification pathways, then this can cause a lot of oxidative stress, which of course isn’t a good thing.

The Role of The Phase One Detoxification Enzymes

Earlier I mentioned how certain enzymes are required for phase one detoxification, and these are called cytochrome P450 enzymes.  These enzymes are necessary for the biotransformation process.  However, certain nutrients, herbs, and drugs can either induce (i.e. speed up) or inhibit these enzymes.  Having certain genetic defects can also affect these phase one detoxification enzymes.  But what’s the significance of this?  Well, if something induces one of these CYP450 enzymes, then this increase in enzyme activity can in turn cause an increase in the reactive intermediates, which can cause further damage…unless if the phase two system is upregulated as well.  On the other hand, downregulating or slowing down these enzymes to some extent can be beneficial.  In other words, while you don’t want to completely inhibit these phase one enzymes, taking certain nutrients to slow down the activity of phase one detoxification can reduce the oxidative stress and damage.

It’s also important to understand that inhibiting or inducing these enzymes can cause problems when someone is taking one or more medications that are metabolized by the same enzyme.  Let’s look at an example of this.  CYP3A4 is a phase one enzyme that is involved in the metabolism of many drugs.  And grapefruit juice has compounds that can inhibit the CYP3A4 enzyme.  As a result, if someone is taking a certain drug that is metabolized by the CYP3A4 enzyme and the same day they take the drug they decide to drink some grapefruit juice, then this will decrease the metabolism of this drug, causing it to build up in the system.  On the other hand, the herb St. John’s Wort can lead to an increase in the metabolism of the CYP3A4, which can decrease the effectiveness of certain drugs.  This is one reason why St. John’s Wort is contraindicated when taking certain medications.

Does this mean you should never drink grapefruit juice or take St. John’s Wort?  Of course not, but if you are taking medication you might want to do some research to see if it is metabolized by the CYP3A4 enzyme, and if this is the case you probably would want to refrain from drinking grapefruit juice or taking St. Johns Wort.  Click here for a list of drugs that are metabolized by CYP3A4 and 3A5.  For those who take bioidentical hormones, you’ll notice that CYP3A4 and 3A5 metabolizes estradiol, progesterone, and testosterone.  The point I’m trying to make is that nutrients or herbs that inhibit or slow down these phase one enzymes can cause certain drugs to build up in the bloodstream, while speeding up the enzymes will increase the metabolism of certain drugs, which can reduce their effectiveness.

Understanding Some of The Phase One Detoxification Enzymes

What I’d like to do below is discuss a few of the more common CYP450 enzymes so you can better understand how they help to biotransform certain chemicals in the body.  However, it’s important to understand that these enzymes can have multiple roles.  For example, I’ll discuss how the CYP1A2 enzyme plays a role in metabolizing caffeine, but this enzyme is also important for estrogen metabolism.

Let’s go ahead and take a look at some of these enzymes:

CYP3A4 and 5.  As I mentioned earlier, the CYP3A4 enzyme is primarily involved in drug metabolism, and it is involved in the metabolism of certain hormones.  The CYP3A5 enzyme also is involved in drug metabolism.  In fact, 40 to 45% of all drugs are metabolized through these enzymes.  This includes acetaminophen, codeine, cyclosporin A, diazepam and erythromycin (1).

Earlier I mentioned how grapefruit juice can inhibit the CYP3A4 enzyme, which can cause certain medications to build up in the bloodstream.  Other agents that can inhibit this enzyme include antifungal medications, along with resveratrol.  I also mentioned how St. John’s Wort can cause induction of this enzyme, which in turn will speed up the clearance of certain medications from the body.  Red wine and licorice root can also induce this enzyme.

Can Grapefruit Juice Affect Thyroid Hormone Metabolism?

Getting back to grapefruit juice, one small study looked at the effect of grapefruit juice on levothyroxine metabolism (2).  The study showed that grapefruit juice might slightly delay the absorption of levothyroxine, but it only has a minor effect on its bioavailability.  I couldn’t find any studies which showed if grapefruit juice can affect the absorption or bioavailability of antithyroid medication, but one study  I came across showed that methimazole can cause a dramatic decrease of CYP3A4 activity, while partially decreasing the activities of some other CYP enzymes (3).  What this means is that if someone is taking one or more medications along with Methimazole, and if those medications are metabolized by the phase one detoxification enzymes that are affected by Methimazole, then the blood levels of some or all of these can be greatly increased.

CYP2D6.  This enzyme is involved in 25-30% of drug metabolism, as it helps to transform many antidepressants, antipsychotics, analgesics and antitussives, some beta blockers, antiarrythmics and antiemetics (4).  CYP2D6 genetic polymorphisms are very common (4).  Smoking cigarettes and eating charlbroiled meat can induce this enzyme (5) (6).  So if someone is taking a medication that is metabolized by the CYP2D6 enzyme and is a smoker, or eats a very well-done grilled hamburger, then this can actually increase the metabolism of the drug.

Earlier I mentioned how CYP2D6 genetic defects are very common. Tamoxifen is one of the drugs metabolized by CYP2D6, and this drug is commonly recommended as a treatment for some cases of breast cancer.  And just to show the impact these phase one enzymes can have, one research study shows that after taking tamoxifen for five years, women who had reduced CYP2D6 metabolism had an increased incidence of relapsing or dying at a rate that was 2.5 times higher than women with normal CYP2D6 (7).  In other words, if someone has a genetic polymorphism of the CYP2D6 gene, then they probably shouldn’t be given tamoxifen.  Fortunately this can be tested for, which I’ll talk more about shortly.

CYP1A2.  Although this enzyme is involved in the biotransformation of some drugs, it also plays a big role in the metabolism of caffeine.  I’ve spoken about this in a past blog post, as if someone has an upregulated CYP1A2 gene then they are considered to be a fast metabolizer of caffeine, and thus they are able to clear caffeine rapidly from the body.  On the other hand, if someone has a downregulated CYP1A2 gene then they will be a slow metabolizer of caffeine, and these are usually the people who have problems sleeping when drinking coffee, especially later in the day.  The CYP1A2 enzyme is also important in the biotransformation of 2-OH estradiol, which is considered to be one of the “good” estrogen metabolites.

CYP1B1.  This enzyme helps to transform certain pro-carcinogenic (cancer causing) chemicals into reactive intermediates.  For example, it helps to transform estrogen into the 4-OH metabolites, which is considered to be a “bad” estrogen metabolite.  Other chemicals can induce the CYP1B1 enzyme, such as PCBs, the chemicals in cigarette smoke, UV light, and even xenoestrogens.  In other words, exposure to these chemicals will cause the body to convert more of these chemicals into reactive intermediates.

Is this a good thing or a bad thing?  Well, it can be a good thing if you have a properly functioning phase two system (which I’ll talk about in the next blog post), as this will help to convert these reactive intermediates into water soluble molecules that will be excreted.  On the other hand, if someone has problems with their phase two detoxification pathways then these reactive intermediates can build up, which can increase the risk of cancer and other chronic health conditions.

But even if they have a properly functioning phase two system, if they are exposed to a high amount of environmental toxins then this still can be a problem, and in this case you might want to do things which can inhibit or downregulate this enzyme.  CYP1B1 is downregulated by DHEA, polyphenols, resveratrol, and pomegranate.  So if someone is exposed to large amounts of cancer-causing chemicals which are transformed into reactive intermediates, it probably would be a good idea to increase your consumption of polyphenol by consuming more vegetables, fruits, and spices, or perhaps you can take some resveratrol or eat some pomegranate.

CYP2E1.  This enzyme is involved in the metabolism of many different chemicals, including acetaldehyde, acetaminophen, acrylamide, aniline, benzene, butanol, carbon tetrachloride, diethylether, dimethyl sulfoxide, ethyl carbamate, ethylene chloride, halothane, glycerol, ethylene glycol, N-nitrosodimethylamine, 4-nitrophenol, pyrazole, pyridine, and vinyl chloride (8).  It is induced by ethanol, benzene, and styrene, and inhibited by grape seed extract, resveratrol, garlic, licorice root, and watercress.

It’s important to keep in mind that when I list certain nutrients, or herbs, and medications that can induce or inhibit a specific enzyme, these are just a few examples.  You’ll notice that with some enzymes I’ll list more inducers and inhibitors than others, and one reason is because with some enzymes we have a greater knowledge of the inducers and inhibitors.  And unfortunately there is the possibility that there are nutrients, herbs, and drugs which can induce or inhibit a specific enzyme but this hasn’t yet been discovered.

The Role Of Diet In Phase 1 Detoxification

Although phase two is more dependent on nutrients, eating well in phase one is of course important.  Earlier I spoke about the importance of antioxidants in helping to minimize the damaging effects of the reactive intermediates formed in phase one detoxification.  And while you can take antioxidant supplements, you really do want to make sure you eat a good amount of antioxidant rich foods such as vegetables, fruit, and even certain beverages such as green tea.  It’s also important to know that the CYP450 enzymes are heme-dependent, which means that they require iron to function properly.

This is one of the reasons why I have just about all of my patients get a full iron panel.  It’s also important to know that fasting can induce certain CYP450 enzymes.  This includes CYP2B1, CYP2B2, and CYP2E1 (9).  So in other words, fasting can help to increase the metabolism of these enzymes, which can increase the clearance of certain chemicals.  While this might sound like a good thing, if someone is exposed to a lot of environmental toxins and/or has inefficient phase two detoxification pathways, then this can lead to the buildup of reactive intermediates and make the person feel sick.  I’m not suggesting that fasting is never a good idea, but you do want to be cautious.

This might explain why many people (although not everyone) feels better when doing a juice fast, while some people might feel lousy when doing a water fast for a few days.  A juice fast involves plenty of antioxidants, which helps to quench the free radicals produced in phase one, but the nutrients in the fruits and vegetables also help to support phase two detoxification.  The problem is that phase two detoxification also requires sufficient protein, and so while there have been some great success stories involving people who did a juice fast for a prolonged period of time, it can also be problematic if you do it for too long.

How Genetic Mutations Can Affect Phase One Detoxification

I’m not going to get into great detail about genetic polymorphisms (SNPs), which are common genetic mutations.  But one can’t overlook these, as if someone has a genetic defect of one or more of the phase one detoxification enzymes then this can cause a lot of problems.  For example, in this blog post I mentioned how CYP3A4 and CYP2D6 are both involved in the metabolism of many different medications.  And if someone has a genetic defect in one or both of these phase one detoxification enzymes then this can affect the absorption of medications that are metabolized by these enzymes.  And of course people can have genetic polymorphisms of other phase one detoxification enzymes as well.

So the next question you probably have is…”how can I determine if I have a genetic polymorphism of the CYP3A4 or CYP2D6 enzyme, or other phase one detoxification enzymes?”  Fortunately genetic testing is available, as many labs offer it, and many people use a company such as 23andme, although this also requires using a third party service such as Genetic Genie or Nutrahacker to list the specific genetic polymorphisms.  If a medical doctor prescribes a drug that is metabolized by one of these enzymes, it would be a good idea to have the person do some genetic testing, although I realize that there are times when time is a factor and the person might need to take a certain medication sooner than later.  This is one reason why I think that genetic testing will become more routine in the future, as there will be a time and place when medical doctors will take into account the person’s genetics when prescribing certain medications.

What’s The Best Way To Support Phase One Detoxification?

I realize that this blog post was advanced for some people, and so I’ll summarize everything here so that you will better understand how to support and optimize phase one detoxification.

1. Consume plenty of antioxidants. You learned that phase one involves the transformation of fat soluble molecules into reactive intermediates. And so one thing you want to do is to make sure you consume plenty of antioxidants. While taking supplements to increase glutathione production is something some people need to consider, you also want to eat plenty of antioxidant-rich foods, such as vegetables, fruits, and green tea.

2. Downregulate phase one detoxification enzymes. You also learned about inhibiting and inducing phase one enzymes. While there can be benefits of both induction and inhibition, the main concern with inducing one or more of the phase one enzymes is that it can lead to an excess of reactive intermediates. And so typically you will want to do things to inhibit or downregulate these phase one enzymes. And while different nutrients are required to inhibit certain enzymes, some of the more common nutrients that can help to slow down the phase one enzymes include resveratrol, polyphenols, pomegranate, and garlic.

3. Consider doing genetic testing. You also might want to consider doing some testing to determine which genetic polymorphisms of the phase one detoxification enzymes you have. Notice I didn’t say “if” you have genetic polymorphisms, as pretty much everyone has certain genetic polymorphisms, although some are more significant than others. Although I personally obtained a 23andme test a few years ago, I currently don’t recommend genetic testing to all of my patients, and I’m admittedly not an expert when it comes to interpreting the results of such tests. But I am continuously trying to expand my knowledge in this area, and as I mentioned earlier, I do think that such testing will become more routine in the future.

So hopefully you have a better understanding of phase one detoxification.  It admittedly can be complex, and one of the big keys to optimizing phase one detoxification is to make sure you consume sufficient antioxidants to help offset the damage caused by the reactive intermediates.  You also learned about how certain nutrients and herbs can induce and inhibit the phase one detoxification enzymes.  And while the topic of genetic polymorphisms is complex, hopefully you realize that certain genetic defects of the phase one detoxification enzymes can affect the metabolism of different medications.

4 Reasons Why Soy Should Be Avoided In Those With Thyroid Conditions

Soy is definitely one of the more controversial foods with regards to thyroid health.  While there are some health benefits of eating organic, fermented soy, there are also some negative health effects that soy can have.  In this blog post I’m going to discuss four reasons why people with thyroid and autoimmune thyroid conditions should consider avoiding soy while restoring their health.

1. Many people have soy allergies and sensitivities.  The Food and Agriculture Organization of the United Nations includes soy in its list of the 8 most significant food allergens, and at least 16 potential soy protein allergens have been identified (1).  There is evidence that approximately 50% of children with a soy allergy outgrew their allergy by age 7 years (2).  But of course this means that 50% don’t outgrow the allergy.  Plus, many people don’t have IgE-mediated soy allergies, but instead have an IgG-mediated soy sensitivity.

But what’s the difference between a soy allergy and a sensitivity to soy?  I’m not going to get into detail about this here, as if you’d like more information you can read an article I wrote entitled “Food Allergies, Sensitivities, and Thyroid Health“.  But essentially a soy allergy involves an immediate reaction, whereas a soy sensitivity involves a delayed reaction.  In other words, if someone has a soy allergy they typically will have a negative reaction within a few minutes of consuming soy.  On the other hand, if someone has a soy sensitivity they might not have a negative reaction for a few hours, or perhaps even a few days after consuming soy.

What’s wrong with continuing to eat soy if you have an allergy or sensitivity?  The problem with eating any food that you have an allergy or sensitivity to is that this will result in inflammation.  This in turn can interfere with the healing process.  And while you can run a food allergy or food sensitivity panel to determine if you react to soy, these tests aren’t completely accurate.

2. Most soy is genetically modified.  Unfortunately most of the soy is genetically modified.  Some actually think this is a good thing, and there are a few studies which suggest that genetically modified soy might be less allergenic than non-GMO soy (3) (4).  But the problems with GMOs doesn’t just relate to allergies.  One of the main concerns is that genetically modified soybeans contain high residues of glyphosate.

I spoke about glyphosate in greater detail in an article entitled “Does Glyphosate Have a Negative Effect on Thyroid Health?“.  Glyphosate is the active ingredient in the herbicide Roundup, and while it can have an adverse effect on our health in numerous ways, one of the main problems is that it can have a negative effect on our gut microbiota.  This gut dysbiosis can make someone more susceptible to developing an autoimmune condition such as Graves’ Disease and Hashimoto’s Thyroiditis.

3. Soy has goitrogenic properties.  Goitrogens are substances which inhibit thyroid function.  And a few studies have shown that soy has goitrogenic effects (5) (6) (7).  One of these studies demonstrated that the effect on the thyroid hormones was minimal, although the study involved short-term soy consumption, lasting only seven consecutive days.  On the other hand, another study involving soy supplementation for eight weeks in those with subclinical hypothyroidism showed that there is a 3-fold increased risk of developing overt hypothyroidism, although soy also helped to decrease insulin resistance, inflammation, and blood pressure (8).

Should other goitrogenic foods be avoided as well, such as cruciferous vegetables?  I usually don’t recommend for my patients with hypothyroidism and Hashimoto’s Thyroiditis to avoid cruciferous vegetables.  After all, foods such as broccoli, kale, cabbage, and cauliflower have numerous health benefits, and I think that most people should be eating these foods on a daily basis.  I’m not suggesting for people to eat four or five cups of raw cruciferous vegetables per day, but having one or two servings of these foods usually won’t cause any problems from a goitrogenic standpoint.

4. Soy has phytates.  Phytic acid is an anti-nutrient that is found in grains, nuts, seeds, and legumes, including soybeans.  And studies show that the phytates in soy can lead to a decrease in iron and calcium absorption (9) (10).  The good news is that soaking and fermenting soy can significantly decrease the levels of phytic acid.

Should You Be Concerned About the Estrogenic Properties of Soy?

Isoflavones are a type of phytoestrogen found mostly in soy products, and there is some controversy over whether phytoestrogens can be harmful to our health.  I wrote an article on this entitled “The Truth About Soy, Flaxseed, And Other Phytoestrogens“.  While some consider soy as being an endocrine disruptor, the research I have found doesn’t show this, and there are actually numerous benefits to phytoestrogens.  However, I will admit that I try to avoid soy as much as I can, and most of the phytoestrogens I get are from other sources, such as flaxseed.

In summary, soy should be avoided in those with thyroid and autoimmune thyroid conditions.  While there are some health benefits of eating organic, fermented soy, many people have soy allergies and sensitivities.  In addition, soy has goitrogenic properties, and it also has phytates, which can interfere with the absorption of nutrients.  As a result, I usually recommend for my patients to avoid eating soy.

What’s Your Experience With The Autoimmune Paleo Diet?

Many people with autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis follow an autoimmune paleo (AIP) diet.  I’ve spoken about this diet numerous times in other blog posts and articles.  An AIP diet is similar to a “standard” paleo diet, but also excludes eggs, nightshades, and nuts/seeds.  I commonly recommend this diet to my patients, and while some people do great when following it, others don’t do as well.

In the past I wrote a blog post entitled “Should Everyone With Graves’ Disease and Hashimoto’s Thyroiditis Follow an Autoimmune Paleo Diet?“.  Although I commonly recommend an autoimmune paleo diet to my patients, in this blog post I spoke about some of the common “flaws” of this diet.  The truth is that there is no diet that perfectly fits everyone, and this applies to the autoimmune paleo diet.

Anyway, for those who have already followed an autoimmune paleo diet, or are currently following an autoimmune paleo diet, I’d like for you to share your experience in the comments below.  If you followed an autoimmune paleo diet and noticed an improvement in your symptoms and test results please let me know!  Or if you followed an AIP diet and felt worse please let me know!  Please feel free to be as specific as possible, as I’d love to hear how you felt from a symptomatic standpoint when following an AIP diet, if there were any positive or negative changes in your test results, etc.  Thank you in advance for participating!

Can Eating Dirt Benefit Your Thyroid Health?

Recently I listened to Dr. Josh Axe’s book “Eat Dirt” on Audible.  As a side note, if you’re not familiar with Audible it’s something to check out, as I frequently listen to audiobooks while driving, working out, preparing my meals, etc.  Anyway, getting back to Dr. Axe’s book, I thought it was very good and is worth reading (or listening to).  He talks a lot about leaky gut syndrome, but he also talks about the hygiene hypothesis, and there is some evidence in the research that discusses how this might play a role in the development of autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.

Well before Dr. Axe wrote his book, there was an article released by the New England Journal of Medicine entitled “Eat Dirt-The Hygiene Hypothesis and Allergic Diseases” (1).  This article starts out by discussing how there has been an epidemic of both autoimmune and allergic diseases, which is more common in Western, industrialized countries.  And the basis behind the hygiene hypothesis is that we’re not being exposed to as many microorganisms (both good and bad), and this essentially weakens or suppresses our immune system.  This in turn can make us more susceptible to developing infections, allergies, and autoimmune conditions.

This might seem to be counterintuitive to some people, as many believe that is a good idea to avoid all “bad” microorganisms.  After all, this is one of the reasons why there are so many vaccines given during childhood these days, and why many people receive the flu shot on an annual basis.  I’m not suggesting that it’s beneficial to get the flu, or serious illnesses such as polio or tetanus.  However, we are going to extremes to avoid exposure to all of these microorganisms, and the hygiene hypothesis suggests that there can be negative consequences of taking this approach.

But why are we not being exposed to as many microorganisms?  Well, there are a few reasons for this:

1. We spend too much time indoors and not enough time in our environment.  This is true with both children and adults.  As a child I didn’t have access to all of the electronics that are available these days, and so I frequently went outside to play with my friends.  These days many children spend too much time on electronic devices (i.e. computers, video game systems, IPads, etc.), and not enough time exploring the environment.  On average, adults are spending more and more time indoors as well.  After all, who needs to go out and socialize when you can simply login to Facebook or chat with someone through Skype?

2. We are becoming too sanitary.  Widespread access to clean water, soap, and chemicals to aid in cleaning dates back to the end of the 19th century (2), and so this is unlikely to be a big factor in the development of autoimmunity.  But one thing that has changed greatly is the use of hand sanitizers.  For example, when I was a child there wasn’t the widespread use of hand sanitizers as there is today.  And while soap was available, chemicals such as Triclosan weren’t in all of the soaps like they are these days.  Not too long ago I wrote a blog post entitled “Hand Sanitizer, Triclosan, and Thyroid Health“.  Triclosan is commonly used in soaps and hand sanitizers, and while the post focused on some of the health risks associated with this chemical, perhaps the main concern is that overuse of this will lead to a decreased exposure to microorganisms, which in turn can have a negative effect on our immune system health.

3. The birth process.  Most births take place in a hospital setting, and frequently the baby is bathed too soon. Babies are born covered in a white substance called vernix, and this is a protective material that helps to prevent common infections.  So while this blog post has focused on how we should be exposed to a greater number of microorganisms, in this situation you want to delay bathing a newborn due to the antimicrobial properties of the vernix (3).  This is why some hospitals enforce “delayed bathing.

The increase in Cesarean deliveries can also play a role in the development of autoimmunity related to the hygiene hypothesis (4).  The reason for this is because being born via a C-section can potentially lead to a change in long term colonization of the developing intestinal tract, which in turn can alter the development of the immune system (4).  Approximately one third of births in the United States are through cesarean delivery.  And while some of these are necessary, many others are due to maternal request.

4. Vaccines.  I’m not going to go into much detail about the controversy behind vaccines, but many more vaccines are given these days than in the past, which further reduces the chances of children and teenagers getting infections.  I realize that some of these infections can be life-threatening, and everything of course comes down to risks vs. benefits.  While it’s understandable for parents to be concerned about their children developing certain infections, they also should be concerned about the risks associated with vaccines as well, not only as they relate to the hygiene hypothesis, but also the additives included in them.  According to the Center for Disease Control (who is in favor of vaccines), some of the common substances found in vaccines include aluminum, antibiotics, formaldehyde, monosodium glutamine (MSG), and thimerosal (5).

So What Can You Do?

If the hygiene hypothesis is one of the factors responsible for the increase in autoimmunity over the last few decades, then what can be done to help prevent the development of autoimmune conditions?  Here are a few suggestions:

Eat some dirt.  Okay, so you probably won’t eat dirt, but I definitely would try to spend more time outdoors.  This admittedly is something I need to do more of, as without question I spend too much time indoors.

Use more natural soaps and avoid soaps and hand sanitizers with Triclosan.  If you frequently use antimicrobial soaps and hand sanitizers then I would encourage you to switch to more natural products.  There are plenty of natural options with regards to soaps and hand sanitizers, including essential oils.

Sleep with your pet.  If you have a dog or a cat that spends times outside then consider inviting him or her into your bed at night.  This is especially true if you don’t spend much time outdoors.

Be cautious about taking antibiotics, and educate yourself about vaccinations.  Once again, I’m not going to get into the vaccine controversy, but I will recommend to educate yourself about vaccines, especially if you have young children, or are planning on having children.  Even if you are in favor of vaccinations, consider spacing them out.

Read Dr. Axe’s book.  I’m not getting anything for promoting Dr. Axe’s book, but I do think it’s worth reading, or listening to on Audible like I did.

In summary, the hygiene hypothesis suggests that autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis might be more common due to a decreased exposure to microorganisms.  Some of the reasons behind this decreased exposure includes not spending as much time outdoors, using too many chemically-laden soaps and hand sanitizers, the birth process, and too many vaccines.  So while there are many factors that can lead to the development of an autoimmune condition, with regards to the hygiene hypothesis, some of the things we can do to help prevent the development of autoimmunity include spending more times outdoors, using less soaps and hand sanitizers with Triclosan, sleeping with your pet, and being cautious about taking antibiotics and vaccines.

Can Olive Oil Affect Thyroid Health?

In the previous blog post I discussed the health benefits of coconut oil, and in this post I will be focusing on the benefits of olive oil.  Towards the end of this post I will also mention a few other healthier oils.  In addition, I will list a few oils you should avoid whenever possible.  I will also discuss how you can avoid olive oil fraud, as many people think they are consuming olive oil when this isn’t the case.

Basic facts: Olive oil is obtained from the olive.  With regards to its fatty acid content, olive oil is composed mostly of oleic acid, which is a monounsaturated fat that is responsible for many of the health benefits of olive oil.  But olive oil also consists of other fatty acids, including palmitic acid and linoleic acid.  In addition, olive oil has numerous polyphenols which also have many different health benefits.  What I’d like to do is discuss some of the health benefits of oleic acid and the polyphenols of olive oil.

Oleic acid.  Oleic acid isn’t exclusively found in olive oil.  Canola oil and sunflower oil are actually high in oleic acid as well.  Almonds are a good source, as are avocados, along with beef, chicken, and eggs.  As for some of the health benefits, one study showed that higher plasma oleic acid levels due to olive oil consumption was associated with lower stroke incidence (1).  There is also evidence that olive oil reduces blood pressure, and one study showed that it’s the oleic acid content that’s responsible for this (2).  Another study showed that oleic acid can help to inhibit the growth of breast cancer cells (3).  Some studies suggest that oleic acid might also have a beneficial effect on autoimmune and inflammatory conditions (4).

Polyphenols.  Some of the different polyphenols of olive oil include tyrosol, hydroxytyrosol, oleuropein, ligstroside, apigenin, luteolin, quercetin, rutin, and there are numerous others (5).  These polyphenols can have protective effects on cardiovascular risk factors, and one study showed that consumption of olive oil polyphenols decreased plasma LDL concentrations and LDL atherogenicity (6).  Another study showed that olive oil polyphenols enhance HDL function in humans (7).  LDL is known as the “bad cholesterol”, and HDL is referred to as the “good cholesterol”, and while these are actually lipoproteins, the important thing to understand is that olive oil can have a beneficial effect on our lipid markers by increasing HDL and decreasing LDL.

Here are some of the uses of olive oil:

  • Olive oil is a great oil for cooking. Just as is the case with coconut oil, extra virgin olive oil resists oxidation at high temperatures.
  • Put olive oil on your salad and/or mix with other vegetables. I’ve never been a big fan of salad dressings, but I do enjoy adding olive oil to my salads.  I also add olive oil to other vegetables, such as steamed broccoli.
  • Add to your smoothie. I usually don’t add olive oil to my smoothies, as I usually have a daily salad and I add plenty of olive oil to it.  However, I commonly add one tablespoon of olive oil to my wife’s smoothies, which I prepare for her in the morning.

Why Choose Extra Virgin Olive Oil?

There are many different varieties of olives.  The reason why you want to always buy extra virgin olive oil is because this has higher amounts of nutrients and antioxidants.  Other types of olive oils are extracted using solvents and other chemicals, whereas extra virgin olive oil is obtained from the olive using a “cold-press technique”, which doesn’t alter the chemical natural (8).  In fact, the term “virgin” means that the oil was produced with no chemical treatment.

Other Research Studies on Olive Oil

Just as I did with coconut oil in the last blog post, I would like to mention some of the studies which discuss the health benefits of using olive oil.

Cardiovascular benefits.  Multiple studies show that olive oil can benefit cardiovascular health.  One study showed that olive oil decreased systolic blood pressure and increased HDL-C concentrations (9).  There is also evidence that extra virgin olive oil consumption can reduce the risk of atrial fibrillation (10).

Type 2 diabetes.  There is evidence that higher olive oil consumption is associated with a lower risk of type 2 diabetes in women (11).  Another study showed that extra virgin olive oil improves post-prandial glucose and lipid profile in those with impaired fasting glucose (12).

Inflammation.  There is evidence that olive oil can exert beneficial effects on markers of inflammation (13) (14).  One study discussed how extra virgin olive oil has joint protective effects by significantly reducing the levels of proinflammatory cytokines and prostaglandin E2 in the joint (15).

Osteoporosis.  A few studies show evidence that olive oil phenols can prevent the loss of bone mass and increase bone mineral density (16) (17).

Neuroprotective effects.  Olive oil phenols have been shown to have neuroprotective effects against cerebral ischemia, spinal cord injury, Huntington’s disease, Alzheimer’s diseases, multiple sclerosis, Parkinson’s disease, aging, and peripheral neuropathy (18).

Cancer.  Earlier I mentioned how the oleic acid in olive oil can help to inhibit the growth of breast cancer cells.  And there are a few other studies which show that olive oil can have a protective effect not only with breast cancer, but with colorectal cancer as well (19) (20).

Beware Of Olive Oil Fraud

For years I had purchased organic extra virgin olive oil, and just like millions of other people, I didn’t think twice about the possibility of it not being olive oil.  But Tom Mueller opened my eyes in his book entitled “Extra Virginity: The Sublime and Scandalous World of Olive Oil”.  He discusses how some unscrupulous companies use other unhealthy oils (i.e. soybean oil), and sell it as extra virgin olive oil.  You might be wondering how such companies can get away with it, and for more information I would recommend reading his book.  But for now I’ll provide a link to “Tom’s olive oil supermarket picks“.   When purchasing olive oil, you want to make sure it has a seal from the International Olive Oil Council (IOC), and it should also have a harvesting date on the label.

Other Healthy Oils

In addition to consuming coconut oil and olive oil, here a few other healthier oils you can consume.

Avocado oil

Palm oil

Macadamia nut oil

Flax oil

Avocado oil is probably the healthiest oil from this list.  If someone is following an autoimmune paleo diet, then consuming macadamia nut oil is somewhat controversial.  And while palm oil is allowed, the harvesting of palm trees for palm oil frequently results in the destruction of tropical forests, which in turns destroys the habitats of many animals.  Indonesia might be a potential source of palm oil without the concern of deforestation (21).  Although I like flax oil, keep in mind that it oxidizes easily, and so you want to make sure that when you purchase it that it’s refrigerated, and then when you bring it home you want to put in the refrigerator immediately.

Unhealthy Oils

On the other hand, the following oils are ones that are best to be avoided:

Cottonseed oil

Peanut oil

Rapeseed oil

Safflower oil

Soybean oil

Sunflower oil

Can Olive Oil Affect Thyroid Health?

Just as is the case with coconut oil, I didn’t find any studies which showed that olive oil directly affects thyroid health.  However, it might indirectly benefit people with autoimmune thyroid conditions by helping to reduce inflammation.  And while there are many other nutrients that can help to reduce inflammation, olive oil should be one that you consume on a regular basis.

So hopefully you learned some valuable information about the health benefits of olive oil by reading this blog post.  Most of the health benefits of olive oil come from oleic acid and the polyphenols.  Olive oil can be used for cooking, as a salad dressing, and you can even add olive oil to your smoothies.  Extra virgin olive oil has higher amounts of nutrients and antioxidants.  When you purchase olive oil please make sure it has a seal from the International Olive Oil Council, and it should also have a harvesting date on the label.  Some other healthy oils include avocado oil, palm oil, macadamia nut oil, and flax oil.  Some of the oils you want to avoid include cottonseed oil, peanut oil, rapeseed oil, safflower oil, soybean oil, and sunflower oil.


Can Coconut Oil Affect Thyroid Health?

One of the biggest problems with eating out is that most restaurants use unhealthy oils.  And because you don’t have control over the oils these places use, you want to try to avoid consuming these oils as much as possible, and of course when you are cooking at home you want to use higher quality oils.  Olive oil and coconut oil are two of the healthier oils, and in this blog post I’ll discuss many of the health benefits of coconut oil, and the next blog post I will focus on olive oil.  In the next post I will also mention a few other healthier oils, and I will also discuss some of the oils you should try your best to avoid.

So let’s go ahead and talk about coconut oil…

Basic facts: coconut oil is extracted from the meat of coconuts.  It is an excellent source of medium chain triglycerides (MCTs), which have numerous health benefits.  There are a few different components of coconut oil, but three of the main ones include lauric acid, capric acid, and caprylic acid.  Approximately 50% of coconut oil consists of lauric acid.  Let’s take a look at each of these compounds:

Lauric acid.  This is also known as dodecanoic acid, and as I mentioned above, it compromises approximately half of the fatty acid content in coconut oil.  One study looked at the antimicrobial effects of virgin coconut oil on Clostridium difficile (1).  The study showed that while exposure to lauric acid, capric acid, and caprylic acid inhibited its growth, lauric acid had the greatest inhibitory effect (1).  Another study showed that lauric acid can be an alternative for the antibiotic treatment of acne vulgaris (2).

Capric acid.  This is also known as decanoic acid, and like lauric acid, it’s a type of saturated fatty acid in coconut oil.  Like lauric acid, capric acid also has numerous antimicrobial properties, as while a study I mentioned earlier showed that lauric acid had the greatest inhibitory effect on C. difficile, the study showed that capric acid also had inhibitory properties (1).  Both capric acid and lauric acid demonstrate bactericidal and anti-inflammatory activities against Propionibacterium acnes, which might be involved in acne inflammation (3).  Another study showed that capric acid caused the fastest and most effective killing of three strains of Candida albicans, although lauric acid was the most active at lower concentrations and after a longer incubation time (4).  Another study showed that capric acid has inhibitory effects on osteoclast development (5).  Osteoclasts break down bone, and so capric acid might be useful for the treatment of bone resorption-associated conditions (5).

Caprylic acid.  This is also known as octanoic acid.  Caprylic acid also has antimicrobial properties.  In fact, one study claimed that caprylic acid is superior to Diflucan, which is a potent prescription antifungal (6).  The same study also claimed that caprylic acid has potential application for anti-cancer, anti-aging, anti-Alzheimer’s disease, anti-autism, anti-infection, and general circulatory improvement (6).

Uses: Coconut oil has many different uses.  Here are just a few of them:

  • It’s a great oil for cooking. Because of its high saturated fat content it is slow to oxidize, and thus is less likely to become rancid like most other oils.
  • Add coconut oil to your smoothies (like I do!). I usually rotate between coconut oil and avocados, and when I add coconut oil to my smoothies I’ll add approximately one tablespoon.
  • Use it as a lotion or moisturizer for dry skin
  • It’s great for oil pulling. This is something I commonly do, as I will put a little less than one tablespoon of coconut oil in my mouth a few days per week and swish it around.  And there is a study which shows that oil pulling with coconut oil can decrease plaque formation and gingivitis (7).
  • Many people use coconut oil as a carrier oil for essential oils
  • Coconut oil can also be used as a hair conditioner, although I can’t say that I personally have used it in this manner.

What Type Of Coconut Oil Should You Use?

Coconut oil needs to be extracted from the coconut.  Virgin coconut oil is the least refined type.  Virgin coconut oil has a higher antioxidant status than non-virgin coconut oil (8).  I add virgin coconut oil to my smoothies.  However, some sources claim that you want to use refined coconut oil when cooking at very high temperatures, as it has a higher smoke point than virgin coconut oil.  The smoke point of an oil is the temperature under which volatile compounds and other potentially harmful products are released.  If you are using coconut oil as a carrier oil for essential oils then you want to use either virgin coconut oil, or fractionated coconut oil.

Other Research Studies on Coconut Oil

Although earlier I discussed some of the research with regards to the individual components of coconut oil (lauric acid, capric acid, and caprylic acid), there are many other studies which discuss the health benefits of using coconut oil.

Cardiovascular health.  Coconut oil can benefit cardiovascular health, and one study showed how virgin coconut oil has cardioprotective effects (9).  Another study showed that virgin coconut oil prevents blood pressure elevation and improves endothelial function (10).  Another study shows that coconut oil can lead to a beneficial lipid profile (11).

Candida.  Coconut oil has antimicrobial properties, and can be especially effective against Candida species.  I mentioned some of the research regarding Candida earlier, and one study discussed the problems with drug-resistant Candida species, and suggested that coconut oil should be used in the treatment of fungal infections (12).

Insulin resistance.  Can coconut oil help with insulin resistance?  One study showed evidence that virgin coconut oil might prevent the development of insulin resistance (13).  Another study showed that coconut oil can lead to lower glucose and insulin concentrations (14).

Alzheimer’s disease.  One study showed that the medium-chain fatty acids of coconut oil might be beneficial in Alzheimer’s disease by converting to ketones, which are an alternative energy source in the brain (15).

Anti-inflammatory and analgesic properties.  One study I came across showed that virgin coconut oil has anti-inflammatory and analgesic properties (16).

Bone density.  A rat study I came across showed that rats who consumed virgin coconut oil had greater bone volume, and the study concluded that virgin coconut oil was effective in maintaining bone structure and preventing bone loss (17).

Can Coconut Oil Increase Thyroid Hormone Production?

Can coconut oil have a direct effect on thyroid health?  Well, some sources claim that coconut oil can raise basal body temperatures and increase metabolism.  And because of this some feel that coconut oil can benefit people with hypothyroid conditions, and if you do some searching on the Internet you’ll find some websites which claim that taking coconut oil can help to boost thyroid function.  And if this is the case, then those with hyperthyroidism and Graves’ Disease might be concerned that taking coconut oil can be harmful by increasing thyroid hormone production.  Well, there are no studies I’m aware of which show that taking coconut oil can improve thyroid function.  In addition, I commonly recommend coconut oil to those with both hypothyroid and hyperthyroid conditions, and I can’t say that I’ve seen problems with people with hyperthyroidism and Graves’ Disease taking coconut oil.

So hopefully you learned some valuable information about coconut oil in this blog post.  Although it is questionable as to whether coconut oil has a direct effect on thyroid health, it seems to have many other health benefits.  One of the greatest benefits is that it has antimicrobial properties.  Coconut oil is also a great oil for cooking, it can be used for oil pulling and as a carrier for essential oils, it can be used as a lotion or moisturizer, and it can be added to your smoothies.  Virgin coconut oil is the least refined type, and it has a higher antioxidant status than non-virgin coconut oil.  In the next blog post I’m going to talk in detail about olive oil, and I’ll also briefly mention a few other healthier oils you can consume.

What’s The Difference Between Graves’ Disease and Hashimoto’s Thyroiditis?

Occasionally someone will ask me what the difference is between Hashimoto’s Thyroiditis and Graves’ Disease, and so I figured I’d write a brief blog post which discusses the main differences and similarities between these two conditions.  First of all, both Graves’ Disease and Hashimoto’s Thyroiditis are autoimmune conditions that affect the thyroid gland.  However, they both affect the thyroid gland differently, and because of this the treatment for managing the symptoms are also different.

Let’s take a look at the similarities and differences between Graves’ Disease and Hashimoto’s Thyroiditis:

Here Are The Similarities Between Graves’ Disease and Hashimoto’s Thyroiditis:

1. Both Graves’ Disease and Hashimoto’s Thyroiditis are Autoimmune Thyroid Conditions.  Both of these are autoimmune conditions which affect the thyroid gland.  And so while managing the thyroid symptoms frequently is necessary, the overall goal should be to restore the health of the immune system.

2. Both Graves’ Disease and Hashimoto’s Involve The Triad of Autoimmunity.  The triad of autoimmunity involves 1) a genetic predisposition, 2) an environmental trigger, and 3) a leaky gut.  To be honest, it hasn’t been proven that everyone with an autoimmune condition has a leaky gut, although the evidence is very strong.  But assuming this is true, then the goal with both Graves’ Disease and Hashimoto’s Thyroiditis should be to detect and remove the environmental trigger, along with doing things to heal the gut.  Of course nothing can be done for the genetic predisposition, but the good news is that the autoimmune component can be reversed if the trigger is removed and the gut is healed.

3. Most Endocrinologists Don’t Address The Autoimmune Component.  Unfortunately, most endocrinologists focus on the thyroid gland, while not doing anything to improve the health of the immune system.  This comes down to the training they receive in medical school.

4. Both Graves’ Disease and Hashimoto’s Can Be Treated Naturally.  Even though there isn’t a permanent cure for autoimmune thyroid conditions, following a natural treatment protocol can help to reverse the autoimmune component.  And so it is possible to get into remission and then maintain your health thereafter.

Here Are The Differences Between Graves’ Disease and Hashimoto’s Thyroiditis:

1. Graves’ Disease and Hashimoto’s Thyroiditis Affect the Thyroid Gland Differently.  Most people reading this know that Graves’ Disease is typically associated with hyperthyroidism, while Hashimoto’s Thyroiditis is usually associated with hypothyroidism.  And the reason for this is because the immune system attacks different parts of the thyroid gland with different autoimmune conditions.  So with Graves’ Disease the immune system attacks the TSH receptors, which causes the thyroid gland to secrete an excess amount of thyroid hormone.  Here is an article I wrote on the symptoms of hyperthyroidism.  “On the other hand, Hashimoto’s Thyroiditis involves damage to either thyroglobulin, which is a protein of the thyroid gland, or thyroid peroxidase, which is an enzyme involved in the production of thyroid hormone.  Here is an article I wrote on the symptoms of hypothyroidism.

2. Graves’ Disease and Hashimoto’s Thyroiditis are characterized by different thyroid autoantibodies.  I mentioned how with Graves’ Disease the immune system attacks the TSH receptors, and because of this, most people with this condition will have TSH receptor antibodies, with the most common type being thyroid stimulating immunoglobulins.  On the other hand, Hashimoto’s Thyroiditis typically involves either thyroglobulin antibodies, thyroid peroxidase antibodies, or in some cases both of these antibodies are elevated.

Can Someone Have Both Hashimoto’s Thyroiditis and Graves’ Disease At The Same Time?

It is possible for someone to have the antibodies for both Graves’ Disease and Hashimoto’s Thyroiditis.  This is actually common, as a lot of people with elevated thyroid stimulating immunoglobulins also have elevated thyroid peroxidase antibodies.  Some people have elevated thyroid stimulating immunoglobulins and elevated thyroglobulin antibodies.  And there are some people who have all three thyroid antibodies elevated.

This doesn’t necessarily mean that people with the antibodies for both Hashimoto’s Thyroiditis and Graves’ Disease will have symptoms of both hypothyroidism and hyperthyroidism.  For example, many people with elevated thyroid stimulating immunoglobulins and thyroglobulin antibodies will primarily experience hyperthyroid symptoms initially.  However, if the autoimmune component isn’t addressed then they very well might become hypothyroid in the future due to damage to the thyroid gland.  With that being said, there are some people with both types of antibodies who do experience a fluctuation of hypothyroid and hyperthyroid symptoms.

Keep in mind that if someone does have the antibodies for both Hashimoto’s Thyroiditis and Graves’ Disease then the treatment approach will be similar to someone who only has one type of antibody.  In other words, the primary goal is to reverse the autoimmune component.  However, the symptom management will of course differ depending on whether the person is experiencing hyperthyroid or hypothyroid symptoms.

So hopefully you understand some of the similarities and differences between Graves’ Disease and Hashimoto’s Thyroiditis.  Both of these are autoimmune conditions that affect the thyroid gland, and both involve the triad of autoimmunity.  However, these conditions affect the thyroid gland differently, and they are characterized by different thyroid autoantibodies.  And it is possible to have the antibodies for both Hashimoto’s and Graves’ Disease.  The good news is that it is possible to reverse the autoimmune component of these conditions.

Happy Thanksgiving!

I’d like to wish you a happy Thanksgiving!  I want you to know that I sincerely appreciate you!  Thank you so much for reading my articles and blog posts.  I’d also like to thank all of the other healthcare professionals who educate their patients, email subscribers, etc.  Even though we still have one more month to go in 2016, I’m already preparing to share more great content with you in 2017!

Best of health,

Dr. Eric

What’s Your Experience With Dairy?

Last month I wrote a blog post entitled “What’s Your Experience With Gluten?”  Not surprisingly, many of the comments received were from people who felt better upon eliminating gluten from their diet.  While not everyone who gives up gluten notices an improvement in their symptoms or labs, many people do.  And the same is true with dairy, although I will say that in general people seem to be more resistant to give up dairy.  And while having pasteurized and homogenized milk might not be healthy for you, other forms of dairy do have health benefits.

For example, many people do well when consuming raw dairy.  Others do fine eating fermented forms of dairy, such as kefir.  And many people do well when eating grass fed butter and ghee.  But if someone is following a strict autoimmune paleo diet, or even a standard paleo diet, then all forms of dairy should be excluded.

Anyway, I’d like for you to share your experience with dairy.  You can talk about milk, cheese, butter, ghee, etc.  You can talk about pasteurized dairy, raw dairy, and fermented dairy.  If you have been dairy free for awhile and feel like it has benefited your health please let me know!  And if you consume dairy regularly and are doing well please let me know!  Thank you in advance for participating!

Interview With Thyroid Coach Jen Wittman

Today’s blog post includes an interview of Jen Wittman, who reversed her Hashimoto’s condition through diet and lifestyle.  Jen is a holistic health care expert and a thyroid/autoimmune coach who has degrees in culinary arts, psychology, transformational coaching, nutrition, and Italian.  She spent a year honing her cooking skills in Italy and is passionate about physical rejuvenation, family, laughter and helping people craft the life of their dreams.

Dr. Eric: When reading your book it looked like you had a similar diet to myself growing up!  Chips Ahoy, Spaghetti O’s, Hostess cupcakes, Pepsi, etc.  How hard did you find it to make the transition from eating junk food to eating a clean diet?

Jen: At first, I found it terribly challenging to transition from eating junk food to eating a clean diet not because the changes were difficult but because I had a lot of emotional ties to certain foods and my general mindset around changing my diet. I wanted to see if I could reverse Hashimoto’s without altering my diet at all…and I tried…but it didn’t work. I tried every other healing modality I could find just so I could avoid making any dietary changes, but over time, it became clear that if I didn’t change my diet, my health wouldn’t improve either. In fact, I realize now that I stayed sick an extra year and a half because I was unwilling to change my diet. Once I changed my mindset and looked at changing my diet as a gift I was giving myself, my health improved immediately. Each nourishing dietary change I made gave me more energy and helped me to get my thyroid and antibody levels back to optimal.

Dr. Eric: How challenging was it to give up gluten?

Jen: As a trained chef, foodie and Italy lover, it was especially challenging at first for me to give up gluten. I didn’t want to give up any of my favorite foods like biscuits and gravy, fried mozzarella sticks, pastas and pastries. I just didn’t want to do it. But one day, I felt so awful that I decided I’d had enough. Was eating a donut more important than having the energy to play with my son? Was having a croissandwich more important than feeling fit in my body and having my hair back? Was it worth it to feel crummy everyday just so I could eat foods with gluten? No! In the end, I decided my health, my energy, my mood and my body were more important than gluten. Once I put the emphasis on feeling my best by eliminating gluten, it was easy to make the switch.

Dr. Eric: When you moved from Los Angeles to Italy you spoke about the “Italian lifestyle” and compared it to the “United States lifestyle”.  Can you please elaborate on this?

Jen: Yes! The Italian lifestyle was so eye opening for me. I was used to the Type-A go-go-go lifestyle of the U.S. – fast food, lots of doing, lots of multi-tasking and an overwhelming schedule. When I got to Italy, I was so surprised at how different it was from the U.S. First, food is really valued there. The ingredients are high quality, unprocessed, simple, and fresh. People really honor their meals by sitting down and taking time to eat together (not alone, in the car or standing up!). One eats at home usually for all meals and eats “slow” food. In general, everything is done at a slower pace in Italy. “Being” with friends and family is more of a priority than “doing” a million things. It really helped me understand the importance of balancing work and life in healthier way.

Dr. Eric: You developed Hashimoto’s Thyroiditis during your pregnancy.  Can you explain why it’s common for women to develop Hashimoto’s when pregnant?

Jen: So many major shifts happen during pregnancy – changes in hormone levels and immune function can play a role. Sometimes, pituitary function changes as well. And many women are now going into their pregnancies already stressed by demanding work/life schedules, or physical challenges like food sensitivities, autoimmune conditions, gut infections or blood sugar imbalances. These challenges coupled with the enormous hormonal changes during and post-pregnancy make women’s bodies the perfect storm for Hashimoto’s (and post-partum depression) to occur.

Dr. Eric: In your book you mentioned that “love” is what allowed you to heal and reverse the symptoms of your condition?  Can you please talk about this?

Jen: Yes, I was really awakened (by one of my doctors) to the fact that as women, we tend to nourish, care for and serve everyone else in our world but we don’t often apply that same love to ourselves.

As I learned more about thyroid and autoimmune conditions, it became clear that my needs weren’t being met…and I wasn’t allowing them to be. I often didn’t speak up when I needed help and I rarely reached out for support. I wasn’t showing myself the same love I was giving to others. And when you think of what an autoimmune condition is, it really is the body attacking itself. And with Hashimoto’s, the body is attacking your thyroid, the seat of communication. So, if you’re not speaking your mind and your truth, and you’re holding on to a lot of stress, anger, shame, guilt and you’re not asking for help, your body is manifesting symptoms in your thyroid to get your attention. For Hashimoto’s, I see it time and time again with my clients, the message your body is screaming at you is that you need to love yourself, care for yourself and speak your mind. You have to nourish yourself first before you can take care of everyone else.

Dr. Eric: In your book you discussed how you started a self-love practice every single day.  How did this benefit you?  Also, I assume this is something you recommend for others to do?

Jen: Yes, I’d absolutely recommend this practice to do. It has benefited me enormously by allowing me to put myself first at some point every day. It has helped me to reduce my stress levels and have more energy throughout the day as well.

Dr. Eric: You spoke about how your thyroid levels were always within the “normal” range, but not within the optimal range when you were dealing with Hashimoto’s.  Can you talk about this, and why people can’t rely on the lab reference ranges?

Jen: Yes. This is the single most prominent reason thyroid conditions go undiagnosed and misdiagnosed so often. The lab reference ranges for normal thyroid levels are way too large and aren’t even based on people with thyroid conditions. So, a person can have all the symptoms of a thyroid condition but their thyroid levels look normal because the range is so large. Instead, the key is to focus on the optimal functional levels for your thyroid. For most people, being just outside the optimal ranges in one direction or the other indicates that the thyroid isn’t functioning optimally and this is why you’re having so many symptoms. When we look at symptomatic clients/patients, we can see that those with symptoms often fall outside of the optimal ranges but within the “normal” ranges. And, the medical community/insurance companies need to start diagnosing thyroid conditions when they fall outside of the optimal range so that more people can catch the condition in its early phase; making it easier to reverse.

Dr. Eric: Can you please talk about the three transformative phases of healing?

Jen: Sure! When it came to healing thyroid and autoimmune conditions in my practice, three stages began to emerge consistently. I called them The Caterpillar, The Cocoon and The Butterfly.

The Caterpillar is the phase of nourishment – nourishing your body and mind with healing foods and self-care. In this phase, you are putting the most focus on your healing.

The Cocoon is the phase of restoration. It is a time of rest so your body can repair itself. It’s also the optimal time to go within and address stresses, obstacles and getting the support you need from others. During this phase, your body is rebuilding and rebalancing itself.

The Butterfly is the phase of freedom. This is when you emerge from the cocoon whole again and ready to fly. You can put less focus on healing because your symptoms are gone and the thyroid or autoimmune condition has been reversed.

To discover which phase you’re in, there’s a free assessment on my site. Click here.

Dr. Eric: Can you explain why having a healthy thyroid is necessary to have a healthy gut, and vice versa?

Jen: Poor gut health is intricately connected to low thyroid function and additionally, can trigger Hashimoto’s disease.  When your thyroid isn’t functioning optimally, it causes inflammation and immune dysregulation which in turn causes a leaky gut. The leaky gut then causes more inflammation and immune dysregulation which then further harms the thyroid. Press repeat. The cycle of destruction is endless if it is not addressed.

Dr. Eric: You mentioned how limiting sugar is one of the fastest ways to see results when you’re trying to heal from Hashimoto’s.  Why is this?

Jen: Sugar is so incredibly inflammatory to the body. When there’s a lot of sugar in your diet, your body spends a lot of time and energy dealing with the inflammation and not repairing itself. Also, oftentimes, women with thyroid conditions also have issues with candida and sugar feeds candida. It also promotes weight gain and blood sugar, insulin and leptin imbalances.

Dr. Eric: I’m always encouraging my patients to eat more veggies, and in your book you also said that you believe in “veggie heavy Paleo eating”.  How many servings of vegetables per day do you recommend?

Jen: I’m lazy about counting calories (which I never recommend) or servings…instead, I like to make things quick and simple and encourage folks to look at their plates. At each meal, make sure 75% of your plate is filled with veggies. I recommend 50% cooked veggies and 25% raw (like a salad) and then 25% a high quality protein. That’s just a simple way to eyeball it. I also encourage fruit smoothies with greens and fresh green juices as a way to get more veggies in your diet. I am personally not a veggie lover. I wasn’t raised to be…so this is my simple way to make sure I’m getting enough veggies in my diet.

Dr. Eric: What are some of your favorite techniques for managing stress?

Jen: For me, it’s singing. Singing massages the thyroid, it helps regulate breathing and it immediately puts me in a less stressed mood. Other techniques I love for managing stress are EFT (Emotional Freedom Technique), acupuncture, massage, epsom salt baths and journaling. Really though, anything that brings you joy and helps you refocus your energy on giving time and care to yourself, is a great tool for managing stress.

Dr. Eric: Thank you for this interview Jen.  Please tell my readers where they can find out more about you.

Jen: You can find me at Thyroid Loving Care and right now, I’m able to give away free digital copies of my book, Healing Hashimoto’s Naturally. And, if you’re a food lover like me, follow my adventures at The Gluten-Free Food Crawl, where I go all over the globe in search of the best gluten-free meals out there.

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Here are some of my patients with thyroid and autoimmune thyroid conditions who have benefited from following a natural treatment protocol.

I was concerned about an ongoing "mental fog" and forgetfulness I had - which is one of the symptoms of Hashimoto's. I was having trouble losing weight and also felt very low in energy. Since following Dr. Osansky's recommendations I have found that I have a greater sense of calm - something I didn't expect from the treatment and changes in diet and lifestyle. In addition to getting my Hashimoto's under control, I have enjoyed other health benefits as well. I no longer suffer from anemia, my Vitamin D levels are normal and my immune system is strong. My thyroid blood tests also improved. Although it's a commitment and initial expense, it is completely worth it in the long run. Given the alternative (taking thyroid medication for the rest of your life), in my opinion it's a no brainer. If you give a natural treatment protocol a fair chance you'd be surprised at how much more empowered you'll feel about your illness and treating it. A natural treatment protocol is an effective solution that puts you in the driver's seat when it comes to your health. Traditional methods do the exact opposite.

Maria DeSimmone
Howard Beach, NY

Since following the natural treatment protocol I have all of the energy that I had before Graves' Disease, and not being on the meds feel wonderful. Being able to do all of the things that I used to do is fantastic, as we all take so many things for granted in life, and our health/body is very sensitive so what we feed it is so important, good in good out. Little by little my blood work came back to the normal range (within 4 to 6 months) but you have to follow the protocol.

Michael Addario
Albany, NY

When I first began the natural treatment plan for my autoimmune hypothyroid condition my top five symptoms were chest pain (diagnosed with costochondritis), fatigue, memory loss, stomach upset, and muscle weakness. No matter how much rest I got, I was still tired. Additionally I did not sleep well either. Originally, I didn't feel much different. I believe the reason for that to be because I was only taking a portion of the recommended natural supplements, as well as the fact that I had only changed some of my diet. When I really got serious about making changes is when I began to really see improvements. Although this does require a change in lifestyle, I feel much better today. The natural treatment protocol allowed me to delve deeper into the root of the problem and address it so that I will hopefully not need to be on these supplements for the rest of my life. I have already cut back on some of my supplements since my last blood work results.

Adah Thompson
Rossville, GA

Through my own research, I discovered that there are many side effects to radioactive iodine treatment. However, every visit to the endocrinologist ended with them stating that this was the only treatment for Graves Disease. In fact, one endocrinologist yelled at me and stated that I had to have the procedure done by November because of the dangerous side effects of the medication. I found Dr. Osansky’s website and read all his articles. I was immediately convinced that he could help me because one of his articles described his symptoms and it seemed as though he was describing my symptoms. I wanted a doctor who had this experience and could tell me what to expect.

Since starting the natural protocol, I feel full of energy. I look forward to seeing my students instead of dreading each day. My eating habits have totally changed. I can actually function when I get home. I used to sleep during the two week Christmas holidays, but this year I actually painted, cleaned and exercised. It has truly been a lifestyle change. My blood tests show tremendous improvement. In fact the same endocrinologist who yelled at me sent me a letter indicating that I should immediately start lowering the Methimazole.

Norma Lopez
Houston, TX
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Natural Treatment Methods:
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Conventional Treatment
Radioactive Iodine
Thyroid Hormone