In this episode, Dr. Eric Osansky explores a common question he receives from people with hyperthyroidism: Can I incorporate intermittent fasting? While fasting has been praised for benefits such as weight loss, blood sugar regulation, reduced inflammation, and improved metabolic health, Dr. Eric explains why those with hyperthyroidism and Graves’ disease need to approach fasting differently than the general population.

Dr. Eric reviews the most common fasting methods, including overnight fasting, 16:8 intermittent fasting, alternate-day fasting, water fasting, and fasting-mimicking diets. He explains how hyperthyroidism creates a catabolic state characterized by increased metabolism, muscle breakdown, and weight loss, making prolonged fasting potentially problematic for some people. He also discusses the important roles of adrenal health, cortisol balance, blood sugar regulation, insulin resistance, and stress when determining whether fasting is appropriate.

Throughout the episode, Dr. Eric emphasizes the importance of individualization. While fasting may offer benefits for certain people, especially those with stable thyroid levels and insulin resistance, it may be counterproductive for others who are actively hyperthyroid, losing weight, struggling with adrenal dysfunction, or experiencing significant symptoms. If you want a balanced, practical perspective on fasting and hyperthyroidism, you’ll get a lot out of this episode.

Click Here to listen to it on the Save My Thyroid podcast

Dr. Eric Osansky:

Intermittent fasting has become incredibly popular over the last decade. Some people swear by it for weight loss, blood sugar balance, inflammation, even longevity. But if you have hyperthyroidism, including Graves’ or toxic multinodular goiter, the question is: Should you be fasting?

The answer isn’t necessarily yes or no. In some cases, fasting can be helpful while in others it can slow down your recovery.

What you need to keep in mind is that when it comes to fasting, most of the fasting advice is directed toward a general population. There isn’t a lot out there when it comes to hyperthyroidism and fasting, at least not in the research. People with hyperthyroidism, they do have unique consideration.

Remember there is not a one size fits all approach. If you’re reading a book on intermittent fasting, for example, or watching YouTube videos, keep in mind that the people who are talking about it usually are not dealing with hyperthyroidism. That does make a big difference.

Let’s briefly talk about the different types of fasting. I won’t go into great detail here. You can learn more about this elsewhere.

The most basic type is an overnight 12-hour fast, where you stop eating at 7pm and then eat the next morning at 7am, for example. You can vary that. Maybe you stop eating at 6pm and eat at 6am. You could do a 14-hour fasting window. Very popular is 16-8 fasting, where you’re fasting for 16 hours, and you have an 8-hour eating window.

There is alternate day fasting. There is 24-hour fasting. There is multiple-day fasting. There is water fasting.

There is also what’s called fasting mimicking diets. The goal is to replace the benefits of intermittent fasting without restricting the eating that is associated with traditional fasting. Essentially, it allows a limited intake of specific nutrients to help sustain the body. Usually, you are following this diet over a five-day period. Many times, people will do it once a month for a few consecutive months.

As far as why people are interested in fasting, there are numerous benefits. The #1 reason is weight loss. People want to lose weight. When I dealt with hyperthyroidism, I did not want to lose weight. I was losing too much weight. I would have not been a good fit for intermittent fasting. There are some people with hyperthyroidism who aren’t losing weight. That is one of the potential benefits.

Blood sugar regulation. If someone is dealing with insulin resistance, type 2 diabetes.

Inflammation. Some will talk about fasting, including intermittent fasting, for reducing inflammation, especially if someone has autoimmune conditions. It could be a piece of the puzzle. I would keep your expectations in check. Fasting alone is probably not going to completely eliminate the inflammation. Maybe it will reduce it to some extent. Maybe not. Depends on the person.

There is what’s called autophagy, which is cellular cleanup, improving metabolic flexibility, which is the body’s ability to shift between burning glucose and fat for energy. Those are probably the main benefits. I’m sure there are others. Giving your digestive system a rest would be a potential benefit of intermittent fasting.

Why is fasting more challenging with hyperthyroidism? The reason is because hyperthyroidism is considered to be a catabolic state. Catabolism means you have increased muscle breakdown, typically weight loss, and increased metabolic rate. If you have an elevated resting heart rate, like I did when dealing with Graves’.

Sometimes, it’s strange just because you figure if you have that increased metabolism, you will lose weight. A lot of people do lose weight. Weight loss is very common. But there is a decent amount of people who don’t lose weight, even if they have an increased resting heart rate. They also might be losing muscle mass, even if they are not losing weight. The classic hyperthyroid case, you not only have the increased metabolic rate, but you also have muscle breakdown as well as weight loss. I fell under that category when I dealt with Graves’. Not everybody does.

The concern with fasting, if you are in that state of catabolism already, that fasting may already further increase the tissue breakdown in people with hyperthyroidism who are losing weight, losing muscle. When you have hyperthyroidism, you might need more calories. The key is not just getting more calories, but with any health condition, make sure you are eating healthy foods, nutrient dense foods.

A problem with fasting, even intermittent fasting, is some people aren’t getting enough calories. If you are doing a 12-hour fast or a 14-hour fast, you are probably fine. Even if you are doing a 16-8 fast, it might be okay. Over the years, I have had people do 20-hour fasts every single day. Only a four-hour eating window. When that’s the case, they are probably not getting enough calories or nutrients or protein.

Anything over 16-8 is a bit extreme if you’re doing it every single day, especially if you’re dealing with hyperthyroidism. Not to say 16-8 is acceptable for everyone. You need to be careful if you’re dealing with hyperthyroidism, which you probably are if you’re listening to this.

Remember, everyone is different. Not everyone has classic hyperthyroid signs and symptoms, including weight loss. If that’s the case, maybe you can get away with the 16-8 fast. Maybe you could get some benefits from a 16-8 fast. If you are losing a lot of weight, a lot of muscle, with that increased metabolism, then 16-8 or even 14 hours might be too extreme for you. Everyone is different.

In addition, we need to look at the adrenals, blood sugar. When it comes to cortisol and hyperthyroidism, a lot of people with hyperthyroidism have cortisol imbalances. I know I did when I dealt with Graves’. I had low cortisol, but some people have high cortisol. The only way to know for sure is by testing.

Blood sugar imbalances are very common. You could test not just fasting glucose; that’s what most doctors do. It’s great if you test fasting glucose, but you also want to test fasting insulin and hemoglobin A1C, which is the average blood glucose over a period of 2-4 months. I wouldn’t look at any one of these alone. Do all three. There are other blood sugar markers. At the very least, do fasting glucose, fasting insulin, and hemoglobin A1C.

In some cases, some people will get what’s called a continuous glucose monitor (CGM), which is constantly looking at glucose levels throughout the day. Usually, you tie it into an app. I have tried that out for a few weeks. Working with a practitioner is a good idea if you’re using one. Usually, you will need a prescription for one anyway. These days, there are companies where you can purchase on your own. Many times, you will need to work with someone.

Cortisol imbalances are a big issue. The reason is stress is a big factor. Chronic stress is a big factor. The reason I am bringing this up is because intermittent fasting can be a stressor as well. Not everybody perceives it as being a stressor. It’s one of these things where it could be a physiological stressor, especially if you are doing extreme fasting. I mentioned someone who is fasting 20 hours a day with a four-hour eating window, or an 18-6 fast, where you fast for 18 hours and eat for six hours. That could put stress on your body.

From a psychological standpoint, the perception of stress also could be difficult. If you only have that 4-6-hour eating window, psychologically, some people might be fine with that. That could also affect stress from an emotional standpoint.

If you are dealing with something like insulin resistance, fasting without question can improve insulin sensitivity in people. You also need to consider the impact it has on your adrenals.

You also need to see how you feel. If you’re doing intermittent fasting, even if you are doing a 16-8 fast, and you’re experiencing increased anxiety, increased shakiness, palpitations. I know these are common symptoms with hyperthyroidism. I’m saying if it seems more extreme with the fasting. Getting disrupted sleep. Any exacerbation of symptoms when you start fasting, maybe that’s telling you that it’s a little bit too extreme. You want to listen to your body.

I already mentioned a few situations when you want to be cautious about intermittent fasting when you’re dealing with hyperthyroidism. If you’re having extremely elevated thyroid hormones, or even if they are moderately elevated, they don’t have to be off the charts. Even without looking at your thyroid hormones, if you’re losing weight and muscle, it may not be a good idea to do longer fasts.

If you’re one of those people with hyperthyroidism where you’re not losing weight, maybe even having difficulty losing weight, but still moderate to severely hyperthyroid, which it doesn’t make sense but does happen in some cases, if your thyroid hormones are extremely elevated, you also might want to be cautious about doing intermittent fasting. 12-14 hours is okay for most people, but going beyond that, I would work with a healthcare practitioner.

I already mentioned if you’re having weight loss, especially significant weight loss, I lost 42 pounds total when I dealt with Graves’. I mentioned muscle wasting. If you’re having blood sugar imbalances. If you’re having insulin resistance, intermittent fasting could help in some cases. If you are having hypoglycemia, low blood sugar, it’s probably not a good idea to incorporate intermittent fasting.

Listen to your body. If you’re having increased anxiety, sleep issues. There are other common scenarios, like if someone is pregnant, then you probably don’t want to do extreme fasting. I wouldn’t say 16-8 fasting is extreme, but I would definitely work with a practitioner if you plan on doing that and are pregnant. If you are pregnant, you want to make sure you get enough nutrients for you and the baby that you get through food. If you are only eating 4-6 hours a day, even eight hours a day, that still might not be enough if pregnant.

When is fasting considered reasonable for those who have hyperthyroidism? If your thyroid levels have stabilized, if you are not actively hyperthyroid- I am not giving recommendations and saying if everything looks good, go ahead and fast. But that’s one scenario where fasting might be okay.

Adrenal health. Healthy adrenals. Doing an adrenal saliva panel or maybe a dried urine test, like the DUTCH test. Looking not just at a single cortisol level but cortisol levels throughout the day. Blood sugar, looking at glucose, insulin, hemoglobin A1C.

You should also have a healthy relationship with food. Fasting should not become another source of stress. If you’re stressed out because you’re fasting, and I mentioned this earlier, it could be physiological stressors, but it could be emotional stressors. The fasting itself could be a stressor. That is probably not a good idea if that increases stress.

When it comes to specifically Graves’, there are some practitioners out there who talk about fasting helping with autoimmunity, with the immune system response. It could reduce inflammation, modulate the immune system. Fasting can have these benefits.

Autoimmune hyperthyroidism is different. I don’t want to keep on repeating myself. If you’re dealing with Graves’, yet you’re losing a lot of weight, you’re losing a lot of muscle, your adrenals aren’t great, then everything comes down to risk versus benefit. Fasting might still offer some benefit with the autoimmune component.

I don’t even want to say it’s a piece of the puzzle. I talk about how diet is a piece of the puzzle. For example, when I dealt with Graves’, I didn’t do any fasting. My situation is different than yours. If someone is dealing with Graves’, and they are having difficulty losing weight, then maybe in that case, fasting would be okay. It also depends. If your adrenals are not in great shape, it could be an increased stressor. Of course, I will be biased because I am a natural healthcare practitioner, but I recommend working with someone and not doing this on your own.

Hyperthyroidism is complex. Autoimmunity is complex. Autoimmune conditions such as Graves’ are complex. Especially when it comes to Graves’, it’s finding and removing triggers: food triggers, environmental toxins and toxicants, gut infections, chronic stress, correcting nutrient deficiencies, healing the gut. All of these are important. If all you do is intermittent fasting, you are not going to reverse Graves’.

I will say that many people over the years have reversed Graves’ without intermittent fasting. I can’t say that fasting is necessary in most people with hyperthyroidism and Graves’. It could offer some benefits in some situations, but you want to be careful. Work with someone. Remember that fasting alone is definitely not a treatment for Graves’ or any other type of hyperthyroidism.

I would say start out more conservatively. If you haven’t done anything when it comes to fasting, or even if you have, if you have been doing extreme fasting, cut back. I would recommend for those who haven’t done anything to start with a 12-hour overnight fast. If you have been fasting for 20 hours a day, and you don’t want to cut back to 12 hours, maybe 14 hours. Finish dinner at 6/7pm. Eat breakfast at 6/7am. If you were to stop eating dinner at 6pm and eat breakfast at 8am, which is 14 hours, most people can handle that as well.

Everyone is unique. If someone has hypoglycemia, you might not want to do that. Not everybody with hypoglycemia is the same.

Start with a 12-hour fast. Consider gradually progressing to 13-14 hours. Pay careful attention to any symptoms you’re experiencing. If you’re experiencing any increase in symptoms. I mentioned specifically anxiety, palpitations, poor sleep, increased fatigue. Obviously things like dizziness are not good. Listen to your body. Don’t try to tough it out when it comes to fasting.

Keep in mind there are alternatives. Focusing on eating nutrient-dense foods, plenty of protein, healthy fats, fiber. Reduce snacking. Maybe rather than doing a fast, have specific eating windows. Don’t snack. Have three meals per day. Make sure all the meals that you eat are nutrient dense, healthy meals.

Block out time for stress management. Prioritize sleep. These are all important. Many people can achieve really good health benefits without doing aggressive fasting. As I mentioned, I don’t know if I would consider 16-8 fasting to be aggressive, but it depends. Someone with active hyperthyroidism, especially if you are losing weight, muscle mass, then I would say 16-8- When I dealt with Graves’, 16-8 fasting would have been too aggressive for me. Not everybody is in that same situation, but a lot of people are.

If you’re experiencing moderate to severe hyperthyroidism, especially weight loss, muscle loss, be cautious when it comes to fasting. Like I said, you also have to look at other things like blood sugar markers, adrenals.

I am not against fasting. This solo episode might give you the impression that I am not a big fan of fasting. I have done 16-8 fasting. Most nights, I am usually doing 14-hour fasts. At least 12-14 hours. Sometimes, I do 16-8 fasts. I did it more frequently in the past. Now, I just listen to my body. A few years ago, I would stop eating at 6pm and eat again at 10am the next morning. If I’m hungry, I won’t wait just to go 16 hours. I will eat if I’m hungry after 12 hours or 14 hours.

Focus on healing right now. You don’t need to fast in order to heal. Maybe later on, you introduce it. Or start with 12 hours and gradually increase to 13, 14 hours.

My point is, don’t force fasting. Don’t fast because it’s popular, and you have friends who are doing it or hear about others doing it.

I’ll wrap things up. Fasting is not necessarily good or bad for people with Graves’ and other types of hyperthyroidism. If you have active hyperthyroidism, if you’re losing weight, if you’re losing muscle, have unstable blood sugar levels, blood sugar imbalances, compromised adrenals, you want to be careful about doing more than 12-14 hours’ worth of fasting.

A 12-hour overnight fast is a reasonable starting point. Just because fasting can be beneficial for some people doesn’t mean it’s beneficial for others. The question isn’t whether fasting is healthy. The question is whether it’s healthy for you, based on where you are in your hyperthyroid healing journey.

I also put together a few questions people might have. One question some people have every now and then is: Can fasting lower thyroid hormone or thyroid antibodies? I will say there is some evidence that restricting calories extremely can actually lower thyroid hormones. It’s not the way you want to go about it. You don’t want to do extreme fasting. That’s not addressing the cause of the hyperthyroidism. In some cases, fasting might be able to help lower thyroid hormone levels. It’s not going to do much from an autoimmune component as far as lowering thyroid antibodies.

Can fasting help with weight gain in Graves’? Maybe. It depends. Not everybody is the same. If someone is having insulin resistance and Graves’, maybe. I would say work with a healthcare practitioner.

Is fasting different for Hashimoto’s’ versus Graves’? Those with Hashimoto’s usually aren’t losing weight. Many people with Graves’ are losing weight, but a lot of people with Hashimoto’s have adrenal imbalances and blood sugar imbalances. If it’s blood sugar imbalances like insulin resistance, maybe it’s okay. If it’s hypoglycemia, maybe not. If someone has compromised adrenals regardless of whether they have Graves’ or Hashimoto’s or a different autoimmune condition, you want to be cautious.

You can learn more about diet by reading my book The Hyperthyroid Healing Diet. I don’t talk a lot about fasting in it, but it’s in there a little bit. My Healing Graves’ Naturally newsletter, SaveMyThyroid.com/GravesNewsletter.

Like I said, I will always recommend working with a healthcare practitioner, usually a natural one. If you go to your primary care doctor or your endocrinologist, they are probably not going to be big fans of fasting. In all likelihood, they will tell you that diet won’t make any difference when it comes to your hyperthyroid condition. You probably don’t want to bring up diet at all to your endocrinologist.

I am not against intermittent fasting, especially in a healthier state. If you are healing, you want to be cautious.

Thanks again for tuning in. Look forward to catching you in the next episode.

***

Hopefully, you found this solo episode on fasting and hyperthyroidism to be helpful. Over the years, I have had a number of people ask me about water fasts on hyperthyroidism. Three-day fasts, if not five-day fasts.

I don’t usually recommend this for some of the same reasons I mentioned during the episode. If someone is losing a lot of weight, you don’t want to do this. Even if you are not losing a lot of weight, it puts a lot of stress on the body.

Everything is risk versus benefit. If someone is in a healthier state, they are dealing with insulin resistance, maybe the benefits very well might outweigh the risks. Even if someone is not losing weight, maybe you have problems losing weight. If your adrenals aren’t in great shape, then I’m not sure if you want to do a three-day water fast, let alone a five-day water fast.

24-hour water fast? I wouldn’t do them regularly. It’s different if you’re in a better state of health. That’s why people are trying to incorporate water fasting and juice fasting to try to get into a healthier state, to help benefit their health. You definitely want to be careful. Work with someone.

If you are working with me, just to be up front, I wouldn’t recommend a three-day water fast or regular 24-hour fasting. If you are looking to do those, you wouldn’t want to work with me because I won’t tell you to do those types of fasts.

Fasting and insulin resistance. I spoke about this a little bit during the episode. If someone has insulin resistance and hyperthyroidism, and they are not losing weight, intermittent fasting, 12-14 hours is something to consider. 16-8, maybe in the case where someone is not losing weight.

It depends on the state of your adrenals, which is why I would recommend doing an adrenal saliva test or dried urine test to look at the circadian rhythm of cortisol. That would be a situation where I would at least consider it.

If someone has insulin resistance and hyperthyroidism, whether it’s Graves’ or toxic multinodular goiter, and they are struggling to lose weight, and maybe their adrenals don’t look too bad, maybe doing a 16-8 fast is something they could do. Keep in mind it doesn’t work with everybody. Fasting can sometimes work wonders, but sometimes there are other things you need to do.

With insulin resistance, there is an inflammatory component, so you might need to do other things to reduce inflammation.

Fasting as a source of stress. I mentioned this already. Tying it into the adrenals. Fasting itself could be a stressor. I mentioned if you already have weakened adrenals, you might want to be careful about fasting.

Also, fasting itself could be a stressor in some people. Some people are excited about fasting. They think about this positively. Others learn about fasting and are not happy about it, but they are doing it to try to lose weight or general health benefits. Maybe they heard it can help with the immune system, which I’ll discuss next. Especially if you have a negative mindset toward fasting, and then you’re doing it, just like you have a negative mindset toward AIP or any diet, it could be a big emotional stressor.

It could be a big physical stressor, too, if your body is not ready for it. If you are losing weight and/or your adrenals are compromised.

I am not trying to talk negatively about fasting, but I am warning you. I have done 16-8 fasting. I regularly do 12-14-hour fasts. I know people who do more extreme fasting, and it’s benefited them. You just want to be careful. Hyperthyroidism is different than many other health conditions.

Finally, can fasting benefit autoimmunity? There are practitioners talking about the benefits of it. I discussed this a little bit during the episode. All I’ll say is it could in some cases benefit the immune system. I also can’t say it’s necessary.

There are a lot of things out there that can add benefits. Doing hyperbaric oxygen might have benefits. That is a little bit more extreme because you’d have to go somewhere or buy your own hyperbaric oxygen chamber. Fasting is simple and easy. Could put stress on your body, but it is definitely easier than some other things.

I wouldn’t say it’s absolutely necessary. I have had a lot of success over the years helping people with hyperthyroidism, Graves’, toxic multinodular goiter, without recommending fasting. I can’t say that I’m going to recommend fasting. I’ve mentioned this already. Everyone is different. There definitely are benefits of fasting and caloric restriction. Most of the studies on fasting and caloric restriction are more animal studies. It doesn’t mean there are not benefits with humans. Like I said, really be careful. If you really are thinking about it, work with someone.

The problem is, if you work with someone, it probably won’t be someone who is too familiar with hyperthyroidism. I honestly don’t know anyone who focuses on hyperthyroidism and also has a lot of experience with fasting. You might be on your own. If you are working with someone who has a lot of experience with fasting, they could do some of their own research.

If you work with someone who has a lot of experience with fasting, not with hyperthyroidism specifically, and they tell you, “I’m not sure. Maybe I wouldn’t do it in your situation,” that’s a red flag. If someone who is an advocate of fasting is telling you that maybe you shouldn’t fast, you want to be cautious.

With me, I am neutral. I am not against fasting. I am just cautious. If you work with someone who recommends fasting on a regular basis, and they are not sure in your situation, then you might want to think twice about doing it, at least while healing. Maybe in the future, you probably could do it. While healing, maybe don’t do it.

That’s all I want to talk about with regard to fasting. As usual, hope you found this information to be valuable. Look forward to catching you in the next episode.

In this episode, Dr. Eric Osansky welcomes thyroid patient advocate, speaker, and bestselling author Rachel Hill to discuss her book, The Positive Thyroid Pregnancy Book. Drawing from both her personal experiences and years of supporting thyroid patients, Rachel shares practical guidance for navigating fertility, pregnancy, and postpartum health while managing hypothyroidism and Hashimoto’s thyroiditis. While her focus is primarily on hypothyroidism, much of the conversation applies to anyone dealing with thyroid or autoimmune thyroid conditions.

Together, they explore some of the biggest challenges thyroid patients face when trying to conceive, including infertility, miscarriage risk, thyroid antibody management, medication considerations, and optimizing thyroid hormone levels. Rachel also discusses the importance of tracking thyroid labs throughout pregnancy, reducing thyroid antibodies before conception when possible, supporting gut and immune health, balancing blood sugar, addressing nutrient deficiencies, and understanding the role of hormones, diet, exercise, and environmental toxins in fertility and pregnancy outcomes.

The conversation concludes with practical advice on prenatal supplements, postpartum thyroid health, building a supportive healthcare team, and advocating for yourself throughout the entire pregnancy journey. If you want a clearer understanding of how to prepare for a healthy pregnancy while managing a thyroid condition, you’ll get a lot out of this episode.

Click Here to listen to it on the Save My Thyroid podcast

Dr. Eric Osansky:

I am super excited to chat with Rachel Hill, who is the multi award-winning thyroid advocate, speaker, and best-selling author behind The Invisible Hypothyroidism and four thyroid patient books. In this conversation, we will be talking about her book The Positive Thyroid Pregnancy Book. Rachel, thank you so much for joining us.

Rachel Hill:

Thank you so much for having me on. I’m really excited to discuss a really important topic today.

Dr. Eric:

Same here. You’ve written a number of different books. The question I’m about to ask is, why did you write The Positive Thyroid Pregnancy Book? I assume it’s your own experience, but there is also not a lot of information out there when it comes to thyroid and pregnancy. Were those two of the biggest motivating factors? Maybe there were other reasons, too.

Rachel:

I’d say you hit the nail on the head there. I have one called The Patient Expert about navigating a new diagnosis. One about relationships with your spouse, friends, and family. For me, writing has to come from an organic place. It’s often a representation of where I am in my own thyroid journey.

I now have two sons who are six and four. When I went through my own pregnancies, it was an overwhelming time of not knowing where to turn for this information. I think there are one or two books out there. They can be quite clinical. They are written by doctors, brilliant doctors, but they are not easy for someone who is perhaps brain fogged, fatigued, with these typical thyroid symptoms. It’s not easy for us to digest. They can be really long books.

I wanted to create something that had all of the essential information but without all the fluff and jargon. Just the need-to-know information that we thyroid patients can go ahead and implement.

My work is always there to be utilized alongside your doctor, functional medicine practitioner, chiropractor, whomever you’re working with. I want thyroid patients to feel empowered to know what they can do specifically and what questions to ask in the doctor’s office. How to advocate not only for themselves but for their unborn child when they are pregnant.

Writing The Positive Thyroid Pregnancy Book is something I pieced together over 3-4 years of going through a couple of pregnancies that were incredibly different. One with a thyroid condition well managed, and the other one was the complete opposite. It gave me a lot of personal experience to use as well that will hopefully not only help the thyroid patients but give them validation for what it is we go through.

I really wanted to put some difficult experiences into something useful. It was important to me that it was a positive book to read, hence the name. When you Google “hypothyroidism pregnancy,” thyroid in general and pregnancy, fertility, it’s doom and gloom. At least when I was Googling, “chances of miscarriage,” you end up going down this terrible black hole. It’s not positive information that comes up.

When we get to the truth of it, thyroid patients can have children. We just need to know this crucial information in order to help support ourselves with the best chances of getting there. That’s why I created it.

Dr. Eric:

Wonderful. Glad you did create the book as well as your other books. Let’s start by discussing some of the biggest challenges women with thyroid conditions experience when they are trying to have a healthy pregnancy. If you want to tie it into some of your own experiences, I’m sure you have seen a lot of different experiences from other women who were pregnant with hypothyroidism/Hashimoto’s.

Rachel:

The single biggest struggle that we have is falling pregnant. A lot of people don’t realize how important their thyroid gland is for their fertility.

Second to that is being able to hold onto the pregnancy. I experienced a miscarriage as my first pregnancy, which was a trigger for me feeling like, “Okay, I need to understand more of what I can do, more of what is going on,” and delving into that research. I found so much that thyroid patients don’t know. It’s not easily accessible, or at least it wasn’t before I wrote this book.

Understanding the T4 synthetic medications, like levothyroxine or Synthroid, they work for a lot of people, but they don’t work for everyone. When I say “work,” we’re not just talking about getting your thyroid test results normal. We are talking about actual symptoms and your quality of life and whether your thyroid test results are optimal as opposed to normal, fine, or in range, all these phrases we all hear. That alone can be the biggest step we can make to combating fertility struggles, pregnancy loss.

It’s such a simple thing, yet a lot of us don’t know to ask those questions to get a copy of our own test results and look at them and understand them. When it comes to the biggest issues that we face, that pregnancy loss, falling pregnant, they’re often the biggest ones. It’s just about how we can then navigate that and understand what we can ask to overcome those.

Dr. Eric:

Thyroid hormone replacement, I’m glad you brought that up because a lot of women are on levothyroxine. Some women do fine with it, and some don’t. You need to convert that T4 into T3. That’s a big problem.

Do you have a preference? It is individual, but I don’t know if you personally take levothyroxine or if you like desiccated thyroid. Is desiccated thyroid safe to take during pregnancy? There is also some debate. If you ask conventional medical doctors, they would say no, that you need to be on levothyroxine. I’d love to know your thoughts about what is safe, what is optimal during pregnancy when it comes to thyroid hormone replacement.

Rachel:

I always say there is no one best thyroid medication. It’s the one that works best for each person. When we say that it works best for you, we are looking at optimal thyroid hormone levels as well as symptom relief and overall quality of life.

For me, I am currently on Armour Thyroid plus a small amount, 25mcg, of levothyroxine on the side. This is not very conventional. It was something that I was almost hesitant to share when I first made that switch because a lot of people are very opinionated on thyroid medication options.

When I was diagnosed almost 11 years ago now, I was started on levothyroxine. I felt awful. I was gaining more symptoms, gaining weight. My mental health was down the drain. I then explored the route of natural desiccated thyroid medications. I started off self-sourcing that from Thailand because here in the UK, it’s incredibly hard to get, if not impossible, through our national health care system.

When I knew, and this is something I talk about a lot in the book, that I wanted to start a family, it was important for me to move from self-sourcing medication to having it prescribed. It was never something I wanted to do long-term. It was more a stopgap to get my health back enough that I could function at work.

This is something we don’t hear a lot about. There are thyroid patients who are not optimally treated where it impacts their work life, relationships, absolutely everything. Once I was well enough to be able to digest and understand this thyroid research, I could find a private doctor here in the UK to prescribe.

I have been on Armour Thyroid up to seven years. Levothyroxine was added in after my first pregnancy. The Armour Thyroid was no longer optimizing all my levels on its own. My free T3 was great. TSH was fine. But my free T4 was quite low. We tweaked and tried things, and adding that small amount of T4 in is what got me to my happy place, where I am optimally treated now.

Going forward, that has to be closely and consistently checked in with, moderated. Needs can change over time.

Through my first pregnancy, I was just on Armour Thyroid. Textbook pregnancy, very easy, very straightforward, no major issues. Second pregnancy came along. By this point, I was on both Armour and levothyroxine. My levels would drop very quickly. I think it happened three or four times by the time I was six months pregnant. The Armour didn’t need adjusting until I was about seven months pregnant. The levothyroxine was all over the place. That was a lot harder to keep on top of.

For that reason, as well as many of the guidelines I referenced during the book as well, I am a big advocate of women having their thyroid levels tested every 4-6 weeks throughout pregnancy. We all react so differently. Each pregnancy can be individual. Each woman is individual. Each thyroid condition is individual. You never really know how your body is going to react.

I am an example of a woman who had two very different reactions and needs in terms of those thyroid medication adjustments. Obviously, for people who are just on levothyroxine alone, they do often find they need that medication increase almost as soon as they find out they are pregnant. That need increases.

In terms of medication options, I am a big advocate of each person finding what works for them, in their pregnancy as well. You will find more conventional doctors are not as keen on using T3 medications. They will argue that it doesn’t pass through to the baby, that T4 is what’s needed for the baby to grow.

I would argue that T3 is important for Mom to feel well, that Mom also has to have energy, good mental health, and be able to focus and feel well throughout her pregnancy. I am not a fan of the one size fits all that we often see in the thyroid world.

It is worth knowing that you might get pushback from certain doctors if you aren’t someone who does well on levothyroxine. Ultimately, if you feel like you need T3 medication, it’s important to get stabilized on that before falling pregnant. You want to get stable and settled on that before a pregnancy. Once you are pregnant, it’s much less likely that a doctor will suddenly change your thyroid medication.

There are a lot of things to consider. Ultimately, we want to find what works for each person in order for you to feel well and grow a happy, healthy baby and have a happy, healthy pregnancy.

Dr. Eric:

Agreed. When it comes to testing, what do you recommend testing? Just TSH, free T4, free T3? Anything else?

Rachel:

Thyroid antibodies. Being a thyroid advocate for Hashimoto’s and hypothyroidism, there are antibodies. TG and TPO are the two that can be really helpful. Before getting pregnant, checking if you have Hashimoto’s, which over 90% of those with hypothyroidism do. If possible, trying to reduce those thyroid antibodies.

Unfortunately, there is no one magical thing that works for everyone with that. We often have to try different things. Some people are really stubborn. If you’re able to reduce those before you fall pregnant again, that can help with fertility. Monitoring them throughout pregnancy can be helpful. Checking them every month is probably not necessary. A couple times throughout your pregnancy is fine.

What most people find, and I had this as well, is Hashimoto’s and thyroid antibodies often go really low, if not down to zero, when you’re pregnant. There is a change that happens, Th1 to Th2, that happens when you’re pregnant. This often puts a lot of health conditions into remission. They flare back up when you’re post-partum. That’s normal. As I talked about in the book, knowing how to prepare for yourself and not getting angry at your body when that happens. Since it’s expected to happen, knowing what to do is often the best way forward.

Throughout the pregnancy, TSH, free T3, free T4, absolutely should be checked all the way through. Aiming for them to be optimal as opposed to just within range will support your pregnancy as much as possible.

Dr. Eric:

Any reason to look at reverse T3 before or during pregnancy?

Rachel:

I am more mixed on this one. It can be helpful in showing up if there are other stresses going on in the body. When you’re pregnant, I would hope or promote that people do things to keep that low anyway. Pregnancy is a stressor. Seeing that rise throughout pregnancy wouldn’t be surprising.

I like to focus on what we can do instead of the things we can’t control. Anyone who has gone through pregnancy will tell you there is a lot you can’t control. It’s not about wanting to control everything. It’s about understanding what is reasonably in your control that you can do that won’t add further stress at the same time.

Dr. Eric:

Makes sense. With the antibodies, you mentioned that if you can, you want to try to lower and normalize them before pregnancy. As you mentioned, with immune shifts, they might normalize during pregnancy anyway. If someone has elevated TG and/or TPO antibodies and are trying to conceive, even if they are not successful in lowering or normalizing them prior to conceiving, they could still conceive and have a healthy pregnancy, correct?

Rachel:

Yeah. The thing with wanting to lower them is your risks of miscarriage are higher if you have high thyroid antibody levels. I always recommend, if you can give it time, to give it 6-12 months to try to lower them through various things.

We know selenium supplementation can help. Vitamin D has been shown as well. I am not a fan of supplementing with things we don’t necessarily need. We don’t want to give ourselves problems by having really high levels of Vitamin D, for example. That won’t help. If you are doing blood tests and can see there is room to top that up, and we are already low in it, that can help.

In terms of diet, going gluten-free, that reduced my thyroid antibodies. It didn’t even measure past a certain number. It said more than 1,300 for my TPO. I got them all the way down to 40 just by going gluten-free.

Blood sugar balancing. Reducing alcohol. Going dairy-free can help. Gluten is the biggest one. Optimizing your thyroid hormone levels alone can help with thyroid antibody levels. Improving your gut health. Keeping your nervous system and adrenals in check. There are so many things you can try. I often describe it like a big jigsaw puzzle. There are often a few different pieces that we can slot in, and that gives us results.

As I said before, there is no cookie cutter approach of what can help reduce thyroid antibody levels. It’s some sort of trial and error and some digging into what triggered your thyroid condition in the first place. That can often unearth areas we can work on and improve as well. Naturally, when you’re feeling less stressed, those thyroid antibodies tend to drop down anyway.

Look at reducing them before pregnancy. It gives us a better chance of holding onto a pregnancy and falling pregnant in the first place and having that healthier pregnancy throughout those nine months.

We do have to appreciate that a lot of people spend years trying to lower them, and they haven’t found anything that has worked either. Women hear all about this biological clock. As much as I do want to promote that women can also have a career and do other things, that we are not just here to produce children, we do need to be aware of the biological clock if we want to optimize our fertility.

It does drop off from as early as 28 years old. For a lot of people, they are not having children in their 20s, so if they get into their 30s and may want to delay it longer for the sake of trying to reduce thyroid antibody levels, there has to be a balance struck between what is reasonable and when perhaps it is time to go forward and see if it still happens for you.

I talk about this in the book. There is no perfect time. Your thyroid health is just one side of it. There are other parts in your life that you are weighing when it is time to start or expand your family. It’s a really personal decision. We have to figure out what makes the most sense for us.

Dr. Eric:

When trying to prevent miscarriages, having healthy thyroid hormone levels, doing your best to lower thyroid antibodies. Anything else that women can do, like optimizing sex hormones or any other tips you can give to prevent miscarriages from happening?

Rachel:

There is a phrase we hear a lot, estrogen dominance, in our community. Whether that is strictly a health issue within its own right is hotly debated. I was someone who did have high levels of estrogen throughout my cycle when I shouldn’t have. My skin was so oily, my hair was falling out, I had frequent migraines. At the time, I was working with a functional medicine practitioner. Whether people debate that is a real thing or not, what she did with me in terms of improving, it is embarrassing. People don’t talk about it. Things like your gut health, bowel movements, it certainly helped me, and it improved my fertility.

I went from not regularly ovulating. My cycles were 10 days long, then 40 days, then 20 days, all over the place. Working on supporting that natural flow of hormones, where your estrogen is building up for the first half of the cycle, and then progesterone is taking front and center. Working so we are seeing more of that natural shape, the curves we want to see, definitely helped me regulate my cycles.

Instead of focusing on just estrogen or progesterone being a certain number, which is tricky because they fluctuate throughout the month, so it’s hard to know where that should be. Focusing more on having regular healthy menstrual cycles, aiming for that 30-40-day regular cycle, getting to know what is normal for you will reflect what your hormones are doing for you than zoning in on a specific hormone.

When I’d gone from these irregular cycles to seeing them being 28-30 days every month, being able to pinpoint when my body is ovulating, once you understand your cycles, and you can take a basal body temperature reading to help with this, there are many other ways that you can track your cycle. It helps you with your fertility.

People don’t understand that you’re only actually fertile for a few days each month. That alone can help you pinpoint the window that you are going to be fertile that month and hopefully get you on the journey to becoming a parent.

I am hesitant to zone in on specific hormones. Working with a practitioner who knows how to help you get to the point of understanding your cycles and where possible regulating them more and understanding the flow, that can be incredibly helpful. That is where I stand with those things.

Dr. Eric:

I don’t know if you have the answer to this, but are you aware of any research about exposure to endocrine disrupting chemicals? We are exposed to a lot of toxicants and microplastics. I’m sure they affect fertility, but I don’t know if increasing miscarriage rates has been researched.  

Rachel:

Not super specifically. When they talk about endocrine disruptors, that can impact your hormones and your thyroid and cycles. I would suspect there is a link in that way. I think there is. Space to talk about this stuff and give people tips on how to maybe reduce exposure in certain ways. I wouldn’t want people to stress so much that that stress is impacting their fertility or a chance for pregnancy.

There is that balance. I talk about this balance in terms of diet and exercise. You don’t want to ignore that stuff completely, but there is a balance that we want to find where it is helping us instead of hindering us.

Dr. Eric:

Let’s talk more about diet. You mentioned gluten-free. Of course, you want to eat whole, healthy foods as much as you can. There are diets like AIP. A lot of people with autoimmunity follow a carnivore diet. There is debate on how much protein you should have in general. If you could touch upon some of these topics. There is no perfect diet that fits everyone.

Do you recommend a certain amount of protein for women who are pregnant? When it comes to diets, are there concerns about restrictive diets? I recommend AIP a lot. It’s restrictive, but it’s also nutrient-dense. We could make that argument with carnivore. Are there any concerns you have about any of these diets? If you could talk about protein and fat needs for pregnant women.

Rachel:

Like you said, I don’t recommend any one diet for everyone. We have to find what works for us. We react differently to different foods, especially thyroid patients. Gluten, dairy, they are the big ones. Eggs, all grains, soy. That could be anything from a digestive issue to something more subtle, like headaches or fatigue, which could take a while to pinpoint down to food.

When it comes to diets like the AIP diet, you probably have more to say as a practitioner on this than I do. I understand it to be more of a temporary diet that you would do for a certain amount of time to reduce inflammation, to help give the gut time to heal, to get back to a good place, to identify trigger foods. If foods are causing digestive complaints, headaches, skin rashes.

In terms of an example, with AIP, when you’re pregnant, you probably want to be eating a lot of whole foods, a lot of variety. Those sort of restrictive diets would be done before you’re pregnant and/or trying to conceive. I talk in the book about having this 6-12-month period of getting all your ducks in a row, getting your health in as best a place as possible, so you can go into pregnancy with your mind and body prepared for it and with as good a chance as possible of having a positive experience.

With those more restrictive diets, they are not recommended once you become pregnant. By all means, if you do need to do those for a certain amount of time to reduce your thyroid antibodies and give your gut time to heal. Gut health is such a big part of this thyroid jigsaw puzzle for so many of us. That can be helpful.

Fiber and protein needs. I don’t follow a specific amount. Here in the UK, they currently recommend 30g of fiber a day, which I don’t think is that much. When you see it in front of you, there is room to improve that.

When it comes to protein, national recommendations aren’t a thing over here. What I do know, and what a functional medicine practitioner told me years ago, which completely changed my approach to food and feeling satiated, blood sugar balance, when building a plate of food, aim for it to be 1/3 protein, 1/3 carbs, 1/3 healthy fats. If you can increase protein and healthy fats on your plate, great, but do not have more than 1/3 of carbs on your plate as you’re looking at it. That then more or less creates a meal.

You can do it with your snacks as well. If you are going to have an apple, you probably want to have olives or nuts alongside as well. That will give you more energy to keep you going for longer, stay focused, keep the headaches and fatigue at bay. You will hopefully also look after your gut and address things like constipation. You are more likely to have constipation and brain fog and fatigue.

Sometimes, making these principles safe to look at when you’re building a plate of food can be one of the best ways forward. What people who are already tired or brain fogged don’t need are complicated changes to their day to day. I am a big fan of making these really easy to look at and form day to day instead of things being another roadblock. That is my approach to things like protein, healthy fats, and fiber, not just through pregnancy or trying to conceive.

There are some easy dietary changes you can make day to day. We know about reducing ultra processed foods. We know most of us are not eating anywhere near enough fiber. With simple changes like swapping out regular white basmati rice for brown whole grain rice, or the same with pasta. Over here, we have a lot of lentil pasta. Really easy swaps, naturally gluten free for people who can’t have gluten. They can make such a positive impact on your gut health, bowel issues, fatigue, headaches. A big advocate.

We are not drinking enough water for the most part. It’s such a common thing. It’s free. People forget it all the time. It’s one of the biggest ways you can improve your mental focus and energy. People don’t realize how dehydrated they are.

Dr. Eric:

Agreed. What about exercise? Too much, too little during pregnancy when dealing with a thyroid condition?

Rachel:

One thing I learned was to listen to my body to figure out not only what was working and not working throughout each stage of pregnancy but also day to day. Your hormones are fluctuating so much. One week your body will go through a lot of growth to grow the placenta. The baby goes through a rapid period of growth. You’re more tired and hungry. Sometimes, we don’t only need to consider what is working for us in terms of a trimester or pregnancy in general. It can fluctuate day to day.

I would have an aim of going swimming twice a week. I went to a prenatal yoga class once a week. I walked every day. As pregnancy progressed, the walks became shorter and shorter because of pain setting in when you get more pregnant. I used to do salsa dance classes. I couldn’t keep them up because my center of gravity was changing as the belly grows. I almost tumbled and fell over a few times. I had to pause it after pregnancy.

There are things we can do in terms of keeping an eye on day to day. One day, you might be able to go for a 30-minute walk. The next day, you can only manage five minutes. Maybe keeping a log of these things. Is this more of an overall trend? Do I need to get my iron checked? So many people who are pregnant and thyroid patients all have low iron levels, which can make exercise hard. Or is it just my body is doing a lot more growth this week? Am I not sleeping well? Getting to know your body can be so important.

If you’re exercising while pregnant and having heart palpitations, dizziness, back pain, long lasting fatigue, thyroid flares, which is a period of your thyroid symptoms flaring up, those are signs that the current exercise may not be working for you. It could be too strenuous. It could be that you’re doing too much. It could be the time of day. When I was pregnant, I felt best late afternoon, so that was when I would get my exercise in or go swimming. All these things are really important.

As long as you are keeping your body moving throughout pregnancy, that will do so much more for your health rather than writing all exercise off or pushing and doing too much. Yoga, walking, swimming, all of those are perfectly safe for most pregnant people. If you were lifting weights or doing strength training before pregnancy, that is often okay to continue during most of pregnancy.

You are more likely to injure yourself once you’re pregnant because of the hormone relaxing. It relaxes a lot of your body and joints. We have to keep things like that in mind. Ultimately, when your energy is going up and down, you just need to check in and tune in with your own body and listen to what is and isn’t working.

Some exercise is better than nothing. If you’re having a hard day, some simple yoga stretches or a walk around the garden can still be beneficial for your physical and mental health.

Dr. Eric:

You spoke a little bit about the immune system. We chatted about how the antibodies might normalize during pregnancy because of Th1/Th2 balance. Also, a lot of women do experience post-partum thyroiditis. Is there anything women can do not to completely prevent post-partum thyroiditis from developing but minimize it?

Rachel:

In terms of post-partum thyroiditis, it is most often triggered by that immune change, as far as I can understand. Continuing through pregnancy the things that might keep your Hashimoto’s under control if you have been lucky to get to that point can help. Things like learning to regulate our nervous system, looking after our adrenal health, things like that can go quite a long way. Not just for managing or trying to avoid post-partum thyroiditis, but also the thyroid crash that happens when you’re post-partum.

If you have practices in place that help you feel calm and the opposite of fight or flight nailed down pre-pregnancy, hopefully throughout pregnancy, post-partum, those things alone can go a long way to helping you get your health back to a more stable place.

I personally had my functional medicine practitioner on speed dial. When I’m post-partum, my thyroid antibodies will probably go crazy. I imagine things like iron will drop after giving birth. I had all these ideas. My thyroid levels will go up and down. I had her ready to contact.

I was actually pleasantly surprised when I had everything tested six weeks post-partum that everything had settled nicely on its own. It wasn’t until I was six months post-partum that things started to go awry.

When I spoke to her, she said I probably did quite a good job of trying to do things to support keeping my body in a place where it feels safe throughout pregnancy and post-partum. Once that bundle of joy is here, and they are keeping you up throughout the night, and they are screaming during the day, your body turns to what is more familiar. That regulation of feeling like you have things down day to day tends to change. She says she sees it more at that six-month mark.

I had a conversation with Dr. Izabella Wentz about this as well. She said the same thing. It seems really common. I would say it’s helpful to have that plan in mind. What can I do to promote this during pregnancy and post-partum?

If things do go pear-shaped, you can only do so much. Pregnancy and giving birth is such a huge stressor on our body that we have to be kind to ourselves and remember we can only do so much. That’s okay. Give yourself grace. Know what those next steps are going to be. That alone can give your body a lot of comfort and knowing that you have thought ahead, and there is a plan if you need it.

Dr. Eric:

How about supplementation during pregnancy? I assume you recommend a prenatal vitamin. Do you recommend anything else? Does it depend on the person? Are there any essentials for supplementation?  

Rachel:

A good quality multivitamin that delivers all of those key nutrients that your body needs when you are growing a pregnancy, including omega-3 fatty acids and DHEA. They often get missed out. Those are important for mom and baby throughout pregnancy. That is usually where we start.

From there, a lot of people often need extra iron. We don’t want to be supplementing iron if we don’t need it. A lot of people have high levels and don’t have a clue. Throughout pregnancy, you want to be running everything through your providers.

I recommend having more of a health care team throughout pregnancy. You might have a primary care doctor. You might have a functional medicine practitioner, a naturopath, something like that, alongside. Here in the UK, we have midwives as well. It can be helpful to have this team to bounce all of these ideas off of different people who have different inputs and specialties and the ability to test different things.

When you are looking at iron, vitamin D, make sure to test before you take.

Folate. Methyl folate specifically. You want methylated folate because a lot of people don’t do anything with regular folate. Those are important.

It’s more important to be supplementing the right things when you are optimizing your fertility. You don’t want to fall pregnant and realize your iron is quite low. That can take ages to build back up in your blood. That can take months to get to an optimal place.

Things like Vitamin D as well. Zinc. You need healthy iron, Vitamin D, and zinc to have good fertility. This goes for men as well.

In terms of supplementation, I fully recommend people get a full workup when they are thinking about starting a family and improving that before conceiving. When you fall pregnant, it’s about keeping up with what your body really needs.

Testing your thyroid levels throughout pregnancy. Key vitamin levels like Vitamin D, B12, iron, ferritin. That can be checked in probably every few months to keep a close eye on it.

If you are particularly fatigued, check those things sooner. It’s easy for doctors to write off tiredness and brain fog as normal pregnancy symptoms, but it could be low thyroid, low vitamin levels. We benefit a lot from being clued in on this. This is why I want to empower other thyroid patients to know what to ask for, so those things aren’t being missed.

Dr. Eric:

You brought up a few important points. Omega-3 fatty acids. If it’s not in the prenatal, and women are not eating fish on a regular basis, there is a good chance she is not getting enough. You need EPA and DHEA for the brain health of the baby.

You mentioned methylated folate because a lot of these prenatals still have folic acid. That’s important.

Iron, you don’t want to be low on iron. You want to be careful because too much iron can cause oxidative stress.

What you briefly mentioned is the importance of the male. We are focusing on the female during this conversation, but that is another conversation, too. Sometimes, when women have problems conceiving, it’s not always related to the woman. It could be the health of the man.

You want to do everything you can to prepare for a healthy pregnancy on both sides. Eat a healthy diet and optimize nutrients and reduce toxic load. Same thing with the endocrine disrupting chemicals. A lot of what relates to women when preparing for a healthy pregnancy probably also relates to men, too. Would you agree?

Rachel:

Definitely. It’s 50% from both, isn’t it? It’s equally as important. That’s something we are only starting to understand more now. I saw some interesting research that said that conditions such as morning sickness and preeclampsia could be linked to the sperm quality. If you are having a horrible time with morning sickness, you probably need to have a word with your partner about what he did to his sperm.

The omega-3 fatty acids, zinc, especially, really important for sperm quality. And Vitamin D. Here in the UK, it is estimated that as many as 90% of us are low in Vitamin D because we don’t get a lot of sunshine unfortunately. A lot of people don’t have a clue. A lot of people don’t realize.

It’s easy to write tiredness off or feeling like you lack focus and that mental clarity. It’s easy to write that off as having a busy life or not sleeping well or getting older. It’s important to ask these questions and get these things checked out if you are thinking about starting or expanding your family. It is something that can be simply treated that avoids issues and heartbreak further down the line.

I touch on this briefly in the book. It is more from a female point of view. There are things that men can do as well to improve their sperm quality, so we can mitigate any issues that might come from there.

Dr. Eric:

You already sort of answered this question I was going to ask about working with a team. You mentioned your primary but maybe a functional medicine doctor and a midwife. When it comes to women who are thinking about doing a home birth, if they had the right team in place, is that something that is safe to do for someone with hypothyroidism?

Rachel:

The short answer is yes. The longer answer is we are still different. It depends on how your pregnancy is going. When you are pregnant, you will be classified as low risk or high risk for other issues or complications coming up during birth.

For me personally, I chose to give birth at a hospital but in the midwife-led unit. They don’t monitor you with a lot of equipment. It’s monitoring you based on the signs you are giving. It is offering the environment you would have if you were having a home birth but with that added security of knowing there are medical professionals there. There are midwives, not doctors. That is where I felt most calm. If things do take a turn, because we can’t be in control of everything, at least I am next door to the hospital if I need it.

In the same way, being able to be in a room that was dimly lit. We were able to play calming music. We were able to be in control of the environment. I felt that was going to give me the best chance possible of having a straightforward birth that wouldn’t require intervention. If things aren’t progressing well because your oxytocin can’t pick up and keep progressing labor at a different speed. That was important for me.

For other people considering a similar birth, a home birth can be possible. It will depend on your situation. If your doctor classifies you as high risk, because your thyroid condition is hard to stabilize or something comes up in your pregnancy like preeclampsia or someone who can have an issue with their liver, lots of things can crop up. Your doctor might be less comfortable with you giving birth outside a medical setting. Then that will definitely play a part.

Having a thyroid condition doesn’t automatically mean you will have more complications or you are high risk, especially if you are being closely monitored. You are monitoring and optimizing your thyroid levels. As long as all those things are in place, for the vast majority of people, they don’t need an involved birth plan.

Dr. Eric:

We covered a lot. You go into greater detail in your book. For more information, check that out.

Before we wrap up, there are a lot of things I could have asked you. Anything you really wanted to talk about that I didn’t ask you? Any final words of wisdom?

Rachel:

I think we have covered all the key areas. My #1 piece of advice for anyone in their thyroid journey is continue to be your own thyroid health advocate. Continue to ask questions. Learn through resources like this podcast and books. However best it is you can take in that information. Continue to advocate for yourself, and learn what you can ask in the doctor’s office. Learn what you can do yourself.

Whether you are pregnant or way past that stage in your thyroid journey, learning how to advocate for yourself is crucial. It will make the difference between whether you have good quality of life or whether you struggle. Having optimal thyroid treatment and a good set of practitioners, and how active you are in your own health care. That alone is the #1 thing we can do, and that is the key message in everything I do.

Dr. Eric:

Where can people learn more about you, Rachel?

Rachel:

You can find me online under TheInvisibleHypothyroidism.com. That is my blog where I started 11 years ago. I have around 500 articles and blogs on there now, covering all aspects of living with thyroid disease.

I am active on Facebook and Instagram. I have four books on Amazon. My Substack newsletter is something I am really passionate about at the moment. I am continuing to focus on particular topics that I think thyroid patients need to know more about. It’s a weekly roundup. I include thyroid research, developments, interesting podcast episodes that thyroid patients would find interesting. I collate that in a weekly broadcast. I also focus on particular topics, so we can keep learning together.

What is so great about existing in this thyroid sphere is that we are constantly learning more and more stuff. There is always more we can do or share with others. Come and find me. Join the community. We have a lot to learn from one another.

Dr. Eric:

Thanks so much. This was a great conversation. Really appreciate everything you do for women with thyroid conditions. Check out Rachel’s book on pregnancy and her other books as well. Thank you so much for this conversation, Rachel.

Rachel:

Thank you so much for having me.

***

Dr. Eric:

That was an excellent conversation with Rachel Hill, discussing how to have a positive thyroid pregnancy. Preparing for a healthy pregnancy. She definitely goes into greater detail in her book. Of course, you want to eat healthy, reduce stress. You want to take 6-12 months prior to conception to optimize your health, according to her.

Quite frankly, there are things you can’t do during pregnancy, such as detoxify. I would agree that at least six months prior to conception, do what you can to optimize your health. If you aren’t eating healthy, you don’t want to wait until you’re pregnant. You want to try to eat as healthy as you can prior to conceiving.

Same thing with reducing stress, getting sufficient sleep, reducing your toxic burden is huge. Once you’re pregnant, you can’t do things to detoxify. You can do a lot when you’re not pregnant. If you’re drinking water out of plastic bottles now, now is the time to stop, not when you’re pregnant. That could also affect conception and fertility.

She also mentioned the male. The male could also be preparing. I know a lot of men may not want to change their diet and do these other things, like avoiding endocrine disrupting chemicals. All these things can be helpful.

Thyroid medication. She personally took Armour Thyroid. I will talk about antithyroid medication. Preparing for a healthy pregnancy relates to both hyper and hypothyroidism. With thyroid medication, obviously Armour doesn’t relate to hyperthyroidism. I thought it was important to have this conversation because some women are under the impression that they have to take levothyroxine, that it’s not safe to take Armour, NP thyroid.

I can’t give recommendations. I am not recommending for women to switch from Synthroid to Armour. This is ultimately between you and your health care practitioner. My point is if you speak with an endocrinologist, they are probably not going to speak highly about Armour or NP thyroid. You probably will need to speak with another practitioner who is willing to prescribe these.

Antithyroid medication. I am not a huge fan of antithyroid meds, but there is a time and place for them. You want healthy thyroid hormone levels during pregnancy. If you have low thyroid hormone, it makes sense to take thyroid hormone replacement, even if you don’t want to take it. Something you should consider for the health of your baby.

Same thing if you have elevated thyroid hormones. I know you don’t want your baby exposed to PTU, which will be prescribed during the first trimester, not methimazole or carbimazole. In a perfect world, you wouldn’t take it. If you are hyper, especially moderately to severely hyper, you want to do something. Unmanaged hyperthyroidism isn’t a good thing.

Lowering thyroid antibodies prior to conceiving. She mentioned how you want to try to do that. That ties into what I will discuss next, which is preventing miscarriages from occurring.

We also had a conversation about how because of the immune system shifts during pregnancy, the antibodies might normalize during a first trimester because many people with Hashimoto’s are what’s called Th1 dominant. Many people with Graves’ are Th2 dominant. A lot of times, you get the switch from Th1 to Th2 dominant during the first trimester.

If someone has Hashimoto’s, the immune system will calm down, and the antibodies may lower or normalize as a result. With Graves’, sometimes the opposite happens, where things flare up. It’s not perfect. Some people with Hashimoto’s may flare, and some people with Graves’, it may calm down. There is still a lot we don’t know.

When it comes to preventing miscarriages, having healthy thyroid hormones is important. Healthy thyroid hormone is more important for conceiving in the first place. Not to say that it can’t play a role in having a miscarriage, but she did mention the antibodies. I have seen this, too, not just with Hashimoto’s antibodies, but Graves’ antibodies, having elevated TSIs doesn’t mean you will get a miscarriage, but it increases the risk. You could still have a healthy pregnancy with elevated thyroid antibodies, but there is an increased risk factor.

She spoke about estrogen dominance. Keep in mind that estrogen dominance doesn’t just mean high estrogen. It could mean low progesterone. That is a big reason for miscarriages, women having low progesterone. When we think of low progesterone, one reason is adrenals. You need healthy adrenals to have healthy progesterone.

There are also the endocrine disrupting chemicals that I mentioned and other toxins and toxicants. You can’t avoid everything, but when it comes to cleaners, cosmetics in your home, you could use as many natural cleaners and cosmetics. Drinking water out of plastic bottles, if you are doing that, if you are buying plastic water bottles by the case, I definitely would recommend taking a break from those. Ideally, a permanent break, at least on a day in, day out basis. Definitely could affect fertility and potentially can play a role with miscarriage.

As we discussed, neither one of us has done the research. I don’t know what research is out there when it comes to endocrine disrupting chemicals and miscarriages. It wouldn’t be a surprise if that could be a possible factor.

Preventing post-partum thyroiditis. There is no perfect thing you can do. One thing is at least according to the research, supplementing with selenium. I think it’s 200mcg. I am not sure. I’d have to double check. You also want to be careful because you may have selenium in your prenatal. Usually, it’s not a lot. You might have 50mcg. If you supplement with 200mcg, that is 250mcg. You do want to be careful about selenium toxicity.

I have another episode where I spoke about this. I think I interviewed someone a few years ago. It might have been Dr. Betty Murray who brought this up, too. She spoke about post-partum thyroiditis. Selenium could potentially prevent that from happening.

We also spoke about diet during pregnancy, like AIP, carnivore. It sounded like she recommended following these diets prior to getting pregnant. You may be restricting too many foods. If you are eating a wide variety of meat and vegetables and fruits, it’s not like you need to eat grains and legumes. Eggs are nutrient dense. It’s nice if you like eggs and could eat eggs. They are nutrient dense, extra source of protein. Maybe follow a paleo type diet.

If you are carnivore, you are not having plant-based foods. If you are getting a lot of nutrients through meat and animal-based protein, you don’t have to eat veggies and fruits. Another reason why you should speak with a practitioner.

Supplements during pregnancy. Definitely want to make sure you are getting enough omegas and natural folate like methyl folate, not synthetic folate. You want to test for iron and Vitamin D.

We didn’t mention iodine. I can’t believe I forgot to ask her about iodine in a multivitamin. My perspective is you want to make sure you have enough iodine. You don’t want to take separate iodine supplements, but iodine is important for the health of the baby. Most prenatals will have iodine though. I am not saying to take extra iodine. I don’t think there is a prenatal out there that doesn’t have iodine; that is because it is important. If there is a prenatal without iodine, I am not sure if I would recommend taking that one. It is up to you. You don’t want to be iodine deficient. Especially if you have hyperthyroidism, even if you have Hashimoto’s, there is concerns with iodine. Prenatal, definitely take one with iodine.

In general, talking about hyperthyroidism and pregnancy. Like I said, there is a lot of overlap. The difference is the symptom management aspect between hyperthyroidism and hypothyroidism. If your thyroid hormone levels are low, you might want to consider thyroid hormone replacement for the sake of the baby.

With hyperthyroidism, if you have elevated thyroid hormone, that is not good. You are not really supposed to take bugleweed or higher doses of L-carnitine. Unfortunately, I don’t have a perfect solution when it comes to the symptom management aspect of hyperthyroidism.

When it comes to Graves’ and Hashimoto’s and pregnancy, you will still do things to find and remove triggers and support the gut. But there are restrictions. You might not be able to do everything you can while pregnant that you can when you’re not, like certain herbs.

Really important topic. I think I covered this a number of years ago in a solo episode, but I wanted to get someone who is more of an expert than myself, so I did. Rachel wrote a book on pregnancy. Definitely check it out if you are thinking about conceiving or are currently pregnant.

Thanks again for tuning in. Hope you found this episode to be valuable. Look forward to catching you in the next one.

In this episode, Dr. Eric Osansky takes a deep dive into black seed oil (Nigella sativa) and its potential role in supporting thyroid and autoimmune thyroid conditions such as Hashimoto’s thyroiditis and Graves’ disease. He explains the differences between whole black seed, powdered black seed, black seed oil, and black seed essential oil, highlighting why these distinctions matter when interpreting the research.

Dr. Eric reviews the available studies, including a clinical trial involving people with Hashimoto’s thyroiditis that demonstrated improvements in thyroid markers, thyroid antibodies, and metabolic health. He also discusses the antioxidant, anti-inflammatory, and immune-modulating properties of Nigella sativa, exploring how these mechanisms may support immune system balance and potentially benefit those with autoimmune conditions. Along the way, he addresses important considerations such as supplement quality, thymoquinone content, product variability, and potential contraindications.

Finally, Dr. Eric offers a balanced perspective on where black seed oil fits into a comprehensive thyroid-healing strategy. While the research is promising, he explains why it isn’t a supplement he routinely recommends to every patient and discusses how it compares to other antioxidant-support supplements. If you want a clearer understanding of black seed oil, the science behind it, and whether it may have a place in your thyroid health journey, you’ll get a lot out of this episode.

Click Here to listen to it on the Save My Thyroid podcast

Dr. Eric Osansky:

Over the years, I’ve received a lot of questions related to black seed oil. I wanted to dedicate a podcast episode to it.

Just to be up front, I am not a black seed oil expert, even though I did write an article back in December 2018 that was comprehensive. I am not a novice, but I had to do some research. I do have some information in front of me based on the research I’ve done.

The purposes of this podcast episode are 1) to discuss whether it can help people with thyroid and especially autoimmune thyroid conditions and 2) to explain the difference between black cumin, black seed, black seed oil, powdered seed.

Black seed oil comes from nigella sativa, which is also called black cumin. There’s what’s called thymoquinone, which is one of its best studied active compounds. When you see nigella sativa, commonly called black seed or black cumin or black caraway, however, black cumin can sometimes refer to a different plant in a culinary context.

If you are purchasing a supplement, you do want to read the label. You always want to read the label. Make sure it says, “nigella sativa.” When it comes to the thyroid and autoimmune thyroid research, the studies are referring specifically to nigella sativa. There is not a lot of studies out there, but we will talk about a couple of them.

Let’s start by talking about the whole seed versus powder versus oil, the different types. There are different preparations. You need to be aware of what the studies show.

Whole black seed is the intact seeds of nigella sativa. They contain fixed oils or fatty acids, volatile oils, fiber, protein, minerals, phytochemicals, including thymoquinone. Whole seeds are commonly used in traditional medicine and cooking.

There is the powdered black seed or ground seed. This simply is the whole seed that has been ground into powder. There is a study out there that involves Hashimoto’s patients that used the powdered seed. It did not use black seed oil. A lot of people take it as a capsule or soft gel, or they might take it in liquid form. This study used the powdered seed. That means that participants in the study consumed the oil fraction, including the fiber, protein, polyphenols, and all naturally occurring seed compounds together.

The reason this is important is because some of the benefits could come from the synergy among the seed components rather than thymoquinone alone. When you take a supplement, the benefit is typically it has higher amounts or concentration of thymoquinone.

I get questions about eating Brazil nuts or taking a selenium supplement. Brazil nuts are higher in selenium. If you are trying to correct a selenium deficiency, you might be better off taking a selenium supplement because you know how much selenium you are getting. You don’t know how much you’re getting in a Brazil nut. There are other benefits in a Brazil nut, like protein, fats, etc. That is the best way to compare right now.

The powdered black seed is close to consuming the whole food, whereas black seed oil is more of a concentrated fat extract. Black seed oil is produced by extracting the oil portion from seeds often through cold pressing, solvent extraction, steam distillation, especially for essential oil fractions. However, it lacks much of the fiber, protein, T matrix, and some water soluble compounds. This is why black seed oil is not identical to powdered seed in either composition or research.

Why does this matter? This matters because the Hashimoto’s study that is usually referred to when it comes to black seed oil does not involve black seed oil. It involves using the powdered seed. Human Hashimoto’s trials used 2g per day of powdered nigella sativa, not black seed oil capsules or liquid oil tinctures or essential oil preparations. As a result, we can’t automatically assume black seed oil produces the same clinical effects observed in the powdered seed study. This doesn’t mean it can’t offer potential benefits.

With powdered seed, the advantage is it had a broader nutrient profile. Similar to eating that Brazil nut compared to taking a selenium supplement. The broader nutrient profile has the fiber, minerals, polyphenols, fat soluble and non-fat soluble constituents. Close to the whole food form. That’s what they used in thyroid research with the Hashimoto’s study.

The potential disadvantages is it has a lower thymoquinone concentration, so less concentrated than taking it in supplement form, like the soft gel or liquid form. As a result, larger doses may be needed. I mentioned the study did use 2g of the powdered form.

Also, taste and texture. I personally have never tried powdered form. Apparently, some people don’t like the taste of it. They are usually mixing it in water or a smoothie, which maybe wouldn’t be as bad.

Black seed oil has some potential advantages. It is more concentrated, so it has higher concentration of lipid soluble compounds, like thymoquinone.

Dosing is easier. Unless we have difficulty swallowing capsules and soft gels, which is the case with some people. Other than that, then you probably might find it easier to take a soft gel than mix a powder into liquid or a liquid oil. I usually do.

Also better absorption of fat-soluble constituents. Definitely improves bioavailability of some of the compounds.

Potential disadvantages of black seed oil. The research does not use black seed oil. The product variability. The thymoquinone content can vary dramatically between products.

You want to be careful when you purchase any supplement. That’s why it’s also a good idea to get supplements whenever you can that are third party tested, so you know what’s on the label is what you are actually taking.

Another disadvantage is it may lack the whole seed synergy because it’s removing fiber and the portions of the original seed matrix.

Also, just a reminder that not all black seed oils are the same. There are different variables, extraction method, cold press versus refined. The thymoquinone concentration.

Oxidation rancidity. With fish oils, that’s why you want to be careful. Some people might go to Costco or Sam’s Club and get a year’s supply of fish oils. You’re saving money, but if they go rancid, if they are higher in oxidation, then not only are you not getting the benefits, but in some cases, it could be harmful.

If you take a probiotic, and what’s on the label is not in the supplement, like it has lower concentration of probiotics, it won’t hurt you. You just won’t get the benefits. If you take rancid fish oils or black cumin, it might actually increase oxidative stress, which is not a good thing.

You want to be careful. That’s why you also don’t want to get these on Amazon. If you do, make sure you get them from the right store. Make sure you can trust the source. Don’t get them randomly from eBay or places like that.

I am referring to the research here I have done. Black seed essential oil, highly concentrated volatile fraction, not equivalent to culinary or supplement oils. Usually not used in the same way as standard black seed oil.

If you get oregano oil, you get oregano oil as an essential oil or a supplement, like a soft gel or tablet. Either way, it’s not exactly the same. You definitely won’t use it the same way. You might take a soft gel or a capsule or tablet in supplement form, whereas in the oil, you will want to mix it with fractionated coconut oil and only use 1-2 drops. Diluting it is important. It might have some of the same benefits, but it’s different.

Most people aren’t using the black seed essential oil, that I know of. When they have questions, it’s usually in supplement form. The cold press black seed oil is the most common supplement form.

Culinary oils. We are not talking about this, but they may vary greatly in purity and concentration.

How can black seed oil potentially benefit Hashimoto’s and Graves’? Even this study that focuses on Hashimoto’s, it seems like it’s more related to the antioxidant properties, not the direct effects it has on the hormone.

Some might look at that journal article and see that it benefited people with Hashimoto’s and automatically think you want to avoid it if you have Graves’. That is not necessarily the case.

The way it could benefit people with autoimmune conditions is by its antioxidant, anti-inflammatory, and immunomodulatory effects. It has been shown to reduce inflammatory cytokines, oxidative stress and Influence regulatory T cells.

I have spoken about these in the past. Regulatory T cells help to keep autoimmunity in check. You want an abundance of them. It might reduce NF kappa B, which is involved in inflammation.

This specific study involving Hashimoto’s was an eight-week, randomized, placebo-controlled trial in 40 Hashimoto’s patients. Smaller study. As I mentioned earlier, it used 2g per day of powdered nigella sativa, not specifically black seed oil.

The outcomes include decreased TSH, which if you have Hashimoto’s, you usually have higher TSH; decreased anti-TPOs; increased T3. It increased T3 by reducing the oxidative stress and TPO antibodies. It also resulted in reductions in weight, BMI, waist circumference.

The article I wrote was titled, “Can Black Seed Oil Help with Hashimoto’s and Graves’?” That was released in December 2018.

When it comes to Graves’, there is not a comparable study looking at how it works in Graves’. My guess is it probably would have similar results, not with increasing T3, but reducing inflammation and oxidative stress. As a result, probably it would help with hyperthyroidism.

There is an animal study that is relevant to hyperthyroidism, but it is an animal study. It is a rat study that used nigella sativa. It used an essential oil in both hyperthyroid and hypothyroid models. The study suggested potential benefit for thyroid hormone abnormalities and oxidative stress. It emphasized that animal hyperthyroidism models are not the same as human Graves’, which is true.

It said, “Our findings suggest that nigella sativa may have beneficial effects on thyroid gland abnormalities, owing to its antioxidant properties.” It’s not directly impacting the thyroid necessarily, but helping to reduce oxidative stress, inflammation, which can potentially benefit people with Graves’ and Hashimoto’s.

If you look at the article I wrote in 2018, I also discuss other benefits. Black seed or cumin has antimicrobial activity. Viruses, too. There are some studies showing it can help with COVID. Blood sugar support, lipid effects. It could help lower LDL, triglycerides. It could increase HDL. I mentioned antioxidant effects. Liver support.

I already mentioned powdered versus seed oil. Human trials with Hashimoto’s used powdered seed, not black seed oil in supplement form. Thymoquinone concentration differences.

Some potential contraindications. If you are pregnant or breastfeeding. If you are taking blood thinning medication. I am not recommending for people to take it. That is not the purpose here. I am educating people on the potential benefits of black seed. I always recommend to work with a practitioner.

The bottom line here is the evidence is more promising for Hashimoto’s. Even with that, it’s just that single study involving 40 people. There is no specific study for humans involving Graves’. Since it can reduce oxidative stress, it could make sense for it to benefit people with both conditions.

That being said, I typically don’t recommend black seed to my patients. It’s not because I don’t think it can be beneficial. Quite frankly, I take it. I don’t take it every day. I take what’s called a Annatto-E Synergy from the company Designs for Health. It does have nigella sativa. It is third party verified. It is on my site, SaveMyThyroid.com/BlackSeedOil. First of all, I don’t take it religiously. The dose is two soft gels. I can’t say I always take two.

The reason I don’t recommend it to all my patients is because there are other priorities. When it comes to supplements, I am not shy about recommending them. At the same time, I don’t want people taking dozens of supplements just for the sake of taking them. There are a lot of supplements that can be beneficial. Black seed can be. At the same time, it’s not like we can have a black seed deficiency. There are other supplements that I usually prioritize.

If you’re someone who has worked with me, and are wondering, “You’re taking it, but you didn’t recommend it for me,” when I dealt with Graves’, I did not take it. Over the last few years, I added it to the supplements I’m taking. I rotate it. Maybe I take it a few days a week. I usually take one soft gel.

Should I take it every day? I don’t know. Should I not take it at all? I don’t know. That’s what I do. This doesn’t mean you should do this.

Hopefully, you have a better understanding about what it is. Whether or not you choose to take it, up to you. At least you’re familiar with some of the research. Feel free to do your own research. Read some journal articles. Read my article on NaturalEndocrineSolutions.com.

***

Should you take black seed powder or black seed oil? I mentioned how on a wellness basis, I take black seed oil. I take Annatto-E Synergy from Designs for Health.

The study on Hashimoto’s showed it was the actual powder. Another study used essential oil. There are no thyroid related studies that involved taking black seed oil in capsule form, even though that’s how most people take it.

It really is up to you if you decide to take it. Once again, I am not recommending to take it or not. As I mentioned, it’s not something I usually have people I work with take. I don’t have everyone across the board take this.

If you want to do what they did in the study, then it makes sense to take black seed powder. I honestly haven’t done research on companies that have black seed powder. You would have to do that. Keep in mind that the Hashimoto’s study did use black seed powder, not the black seed oil supplements. The whole black seed was ground into powder.

Black seed oil versus other antioxidant supplements. For example, one of my favorite antioxidants is NAC. I commonly give it. Alpha lipoic acid or liposomal glutathione. Those are usually priorities over black seed oil. That is my approach with supplementation.

It’s not like someone can’t take NAC and black seed oil or liposomal glutathione and black seed oil. They can do both. I don’t really know if they actually need to take both.

As I mentioned, you can’t have a black seed deficiency. You can have a glutathione deficiency, for example. NAC is made from different amino acids, including cysteine and glycine. Definitely is different if you choose to take other antioxidant supplements.

Can black seed oil benefit those with non-autoimmune thyroid conditions, like multinodular goiter or subacute thyroiditis? There are no studies showing this, but it’s not like oxidative stress is exclusive to those with autoimmune conditions.

Once again, I don’t recommend it across the board to those with Graves’ and Hashimoto’s, let alone those with non-autoimmune thyroid conditions. Potentially, it could. There are also other benefits, so you might want to read my article. Even though it’s from 2018, it’s still relevant.

Finally, something I didn’t address that you might be wondering. How long can you safely take black seed oil? There is not a lot of research here. If you do some searching online, it might say three months max.

It does seem to be well tolerated. You definitely could monitor your liver enzymes and kidney markers, doing a comprehensive metabolic panel every couple months. If things are looking good, then you might be able to go beyond three months. Like I said, I am not specifically giving recommendations here.

It seems like it’s more for precautionary measures if you see where they say not to take it for longer than three months. Some people could have GI effects from any supplement.

Overall, it seems to be pretty safe. I have been taking it for probably a few years, but I don’t take it consistently. I might take one soft gel 2-3 days a week. It seems like that is fine. I test my liver numbers at least once a year. I do a CBC and CMP and lipid panel and other panels. It doesn’t seem like the black cumin is having a negative effect. I also take other supplements, not just black cumin. All those typically look good.

Those are the main things I wanted to discuss here. If there are any questions, every now and then, I do have a Q&A call. Let me know if you have more. I am not an expert on black cumin, even though I did write an article years ago. If I don’t know the answers to your questions, I will do additional research.

Thanks so much for listening. Look forward to catching you in a future episode.

 

In this episode, Dr. Eric Osansky tackles a question that often surprises thyroid patients: Can Hashimoto’s thyroiditis turn into Graves’ disease, and can Graves’ disease eventually become Hashimoto’s? While these conditions are commonly viewed as opposites—one causing hypothyroidism and the other hyperthyroidism—Dr. Eric explains why the relationship between them isn’t always so straightforward.

Dr. Eric breaks down the differences between the thyroid antibodies associated with each condition, explains how antibody patterns can overlap, and discusses why some people test positive for both Graves’ and Hashimoto’s antibodies at the same time. He also explores possible reasons these transitions occur, including immune dysregulation, environmental triggers, gut health issues, nutrient deficiencies, chronic stress, infections, mold exposure, and hormonal changes. Along the way, he clarifies common misconceptions about Hashitoxicosis, “thyroid burnout,” and the importance of proper antibody testing.

Most importantly, Dr. Eric emphasizes that both Graves’ disease and Hashimoto’s are immune system conditions rather than simply thyroid disorders. By focusing on identifying triggers, restoring immune balance, and supporting gut health, it’s possible to improve symptoms, lower antibodies, and achieve long-term remission. If you want a clearer understanding of how autoimmune thyroid conditions can evolve over time—and what you can do about it—you’ll get a lot out of this episode.

Click Here to listen to it on the Save My Thyroid podcast

Dr. Eric Osansky:

Most people think Hashimoto’s and Graves’ are complete opposites. One causes hypothyroidism, and the other causes hyperthyroidism. End of story, right?

What many people don’t realize is that some people with Hashimoto’s later develop Graves’, and some people with Graves’ later develop Hashimoto’s. In this episode, I’m going to explain why this can happen and how you should handle this from a natural treatment perspective.

Here are a few things you need to keep in mind. First, Hashimoto’s and Graves’ are of course both autoimmune thyroid conditions. As a result, the immune system, not the thyroid gland itself, is the underlying issue.

Another thing to keep in mind is these conditions can overlap. While some people have the antibodies associated with Hashimoto’s, and other people have the antibodies associated with Graves’, others have the antibodies associated with both conditions at the same time.

Let’s discuss the traditional overviews of Hashimoto’s and Graves’, starting with Hashimoto’s. Hashimoto’s is usually associated with hypothyroidism, lower thyroid hormones. Many times, thyroid hormones are within the lab range. Most medical doctors focus on TSH, which is thyroid stimulating hormone and a pituitary hormone. If TSH is high in the presence of certain antibodies, that is when they make the diagnosis of Hashimoto’s.

Which antibodies are we talking about? If someone has elevated TSH associated with TPO antibodies (thyroid peroxidase) or TG antibodies (thyroid globulin), that person typically will be diagnosed with Hashimoto’s. I’ll talk more about antibodies later.

In a nutshell, when you have these antibodies, it means your immune system can be damaging thyroid tissue, which can lead to lower thyroid hormones as well as the elevation in TSH.

Some of the more common symptoms associated with Hashimoto’s: fatigue, weight gain, cold intolerance, constipation, brain fog.

Many of you know I personally dealt with Graves’ many years ago. Graves’ usually is associated with hyperthyroidism. The antibodies associated with Graves’ are typically TSIs (thyroid stimulating immunoglobulins). TSI is a type of thyroid receptor antibody (TRAB). On a lab, it could say either. These antibodies actually stimulate the thyroid gland.

It’s a little bit different than Hashimoto’s. With Hashimoto’s, it’s not the antibodies themselves that are damaging the thyroid gland; it’s the immune system. With Graves’, from what we understand, it’s the antibodies that are stimulating those TSH receptors. That will lead to the increase in the production of thyroid hormone.

As a result, some of the more common symptoms associated with Graves’ include heart palpitations, tachycardia, anxiety, tremors, heat intolerance, weight loss, insomnia. Not everybody will experience these symptoms. I have worked with countless people over the years with Graves’ who are actually gaining weight and not losing weight. Every now and then, someone is more subclinical, where they might not have increased resting heart rate or palpitations.

I want to expand on why these conditions are a bit complicated. Once again, usually, when you go to an endocrinologist, it’s either Graves’ or Hashimoto’s. Either you have Graves’ or Hashimoto’s. Again, it’s not uncommon for some people to have the antibodies for both Graves’ and Hashimoto’s simultaneously.

The problem is they won’t always test all the antibodies. I’m not saying everybody should have all the antibodies tested. I’m going to talk more about thyroid antibodies shortly. Essentially, they will just focus on one or the other. They’re not doing anything for the autoimmune component, but that’s why they are not focusing mostly on the antibodies but focusing more on whether someone has hyperthyroidism or hypothyroidism.

In my experience, I will say I have seen many people who have overlapping antibodies. I have seen where thyroid function can shift over time. This is in the absence of taking medication. Obviously, if someone has Graves’ and is taking antithyroid medication such as methimazole or PTU, then we would expect them to become hypo.

If someone is dealing with Hashimoto’s and taking too much thyroid hormone replacement, whether it’s levothyroxine or desiccated thyroid, they might become a little bit hyper.

I’m not talking about the shifts in thyroid function when someone is taking medication, but when they’re not taking anything at all, based on the autoimmune component that we discussed earlier.

The diagnosis of Graves’ or Hashimoto’s by an endocrinologist or other medical doctor usually depends on which antibodies are dominant and how the thyroid is functioning at the moment.

The million-dollar question: Can Hashimoto’s turn into Graves’? The research does show that people make the transition from Hashimoto’s to Graves’. Sometimes, this can occur years after the original diagnosis. It definitely can happen. I have had people come in with Graves’ but with a history of Hashimoto’s. This isn’t uncommon. They might have had Hashimoto’s five, 10, 15 years ago.

Why does this happen? We’ll also talk about the opposite, too. Let’s first focus on Hashimoto’s turning into Graves’.

One mechanism is antibodies shift. There is overlap between Hashimoto’s turning into Graves’ and Graves’ turning into Hashimoto’s. Antibody shifts relate to both of these. If you have TPO and TG antibodies, maybe you have those initially. Maybe someone didn’t have TSIs. The problem is usually you’re not testing for all the antibodies. If someone is diagnosed with Hashimoto’s, maybe they do have TSIs, but they were never tested for it. Eventually, Initially, the Hashimoto’s is dominant, but over time, the Graves’ becomes more dominant. There could be different reasons for this. The point is, the person might have had both the antibodies for Graves’ and Hashimoto’s many years ago, but they weren’t tested.

Another possibility is maybe the person didn’t have Graves’ antibodies, but they were exposed to a different trigger years later. Then they developed Graves’ antibodies. The research clearly shows, and I have discussed this on other podcast episodes, is if you have one autoimmune condition, you’re at greater risk for developing other autoimmune conditions in the future.

It’s not like if someone has antibodies for Hashimoto’s and Graves’, and on top of that, they have antibodies to rheumatoid arthritis and multiple sclerosis, it’s not like these people developed all these antibodies at the same time. Maybe they started out with one type of antibody. Over time, they developed other antibodies.

Even if someone did have all three antibodies (TPO, TG, and TSI), it’s not as if they developed them all at the same time. It is possible still when they started developing Hashimoto’s, maybe they did have all three antibodies that they were never tested for. It’s also possible they didn’t have Graves’ antibodies at first and developed them later on.

When it comes to autoimmune conditions, there is immune dysregulation, the loss of immune tolerance, regulatory T cell dysfunction. Regulatory T cells help keep autoimmunity in check. You want to have an abundance of them. There could be different factors that decrease them. Even nutrient deficiencies in selenium, Vitamin D, Vitamin A can cause a decrease in regulatory T cells.

There are different triggers that can trigger different autoimmune conditions. I have spoken about these in detail in other episodes. I have had episodes dedicated to all these that I will mention briefly here. There is chronic stress, gut infections, viral infections, mold exposure, hormonal shifts, excess iodine.

I am not anti-iodine, but excess iodine in certain susceptible individuals can be a potential trigger. I personally have had good experience with iodine when I dealt with Graves’. I didn’t have bad experiences. Over the years, I have seen people not have a good experience. There is a lot of controversy when it comes to iodine. There are separate episodes on the podcast on this.

Graves’ can also turn into Hashimoto’s. I would say this is probably more common than Hashimoto’s turning into Graves’. I could easily have made the title of the podcast episode the vice versa. Either way, the answer is yes.

Some people will initially present with hyperthyroidism in the presence of those Graves’ antibodies. Over time, if they have those other antibodies, either TPO or TG, they can become hypothyroid. This is probably the most common way for Graves’ to turn into Hashimoto’s.

It’s not as if I was going to say it’s not as if someone has Graves’ antibodies, and then they disappear and develop Hashimoto’s. That being said, someone could have Graves’. Then they are doing things to restore their health. Then their Graves’ normalizes, and then they develop Hashimoto’s.

The truth is, when someone is following a natural treatment protocol of some type, it should help with other autoimmune conditions. You shouldn’t get Graves’ into remission and develop Hashimoto’s. I’m not saying it never happens.

For example, I have been in remission since 2009. I could relapse. I could also develop a different autoimmune condition. If I’m keeping my immune system in a healthier state, the goal is not to develop any autoimmune condition. It’s not foolproof. There is always a chance.

Like I said, maybe if I fell off the wagon with my diet or stress management or something else, maybe I wouldn’t relapse and develop Graves’. Maybe I would develop a different autoimmune condition.

Autoimmunity is complex. There are so many things going on in the body. We don’t know everything. That’s why you want to do everything you can to optimize your immune system. It’s a constant work in progress.

What I’d like to do next is talk briefly about the role of antibodies. I’m not going to get into great detail because I have a good number of episodes where I talk about antibodies. I have separate episodes on TPO, TG, and TSI. I have a six-part series where I discuss how to lower antibodies because that’s another question I commonly get asked. There is a lot of information on the podcast about antibodies and lowering antibodies.

I’ll briefly mention antibodies here. TPOs are the most common type of thyroid antibody. They are more commonly associated with Hashimoto’s. A lot of people with Graves’ have them as well. When I dealt with Graves’, I did not have TPO antibodies. According to the literature, approximately 60-80% of people with Graves’ also have TPOs.

There are TG antibodies, sometimes known as anti-TG antibodies. These are, like TPOs, more closely associated with Hashimoto’s. TPOs are very common in those with Graves’, and TGs are in people with Graves’ about 20-30% of the time.

TSIs or TRABs are typically associated with Graves’. People can have 2/3 antibodies. People could have all three antibodies. If you start out with Graves’ with all three antibodies, it doesn’t mean you’re always going to progress to Hashimoto’s. It doesn’t always mean you will be hypothyroid. Even if you do, it can take quite a long time for that to happen.

Similar with the opposite. If you have antibodies to Hashimoto’s, and you’re predominantly hypothyroid, yet you also have the antibodies for Graves’, it doesn’t mean you will eventually develop Graves’. It all comes down to trying to do everything you can to optimize your immune system health, your gut health.

As far as some of the takeaways here, the diagnosis isn’t always the full story. Just because you were diagnosed with Hashimoto’s or Graves’ doesn’t mean you can’t develop another autoimmune thyroid condition.

Another thing to keep in mind is sometimes misdiagnoses happen. There is also what’s called Hashitoxicosis. Someone presents with hyperthyroidism, so elevated thyroid hormones, but they have negative Graves’ antibodies. They only have the antibodies associated with Hashimoto’s, TPO and/or TG antibodies.

What happens is in this situation, the immune system damages the thyroid gland, which causes a rush of thyroid hormone into the bloodstream, presenting with hyperthyroidism. This is usually transient.

Many times, a person with Hashitoxicosis will be diagnosed with Graves’. You figure that endocrinologists would know the difference. I am not saying they don’t. A good number who I have seen over the years, even with Graves’ patients, where someone is hyper, and they have only tested TPO and/or TGs. They haven’t tested the Graves’ antibodies. Yet they diagnose the person as having Graves’. You can’t make that diagnosis.

They will use other methods as well such as a radioactive iodine uptake test. If they didn’t do an uptake test, which I am not a huge fan of, or test the TSIs or TRABs, and someone is hyper in the presence of TPO and/or TGs, the truth is, we don’t know. It could be Hashitoxicosis or Graves’. If they test the antibodies for Graves’, and they are positive, it’s probably Graves’, and they also have the antibodies to Hashimoto’s.

There are signs that someone might be transitioning first from Hashimoto’s to Graves’. They had Hashimoto’s. Maybe they are taking thyroid hormone replacement because they had low thyroid hormone. What typically happens if someone is taking thyroid hormone replacement, but they don’t need it, is they will become hyper.

If you’re not hyper or hypo, yet you take levothyroxine or desiccated thyroid, you will start feeling hyper. You will get heart palpitations or increased resting heart rate. You might feel anxious, lose some weight, or get heat intolerance. When you do your next thyroid panel, you will probably have lower TSH or increased thyroid hormones.

From a symptom management perspective, it’s usually not too difficult to know when someone is becoming hyper. It could simply be too much medication. It doesn’t mean if someone has Hashimoto’s and are on thyroid hormone replacement and start experiencing hyper symptoms, it doesn’t mean you are transitioning to Graves’. Maybe you need your medication dosage reduced. It might be worth, next time you do a blood test, testing for Graves’ antibodies just to make sure. If they’re negative, it might be just an adjustment in thyroid hormone. If they’re positive, you want to monitor the situation.

If someone has Graves’ and are making a transition to Hashimoto’s, you will see the hyperthyroid symptoms improve. Maybe you will get some hypo symptoms, like fatigue, cold intolerance, weight gain. On a blood test, TSH will rise. Thyroid hormone levels would probably decline. Maybe they will still be within the reference range but on the lower side.

Again, if you have Graves’ and are taking antithyroid medication, we would expect your numbers not to become hypo. It’s common for people who are on antithyroid medication to become hypo. The point is if you’re on antithyroid medication, we don’t know if you’re experiencing those symptoms because you need the dosage to be reduced.

If you have a history of Graves’, and you’re not taking any antithyroid medication or natural antithyroid agents like bugleweed or L-carnitine, but eventually you are experiencing hypo symptoms, then maybe you are making a transition. It could be a little bit more challenging. There are other factors that could cause fatigue, weight gain, and other hypo symptoms. At the very least, look at all three antibodies.

As far as why this matters clinically, first of all, you want to avoid misdiagnosis. Symptoms can overlap. People with Hashimoto’s sometimes can have hyper symptoms. People with Graves’, it’s not as common to have hypo symptoms, but as I mentioned, some people with Graves’ will gain weight or have coldness or other hypo symptoms. I am not talking about if someone is taking antithyroid medication because that will commonly lead to hypothyroidism. In the absence of taking antithyroid medication.

Once again, you want to not just look at the thyroid panel, but testing the right thyroid antibodies. Monitoring the situation is important. Doing regular thyroid panels. One of the biggest mistakes I see endocrinologists make for someone, especially if someone was recently diagnosed, if they are still taking medication, they won’t test frequently enough.

Especially with Graves’, if someone is put on methimazole or PTU, they might in some cases say, “Let’s retest in three months.” I am not saying that’s the norm. You want to make sure to retest every 1-2 months, four weeks to eight weeks. Eight weeks max. Depends on the situation.

If someone is dealing with Hashimoto’s and have been on levothyroxine for a long time, in that situation, I could understand not testing every couple of months. Maybe they will go longer. If someone is experiencing a change in symptoms, definitely don’t be shy about reaching out to your doctor and getting a thyroid panel. If you’re not working with someone or paying out of pocket, there are plenty of places you could do your own labs and look at your own thyroid numbers.

Also remember from a natural healthcare perspective or functional medicine perspective, you don’t just want to focus on the thyroid. It’s really about the immune system. Graves’ and Hashimoto’s are both autoimmune conditions, so it’s really about addressing the underlying immune dysfunction.

In previous episodes, I have spoken many times about the triad of autoimmunity, also known as the three-legged stool, which is genetics, exposure to one or more environmental triggers, and that increase in intestinal permeability, a leaky gut. You can’t change your genes, but you can find and remove triggers and do things to heal the gut.

When we talk about gut health, it’s not just leaky gut, but other changes to the gut microbiome, which is called dysbiosis, an imbalance in the gut flora. There is a lot people can do to improve their gut health. A lot of this can be done through diet and stress management. A lot affects the gut microbiome in positive and negative ways. Stress is huge. If you’re in fight or flight constantly, that will have a negative effect on your overall health and adrenals, but even your gut microbiome.

In this day and age, all these environmental toxins and toxicants dysregulate the immune system and also affect permeability of the gut and cause dysbiosis. We’re talking about the microplastics, glyphosate, mold and mycotoxins. There is a lot of things to consider.

Of course, we don’t want to neglect the foundations. Eating a healthy anti-inflammatory diet. Blocking out time for stress management. Getting regular sleep. Moving regularly. All these are important.

The final question is whether remission is possible. It can become really frustrating. When someone has a history of Hashimoto’s, and then 10-15 years after being diagnosed, they get diagnosed with Graves’. Many times, when this happens, they haven’t done anything for the Hashimoto’s. They might just be taking thyroid hormone replacement.

But sometimes they did. Maybe this person saw a natural healthcare practitioner, and they did things to improve their health. Maybe they didn’t have to go on thyroid hormone replacement. That took place many years ago. All of a sudden, 10, 12, 15 years later, they think their health is good, and they develop Graves’.

In that case, it could be very frustrating. It’s frustrating in any situation, but if all they did was go on thyroid hormone replacement and later developed Graves’, based on everything I’ve said here and in other episodes, it’s understandable why that might happen. The levothyroxine or desiccated thyroid is not doing anything for the autoimmune component. It wouldn’t be a big shocker to develop another autoimmune condition in the future.

Even if you were doing things from a natural standpoint, years ago, and then ended up making a transition from Hashimoto’s to Graves’, yes, you could restore your health. You could get into remission. It’s similar if someone has a history of Graves’ and makes the transition to Hashimoto’s.

Can you lower and normalize antibodies? Yes. It’s not easy but definitely can be done.

Can you resolve all the symptoms associated with hyperthyroidism and hypothyroidism? Yes. Might not be easy but definitely possible.

Can you eventually get to the point where your body doesn’t need the medication? With Graves’, definitely. It’s not damaging the thyroid gland. If someone is taking antithyroid medication for 5, 10, 15 years, and many endocrinologists won’t allow that, but some will, there is research showing you could take methimazole in lower doses for that long. Some endocrinologists will allow that. If you have been on medication for a long time, and you have been dealing with Graves’, then it’s definitely possible to get your body to the point where you don’t need medication.

With Hashimoto’s, it’s a little bit different. You can get to that point. There are also some people who need to be on thyroid hormone replacement, I don’t want to say permanently, but for a prolonged period of time.

It depends on how much damage has been done to the thyroid gland. It’s not necessarily tied to how long you’ve had hypothyroidism or been on thyroid hormone replacement. It’s related to the dosage. If you’re on a higher dose of levothyroxine, like 125mcg compared to 50mcg, you’re probably on the higher dose because there is more damage taking place to the thyroid gland. It would be more challenging to get to the point where you don’t need the thyroid hormone replacement. I am not saying it isn’t possible, but it can take more time.

There are other options to consider that might help in that situation, like cold laser therapy, which I have interviewed some practitioners about. That’s different than red light therapy.

Lowering and normalizing antibodies is possible. Getting rid of symptoms is possible. Getting to the point where you don’t need thyroid medication is possible. Long-term remission is possible. I am a perfect example of this.

Some people hate when I use the term “remission.” I am cautious about using “cured.” I am superstitious. If I start saying I’m cured from Graves’. I’ll relapse. Either way, I use the term “permanent remission,” which essentially is cured. Regardless of the term, it is possible. All these are possible. Maintaining a state of wellness is possible.

Keep in mind that there is no one size fits all approach. Ultimately, the goal is to restore the health of the person’s immune system.

A few final thoughts here. Hashimoto’s and Graves’ are both more autoimmune conditions that affect the thyroid. I had someone recently in my Healing Graves’ Naturally Scool community who was surprised when they heard me say in this case that Graves’ was more of an immune system condition. They thought the thyroid caused Graves’.

I make the assumption that most people know because I have said it so many times. Some people are listening to this and are not as familiar with Graves’ and Hashimoto’s and might think that the thyroid is what you want to focus on. Not that you want to neglect the thyroid, but it’s more of the immune system that you want to focus on.

As we have been chatting about during this episode, some people can transition from one condition to the other. It’s possible to have multiple antibodies. It’s actually quite common. It’s not rare to have all three antibodies. There are other antibodies other than the ones I mentioned here. I discuss this on other episodes. Those are the three main antibodies.

Addressing immune system health is just as important as managing thyroid hormone levels, arguably even more important.

Some questions that people commonly ask me, starting with: Can you have Graves’ and Hashimoto’s at the same time? This hopefully answered that question. You can have the antibodies for both at the same time, and it’s quite common.

Should people test for all three antibodies, regardless of which diagnosis they receive? We could look at it a few different ways. If you are taking a natural approach, it might not make a difference. If you are addressing the autoimmune component of Graves’, there is a lot of overlap between addressing Graves’ and Hashimoto’s naturally.

That being said, it’s not a bad idea. If you have health insurance, and it will be covered, definitely not a bad idea. The TSIs are typically a little more costly than TPO and TG. Also depends on which lab you go to. Maybe your insurance will cover it if your doctor is willing to order all three. In a perfect world, I’d say go ahead and test for all three.

When I dealt with Graves’, I only had TSIs tested and TPOs tested, which were negative. I did not have TGs tested until years later, after I was in remission. It’s not as if it’s necessarily going to change anything. Then again, if someone has multiple antibodies, and after six months or nine months, however long it takes, you have your TSIs negative, but you still have the other antibodies as positive, then you might still want to do things to improve your immune system health.

Can gut healing reduce thyroid antibodies? Gut healing is a piece of the puzzle. If you have Graves’ or Hashimoto’s or antibodies for both without a healthy gut, it will be difficult to normalize thyroid antibodies. When someone has a problem and are struggling with thyroid antibodies, I would look into gut health.

How often should thyroid antibodies be retested? I usually recommend a thyroid panel every 6-8 weeks. Usually no longer than two months. If someone is maintaining a state of wellness, that’s a different story.

Let’s say you’re having your thyroid panel tested every six weeks. If you could get the antibodies tested every time, great. If you’re paying out of pocket, and money is tight, then do it every other time. Or maybe your endocrinologist is ordering them sometimes, but some refuse to do thyroid antibody testing, especially after the first time. They will do it for a diagnosis, but after that, it can be difficult to get them to retest.

If you’re not already subscribed to this podcast, please go ahead and subscribe now. If you liked what you’ve listened to, feel free to give a review.

I’ll also mention a few other resources you might want to check out. First, there is my books. I have three books. The first book that came out is Natural Treatment Solutions for Hyperthyroidism and Graves’, which came out in 2011 originally but is now in its third edition. It came out in 2023.

Hashimoto’s Triggers came out in 2018. The information is still relevant for finding and removing triggers. I still recommend this.

My latest book is The Hyperthyroid Healing Diet, which focuses on diet and lifestyle for those with hyperthyroidism and Graves’.

I also have a Healthy Gut, Healthy Thyroid newsletter, whether you have Hashimoto’s, Graves’, or the antibodies for both. SaveMyThyroid.com/Newsletter is how you can sign up. This newsletter comes out every other Sunday.

Healing Graves’ Naturally is a Substack. If you have Graves’, you might want to sign up for this. You could sign up by visiting SaveMyThyroid.com/GravesNewsletter.

As usual, I hope you found this episode to be valuable. Thank you so much for listening. Look forward to catching you in the next episode.

***

One thing I want to say when someone has Graves’ and eventually become hypothyroid, you will hear many endocrinologists tell the patient that their thyroid is essentially burning out. The question is can your thyroid burn out? I have a separate episode from a couple of years ago on the topic.

The thyroid gland does not burn out if you have Graves’. If someone has Graves’, and eventually they become hypo, typically, it’s because they also have the antibodies for Hashimoto’s in the background. Maybe the endocrinologist tested for them or maybe not.

Either way, in the background, there is damage taking place to the thyroid gland. For the time being, the person is predominantly hyperthyroid. You get the immune system stimulating the TRABs. Over time, as more damage occurs, the body won’t be able to do that, and the person will become more hypo. No, your thyroid cannot burn out.

Graves’ versus Hashitoxicosis. I discussed this a little bit. For some people, it’s confusing. For some endocrinologists, it’s confusing. Over the years, I’ve had some endocrinologists diagnose someone with Graves’ when they really have Hashitoxicosis. I can’t say I’ve had that happen a lot.

False negative Graves’ antibodies is possible, but it’s not too common. If someone has hyperthyroidism—elevated thyroid hormone levels and depressed TSH—and they have elevated TPO and/or elevated TGs, and if both the TRABs and TSIs are negative, then the person probably has Hashitoxicosis.

It’s important to mention that over the years, I’ve favored TSIs because it’s more specific than TRAB. I have seen a few cases where TSI was negative, but TRAB was positive. If someone tests TPO, TG, and TSI, and TPO and TG are positive, but TSI is negative, and the person is hyperthyroid, this doesn’t automatically rule out Graves’. I would look at TRAB.

I want to briefly talk about different triggers for different thyroid antibodies. This is why you will see some thyroid antibodies decreasing and others not. Maybe you see TSI decrease and TPO not decrease and maybe even increase. I am not saying it’s only related to different triggers.

In all honesty, it does seem more challenging to lower TPO and TG when compared to TSI. Usually, something is missing if the other antibodies aren’t lowering and normalizing. They might rollercoaster back and forth, so you won’t always see them gradually decrease. Over time, the goal is to have them decrease and normalize.

Even if you have Hashimoto’s, with elevated TPO and TG antibodies, and one of those normalizes, but the other doesn’t, that is also an indication that something is missing.

Testing for other auto antibodies. Not just thyroid antibodies, but if you have one autoimmune condition, you are more likely to develop other autoimmune conditions. I have had a few people over the years ask me why not test for other antibodies? You could. You could do this through a blood test if your insurance covers it. Cyrex Labs has an Array #5, which looks at a few dozen antibodies. I do think those with Graves’ or Hashimoto’s, if you’re currently consuming gluten, it’s a good idea to test for Celiac because that is more common.

I can’t say I recommend widespread antibody testing in people with Graves’ and Hashimoto’s. if your insurance covers it, that’s fine. You could go to your doctor and ask for that. When I recommend blood tests, I don’t have people test for dozens of other auto antibodies.

The reason is by addressing the autoimmune component of Graves’ and Hashimoto’s, there is definitely overlap when it comes to other autoimmune conditions. You should also be addressing other autoimmune conditions and prevent other autoimmune conditions from developing.

Like I said, you might see one or two thyroid antibodies decrease and the other one not decrease. Is there a chance you might have other auto antibodies that don’t decrease and normalize? There is that chance. Based on that, maybe you want to test all antibodies.

I will say this. With Graves’, I only had TSI positive. Over the years, I’ve tested pretty much the ones I mentioned. I have never been positive for TPO or TG. TRAB, I didn’t test back then when I dealt with Graves’, but since then, I have tested. All the thyroid antibodies have been negative, but I haven’t tested for other autoimmune conditions other than Celiac. If you’re testing for Celiac, you need to be consuming gluten for the test to be accurate.

My point is there is a chance I might have other autoimmune antibodies, and maybe I should test for them. I just haven’t done so. That’s my approach. Of course, you’re welcome to do that.

Sometimes, I will have patients who work with other practitioners who test all the antibodies. Most of the time, they are negative. There are times when they are positive. I will see someone who has RA antibodies or lupus antibodies.

That is really all I want to discuss here. Again, hope you found the episode to be valuable. Thank you for listening. Look forward to catching you in the next episode.

In this episode, Dr. Eric interviews acupuncturist, author, and educator Robin Ray Green about the often-overlooked environmental stressors that can silently interfere with thyroid health, immune function, energy, and healing. Drawing from her own personal journey with mold illness, Robin explains how invisible stressors like mold, poor water quality, EMFs, and air pollution can overwhelm the body—even when someone is following a clean diet and healthy lifestyle.

Robin shares how chronic mold exposure dramatically impacted her health, leading to debilitating fatigue, brain fog, and burnout despite doing everything “right.” This experience led her to explore the deeper root causes of chronic illness and uncover how environmental toxins, poor sleep environments, electronic pollution, and hidden emotional stressors can keep the body stuck in a constant state of stress and inflammation.

The conversation also explores practical strategies for reducing toxic burden, improving sleep quality, choosing better water filtration systems, minimizing EMF exposure, and supporting the body’s natural healing processes. If you want a clearer, more balanced understanding of the hidden stressors affecting your thyroid and overall health, you’ll get a lot out of this episode.

Click Here to listen to it on the Save My Thyroid podcast

Dr. Eric Osansky:

I am delighted to be chatting with Robin Ray Green about the invisible stressors. It’s going to be a wonderful conversation. Robin has an amazing Substack newsletter. She has a lot of great articles, but this was one of the amazing articles. I think you will find this extremely helpful.

Let me dive into Robin’s bio here. Robin Ray Green is an acupuncturist, author of the Hay House book Heal Your Child from the Inside Out, and cofounder of Thrive Ear Seeds. She is the former founder of the Center for Acupuncture Pediatrics, where she trained practitioners worldwide in pediatric acupuncture.

With more than two decades of clinical experience, Robin focuses on helping people understand the hidden factors that drain energy and interfere with healing, translating complex health topics into practical steps that actually help. Thank you so much for joining us, Robin.

Robin Ray Green:

Thank you so much for having me.

Dr. Eric:

This is going to be a good conversation. We got a little bit of your background with your bio, but let’s dive deeper. Why do you do what you currently do in the health space? You can also expand on that, why you decided to create the Substack. Really would love to learn more about you.

Robin:

My background of course is in acupuncture and pediatrics. I spent many years working with kids. When I wrote my book, I really talked about solving the end wellness gap, that space a lot of people are in when they are not really sick sick, they’re not in a hospital, but they’re not well either. There is a lot of people who fall into that gap. I saw that a lot with pediatrics.

In 2019, I sold my practice and moved to Idaho. We moved into this gorgeous, huge house. I was so excited to be there. As soon as I got there, I was exhausted. I didn’t know what was going on. I thought maybe it was the stress of the move and selling my practice. A very stressful time, of course.

Then we had a leak in the roof shortly after we moved in. Within a year of being there, I started to get sicker and sicker. I had no energy. I had brain fog. I could barely work an hour or two a day. I loved to write. I have written a whole book. I could write more than an hour before my brain was just gone.

Once I figured out that mold was the culprit underneath all of that, that was when I realized that I was doing so many things right. I was getting 8+ hours of sleep. I was eating a clean diet. I was exercising four times a week. What is going on? Why am I not feeling better? This should be the best I have felt in a really long time, given all the things I was doing. I wasn’t working at the time. Turns out it was this mold issue.

When I started to explore healing for mold, that was when I discovered that this home I was living in, that was gorgeous on the outside, was really making me sick. There were many different problems with the air, the mold, the water—we were on well water—as well as EMFs.

You can’t out-acupuncture, out-diet, out-supplement those stressors that are in your environment. So many of us go on our healing journey, and we get better to a point. Then we get kind of stuck somewhere. A lot of times, it’s these hidden stressors in our homes that could be part of the picture. It’s often not addressed in protocols, dealing with the various issues people have.

Dr. Eric:

It started with the mold. The first year, you felt fine. Then there was a leak initially when you moved in. It developed over the first year, and that is when you started feeling lousy?

Robin:

Yeah, I felt exhausted initially, and then I was doing okay. It was a slow dive down into this dark place, where I felt terrible, even despite everything I was doing.

Dr. Eric:

How did you find out it was mold? Did you randomly decide to test your home for mold? Did you do a urinary mycotoxins test?

Robin:

Great question. First of all, it was really speaking with another expert and tracing back my symptoms and asking the right questions. Has there been a water leak in your house? Is there any visible mold?

Once I saw the mold, then I did the urine mycotoxin testing. That was really interesting because we tested the whole family once. My husband and my two sons had one type of mycotoxin, and I had five different types, which, then tracing back my history, this is not my first exposure.

When I was a teenager, we had a water leak in the master bathroom, and there was a serious mold problem in the house. Going back earlier to childhood, I lived in a house with a basement, which probably also had mold. I had these mold exposures and probably a genetic predisposition to difficulty detoxing mold. Our mold panels showed very different variations, which is why sometimes multiple people can be in the same mold environment with different reactions. That was one of the things we learned when we tested.

Dr. Eric:

Now that you’re aware of this, how common do you see it with others, not just mold, but these other invisible stressors? You mentioned the well water. You mentioned EMFs. There are other hidden stressors in our home.

Robin:

I think it’s incredibly common. I think it’s way more common than people realize. When you’re at full capacity, your cup is empty, and you don’t have a high body burden or toxic load. A little EMFs here, a little water toxin exposure there. Maybe some fluoride in your water or something like that. You’re not filtering your air.

Your body is resilient. It’s meant to heal, meant to repair. When that cup is almost full, and then you add in poor quality water, fluoride, EMFs, working in an office where I was surrounded by a smart meter and no mesh WiFi router and all of these things, I thought I was depressed. It turns out it was not that. It was the EMF exposures I was getting.

It’s not sexy to talk about, so it feels like when you can take a supplement or be on a protocol that you’re taking action, but removing things feels less exciting to do. You don’t lay in a room with a WiFi router and think, “WiFi did a number on me.” That’s usually not people’s experience. It’s after things are taken away for a while, you realize, “I’m sleeping better. I feel better.” It’s not quite as obvious, these environmental stressors. If we don’t take care of them, it’s like trying to dry off while you’re still in the shower.

Dr. Eric:

Excellent point. You do mention in an article that people keep adding solutions. They will add more protein. You mentioned going on a stricter diet, avoiding gluten. Not that these can’t be helpful, but in your example, when you dealt with mold as well as the EMFs, adding more protein wasn’t the solution. Wouldn’t have had much of an impact.

Same thing with the diet. You can make diet changes. I’m sure you talk about diet and lifestyle. Those are extremely important. That’s the one thing I always talk about. Many times, you have to go beyond diet and lifestyle. That’s a piece of the puzzle. Some people, that’s all they do, clean up their diet, manage stress, get sufficient sleep. Some people, maybe that’s enough. For others, it’s not enough, especially if you’re sensitive to mold, and you have a mold issue in your home. Other environmental toxins and toxicants.

That’s why we’re chatting. It’s such a big problem and something people overlook. You probably hear this, too, about the change in the diet. “I changed my diet and still feel lousy.” We probably need to look elsewhere.

Robin:

Exactly. I think that’s one of the things. I was that person. What am I missing? I was bootstrapping my health in every way possible. I was on cleanses and detoxes and doing all the things. That was a really important element. T

he environmental factors were affecting my sleep. When you are not sleeping well, you won’t repair well. Even if you are exercising five days a week, and you’re on that clean paleo diet, and you measure every calorie and you know you’re not overeating, and yet you’re gaining weight, I feel like I so understand what people are going through when they feel like they are doing all the right things and not seeing the results. There is usually something hidden in there that hasn’t been addressed yet.

I get really curious. If it’s my gut, what is throwing my gut out of balance? It’s an absolutely reasonable question to ask. Am I eating too much sugar? Could it be gluten? Dairy? Nightshades? Those are all reasonable questions.

Going even further upstream is like, could it be the water I’m drinking? Am I drinking fluoridated water? Am I drinking bottled water with microplastics? Is my refrigerator filter really taking care of all of the things I’m being exposed to, or just 32 of the 10,000 possible things that could be in our water?

It’s important to start asking those questions because we have to empty out that cup, so we can be able to support the body in its healing. I truly believe when we remove the interference, the thing that is blocking us from healing, that the body really does know how to heal itself, but we haven’t figured out that signal that we’re getting.

Where is that cause coming from? If it’s an autoimmune issue, why is the immune system attacking itself? There has to be a good reason. It’s just a matter of being a detective. These are those missing pieces that can make a big difference.

Dr. Eric:

I definitely agree. With the water, you had well water. Did you run testing on the well water, and after testing, switch to a different source? Or even without testing, did you start purifying your water and drink cleaner water?

Robin:

This is what I actually did. I took our purified water, which was going through a filtration system, and I distilled it. I actually have this picture somewhere on my Substack. You can see this brown, goopy stuff at the bottom. This brown oily film that was in there smelled really bad. That is what did it for me. This water is not clean.

That’s the deceiving thing about municipal water. It looks fine, but all of the chemicals that are in it are suspended, so they are not dropping out to the bottom. They are suspended in the water, so you can’t see it. It looks clean and pure. Distilling it was the thing that caught my attention. I realized I am bathing in this. I love to take baths. I’m drinking this. I’m showering in this. This is really not okay.

Dr. Eric:

I can relate. Currently, we use reverse osmosis. We used to have our own distiller, too. We would distill the tap. Unless they changed the way distillers work, as it’s been a long time, but it takes a while to distill it. You have the residue in there. I know exactly what you’re talking about. My wife and I would look at it and be like, ugh, that is disgusting, like you said. With the distiller, you can see.  

Robin:

If people want to know what’s in their water, EWG has a tap water database they just updated again. You can input your zip code, and it will tell you what chemicals are in your water.

Locally, here in Idaho, look up Eagle Water to see what it had. We had uranium, radon, and other radioactive elements in the water, which is also removed when you distill. You can get rid of that.

I also think it really opened my eyes to be like, oh, I buy a kombucha. What water is in there? I get a coffee at Starbucks. Is it just tap water? I have no idea what kind of water I’m drinking. Not that I don’t ever do those things. I still do. Now I have more awareness about how much I want to do that. I think not a lot.

Dr. Eric:

We’re on the same page. You also mentioned the microplastics from drinking out of plastic water bottles. If I’m on vacation, I’ll try to bring my stainless-steel water bottles. Again, if you’re in an airport, you can’t bring water to the airport. I’ll be drinking out of a plastic water bottle. I haven’t seen in an airport yet Mountain Valley Springs in a glass bottle. That would be nice inside the airport. There is a time and place.

The problem is when someone is buying it by the case, they are going to Costco or Sam’s Club and just buying whatever 36-pack of bottled water. That is their main source. Or like you said, drinking the tap water. I don’t know which is worse. I guess the plastic water bottles, you’re dealing with plastics. The thing is, at least you know what the plastic water bottles have microplastics. With tap water, you have no idea what’s in there. There is probably microplastics in the tap water, too.

In all seriousness, ideally, you want to filter it. I use reverse osmosis. You use distilled. Both of those are good. Even drinking good quality spring water out of a glass bottle, like Mountain Valley Springs. I don’t know your opinion on that.

Robin:

There is good, better, best in my opinion. Any kind of filtration is good. I don’t want to discourage people from using their filtration. If you can upgrade to reverse osmosis or distilling, my preferred method, and add minerals back in, unfortunately, there just isn’t a clean, pure source of water on Earth, unless it’s from a glacier from thousands of years ago, which we probably don’t have access to.

I also believe in the 80/20 rule. I am not going to be perfect at it. I will just do my best. When I travel or am at airports, you just have to do what you have to do. Staying hydrated is more important. In those moments when you’re recovering, it’s important to pay closer attention and be a little stricter during that period.

Dr. Eric:

Exactly. What you mentioned is a big concern with both reverse osmosis and distilled water. People say, “If it’s removing the minerals,” like you said, you can add the minerals back. Plus you are getting minerals from the food you eat. It’s not like you’re just depending on water. Everything is risk versus benefit. I’d rather remove the toxins and toxicants from the water. Again, you can add back minerals, like you do, and I do as well. I’d rather do that than drink spring water out of a plastic bottle, for example. You get the minerals, but you are dealing with all the toxins and toxicants.

Using a lesser filter, some will use a Brita filter, not to say anything bad about Brita, but most of these over-the-counter filters aren’t removing enough.

Robin:

Forever chemicals are the big one. Brita and most refrigerator filters won’t remove the PFOAs.

There are products on the market like Aurmina and others, which are ionic sulfated minerals. It’s returning your water back to spring water again, which is amazing. That’s what we want to be drinking. It gives you all the trace minerals that you need. It’s really interesting.

Dr. Eric:

 Ionic sulfated minerals?

Robin:

Yes.

Dr. Eric:

Let’s switch gears and talk about EMFs, electronic pollution. You mentioned that you have your mesh network. The smart meter, I’m curious what you did. I was diagnosed in 2018 with chronic Lyme and bartonella. At that time, I was aware of EMFs before that, but I paid more attention to them when I was diagnosed.

Having a smart meter right outside our home, I was able to get it turned off. I wasn’t able to get it removed. Did you do the same thing? Were you able to get it turned off or actually removed?

Robin:

If anyone has the option to turn it off and go manual, that’d be the gold standard. Here in Idaho, we are one of the only states where they won’t remove it, and there is no replacement for it yet. We have to start legislation to change that because we have no option. We moved into a brand-new home, so we have the latest smart meter.

Inside, we have dirty electricity filters to help mitigate some of that. Our second home out from the mold house now. In the other home, we had a whole house dirty electricity filter to offset that. That was our solution since we couldn’t take an axe to it and get rid of it. I definitely think that when you’re recovering, EMFs are something that can speed things up or slow it down depending on your exposure levels.

Dr. Eric:

It’s funny you mentioned a mesh network. I was looking to change the internet in our house. When we contacted Google Fiber, they were talking about the mesh network. At the time, I didn’t know what that was. I did some research, and it’s Bluetooth and WiFi throughout the house.

Robin:

It’s amplified. The original house we were in when we moved here was 4,500 square feet. We were more out in the country, so we didn’t have good internet. We set up the mesh router in my office, so I was surrounded by my phone, computer. The smart meter was just outside the office window, and the mesh router was right next to me. I was getting radiofrequency radiation at a high level for someone who was being exposed to mold simultaneously.

What’s funny is I hated that office. I didn’t want to work in there. I felt depressed. Maybe it’s because I have a north-facing window, and I was not getting enough sunlight in the room. I had all these reasons why. We had a little sunroom on the opposite end of the house. I moved my office over there at one point, and it was so much better. It was so light and bright, so in my mind, I thought it was just the light. It was a light issue making me feel depressed.

What really convinced me that EMFs were part of the picture was when I measured. I didn’t buy an EMF meter off Amazon for $50 but a radiofrequency meter, a body voltage meter, and a dirty electricity meter. I went around the house. I sat at my desk and measured how much electricity was running through my body. The Building Biologists, for sleep, recommended your body voltage should be under 100mv. During the day, sitting at my desk, my body voltage was 5,000mv.

On top of that, the radiation was off the charts for both the EMF meter and the mesh router that were in that office.

Even though I didn’t know that was the problem, I knew I did not like being in that space at all. I was sleeping terribly, also due to body voltage and dirty electricity. There was an outlet a foot and a half from my head, and the dirty electricity, which also omits EMFs around the outlet, they talk about safe levels as 25. Mine was 725. My body voltage in my bed was 11,000mv. No wonder I couldn’t get a deep, restful night’s sleep. I had so many signals hitting my nervous system all night long. It was hard to get a deep night’s sleep.

The second thing that convinced me was I turned my breaker off at night. The WiFi was off. There was no power into my bedroom, so there was no dirty electricity. It didn’t bring my body voltage under 100, but it did bring it down to 300, which is a vast improvement from 11,000. That first night of sleep without the electricity was the first fantastic night of sleep since I’d moved to Idaho. That was probably a year and a half or so after moving, and I felt like a different person.

From there, mitigating became super simple. I need to wire my computers instead of using WiFi. Have a case that blocks radiation from my phone. I’m using a wired keyboard and a wired mouse. I don’t use Bluetooth. I don’t have Bluetooth or WiFi on my computer. Controlling those outputs. Some people do, but I didn’t need to wear EMF-blocking clothing because I was able to bring my exposures way down. That was life-changing for me. I started to heal a lot faster once those stressors were removed from my environment.

Dr. Eric:

It sounds like you have done your research. What do you think about those EMF-blocking pendants?

Robin:

Great question. Wouldn’t that be nice if you could just wear a pendant and not have to worry about it? I actually do have one. I have a Scalar Energy pendant, and I do like it. I don’t know if it’s doing anything.

What it boiled down to for me was you’ll go to the companies, and they have great marketing. They talk about heart rate variability or cortisol or other measurements that are reduced when people wear pendants. They do their own research. It may be excellent or not. I don’t know.

My personal feeling is I can trust when I can block and measure. I can turn off my breaker, and I can measure. I can turn off my WiFi and know that signal is gone. My fear with the pendants is I don’t want that to give me this feeling that I can have all these exposures. I think it’s totally fine if you like it, and it feels good for you. I wouldn’t have that as my first line of defense against EMFs.

Dr. Eric:

Makes sense. I don’t have one. I have thought about getting one. You don’t know 100% if it’s working. You’d still want to take other precautions. It’s like insurance or backup.

Robin:

The very technology they say they are using to mitigate the waves is literally untestable. Other than testing the physiological effects, like with Scalar Energy, you can’t test for it to see that it’s changing the harmonics of the EMFs.

Like I said, I still have one. I think it’s really cute, so I still wear it from time to time. That’s not my first line of defense.

Dr. Eric:

Out of curiosity, when it comes to measuring, do you have a favorite online store? Do you get them on Amazon? I think LessEMFs.com is one.

Robin:

I love them. That’s where I got my body voltage kit. The initial meter I have, they don’t sell anymore. I found a similar one on Amazon. You can purchase it from Amazon. The dirty electricity meter, you can also get on Amazon or Green Wave Filters. They have a nice one. When you plug it into your outlet, it will show you your dirty electricity reading. When you mitigate, it will show the drop in percentage. You just dropped your dirty electricity by 75%, etc.

Dr. Eric:

We spoke about mold, water, and EMFs. What other invisible stressors would you say people need to be aware of?  

Robin:

Air quality is really important. We are taking 20,000 breaths a day. Our lungs don’t have a filter the way our digestive system does. If you eat a toxin or something with heavy metals, you’re going to filter some of that through your digestive system. It won’t go straight in.

Your lungs don’t have that. If there are volatile organic compounds (VOCs), or if you live in a place with mold that you haven’t been able to mitigate, I mean, mold is everywhere. That’s the honest truth. We won’t be able to get away from it. We just don’t want high levels of black mold in our environment.

Having an air filter. If you can only do one place, I would do one in your bedroom. You’re spending hopefully 8+ hours in there. At night, when your body is meant to repair and relax. We have air filters. We use the AirDoctors. We have one in every room.

I also have, which is amazing if you do have mold in your house, a pure ozone air purifier. It has a regular filter mode, and it will produce ozone. If you have a room with mildew or mold, you can put it on purify, and there are different protocols.

One is where everybody leaves the house, and you set it for 24 hours. The ozone kills mold and all that stuff in the air. If there is smoke or other things, it will get rid of that. That is my next level one that I break out occasionally, especially after 4^th of July. There are a lot of air pollutants from fireworks. People love fireworks in Idaho. It’s like a war zone. It’s going on for hours. We have those air purifiers going after a night like that.

Dr. Eric:

I don’t have the office any longer, but in 2017, we moved into an office in a building. Right outside the office was a water fountain. Who knows how long it was there. I guess it was either the first or second day we moved in that the water fountain leaked and went all over the office. My staff person, Kate, she is still with me, but she is very in tune with mold and EMFs. She uses a router shield and all that. She had an ozone generator, so right after that happened, she took her ozone generator into the office. We were out of there for at least 24 hours.

We never had any issues with the mold. If we didn’t know any better and left it up to the maintenance for the building, we very well might have. Great advice.

Having HEPA air filters. AirDoctor is a HEPA?  

Robin:

Yeah, ultra-HEPA.

Dr. Eric:

There’s IQAir and a number of other good ones out there. If you could only have it in one room, like you said, the room where you sleep. If you have children, it would be nice to have multiple air filters in different bedrooms.

How about the mattress you sleep on? You mentioned VOCs. There is flame retardant. I can’t say I have all-natural furniture throughout the house. I’m sure there is some off gassing. Same thing if you get a new car. That is a drawback. It is difficult to avoid it.

You mentioned having an air purifier in your room. Hopefully we are spending at least 7-8 hours in our bedroom sleeping. I talk about a natural mattress. Not to run out to get a new one if you don’t have one now, but something to consider when you are in the market for a natural mattress.

Robin:

Absolutely. The off gassing that is happening from the flame retardants, you have to go to lengths to find one that doesn’t have all that. In a pinch, if you’re concerned about it, you can layer a wool blanket over the mattress. I’m like the princess and the pea. I have a blanket and this memory foam one and this bamboo one over that. I have multiple layers on top. You just do the best you can. If you have air filtration in there, that will be helpful.

Let’s say you just got a new mattress. If you can, let it off gas for a few days before bringing it into the house if that’s available to you. 100% agree.

The next mattress we upgrade to will be a natural one. Wasn’t on my radar when we moved here. It was after we got the new mattress that I should have fixed that. A wool blanket is a good mid solution if you’re in that spot right now.

Also, don’t stress over every little thing. I don’t want anyone to walk away from this podcast thinking they’re doing it all wrong. I fixed all these things over time, over the course of a few years. We fixed this thing, then the next one. Do it as you can, in stages. If you do something consistently over time, you will be in a much better place.

Dr. Eric:

Another invisible stressor is the cleaners and cosmetics we use on a daily basis. I agree with you. Just start with one or two things that you use the most if it’s overwhelming to you. If you’re using 409 to spray everywhere, maybe replace that with a more natural cleaner. Replace one once a week or even once a month. After a year, that’s 12 new products.

Robin:

Honestly, the microfiber cloth for me, as the person in my house who wipes the counters down several times a day, I do a lot of cleaning. It’s a cloth and water, and that’s it. It cleans up fantastically well. You can just get them on Amazon. I bought a starter kit for $25, and it’s been going strong for a long time.

Just one little change here. Let’s not get the Lysol toilet bowl cleaner. There are these natural pellets you can drop in. They fizz and do their thing. You wipe it down, and you don’t need a gas mask to go in your bathroom.

Dr. Eric:

In the article, you mention your Clear LPFs framework. What is that? What does LPF stand for?

Robin:

That is from traditional Chinese medicine. It stands for Latent Pathogenic Factors. The way we see it in Chinese medicine, LPFs are these elements that hide in the body. From a modern perspective, in Chinese medicine, we would call them the six evils: heat, damp, cold, dryness, things like that. The translation is that it’s more like infections, toxins, metals, mold, things that create mayhem in the body. It can even be emotions and stored trauma that can all be in your body.

Your energy gets tied up constantly dealing with it. You talked about having Lyme and bartonella. It’s that type of stealthy infection that can come out. Your body’s resources get tied up fighting it, and you feel exhausted. If you don’t feel like yourself and all these weird brain fog and fatigue and sleeping problems and hormones go out of whack. They’re hiding there.

Most conventional investigations and labs are not going to necessarily catch them. You have to search harder for these guys. Some of the modern ones that show up a lot are parasites; liver and gallbladder congestion; stagnant, sluggish bile; people having difficulty digesting fats. They have done a lot of work on their diet, but their gallbladder is not giving them the bile they need to digest their fats. Heavy metals, toxins, mold or chemicals. Stealth infections.

Alos, a lot of unprocessed emotions and patterns. Maybe beliefs that we got programmed in childhood. Beliefs about ourselves or healing can also be latent and affect how well our body is able to heal.

Dr. Eric:

You mentioned stealth infections. I mentioned my experience with chronic Lyme. We are always going to be exposed to viruses, Lyme, all these things. EMFs drag down the immune system and make you more susceptible.

I had a question about EBV. Is there any way to get rid of EBV? If it reactivates, with these viruses, I know I still have Lyme. There is some debate. Some say you can get rid of it. Once you have it, you have it, is how I understand it because it’s intracellular. I feel fine. If I didn’t know I had Lyme years ago, I wouldn’t know. To me, it’s living in harmony. By addressing a mold issue, reducing EMFs, reducing your overall toxic burden will help you live in harmony and reduce the impact of those stealth infections.

Robin:

I love that, living in harmony with them. It’s almost like when we’re affected by those LPFs, they become pathogenic. As we remove those, they are in a less pathogenic state. They’re in a more harmonious state with the body. I feel the same thing with mold. I may never get it all the way out of my body, but it doesn’t have to be dragging my energy down and making me feel awful.

Dr. Eric:

Good point. That is a concern with some people. There is only so much I can do. Even if I address all the mold in my home, maybe my friend’s home or mom’s home has mold, or if I go on vacation, I don’t know. If you’re greatly reducing your toxic burden and doing things to support detoxification, it can help you better tolerate the exposure to mold.

Overall in your home, you won’t get rid of all the environmental toxins. You could do the most in your home. Once you’re outside, there’s only so much you can control. In your home, there will be things you’re exposed to, but the lower your toxic burden, the more vigorous your immune system will be, and the more you can deal with mycotoxins, environmental toxins, and toxicants.

Robin:

I noticed in myself a trauma response to mold almost. In those first few years, while I was detoxing and healing, if I was in an environment that had mold, I could tell immediately. I could feel it. I could feel my sinuses getting clogged. Then the fear would come, of “Oh no! I’m being exposed again.” That’s creating a whole physiological cascade that is not supporting healing.

I had to do some of my own trauma work to release the trauma of the mold. Now that I’m five years out from that initial exposure, I can still tell there is mold. I don’t want to flee from the room immediately with mold now. It’s a common thing. You go to a hotel. There could be water damage. You could be staying in a place with mold. It’s getting to a place, both physically and emotionally, where if you have that exposure, you know it won’t cause a major setback.

Dr. Eric:

Before we wrap things up, if anyone listening to this is feeling overwhelmed, because you gave a lot of great information, when it comes to those hidden stressors we spoke about, what are some things you would say to start with? Pure water, get an air filter, unplug your WiFi? 2-3 things to get started?

Robin:

I would say to prioritize your sleep environment. Everything gets harder when your sleep is off. That is where I would do some exploring. Try turning your WiFi off at night. Unplug it. Remove your phone from your bedroom. I have a battery-operated alarm clock now. I don’t have my phone in my room. Your room is your sacred space. It’s dark and cool.

The biggest thing that interferes with our sleep is EMFs. Your body voltage, especially if you have a plug-in bed. Sleep is when your body detoxifies. It’s when it repairs. It’s when it balances things out. If sleep is broken, it’s harder to fix things. That would be my first place to start.

If I had to give a second, it would be switching water. Filtering or distilling your water and adding back in some minerals. That alone is huge for recouping energy to do healing work.

Dr. Eric:

Anything else that I should have asked you that I didn’t ask you? Any last words of wisdom?

Robin:

The emotional and spiritual layer of healing. It often gets overlooked because we’re so focused on the protocols. It’s something we can actively do. Protocols are important. I learned through my mold recovery that there is often an invisible layer underneath—beliefs, patterns, emotional programs—that can keep the body stuck, even when you’re doing everything right.

I think there are some questions worth asking. Being really curious, not judgmental. This is something in my own work I have done, asking myself, “What have I gained from being sick? What did my illness protect me from?” It gives me chills to ask those questions.

There were things I gained from being sick. It did protect me from some things. What happens in my life if I actually get fully well? What does that mean? It’s not about blaming, or you manifested your illness. I don’t believe any of that. It’s curiosity about what might be running underneath some physical symptoms, especially people who have worked hard. They have addressed hidden stressors and their diet. It’s important to go alongside healing.

In addition to the protocols, a missing piece is often another supplement or an environmental stressor or an emotional pattern that hasn’t been unwound yet.

Dr. Eric:

If you could remind people where to find you, the Substack. I’ll let you take over.

Robin:

My Substack is “Solving the Unwellness Gap.” TheRRGSubstack.com.

I have a wealth of information on my website, RobinRayGreen.com. I offer clarity sessions, where I use pattern recognition, intuitive insight, and my 20+ years of clinical experience to help people figure out the answers to chronic, complex, and mystery symptoms, especially when your labs are normal. I help people narrow in on what those root causes might be and what their next step is.

Dr. Eric:

You also have a recommendations and easy swaps list. RobinRayGreen.com/Recommendations.

Thank you so much, Robin. You gave a wealth of information. I like to say this with every interview I do, but this one could really benefit everyone. We all have invisible stressors. Some people do more than others. Without getting stressed out, there is usually more that people can do. The first thing is awareness. I’m sure there are people listening to this who aren’t aware of what you brought up. Thanks for bringing awareness, so people can take action.

Robin:

It’s been delightful to have this conversation and share these different stressors. Like you said on my recommendations page, all my easy swaps. I have researched everything, personally tested it. These are the things that survived.

Whomever is listening to this, decide on one thing to do, and do that. You’re on the right track.

Dr. Eric:

Great advice. Thank you so much. Really enjoyed chatting with you. Definitely need to have you back in the future.

Robin:

Would love that.

***

Dr. Eric:

That was a wonderful conversation with Robin. We discussed turning off your smart meter. I mentioned how when I dealt with Lyme, I was able to do this. I had to get a medical doctor to do this. It’s now been almost eight years.

I was working with a functional medicine practitioner. The head of the clinic was a medical doctor, but I was working with a physician’s assistant who had a history of Lyme herself. She was able to write a letter to Duke Energy to turn off the smart meter and monitor it manually. Not every place is able to do that. Something to look into.

I did not know if the smart meter was causing a problem. It was a suggestion by the practitioner I was working with. I was honestly a little bit skeptical whether EMFs were a big issue, if an issue at all, with Lyme and bartonella. It wasn’t a big deal. I sent in a letter, and they turned it off. If they didn’t turn it off, they wouldn’t have. They do have shields on LessEMFs.com for your smart meter as well.

Mesh network concerns. I mentioned how once I was trying to speed up the internet in my home, and they brought up a mesh network, I wasn’t sure what that was. Before having it installed, I did some research and realized that it is Bluetooth everywhere, something I didn’t want. I didn’t go for that option.

She mentioned how she had a mesh network that was affecting her health. She seemed to be somewhat sensitive to EMFs. Even if you don’t feel you’re sensitive, I don’t, but that’s why I wasn’t too concerned about the smart meter. I was concerned to a degree, but personally, I didn’t feel it was responsible for my Lyme and bartonella.

I think it was already installed when I moved into my current home. When I moved in, I wasn’t thinking about removing a smart meter. When I was diagnosed with Lyme and bartonella, I wasn’t thinking about EMFs. Even though I wasn’t stressing about the smart meter, I wasn’t about to add a mesh network into the home when I learned what it was.

Not only concerns with me but concerns for my family. The smart meter is right outside my office. At least my family wouldn’t get as much exposure as me. The mesh network would affect the whole household.

If you have one, up to you to decide to keep it. If you were thinking about getting one, you might want to reconsider.

Distilled water versus reverse osmosis. She mentioned she uses distilled water. I used to have a distiller. We had a distiller for quite a long time. We had a few different ones that we purchased. We definitely saw the leftover gunk in the distiller. You could see what it gets rid of.

I think reverse osmosis is just as good. Both of those could remove most of the toxins and toxicants. They both do remove minerals as well. As I mentioned in previous episodes, you’re not getting most of the minerals from the water. More recently, over the last couple years, I did start adding minerals into the water. You could take a multivitamin with minerals. You are getting minerals mostly from the food you eat. Again, you can supplement if you’re concerned.

Choosing an air purifier. She said she uses the AirDoctor, which is a HEPA air filter. I have heard good things about it. I have a few Blueair filters in my home and one in the office. I have heard good things about IQAir.

Getting an air purifier and then keeping it in your bedroom. If you have multiple bedrooms, ideally you’d want to get one for each room. An alternative is to rotate the purifiers through the rooms, as long as they’re not too big. We can move ours from room to room if we wanted to. That’s the case with many air purifiers. If you need to, start with one, and rotate.

Speaking of the bedroom, focusing on the bedroom. Toward the end of the interview, she said this would be the #1 thing she would focus on, if we had to choose one. She said #2 would be water. She would focus on reducing/eliminating EMFs and replacing the water with, in her opinion, distilled water, and in my opinion, reverse osmosis water.

I think I mentioned this, spring water out of a glass bottle, like Mountain Valley Springs, is also an option to consider. That does have the minerals. Either way, if you’re drinking tap water and/or water out of a plastic bottle on a day-in, day-out basis, definitely want to replace your water. To me, that might be #1, before focusing on your bedroom.

Getting back to the bedroom, I did ask her about getting a natural mattress. I think I mentioned previously in other episodes that I have an Avocado mattress. There was a little bit of controversy over their certifications. When I first purchased it, they didn’t have as many certifications as some other companies like Naturepedic.

We tried out Naturepedic. There was an Asheville, NC store before the pandemic, where they had Naturepedic mattresses. They were okay. We decided to give Avocado a try, even though we couldn’t try it. We had to order it and give it a try. They had a guarantee that if you didn’t like it, you could send it back. They were a newer company. They didn’t have as many certifications, but they had some. They were up and coming. We figured, “Hey, let’s give them a chance,” and we did.

There was a lawsuit against them, which I’m pretty sure was overturned. I think everything is good with their mattress now. But we’ll see. We’ve had their mattress for a while now. Close to 10 years. We might be in the market soon for another one. We’ll have to see.

From a comfort aspect, we do like Avocado. We’ll have to revisit the certifications. It’s definitely better than it was when we first bought it. We’ll have to look into it more deeply. I don’t think anything came of that. Just making you aware. In case you’re in the market for a mattress, do your research. Maybe Avocado isn’t the best mattress to go with right now. Maybe look into Naturepedic or some of the other ones.

I think that’s all I want to say here. Again, this was really enjoyable. Definitely recommend to check out Robin’s Substack, and my Substack, too. Healing Graves’ Naturally on Substack. I also have a newsletter you can subscribe to, SaveMyThyroid.com/newsletter.

Thanks again for tuning into this episode. Hope to catch you on the next one.