This episdoe explores the connection between mental health and thyroid autoimmunity, and why symptoms like anxiety, low mood, or brain fog are often biologically influenced, not just emotional. I walk through how thyroid hormone imbalances, inflammation, and nervous system regulation can affect mental well-being, including the role of the gut. If you would prefer to listen to the interview you can access it by Clicking Here.

Mental health challenges are often an overlooked part of thyroid and autoimmune disease and that matters more than most people realize.

A lot of people with thyroid and autoimmune thyroid conditions experience symptoms such as anxiety; depression; irritability; for those with Graves’, there is something called Graves’ rage, which I have a past podcast on this topic; brain fog. 

What’s important to understand is these are not just emotional symptoms. Anxiety, depression, Graves’ rage, these are often biologically driven. 

I had on the podcast a few years ago Dr. Aimie Apigian, who has a book now called The Biology of Trauma that was recently released as a podcast. The episode she was on on my podcast focused on the biology of trauma, but she has her own podcast where she talks about the biology of trauma. It’s also one of her programs.

Again, the goal is not just about the emotions. Biology definitely plays a role. This of course is a podcast that focuses on helping people with thyroid and autoimmune thyroid conditions. There are other factors here. 

That being said, I want to start by talking about the impact of thyroid hormone imbalances. We have the main thyroid hormones, T4 and T3. There is also T1 and T2, which we’re still learning about. The thyroid gland produces mostly T4 and a little bit of T3. What happens is T4 converts into T3, and T3 is the active form of thyroid hormone. This influences most tissues in the body as well as the neurotransmitters, such as serotonin, dopamine, GABA. 

When we think of neurotransmitters, a lot of people think about the brain, but they’re not thinking about other factors that influence these neurotransmitters, including the gut. We’ll talk about the role of the gut later on because you do need a healthy gut to have healthy neurotransmitters. Arguably, you also need healthy thyroid hormones to have healthy neurotransmitters. If you have imbalances in thyroid hormones, they will affect neurotransmitters in different ways. 

If someone has hyperthyroidism, including Graves’, they’re more likely to experience anxiety with elevation of thyroid hormone. Doesn’t mean that you can’t experience depression if you have hyperthyroidism. Anxiety is certainly more common. 

Some people have anxiety prior to their hyperthyroid diagnosis, so it’s not always the hyperthyroidism. Sometimes, hyperthyroidism is exacerbating the anxiety. I have seen that in quite a number of patients, where they had anxiety for many years. They were diagnosed with hyperthyroidism, many times Graves’, but it could also be a different hyperthyroid condition, and their anxiety worsened. Sometimes, the person never had anxiety until they were diagnosed with hyperthyroidism. 

There is a biological factor behind this anxiety. It’s not just emotional. Many doctors will dismiss this. 

Depression, more common in low thyroid, hypothyroid states. People with hypothyroidism can experience anxiety, too. People with hyperthyroidism can definitely experience depression. 

Like I said, we also need to consider the conversion. If someone has a problem converting T4 into T3, T4 might look good on a blood test as well as TSH. The person might have low T3 levels, and that could be a factor in causing some of these symptoms, usually more likely depression. Like I said, it’s not like someone with hypothyroidism can’t experience anxiety. Same thing with hyperthyroid folks experiencing depression.

I want to talk about the autoimmune component. It’s not just about the thyroid hormone imbalance. When you deal with autoimmunity, you have increasing proinflammatory cytokines. It’s a proinflammatory state. This inflammation can affect the brain. Not everybody with Graves’ and Hashimoto’s will have neuroinflammation, brain inflammation, but that definitely is a factor to consider. 

There are certain markers that you can test for. Obviously, you can test for thyroid hormones. You could test for cytokines. There are companies that test for cytokines. I can’t say I do that. 

Many years ago, there was a book by Dr. Datis Kharazzian, Why Do I Still Have Thyroid Symptoms?, from 2010. He was the first one I know of who spoke about cytokines. They were more popular back then, as far as the testing. 

I don’t see a lot of functional medicine practitioners test for cytokines these days. Not to say none of them don’t. I’m sure some do. Back then, 10-15 years ago, it was more common. They’re expensive. I can’t say they give a lot of useful information. Some of the markers can be valuable maybe. The point is, you could test for cytokines if you really wanted to. 

Talking about neuroinflammation, there is a marker called quinolinic acid, which you can test for on an organic acids test. Also, the DUTCH test has a little section that looks at organic acids. Not as comprehensive as companies like Mosaic Diagnostics or Genovva. They have more comprehensive organic acids tests. The DUTCH test has a little organic acids section, and they look at quinolinic acid. 

If this marker is elevated, that means you very well might have brain inflammation. It’s not telling you what the cause of the inflammation is, but still, it could be helpful. If you have neuroinflammation, you probably want to know it.

You might have heard me talk about the triad of autoimmunity. There are three components necessary for autoimmunity to develop. One is a genetic predisposition. Two is an exposure to one or more environmental triggers. Three is an increase in intestinal permeability.

I am bringing this up because if you have that increase in intestinal permeability, which is a medical term for a leaky gut, there is a decent chance you have increased permeability in the blood-brain barrier. If you have a leaky gut, you might also have a leaky brain. 

You could also test for this, too. Rx Labs is one company that offers a test. They have different arrays. It’s Array #20, which is their blood-brain permeability test. I can’t say this is something I commonly test for. Just like cytokines, which I also don’t test for. You could test for a leaky brain though. 

That is the relationship between the thyroid and mental health symptoms. Again, having that inflammation, especially neuroinflammation, can also lead to anxiety, depression. 

The point is you want to balance the thyroid hormones. You probably want to do more than that. If someone has hyperthyroidism, you want to lower those hormones, whether it’s through antithyroid medication such as methimazole or PTU; or a natural approach, like I took the herb bugleweed. I also took motherwort, but that was more for symptoms; that doesn’t affect thyroid hormones. L-carnitine in higher doses can also block the entry of thyroid hormone into the cell, so that is also an option to consider. Lithium orotate. 

If someone has low thyroid hormones, there is a time and place for thyroid hormone replacement to increase the thyroid hormones. 

Most people with thyroid hormone issues also have an autoimmune component. Most people with hyperthyroidism have Graves’. Most people with hypothyroidism have Hashimoto’s. If someone has anxiety, depression, brain fog, in addition to balancing the thyroid hormones, you want to address the autoimmune component, reduce the inflammation. If someone has neuroinflammation, you want to reduce that as well.

When it comes to leaky gut versus leaky brain, I’m pretty sure I’ve had some practitioners on the podcast who have spoken about this. A lot of the factors that help heal the gut will also heal the brain. I have spoken a lot in other podcast episodes about gut health and leaky gut.

I want to talk a little bit about adrenals and trauma. Chronic stress affects what’s called the HPA axis, which is the hypothalamic pituitary adrenal axis. It causes HPA axis dysregulation. This can also sometimes lead to some mental health symptoms. 

Keep in mind that there is not only the HPA axis, but the HPT axis, the hypothalamic pituitary thyroid axis. Chronic stress affects the adrenals and also has an impact on the thyroid. 

Then there is trauma. Trauma is pretty common. Getting back to what I said earlier, emotional trauma can have physiological consequences. It’s not uncommon to have the onset of Graves’ or Hashimoto’s or the antibodies for both, because a lot of people do have antibodies for both, after major life events, after major stressors, traumas. 

Without question, chronic stress was a big factor in my Graves’ condition, which I’ve mentioned in previous episodes. I don’t think trauma was a big factor in the development of my Graves’ condition. The truth is, sometimes, we don’t know. I was in denial about stress. I knew chronic stress was a factor, but I thought I did a good job of handling it. 

Sometimes, there are traumas that we remember, but there are traumas that we might not remember. There might be some traumas that I don’t remember, and sometimes, the smaller traumas might affect us in ways that we don’t think. 

When we think about traumas, sometimes we think about sexual abuse or physical abuse. Again, it doesn’t have to be this. Everybody’s perception of trauma is different. 

I should mention I didn’t think I experienced anxiety or depression when I dealt with Graves’ back in 2008/2009. It doesn’t mean my mental health was in a perfect state. I definitely don’t think it was. 

I wouldn’t say I was depressed, but I was pretty despondent when I learned that I had Graves’. I think it was even before then, when I learned I had hyperthyroidism. I suspected I had Graves’ before testing, which knowing what I know now, I should have tested on my own. I played a waiting game and saw an endocrinologist. Back then, I didn’t have the experience I have now. I was a practicing chiropractor and was not doing what I do now. I was relying on the so-called experts.

I wouldn’t say my mental health was in a great state back then. I don’t recall having any anxiety or true depression. 

Getting back to trauma. The thing with trauma, when we talk about chronic stress affecting the HPA axis, which is bad enough, causing the HPA axis dysregulation, chronic stress and trauma can also in some cases lead to nervous system dysregulation. 

The nervous system controls every cell and tissue of the body. This is something we learned in chiropractic school. Chiropractors are perceived as being back and neck pain doctors, but we are actually nervous system doctors. That is our main focus, at least when I was in chiropractic school. We were taught about balancing the nervous system, not addressing neck and back pain. We addressed neck and back pain by balancing the nervous system.

The nervous system controls the thyroid gland. It controls the gut. You really do need to have a healthy nervous system to have a healthy body. Knowing that, you can understand how trauma can have dire consequences on your entire body and potentially lead to a chronic health condition such as Graves’ or Hashimoto’s. 

Now, I want to talk a little bit more about the gut. I mentioned earlier that a healthy gut is important for healthy neurotransmitters. Most of the neurotransmitters are actually produced in the gut. More than 90% of serotonin is produced in the gut. 

If you have a lot of dysbiosis, which is an imbalance, specifically gut dysbiosis, that could cause imbalances of neurotransmitters, which can lead to symptoms such as anxiety, depression, brain fog. Having an unhealthy gut can also affect mental health. 

This isn’t just me saying this. This is based on research. There is also functional medicine psychiatrist Dr. Kelly Brogan, who has written a few books, including one called A Mind of Your Own. She talks about the impact of gut on depression and anxiety. I highly recommend reading her book. I’m pretty sure I listened to it on Audible. Either way, reading, listening. She also has an article on her website, “Depression Starts in Your Gut.” 

Healthy thyroid, healthy immune system, healthy nervous system, healthy gut. The nervous system and gut have that relationship because you have the vagus nerve. Everything is connected. I’ll talk more about vagus nerve exercises later.

Sticking with gut issues that could potentially- First of all, gut issues play a role in autoimmunity, but they could also play a role in imbalances of neurotransmitters. 

SIBO is one. This is too much bacteria in the small intestine. You could do a test. There is breath testing. Some people like to do regular testing. Some people don’t like to do testing. I like testing, even though it’s not perfect. If someone has it, it’s nice to see it and potentially retest. SIBO can definitely be a factor in increasing permeability of the gut.

H-pylori is a potential trigger of thyroid autoimmunity. 

Candida overgrowth. Candida is a type of yeast. Yeast is normal in the gut. We are not trying to completely get rid of the yeast. We just want to address the overgrowth. 

I mentioned a leaky gut. These things—SIBO, H-pylori, candida, parasites—can all cause that leaky gut. We spoke about the impact of leaky gut. If you have a leaky gut, there is a good chance you have a leaky brain, especially if you have these mental health symptoms. It could also be related to the imbalance of thyroid hormone. It doesn’t mean you necessarily have a leaky brain, but something to consider.

I also want to talk about nutrient deficiencies. They can affect mood. Nutrients are important for optimal thyroid health. We know we need healthy levels of iron. Iodine is controversial, but you still need healthy iodine for healthy thyroid hormones. Zinc as well. 

You need optimal gut health for optimal digestion and absorption of nutrients. If you have an increased toxic burden, which most of us have, that will use more nutrients. Detoxification is nutrient dependent. Mitochondria, which are the energy powerhouses of the cells, are nutrient dependent. We can’t overlook the importance of nutrients. 

If you’re deficient in nutrients, that can lead to symptoms. Iron, zinc, magnesium, selenium, some of the B vitamins (B12 and folate, B6). A lot of different factors. 

Thyroid health definitely is important, but it goes beyond the thyroid. 

We are not done yet. There are also medications. Medications can play a role in the development of mental health symptoms. For those with hyperthyroidism, a lot of people take antithyroid medication. Time and place for antithyroid meds. 

Beta blockers, too. Some take beta blockers. Some beta blockers, like propranolol, affect the conversion of T4 to T3. They inhibit that conversion. They’re lowering thyroid hormones, which is what you want. If it’s too high, that can cause anxiety. Some people will take too high of a dose, and they will be hypo for a while. They might experience other symptoms related to low thyroid hormones.

Same thing if someone has hypothyroidism, and they are on thyroid hormone replacement, whether it’s levothyroxine or desiccated thyroid. If they are taking too much, it could cause anxiety or hyper symptoms and lead to anxiety. 

Of course, there are medications to treat some of these symptoms, like anxiety. Like I said, it’s not just symptoms. You don’t want to mask the symptoms. You want to address the cause of the problem. There is a time and place for antidepressants and medications for anxiety, but these are not addressing the thyroid hormone imbalance or neuroinflammation or gut imbalances or nutrient deficiencies or regulating the nervous system. Time and place for medications, but you always want to address the cause of the problem.

When someone works with me, and they’re taking either antithyroid medication or thyroid hormone replacement, that’s fine if they want to do that. A lot of my patients do. If they are tolerating the meds, where side effects are common, I’m okay with that because you want to be safe while addressing the cause of the problem. 

As we wrap this up, let’s go ahead and summarize what we spoke about. When it comes to thyroid hormones, you want to balance the thyroid hormone levels safely. Some people will take antithyroid meds or bugleweed. If you have hypothyroidism, maybe it’s thyroid hormone replacement or glandulars. If you have Graves’ or Hashimoto’s or antibodies for both, you want to address the autoimmune component as well. 

Gut health is important. A lot of people have gut issues even if they don’t have symptoms. 

I spoke about adrenal support and regulating the nervous system for those who have dysregulation there. You might want to start with blocking out time for stress management, starting with five minutes a day. Get into a routine of stress handling. 

You might need to go beyond that. You might need to do some vagus nerve exercises such as humming, singing out loud, vigorous gargling, coldness, whether it’s cold showers like I take. Some people do cold plunges. I mentioned nervous system retraining in some cases. 

Addressing nutrient deficiencies. 

You might need to work with someone such as a counselor or psychologist who focuses on trauma, such as Dr. Aimie. Maybe even join a program such as Primal Trust or the Gupta Method. It depends. 

If it’s related to the thyroid hormone imbalance and autoimmunity, working with someone like me or someone else who focuses on Graves’ or Hashimoto’s might be all that you need. If it’s more of a trauma problem, where you need nervous system retraining, to some extent, I help people with that, but there are definitely people who focus more on that all the time with their patients and clients.

Final takeaways. You don’t want to dismiss anxiety or depression as just stress. It’s not just stress or emotional symptoms. There is a physiological basis often. 

Always look at gut health, especially if the mental health symptoms persist. I always give gut support. I can’t say I do comprehensive gut testing on every single person. I do a lot of GI Maps. I have done SIBO testing. I have done organic acids testing, which looks at yeast and Clostridia. It doesn’t mean everybody needs to spend thousands of dollars on testing. Some people do need to do more comprehensive testing than others. Don’t overlook gut health. 

Of course, the basics. Prioritize sleep, blood sugar stability. Address nutrients. If necessary, seek help for trauma. Maybe look into nervous system retraining. 

When it comes to thyroid hormone imbalances and the autoimmune component, work with a practitioner who understands thyroid autoimmunity. 

I think that’s it. We covered a lot. It’s something that I haven’t spoken about enough on the podcast. I have had some experts talk about anxiety and depression, so it’s not like it hasn’t been covered. Really wanted to do a solo episode to tie everything together. 

Hope you found this episode to be valuable. Appreciate you taking the time to listen to this. I’ll wrap it up and look forward to catching you in the next episode.

 

This is Part 2 of a two-part Your Thyroid Questions Answered series, wherein I answer a mix of situational and common thyroid health questions submitted by listeners with Graves’, Hashimoto’s, and other thyroid conditions. We cover topics like thyroid antibodies, lab interpretation, medication decisions, iodine, fatigue, hair loss, nodules, and lifestyle factors such as fasting and gut health.  If you would prefer to listen to the interview you can access it by Clicking Here.

In this episode, I’m tackling your top thyroid questions. We’ll dive into topics like reducing thyroid nodules, understanding your TSH numbers, and managing autoimmune thyroid conditions like Hashimoto’s. From managing inflammation to figuring out if you can ever get off thyroid meds, I’ll give you real, actionable answers. Let’s get started. 

What can I do to reduce thyroid nodules, which are causing my TSH numbers to be low? 

There is an underlying cause of thyroid nodules. Unfortunately, most medical doctors don’t do anything to address the cause of the problem, not just with thyroid nodules, but with many other thyroid and autoimmune thyroid conditions. 

Some of the common causes of thyroid nodules include insulin resistance, problems metabolizing estrogen, overall inflammation. I do have some other episodes on the podcast talking about thyroid nodules. You might want to do a search on my website, SaveMyThyroid.com, for thyroid nodules to find those episodes. I have solo episodes and some people I interview.

You definitely want to do things. If someone has blood sugar imbalances, you want to address that. If someone has problems with estrogen metabolism, which you could find out by doing a dried urine test like the DUTCH test, you would want to do things to support the metabolism of estrogen. 

I won’t get into great detail here because I have separate episodes where I talk about more specifically things you can do. If you have problems with estrogen metabolism, I do have episodes where I focus more on that. Same thing with insulin resistance and type 2 diabetes. 

There is also what’s called radiofrequency ablation, which is not radioactive iodine. Some people get the two confused. Radiofrequency ablation is using radiofrequency waves to shrink the nodules. The downside is you are not addressing the cause of the problem. It can also be expensive if insurance doesn’t cover it. 

It is another way to save someone’s thyroid because when someone has especially larger nodules, suspicious nodules, many times, medical doctors will recommend thyroid removal/thyroid surgery. There are things you can do to shrink thyroid nodules. 

Those of us who are euthyroid, but with thyroid eye disease (TED) and elevated TSI but normal TRAB, what supplements might be recommended to reduce inflammation? 

This is a perfect example. Usually, if TSI is elevated, TRAB will be elevated. TSI is a little bit more specific when it comes to Graves’ and TED. If someone just has TRAB and is negative, you might want to consider testing TSI. And vice versa. If someone has negative TSI with hyperthyroidism and/or TED, you might want to look at testing TRAB. 

Supplements. Selenium is important. Having healthy Vitamin D levels is important. Healthy omega-3 fatty acids. Supplementation could help with all of these. 

When I say Vitamin D, you could try to get as much sun as you can, but you could also supplement with Vitamin D. 

Same thing with omegas. Try to get as much as you can through fish, even though I can’t say I recommend eating fish every day because of the toxins and toxicants in fish. Eating it 2-3 times a week could give you a good amount of omegas. I can’t say I never eat fish, but I don’t eat it frequently. I rely more on omega-3 supplements in the form of fish oils. 

There are other supplements. I actually have a TED bundle, which you can find out more about at TEDBundle.com. It does have selenium, and it has something called SMT BerbALA, which is a combination of berberine and alpha lipoic acid. The research shows that both of those can help with TED. I have had people take the TED Bundle, which has three supplements: selenium, SMT BerbALA, and SMT Immune, which is an immune supplement that helps with reducing inflammation and supporting the immune system. 

That was the question: What supplements might be recommended to reduce inflammation? SMT Immune can help with reducing inflammation, but the selenium and alpha lipoic acid help reduce oxidative stress, which is a big factor in TED. 

I believe that taking my thyroid meds for years, diagnosed hypothyroid, based on lab values, caused the atrophy of my thyroid that is seen on ultrasounds. What do I do now? My gland is supposedly gone. Now I am truly dependent on levothyroxine for my whole life. Do you have any experience in helping regrow the thyroid? How do I get off levothyroxine? 

Good question. I unfortunately don’t have a great answer, meaning that I can’t say yes, I’ve had people in a similar situation follow this protocol to help grow back the thyroid. There are some situations where if someone has been on thyroid hormone replacement for a long time, and they have Hashimoto’s, which is causing damage to the thyroid gland, or in your case, maybe that’s not the case, it’s just the atrophy. 

One thing you could look into is cold laser therapy. I have some episodes, one by Kirk Gair. You should find the episode on my website. That might help regain thyroid function. 

If it’s atrophied that much, I don’t even know if there is hope with that. I’m not saying there is absolutely no hope. Maybe in the future, things like stem cells might help. 

I wouldn’t say to give up. I would have realistic expectations. Might be worth speaking with a different practitioner. I am probably not the practitioner in this situation, but there are others who might be able to help potentially, like Dr. Kirk. 

Tried a tiny bit of L-carnitine. I was wondering why it made me sleep the whole day. Just wondering what your thoughts are.

Interesting. I’ve had a lot of people take L-carnitine. Helps to support mitochondria, which usually does the opposite. It might help with energy. Helped with fatty acid oxidation. 

It does block the entry. This is higher amounts, but you took a small amount. Higher amounts block the entry of thyroid hormone into the cell. I have not seen people go hypo on L-carnitine, but if it had that effect, it could make someone sleepy.

Otherwise, I don’t have a great explanation other than everybody is different. For example, I’ve had people take magnesium at night and have issues sleeping, whereas magnesium usually promotes relaxation to help people sleep. All I could say is listen to your body. For whatever reason, if L-carnitine or any other supplement is not agreeing with you, it’s probably best not to take it. 

I have Hashimoto’s, and I’m wondering what your stance is on vaccines, particularly the shingles and pneumonia vaccine. I am 58 years old, and I am wondering if you ever recommend getting these vaccines. I am generally healthy other than my thyroid disease and arthritis. I have never received the COVID vaccine and only took the flu vaccine when I worked in a hospital, and it was required for employment. Thanks for all that you do. 

Thanks, Joanne. You will get a biased opinion from me. I am not completely opposed to vaccines, but I can’t say I’m a big fan of them either. Everything is risk versus benefit. For example, I didn’t get the COVID vaccine either. COVID can trigger thyroid autoimmunity, so the vaccine or COVID could be a trigger. You don’t get the vaccine, and you can get COVID. Or you could get the vaccine, and the vaccine itself could be a trigger.

I recently turned 55. I’ve had shingles. I had shingles in 2016. It wasn’t fun to deal with it, but I made it through. Some cases are definitely worse than others. Pneumonia, I dealt with COVID pneumonia, which also wasn’t fun, in 2022. I don’t get sick a lot. 

Shingles, in my case, was mild. The COVID pneumonia hit me hard. The vaccine is not specifically for COVID pneumonia. 

I can’t tell you not to get these. I just focus on optimizing my immune system health, which is not perfect, but neither is the vaccine. There is a chance you could get a reaction. It could sometimes make things worse, like exacerbate Hashimoto’s conditions potentially. Like I said, it’s not always an easy decision.

For me, I won’t say it’s not an easy decision. It kind of is. To me, that’s my approach. Even when I got COVID pneumonia, I didn’t question not getting the vaccine. Same with shingles. I don’t think about it. To me, I feel very comfortable not getting them. Even if I were to get shingles again, because you can get shingles more than once, as well as pneumonia. 

Up to you. Hopefully, this helps. Like I said, I am more biased. That’s my approach. 

I’ll say this. Either way, you want to optimize your immune system. Even if you got the vaccine, it’s not a replacement for improving your immune system health, eating well, managing stress, getting sufficient sleep. This can all help to optimize your immune system. 

There are other things that are supplements as well. Having healthy Vitamin D levels is important. 

If you have a hot nodule, will you for sure have a flareup again after getting off of methimazole? If your numbers are looking good (T4, T3, TSH), or does that mean your nodules are calming down? 

If you’re off the methimazole, and your numbers look good, and if they look good for a while- 

Nodules are different than Graves’. If the nodule hasn’t been addressed, and someone gets off of methimazole, they usually become hyper really quickly. If you’re getting the cause of the hot nodule addressed, and you’re off methimazole, and your numbers look good at least for a few weeks, that’s a good sign. 

If the hot nodule hasn’t been addressed, there is a good chance you will become hyper again. 

I would like to know why I have severe symptoms for months, then am pretty normal. My T4 direct dialysis has been high for well over a year. T3 seems to be normal. TSH is borderline low and barely in normal range. 

Kind of hyper. T4 is high. T3 is okay. TSH is low. Been on cabergoline and just changed to methimazole a couple months ago by a new endocrinologist. Have no diagnosis other than maybe hyperthyroid. 

I wonder if she meant carbimazole because cabergoline is different. That’s a different medication. You’re on methimazole right now and have no diagnosis other than hyperthyroid. Had a goiter 10-12 years ago that went away with no treatment other than a short-term beta blocker. 

Symptoms are not quite the same. You are not having weight loss or heart racing as before. Chills, headaches, mouth sores, itching, diarrhea, muscle weakness and pain, extreme fatigue, and can’t sleep for more than four hours uninterrupted. What can I do? I feel like I’m going insane. 

You said you’ve had these symptoms for months. Your T4 has been high for over a year. I don’t know if you’ve tested for Graves’. With Graves’, usually T4 and T3 are high, and TSH is undetectable, not just borderline low. 

Subacute thyroiditis, usually both are high. It’s usually caused by a virus, which can cause some of these, the chills, headaches, mouth sores, weakness. Usually, subacute thyroiditis is transient. It doesn’t last for over a year. 

Based on this, that’s why it’s always good, in all cases, but this is a little bit unique, this case of hyperthyroidism. I definitely would recommend working with a practitioner. Doesn’t mean it has to be me, but someone else who has a lot of knowledge of hyperthyroidism.

With someone like you, I’d love to go through the case history. Look at other blood tests. Definitely some basics, like a CBC, a comprehensive metabolic panel. We probably need to dig deeper. 

I am saying “we,” but it doesn’t mean you need to work with me. I would work with someone. Chances are your medical doctor is just going to say to keep taking methimazole, whether it’s a primary care doctor or endocrinologist. They won’t look into the cause of the problem.

Besides the thyroid numbers not looking normal, all these symptoms are affecting your quality of life. You’re not going insane because you definitely have an imbalanced thyroid. Those symptoms are really negatively affecting your daily life. Like I said, I would work on- 

You definitely want to get those numbers. The T4 has been high, and that could affect some of these symptoms: sleep, muscle weakness, diarrhea. I can’t say that hyperthyroidism commonly causes chills and headaches and mouth sores. Some of these others, it could. Not everybody has fatigue with hyperthyroidism, but it does put a lot of stress on the mitochondria, the energy powerhouses of the cells. Like I said, I would work with someone. 

I wish I had quick answers for questions like these. That’s the thing. Sometimes, I do have a quick response. Other times, you really need to dig deeper. This is one of these times. 

When it says you can’t eat any food before taking levothyroxine or Synthroid, does that also include not drinking anything like coffee or juice until after the half hour or hour? 

Ideally, you want to avoid everything, even coffee, juice, even green tea. Wait at least an hour before taking the thyroid hormone replacements. 

I found out about my hyperactive thyroid through a routine fertility check in September 2025. My TSH was .01. My T3 and T4 were well within the normal range. I was diagnosed with Graves’ about two months later and started taking 50mg of PTU three times a day. Eager to get everything sorted out in the hopes of getting my body ready for pregnancy. I have since learned that this process is more complicated. My neutrophils dipped into the mid-500s, which made me nervous. I stopped taking PTU, and I’ve started taking Thyroid Calming, one teaspoon three times a day. I have bugleweed ready when that bottle is gone. My functional doctor suspects an underlying infection, like a parasite, causing my immune system suppression. I did a tick panel through Vibrant Labs and am following up with a toxo test today. Throughout my process, I am completely asymptomatic. What would you suggest to do from here? 

Obviously, I can’t tell you to stop the medication. You already stopped the PTU. At the very least, it’s good that you’re trying to do something to manage symptoms. Thyroid Calming and making a transition to bugleweed. That can help potentially manage the hyperthyroid symptoms. While doing that, you want to address the cause of the problem, which it looks like you’re looking to do. 

I don’t think you mentioned changing your diet. Maybe you are already eating a healthy diet. If not, definitely check out my book The Hyperthyroid Healing Diet. 

It could be infection. Looking at parasites, ticks, a toxo test for environmental toxins. Don’t overlook the basics, like nutrient deficiencies as well as having healthy adrenals, for example. 

I think what you’re doing is really good. Make sure you incorporate the foundations: healthy diet, stress management, proper sleep. See what these tests show. You’re doing something to find triggers. When dealing with Graves’, you want to find and remove triggers; do things to heal the gut. 

I think you’re doing great. I’m not sure if you’re following the foundations of healing I just mentioned. Just like I said, there are other tests, like adrenal testing or DUTCH testing, to consider. I sometimes recommend a comprehensive stool panel, like the GI Map or GI Effects. 

If you haven’t checked out my books, a lot of these questions would be answered as far as finding and removing triggers in Natural Treatment Solutions for Hyperthyroidism and Graves’, which is now in its third edition.

For Hashimoto’s, I have Hashimoto’s Triggers, which is comprehensive.

I am hypothyroid. No Hashimoto’s antibodies. Can I ever get off the thyroid hormones I have taken for 25 years? 

25 years is a long time. It doesn’t mean that it’s impossible. It’s not necessarily the duration that you’re taking it, but the amount of damage that is taking place. The higher the dose of thyroid hormone replacement, the more difficult it will be to get off of it. If you’re on a lower or medium dose, I’m not saying it will be easy, but it won’t be as challenging. 

You want to address the cause of the problem. If it’s non-autoimmune, what’s the reason? It’s not always easy to find that out. Maybe you’re exposed to a lot of endocrine-disrupting chemicals, like microplastics. You need to do things to reduce your toxic burden, for example. Maybe you need to address certain nutrient deficiencies. 

I wouldn’t give up hope. I would recommend working with a natural healthcare practitioner. 

I’m on 40mg of methimazole. My last blood test showed my alkaline phosphatase was 278. Should I be concerned? My PCP hasn’t addressed it, nor my endocrinologist.

I do have a podcast episode talking about alkaline phosphatase. It’s very common with hyperthyroidism. That is pretty high. I haven’t seen it that high before.

That usually relates to bone turnover. Some are concerned it relates to liver. I would focus more on ALT and AST with liver enzymes. The alkaline phosphatase usually is bone turnover, which is not great either. Over time, it could lead to low bone density. You might want to in the future consider a bone density test. 

For now, I would continue working on getting those thyroid hormone levels down. You’re taking 40mg of methimazole, which is a pretty good dose. I’m guessing that’s going to help with the thyroid hormones. It should be just a matter of time before that decreases. 

If it doesn’t start heading in the right direction, definitely check in again with your PCP. It is pretty common, and it could take a few months before you start seeing significant improvements. 

I have Hashimoto’s thyroiditis. I am on levothyroxine daily for life. My thyroid metabolism is controlled by levothyroxine. I also have osteoporosis, which I understand can progress due to my hypothyroidism and my age, which is now 76. Other than bisphosphonate medications and resistance exercise, is there any way to slow the progression or reverse my osteoporosis? 

I do have episodes where I have interviewed people on this, like Margie Bissinger, Kevin Ellis. The answer is yes. I am not saying there is not a time and place for medications. The bisphosphonates affect the osteoclasts, which break down bone, but there are medications such as Forteo which increase osteoblasts, which help build bone. I am not saying to do that. With the bisphosphonates, like Phosphomax, the side effects are definitely a concern. 

Diet. Make sure you are getting enough Vitamin D, calcium, magnesium. For years, I overestimated the amount of calcium I was getting through green, leafy vegetables and broccoli. I don’t eat fish with bones, which is a really good source of calcium. If you are also not eating fish with bones, and you are not consuming dairy, then you might want to consider supplementing with calcium. 

Now that I’m in a state of wellness, I started drinking goat milk kefir. I also supplement with some calcium. Some people are scared of supplementing with calcium. You don’t want to take massive doses of calcium. 

According to the people I’ve interviewed, you should have at least 1,000-1,200mg of calcium per day. If you’re getting 800mg through diet, then you would want to supplement with 200-400mg per day, for example.

The resistance exercise is great. I use a vibration plate. I have a weighted vest, which is popular these days. You just want to be careful to start with lighter weights and build your weight up.

There is hyper resistance exercise as well. You might want to work with a personal trainer if you are not used to doing these exercises. Squats and deadlifts are really good. I don’t enjoy them, but they are good for bone density. 

Can hyperthyroidism turn into hypothyroidism over time? Can having too much thyroid hormone turn into too little thyroid hormone? 

We do see this sometimes. Especially if someone has the antibodies for both Graves’ and Hashimoto’s, someone might come in who has hyperthyroidism due to Graves’, but they also have the Hashimoto’s antibodies. In the background, it’s causing damage to the thyroid gland. Over time, they become hypo. 

In this case, you’d want to address the autoimmune component of both Graves’ and Hashimoto’s. Thankfully, there is overlap between addressing those antibodies and immune system health. It’s not exactly the same. That’s why it’s always good to work with someone. 

In my case, I focus more on Graves’, but I also wrote a book on Hashimoto’s. If someone has Graves’ who I am working with and has the antibodies for Hashimoto’s, I feel comfortable working with them. Like I said, there is a lot of overlap: finding and removing triggers, healing the gut.

I’m sure others would like to know the effects of their other medications and eating habits on levothyroxine and the thyroid. 

It’s a pretty broad question. Different medications. If someone takes antithyroid medication, that will suppress thyroid. I wish it was more specific. I don’t know. There are too many medications to cover here. 

If you’re on medication and are worried about interactions with levothyroxine, your prescribing doctor should know. The pharmacist should also know. They are more of an expert than I am. If you listed a bunch of different medications that I was not familiar with, I wouldn’t be able to answer interactions between them and levothyroxine. That’s why there are pharmacists. Many medical doctors are also not familiar with these interactions. That’s what pharmacists are trained in. They also have a database to refer to if necessary.

Eating habits depends. There is that myth that people with low thyroid should avoid cruciferous vegetables because they’re goitrogenic and will inhibit thyroid hormone production. Maybe if someone is eating very large amounts of raw cruciferous vegetables, that might be a concern in some people. In most people, that still wouldn’t be a concern.

My patients with Hashimoto’s and non-autoimmune hypothyroid conditions do not have problems eating cruciferous vegetables. If you cook them, even if you lightly steam broccoli, that will reduce the goitrogenic properties. 

There might be other questions. Again, it’s very broad, so I can’t possibly cover all of the different foods here. I do talk about different foods on my podcast and in my books. 

Can a subdural hematoma that I had in December 2011 cause my hyperthyroidism beginning in February 2017? 

This isn’t one that will apply to most people. TBIs, traumatic brain injuries, are more popular. I have had some experts on the podcast talk about how TBIs can affect potentially the thyroid, the immune system.

No way to know for sure if it was responsible for the hyperthyroidism six years later. It’s possible, but there is no way to know 100%. I don’t know if there is anybody who could make that connection. A correlation doesn’t always mean causation of course. 

What causes Hashimoto’s disease to flare up? 

There could be different factors. I talk about different categories of triggers. Food for example. Different foods can cause Hashimoto’s to flare up. A lot of stress. 

Being exposed to a virus. We spoke about COVID. I saw it more with Graves’, but I also see more Graves’ patients. Viruses can cause Hashimoto’s to flare up. Even if someone has the flu, that could exacerbate Hashimoto’s. 

Being exposed to certain environmental toxins and toxicants such as mold could cause flareups. 

In my book Hashimoto’s Triggers, a lot of those triggers can also cause flareups. They are triggers, meaning they can lead to Hashimoto’s, but if someone already has Hashimoto’s, many of the triggers I discuss in my book can actually flare up Hashimoto’s as well. 

I have not been diagnosed with Graves’ or Hashimoto’s although my latest endocrinologist said the results did not say it was Hashimoto’s, but she thinks it was Hashimoto’s. What are the possible causes for my need for Armor and cytomel? Is this curable? Will I be on meds for the rest of my life? I’m 56. 

It depends on the cause. If it’s Hashimoto’s, some people do need to be on thyroid hormone replacement permanently. Not everybody. It’s not autoimmune, so you are trying to find the cause of the problem. If it’s Hashimoto’s, then I could understand needing to be on some type of thyroid hormone replacement. 

If you have problems converting T4 into T3, like if you have normal T4 levels and lower T3 levels, then that would explain being on T3 although the Armor also has T3. I don’t see a lot of people on desiccated thyroid like Armor and also take T3 separately. Most people would just be on desiccated thyroid, like Armor. That would be based on the thyroid numbers. If you have a TSH that is high, and thyroid hormone levels that are low or on the lower side, that would be an indication for Armor. 

I have terrible pompholyx on the back of my hands [which is kind of like an autoimmune skin condition like an eczema]. It’s been there for at least eight years. In June 2023, I was diagnosed with Graves’ and had many subclinical symptoms prior, including the pompholyx. I went into remission from Graves’ in September 2024. In November 2024, I was diagnosed with Hashimoto’s. Is pompholyx a condition that comes about due to thyroid dysfunction? How can I best treat it other than using steroid ointments? 

It is not connected to the thyroid, but it is connected to the immune system and the gut. Most immune system cells are located in the gut. I had Dr. Julie Greenberg on the podcast a few years ago; she is a naturopathic dermatologist. She reinforced that most skin conditions are caused by problems with the gut. 

That is where I would focus. I would focus on improving your gut health, and doing that will improve your immune system health. 

You might need to do this in other ways. If you have low Vitamin D levels, you might need to get the Vitamin D levels up. If you have low omega-3 fatty acid levels, gotta get those levels up. Selenium can help. Eating healthy diet, stress management, proper sleep, all those are important for optimal immune system health. 

That would be the goal for 2026: focus on optimizing your immune system health. Doing a lot of this through improving your gut health. 

This question probably should have been asked earlier, maybe even in episode one: Thanks for all your TLC and reporting on thyroid issues. My biggest question in dealing with Hashimoto’s for several years is why can’t I lose weight? It seems impossible to lose even a little and then expect it to stay off. 

There are some people with Graves’, hyperthyroidism, and other types of hyperthyroid conditions. Many people lose weight, like I lost a lot of weight. I also work with people who can’t lose weight. 

With Hashimoto’s, it could be the thyroid. With Graves’, it wouldn’t be the thyroid. With Hashimoto’s, your thyroid could be low. A lot of people have okay T4 levels, but they have problems converting T4 into T3. T3 is the active form of thyroid hormone.

High cortisol can cause problems with weight. Insulin resistance or leptin resistance. Those many times go together. Even increased toxic burden can make it difficult to lose weight. 

Again, working with someone, you maybe already have worked with different people. You probably have done a lot from the diet perspective. It’s still important to eat a healthy diet, manage your stress, and get sufficient sleep. 

In addition to that, you might want to do adrenal testing. See what your cortisol looks like. Healthy gut microbiome. There is a lot of research showing that gut microbiome imbalances can make it difficult to lose weight. Doing some testing for blood sugar, not just hemoglobin A1C and fasting glucose, but fasting insulin. Also looking at leptin as well. Doing as much as you can to reduce your toxic load. 

I understand. It can be difficult. I am in my 50s now. Not that I’m necessarily trying to lose weight. I could more easily gain weight than I could in the past. It’s not as easy to lose weight. It was much easier to lose weight in the past. 

As we get older, that’s also an issue. You don’t put your age, so for all I know, you could be in your 20s or 30s, so that might not be a factor. If you are in your 40s, 50s, 60s, I hate blaming age because it’s not just age. I know I have to work harder. 

Staying active is important. I do a lot of walking and resistance exercise. If you do resistance exercise, you will build up muscle. You might not lose weight on the scales, but you are losing fat. You need to consider that as well. 

I have a question about iodine. I have read so many conflicting things. Some say for example supplementation is desirable with Hashimoto’s. Others say it’s dangerous. As usual, I suspect the truth is somewhere in the middle. Can we test our iodine levels to get a feel for whether we need more, less, or the same? If you have time to answer this and feel it would benefit others, it would be great to hear your insights. 

You could test for iodine. There is no perfect way of testing for iodine. Blood isn’t a great way. Urine is better. It’s still not perfect. There is a lab for those in the United States, Hakala Labs. They do urinary testing. They do spot urinary testing. 

Iodine loading testing. A little bit risky because you are taking a 50mg tablet of potassium iodide and measuring the excretion. I have done it before. I did fine. Some people don’t do fine. 

Everybody is different. I have had good experiences with iodine. I am cautious about iodine in my patients. Separate iodine supplements or even eating foods that are really high in iodine. 

I have noticed that some people don’t do well with iodine. There are different reasons. I understand someone needs to have healthy antioxidant levels, like if they take iodine and don’t have healthy selenium, that could cause a lot of oxidative stress. There is iodine and the other halides like bromine and chloride. Sometimes you get a detox reaction. 

There are also other factors. I have had moreso with Graves’ because I see more people with Graves’, but with Hashimoto’s, it could exacerbate Hashimoto’s. I talk about this in my book, too. I see at least a few times a year people with Graves’ where it seems like it was initiated when they took iodine supplementation. Not usually when they eat foods high in iodine. Even iodine contrast could be a concern. I have a podcast episode on that. 

Testing is always a good idea, but the testing is not perfect. If you’re low on iodine in the urinary test, I would be careful about supplementing separately without working with a practitioner. 

First of all, happy 2026 to you. Secondly, please excuse my English; I’m from Spain. Diagnosed with hypothyroidism about eight years ago on silent reflux with slow, difficult digestion. I have been feeling very cold with lots of muscle pains and cramps from some months. I thought it was my thyroid and asked for some tests from my family doctor. My TSH looked very normal at 1.66. I take 15mg of thyroid hormone replacement. Ferritin was very low at 7ng/ml. Could the ferritin values explain all the cold and muscle pains? Is there a link between low ferritin and low thyroid function and digestive problems? 

I have written about this. Iron is important for optimal thyroid health. If you have low thyroid, it could be a factor and thereby cause some of those symptoms. 

I wouldn’t say low iron would cause digestive problems. Usually, it’s the opposite. Having digestive problems can cause low iron and low ferritin. 

You mentioned you suspect you suffer from hypochloridria, low stomach acid, which definitely could be a factor. Low thyroid could cause hypochloridria. So can other factors. Even chronic stress can cause low stomach acid as well. 

You have been taking butane HCl for the last 10 days prior to sending this. Protein digestion feels better. 

There is a time and place for supplementation with iron. You also want to do things to address the iron deficiency. You’re 68 years old, you mentioned, so you’re not cycling. You’re not menstruating, so you’re not losing blood that way. 

You said no blood in the feces according to the test. There is no GI bleeding. I am thinking that gut health, even if you are not having GI bleeding, if you are having low stomach acid, maybe H-pylori or SIBO. A lot of things can cause maldigestion, malabsorption of nutrients. 

My husband is hypothyroid. Before taking medication, his only symptoms were cold hands and feet and hair loss in his armpits, calves, and eyebrows. His TSH was around 9 or 10. He is very thin and muscular with pretty good energy at age 68. He has tried all sorts of thyroid meds, compounded T3/T4, NP thyroid, glandulars. The only thing that moves is his TSH, which goes down between 1-2, which is great. However, T3, T4, free T3, free T4 are all at the bottom range or lower. 

TSH is looking good, but your husband’s thyroid hormones are on the lower side or maybe even below the range.

How concerned should he be? Is he just chasing numbers instead of going by how he feels? 

There is concern. I would recommend working with someone because the body is complex. Everybody is different. 

It’s great that the thyroid replacement hormone is helping with the TSH. Of course, the thyroid hormones are important. It does seem like they are helping with the thyroid hormones. 

I don’t know if he has some thyroid hormone resistance going on, like insulin resistance, where the thyroid hormone in this case is not getting into the cell. That is a possibility. Focusing more on the receptor, like Vitamin A, zinc, omega-3 fatty acids.

It’s another reason to consider working with someone. It’s been a frustrating journey for a very long time. Most medical doctors and endocrinologists will look at TSH and probably say it’s okay based on that number. I definitely don’t agree with that. I would say to work with someone. Find a natural health care practitioner who has experience with hypothyroidism. 

Like I said toward the beginning, some cases are more complex than others. I wish I could solve every question. When you don’t have to get any more information, don’t have to consider working with someone. In this case and some other questions that I answered, it would be a good idea to work with a practitioner. 

That is it. Between the first episode and second episode, we went a while. Well over an hour, which is why I split this up into two episodes. I didn’t want to go an hour and a half. It’s fun to do this. There are some great questions. I apologize for any questions I didn’t get to. Good amount of questions I didn’t get to unfortunately. Thanks for sending your questions. I will be doing this again sometime in the future. 

Best of health, everybody, in 2026. Happy new year. Tune into future episodes. Look forward to catching you in the next episode. 

In this episode, I speak with Justin Harris, a certified functional genomics practitioner, who explains how understanding your genetic blueprint can unlock personalized strategies for managing thyroid health. We dive into how genetics influences key factors like oxidative stress, detox pathways, and autoimmune conditions such as Hashimoto’s and Graves’ disease.  If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I want you to expand on your background. It always fascinates me as to why my guests started doing what they do now. How did you start working with The DNA Company, becoming an FDN practitioner, a certified functional genomics practitioner? 

Justin Harris: 

It’s quite the story, Dr. Eric, honestly. I think most of us have some sort of a wounded healer journey that we started with. I’m no exception.

When I was a teenager, I had acne. Many teenagers have that. Unfortunately, my doctor put me on antibiotics really early on. It was literally my 13th birthday. I started on this cycle of antibiotics. When I say “cycle,” this was meant to be a couple of week treatment. I stayed on it for a really long time, from age 13 to age 18 straight. I was on tetracycline. You all know, you’re not supposed to be killing your flora for that length of time. I wasn’t put on probiotics at the same time. It ended up really wreaking havoc on my health. 

You start to dive down the rabbit hole. I’ll follow the Canada food guy. You get this generic health advice. When it doesn’t work, which it inevitably doesn’t work, you dig deeper and deeper. I started messing around, taking different supplements. I worked in the supplement industry because I had a passion for ingredients. 

I became a personal trainer. I became a nutritionist. Then I got really interested in evolutionary biology. I asked myself where does the human genome start? What are the lifestyle behaviors that got us to this point? I ended up becoming the primal health coach. The whole thing is stemming from that evolution biology and ancestral lifestyle behavior component. 

It was just a natural transition from there to want to personalize what I was doing. I think the primal blueprint is something that really applies to all of us. Within that is the more personalized genetics. 

I heard about The DNA Company, and I learned that they have a certification called Functional Genomics and DNA University. If I take my already existing health coaching certification and utilize this to filter it down and figure out the more nuanced components to what people’s health is looking like. I did that. As soon as I started adding in the genetic considerations, my actual results with clients started going way better. 

I knew hundreds of things about my clients before I met them by understanding their genetic report. I could see what their genetic insulin response would look like. I could see what their dopamine response would look like. I could see their detoxification pathways, micronutrient pathways, red flags, different ways I could personalize.

FDN came in because I recognized that genes are extremely upstream. They are way up in the rapids. Genes encode enzymes, and enzymes tell the cells how to behave. That’s great as an upstream indicator. I recognized I wanted a way to have windows into the downstream. 

That’s where FDN came in because I could really look and have a high-quality set of labs. The genes are suggesting this; it’s showing up this way that I can see with the lab. Everything in between is lifestyle behavior. 

I call it alignment with your assignment. Your genes are your assignment. The better we can pull you into alignment with your assignment, the more your physiology starts to heal itself.

Now I am doing this full-time. Functional genomics, really analyzing lab work markers. Being that primal health coach that I already was but with way more tools at my disposal for personalization. 

I think functional health is moving in a direction where people don’t want blanket answers anymore. They want real personalized strategies and approaches. That’s what we’ve been building out at The DNA Company. It’s going great so far. 

Dr. Eric: 

Awesome. How long have you been doing this? When did you get your certification in genomics? 

Justin: 

It’s been about three years now. 

Dr. Eric: 

Very cool. It’s definitely evolving. When it comes to genetics, I don’t know if you want to say there is a love/hate relationship. A lot of people find it fascinating and interesting. Some people wonder is it really something- You could change the expression of genes, but you can’t change your genes themselves. Some people feel stuck. “Do I want to look at my genes if I can’t change what’s on a genetic report?” What would your response be to that? 

Justin: 

Absolutely. We encounter that constantly. This hesitance. People don’t necessarily want to know what some of their genetic red flags are because it’s scary. 

The reason why we do functional genomics as opposed to just genomics is I’m a “what do we do about it” guy. The devil you know is certainly better than the devil you don’t know. Once we know the devil, we can start to put strategies in place to work yourself out of it. 

Genes really represent hardware. It’s the hardware of your system. They’re static. You can’t change what they are. Epigenetics represent software. You can change that. You can download new apps, and you can upgrade the software. 

Our lifestyle behaviors, energy, thoughts, actions is what we have control over. Understanding what that baseline blueprint looks like in the first place allows you to know where you need to put your priorities. It can guide your epigenetic behavior. 

For example, we look at genes that are associated with oxidative stress clearance. I have clients with poor oxidative stress, and they are marathon runners. Their epigenetic output and lifestyle behaviors are such that they are creating massive amounts of free radicals and oxidative stress. Now that we know that, we can put some interventions in place to help clear that oxidative stress further. We may actually alter what your lifestyle behaviors are. Maybe we will favor weight training and less high cardio. 

We can look at the same thing with regard to macronutrient intake or blood sugar regulation and insulin response. We can tailor your diet, the way you work out, the way you supplement. There are genes associated with sleep. It goes on and on. That’s why we zoom out and take that functional, 360-degree view. 

It’s more of an empowering thing than anything. None of the conversations I have with clients are doom and gloom. This is good. We know what’s wrong. We know indicators as to what’s wrong, so we can do something about it. It eliminates that throwing spaghetti at a wall aspect. Now I know the areas of your physiology that need to be reinforced. 

A lot of my job is connecting the cellular pathway to the genomic pathway. People show up with symptoms, and it’s important to recognize that symptoms are not the problem; they are the result of the problem. 

If I could look at your genes and your genotype and say, “Okay, at a baseline, your cells are being told this, and they’re being told to do this job in a suboptimal manner,” now I know an area that absolutely needs intervention and reinforcement, be that from supplements, lifestyle tactics, etc. We have seen incredible healing as practitioners because we know what that upstream balance really looks like in the genes. 

Dr. Eric: 

Well said. One of the most well-known genetic SNPs, MTHFR, I have personal experience as a lot of people do. When I saw years ago that I had elevated homocysteine, sure enough, I did some genetic testing and had the MTHFR homozygous CC77T variation. At one end, it’s like you can’t change it. There’s nothing I could do. But knowing I could support it and do things to lower homocysteine, which when you have an elevated homocysteine, there is cardiovascular risk and some other roles, which I’m sure you’re familiar with. You’re the expert, so you’re going to be doing most of the talking.

Let’s jump to the nitty gritty and talk about some of the more key genes influencing thyroid, immunity. You mentioned oxidative stress, which is huge when it comes to autoimmune conditions such as Graves’ and Hashimoto’s. 

Justin: 

We have whole panels that are associated with various ways your body detoxifies itself. For example, the oxidative stress pathway. There are a couple of genes. The first one is SOD2, superoxide dismutase. 

Just to zoom out for a second, within the mitochondria, every second that the mitochondria are creating the ATP that fuels every cell in your body, it’s also creating a byproduct to that ATP. It’s just like when you light a fire, you have to have smoke. Energy creation is the fire, and smoke would be the oxidative stress, reactive oxygen species. 

The universe, the good lord, whatever you believe in, also blessed us with a HEPA filter in the mitochondria to clear those ROS. That HEPA filter is SOD2. 

The second mover there is glutathione peroxidase. This is also genetically encoded, so there is a gene called GPX. The way that it works is that SOD2 soaps and scrubs the dishes, and GPX rinses them and clears them away. 

Understand that what I said there is genes encode these enzymes, and when we know the genotype, we can see what the speed of these clearance enzymes actually are. If you have a CT or TT genotype for SOD2, it represents a reduced clearance. That SOD2 could be slow. 

Mine actually is slow myself. I have the TT genotype. That can reduce SOD2 function by up to 70%. Very significant. I’m also an athlete. I’m always creating these free radicals that I know I genetically don’t clear particularly well. This guides the therapy because now I know that oxidative stress is among the things that I have to prioritize. 

If I had fast SOD2 and GPX, it would be less of a priority because that job is being done on its own quite well. Every gene represents a job that needs to be done. My genes are not doing that job well. Okay, I am going to add in some clearance factors. I will make sure I’m in the infrared sauna. Maybe I’ll use some peptides like carbon 60. Maybe it’s hydrogen water, added antioxidants. It could be intermittent fasting, anything that improves that clearance rate. 

Knowing there is a problem is a good call. Understanding the lab markers, there is one called 8-OHdG, which is a pretty direct marker of oxidative stress and how it’s impacting the DNA. I can also measure it. Know the red flag in the genes, understand markers that you can look at to see how it’s going, and control that middle ground, the energy, thoughts, and actions associated with it. 

Dr. Eric:

For example, you said you could measure it. I don’t know if you do the DUTCH test. There are a few different tests that look at that oxidative stress marker, the 8-OHdG. It doesn’t say why you have that oxidative stress. If you have genetic testing, and you mentioned SOD2 and GPX genes, if you have genetic variations in those, depending on the variations, that could mean that you need to do more for the oxidative stress to reduce it, if I’m understanding you correctly. 

Justin: 

Yeah. At The DNA Company, the panel we landed on, we are only really testing for a couple hundred genes, which is a very small segment of the actual genome. Understand here that genome sequencing, the more SNPs that you look for, the more expensive the test is. The more you look, the more you have to pay. 

Also, many of these genes are not fully hashed out, and they are not necessarily actionable. We use something called the DNA 360, which was really wound down to the main genes associated with the main systems of the body that deal with inflammation and detoxification, sex hormones, executive function (dopamine, serotonin, etc.). We whittled it down into systems that are meant to be applicable to the general public. We’re not zooming in on really specific genes associated with conditions, but the genes we do look at when you zoom out are applicable to all of it.

If you have a thyroid condition or MS or whatever, it still matters the way your body detoxes. It matters the way your body deals with inflammation. It matters how you methylate, MTHFR, etc. it’s applicable to the general pop because health problems can be manifestations of upstream issues. We’re looking as far upstream as it gets to understand baseline encoding processes that suck or don’t suck in your body. That’s what we do. We like to work forward from the genes as opposed to working backward from the symptomology. 

Dr. Eric: 

I do have a question. I’m not sure if you can answer this. With relation to estrogen metabolism, two of the bigger genes here are MTHFR and COMT. I don’t know if there are others related to estrogen metabolism that are important. 

Justin: 

We have a whole sex hormone pathway, the steroidogenesis pathway. A lot of the genes in there come from a family of enzymes called CYP450. It’s a step-by-step process as you know. 

What we do is we look at the initial step of progesterone converting to testosterone. That’s done by a gene called CYP17A1. The speed of that enzyme really dictates what’s called dominance. If you have a heck of a lot of that initial testosterone conversion right off the bat because of this CYP17A1 enzyme, that creates what we call dominance. You get that bigger pulse as soon as you hit puberty. That is the first step there that we look at.

From there, we can actually see if the testosterone is androgenizing, which means it’s converting to DHT from a gene called SRD5A2. How much of that testosterone is aromatizing via a gene called CYP19A1? We determine if you are more dominant in the first place. Once we establish that, are you more androgen or estrogen dominant?

From there, the pathway goes even further. Now we start looking at metabolites of the estrogen. We can actually see genetically based on the enzyme pathway what the conversion rate is to things like 2-hydroxyestrogen, which is quite protective to the body, or the inflammatory 4- or 16 alpha-hydroxyestrogen. We can see how that pathway looks.

Let me say if there are any practitioners in the audience who do HRT, endocrinologists, etc., it’s a really good idea to understand these enzyme pathways before you prescribe hormones. Whether your body made the hormone or you took it in exogenously, the enzyme pathway is still going to steer what that ultimately looks like. If you add in estradiol or something like that, you will want to know how much 4-hydroxyestrogen is taking place. You may need to add in an intervention, some DIM or sulforaphane to protect from the estrogen toxicity. 

Dr. Eric: 

If you do a DUTCH, it will show those metabolites that you just mentioned. Again, it’s not necessarily telling you why you might have excess 4-hydroxy or 16 alpha-hydroxy. 

I don’t know if you use the DUTCH test or how familiar you are with it. It gives an indication of low methylation. If you have low methylation, and I have seen this before, and your homocysteine looks fine. I know it’s not perfect. There are other ways to determine methylation. 

If you look at a DUTCH test and see low methylation, elevated 4-hydroxy or 16 alpha-hydroxy, and again, homocysteine looks good, does that mean that there might be something else causing problems with methylation? Or is the test not accurate in saying there is low methylation when it says that? 

Justin: 

We actually also have a full panel for methylation. I always preface the hormone conversation with the methylation conversation to make sure we are supporting that cycle to the best of our ability. 

The DNA Company differs a little bit from these genetic testing companies because MTHFR is just one gene in the panel that we look at. There are actually several genes in the panel. You mentioned COMT; that would be one of them. There is SHMT1, methionine synthase, methionine synthase reductase. It’s a whole step by step pathway.

What we do is look at the different enzyme speeds within the methylation cascade. We look at how we support it. Some people don’t do well with methylated vitamins as you know. A lot of that has to do with if you’re kind of at risk of overmethylating. Some people under, and some people over. 

We always make sure that we’re supporting that cycle with our targeted therapies, different types of B vitamins. Some people need sublingual formats; some don’t. Some people need the support of the methyl group; some people don’t. We make sure that the methylation cycle in and of itself is being supported prior to talking about things that are being methylated, like hormones. Again, we zoom out. It’s a whole 360-degree viewpoint. We get the detoxification working as well. 

Let’s say you have liver congestion. That’s going to impact your body’s ability to convert hormones. There’s some liver dependence with thyroid as well. If your liver is all messed up, and you won’t get proper T4 to T3 conversion because so much of that happens in the liver as you know, we look at it all. We are treating the whole body instead of treating one thing at a time, if that makes sense. 

Dr. Eric: 

Yes, it does. I have a newsletter, Healthy Gut, Healthy Thyroid. Are there any panels that The DNA Company offers that relates to optimal gut health? 

Justin: 

Yes, we work with a company called Jona. They get our Gut 360 Premium test. That would be like the stool test that we look at. 

Within the genes, there is a really important one that has some correlation to things like Hashimoto’s, Graves’, etc. We have a panel that is glutathionization. 

One of the things that’s really cool about what we do is we don’t just test for SNPs. Most genetic companies do what’s called SNP testing, single nucleotide polymorphism. It’s like a spelling mistake within the gene. We look at other stuff as well like copy number variations (CNVs), indels, and deletions. There are different types of genes as well besides SNPs. Some of the most important genes we look at are CNVs. How many copies did you get from your parents? You can have zero, one, or two copies. 

There is a particular gene that I look at in relation to autoimmunity called GSTM1. It’s associated with glutathione at the level of the gut microbiome. If you’re not familiar, glutathione is a very important part of phase two detoxification. 

What we’ve found clinically is there is a sweet spot genotype for GSTM1. If you have zero copies, like yours truly, it means you don’t detoxify well at all at the level of the gut. You’re literally missing one of the primary detox genes. 

One copy is actually appropriate. If you have one, you’re detoxing well, but you won’t overdo it. 

Two copies, we have found significant clinical correlation with autoimmunity. It’s almost like your gut is too good at recognizing things as enemies. It incites that immune response when you take in something that it doesn’t look like. That could be glyphosate. That could be a food sensitivity, gluten, if you’re sensitive there. 

A whole lifetime of that immune response being kicked off, that’s what tends to wear away that mucosal barrier. You end up with a mucosal injury, so-called leaky gut. You and I both know that leaky gut is a major factor when it comes to all things immune system related. 80% of your immune system lives in the gut. 

Once that starts, that’s the beginning of Hashimoto’s. It could be RA, eczema. A lot of people with two copies of GSTM1 end up having that as an issue. There is some pretty strong connective tissue there between Hashimoto’s, Graves’, etc. 

Dr. Eric: 

How about caffeine? To determine if you are a slow and fast metabolizer of caffeine? 

Justin: 

I mentioned the CYP450 family of enzymes. There is one called CYP1A2. It’s actually a phase one detox enzyme as well. That’s one of its main jobs. Phase one detox being taking fat soluble toxins, changing them around to make them water soluble, so your body can get rid of them with phases two and three. 

It also metabolizes stimulants being caffeine, ephedrine, kratom, whatever you people are doing. That’s one of the main things that it does. If you have a faster genotype there, it means your body rapidly works through the caffeine. 

There are pluses and minuses. Genes are never good or evil; it’s a context-specific thing. I have a fast CYP182. If I have caffeine, I can have it later in the day without it disrupting sleep. It takes a while for other people to work through it. It can be disruptive of circadian rhythm and things like that. 

It’s an interesting thing that we look at. I usually get people to do caffeine cycling if they are slower for CYP182 to make sure they are not messing with their sleep. 

Dr. Eric: 

I am a fast metabolizer as well. Unfortunately, I don’t drink coffee. I do drink green tea. I can’t say I take advantage of drinking coffee late at night. 

Justin: 

It’s not necessary, but it’s one of those things that a lot of people are into, myself included. 

Dr. Eric: 

How about some of the genes tying into weight loss? There is a lot of interest there with GLP1s. How do genetics and testing tie into that? 

Justin: 

There are quite a few genes of relevance there. It’s almost like what gene doesn’t matter when it comes to things like weight loss and ideal body composition? 

We have a whole executive function panel as well that looks at the dopamine pathways. If you have a high binding of dopamine, you’re a lot more likely to have binging or addictive behaviors. 

We also have a whole diet and nutrition panel that looks at things like satiety signaling, ideal macro and micronutrient synthesis. We can see genetically speaking if you will do well metabolizing starches versus lipids. We have a great gene called TCF7L2 that is a tremendous indicator for insulin response. Some people are genetically dysregulated for insulin, and they can have 1.5 greater times insulin response when they take in an energy dense meal. That matters for blood sugar management. 

With regard to the GLP1s, it’s interesting. There is a gene called fucosyltransferase, FUT2. We include it in our methylation panel because it has a secondary job of being a transporter gene for Vitamin B12. Cobalamin is unique in that it’s the only micronutrient that does not get passably absorbed into the gut. it requires the secretion of an Uber to get through the gut lumen. FUT2 does that.

It also has a significant impact over the microbiome. It influences short chain fatty acids, which influence GLP1 production in the first place.

If you’re what we call a nonsecreter, which means you have an AA genotype of the FUT2 gene, it means that you’re not creating a heck of a lot of those GLP1s in the first place. These are the people who tend to respond a little bit better to taking GLP1s because you’re overriding the mechanism by taking a peptide and injecting it.

GLP1 response is determined by other stuff as well. I typically don’t recommend stuff like that. If so, or if a client comes to me who is already taking it, I will also look at things like their glutathione profiles. If you’re suboptimal for glutathione, you may be the one who gets nausea and an upset stomach. 

Understanding your detox pathways, your insulin response, your macronutrient response, then your satiety pathways. We look at a gene called FTO, which works on the gut-brain axis, that bidirectional circuit of your gut communicating with your brain. 

When you start chewing food down, there is a signal that is supposed to go from your gut to your brain, saying, “We’re all set, mate. You don’t need to keep eating calories.” For people who have dysregulation in this FTO gene, it’s a much slower signal. By the time it hits your brain, you’ve already gone back and had the second or third portion. 

We look at it from several different angles as you can imagine. It helps to guide therapies, how we do it. For some people, you need to prioritize detox. For some people, it’s more of a cognitive binging problem. For some people, it’s gut health related, insulin response related. Just knowing the genes, it helps you to guide what that therapy looks like. It helps you be more detailed with your intervention. 

Dr. Eric: 

In that example, if you have a genetic variation of FTO, as far as intervention, it sounds like you have to look at some of the other genes as well to determine which direction to go. 

Justin: 

Yeah. Being a health coach, I’ll recommend everything from an appetite suppressant, like a ketone ester, to a gratitude practice before your meal to help you get in that receptive, parasympathetic state, all the way to chewing your food properly. That will help speed the signal up. 

How many people are not chewing their food down? Their saliva isn’t changing the pH and aren’t getting that signal moving quickly. There are many tactics that you can use to health coach them out of it. This is why this person has difficulty not going back for the second and third servings. There is a genetic element. We just coach them out of that as you would with anything else. 

Dr. Eric: 

Does the panel also look at markers related to histamine? 

Justin: 

We have a bunch of new genes being created in there. Among them are the DAO enzyme. There are a few genes relative to that. We will be looking at histamine genes in the near future, like in 2026. It hasn’t completely rolled out yet. That’s a sneak peek for you guys. 

I do consider histamine as well with any genes that impact the HPA axis. Some people for example, even if you have a really bad anxiety response, which we do look at genetically within our adrenaline pathway, you are a more cortisol dominant person more likely. We know when the HPA axis gets kicked off, the mast cells will release proinflammatory cytokines, histamine, and tumor necrosis factor alpha, etc. We look at it a little bit more indirectly, but it will be more direct shortly here with the DAO enzyme genes. 

Dr. Eric: 

I’m sure there are many other genes you could talk about. Let’s talk about any health condition, whether it’s thyroid-related, autoimmune thyroid-related. You look at all the different systems. All these are relevant in some shape or form. 

How about bone health? Are there any genetics that relate to bone health with The DNA Company? 

Justin: 

I would say the most relevant ones would be the Vitamin D pathway, Vitamin D being quite important for such a thing. Practitioners even now are a little bit too linear in their recommendations for Vitamin D. They give an IU dosage and maybe base it on body weight. 

We have a whole pathway associated with Vitamin D. As you know, it’s more of a hormone than a micronutrient. You’re not getting so much of it from a dietary pathway as you are a hormonic pathway. 

There are three genes involved. We have just added a fourth. When you get sunshine on your skin, your body doesn’t make active Vitamin D, D3. It makes a precursor to D3 called D2. D2 is inactive and has to be converted to D3 in order to exert its influence over the cells. 

There is an enzyme encoded by a gene called CYP2R1. There is that CYP family as well. That’s what does the initial conversion.

Once it’s active in its D3 useful format, the second gene takes over, GCVDBP, Vitamin D binding protein. VDBP is the Uber that takes the now active D3 to the receptor site. You can be suboptimal for both of these genes, none of these genes. That guides dosing protocols. 

The third gene that we look at is the receptor itself. It’s simply called VDR, the Vitamin D receptor. I look at that being like the bouncer at the nightclub. He is letting the Vitamin D in. Some people’s bouncer is a hardass. He’s not letting people in very well. The other people have a bouncer who is texting and is like, “Yeah, get in there, whatever.”

That guides how you go about your dosing. Some people don’t do well with a large Vitamin D dose in one go. You can take 5,000-10,000 IUs. If you have suboptimal delivery, you’re not going to get it into the receptor, and it won’t do its job until it’s in that receptor. That would mean that you need to take smaller doses, but you better space it out by a couple hours because you’re effectively putting more people in the line to get into the nightclub. 

Dr. Eric: 

Very interesting. If someone is taking 10,000 IUs of Vitamin D, which is a decent dose, not that practitioners haven’t recommended higher doses, but you wouldn’t want to continue taking 10,000 IUs of Vitamin D indefinitely. Someone takes 10,000 IUs for a couple of months, and they do a 35 hydroxy Vitamin D, and it’s still not optimal. 

Even taking into consideration genetics. I have thought about that, too. I am not familiar with all the genes you mentioned, but the VDR, I am. Logically, you would think, “Well, maybe you have that genetic polymorphism, so you’re one of the people who need more. Maybe you need 15,000 IUs.” 

What you’re saying is that may backfire because you don’t want to give that all at once. Maybe the problem is that they’re just taking it all at once when you should space it out. Don’t even need 10,000. Maybe you can get away with 6,000. Make the math easy. 2,000 IUs three times a day. 

Justin: 

It’s a protocol problem, not a volume of Vitamin D problem. You’re right. The first place any practitioner would go makes sense. You need more; let’s up the dose. A delivery problem is what’s actually going on there. 

There are risk factors as well with taking massive amounts of Vitamin D that is not being absorbed. Especially if you are doing it in the absence of K2, we know there is such a thing as Vitamin D toxicity, and it can calcify in the arteries. 

One thing I look at when I go about this Vitamin D dosing protocol is I look at their APOE gene. Everyone knows about this, just like MTHFR. If you have a 4 allele in APOE, which by the way I have a 4 allele, it makes it so there is a stronger likelihood of calcification of your cholesterol that will go on within the endothelium of the body. 

If you have a 4 allele, and you think it’s a good idea to take massive amounts of Vitamin D3 without any K2, you could create a cardiovascular issue just like that, or amplify a cardiovascular issue, which proper Vitamin D can help the cardiovascular issue. It’s anti-inflammatory. You’re boosting your immune system. 

This is where the genes are valuable. It can allow you to guide interventions and protocols and avoid mistakes. I’ll tell ya, even with the glutathione pathway, if you’re suboptimal for all of your glutathione genetics, understand that genes are like little instruction manuals. If you’re not detoxing well, a lot of well-informed practitioners will give you a big dose of glutathione, thinking it’s ideal to raise that up. 

If you’re missing the instruction manual internally for what we do with the glutathione, now we have given major amounts of a substrate that the body has no instruction for what to do with. Instead of binding to toxins, it might just go bind to something else, like minerals. We have seen that. People deplete their mineral reserves because they are taking IV glutathione and are missing the genes for what to do with it. 

Functional genomics in my opinion is a layer of personalization. I recommend it for absolutely anybody. If you’re a personal trainer, a nutritionist, why wouldn’t you want to know your client’s insulin response? It only makes sense if you’re a cardiologist and don’t understand the APOE gene, the nitric oxide genes. 

There is a gene called 9P21 that translates to the density and toughness of your endothelium. Some people genetically are a lot thinner and weaker there. When you have inflammation, there are these micro tears that happen along the lining of that endothelium, and you will want to know that as a practitioner. Do they have rhino lining, as the endothelium? Is it plastic, saran wrap? You want to know these kinds of things.

Any practitioners in the audience, you can take what your already existing practice is, utilize functional genomics as a filter to know “I better not prescribe that, so I should go this route.” It’s a way of dialing it in that much further. I have seen significant results with many people. 

Dr. Eric: 

If I asked a question which you just answered, who should consider getting genetic testing? The answer probably would be everybody. If I reworded it to say is there anybody who should not consider genetic testing, would you say the answer would probably be no? 

Justin: 

I’d say anybody who doesn’t want to be healthy, you can avoid it. I hate to be this guy and be so adamant about it because not everything is for everyone. 

In the case of genes, especially the way we do it, because we really highly prioritize cybersecurity, we won’t sell your stuff to Bill Gates. The day that happens is the day I’m no longer associated. The samples are destroyed. Everything is protected. It will give you a 360-degree view of what your genes are. We are not testing nine million SNPs. We are testing 200 things that are clinically relevant for what your health picture will look like.

I will say there is something called subclinical. That means before the problem shows up. I try to get people in that subclinical zone, before they’re actually having a disease manifesting. If you’re a child, or you’re a young person or someone who is interested in health, you really should know what your blueprint looks like. You can establish the highest quality epigenetic environment that way, by knowing what the weak points are. 

If you give your body the best quality information, understanding what that blueprint looks like, you can establish high quality methylation patterns early on. Your body is going to be strengthened in any number of ways. 

We even look at a gene called brain derived neurotropic factor, BDNF, which is a Miracle Gro for your brain. We know if you have genetically suboptimal BDNF, or your kid does, you may not want to put them into football or something where they may be taking a lot of shots to the head. They may do better on the golf course. We know that concussions require BDNF to help recover. It can even guide different lifestyle stuff early on.

If you know that your kid doesn’t process Vitamin C very well, there is a gene for that, SLC23A1. This is the kid that is going to do better if we incorporate more of that into their diet. Just that guidance and providing the ideal epigenetic environment, you will know what to do once you know what the blueprint looks like. 

Dr. Eric: 

This has been awesome. Anything else you’d like to discuss before we wrap up? Anything I should have asked you that I didn’t ask you? 

Justin: 

I think this was great. I think you asked all the right questions. I believe it was Reed Davis who said, “The general principles of health building always outweigh specific treatments.” As a health coach, I operate in that realm. I try to treat the whole body holistically as opposed to zooming in on one symptom over another.

There is this concept in personal training called moving from general to specific. You start with general exercises. If you’re a golfer or something, you get more into rotational exercises. You get into the specified zone once you have covered all of your basics. Provide your body with high quality epigenetic signals. That’s all your body understands: how to take in information, methylate it. You end up with what’s called an acquired phenotype based on your lifestyle behaviors. 

Living a healthy lifestyle is a great start, but then you can use the genes to personalize that healthy lifestyle. It’s not the same for everyone. We’re all beautiful, unique snowflakes, including yourself, Dr. Eric. I don’t mean to call you a snowflake; you’re not a snowflake, but you know what I mean. 

That’s what functional genomics offers. It’s an exciting area that will help revolutionize functional health. 

Dr. Eric:

Thank you for this. Where can people find out more about you and The DNA Company?  

Justin: 

The DNA Company is at TheDNACompany.com. We also have a YouTube page where we upload the DNA Talks podcast as well as weekly webinars. I actually did all three of them this week, which was a lot of public speaking. We cover different topics, and we also plug it through that filter of functional genomics.

I have Instagram, @JustinHarrisOfficial. That’s where you can find me.

I hope we maybe do a round two sometime. This was great. 

Dr. Eric: 

I agree. In the future for sure. They are always adding genes to the panel, so I’m sure we will have more to talk about in the future. This was awesome. Thank you so much, Justin. 

 

This is Part 1 of a two-part Your Thyroid Questions Answered series, wherein I answer a mix of situational and common thyroid health questions submitted by listeners with Graves’, Hashimoto’s, and other thyroid conditions. We cover topics like thyroid antibodies, lab interpretation, medication decisions, iodine, fatigue, hair loss, nodules, and lifestyle factors such as fasting and gut health.  If you would prefer to listen to the interview you can access it by Clicking Here.

In this episode, I am going to answer multiple questions related to thyroid health. While I wish I could answer all the questions submitted to me, I chose questions that I think can benefit a lot of people with thyroid and autoimmune thyroid conditions.

While some of the questions are specific to hypothyroidism and Hashimoto’s, many of them can benefit those with any thyroid or autoimmune thyroid condition.

I have gone through all the questions submitted, and since there are a lot of great questions, I am splitting this up into two separate parts. This episode is the first part, and then in two weeks, I will finish up with my responses to the rest of the questions. Next week, there is an interview scheduled.

Initially, I was going to dedicate one episode to hyperthyroidism and another to hypothyroidism. I decided not to do this because some of the questions related to Graves’ can benefit those with Hashimoto’s and vice versa. What I plan on doing is rotating the questions. That being said, let’s go ahead and get started. 

The first question asks if we can cover which specific antibodies affect the eyes and how to reduce them. Is it TSI or TRAB?

This is specific for Graves’, and this probably wouldn’t be of much benefit for those with Hashimoto’s. A small percentage of those with Hashimoto’s can get thyroid eye disease (TED).

With TED, it’s the TSIs that attack not only the TSH receptors but the tissues of the eyes. TSI is a type of TRAB. You could look at both. You could look at TSI and TRAB. Some practitioners will recommend both tests. If you will choose between one or the other, go with TSI because it is the more specific antibody associated with Graves’. 

I am getting conflicting ideas from doctors about taking both T3 and T4 meds. Which is the best blood test to determine what meds to take? One doctor is a naturopath, and the other is an allopath. I lean toward a more natural healing modality. I sure don’t want to be on meds for the remainder of my life. 

Thanks for your question. Karen is taking pretty much bioidentical T3 as well as synthetic T4. I like to look at the free hormones, free T4 and free T3. Some doctors just look at T4. Usually, they will do a free T4. You could do a total T4 and total T3. 

If I have to choose between one or the other, I would say free T4 and free T3. Of course, TSH, too. Even though thyroid hormones are more important than TSH, you still want to look at TSH. TSH, free T4, free T3 is what we want to look at.

What is the difference between hyperthyroidism and Graves’? 

Hyperthyroidism is when you have elevation in thyroid hormone, so you have elevated T4 and T3 and a depressed TSH. Graves’ is an autoimmune type of hyperthyroidism. Most hyperthyroid conditions are Graves’. There are exceptions like toxic multinodular goiter. There is also subclinical hyperthyroidism, when someone has depressed TSH, but their thyroid hormones are normal.

Not all cases of hyperthyroidism are Graves’. You could have different types like I mentioned. Graves’ is a type of hyperthyroidism that is autoimmune. Not only do you have elevated T4 and T3 and depressed TSH, but you also usually have elevated antibodies. Specifically TSIs, which is a type of TRAB. 

Why do none of the thyroid medications I have taken seem to work? This is the fifth one. They seem to give me less energy. The one I am taking now, Armor, seems to make me feel worse, tired, no energy, plus swollen ankle in left foot, which I have read is one of the side effects. I have also tried plain iodine. My hair is like straw, very dry. I have brain fog. I’m at a loss and don’t know what to do. I can’t afford the right blood tests. My doctors said I have the correct blood test. I’ve tried different vitamins but nothing yet. 

I think this is a different Karen who asked this question. I wish you mentioned which blood tests you actually did. I would look at TSH. Maybe they did a T4, but you also want to look at T3. Ideally, in this situation, reverse T3 would be good. I know you said you can’t afford that. That’s ideally what I would be looking at. If T4 is converting into T3, that would be my question. If you are just looking at TSH and T4, you don’t know that. That’s what I suspect might be happening.

There is also the possibility of thyroid hormone resistance where you have too much thyroid hormone, but it’s not entering the cell. Usually, that will present as normal or high TSH, and T4 and perhaps even T3 being on the higher end. 

It’s like insulin resistance. You have plenty of insulin. If you do a fasting insulin, your insulin will typically be high in insulin resistance, but it’s not getting in the cell. Similar with this. A lot of times, you will see thyroid hormones on the higher side, perhaps elevated. Unlike hyperthyroidism, where the TSH is depressed, in the case of thyroid hormone resistance, TSH will be normal or elevated.

Why do my test results show my thyroid levels vacillating between hyperthyroidism and hypothyroidism? I have Graves’. 

This person is on 100mcg of levothyroxine. My question, which I know you won’t be able to answer here: You said you have Graves’, but you’re on thyroid hormone replacement. Do you have Graves’ and get radioactive iodine or thyroid surgery? 

I’m thinking that’s not the case. In that case, it would be obvious that you would be hyper, and when you get thyroid surgery, you’d be hypo. Here, it sounds like your numbers are still going back and forth between hyper and hypo. 

If you have Graves’, another scenario is if you’re on block and replacement therapy. This is when someone is on antithyroid medication, like methimazole, and levothyroxine. I don’t know if this is the case because you only mentioned levothyroxine. I am not exactly sure of the situation. 

I don’t know. In a situation like this, I’d love to see some of your past labs, at least your last few labs showing the hyper numbers and hypo numbers, and knowing if you are just on levothyroxine. 

What antibodies do you have? Do you just have Graves’ antibodies? Do you have Hashimoto’s antibodies? There could be a number of reasons why someone would go back and forth between hyper and hypo.

If someone is dealing with Graves’ and is on a higher dose of antithyroid medication, that would potentially make them hypo. Some people are on block and replace therapy, so they are giving thyroid hormone to try to minimize that.

There is also Hashitoxicosis, which is Hashimoto’s but also presents as transient hyperthyroidism. Sometimes, it gets misdiagnosed as Graves’. 

In this case, I don’t have enough information to tell you, but those are some of the scenarios when someone will go back and forth between hyperthyroidism and hypothyroidism. I am curious if you are also on methimazole or a different type of antithyroid medication. 

My endocrinologist thinks I have hyperparathyroidism and wants to do surgery, but I’m not sure I want to do that. I don’t think surgery is the answer. I’m trying to cure it naturally to treat hyperparathyroidism. 

Another similar question came in, asking: Could you address root causes and natural solutions for parathyroid issues? 

Even though the word “parathyroid” has “thyroid” in it, it’s completely different. It’s near the thyroid, but it’s still not the same. 

Unfortunately, I don’t work with parathyroid issues. I have written an article and have a podcast episode on parathyroid issues, hyperparathyroidism. Most cases of hyperparathyroidism are usually related to benign adenoma, which if that is the case, I do not know any cure. I have had a few patients who have tried to treat it naturally without success. Very small sample size. 

If you have primary hyperparathyroidism, which is usually the case, surgery for the adenoma is usually required. Maybe there is someone out there who is treating hyperparathyroidism naturally. I am just not aware of anybody doing that. 

I really feel bad when someone asks me about this because I don’t have a natural solution, and I am not sure of any out there. 

I interviewed Dr. Divya Boone on the podcast. She is a surgeon. She is open to functional medicine, but she does surgery on the parathyroid glands. Even though she is open to functional medicine, she is probably still biased. Most endocrinologists are biased. 

Obviously, there are natural approaches for Graves’ and Hashimoto’s. I am not sure of anybody out there who focuses on that or who has had success when the cause is a benign adenoma. 

If there are other underlying imbalances, and it’s not a benign adenoma, of course, I would say make dietary changes. Do things to improve stress management. Get proper sleep. Optimize adrenal health and gut health. Correct nutrient deficiencies, including Vitamin D. I would definitely do those things. 

Like I said, if it is a benign adenoma, unfortunately, the only solution I know of is surgery. 

I am at a crossroads. I have had Graves’ for 20+ years controlled by Tapezol. The recent move and all the stress related to it seems to have sent my thyroid off the charts. I am being held steady by a fairly high dose of 30mg per day. I have worked with a functional medicine nutritionist in the recent past and did many diet and lifestyle changes, which did not affect my labs. My physician is suggesting for me to have thyroid ablation. I am worried about the side effects of this procedure and if it will really help. Do you have any suggestions I might try before giving into the procedure?

Thank you for your question, Kathy. You have been dealing with Graves’ for a long time, 20+ years. You mentioned stress could be a factor. You could take a higher dose, but it’s not a low dose. If someone is on 5mg of methimazole, studies show that 5mg taken for many years is safe. 30mg is a large dose. I know I personally wouldn’t want to be on 30mg indefinitely. 

I know you said you worked with a functional medicine nutritionist and did diet and lifestyle changes, which did not affect your labs. Did you make the right changes? I’m not sure. I’m not sure if you read my book The Hyperthyroid Healing Diet. I recommend that.

Let’s say you did do everything I recommend in the book. In the book, I have a section going beyond the hyperthyroid healing diet, going beyond diet and lifestyle, doing testing to find and remove triggers. There could be triggers other than food and stress. I do have suggestions. That would be- 

I know you already worked with a functional medicine nutritionist, but I recommend working with someone else who has experience with hyperthyroidism. I do remote consults, so I’m an option. If it’s someone else, that’s perfectly fine. 

I wouldn’t give up by working with one functional medicine practitioner who only addressed diet and lifestyle, which is great that they did that, but you want to at least try going beyond diet and lifestyle. 

I agree. Thyroid ablation, radioactive iodine, if you choose that as an option at all, it should be the last option. There is a debate of should you get surgery instead of radioactive iodine if it comes to that? I am not a big fan of radioactive iodine period. I am not a big fan of surgery. Everything is risks versus benefits. 

One of the concerns with thyroid ablation is if you have underlying thyroid eye disease, that could cause a flareup. In your case, maybe less likely since you’ve had Graves’ for such a long time. 

I’m with you. I’d be concerned about the side effects of the process. Concerns with cancer with radioactive iodine. Try to dig deeper. Work with someone to do some testing to find and remove triggers, heal the gut. That would be my recommendation before you give in to the procedure as you mentioned. 

I just had a bunch of immune system blood tests done. The ANA was positive. I know that doesn’t mean a lot until further testing, but I’m not sure if I need an endocrinologist or rheumatologist. I am hyperthyroid. I take 60mg of NP thyroid per day. 

I wouldn’t say you necessarily need to see a rheumatologist because you have a positive ANA. One question I have is have you been tested for the antibodies for Hashimoto’s? TPO and TG. ANA could mean lupus or Shogren’s, but it doesn’t always mean those. Many times, it doesn’t. I have seen people with Hashimoto’s or Graves’ who have positive ANA, but it seems like they’re negative for all other antibodies. 

If you have Hashimoto’s, that could be the reason. In that case, I don’t think it would be beneficial to see a rheumatologist. It won’t hurt to get further diagnosed. A rheumatologist might run some additional testing. 

If you have Hashimoto’s, just remember that’s an autoimmune thyroid condition. While the NP thyroid might be necessary to take, it’s not doing anything to address the immune system component. Whether you have Hashimoto’s or RA or lupus or Shogren’s, you want to do things to optimize your immune system. 

What triggers Graves’ or makes it worse? 

There could be a lot of things that trigger Graves’. The same question could be asked with Hashimoto’s or other autoimmune conditions. With most autoimmune conditions, there are multiple triggers.

I talk about four categories of triggers for both Graves’ and Hashimoto’s. One is food such as gluten. Two would be stress. A lot of people underestimate the impact of chronic stress on our health. Three would be chemicals and environmental toxins or toxicants. A lot of people overlook the impact of environmental toxins and toxicants. They can definitely be triggers. Four is infections such as EBV, H-pylori, parasites, Lyme. There could be a number of triggers. I didn’t mention toxic mold, but that falls under environmental toxins. 

These factors can trigger Graves’ and/or make Graves’ worse. That’s why you want to try to find the triggers. You could maybe just do an elimination diet, do things to manage stress. Some people do need to do functional medicine testing to find and ultimately remove the triggers. 

Why is it that everything I read says iodine is important for the health of your thyroid, but my doctor/endocrinologist tells me not to take any iodine or supplements with iodine in them? He used to tell me that it was because there was iodine in my prescription thyroid medication. Now I have recently quit taking any thyroid prescription meds, and he still tells me not to take any iodine. I took Nature Throid for a few years until they stopped making it, so my doctor put me back on Synthroid. I recently read that it can cause cancer, so I told my doctor I wanted to get off all thyroid prescription meds. He agreed we could try, so I asked him again if I didn’t need iodine. He told me not to take iodine. Is this correct? 

Gwen, thanks for your question. Iodine is controversial in those with both Hashimoto’s and Graves’. In this situation, I don’t think you mentioned that you have Hashimoto’s, but if you’re taking Armor or Nature Throid or Synthroid, you are getting treated for hypothyroidism.

Without question, iodine is important for thyroid function and breast health. You don’t want to not have any iodine in diet for example, but iodine also could be problematic in both Graves’ and Hashimoto’s. it can be beneficial in some situations, but in some situations, it could exacerbate the thyroid condition, moreso with hyperthyroidism. Iodine can also in some cases suppress thyroid when taking higher amounts of it. It could also exacerbate the autoimmune response of Graves’ and Hashimoto’s. 

That’s why your doctor is a bit cautious, which I can understand. I don’t recommend for people to completely avoid iodine. Getting some iodine through the food you eat is fine. If someone is taking a multivitamin with iodine, I am usually not concerned. I know other practitioners express concern. 

It does depend on the person. I get more concerned when someone is eating food really high in iodine, like kelp or shellfish in some cases, or if they are taking separate iodine supplements, especially mg doses of iodine. 

Hope that answers your question. Iodine is important, but I would be cautious about larger amounts of iodine in certain foods as well as supplements.

Can I ask you how to proceed? My TSH is high at 6.21, but my free T4 is 19.1 and free T3 is 4.2. These are considered normal range according to the laboratory. 

This is probably someone who is overseas. Usually in the United States, that free T4 would be a crazy high number. Most labs wouldn’t go up that high. Free T3, that would be on the higher end. Here, it’s normal, but TSH is high. 

Shall I take an iodine supplement or T4 supplement despite the lab findings? 

As I just mentioned, with iodine, I would be cautious. You can do a urinary iodine test and see what your iodine levels look like. In the US, there is one, Hakala Labs. Most doctors would put you on T4 because TSH is high, and they pay more attention to TSH than free T4 and free T3. Your free T4 looks a bit on the higher side from the range. Different range than in the US. 

I’m wondering in this case, is it pituitary? Is it a problem converting T4 to T3? Possibly. Usually, that wouldn’t cause TSH- TSH is more dependent on T4 and T3, but T3 is active form of thyroid hormone. Those are the two things I would look into. 

Is it a pituitary problem, or is it a problem converting T4 to T3? Either way, you’d want to be cautious about T4. If you have problems converting T4 to T3, taking more T4 won’t help with that. If it’s a pituitary problem, taking T4 won’t help with that. 

Although you’ve spoken about this in the past, my one question is how I can stop the rest of my hair falling out. Right now, it’s falling out. Again, it’s purely diet. 

I’m not sure what you mean by that. That’s by Jennifer. Jennifer, hair loss unfortunately is very common with both hyperthyroidism and hypothyroidism. Balance the thyroid hormones. 

Nutrient deficiencies can sometimes cause hair loss. I know biotin although I’ve had Julie Olson on the podcast talking about how biotin is overrated and usually not responsible for hair loss. Others don’t necessarily agree. There could be other deficiencies like iron and zinc that could play a role as well. Many times, this relates to gut health, so having a healthy gut is important for healthy nutrient digestion and absorption. 

Those are the main factors. Balancing the hormones, correcting nutrient deficiencies. You’re asking if it’s purely diet. I misunderstood. I am looking at the question again. Is it purely diet? No, I don’t think it’s purely diet. Even once the thyroid hormones are in balance, it can take time for the hair loss to stop and for it to start growing back. I also want to let you know about that. Thyroid hormones are in balance, and hair loss won’t stop right away. It can take a few weeks, sometimes a month or two.

No, it’s usually not just a diet issue. You need to balance thyroid hormones. Eating a healthy diet is a piece of the puzzle when it comes to that. You usually need to do more than just eating a healthy diet.

Just wanted to thank you for all your advice that you share frequently. I have implemented many of your suggestions with diet and environment with great success. While technically my endocrinologist says I still have Graves’, my bloodwork is and has been in the normal range for a year. I continue without symptoms and contribute my success to the things I have learned from you. So thankful not to be on any antithyroid medications and still have my thyroid. Thank you again, and wish you a very happy and healthy new year. 

This was just a compliment. I intentionally left this in because it’s nice to have some people who follow my recommendations and get great results. I was thinking not to include this because it’s not a question. I did decide to leave it in. 

Another example of how there is hope out there. It’s not easy to restore one’s health whether you have hyperthyroidism or hypothyroidism, but it’s definitely possible.

Is there anything that can be done to prevent postpartum thyroiditis with Hashimoto’s? 

Research shows supplementing with 200mcg of selenium, especially in the third trimester, can help to prevent postpartum thyroiditis. That is one thing that most people can do. Just doing that alone won’t guarantee you won’t develop postpartum thyroiditis, but it can potentially help.

Other things are of course eat a whole, healthy foods diet. Avoid common allergens such as gluten and dairy. Try to minimize stress. Block out time for stress management on a regular basis. Get regular sleep. Incorporate the foundations: diet, stress management, sleep. 

Some might be tempted to take Brazil nuts. You just don’t know how much selenium you are getting in one nut. That’s why in this case you might, especially if you have a history of postpartum thyroiditis, or if not, are worried about developing it. 

I am not specifically telling you to take selenium because I can’t give specific recommendations here. The research shows that 200mcg of selenium can prevent postpartum thyroiditis from developing.

I do have a few questions related to thyroid health. Graves’, which might also be helpful for others. 

I decide to answer these because they are really good. They are not just beneficial for those with Graves’. Even those with Hashimoto’s can get benefit from these. Or those with a nonautoimmune thyroid condition. 

The first question is related to intermittent fasting. I have read that fasting in general may not be ideal for people with Graves’. However, I personally feel much better when I eat my first meal around noon. Is intermittent fasting truly harmful in this case, or can it be okay if it truly feels good and stress levels are low? 

I am not against intermittent fasting. Most people could do 12-14 hours of that. The concern is if someone is doing a 16-8 fast, that’s not too terrible. If you’re eating at noon, and you’re stopping at 6pm, we are talking about 18 hours without eating, so only a six-hour eating window. 18 hours of fasting, six hours where you’re eating. 

The question is would you be getting enough protein during that time? Enough nutrients? Six hours isn’t a lot of time. It depends. If you’re doing a 16-8, if you’re eating around noon and then eating until 8pm, eating a later dinner, that might be okay. 

I would be concerned if you are going longer than that, especially on a day in, day out basis. Even though you feel good, I wonder if some of that is mental, psychological. Not to say you’re not feeling good. I have done intermittent fasting. When I do it, I feel good overall. It doesn’t mean if you’re doing 18 hours a day, that it’s a good thing. Maybe it’s not putting stress on your adrenals, but I’d be concerned that it might be.

Another concern is if you are getting enough protein and nutrients. 

The next question is related to gut testing and gut protocols. Do you think expensive stool tests and gut protocols are actually worth it? In your experience, do they provide meaningful insight to improvements for thyroid patients? 

This could apply to those with any type of thyroid or autoimmune thyroid condition. Comprehensive stool tests like GI Maps or GI Effects, I don’t recommend it to every single person. I can’t say every single person needs to do comprehensive stool testing. It does depend on the person.

In some cases, they can be helpful. Not necessarily across the board.

Gut protocols, it depends. I am a big fan of probiotics and digestive enzymes. I wouldn’t say everybody needs to take a gut healing supplement, even though I have one, SMT GI Restore, which I do like. I don’t think everybody needs to take it. I don’t think everybody needs to follow an antimicrobial protocol. I do think there is a time and place for comprehensive stool testing.

From a thyroid and autoimmune thyroid perspective, is a vegetarian/vegan or meat-based diet generally more beneficial? Does it depend entirely on the individual? 

There is no diet that fits everyone perfectly. To some extent, it depends on the individual. I do recommend more of a paleo diet or AIP diet, at least while healing. I can’t say I recommend a vegan or vegetarian diet. If someone is following a vegan or vegetarian diet, they can still get good results. 

In my book The Hyperthyroid Healing Diet, I have a level 1 diet, which is suitable for vegans and vegetarians. 

Is complete alcohol avoidance really essential with Graves’? I personally find that having a few glasses of wine with friends once in a while helps me relax. Can even small amounts be problematic? 

Christina asked all these questions. Another great question for all thyroid conditions. I recommend while healing to take a break from alcohol because it can affect permeability of the gut. I know it also can have some benefits as well. The polyphenols. It’s hard to gauge risks versus benefits. 

Do the benefits outweigh the risks? Ultimately, it’s up to you. I am not saying it will be impossible to heal yourself if you’re drinking a glass of wine every now and then. I also wouldn’t say there would be no concern. 

It’s not the same as gluten. I get this question a lot with gluten. If I have gluten once or twice a week in small amounts, can I heal? The answer is you might be able to heal, but it’s a variable that probably is better not to be introduced while healing. Many will continue to avoid gluten, even after they have restored their health. 

I would say, to play it safe, it would be best to avoid drinking wine while healing.

I have had thyroid tests by two different doctors. One a regular medical doctor, the other an endocrinologist. They both said my thyroid dose is fine. Since the meds were lowered at least nine months ago, I am deeply exhausted all the time. My sleep is bad. I have had hair fall out. Eyelashes growing a little back now. Without changing my diet, which has always been really good—I eat organic—I gained weight. Now I am even more careful about what I am eating but not losing weight. Exhausted and frustrated. My question: How can I help my thyroid if the point after testing has not been helpful? Thank you for your help as always. 

Thanks for your question, Susan. Even though you are seeing two different doctors, it sounds like you may need to see a functional medicine practitioner. Your thyroid numbers might be within lab range, but it sounds like they might not be optimal. 

Are they also looking at T3? As I mentioned earlier, some practitioners look at TSH and T4 but not T3. If they’re not looking at T3, you don’t know if that’s optimal, if your body is converting T4 into T3. Even if they did look at it, are the numbers optimal, or are they just within the range? Even though it’s two different doctors, most conventional doctors will just pay attention to the reference range. If your TSH is 4, which is within most lab reference ranges, and your T3/T4 are on the lower side, they will say everything looks good even though it’s not. 

You might want to get an opinion from a functional medicine doctor, especially one who looks at thyroid labs on a daily basis. 

I have multinodular goiter, but my thyroid blood test numbers are all still within normal range. My ferritin is low, and I’m in my mid-40s with many thyroid symptoms. There is a lot of overlap to perimenopause symptoms. If numbers are within range, do I assume my symptoms are perimenopause-related? Some examples are occasional hair loss with some overall hair loss over the past five years; tired; lack of motivation; weight gain; tight fascia throughout the right side of my body; terrible plantar fasciitis for over a year; rib area fascia pain that can’t be explained by any tests; being cold often. 

Let me get to this first question. It’s possible that the symptoms are perimenopause. Again, it goes back to what I mentioned earlier. Normal numbers between optimal. You put “normal” in quotes, so I think you also are aware that it might not be optimal. If your numbers are not optimal, that could be causing it. It still could be thyroid-related, even though the labs are within normal range. 

It could be a combination of the thyroid hormones and estrogen, progesterone. I definitely would be getting this evaluated more. Maybe do a dried urine test like the DUTCH test. Hopefully you had not just TSH but free T4 and free T3 tested. In this case, maybe reverse T3 as well.

Can a thyroid be healthy even with multiple large nodules? 

Right away, I’ll say no. if you have large nodules, I wouldn’t say you have a healthy thyroid. Can you still have normal thyroid function with larger nodules? You could. I wouldn’t say it’s a healthy thyroid because you don’t want any nodules.

Is removing the thyroid nodules, if they cause pressure, a good idea? 

Essentially you are asking if you can do a partial thyroidectomy. Does having a multinodular goiter mean that your thyroid will start having problems at some point that you should start treating now? 

You did have HRT. A couple of things. You could look into addressing the cause of the large nodules. Problems with estrogen metabolism, how you metabolize estrogen. The DUTCH test could look at how you metabolize estrogen. Insulin resistance could also be a factor with large nodules. 

Before looking into surgery, look into radiofrequency ablation, which is not the same as radioactive iodine. It’s in pointing the thyroid nodules, using radiofrequencies to shrink the nodules. I had Dr. Angela Mazza on the podcast to talk about this. That is an option for some people with nodules. It’s not getting rid of the cause. If it’s saving the thyroid, preventing the thyroid from getting surgically removed, even a partial thyroidectomy, I would look into it.

I am curious why thyroid issues cause high cholesterol, particularly high HDL. 

Thyroid issues, I won’t say they typically cause high cholesterol. If HDL is really high, that could be a result of inflammation. Cholesterol thyroid hormones will affect cholesterol metabolism. For example, if someone has low thyroid hormone, so hypothyroidism, typically, you will have higher cholesterol, higher LDL, and you might have lower HDL. High HDL is more of an inflammatory issue. 

If someone has hyperthyroidism, too much thyroid hormone, then that will typically lower cholesterol and LDL. If the question specifically is about HDL, and it’s high, there is some type of inflammation going on in the body, which is common with Graves’ and Hashimoto’s, not to say most people have high HDL. 

I would love a diet plan. What to eat and what not to eat. Also, experiencing blurry vision. I have good and bad days. Today is a bad day. I just got my latest blood test results. Comparing it to the one I did three weeks ago, my thyroid is not responding. They are increasing methimazole to 20mg. In the meantime, I am trying to educate myself. I am planning on meeting with a functional medicine doctor. 

That’s wonderful about meeting with a functional medicine doctor. For what to eat and what not to eat, I am going to pitch my book, The Hyperthyroid Healing Diet. It’s not free. That goes into specifics about what to eat, what not to eat. I would recommend getting The Hyperthyroid Healing Diet, as it would take too long to go over everything here.

It depends. If you have Graves’, you probably want to follow a level 3 diet, which is similar to AIP. If not, maybe a level 2 diet, which is a modified paleo diet.

Blurry vision. It could be related to TED but also blood sugar can cause that as well. I am not sure if you have seen an eye specialist to get it checked out. With Graves’, it’s not uncommon to have TED. Not necessarily an optometrist but probably an ophthalmologist would be a better idea to play it safe. Great that you are seeing a functional medicine doctor. 

If someone has hypothyroidism for a long time, and they have never taken synthetic thyroid or had surgery, is it possible for something to be off with thyroid supplements? 

Sounds like you are not on synthetic thyroid but are on a certain thyroid supplement. 

If I don’t take it, my body falls apart. The first symptom is super tightness around my spine and hips, and I am unable to walk. It is excruciating, and at its worst, I cannot even sit or stand without it taking a whole minute to get up and down slowly from a chair. 

It depends on the situation. I can’t say everyone with hypothyroidism can get off thyroid hormone replacement or a supplement that has thyroid hormone replacement in there. I don’t know if it’s a thyroid glandular supplement or another supplement with nutritional support.

What you want to do ideally is address the underlying cause. If you address the underlying cause, that will increase the chances that you won’t need thyroid hormone replacement. I am not telling people to stop thyroid hormone replacement because there is a time and place for that. 

There are people who need thyroid hormone replacement. There are people who address the cause of the problem, but here is so much damage that has been done to the thyroid gland that they still need thyroid hormone replacement.

The answer is yes, it’s possible to not rely on the supplement. There is no guarantee. You don’t want just to take the supplement. You want to clean up your diet, manage your stress, find your triggers and underlying imbalances, and do things to heal the gut. 

I should have mentioned at the beginning that I am going to have a separate Q&A episode on bugleweed and related herbs. There are a few other questions. We have a decent number of questions related to bugleweed and motherwort. I have answered a few of them between this next one and the next session. A couple of them, I’ll be answering, but I decided to have a separate episode focusing on bugleweed. I am not answering five or six questions related to it here. I’ll have that separate episode coming out soon.

For hyperthyroidism, I take bugleweed, L-carnitine, selenium, and myoinositol. Can I quit taking one or two, or should I take them all? 

It’s up to you. I can’t specifically tell you what to do. I will say, when I dealt with Graves’ personally, I just took bugleweed and selenium. At the time, I wasn’t familiar with L-carnitine. That was in 2008/2009. That was a long time ago. I have seen some studies that selenium and myoinositol can help with antibodies, moreso Hashimoto’s. 

If I had to go in order, I’d say #1 would be bugleweed. #2 would be selenium. We could easily swap that. I could easily say selenium because you can’t have a bugleweed deficiency, but you can have a selenium deficiency. Myoinositol is optional. Even though I like L-carnitine, I would say it’s optional. 

Can you have normal TSH and still have hypothyroid symptoms? 

The answer is yes. If your TSH is normal, but not within the optimal range, then you could have hypothyroid symptoms. It’s not just TSH. You have to look at T4 and T3. They could easily be less than optimal. 

Many doctors don’t look at the thyroid hormones; they might only look at TSH, or TSH and just T4. T4 converts into T3. If you have a normal TSH but less than optimal T4 and T3, or even optimal T4 but less than optimal T3 because T4 isn’t converting to T3, then yes, you could have hypothyroid symptoms.

The question is is your TSH within the optimal range? Also, did you have T4 and T3 looked at? Are those within the optimal ranges? 

If the answer is no to these questions, you definitely can have hypothyroid symptoms. 

What are the foods I should avoid? 

I would refer you to my book The Hyperthyroid Healing Diet. Again, if you have Hashimoto’s, I have a book Hashimoto’s Triggers, which isn’t related to diet specifically, but it talks about diet. For Hashimoto’s, I am recommending the AIP diet, which in my book, is called level 3. It’s like a modified AIP diet. 

Either way, I would definitely refer to the book. I have lists where I talk about the foods that you should avoid. 

I think I’m going to stop here. Next week’s episode will be an interview with Justin Harris. The following week will be part two of this Q&A episode. Definitely tune in. Look forward to catching you then.

In this episode, I’m joined by Dr. Scott Sherr to explain why energy dysfunction is so common in chronic illness, and how methylene blue is being used clinically to support mitochondrial function, oxidative stress balance, and detoxification. I also explain why this topic is especially relevant for people with thyroid and autoimmune conditions, based on what I see regularly in practice. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with Dr. Scott Sherr. We are going to be talking about a few different things, probably more of an emphasis on methylene blue, but also talking about GABA, maybe a little bit about hyperbaric oxygen. He has a great deal of knowledge. Really excited for this.

Let me dive into his impressive bio here: Dr. Scott Sherr is a board-certified internal medicine physician, certified to practice health optimization medicine and hyperbaric oxygen therapy (HBOT) specialist. His clinical practice is built on health optimization medicine as its foundation, complemented by an integrative approach to HBOT that incorporates cutting-edge and dynamic HBOT protocols, comprehensive laboratory testing, targeted supplementation, personalized practices, synergistic technologies, and more. He is the COO of Troscriptions, VP of Health Optimization Medicine and Practice, Chief Medical Officer of OneBase Health. Thank you so much for joining us, Dr. Scott. 

Dr. Scott Sherr: 

It’s great to be here. Thanks so much for having me, Eric. 

Dr. Eric: 

You’re welcome. Like I said at the top, excited about this conversation. How did you get started? You do have a lot of knowledge, like we said. Methylene blue, the hyperbaric oxygen. How did you really start going in this direction and end up where you are right now? 

Dr. Scott: I

’ll try to give you the short story here. The short story is I grew up pretty alternatively in New York, not in Queens like you, Eric, but on Long Island, until I was 18 years old. My father was a chiropractor, so I grew up out of the box. I decided to go to medical school. This high-minded idea that I could find a way to bridge the gap between conventional or allopathic medicine and alternative medicine. There weren’t defining aspects of alternative medicine at that time. There was integrative medicine or functional medicine or those kinds of things. 

I went to medical school and really fell in love with a field called hyperbaric oxygen therapy because it had the capacity to have both the conventional side of treating people in hospitals with acute trauma and infections, but it also had the amazing capacity to help people heal from a systemic way, from things we didn’t have a lot of options for inside the medical system. Things like stroke, traumatic brain injury, and other things that were interesting to me.

About a decade after finishing my internal medicine residency, so I am an internal medicine doc. My fastest way out to figure out what I wanted to do. I developed what I would call an integrative practice around initially hyperbaric oxygen therapy. It’s still a big part of what I do. 

Over a decade, I realized it was very important that we had a much bigger idea of what would be optimal when someone is thinking about using hyperbaric therapy. It wasn’t that everybody should go into the chamber right away. Oftentimes, if you were sick or had a more complex illness or had more long-term goals, it was better to focus on foundational biology first rather than go directly into the chamber. 

This got me in trouble over the years in the hyperbaric community. I would give lectures like, “Please don’t put them in a hyperbaric chamber right now. Let’s wait 3-5 months and optimize them beforehand.”

I trained in something called health optimization medicine in 2017-2018. This became the foundation for what I do in clinical practice. I realized if you want to make energy effectively, you have to have all the machinery to be able to do that. If I am flooding the body with more oxygen, which is what happens in a chamber, then you’re basically requiring the body to have a huge amount of capacity to make energy and to deal with the waste products or end result of a lot of energy made. You don’t just get energy for free in our body. We have waste products like reactive oxygen species or ROS and free radicals and other things.

My framework foundation became this thing called health optimization medicine. I learned it from a colleague and mentor named Dr. Ted Achacoso who had decided on this framework in his own clinical practice and was in the process of creating a nonprofit organization and asked for help. I became the COO of Health Optimization Medicine and Practice (HOMe/HOPe), where we train practitioners on this framework. That became a huge part of what I do as a foundation.

As a result of that nonprofit, we also knew that along the path to optimizing your health, you need help along the way. You need people to help you most of the time. Also, it’s sometimes really important to help with energy, with focus, with sleep, with stress, as you are trying to optimize your health, which can take a while. It’s not something that happens overnight. It happens over 3-6 months or longer. If it took you 50-60 years to get to where you feel now, you can’t expect to feel tomorrow back like you did when you were in your 20s. 

Troscriptions, the company, came around, initially as an offshoot of the nonprofit, but then as its own company, to develop products that could help people right now along the path.

This is where methylene blue came around. This is where optimizing the GABA system came around. And much more than that. 

My clinical practice right now, the foundational framework is health optimization medicine, which I do with clients all over the world. Optimizing vitamins, minerals, nutrients, cofactors, etc. a little bit differently than most functional medicine looks at the root causes for illness. We are more the root cause of health perspective and looking at optimized markers when you are about 21-30 years of age. It’s a different framework. We can go into it if you have questions.

In essence, that’s a big part of what I do foundationally. I do it by telemedicine. I have the Troscriptions company that I help run that works on the product side of things. I am also still very involved in helping people on the hyperbaric oxygen therapy side, but within the confine of maybe it’s not right for you to do right now. Let’s optimize you before we start considering the chamber. 

Dr. Eric: 

You don’t recommend HBOT for everybody. When someone does get HBOT, it’s usually down the road. 

Dr. Scott: 

It really depends on the person. If there is more of an acute issue, more of an acute trauma, inflammation, low oxygen state, then HBOT may be beneficial to somebody right now, even if they are not as well optimized as they could be.

What I often say is it’s not if hyperbaric oxygen therapy will be helpful, it’s when. When will it be the most optimal for you? It might not be now; it might be later. Or it might be now depending on what’s going on. It’s very individual.

In general, if it’s more of an acute issue, with an acute inflammatory cascade, HBOT could be great for that. It might be something you want to use now, even if you don’t have all your ducks in a row, all your foundational biology figured out, or at least in the process of doing that.

The other bucket is the bigger bucket, which is the chronic medical illness and/or health optimization performance/longevity world. I even argue that in the world of longevity, which is so popular these days, we are still chasing things. HBOT is one of those things. You are chasing a tool where you are not getting your foundation in order first, so you will not benefit from using that tool, either short or long-term. If you don’t have that foundation in order primarily, or at least ongoing while you’re thinking about doing some of those other things. 

Dr. Eric: 

Makes sense. You always want to incorporate those foundations. I’m glad you mentioned that. 

Definitely want to talk about methylene blue, but I want to stay on HBOT for a minute. When I dealt with chronic Lyme in 2018, I was doing a lot of foundational stuff, but I decided to look into other methods, like I ended up doing UV light IV ozone, but the clinic I went to, which focused on Lyme and other chronic health conditions similar to Lyme, HBOT was an option given to me. 

At that point, I did more research on the IV ozone. I’m not super claustrophobic, but looking at the chamber, I was like, I don’t know if I could be in there for an hour and a half. 

For conditions like Lyme, bartonella, chronic health conditions, how does HBOT help? How would that potentially have helped with my Lyme condition, or someone else who is listening to this who might be dealing with chronic Lyme or some other chronic infection? 

Dr. Scott: 

I first learned about HBOT and how to practice it from a nurse in my clinic in San Francisco, where I was at the time, who had chronic Lyme. A lot of chronic Lyme and chronic coinfection patients would come in. 

What I found out very early, and this is alluding to what I said so far, is if you used HBOT in somebody who was very sick, they would not often do well in a hyperbaric chamber. Their system was so inflamed, so toxic already, and had so much infection. If they didn’t have the machinery to support them throughout the process.

Over the years, I had gotten to a point where people need to be about 50-70% better already before even considering HBOT. That is so they have a more foundational biology that can tolerate and leverage going into a hyperbaric chamber. 

With Lyme as an example, what happens is that Lyme, which is called a facultative anaerobe bug, which means that it does not like high oxygen conditions. If you flood the body with a lot more oxygen, especially deeper pressures in the chamber, you will flood the body with more stress on the Lyme bugs, which will kill them off. You will get more Lyme inflammation when the Lyme dies. There is all the inflammation associated with that. Can you actually get rid of the Lyme? Do you have the detox pathway capacity? Are you pooping every day? All these things.

I found that almost all the Lyme patients I’ve worked with over the years, I will highly recommend they work with a Lyme-literate physician at the same time. If they don’t, and they just use HBOT on its own with Lyme, I don’t typically recommend that. 

There is an anti-infective capacity for HBOT, which we can use it for. I have in the past. You have to be mindful of what’s going on physiologically, that it will either tolerate killing a whole bunch of bugs, or it won’t.

When you have a chronic complex medical illness, like chronic Lyme, EBV, or mold, you have long COVID, etc., if there is an infection component, HBOT might be able to address that, even from a viral perspective, there is some evidence that HBOT can improve immune system function as well. There is a capacity there as well to potentially have anti-inflammatory, immune system activation, antimicrobial aspect. 

It also has to be thought about in the ecosystem of how well the body and the person is going to be able to tolerate these kinds of exposures. Typically, you have to go to deeper pressures to see that kind of benefit. A lot of Lyme patients, chronically inflamed patients don’t typically tolerate very deep pressures, at least initially, because they don’t have the capacity to use that oxygen and detox from the energy they make and also use that oxygen to kill bugs and detox from the bugs they are killing. That’s why over the years I have gotten to the point where being 60-70% better is likely a better starting point for HBOT. 

The other thing I would see is people maybe slightly getting better over time using a hyperbaric program for Lyme, even if they were super sick. I remember even the nurse I worked with, she told me about the first time she did a hyperbaric program. She was going in every day in a wheelchair. They had to wheel her out because she couldn’t even walk. She did better for a little while after finishing her program, but then she got worse again. 

This is common if you don’t have enough support throughout the process if you are not 60-70% better already. This is why having a foundation is so important, and having the right doctors to work with who really know how to help you in a foundational way, whether you’re coming from a health perspective or complex medical perspective.

Dr. Eric: 

Makes sense. Methylene blue also has antimicrobial properties from what I understand. Let’s transition to methylene blue. For those who are unfamiliar with it, what is it? 

Dr. Scott: 

We got interested in methylene blue because we were looking for ways to support mitochondrial function very quickly in people who had significant mitochondrial dysfunction. The spectrum is wide. We have about 94% of adults who have some element of mitochondrial dysfunction. 

The mitochondria, for those who don’t know that part, is the part of our cells that make energy. We used to think that if you took biology class in 7th and 8th grade, like my kids just did, you actually see a cell that has one mitochondria in it. We have some cells that have thousands of mitochondria, and we have some cells that have very few. The cells that have the most mitochondria are ovaries and sperm. Fertility is a big lever that mitochondria either will help with or not. Brain, heart, liver, musculoskeletal tissue as well. 

Keeping that all in mind, as I start talking about methylene blue here. 

The thing about methylene blue, to give a little bit of a history, is it’s been around for over 120 years now as a compound. It started as a textile dye back in the 1870s. There are very few antimicrobials around at that time. If you got an infection, there was very little you could do, except hopefully the body walls it off, and you survive. This is one of the reasons why mortality rates and the age we live is much lower compared to now. 

The first indication of methylene blue was it treated malaria. That’s why it got a lot of interest in 1897 and became the first drug registered with our nascent FDA at that time. It got a name called the Magic Bullet as well, which was interesting. The reason why they called it that is you could give very high doses of methylene blue, around 3mg/kg or higher. You would be able to see significant killing of microorganisms or bacteria, fungi, and viruses because you wouldn’t see the killing or harming of the human host. That was something that was very difficult to find. It still is now actually. It was very unusual at the time. 

Between 1897-1950, it was one of the major antimicrobials around. It was used for UTIs. It was used for fungal infections. If you were a WWII soldier, and you were getting shipped off to the Pacific part of the war, you were taking methylene blue prophylactically as something that would prevent you from getting fungal infections from the jungles and islands in the Pacific. There were songs about taking methylene blue at the time because it concentrates in the urine. The higher the dose you take, the more blue your urine would be. They talked about “being blue in the loo,” the loo being the bathroom. 

That was the original chapter of methylene blue being an antimicrobial. When penicillin and other antimicrobials came around in the 1950s, methylene blue became less in favor. They were using more of the antibiotics, as many of you know now, like penicillin and derived drugs.

Fast forward 80 years. A lot of the drugs we use are now resistant because the bugs have created resistant patterns to antibiotics over the years. Methylene blue is coming back a little bit because of this mechanism of action, which we can talk about if you have interest.

The next chapter of methylene blue was the first antipsychotics were derived from it back in the 1950s and 1960s because it has a capacity of what’s called the monoamine oxidase inhibition, which just means it increases norepinephrine, serotonin, and dopamine in a dose-dependent way. The first antipsychotics were derived from methylene blue.

If you were in chemistry class, methylene blue has been used for a long time as a chemical stain of cells. Interestingly, it concentrates in the mitochondria of the cell. That’s where things get interesting. 

There are two medical indications for using methylene blue. If you have a condition called methemoglobinemia, which is when your red blood cells cannot carry oxygen very well, what methylene blue can do is facilitate the carrying of oxygen by those red blood cells. 

If you get poisoned by cyanide, which I don’t recommend, cyanide destroys your mitochondria. Methylene blue can rescue in that case and prevent you from dying if you get poisoned with cyanide if you get it soon enough.

It’s also used in medical marking as well because of the fantastically blue color it is.

In essence, that’s a long way of saying it has a lot of history. It’s been around a long time. Where we’re really focused on using it primarily now is with mitochondrial function. Over the last several decades, there have been a number of researchers who have looked at methylene blue as a mitochondrial support because it has this capacity to compensate for mitochondrial dysfunction, which I said earlier. 

94% of US adults have, from insulin resistance or toxins in our environment or stress in our lives, stressful relationships, stress partners, stressful jobs, even stress from trauma in our childhood we haven’t dealt with, along with medications and infections and things like COVID, medications like metformin or PPIs, we have a lot of insults going on in our mitochondria all the time. 

What’s really interesting about methylene blue is it works both on helping you make more energy in the mitochondria as well as the detoxification side. It’s called a redox cycler, which means it has the capacity to do both, energy production and detoxification. That’s extremely rare. Most compounds either help you make more energy or detox, like antioxidants. There are very few that do both. 

Dr. Eric: 

Go a little bit deeper in how it’s supporting detoxification? 

Dr. Scott: 

Methylene blue can work directly as an antioxidant. When you make ATP, which is our energy currency, which by the way we make just about 150 pounds of ATP every single day, making energy is not free. It’s like gasoline fumes or burning gasoline in your car. You obviously can run your engine with gas, but there is exhaust. 

We have exhaust in our cells. One of the reasons why we age is mitochondria are making so much energy for such a long period of time, and there are these exhaust products that are being made at all times when we have energy production. We make carbon dioxide and water every time we make energy. 

We also make reactive oxygen species. These are free radicals, unpaired electrons that are in our mitochondria and are important. They give the mitochondria a sense of their capacity, their need to make more energy, slow down, speed up, etc. 

What’s required actually is you need to have a balanced neutralization of that reactive oxygen stress with antioxidants. These are things like Vitamin C or glutathione or melatonin, which is a very powerful antioxidant in the mitochondria. The body is always trying to balance this energy production with this capacity to neutralize the stress that is happening from energy production.

What methylene blue can do at low doses, even 4, 8, 12mg, is work directly like an antioxidant in the mitochondria, picking up these free radicals and neutralizing them. 

Fun fact: When methylene blue does this, it turns its color from blue to colorless. 

In addition to working directly as a free radical scavenger in the mitochondria as well as the cytosol as well, at higher doses, around 1mg/kg or so, you start getting the upregulation of the pathway called the Nrf2 pathway. This particular pathway increases your production of an antioxidant called glutathione, which is also known as our master antioxidant. 

It does this in a very interesting way actually. It creates the production of hydrogen peroxide at these higher doses. People know you can buy HPO, but our cells make HPO. This is how they kill bugs. This is how they kill errant cells that are potentially precancerous. HPO is a very important mechanism as to how our body and cells specifically regulate themselves. 

What methylene blue does at these high doses, around 1mg/kg, which is around 50-70mg for most humans, although maybe that’s slightly increasing now because of obesity. In essence, that dosing is antimicrobial. It also is antioxidant-producing if you have the capacity to actually make antioxidants in the first place. That’s what it comes down to with methylene blue. 

Often, you want to start off at low doses and make sure someone tolerates it before going too high. If you do go higher, you might get more of a need for antioxidants, and you potentially don’t have the capacity to make them.

Dr. Eric: 

Thanks for the comprehensive explanation. I know in phase one detoxification, you get those reactive intermediates. It sounds like methylene blue can be helpful acting as an antioxidant to reduce those reactive intermediates and possibly also play a role in phase two detox as well. 

As far as the antimicrobial properties, maybe you could confirm or clarify. It’s not really killing. Its antimicrobial properties are through its antioxidant properties? 

Dr. Scott: 

It’s through its production of hydrogen peroxide. Higher doses of methylene blue create stress on bugs. One of the major antimicrobial mechanisms that we use in a cell is by releasing hydrogen peroxide to kill organisms that shouldn’t be there. Methylene blue enhances that process. It doesn’t have a direct killing effect itself. 

What you can do is make it more anti-infective by adding in red light therapy. High intensity red light at around 680nm or so combined with high amounts of methylene blue, 15mg or above typically, becomes even more anti-infective. Not only do you make hydrogen peroxide, but you actually make what are called free electron O1s. You actually make OH radicals, too. Those are much more oxidative stressful than just hydrogen peroxide.

When you’re making more oxidative molecules, you’re putting more stress on the system. What the body does there as a result is it tries to upregulate pathways that increase antioxidant production. Unfortunately, if you have a chronic complex medical illness, you may not be able to do that easily. 

There are some interesting studies looking at high intensity red light laser along with methylene blue. Really significant studies looking at COVID for example and how you can create more stress on the COVID virus as a result of combining these things together. I use that in clinical practice definitely as an antimicrobial. 

You can use it from an acute perspective. You have an acute infection. You can use higher doses of methylene blue, sometimes up to 2mg/kg, for 5-7 days, depending on the person, and wean them down, along with red light. Methylene blue in these cases can act as a photosynthesizer. You can use that red light in combination.

What’s also interesting is low doses of methylene blue, around 25 or 37.5mg or so, combined with lower intensity red light, the combination is really supportive for mitochondrial function. It can both help enhance energy production, cycle in mitochondria electron transport chain, specifically complex 4, which is also called cytochrome oxidase. Methylene blue can donate electrons directly to that. So can red light. You have that combination be very effective. You obviously can do this with red light panels or by doing it out in the sun. The sun has red light in it as well as other spectrums. 

I combine methylene blue with red light a lot. Typically, it’s lower doses of methylene blue and lower intensity red light. The combination is more supportive for mitochondrial function. The higher doses of methylene blue plus more intense lasers of red light are fantastically anti-infective.

If you want to get fancy, I have done all three. Using methylene blue, then having some red light exposure, then getting into a hyperbaric oxygen chamber. We were using that early in COVID, people going from positive to negative tests in three days and feeling fantastic compared to how they did three days earlier.

To bring that together from an anti-infective perspective, you can have a combination of things. In my world, that became a very important way of looking at how we can help people during the pandemic. 

Dr. Eric: 

For acute infections, you said 2mg/kg of body weight? 

Dr. Scott: 

Typically for an acute infection, I would use higher doses, up to 2mg/kg, for 3-5 days, and then wean them down from there. 

If it’s a more chronic infection, like chronic Lyme, mold, long COVID with potential protein spike replication, they typically respond to 1mg/kg. What you want to do with the chronic people is start them at a lower dose. Every 3-5 days, increase the dose. 

I start the dose at 4, 8, 12.5mg, and increase it every 3-5 days until they get a response. The first response will probably be more of a mitochondrial response. From there, do you want to keep going up? What other therapies are you doing alongside using methylene blue? 

For bartonella, for example, a lot of colleagues use around 15mg twice daily for a period of time. Bartonella also has biofilms that tend to build up. Methylene blue can break up biofilms at these higher doses in the gut, the bladder. There is some evidence clinically that it can help with this condition called intestinal interstices, which is a pretty painful condition of the bladder. Most people are told this is just all in their head. Often, there is a biofilm that is protecting various sets of bacteria and maybe fungi as well from being treated by antimicrobials. Nothing can be used in conjunction for a treatment program for those kinds of things. 

Dosing ranges from 1-2mg for infection. On the higher level, it’s given for a shorter period of time. The lower end of that range, 1mg/kg, you can use that for a relatively long period of time if needed while trying to optimize the infection and get rid of it in other ways, too. 

Dr. Eric: 

A regular UTI, what typically is the recommendation for dosing and duration? 

Dr. Scott: 

At this point, we can’t recommend you take methylene blue instead of an antimicrobial for a UTI. In my clinical practice, what we’ll typically do is if someone has a UTI, which are gram negative bacteria usually, they are more sensitive to being killed by methylene blue, which is good.

For compliant patients, I’ll give them 2mg/kg of methylene blue for about three days. From there, if their symptoms are resolving at that point, we will potentially continue for another 2-3 days. We may start weaning it down the third day. I will usually recommend it being used in conjunction with antimicrobials as a way to support the process and maybe shorten the course you need from an antimicrobial perspective. 

Most of the regimens for acute illness are about 5-7 days. Between 1-2mg per kg. If they are more severe, higher end of the range. If they are less severe, lower end of the range. An acute viral infection that you get coming off an airplane or something like that, that would be more like 1mg/kg for 5-7 days. If you have a UTI or COVID or a more significant infection. 

Dr. Eric: 

Sticking with the UTI, have you tried combining that with the D-mannose, or do you still need an antimicrobial along with that as well? 

Dr. Scott:

I found in my compliant patients, they can get away with just using methylene blue. We are using D-mannose, a common one. Cranberry and hydration and other things. 

Where I have found it shine as well is you can use lower doses of methylene blue prophylactically to prevent recurrent UTIs in those who are more subject or have more of a predilection for those potentially. 

Typically, I have seen 4-8mg every other day in patients with chronic UTIs. I have had some good clinical success using it that way as a preventative. 

It’s not the only thing I’m doing. We talked about D-mannose. We talked about cranberry. Vagina estrogen, if it’s a female who is peri or menopausal. There are other things we can do. I have seen a significant lever and something very easy to do three days a week as a way to help with prevention as well.

Dr. Eric: 

Some expressed concern with it affecting the good microbes, kind of like oregano oil. Everything comes down to risks versus benefits. I also assume the dosage matters, too, when it comes to potentially- Or maybe it doesn’t. 

Dr. Scott: 

No, it does. You’re right. It’s a dose dependent kind of thing. Once you get around to that mg/kg, it becomes more anti-infective. If you’re at a lower dose, 4-8-12-16mg of methylene blue, no major indication from the last five years I have been working with it that it has any detrimental effect on the gut microbiome itself. 

Now, the higher doses, as you mentioned, it’s a risk versus benefit ratio. What I would typically do is use it for a short period of time at these higher doses, if at all possible. If you have a chronic infection, where it might be helpful to be on it for a longer period of time, you have to consider that and have that, as a practitioner, be something you’re considering, that you may be decreasing commensal organisms, like the normal bacteria in your gut, over time. That may be okay if you are trying to address the biofilm that has been difficult to address in other ways. 

I’m not a big fan of ever using antimicrobials, even methylene blue, at higher doses although I feel like it’s less of a nuclear bomb than using penicillin or sipro or urimax or whatever. Those are much more nuclear bombs, at least in clinical practice, that I have seen. 

The reason for that is it also has some mitochondrial support aspects and antioxidant upregulation. It’s not like just giving an antibiotic and calling it Hiroshima and having to completely rebuild the gut from there. Sometimes, that’s necessary. That’s totally okay. We now know there are various strategies that can be helpful in that capacity.

What it comes down to is a risk versus benefit ratio for using higher doses in a shorter period of time in practice. Most of my colleagues who use methylene blue regularly are mostly using it for mitochondrial support. 94% of adults have a need for this in the U.S. This is energy deficit, brain fog, concentration problems, mental health disorders, exercise-induced fatigue, infertility. So many things that the common denominator is mitochondrial dysfunction.

Start out at 4, 8, 12.5mg, a low dose of methylene blue, and slowly titrate that dose until you start feeling better. Every 3-5 days, increasing the dose.

A good example is a lady I spoke to a couple of years ago. She always rings very true in my mind. A physical therapist who had mold exposure. She’d done a lot of great work getting the mold remediated both internally and externally in her home. The mold was gone in her house. The mold wasn’t showing any issues in her blood or urine, but she still felt terrible. Why did she feel so terrible? She had mitochondrial dysfunction, trashed mitochondria from all the years of having those exposures. Even if the mold was gone. 

All she did was 4mg of methylene blue. In five or seven days, she thinks she felt pretty good. She increased it to 8mg, and she felt amazing. She was back to work a week after that. She just needed to have that mitochondrial support along the way, especially now that everything else had been resolved.

I’ve seen this time and time again. They are really doing the hard work of dealing with the Lyme, mold, or infections. They still feel terrible. Often, this is because they have significant mitochondrial dysfunction because of those infections, toxins, and stress. 

If you could start at these lower doses and then increase the dose, the good thing about methylene blue is you don’t need to wait for it to build up in your system for 30 days or two months to see a difference. Once you find the right dose, you know you’ve found the right dose, and you stay on that dose. It depends on why you’re taking it as to how long you take it and how frequently you take it from there.

Coming from a pretty sick place, you might need to take methylene blue seven days a week for a period of a month or two months or longer until you can start weaning it down. Hopefully, you can optimize it in other areas of your life. Hopefully, methylene blue has helped you do that because you now have more energy and detox capacity. You can take that walk around the block. You can do that dietary shift you have been trying to do for a while. 

In other nations’ populations, you’re just using methylene blue even shorter than that for a small amount of support as they do something more stressful or because they have something ongoing that is requiring more support, like they are traveling more for example.

The cool thing about methylene blue is it can work just like oxygen in your cells. If you have less oxygen around, it can work like the oxygen that isn’t there to help you maintain energy capacity for longer as well. 

That’s why it’s great for flying on airplanes for example. Everyone who flies is going to be hypoxic. You’re instantly from sea level, where you are probably at in the moment, then going on an airplane and being pressurized at 8,000 feet, which is 16% oxygen compared to 21%. Another example of how you can use methylene blue more short-term in those examples.

Dr. Eric: 

Because my audience consists of those with thyroid and autoimmune thyroid conditions, could you tie it into thyroid health? Some of the things you mentioned like oxidative stress is a factor when it comes to all autoimmune conditions. Methylene blue can help in that respect. Of course, infections can be a factor with certain autoimmune conditions. Is there anything else showing direct correlation or relationship between methylene blue and thyroid autoimmunity? Any other way methylene blue can potentially help? 

Dr. Scott: 

You’re correct. There are no direct studies looking at methylene blue and thyroid function. However, we have had a good amount of experience over the past five years talking to people who have been having the challenges of thyroid issues for many years, Hashimoto’s and otherwise. 

What it seems to be is the inflammatory component is a big one. If you can decrease inflammation in the system by helping the thyroid and mitochondria neutralize oxidative stress and decrease inflammation, that’s a big deal. That goes across the board for a lot of thyroid conditions at this point.

In addition, what I hear a lot from patients who have thyroid conditions is they feel like they get more energy. That is seeming to correlate with a need for potentially less thyroid medication and also potentially even thyroid antibodies that are going down associated with taking methylene blue.

I’m not making any claims here specifically. Don’t want anybody to stop their medications or change anything without talking to their practitioner. It’s happened enough where people have reached out and said, “I started methylene blue, and I need less of what I was using before because I feel better, and my numbers look better.” It’s a metabolic support in the sense that it’s helping with energy production. 

We didn’t get into the major details here. There are some cool ones. When your mitochondria aren’t working very well, you have these complex mitochondria called protein complexes. Typically, the first two are the ones that are dysfunctional. Those are the two that are most important to help you take energy from the food we eat and bring it to the mitochondria, so we can make our energy currency called ATP. 

What methylene blue can do is it can compensate for dysfunction in any of those complexes, especially 1 and 2. It’s almost like a switch for a lot of people. Especially with autoimmune/inflammatory conditions, once you get enough of that methylene support and play, you can bypass those complexes if you need to and make the electron flow go further down the chain into a place where you can still make energy more effectively. 

You’ve taken those off the table for now. They’re not as involved in the cascade of making energy or the inflammatory result of not being able to make energy effectively. 

You have this really cool combination with methylene blue, this energy enhancement capacity and the detox capacity. That’s the other reason why it’s supportive in a lot of complex medical conditions. It’s not just making more energy. If I can bypass a couple complexes and give you more energy, but you still don’t have the capacity to address the detoxification that is required for making more energy, you will feel worse. 

When you drink caffeine, you get a headache or crash afterwards. You have some nicotine, which is becoming more interesting in the world of thyroid as an anti-inflammatory, something that can help with autoimmune conditions, maybe as a cognitive enhancer as well. Even nicotine is increasing energy production without the additional support of detoxification. 

Methylene blue has that redox side, which is energy and detox at the same time. That’s also why I’ve seen it so clinically effective for patients who have fatigue related to autoimmune inflammatory conditions. We’re not just giving more energy; we’re giving the detox at the same time.

Dr. Eric: 

Are there any contraindications for methylene blue? Anyone who shouldn’t take it? Second question is what differentiates Troscription’s methylene blue from others out there? 

Dr. Scott: 

When it comes to contraindications or reasons why you should not take methylene blue, the first two are unfortunately common across lots of different pharmaceuticals or supplements, which is if you’re pregnant or breastfeeding, please don’t take methylene blue. There is some indication, especially in later trimesters, that there may be a problem. Earlier, there doesn’t seem to be an issue. If you’re pregnant or breastfeeding, just be careful.

The other thing to talk about here is something called serotonin syndrome and another thing called G6PD deficiency. Serotonin is a neurotransmitter. Many of you know that, I’m sure. 

Serotonin is something that is thought to help us regulate our mood. For many years, we used to think people with depression had serotonin deficiency. Doctors were told that your patients with serotonin deficient, give them serotonergic reuptake inhibitors, so these are antidepressants, to make them feel better. 

We now know that serotonin deficiency is not any more common in depressed people as it is in non-depressed people. Fun fact. Many people are on these drugs, SSRIs, SNRIs, and they can be very helpful. I don’t want to say they can’t be helpful because they can.

These drugs increase the amount of serotonin in the synapse in the brain. Methylene blue also increases metaserotonin along with norepinephrine and dopamine. If you’re combining methylene blue with SSRIs and SNRIs, there could potentially be an interaction here. The potential interaction for very low doses of methylene blue, 4, 8, 16mg, the only study that showed the potential interaction could be very severe is using IV methylene blue with SNRIs, causing something called serotonin syndrome. This is where you can get what’s called hemodynamic instability, where your blood pressure can go up and down, and your heart rate, too. It has never been described with oral methylene blue and SSRIs. 

That being said, if you are on any of those medications, you should not take methylene blue without practitioner supervision. 

The most common symptom we see is GI distress. You make more serotonin in your gut than your brain. 95% of those hormones are made in your gut.

The other thing is G6PD deficiency. G6PD is an inherited disorder of red blood cells, where they have a higher risk of breaking under stress. IV methylene blue combined with this particular genetic condition can cause what’s called a hemolytic anemia, where your red blood cells start breaking up. It’s never been described with oral methylene blue. If you’re worried about this, you can always get a genetic test. 

In general, low doses of methylene blue, especially the ones at our company, are extremely safe. We do have a practitioner-only version that is slightly higher dosed. If you are taking that for a longer period of time, consider getting the test done.

Those are two major things that people talk about. The other one to discuss is hypertension. If you have high blood pressure, methylene blue can potentially increase your blood pressure. If you are pre-hypertensive, so you’re not taking meds, but your blood pressure runs kind of high, you can do it as well. That’s because of the norepinephrine that is in there. You have to be aware of that. 

If you are on hypertensive medications, or really any medications, you should be working with a provider closely before starting anything new, supplement or otherwise. Sometimes, people have interactions that you don’t know about. Certainly, high blood pressure medications would be a red flag to take methylene blue without practitioner supervision.

There is also blue urine. Methylene blue concentrates in the bladder itself as it’s being excreted. It’s excreted by the kidneys and bladder. You will have blue urine. 

If you have CKD, you have to be careful taking methylene blue as well because it can build up in the body.

If you’re on dialysis, you shouldn’t take methylene blue because it won’t get excreted through a dialysis machine.

There is this category I call detox symptoms. It’s not uncommon, especially if you start with a too high dose of methylene blue to get more detox symptoms. Your headaches, muscle pain, abdominal comfort, bone pain, joint pain. 

You can get a detox reaction if you start too high of a dose. You’re making that hydrogen peroxide that you talked about before. You may not have enough antioxidants to support that system. Almost always, unless it’s an acute trauma, issue, low oxygen state- 

There are some studies in strokes with animals, where methylene blue can be helpful, along with acute infection. That is where you would want to start off with a higher dose immediately. 

In general, you want to start off at a lower dose, 4-12.5mg, somewhere around there, and then increase your dose slowly over time until you find the right dose for you. You’re addressing the issue you’re looking to address.

Those are the major things to consider when taking methylene blue. 

The other one, which dovetails into your second question, which is quality of methylene blue. That is the biggest additional one. Methylene blue is not made from the ground; it’s made in a lab. One of the naysayers of methylene blue is it’s a synthetic compound. My response to that is that not everything synthetic is bad for us. We live in a synthetic world, under synthetic lights, food, people, like AI bots. We have a lot of synthetic things in our life right now. Sometimes, we need synthetic things to help us, and methylene blue is one of these things. 

If it’s dosed appropriately and clean. In the sense that methylene blue made in a lab can be contaminated with lead, mercury, cadmium, and arsenic. You don’t want those. 

In 2020, Troscriptions was the first company to come out with a commercial methylene blue product. We came out with two, one in February and one in June. The first year of the pandemic. We took about a year and a half longer to launch the company because it took us that long to find a reliable source that wasn’t contaminated with heavy metals, that had the right purity and potency that we were looking for.

Until 2024, there was about 6-8 companies that were making methylene blue. 2025, it was extremely ramped up in popularity because of a number of things. The zeitgeist, everyone was talking about it. There are now 60 companies. 

We have tested them. The liquids cause the big issues because liquids of methylene blue never meet the potency standards. If it says it’s 1mg/ml or 1mg/drop in your liquid methylene blue, the average that we’ve found is between 60-80% potency of what they say. They are getting much less than you think. Sometimes, they are down to 45-50% potency. Even some of the capsules we tested are down at that level.

Then you have to think about the heavy metal component. The heavy metals being cadmium, mercury, lead, and arsenic. You have to be careful what you’re buying out there.

The bigger issue here, and this is more from a supplement at large issue, is most companies, including us, are getting ingredients from outside the United States. Methylene blue we get is coming from Korea and Japan mostly. Also China. 

What these manufacturers do is they are supposed to give you a certificate of analysis with the ingredient. This is supposedly an “independent” review of their ingredients, saying this is exactly what is made in the lab. 

The problem is you can’t trust those certificates of analysis. They can be completely forged. There was a recent scandal on creatine gummies with this thing. Or they can be completely wrong. You test it yourself, which is what we do with all our ingredients, including methylene blue. You find it doesn’t meet the same standards as they said it met when it came from their lab. That’s why we retest everything that comes into the United States independently, to make sure it meets our criteria. 

You have to be careful what you get. A lot of these companies are trusting those ingredient certificates of analysis. Some of them might be saying they are made in the USA. I had someone reach out to me who said, “I bought liquid methylene blue that says it was made in the USA, but it took three weeks to get through customs.” 

What we do at Troscriptions is we have really trusted manufacturers. We do our own independent testing. After we make our Troches, which is the lozenge delivery mechanism, we test them all again to make sure it still meets our purity and potency standards. Only then does it go out to be sold. You will find very few other companies doing that kind of quality control. 

Dr. Eric: 

Wonderful. Troscriptions also has GABA support supplements. It was a long time ago that I learned from- are you familiar with Dr. Datis Kharrazian? He has a book on Hashimoto’s, and he mentioned the GABA Challenge. If you take a regular GABA supplement, if you notice anything different, you probably have a leaky blood/brain barrier. That is the first time I heard of that. Then I was listening to one of your interviews, and you were talking about something similar as well. If you could talk about what Troscriptions offers as far as GABA support, that would be great. 

Dr. Scott: 

How long ago was he talking about that? Out of interest. 

Dr. Eric: 

I think his book was 2016. It might have been before that. I think that’s when his book was published. 

Dr. Scott: 

It’s interesting because we have this blood-brain barrier that is supposed to keep things out. GABA is too big of a molecule to get across under normal circumstances. However, if you have a leaky brain allowing things in that are not supposed to be in there, GABA can get across and make you feel relaxed. 

Typically, what this corresponds to is a leaky gut. Optimizing your gut will optimize the blood-brain barrier and make that less leaky as well. 

GABA is a really interesting compound, neurotransmitter. GABA is our primary inhibitory neurotransmitter in our brain. It’s the brakes of your brain. We have a lot of on switches. Our main on switch is glutamate, our primary excitatory neurotransmitter. Your main off switch is your GABA system. 

Interestingly enough, glutamate is converted into GABA in the brain. It requires Vitamin B6 and magnesium to do that. These two are always supposed to be in this beautiful balance. You have enough glutamate and GABA working together. They are helping regulate your nervous system, so they go up when you’re up and down when you’re down.

Unfortunately, so many of us are stuck in what I call this sympathetic spiral of doom at all times. This sympathetic activation, our fight or flight system is on all the time. We don’t know how to relax. We are constantly anxious. We have depression. We can’t sleep. 

A big part of this is we have become GABA deficient. Our system stops working well, and we don’t have any brakes to press. That truck that has to go down the hill, we don’t have a place to turn off. The brakes are gone. GABA deficiency is associated with anxiety, depression, insomnia. 

Our mind is having a hard time calming down because it also regulates our thought patterns. We typically on average have about 70,000 thoughts every single day. That is just average. If you have anxiety or depression, you have upwards of 120,000 thoughts every single day. We’re not saying these are unique thoughts, but these could be perseverating thoughts about something you’re anxious or depressed about.

What you want to do is think about the GABA system in its totality and see how you can optimize it from the ground up. This is what I do in my health optimization medicine practice, looking at gut health, vitamins, minerals, nutrients, and precursors, like glutamine for example, which is an amino acid that is the primary fuel of the small intestine. If you have a leaky gut, you need more of it. It’s also the precursor to glutamate in the brain. You want to think about that.

You also want to think about probiotics. Certain types of bacteria in our gut help signal our GABA system and make it work better.

Your cofactors, things like magnesium and B6. 

This is important. That’s a long-term play though. That takes time. The other long-term play is how can you understand why somebody is stuck in this fight or flight mode? Is it because they’re married to someone who they don’t like? Do they have a poor relationship with their kids? Did they have trauma as a child? Are they stressed at work? You have to address this stuff to get the brain to start working again. You can give the experience to someone to what it feels like to have those brakes back and be available again by modulating the GABA in a way that doesn’t require you to give GABA itself. 

Fun fact. I have worked with patients over the years where GABA supplements are working for them. We optimize their gut, and their GABA supplements stop working because they no longer can get GABA to the brain. This is clinically very useful for all who are listening to think about this.

What you really want to do is work on all the stuff that takes a harder, longer amount of time. Optimize nutrients, cofactors, gut health, and stress. What we did at Troscriptions is create some products that can help you modulate the GABA system in a much more holistic way without giving GABA itself. Things that modulate the GABA receptor and enhance the GABA receptor. 

We combine locations of where things bind on the receptor together. The combination is really great because it helps support the GABA system right now without depleting more GABA. If you are drinking alcohol, taking benzos, using sleep drugs, these are enhancing the amount of GABA to bind the receptor. If you don’t have a lot of GABA around, you will become more GABA deficient than you were before, and this is also why you have a higher risk of tolerance withdrawal and dependence on those drugs.

In Tro Calm, for example, we use a combination of B3 GABA and cava together. B3 GABA gets across the blood-brain barrier because GABA is attached to B3. B3 is mildly activating, whereas GABA is relaxing, binding to where GABA would bind. Cava comes in and binds to a separate site on the GABA receptor, enhancing the amount of GABA to bind.

In addition, we have CBD and CBG, nonpsychoactive cannabinoids. You can take the Tro Calm and get an anxiolytic, relaxing effect without feeling too tired as well. This is a great combination to support the GABA system. If you are just using cava, you deplete GABA over time because it’s not giving something that is supporting where GABA would bind as well. We use that combination effectively. 

It’s in a troche form. You dissolve a lozenge. It goes between your upper cheek and gum. They are scored. You can take a quarter, half, or full. These lozenges go directly into circulation. These ingredients are more potent because they don’t go through digestion. You can titrate them, too. You can take the dose that works well for you.

We have another combination in our sleep product called Tro Z, which includes something called agaric, which is from amanita muscaria mushroom derivation. It’s a psychedelic mushroom, but this is not a psychedelic compound. At low doses, it binds directly to where GABA would bind.

We also have something called honokiol, from magnolia bark. That combination is great for working on the GABA system in a holistic way. As I mentioned earlier, like Tro Calm does, Tro Z also has things like melatonin, 5HTP, some CBD, CBN, both nonpsychoactive, something called cordycepin, which is from the cortices mushrooms, also increasing deep sleep. It’s a comprehensive formula.

In essence, we are focused on breaking that sympathetic spiral, getting people that GABA urgent tone now, so they can feel like this is what it feels like when my nervous system is more regulated.

From there, hoping they can get back there over time, using the more physiologic and psychological support that is often required to do it more long term. 

Dr. Eric: 

If someone is stuck in that fight or flight response, that is one indication to taking GABA support. 

Dr. Scott: 

If you have a lot of anxiety or depression, we know now there is a new drug that was just released last year, potentially the year before. It was the first antidepressant that works instantly for postpartum depression. It’s a GABA-A agonist. The GABA-A one is the most prominent receptor. It works immediately because it’s working on that GABA system.

Just to be clear, if you have overactivation, depression, issues with sleep, GABA things will likely be helpful for you. Not to say you should stop your medications or do anything you shouldn’t be running by your doctor first. This GABA system is such an underappreciated aspect of why people are having such a hard time now, especially with that sympathetic activation, that synthetic spiral that so many people are going through.  

Dr. Eric: 

One more quick question with GABA. Do you know if liposomal GABA crosses the blood-brain barrier? 

Dr. Scott: 

The only company that I’m familiar with that has a liposomal GABA that has been shown to cross into the brain is QuickSilver Scientific. Otherwise, I would be staying away from it. Even if they say it’s liposomal, I wouldn’t believe it with most companies. 

I do think a combination of GABA itself, whether it’s GABA directly through liposomal or B3 GABA that we have or agaric that binds to where GABA would bind, plus something like cava, CBD, CBG, that combination is really important. If you are just giving something like cava, or even honokiol, or valerian, L-theanine, lemon balm, these are also working on the GABA receptor, without actually modulating or supporting where GABA would bind, so you’re not causing GABA deficiency over time, you will get into trouble. 

You have something like cava that works for somebody. You have to keep increasing the dose for that same reason. With our products, we haven’t noticed any tolerance issue. The same dose works every single time because we’re doing it in this comprehensive way. 

We have higher strength products, too. We have a Tro+ Calm. A Tro+ Somnia, which is our practitioner line. You can get access to those by signing up on our website as a practitioner. If you are a patient or client or someone without a practitioner, we have a practitioner map on our website. You can find someone who might help you if you need higher potency kinds of things as well. 

In essence, the troche is great as a delivery device. It dissolves directly in the mouth. The natto liposomes, like the small liposomes, may also work from a GABA delivery perspective. 

Dr. Eric: 

This was awesome. Others have mentioned you’re a wealth of knowledge. I will say that here. So much great information. Where can people find out more about you, Dr. Scott? Your website, social media? Anything else you want to say? 

Dr. Scott: 

Thanks for having me, Eric. I appreciate it. I tend to take our time, whatever that time is, and use it for a lot of information. Don’t be afraid to wind back down to the beginning and go back over some of this info if you have interest.

I have lots of additional support for you in other locations and resources. Check out my personal website, DrScottSherr.com. You will find my consulting there both on hyperbaric therapy and health optimization medicine, which is the framework we were talking about in the beginning.

It’s also linked to my company. I have a company called Troscriptions. You can find it at Troscriptions.com. You can also find us on socials @Troscriptions. You can find me @DrScottSherr on Instagram. 

If you’re interested in the nonprofit, you can check it out at HomeHope.org or @HomeHopeOrg on Instagram. 

I have a hyperbaric company that specializes in hyperbaric technology and the connection of systems together, One Base Health. OneBaseHealth.com. @OneBaseHealth on Instagram. 

Those are the major places to go. Start with either my website or Troscriptions. You can check out Just Blue, our pure methylene blue troche, at 16mg. 

We have another one called Blue Cannatine, which is a combination of methylene blue, nicotine, caffeine, and CBD. That is for focus, flow, giving you that stimulant feel. Pure methylene blue doesn’t give you a stimulant feel as much; it elevates you and makes you feel more awake, more up, your brain is working better, your mood is better. From an inflammatory perspective, downregulating and helping with that inflammatory load, which can be super helpful for many reasons, especially thyroid conditions. 

Dr. Eric: 

Wonderful. I learned so much about methylene blue. This was awesome. Some things about GABA and HBOT, too. Definitely will need to have you back in the future. Thanks again. Really appreciate it, Dr. Scott. 

Dr. Scott: 

Thanks for having me.