Are you curious about how bugleweed can support thyroid health?

Compiling the most common questions I’ve received over the years, I’ll walk you through about this thyroid-related herb, particularly its role in managing hyperthyroidism. I’ll explain how bugleweed works, its potential mechanisms, and how it compares to more conventional treatments.

From understanding appropriate dosages to recognizing possible side effects, I’ll offer practical insights to help guide you in your decision-making. Whether you’re new to bugleweed or looking for more detailed information, this episode will help you make an informed choice on whether it’s right for your thyroid-healing journey.

Tune in to discover how bugleweed can support your thyroid health and its role in managing hyperthyroidism.

Click Here to listen to the episode on my podcast

Dr. Eric Osansky:

In this episode, I am going to answer questions related to the herb bugleweed. These are a combination of questions I have been asked over the years by patients as well as during my live events as well as in my Hyperthyroid Healing Facebook group and my Healing Graves’ Naturally Skool group.

How does bugleweed work?

Unlike antithyroid medication such as methimazole and PTU, it’s not as clear as to how bugleweed works although when doing research, there seems to be a few different mechanisms I have discovered.

The first is where it could bind to the TSH receptors and block the action of TSIs. In other words, it’s blocking the stimulation of the TSH receptors.

Another mechanism is it potentially can interfere with iodine uptake in the thyroid gland. This would make sense because I don’t see it work only with Graves’. That first mechanism, where it blocks the action of the TSIs, if that was the only mechanism, then it would make sense if it only worked in those with Graves’. It does seem to help in those with other hyperthyroid conditions.

A third possible mechanism is by potentially reducing the conversion of T4 into T3, which is the active form of thyroid hormone.

What dose of bugleweed should Itake?

I have a separate episode where I discuss this, “How Much Bugleweed Should I Take?” It’s been a while since I recorded that episode.

It does depend on the person. When I dealt with Graves’ back in 2008, I took 5ml, which is one teaspoon, twice per day, of a 1:2 extract ratio. Some people take this dose. Some people will take half this amount. I took it twice a day, but some people will take it more than that per day.

It really does depend. I get this question a lot. It would be similar to asking how much methimazole you should take. That also depends. When someone takes antithyroid medication, it’s not like everybody is taking 10mg of methimazole twice a day. Some people will take 20mg of methimazole twice a day. Other people will take 5mg of methimazole once a day.

The variation with bugleweed isn’t as great as with methimazole or other types of antithyroid medication. It’s not as if everybody takes the same dose of bugleweed. If someone takes a less potent extract, instead of 1:2, they take a 1:5 extract, they might need more than one teaspoon/5ml twice a day. They might need 10ml or 12.5ml a few times a day.

How many times a day should I take bugleweed?

When I took bugleweed, as I just mentioned, I took MediHerb bugleweed, which is a 1:2 extract, twice a day. Most of my patients will take it twice a day. Some people will take it three times a day. Some people might only need to take it once a day.

This is ideally why you want to work with a practitioner. It’s not that everybody needs to take bugleweed twice a day or once a day. It does depend on the person. It does depend on the thyroid hormone levels, what the thyroid panel looks like.

Should bugleweed be taken with food or on an empty stomach?

I recommend taking bugleweed away from food. I would say you could either take it first thing waking up in the morning or at night. I commonly recommend taking it 15, 20, 30 minutes before food, let’s say before breakfast and dinner. You don’t have to take it on a completely empty stomach although you can do this.

On the other hand, if you absolutely need to take it with food, let’s say you take it away from food, and it doesn’t agree with you, or you have digestive symptoms. You can take it with food. It will be a little less effective if you take it with food, but you can if you have to.

If someone is taking motherwort, which I also took when I dealt with Graves’, it’s similar. I have someone take bugleweed and motherwort at the same time usually, 15-20 minutes before breakfast and 15-20 minutes before dinner. Someone could also take it first thing in the morning if it’s more convenient or right before going to bed.

Can bugleweed be taken with other supplements?

The answer is yes, usually. I just gave an example with motherwort. Some people will take it with lemon balm. There is also L-carnitine. L-carnitine, when taken in higher doses, it depends. A more recent study showed that only 500mg of L-carnitine combined with 83mcg of selenium, could be effective in lowering thyroid hormone levels and thyroid antibodies. I actually have a separate podcast episode where I discuss this research from August 2025.

The studies prior to that show that between 2,000-4,000mg of L-carnitine can block the entry of thyroid hormone into the cell. For years, that was the dose I was recommending. Ever since this new study came out, and I had the podcast episode on it, some people might choose just to take 500mg.

Getting back to other supplements, like Vitamin D, selenium. There are so many out there. I would say to work with a practitioner. I have no problem usually having people take bugleweed with other supplements that are taken away from food. For example, something like selenium or magnesium. Magnesium, it does depend. Some people will take it before bed.

Let’s say a multivitamin. I will commonly recommend for people to take a multivitamin with food, and bugleweed at least a little bit away from food, so they wouldn’t be taken at the same time. Let’s say someone couldn’t tolerate bugleweed away from food on an empty stomach, so they took it with breakfast and dinner and took a multivitamin with breakfast and dinner, too. That seems to be fine. There does not seem to be any interactions.

There are different types of multivitamins. Some just have vitamins and minerals. Others will have other ingredients, like other herbs. Like I said, you might want to work with another practitioner to get that 1:1 guidance.

For the most part, for most supplements, not just vitamins and minerals, but usually with other herbs, usually bugleweed can be taken. There might be exceptions to be aware of.

If I’m on bugleweed, motherwort, and lemon balm, and also antithyroid medication, how do I know what to reduce and when and at what speed?

In this situation, someone is taking bugleweed, motherwort, lemon balm, and with this specific question, I am not sure if they were taking them individually but a formulation such as Thyroid Calming, which is a common formulation. Either way, they were taking the three herbs and antithyroid medication. In this case, I think it was carbimazole, which converts into methimazole.

Bugleweed, motherwort, and lemon balm are not exactly the same. Bugleweed is the main herb I recommend for its antithyroid properties. Motherwort is more like a natural beta blocker. It’s not exactly the same, but it’s not directly affecting the thyroid gland. Lemon balm might have some mild antithyroid properties, but I rely more on the bugleweed.

If someone is taking bugleweed and antithyroid medication, I would never tell someone to stop taking antithyroid medication. But if they are taking both together, usually they are doing so because they want to rely more on the bugleweed and less on the antithyroid medication.

If they are taking both, and then do a thyroid panel in the future, what you’re looking for is for the numbers to be more on the hypo side. It might not be crazy hypo. Your TSH might not be a 5, 8, or 10. Let’s say it’s even a 2 or 3, which is not considered hypo. I would say optimal TSH would be between 1-1.5.

If someone’s TSH is 2 or 3, and they are on bugleweed and methimazole, the hope is the endocrinologist, and you might have to encourage them to do this,would reduce the dose of the antithyroid medication. Then you would want to stay on the same dose of bugleweed.

I am not giving specific recommendations, but these are what I give to my patients who are on both. I would say to stay on the same dose of bugleweed. Ask your prescribing doctor to reduce the antithyroid medication.

The reason is because some people reduce both. That defeats the purpose. If the goal is to rely more on the bugleweed and less on the antithyroid medication, you don’t want to reduce the dose of bugleweed until you’re at the point where you don’t need antithyroid medication. Hopefully, that makes sense.

If you have the dose of antithyroid medication reduced and stay on the same dose of bugleweed, then let’s say, in another six weeks or so, do another thyroid panel. Similar. If the TSH is a little bit on the higher end, higher than optimal, the hope is that the prescribing doctor will reduce the dose of the antithyroid medication. You will just follow that process.

I mentioned six weeks. You could do it at four weeks or eight weeks. You probably don’t want to do it at less than four weeks in most cases or go more than a couple months.

Is bugleweed safe to take while pregnant or breastfeeding?

There is really no research showing that it’s safe to take either while pregnant or nursing. I don’t recommend bugleweed in either case. It can negatively affect milk supply potentially, so for that reason, you might not want to take it while breastfeeding. There is no evidence about how it affects the developing fetus, at least none that I’m aware of.

When I went through my herbal certification many years ago with Kerry Bone, who is a master herbalist, he is the one I learned about bugleweed from. He said that bugleweed is contraindicated in both pregnancy and during breastfeeding. He is definitely more knowledgeable than I am in herbs, so I didn’t question his research. I have done my own, too, and there is not a lot out there.

If you are pregnant or breastfeeding, you probably shouldn’t take bugleweed.

Is it possible to have a negative reaction to bugleweed?

Yes, it’s possible to have a negative reaction to any herb or supplement. On the podcast, I have an episode where a patient had a negative reaction to bugleweed. I wasn’t sure that it was the bugleweed. I didn’t catch on that it was the bugleweed.

In this case, the symptoms can vary. I don’t see a lot of people have negative reactions to bugleweed. It’s not similar to antithyroid medication, where a lot of people could have negative reactions, but it does happen. You could have rashes for example, just like with being allergic to anything.

In this situation, with the podcast episode, where I discuss the patient, she was having eye symptoms. It seemed similar to TED. I have never seen bugleweed affect the eyes like that. I didn’t think it was bugleweed, but it turned out to be bugleweed. She stopped the bugleweed, and her eye symptoms resolved. To me, it seemed obvious it was the bugleweed. I forgot how long, but it was happening for at least a few weeks.

She was taking bugleweed for a while, so that’s also why I didn’t catch on. Usually, when you have a negative reaction, most of the time, you will know pretty quickly. You won’t be on an herb or supplement for a few months and then all of a sudden have a negative reaction. Unfortunately, it is possible. Thankfully, it’s not common.

Are there any common side effects when taking bugleweed?

This is similar to the question I just answered. I wouldn’t say there are common side effects. It’s not like methimazole in that sense.

Bugleweed can have side effects, like you can have a negative reaction. I wouldn’t say side effects are common when taking bugleweed. That’s the good news. Most people who take bugleweed tolerate it well. Side effects can happen, but I wouldn’t say they’re common, where I could list off the expected symptoms. When someone takes antithyroid medication, many times, it will affect the liver enzymes, for example. I don’t see that with bugleweed. I have been recommending it to people I work with for many years, since 2009.

Is bugleweed just as effective as antithyroid medication?

In most cases, the answer is no, it’s not as effective as methimazole or PTU or carbimazole. Antithyroid medication is definitely more potent and works most of the time.

The problem with antithyroid medication is that side effects are common. With bugleweed, side effects can happen, but they’re not nearly as common.

For 75% of people who take bugleweed, it will work. That leaves about 25% of people who take bugleweed, and it doesn’t work. You need to be careful and make sure you are taking a good quality herb. The potency needs to be good. If someone is taking a 1:5 extract, and they are just taking one dropperful or two a few times a day, it’s lower potency, and they might not be getting the appropriate dose. You want to make sure the dose is appropriate, it’s potent enough, and it’s good quality.

Even in those situations, it wouldn’t be as effective as antithyroid medication. It’s probably 95% effective, maybe even 99%. Very rarely does it not work. Every now and then, there will be someone who says it doesn’t work. The problem is side effects are more common.

Can bugleweed cause hypothyroidism?

Can it cause thyroid hormones to be low? Yes, it could. It’s not nearly as potent as antithyroid medication. I see all the time, for example, people taking methimazole, and they become hypo, and they have to have the dose reduced greatly. It might swing back to hyper.

We don’t see this as commonly with bugleweed. It can potentially make someone hypo. It does have antithyroid properties. Usually, it’s not making someone super hypo, where their TSH is off the charts, and their thyroid hormone levels are super low. There could always be exceptions.

When you take something like bugleweed, that’s why you want to monitor how you feel. Eventually, you want to do another thyroid panel. You don’t want to go 3-4 months or longer without doing an updated thyroid panel.

How can someone wean off of methimazole and replace it with bugleweed?

You could substitute methimazole with a different type of antithyroid medication. The point is, this is another question. I want to take bugleweed. I don’t want to take antithyroid medication, so how can I replace it with bugleweed? I don’t have prescribing rights, so I can’t tell someone to stop taking antithyroid medication.

I gave an idea earlier: if someone is taking bugleweed and methimazole at the same time, usually, I recommend spacing them out, taking them at least 30-45 minutes apart, not exactly at the same time. You are looking for the TSH to get above that optimal range ideally. If the optimal range is 1-1.5, get above 1.5, and then hopefully your prescribing doctor will reduce the dose of the methimazole. You can stay on the same dose of bugleweed.

I should add that there are exceptions. There are cases where someone’s TSH might be still below the 1.5, but still, the dose of methimazole is reduced. For example, if someone is experiencing hypo symptoms, even if their TSH isn’t above 1.5, it might be reduced. If their thyroid hormone levels are on the lower side, which usually means the TSH will be higher, not always. You need to look at the whole picture.

That is the process. You want to do frequent thyroid panels. I would say on average, six weeks apart. You could do it four weeks or eight weeks. I wouldn’t go beyond eight weeks.

Every time an updated thyroid panel is done, if the TSH is a little bit greater than the optimal level, between 1-1.5, then the prescribing doctor will hopefully reduce the methimazole. I recommend for my patients to stay on the same dose of bugleweed until the person doesn’t need the methimazole anymore. At that point, they are just on bugleweed. Eventually, most people I work with get to the point where they don’t need the bugleweed. The goal is not to be on bugleweed permanently.

Are most endocrinologists familiar with bugleweed?

Probably not. I haven’t surveyed endocrinologists. Quite frankly, a lot of my patients, when taking bugleweed, won’t tell their endocrinologists. Those who have told their endocrinologist, there has been mixed reactions. Some seem to be familiar. Whether or not they really are familiar, when the person tells them, maybe they just acted like they were familiar because they’d feel embarrassed otherwise. They shouldn’t be embarrassed because they don’t recommend bugleweed. They’re not taught about it in medical school or when they are becoming an endocrinologist.

My guess is that many endocrinologists are not familiar with bugleweed. Maybe more now than 10-15 years ago, because some might find me on Google or my podcast, not that they are following me. Most are probably trying not to listen to me because they don’t want to hear someone like me talk about natural solutions for hyperthyroidism.

In any case, some might be familiar. I am sure some are familiar. Iwould guess the majority are not familiar with bugleweed. Doesn’t make a difference. Most of them are not going to give you recommendations for bugleweed. If anything, they will tell you to stop taking it if they are familiar with it and just to take antithyroid medication.

Can bugleweed help with Graves’ specifically, or just mild hyperthyroidism?

Bugleweed definitely helps with Graves’, but also I have seen it with other hyperthyroid conditions, such as toxic multinodular goiter, and not just mild hyperthyroidism. I realize some of the research suggests that it could just be effective in mild hyperthyroid cases. That’s not always the case.

That’s not saying that every case of moderate to severe hyperthyroidism, bugleweed will be effective. I still think it’s worth a try. Even if someone doesn’t have Graves’, it could potentially help in some cases.

What should I do if bugleweed isn’t effective?

If bugleweed isn’t effective, there are different options. There is L-carnitine in higher doses. Older research shows between 2,000-4,000mg per day can block the entry of thyroid hormone into the cell.

InAugust 2025, a study came out showing that 500mg of L-carnitine combined with 83mcg of selenium could be effective. This was for Graves’ patients. It was a small study. This combination could help lower the dose of methimazole as well as lower thyroid antibodies, probably more related to the selenium than the L-carnitine. So L-carnitine is an option.

As far as natural agents that have antithyroid properties, motherwort doesn’t have antithyroid properties. Lemon balm is very mild. Lithium orotate is something to consider.

There is of course antithyroid medication. If someone can’t tolerate it, and bugleweed is not effective, and the natural agents aren’t effective, LDN is something to maybe consider. That modulates the immune system.

Cholestyramine is a binder. Not specific for hyperthyroidism, but it can help. I have had some people take it over the years, not a lot. Those who have taken it, it does seem to be effective. I have at least an article and some podcast episodes on symptom management where I talk about cholestyramine and LDN.

If I can’t take bugleweed, what is the alternative? I take lemon balm and motherwort as needed. I am on an AIP diet. Will that help?

That relates to the question I just answered. Lemon balm and motherwort probably won’t be enough for hyperthyroidism.

The AIP diet, that could help with the autoimmune component. I find that usually people need to do more. Plus it takes time for that to happen. You don’t want unmanaged hyperthyroidism for many months.

I would say other options are L-carnitine in higher doses, lithium orotate, cholestyramine, LDN, which is a prescription. If someone doesn’t want to take antithyroid medication for whatever reason- I shouldn’t say “for whatever reason.” I know the reasons people don’t want to take antithyroid medication.

How do you know whether to take bugleweed, motherwort, lemon balm, L-carnitine, or all of these?

When I dealt with Graves’, I didn’t know about L-carnitine. Honestly, I didn’t know a whole lot about lemon balm. I first learned about bugleweed and motherwort, so that’s what I took. I didn’t need lemon balm or L-carnitine.

If you start with bugleweed and motherwort, not everybody needs motherwort. Let’s say you start with bugleweed. If that’s effective, maybe you don’t need to take any of these. In my case, I was still experiencing heart palpitations, so I added motherwort. Some people take lemon balm for its calming effects, especially if they are having anxiety or difficulty sleeping. They might take L-carnitine just for extra support or if the bugleweed doesn’t seem to be doing the job.

I wouldn’t say most people need to take all of these. Some people do decide on their own to take all of these.

Can I take bugleweed if I am taking antithyroid medication?

I can’t give specific recommendations. What I can say is I have had over the years a lot of people take bugleweed while taking antithyroid medication.

I don’t have everybody who is on antithyroid medication take bugleweed. One reason is bugleweed is not cheap. It’s expensive to take a good quality bugleweed.

Some people are perfectly fine just taking antithyroid medication if they are tolerating it well. They probably take other supplements when working with me, so my goal is not to keep giving them supplements.

If someone really wants to get off antithyroid medication sooner than later, taking bugleweed is an option, along with antithyroid medication. With this, I recommend taking it at least 30-45 minutes away from antithyroid medication.

You could take both at the same time. Not everybody listening to this can take it at the same time. Everyone is different. Speak with your practitioner. As I mentioned, a lot of people I have worked with take both. I have some people just take antithyroid medication and people who are like me and just take bugleweed.

If I am taking 5mg of methimazole, what is the equivalent dosage of bugleweed?

This is also a question I get asked a lot. There is no equivalent dose. You can’t convert the two. I will say 5mg of methimazole is a lower dose. If someone is on 5mg, they might be okay with half a teaspoon or a full teaspoon, 2.5ml or 5ml of 1:2 extract, once per day. If they are taking a higher dose, maybe they need that full teaspoon, 5ml, twice a day. In some cases, three times a day.

It does depend. There is not an equivalent dosage. I try my best. I will never tell someone to stop the 5mg of methimazole and replace it with 5ml of bugleweed.

How long can someone safely take bugleweed?

When I took bugleweed, I took it for nine months. I have definitely hadpatients over the years who have taken it for longer. I have had people take bugleweed for years. That’s not my goal.

Sometimes, what happens is people will take it on their own. Someone might be working with me and taking it for well over a year. Then sometimes, someone might work with me for a month or two. I have a program where I work with people. Most people stick with the program, but some people might join for 1-2 months and drop out. They are taking bugleweed, but they are not doing anything else. Maybe what they are also doing is not effective. They will keep on contacting my assistant Kate and order the bugleweed. I might see a few years later, a person I was working with for a month or two keep ordering bugleweed.

As long as the liver enzymes, kidney markers- You might want to keep an eye on those. I have never seen anything bad happen with someone taking bugleweed for a number of years. You always want to monitor the liver enzymes and kidney markers. Of course, monitor the thyroid panel as well.

There is no clear-cut answer in the research. This is going byexperience.

What brand of bugleweed did you take when you dealt with Graves’?

I took MediHerb bugleweed, which is a 1:2 extract. It’s sold by Standard Process, which is just a distributor of bugleweed. They are not a manufacturer. MediHerb is manufactured in Australia, where there are strict standards. They have had a relationship with MediHerb for many years. That’s what I took. It works really well.

Not all my patients take that. Some patients take other brands on their own. If someone gets a recommendation from me, I recommend for them to take the MediHerbbugleweed in most cases.

How can I purchase MediHerbbugleweed?

I get this asked a lot because it’s not easy to get MediHerb bugleweed. Some people purchase supplements on Amazon. You want to be careful about purchasing supplements on Amazon because counterfeiting is very common.

With bugleweed, it’s through Standard Process, and they have some of their supplement line on Amazon. As of recording this, MediHerb is not Standard Process. It’s based out of Australia, and Standard Process is a distributor. You can’t get MediHerb on Amazon.

You might find a random seller. I would be very careful about buying anything from a random seller on Amazon, especially something you consume like a supplement.

A lot of people will reach out to my assistant Kate, staff@naturalendocrinesolutions.com., if you are interested. Or you can find a local practitioner who sells MediHerbbugleweed.

Is it better to buy a brand of bugleweed that is alcohol-free?

With all herbs, unless someone is reacting to the alcohol, I don’t recommend taking herbs that are alcohol-free. You really want the alcohol in there because it does a better job of extracting the phytonutrients. You are getting more of the herb essentially. Using glycerin, there is a time andplace for that.

A brand of bugleweed might have 50% alcohol. If you’re taking 5ml, that’s still a very small amount. It’s not like you’re drinking alcohol. It’s not having the same effect as having a glass of wine or other types of alcoholic beverages.

When I dealt with Graves’, I took MediHerb bugleweed, which is not alcohol-free. A lot of my patients have taken that. When they don’t take that, usually I encourage them to take another brand with ethanol. It is a better solvent than glycerin. It does a better job of extracting phytonutrients from the herb.

Is it okay to take a single herbal supplement that has bugleweed, motherwort, and lemon balm? Is it best to take bugleweed by itself?

I usually recommend taking them separately. There are some combination formulas like ThyroCalm that have motherwort, bugleweed, and lemon balm.

The problem is you might not have enough of each herb to do what you want them to do. Bugleweed is the main antithyroid herb, so if someone is taking a formulation, let’s say Thyroid Calm, which is good quality but not as potent, if it’s helping, that’s great. For some people, it seems like it’s helping, so I will tell them to stick with it.

If it’s not helping, sometimes, people will assume that the herbs aren’t working. You might do better taking bugleweed separately, motherwort separately, lemon balm separately. That’s what I did. I didn’t take lemon balm, but I took bugleweed and motherwort separately. That’s usually what I recommend when working with someone.

Should bugleweed be avoided if I have an enlarged thyroid gland?

I focus on this in another episode. Some bottles of bugleweed will say don’t take it if you have an enlarged thyroid gland, a goiter. When I dealt with Graves’, I had a mild enlargement, a mild goiter. The mild goiter was due to the hyperthyroidism, which bugleweed helps with. When I took bugleweed, that helped with the goiter.

If someone has hypothyroidism due to a goiter, because low thyroid can cause a goiter, you probably don’t want to take bugleweed.

It does depend on the situation. I would work with a practitioner. I won’t say it’s fine for everybody with hyperthyroidism to take bugleweed. Over the years, I have recommended bugleweed to a lot of patients with goiters. It’s typically not going to worsen the goiter. I will say everybody is different.

Is bugleweed still the best herbal supplement for hyperthyroidism, even if my bloodwork shows I am hypo now?

This person was still taking methimazole. If someone is taking bugleweed and antithyroid medication like methimazole and are hypo, to me, it is in a way good. It’s not good that the person is hypo, but this means they need less methimazole.

If they want to rely more on bugleweed, it’s probably a good idea to stay on bugleweed. If you’re hypo on the next blood test, the prescribing doctor should reduce the dose of antithyroid medication further until you don’t need it, and you’re just on bugleweed.

If you’re on bugleweed alone, and your numbers are hypo, you probably would want to reduce the dose of the bugleweed, ideally under the guidance of a practitioner.

If you’re taking it with methimazole, it doesn’t mean you necessarily want to stop taking the bugleweed.

How do you feel about making our own tinctures of bugleweed, motherwort, and lemon balm?

I’m cautious about this because of the potency. I haven’t seen a lot of success of people or even naturopaths making their own tinctures. I would definitely trust a practitioner more, like an herbalist or a naturopath, compared to someone else who is not an herbalist or practitioner trying to make their own tinctures.

Same thing if someone asked if they could drink bugleweed tea instead of taking the bugleweed extract. Usually, it won’t be as potent. Some people choose to do it, but it’s usually not going to be sufficient to manage a person’s symptoms.

Can I take bugleweed in capsule form instead of the liquid?

Most brands of bugleweed come in liquid form, and that’s what I usually recommend to patients. It doesn’t taste great. I understand that. It’s more effective though. Most cases, I will recommend not to take it in capsule form. If someone absolutely wants to take it in capsule form, they can do it. Don’t expect it to be as effective.

Like I said, it’s not always effective even in liquid form. It’s about 75% of the time effective. In capsule form, it’s not that it’s not effective at all, but it’s not as effective as liquid. Even liquid isn’t always effective.

Is it okay to take bugleweed with LDN?

I can’t give specific recommendations, but I will say over the years, I’ve had some people on LDNand take bugleweed, just like you could take antithyroid medication with LDN.

You have to be careful. If the LDN is doing what it’s supposed to do, modulate the immune system, you might not need as much bugleweed. Keep a close eye on the thyroid panel. There doesn’t seem to be any interaction between bugleweed and LDN, at least none I have seen.

Does bugleweed lower thyroid antibodies?

Bugleweed does not lower thyroid antibodies. Bugleweed is just a natural way of managing the hyperthyroidism, lowering thyroid hormones. It does not do anything to address the cause of the problem. It does not lower thyroid antibodies. In order to lower thyroid antibodies, you want to find and remove triggers; do things to heal the gut. Bugleweed is not doing any of that.

Bugleweed is great. I love bugleweed. I took bugleweed personally. A lot of my patients have taken bugleweed over the years. Don’t expect it to lower and normalize your thyroid antibodies.

***

That is it. Those are questions asked of me by my patients or at live events or in my groups over the years. If you are taking bugleweed or thinking about taking bugleweed, hopefully you’ve had all of your questions answered. Or at least most of them. I answered a lot of questions here.

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

 

I recently sat down with indoor air quality expert Michael Rubino to have a thoughtful, eye-opening conversation about mold, hidden water damage, and why so many homes; old and new, may be affecting our health more than we realize.

We covered a lot in this conversation from why mold is often missed (even in newer homes), to the difference between a basic home inspection and a true mold inspection, to how dust testing and mycotoxin testing can sometimes help connect the dots. We also talked about practical steps like HVAC maintenance, proper remediation, and when it makes sense to go deeper versus when not to overreact.

If you want a clearer, more balanced understanding of mold, testing, and indoor air quality, you’ll get a lot out of this episode. Click Here to listen to the episode on the podcast.

Dr. Eric Osansky:

I am super excited to chat with Michael Rubino. We will talk about mold, mold remediation. It’s going to be an awesome conversation. Let’s go ahead and dive into Michael’s bio here.

Michael Rubino has become the renowned leader in the indoor air quality mold and remediation space. As the founder of HomeCleanse and chair of the Change the Air Foundation, Michael continues to push the conversation forward for creating better indoor air quality. He has been featured on dozens of podcasts and news channels as the leading expert on all aspects of mold, remediation, and air quality. He is also a counsel certified mold remediator by IICRC and ACAC and a contributing member, sponsor, and speaker for the Indoor Air Quality Association. Welcome, Michael.

MichaelRubino:

Thank you so much for having me. It’s really funny to hear about yourself in the third person, I have to say that.

Dr. Eric:

You have some impressive credentials. We will get into your background also. I mentioned how I listened to some of your past episodes. I always do that to try to prepare better for an interview. You’re very popular. You’ve helped service numerous celebrities dealing with mold. Gwyneth Paltrow is one of the more famous names. You’ve definitely spread the word, it sounds like.

Michael:

Definitely. I have been gracious enough to be working in this a long time. Being able to pride myself on doing good work. Really being health-focused is such an important thing in this industry. You do enough good jobs, and you tend to get more attention. Of course, obviously the goal is to help people, so it’s been a fun journey.

Dr. Eric:

Let’s talk about that journey. How did it all start? How did you get to where you are right now?

Michael:

My dad has been a restoration contractor since I was five years old, so it’s been in my family lineage. I have been around construction my entire life. You’ll find photographs of me as a kid on job sites, crawling around, messing around, sweeping things up with a broom, carrying in dry wall in and out of places. I have been around the act of construction inside of homes for a long time.

It was really when Hurricane Sandy hit the Northeast in 2012. I was working for my dad’s company at the time. We’re going to a lot of homes where people were complaining of illness. I was in my early to mid-20s at the time.

You didn’t hear a lot about homes making people sick. Even being around the industry my entire life, it’s not really something that came up. When you heard about water damage or mold, it was more of an unsightly thing or a smelly thing. It can produce NVOCs that produce an odor. You were typically called in to deal with it from a visual or odor perspective.

When I started to see a pattern of people getting sick, that’s when I realized, holy cow, I think there is more than what meets the eye here. As I started to dive down the rabbit holes of trying to understand how this affects people from a scientific perspective, from a medical perspective, and what is the industry missing in terms of not connecting the dots here, where people are put in this position to get sick. That’s when I started to see we have an entire industry of people who really do this more from a cosmetic perspective and don’t understand the science behind what they’re doing.

Truth be told, that led to me understanding and developing a process that is still in use today of eradicating these sources from homes and cleaning up the byproducts, which keep things in suspension for people. The simplicity of it is we breathe 20,000 breaths per day. What we’re breathing matters profoundly. If we’re not paying attention to what we’re breathing, we’re typically the adverse effect of it, which has some health consequences.

Dr. Eric:

Agreed. Would you say mold is more of an issue these days, or is it just more well-known? Now you hear all different practitioners talking about mold. People want to have consultations. A lot of people are already aware of mold, learning it from practitioners and videos. Or is it a combination of both? Is it more of an issue and also more well-known?

Michael:

Both. It’s more of an issue, and it’s more well-known. Unfortunately, there are some bad things that come with that. Let me break down why I think it’s both first.

1970s, Richard Nixon is president. We had this global energy crisis. We started to go in this direction of energy efficiency. We never stopped. We build homes tighter today than ever before. It’s not something that people don’t really know. I think people do. They’re just starting to become aware of the effects of what it is like building these super tight homes and being an occupant inside one of them.

The point of the matter is when water comes in, which it will. No structure is going to last forever and not have water damage at some point. As water comes in, the tighter we build these homes, the more we might not be aware there is a problem. The more that problem is impacting each breath we take 20,000 times per day. You have that aspect.

Coupled with the other side effect of having these super tight homes. Human beings are walking compost centers. We are creating bacteria. We are putting bacteria in the environment. We are exposing ourselves to viruses. We have viruses in us. We are putting viruses out into the environment. We have chemicals that we use inside of our homes. Those get put out into the environment. The building products themselves off gas. The paints and adhesives go into our environment. The VOCs from furniture and clothing we bring into our environment. The microplastics. You get the idea. There is a lot of things that get produced into the environment.

When we have these super tight homes, the amount of particles that we’re breathing into our bodies with every breath that we take is exponentially higher than the leaky homes that we used to have with the balloon frame structure that we had. Unfortunately, the time has not been on our side in terms of the direction that we have been heading in construction. That is problem #1.

Problem #2 is we have largely been ignoring mold as a problem for a very long time. It is cyclical, just like anything else in the world. Right now, we are obviously under the cycle of mold is an issue. We are aware of it. We are taking steps toward that. There are still some issues in terms of how we are dealing with it.

To understand, for the past 20-30 years, we have been in this cycle where mold is no big deal. Just throw some bleach on it. By the way, bleach is not effective to get rid of mold. We also say mold is not that big a deal, so we’ll paint over it. If you ask your parents or grandparents, “How many times did you use bleach for mold? How many times did you paint over it?” you will probably hear, “Of course, we did that. That’s what we were told to do. It’s no big deal.” That has a compounding effect on the indoor air quality in homes and buildings across this country. We have to look at it from that perspective.

All the problems that were incorrectly remediated because we used bleach or incorrectly painted over it or incorrectly remediated because we had floods or hurricanes and water damage situations, and theremediation company themselves did it cosmetically and didn’t understand what they were doing scientifically.

I want you to think about that compounding issue for a second. It’s vast. That’s why you look at the largest home survey ever done in 1994, which is pretty old compared to we are in 2026 now. 50% of the homes had a history of water damage in a survey of 1,000 homes. That’s incredible. That means if you look around at the houses in your neighborhood, every other home probably has a history of water damage. That’s not good.

We compound that with the homes getting tighter and tighter. This does mean retrofit homes, too. How many homes have been built in the ‘70s or ‘80s but have been retrofitted with all this spray foam for energy efficiency? Quite a few. Spray foam can be its own topic and conversation. Feel free to ask me questions about it. I’m just talking about air ceiling and getting rid of ventilation and the effects of that currently.

When we look at all of that, and then we realize that people are now more aware of mold, and they’re talking about it more and more, that’s really good. I appreciate the awareness.

There is also this perspective of confusion. People are more confused than ever before. I have seen that quite a bit in the way in which people are communicating about the problem. People come to the table looking for solutions that might not be the right solution, based upon some things they saw in a chat room.

We have a gift and a curse. More awareness. We have also more confusion. I think the path forward is yes, we know that mold is a problem. Yes, we want to reduce our exposure to mold. Yes, we want to rethink how we want to deal with energy efficiency in a way that doesn’t impact the customer inside the home, breathing that air. Yes, we also need to figure out how to deal withit responsibly and ethically, so we are breathing the best possible air we can breathe in a way that makes sense. That’s where we are today.

Dr. Eric:

It sounds like if a house or an apartment has been around for quite a while, there is a good chance it has mold. How about for those who think their house is fairly new, so there is maybe a really good chance that there is no mold. I don’t know if you know the incidence of mold in new construction, percentagewise. If you had to take a guess, if you don’t know that number, what would you say?

Michael:

It’s pretty high. First, a lot of homes are built with yellow pine. Yellow pine tends to grow mold fairly well based upon everything I have seen so far. This is just being boots on the ground, going into these homes. I was building anew construction home myself that had a ton of mold in it unfortunately. A whole lawsuit with the builder, and I had to get out of the contract and find a new place. That’s how bad it was.

I thinkthat goes to show you that unfortunately, mold can be a problem in new construction just as much as it can be a problem in an older home. We have to understand just because it’s new doesn’t mean that we’re not dealing with the same issue.

Why would there be mold in new construction homes? I’ll tell you why. It’s very simple. The vapor barrier wasn’t done properly. There were gaps, tears, protrusions into the vapor barrier, allowing moisture to get into the slab. I see this problem a lot in new construction homes. They’re not inspecting vapor barriers. When you look at building codes, they are inspecting there is one. They are not inspecting and making sure the vapor barrier is well done. That’s what it is. It’s important for you to know that because you need to be the one inspecting the vapor barrier when you’re building a new home to protect your investment.

The second thing is lumber. When we build houses with lumber, we have to understand lumber is semiporous. Lumber will absorb moisture. It will rain, so it will absorb moisture. We don’t need to be afraid of the rain. We just need to know it will rain and deal with that appropriately.

If we put soggy, wet pieces of wood in the soil, I’ll tell you what will happen. The mold and bacteria that live in the soil are going to transfer onto the lumber. There will be enough moisture content for it to do so.

And you can have Chaetomium or Stachybotrys growing on that lumber. It doesn’t necessarily just have to be a humidity mold like Aspergillus, Penicillium, Cladosporium, etc. That is because mold is already part of our ecosystem. It is in our environment outdoors. If there is enough water, mold will grow on it. We have identified that we should not keep wet lumber in the soil. Let’s elevate it out of the soil.

As I say this to you, you’re thinking, I have been driving around and seen houses built in my neighborhood. Guess what? The lumber is sitting in the soil. You’re right. That is a big problem. There is a Structural Building ComponentsAssociation guide that tells builders don’t do that. Does that mean every builder is following that guide? No. Matter of fact, I promise you more people are not following that guide than are following that guide. That is an issue.

If you know that and keep the lumber out of the soil, even when it gets wet, you will minimize the amount of mold growing on that lumber.

Here’s another thing. There is a term in buildings called “dried in.” This means that lumber is erective. The waterproofing on the exterior is done. Even if the roof is not done, as long as the waterproofing membrane on the roof is done, a house could be technically dried in.

There is an aspect of “dried in” that is a very important step. It’s physically drying. If we don’t physically dry the lumber, then it’s not really dried in. You have all these people using these terms, but they are not following all the steps that the term is supposed to cover.

What I mean by that is after the house is built, and it’s erected, and you have the waterproofing on, you are supposed to go around and make sure the wood is not saturated before you bring in insulation and drywall. Pretty simple.

There is a standard to which the wood should dry. I believe it’s below 12-14%, somewhere in that range. You should get the moisture content lower than that. That would be safe to bring in insulation and drywall. You bring that in, and then obviously our HVAC, insulation, drywall, the permeable materials that could get moisture transferred into and grow mold, those are the things you don’t want to bring in until the space is dried in.

Ask me how many times people skip that step. Too many times. You end up getting too much moisture transference from the wood into the insulation and drywall. Now the moisture gets trapped, and mold starts to grow. This has been another big problem in the new construction building practice that is completely avoidable.If you just take the right precautions, you won’t have mold in new construction. Unfortunately, a lot of the right precautions aren’t being taken.

Dr. Eric:

If people took the right precautions, then it would be greatly reduced. Because most don’t, it’s pretty widespread in new construction as well. When someone purchases a home, they also have an inspector, but that inspector might look for mold. There is a difference between a regular home inspector and someone who focuses on mold, like a mold inspector?

Michael:

Yeah. Great point. Somebody just sent me an inspection report yesterday. Aclient of mine, they’re buying a new home. “Take a look at this, and tell me what you think.” They found a bunch of problems, which is great. That’s what they’re there for. A lot of little things you need to take control over and fix that might be very minor problems today but could be bigger problems in the future if you don’t do something with them. That’s why you want to take that report and go to town fixing all of the small things.

But the very first sentence in that report under the inspection terms and conditions was, “We might point out some visible mold. However, this is not a mold inspection. This inspection does not guarantee that the house either has or does not have mold.”

Most people don’t read the terms and conditions of what they’re actually buying. It’s really important because I feel like in this particular case, the client knows they will have to do their own mold inspection. That’s fine.

A lot of people don’t realize that this home inspection is meant to check out the age of your hot water heater and make sure there is not issues with the plumbing devices and electrical devices and overall cursory stuff. Very important stuff. You don’t want to skip it.

It’s not going to catch every problem. It certainly is not going to tell you if there is or isn’t mold inside the home. You want to have a separate mold inspection for that, especially considering a lot of the problems that I see in people’s homes. They’re hidden. They’re not obvious. If you don’t have a good inspection to look for those subtle signs of what could be a problem, and thentesting as close to the problem as possible, you will miss stuff.

I can’t tell you how many calls I’ve gotten from clients over the years, “I just bought this new house. It was built eight years ago. Place was kept in great condition. I moved in and got sick. I need your help.” Just because it’s eight years old, just because it was kept in good condition, doesn’t mean the person who sold you the house, doesn’t mean there was an issue they didn’t know about. A lot of this stuff can be hidden. That’s why it’s so important to get an inspection.

It’s like going to a doctor. You feel a symptom, but the problem is hidden. If you knew what the problem was, you wouldn’t go to a doctor. The problem is hidden, and it’s a doctor’s job to diagnose what the problem might be, so you can get to the solution and the root cause to fix the problem.

It’s not different in a home. You have to diagnose what the problem is. The problem is often hidden. It’s not obvious. It really takes working with specialists to help you get to where you want to go. Hopefully, when you’re listening, you have this aha moment. It really takes a good professional team to help you get where you want to go.

Dr. Eric:

The different types of mold. You named a few before. I know some are more harmful than others. Are there other molds that are a big concern?

I bring this up because we’ll talk about testing, the dust test that you recommend. I don’t know your thoughts on urinary mycotoxins tests. I see a lot of Ochratoxin A. I don’t know if that’s even in small amounts if it’s a concern, and if it’s mostly from the environment, or also you can get mold from food as well. I believe Ochratoxin A could be potentially from food.

If you could just spend a few minutes talking about some of the more concerning molds. I want to hear your thoughts on Ochratoxin Aand any other direction you want to go in this area.

Michael:

I have always been concerned about molds that are in the highest quantities. I want to give you an example. Dust is not toxic, typically. Obviously, dust can be many things.

Let’s say this. Sand is not typically toxic. If I drop you in the middle of a sandstorm, you’re probably not going to feel well. Why is that? The amount of sand is overloading your mucus membranes, your lungs. The systems that are designed to protect you from particles become overloaded. You start coughing. You don’t feel well. Everything will be irritated. You probably won’t feel well for a week.

Why am I bringing that up? If I put you in a moldy home, I don’t care what kind of mold it is. If there is so much of it there, even if it’s Cladosporium, which is more of an allergenic mold that typically doesn’t create toxins, that we know of, you will still feel not your best. I want to start there.

Yes, there are molds that are more concerning than others. These molds are the ones that are either toxigenic or produce mycotoxins which themselves are toxic.

I think I always look at it from this perspective. What is the person complaining about? What is the overall problem they’re trying to solve? How do I help you solve it? Let’s say they have Cladosporium in an attic, and it’s elevated. I have other issues in the home that have way more toxic molds, that have higher quantities, and we’re dealing with a budget because who isn’t? We will want to focus on other things.

I look at all the pieces of the puzzle together and say, “What is it that the person is experiencing? How can we help assist them in creating as healthy of an environment as possible?” It becomes a chess match in terms of trying to figure out where I can make these improvements, so the person is going to breathe in cleaner air, not only scientifically, but what gives them the best shot to get into this environment they can actually heal in.

I am not a healer. I am not a doctor. That’s why this is so important that I work with doctors like Dr. Eric here. At the end of the day, we want to have a tag team approach, where I am creating the environment for them to heal in. When you’re dealing with toxins, you will have to detox. You will have to pull the toxins out of your body. That’s really important to understand. This is a multipronged approach.

I’m a data-driven guy. Let’s say you do have high levels of Ochratoxin Afrom this mycotoxin urinary analysis. I will look for the exact molds in the home, like Aspergillus, that can produce Ochratoxin A. If I see that we have Ochratoxin Aoff the charts, and we have the exact molds, like aspergillus producing the Ochratoxin A, then I will probably tell the client, “To me, it’s a no-brainer. Let’s reduce the amount of Aspergillus you’re being exposed to that produces that exact toxin. At the same time, let’s make sure you’re not eating a diet full of moldy foods, like let’s switch your Folgers coffee to something that’s a little cleaner that might test their coffee for mycotoxins, as one example. Let’s do everything we can to reduce your exposure.”

Usually, when you follow that method of madness, people talk about the most miraculous changes in the overall way they feel, the symptoms they used to experience, all kinds of things.

Shannon Hill is a customer of mine who just within seven days of moving out of her house, so we could go fix her house. She literally was able to remove a GJ feeding tube that was installed into her lower intestine. She was so sick with POTS that she literally couldn’t eat anymore without throwing up. They had to install a GJ Feeding tube to give her the nutrients she needed to be able to stay alive. To remove that within seven days of moving out of your house is incredible.Obviously, thereafter was a long road to recovery.

Could you just imagine that much of a change in your quality of life? It’s miraculous. This is the power of transforming your environment, reducing the amount of toxins you’re breathing, and also working with a doctor to help you simultaneously remove the toxins. It’s life-changing.

You asked about the efficacy of mycotoxin urinary analysis. The method of which you’re doing the analysis, as long as the lab uses ELISA, which is the only validated method for mycotoxin analysis, I don’t see any issue with urinary analysis.

I know that there are some arguments out there regarding if it’s in the home, is it food. It’s hard to answer that question unless you test the home and see what correlation there is. If you see a correlation, it’s a no-brainer. Let’s reduce what we’re being exposed to in the home. That is the way I have approached it. I don’t have a horse in that race in terms of which analysis is the best analysis.

I will say if I see a correlation, I am going to want to guide you to reducing that, so we can get some improvements.

Dr. Eric:

Makes sense. If you see anything significant on the testing, you are going to recommend for the client to address it, which makes sense.

The testing that you recommend, do you recommend the dust test? That’s a PCR-based test, correct?

Michael:

Correct.

Dr. Eric:

How is that different from some of the other testing out there? The plates they use and ERMI testing.

Michael:

Taking a step back, why did I create the dust test in general? Prior to the dust test, people were notoriously using a test called ERMI. It’s still a test out there that people use today. One of the biggest problems I was trying to solve with ERMI, for those who don’t know, ERMI stands for the Environmental Relative Moldiness Index. It is the index behind the data.

Forexample, ERMI uses PCR, just like the dust test. The same technology, MSQPCR. It is a DNA-specific analysis of the particles present in the dust. You take a Swiffer cloth, collect dust from across the house, and scrape 5mg of dust off the Swiffer cloth. You analyze that dust across 36 different species. It will tell you how many particles per mg of dust. They are particles. They are not even the full spore. It’s just whatever particles that could be matched using DNA and how much of each different species do we have of particles per mg of dust.

Now, the value of that is being able to look at the data and say, “That’s a lot of Stachybotrys. If I am seeing a lot of Stachybotrys, that means we have active leaks, or we have had active leaks in the past that maybe are no longer leaking, but the mold was never gotten rid of. It’s still there.” We are looking for active or past leaks.

If I see very high levels of Aspergillus or Penicillium per mg of dust, I’m going, “Okay, I have some humidity issues in the home. Maybe I have alot of mold growth from the HVAC system because there is a lot of moisture that naturally occurs there. Maybe I have a crawl space. Maybe I have waterproofing issues in the bathroom.”

Based upon the type of mold, I am able to have a good gut feeling as to what’s going on in the environment. Then I can make recommendations to do deeper investigations from there.

It’s a very good pre-inspection tool that helps me understand what’s going on in the home. What are people exposed to?

The ERMI score is the score that people typically refer to. It’s not the same thing as the technology, which is MSQPCR.

Basically, the EPA did a joint study, and they investigated 1,000 homes using this technology. They were like, okay, this is about the average home, what it has. That was helpful, but then the score is where things got very flawed.

When I first started in the industry, ERMI was relatively new. You had doctors out there saying, “I need an ERMI score below a 2.” There was a lot of confusion as to what the score meant. The problem with the score is I could open windows and have a ton of outdoor molds come into the home from group 2, and when I do that, I’m going to lower the score.

Now, I can have a low score but have a ton of Stachybotrys or group 1 molds in the environment. Does that mean I have a healthy home? No, it doesn’t. So the score methodology became flawed.

When you remediate, you are removing molds in both columns. The score won’t improve. The score is a subtraction methodology. If I’m subtracting from both columns, I’m not just removing the bad stuff but leaving the good stuff. That score isn’t going to improve. It’s going to stay where it is.

It became really flawed in terms of trying to help people understand where their environment is and if it needs repair, or if the repair has been successful. It created so much confusion there over the last decade.

We need something that gets rid of the score that is imperfect, but the data that everything is built on that is so useful to help us see what is going on inside the home. We need to improve that.

One of the other problems we are trying to solve is a lot of people were like, “I’ve got some mold. What does it mean for me?” This is where correlation really helps. If I’ve got high levels of Ochratoxin A and high levels of Aspergillus that produce Ochratoxin A or Stachybotrys and Trichothecenes, etc., I might now understand that I have the exact toxins in my body that are produced in the exact molds in my home. I might want to take some action. That might help people understand if they make an investment in the air quality of the environment they’re in, it might yield a positive result.

We wanted to help people correlate that data, so they can get to the answers theyneed faster. The dust test is the first test out in the marketplace where you can upload your mycotoxin results from any lab. Doesn’t matter if you get it from Real Time, Mosaic, Vibrant, etc. You can upload your test results from any lab, and it will help you match the toxins in your body withthe molds in your home, so you can decide what you want to do about it.

Do you want to invest money and figure out where the problems are coming from and help eradicate them and reduce your exposure? I hope you do. That’s the reason we’re talking today. That is the idea: to help you get the information you need in a very easy to understand way.

The dust test for me was a tool to help solve a multitude of issues with the technology and how people receive that information. Help themget where they need to go faster through a data-driven process.

Dr. Eric:

That’s really cool. You can upload your mycotoxin test results and see which molds are positive on the dust test and which ones need to be addressed. This obviously makes a lot of sense. Like you said, if you have the dust mycotoxins present and see the molds that correlate with those mycotoxins, you want to get rid of them.

What would be the next step if someone orders a dust test? They find positive mold in the house. Would they then want to hire someone to inspect the home and look? Would they want to call their HVAC? Even if they want to do that, they’re not mold experts, so they might contact your company. Your company offers not just testing but remediation throughout the US.

Michael:

Yes. We make it very simple. When you use the dust test technology, it helps you correlate. It will say next steps. You click on that. It tells you, “Hey, you should clean your HVAC and retest.” Maybe that’s option one.

Option two might be like, based upon your specific results, you probably need an inspection. If you click here, we’ll tell you all the inspectors we work with who we think do a good enough job to help you uncover where the problems are.

That is another topic and issue we’re experiencing across the industry. The different technologies that are available for testing, a lot of inspectors don’t understand those technologies, and they don’t use them properly. You get false negatives when there is actually an issue, or they don’t evenuse any technologies.

They just walk through your house and say you have the most clean house in the world, so there are no problems here. Meanwhile, you have crazy amounts of Stachybotrys behind the wall. On the surface, it looked clean. You would have never guessed. It was like a subtle rusted nail at the very bottom of this baseboard that gave us that super subtle sign. When you opened up the wall, the entire wall was full of termites, mold, you name it.

We need people to be more trained in looking for subtle signs and then testing to actually see where the problems are. If we do that, we’re going to help people get down to the root cause of the issue.

Through the dust test, we’ll help you find somebody that can inspect your home properly. It’s one of those things. You can go to a lab and check your Vitamin D levels. Maybe for you, that’s enough. But for most people, you’re going to want to test a few different things and get a pretty comprehensive lab. That will cost more money than just checking your Vitamin D levels.

When we talk about the different types of testing, sure, you could spend $50 and get an agar plate. You can get 10 of those and scatter them around the house. That won’t help you. It won’t tell you where the problem is coming from.

The further away you put the plate, the less growth you will have on the plate. The closer you put the plate to your problem, the more growth you will have on the plate. Where do you put the plates? You have to put it where you think the problems are. How do you know where the problems are? You have to know how to look for problems.

As you can see, it becomes this difficult thing. I have to be skilled at what I do to find problems, and then the testing just becomes a verification of this is the problem, this is the type of problem, this is how much the problem is. You can see the types of mold, the quantities of mold. That gives you a good indication of how much you have to rip the wall openand see what’s going on and then fix it.

I think it’s really important that you’re not necessarily looking for the cheapest solution when it comes to inspecting your home. You are looking for the right one. The right one will typically be a thorough approach with finding these subtle problems and hidden issues and then testing to verify to see if they are issues. If they are, what type and how big. That really helps drive what you do about it.

You see on the screen here, Michael Rubino, founder of HomeCleanse. I created a company that is nationwide and helps people fix their homes. We need data, the right data, to fix your home. I can’t fix a problem behind a wall if I don’t know there is a problem behind a wall. I need that data to help drive forward what are we doing to this home? How are we going to improve it? What can we do to make sure it never comes back?

That’s why data is so important. It’d be like going to a surgeon with no data. “What am I doing here?”“I don’t know. Just make me feel better, Doc.” You need that data to understand what you need to do. The home is no different.

Dr. Eric:

Makes sense. What is important is you mentioned that a home could look pristine. You mentioned the subtle signs. Someone might not have visible water damage. Arguably, you would know more than me. Maybe more times than not, there is no visible water damage, even when there is mold. Things overall do look pretty good. Like you said, it could be behind thewalls, underneath the floors, in the crawl space or HVAC systems. A lot of places to look. Many people simply don’t look at.

Once the mold is remediated, or let’s say it’s a scenario where someone does a test, and it looks good. What can they do to maintain it? You recommend air purification systems, maintaining the HVAC system, like we have. We have someone come twice a year for our HVAC system to tune it up and maintain it. I assume those things. Anything else?

Michael:

You hit the nail on the head. Once you get the perfect environment, you want to keep it that way. Routine inspections help. Making sure your roof is inspected every year is important. Our roofs are constantly exposed to the elements and weather. It gets windy. Things blow around. You get a lot of rain. Some locations, you get snow and hail. Your roof does take a beating year over year. You want to inspect your roof because if your roof leaks, you will most certainly have water damage and mold. That’s an easy one.

Doors and windows, same thing. They unfortunately don’t last forever. Waterproofing around the doors doesn’t last forever. When those things start to fail, water comes in. Even though it’s not obvious. Sometimes, your drywall looks fine, but water is coming in. It’s coming in behind the drywall, and you don’t know it. Inspecting doors and windows is important.

The HVAC system is the lungs of the home. Many HVAC companies do not know much about mold and do not know much about air quality. Sounds crazy, I know. They’re very good at putting metal together. They’re very good at installing systems and making sure they’re wired up and plumbed properly.

When it comes to the indoor air quality, they don’t know as much. Many of them don’t even know what a Manual J load calculation is. If you don’t know what that is, that is the calculation you do to understand the size of the unit you should be installing, the size of the ductwork you should be installing.

That is based upon many factors, like what type of windows you have and what type of doors you have. What is the installation value in those walls and the attic? It looks at the overall amount of heat or AC that a home might need. If a system is sized too big, it’s going to shut off a lot. When it shuts off a lot, it’s not removing the humidity. Therefore, you probably will have a humidity issue. These are the types of things that many HVAC guys unfortunately don’t know.

You want to make sure you’re vetting your HVAC contractors. You’re not just getting someone who will charge you to replace a filter and not actually inspect the system and make sure it’s going well.

The second thing is you probably want to do a deep cleaning once a year. You could decide to do it in the spring or the fall. Doing a deep cleaning of the evaporator coil, where typically mold and bacteria will grow, as well as cleaning out the ductwork once a year, is probably not a bad idea. It costs you a couple grand, but itwill save you a headache in the long run.

The longer you go without cleanings, the more mold and bacteria will naturally build up in that system. It’s unavoidable. Mold is part of our ecosystem.

The second thing you can do with your HVAC system is install a better filtration system. Many of us have MERV 8 filters on our HVAC systems. We don’t know to buy better filters because none of us have been educated on that. You want to get a better filter if you can.

In my home, I have a MERV 16 filter. It’s one you can get at HomeCleanse if you’re interested to see what it looks like. Basically, it stops particles as small as 7nm from entering into the system 95% of the time. Pretty good. Very small particle. About the size of some viruses. We’re getting real small.

Why do I want to have that? The less I let those particles recirculate throughout the lungs of my home, the more I am capturing these things before I am going to be breathing them in my bedroom at night. We want to look at how we maintain our systems. Installing better filtration is a way we can do just that.

Last but not least, you mentioned air purifiers. Those are amazing things. Having air purifiers in the home is great. Cleaning with non-toxic products instead of chemicals is great. Trying to be mindful about VOCs and some of the other things we bring into our home is smart.

We talked about the homes being tighter than ever before. If we open windows and get fresh air when it’s possible to do so, we should. Getting fresh air, ventilation in, ERV systems installed when we have really tight homes is a smart thing.

Cleaning regularly. Getting rid of dust as it builds up. We won’t just be getting rid of dead hair and skin cells when we do that. We are getting rid of all kinds of contaminants, like mold, bacteria, virus particles. The more we are exposing ourselves to those, the easier it is to get sick.

There are a lot of theories out there. “It’s good for our immune system to breathe all this stuff in.” I don’t think so. Global health is clearly declining. When you look at the trajectory of what we are actually breathing in today versus 30 years ago, it’s in line with the trajectory of chronic illness. We are breathing in a lot more harmful stuff at higher quantities than ever before because of the reasons I named earlier. We want to be more proactive and less reactive. Hopefully, the conversation has been helpful today to do just that.

Dr. Eric:

It’s been helpful for me. There are things I’m doing right, but I’d be lying if I told you we got our roof inspected annually. We probably need to do that. Same thing with cleaning out the ductwork once a year. I think a lot of people listening to this have room for improvement. This has been helpful for me. I’m sure for a lot of listeners, too.

I do have one more question. If someone has a mold issue, there are some people I’ve known who have tossed out everything. They have thrown out clothing, books, even furniture. Is that necessary? Does it depend on the situation? If someone has an extreme toxic mold problem, maybe it is, but in other cases, it’s not?

Michael:

Depends on the situation. I tell that toeverybody. If you have a larger home, you’re probably going to have more grace. The items closest to the problem will likely be more contaminated than the items further away from the problem.

I know that’s not fair. It’s unfortunately economically disproportional. It’s true. When you hear all these stories about everybody burning everything and throwing everything away, these are really worst-case scenarios. It doesn’t mean everybody needs to do that.

There are really inexpensivetape tests you can do, like $35 tests, where you stick a piece of tape on furniture, and you can collect a couple times across each piece. You want to collect to see what mold spores might be present. You can analyze it.

Most often, you will find a lot of the stuff isn’t as contaminated as you might think, which is good. Sometimes, it is, and it just depends on where that item is in relationship to the problems and how bad your problems are.

It’s such a huge variable. It’s easy to get overwhelmed and say, “My neighbor had to do this,” or “I saw in a Facebook group they had to throw everything away and move into a tent.” For some people, that might be what’s necessary. They might be really sick, and their stuff may be very contaminated. Their situation may be very different than yours.

It’s really important for you to trust the process. I would go through it. Obviously, you want to ask these questions. “Hey, what’s my situation like? Should I be more concerned about my stuff?” I get asked that question on every call I’m on. “Should I throw everything away? What’s my situation like?”Most of the time, people don’t want to throw things away. Shocker. It’s another added expense.

We are looking at, in this room, it’s really bad. We should probably be more pragmatic about the things in this room. The stuff across the hall, I’m not as concerned about. We can do a tape test and see what the results look like, so we can make a data-driven decision.

I have been doing this for a long time. The closer you get to the source, it’s theworst. The further away, it gets less and less. This allows us to have some grace when we are thinking about the contents in the home and go through it pragmatically.

Let’s get rid of the problems first. The stuff isn’t the problem. It’s what’s creating the toxins, the spores that is getting all over the stuff that is the problem. Let’s start there. Let’s clean up the environment. Let’s see how you feel. We can always remove things later. That stuff isn’t the source. It’s contaminated by the source. We can always remove contaminated things later. We can’t mess around with the sources. Always want to start there, and let the process dictate, based upon how you feel.

Dr. Eric:

Makes sense. This was amazing. This was a great conversation. Appreciate you coming on the podcast to have this conversation.

Where can people find out more about you? For those who are interested in ordering the dust test and seeing if mold is a problem in their home. Let them know where they can find you and get the test.

Michael:

I have a personal website, TheMichaelRubino.com. It goes along with all the socials, TheMichaelRubino on Instagram, TikTok, YouTube, etc.

From there, you can see everything I’m doing. We have HomeCleanse, HomeCleanse.com. That helps you with the products and services to create better indoor air quality. You can find the dust test on there.

You have Change the Air Foundation, which is a 501(c)3 nonprofit that I’m chairman of the board of. It’s an amazing foundation. There are a ton of free resources, education. We’re out there, fighting for policy change. One of the main pillars of what we do. We know that this is a systemic issue and want to help Congress create powerful legislation that helps protect us against this epidemic. Your support there is always appreciated.

We definitely are here creating the solutions to help people. Please follow along. We’re happy to help.

Dr. Eric:

Wonderful. Michael, this was a pleasure. Thank you again for sharing everything. Looking forward to people’s reactions to this. This is really eye-opening, some of the things you mentioned. There is definitely a lot more that people can do. Even though more people are aware of mold, it’s still greatly overlooked by a lot of other people.

Michael:

You’re so right. I really appreciate you obviously and everything you’re doing. I can’t tell you how many people have come to us who are your patients looking for guidance. It means the world that there are great minds out there who are seeing this as such an important issue and helping people get through it. Thank you for all you do. Really appreciate your work. Glad that we’re able to help educate on the importance of indoor air quality.

Dr. Eric:

Definitely. Thanks again. Have an awesome day. Thanks everyone for listening.

***

That was a great conversation with Michael Rubino.

Hidden mold. Arguably, a lot of mold is hidden. It can be behind walls, under floors, in a crawlspace, in the HVAC system. Just because you can’t see mold doesn’t mean you don’t have a mold problem.

Even new construction, as Michael discussed, can have mold for some of the reasons he mentioned. Even if you have a newer home, it doesn’t rule out mold.

Based on this, the next question is should everyone test for mold? Over the years, I can’t say I have had everybody test for mold. I have had a lot of people do urinary mycotoxin tests, but not most people I work with. Same with testing a house for mold.

Whenever I work with someone, I send a comprehensive follow-up email. From this point on, I think I’m going to give an option to purchase the dust test as well as include this podcast episode once it’s available in that email, so they can learn more about why they might want to consider testing their home for mold rather than someone goes a few months, and they hit a roadblock in their recovery, and later on, we test for mold.

It does depend on the person. I am not saying we never test for mold initially. Across the board, I don’t do this. Based on our conversation, there definitely are people who have it. Maybe they have it, and it’s not the reason why they have Graves’ or Hashimoto’s or another chronic health condition. Maybe it has nothing to do with their progress. Maybe they will progress fine even though they have some mold in the home. In some cases, it will affect someone’s recovery.

This isn’t just about reversing one’s thyroid or autoimmune thyroid condition. That’s a big part of the podcast. But also helping someone achieve optimal health overall as well.

I specifically want to mention Ochratoxin A because I see this a lot on urinary mycotoxins tests. I wouldn’t say some dismiss it, but lower levels are typically dismissed. He did say that high levels are problematic. True with any mold.

If Ochratoxin A shows up in lower levels, maybe not as big of an issue. Maybe it is more related to food. Rather than making an assumption that it is related to food, maybe it is a good idea to do a test like the dust test.

I did not know before this conversation that you could upload your results. If you did a urinary mycotoxin test, you could upload those results. You do the dust test and do that correlation. If any of the molds in the home correlate with the urinary mycotoxins. Very interesting.

There are other mold tests I’ve recommended. I’m going to give this a try for a while. Michael Rubino seems to know what he’s talkingabout. I’ve had other people on the podcast as practitioner talk about different types of testing. Michael focuses on testing and remediation. At least for now, I’m going to start recommending the dust test.

Should you throw away your clothes, books, furniture if you have a mold issue? It depends on the person. If it’s a severe mold problem, and the person has severe symptoms, then maybe.

Also mentioned doing the tape test.

Preventing mold from developing. He mentioned doing HVAC inspections, which I do twice a year. I mentioned how I don’t do an annual roof inspection or the doors and windows. The reason I don’t have someone inspect my roof is you know how it is. Someone inspects it and says you need to fix it even if it doesn’t need fixing. It just means I need to get someone who I can trust, which is the case with any service or business.

Clean out ductwork once per year. Something we have done but not on an annual basis. Like he said, it can be pricey. If you’re trying to focus on your health, when we think about it, we spend so much money on other things that are less important. Something to consider.

HVAC filters. He recommends a MERV 16 filter, which I’m going to check out. He said it’s available on his website.

A great conversation. An important conversation. Not just an interesting one. It affects a lot of people. Alot of people who don’t realize it’s an issue. Unfortunately, a lot of people will never realize it’s an issue, just because they don’t know. It’s not just a matter of not opening up their mind, but some people don’t know. For example, my parents wouldn’t really think about it. It’s not that they’re not opening up their mind. A lot of people are not walking around thinking about mold as possibly being an issue in their house, even if someone has certain health conditions that might be related to it.

I like to think all the interviews I do are important and valuable. This isdefinitely one that most people, if not everyone, should listen to.

That being said, hope you found this episode to be valuable. Look forward to catching you in the next episode.

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.