Recently, I interviewed Laurie Villarreal, and we discussed her thyroid journey, the role of stress in blood sugar regulation, the benefits of using continuous glucose monitors (CGMs) to track blood sugar levels, how to use heart rate variability (HRV) as a tool for assessing stress, tips for managing blood sugar, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am excited to chat with Laurie Villareal, as we are going to talk about blood sugar imbalances. I’m really looking forward to this conversation. I’m going to dive right into Laurie’s impressive bio here. 

Laurie Villareal helps high-achieving, mission-driven women regain control of their weight, health, and hormones in midlife, so they can have more energy to pursue their bold goals and active lifestyles without restrictive diets, stacks of supplements, or overhauling their lives. 

Her unique method artfully blends the science of real-time biofeedback with innate body wisdom to help zoom in on the unique triggers and tweaks that support your body in turning down physiological stress to turn up restoration and healing. 

With a client list spanning the globe and over 20 years of experience in the health and wellness space, you may have seen her in publications such as Self Magazine or Thrive Global or sharing the stage with known persons such as Dr. Joe Dispenza or JJ Virgin. 

She is also a national board-certified health coach, functional nutrition provider, and long-time endurance athlete and movement educator turned hormone specialist after being challenged with her own hard-to-solve hormone health issues. Laurie not only understands her clients’ journeys and challenges, but she has been there, too. Welcome, Laurie.  

Laurie Villareal: 

I’m so happy to be here. Thanks for inviting me. Looking forward to this. 

Dr. Eric: 

Same here. This is going to be a great conversation, talking about blood sugar imbalances, continuous glucose monitors (CGMs). I want to talk about your background because you have your own thyroid journey, which led to you focusing on what you help people with now, correct? 

Laurie: 

Yes, that’s exactly right. 

Dr. Eric: 

Let’s go ahead. If you could give a little bit of that story. 

Laurie: 

Sure. It’s probably similar to a lot of people you’ve worked with, maybe even yourself. I struggled for a number of years actually, where I didn’t exactly know what was going on with my health. I was an athlete, an endurance coach, and trainer. At the time, I understood a lot about health, balancing stress, recovery, eating well. I paid attention to all of those things for decades. That was a really important piece of being an endurance athlete.

For two years, I was noticing small, insignificant symptoms at first that eventually became debilitating. It went from me having regular periods for decades to suddenly having uncontrollable periods that I didn’t know what was going on. As an athlete, sometimes I would run for several hours, and I wasn’t able to manage that, that I was bleeding so uncontrollably. 

I wasn’t recovering well from even my easiest workouts. I say I wasn’t recovering well, but I was not recovering. It would take me what felt like weeks sometimes to recover from easy workouts. I needed naps all the time. I was exhausted when I woke up. 

I began having memory issues, where I couldn’t remember an appointment I saw in my calendar only an hour before. I was having debilitating anxiety that I had never experienced before. 

Same story, like a lot of women or men. My doctors said I was fine. There was nothing wrong. Even though previously I was functioning at a very high level, they thought, Oh well, you’re not doing too bad. But I was nowhere near where I was before.

I definitely took this journey of trying to figure things out on my own. That eventually led me to studying functional nutrition. From there, I ended up learning a lot about balancing blood sugar and stress and all the things that you learn in functional nutrition. I had already studied nutrition, so I knew a lot about it. 

Because I had a family history of diabetes, both my dad and my mom had diabetes, I had been very interested in blood sugar since I was a kid. I didn’t want to get diabetes, and I also wanted to help them take better care of themselves and their diabetes, which they were not that interested in doing. Now I know they have got to want it themselves as well. 

I went down this journey of learning a lot about blood sugar. I got really curious for myself the connections that that could have to some of what I was experiencing. Eventually, I figured out it took some time, but I had made some connections that led me to think it was my thyroid. I ended up working with a practitioner who had said yes, it is, but it wasn’t showing up when the doctors were just measuring TSH. They were looking at it more deeply than that.

In addition, because I was so curious about blood sugar, and I had been using blood sugar devices since I was young, I started paying a lot more attention to that, trying to get curious about what was going on with my blood sugar health. 

I started treating my thyroid and figured out I had hypothyroidism. I realized that some of what had been going on with me was related to stress. I should say a lot of what had been going on, that perhaps had led me to that thyroid journey. Certainly, some of these discoveries were the things that helped me unravel my thyroid healing and get better. 

At the time, when I discovered that I did have something going on with my thyroid, I didn’t want to go straight to medication initially. I wanted to figure out what was actually at the root of this. 

Also, I wanted to take care of my body from a more holistic approach, which definitely studying functional nutrition had helped with that. Getting extra curious about the relationship to stress and what was going on with my blood sugar and inflammation and all of those pieces. I took a deep dive in that area. 

Like I said, I had that family history. I really wanted to better understand that piece. That is a big part of what brought me to what I’m doing now.

Dr. Eric: 

When talking about blood sugar, a lot of people are aware of the impact of diet. I don’t think people think enough about the stress, especially with blood sugar. Let’s say if someone is eating a wonderful diet, whole, healthy foods, minimizing refined foods and sugars, or even completely avoiding them, but they’re stressed out all the time, not getting sufficient sleep, can they still have blood sugar dysregulation? Even if they are eating a really good diet? 

Laurie: 

Absolutely. I have experienced it for myself. Not getting quality or the quantity of sleep your body needs to recover can have an impact on your glucose levels. At the same time, stress has a pretty big impact on your blood sugar levels separate from food. 

Also, when you’re eating while you’re stressed, those foods are going to react very differently from when you have a meal when you’re not stressed. Stress definitely is a huge factor when it comes to blood sugar regulation. It’s one of the biggest ones that the women I work with, maybe it’s not the food; maybe it’s something else I have been ignoring for a while or are just not aware of. Sometimes, we are not aware of the stress we have going on in our body.

For me, some of the stress I had in my particular situation, I wasn’t aware of it. 

Dr. Eric: 

It could go beyond emotional stressors. If someone is overtraining or other physical stressors as well. 

Laurie: 

Absolutely. I like to say there are a lot of different stressors, but they all go into the same bucket. Your stress bucket at the end of the day can have stress from all sorts of things, like physical stress, mental stress, emotional stress, and physiological stress, which we often don’t consider, like infections. There could be a lot of things going on that are creating stress in our bodies. We add a little bit more, and it overflows our bucket.

Dr. Eric: 

When I dealt with Graves’, I was underestimating the impact stress had on my health. That, and also overestimating how I handled stress, too. Double whammy there. 

Laurie: 

It’s very common.

Dr. Eric: 

Exactly. Definitely want to talk about measuring blood sugar, blood testing, CGMs. Do you also recommend measuring adrenals? Do you just take the perspective of most people have adrenal issues, so rather than testing, making the assumption that someone has an adrenal problem? 

Laurie: 

I wouldn’t say I make the assumption, but because- I usually just start straight off with the bio sensors and see what those say. We can right away start making tweaks with them. Later on, down the road, sometimes, we look more specifically into the adrenals, say with cortisol testing is what you’re probably talking about.

Usually, with things like a CGM or HRV, we can see already where their stress is at. At least enough to start making some changes. 

I don’t think I’ve ever had anybody who I’ve worked with who was like, “Your stress is fine.” But of course, there can sometimes be things going on that need a closer look, such as through the data with the bio sensors that I like to use. 

We can sometimes see something going on where maybe they have high cortisol in the evenings when it should be low, or they have low cortisol in the morning when it should be high. In this case, I would probably look sooner than later. 

It’s not that I don’t think it’s important to look at the adrenals right away. It’s more that I think it can be just as effective to start working on stress via the bio sensors and then help women start feeling better and get the results versus going to that testing, waiting for the result to come back, and doing it in that path. I just do it the other way around. 

Dr. Eric: 

Okay. We’ll talk about the bio sensors. What are the consequences of having blood sugar imbalances, whether it’s insulin resistance, hypoglycemia, etc.? 

Laurie: 

It can be different for everyone. They show up differently in different bodies. It could look like feeling like you’re on an energy rollercoaster. It could look like being moody and irritable, having brain fog, having cravings, especially for carbs and caffeine. It can look like waking up feeling sluggish, increased stress, feeling less resilient. 

It could show up feeling like you have other things going on with your hormones. In my case, I had really heavy periods. You can notice changes in your menstrual cycles. Maybe you don’t cycle at all. 

It can show up as skin issues. Strangely, that is actually one of the things that women tend to see the most when they work with me on having a blood sugar imbalance. “My skin issues have cleared up after years of struggling with this.” They had just thought this was their new norm. 

Dr. Eric: 

Is it more common for people with blood sugar imbalances to have problems staying asleep than falling asleep? 

Laurie: 

I certainly see the quality of sleep. The more dysregulated the blood sugar, the lower the quality of sleep usually because blood sugar would tend to be less stable at night if it’s less stable during the day. That instability at night creates poor quality sleep. I see that a lot. 

Whether or not the person is getting the right quantity or going to bed easily or waking up easily, that seems to vary. Certainly, I would say if your blood sugar is dysregulated, your sleep quality is not as good as it could be. You’re likely waking up feeling sluggish. 

What I also notice quite often is in the middle of the night, if you have blood sugar instability, blood sugar can tend to dip down low and wake people up. Either dip down low or increase, depending on what they had for dinner or how the rest of their day went. I can also see highs and lows happening that wake people up and disrupt sleep. There could be a lot going on with sleep and blood sugar. You probably see that, too. 

Dr. Eric: 

Yeah, definitely. I see a lot of disrupted sleep or poor sleep quality. 

Let’s talk about diet. You probably would agree that there is no diet that fits everyone perfectly. There probably are some do’s and don’ts that you recommend when it comes to foods that you would eat. Obviously, refined foods and sugars probably would be a no-no. 

Can you talk more about that? Certain foods that you recommend eating and certain foods that you recommend avoiding in general to have healthy blood sugar? 

Laurie: 

It will look different for every person. And a few things we know that are very supportive are whole foods. Whole foods versus processed foods versus highly refined foods, especially when it comes to carbohydrates. Anything that will go in the blood sugar quickly. The more refined, the more processed it is, that is usually the case. It’s going to raise your blood sugar more quickly, which usually leads to a blood sugar crash afterward.

However, we do notice that when you pair your foods in a certain way, when you order your meals in a certain way, you can actually change that up a little bit. Sometimes, it’s not always about the food, but it’s about how you eat the food. 

As I said earlier, even the state of your stress at the moment you’re eating your meal. 

Absolutely, nutrition is important. Also, having fat, fiber, and protein with whatever you’re eating can help quite a bit to stabilize your glucose levels. That would mean, say you’re having an apple. It might be helpful also to have some nuts with that apple. It might even be more helpful to have some nuts before you have that apple. Once the apple is broken down, that can help the glucose release slower in your bloodstream. That can be more supportive.

In addition, usually people discover that there is this carbohydrate tolerance. Fats and proteins are having less of an impact on blood sugar most of the time than, say, carbohydrates. Especially refined ones. They’re all going to react differently in your body depending on how they are prepared, whether they’re raw or baked or blended. All of these things do matter.

In general, if you’re eating a whole food diet, and you’re paying attention to eating fat, fiber, and protein at the same time, you’re eating the rainbow, you’re getting lots of different nutrients that can be supportive for blood sugar health, I notice that to be- In terms of what works for most people, I would say that can be quite helpful in helping stabilize blood sugar.

Dr. Eric: 

You use the CGMs as well? 

Laurie: 

Yes. 

Dr. Eric: 

Can you talk about that? How do you use CGMs to determine what foods people could get away with, not get away with eating- How their body reacts from a blood sugar perspective. Also, tie that into the HRV that you use as well. 

Laurie: 

Just as an example, before I started using these with clients, I was using the prick monitor for years. I was also using CGMs for myself before I started using them with clients about 10 years ago.

 I would also use it on my husband. It was interesting to see. I have diabetes in my family, so I have the genetics for more likely to have blood sugar issues. We can be so different between him and me in how our body reacts to things. We have worn them together for a few months at a time. Dang, you can eat that, and your blood sugar is fine? I don’t get it. 

We really are so different when it comes to how our body responds to foods. It’s not just our body. It can be the environment. There are a lot of things that play in. Inflammation in our body. What we’re exposed to. How we pair and order our foods. 

When we’re able to wear a CGM, we can not only see how those things are influencing our glucose. We’re seeing in real time that you eat an apple, and you see what is happening on the CGM when you eat it. You’re not just seeing it, but you’re also feeling what your body feels like when your blood sugar does this. 

Sometimes, a woman will eat an apple. It will go up to 200. I have seen this recently. They don’t feel so well. Then the next time, they eat an apple with some nuts, and it bumps up to 140 instead. They don’t have that same aftereffect that they had when they ate it on its own. By using a CGM, you can also begin to see what tweaks and tricks can work for you. Do they actually work for you? 

Also, I could say to eat some nuts with your apple. Maybe your blood sugar is still going to spike, and it will still have an impact and create symptoms for you. I like to use it in a way not to say so it’s good and bad to have your blood sugar at certain levels. Yes, certain levels can be more inflammatory. I like to have a specific range that women are in. 

Also, we pay a lot of attention to how that makes you feel when your blood sugar does X. For some, they can have symptoms right away. They feel tired. For some, they feel cravings 30 minutes later. For some, all day long, they have been tired and hungry. For some, it interrupts their sleep. I really get to pay attention to not only what the CGM is saying with your meal, but also how you feel afterwards, how you feel before. 

We also get to learn what your baseline levels are. If your baseline levels are in the healthier zone, or maybe they are in the prediabetes zone, we know more about if you need more adjustments to help you get into that healthier zone. In that case, there might be some more healing protocols that help to heal your body, so it is responding better to your foods, and your baseline levels are coming down to a healthier range. 

It really depends on where the person is at when they start using the CGM. There is so much information that it can give you, such as how well it’s going while you’re sleeping. How are the foods you’re eating throughout the day, especially at night, influencing your blood sugar throughout the night? How is that affecting your sleep? 

Are you waking up feeling recharged? If you’re not, are there some adjustments you can make and notice at the same time how that impacts your glucose levels? Does that help you have better sleep? It’s just about making connections. Does this help you or not? 

I find that I love data. A lot of people I work with love data. It can be really helpful to see it versus just feeling it. 

Dr. Eric: 

That makes sense. For those who are not familiar with CGMs, how do you know what your blood sugar is in the middle of the night? You’re tying it into an app, correct? Then you can look at the app and see the data. Some people say, “I know if I look at it during the day, I can tell. How do I know throughout the day when I’m not looking at it? In the middle of the night?” If you could talk more about the app you use. 

Laurie: 

We used to have the prick monitor. Now there is a CGM that monitors your glucose pretty much 24/7, especially the newest ones that have just come out. Used to be that you’d have eight hours of data, and it would have to connect with an app on your phone or a little reader. Now via Bluetooth, most of them will send the data straight to an app on your phone. From there, you can see continuously over 24 hours what is going on with your glucose levels. You can see it in the middle of the night and in the day. 

For a lot of people, I often recommend at first just to collect the data without thinking too much about it. Let it collect in the background, and you can look at it later. 

When you are looking at it, you are also in this self-editing state. You are seeing it, but you’re also wanting to fix it. When you’re sleeping at night, it can be nice to see the data and see what’s going on.

Dr. Eric: 

I use the CGM for a couple weeks. I didn’t realize when I used it that you have to have it on Bluetooth all the time. If someone is crazy about that, how about the EMFs? Is there a way around that or not really? 

Laurie: 

Yes. I use the Abbott one. Abbott used to have a 2 where you need Bluetooth. Sometimes, you can find the 2; you don’t need the Bluetooth. In that case, you have to scan it every eight hours. You might miss data if you don’t do that. You can do the same thing with the one that has the Bluetooth. I do recommend turning that off at night. 

It does have an alarm. You don’t want the alarm waking you up at night if your glucose is going low. Chances are, if you’re not a diabetic, it won’t be life-threatening. 

You can turn that Bluetooth off. Then you have to turn it back on in the morning, so it can connect and send the data.

If you’re someone who doesn’t like having Bluetooth on, because I don’t, I just turn it on occasionally and let it connect and sync the data and then turn it back off. You don’t have to have the Bluetooth on continuously. It is on the censor. 

Now that you have asked that question, I don’t know a lot about what it’s doing when you have your phone off, but it’s on your arm. I will look into that.  

Dr. Eric: 

Definitely let me know. I’m curious about that. How about HRV? What do you use to mention heart rate variability? I have had other guests talk about it, but in a minute or two, if you could explain what HRV is. 

Laurie: 

HRV is a measurement of your heart. It’s the space in between the beats of your heart and how far apart they are. We want more variability. The more variability there is, the more resilient the body is. The less variability, the more rigid. 

The HRV is a measurement of your nervous system. When we look at HRV, and we see HRV going up or going down, it depends on how you would use the measurement. You can use the measurement in a number of different ways. For example, if every day you are taking a baseline measurement at the same time. 

Usually, if you use a device, it will give you your daily HRV score. You can use that score from day to day to see how well you’re recovering. Are you restored? Is that number going up or down or staying the same? That says a little bit about your stress levels in terms of how well recovered you are. That’s how I use HRV. 

Before I used HRV, I used heart rate. It was also a measurement you can use to see when you wake up the next day, is your heart rate going up, down, or staying the same? If it’s gone up, it’s a sign that your body isn’t as well recovered. If it’s gone down, you’ve recovered a little bit. Of course, it could mean other things. 

If you are just using the measurement for how well recovered you are and what your stress levels are like, HRV can work just as well as heart rate. And it can also show us other things. Everybody will be different in terms of HRV. 

There is the Oura ring. I like it. It’s my personal favorite. There is also Woop. I have that as well. It measures HRV. Even the Apple Watch measures it. They all measure it a little bit differently. 

A device like the Oura ring will show you daytime HRV. You can also see when your HRV is going high. It’s typically a sign that your body is more restored and in a more relaxed state. When it goes low, you tend to be more in the parasympathetic, upregulated, more of a stressed state. We can use HRV if you have access to it throughout the day to see your daytime stress.

I do like it in a similar way that I like the glucose levels throughout the day because it gives us information. Maybe you didn’t recognize when you had that meeting, your HRV was way low. At the same time, your glucose went way high. There was a stress piece involved maybe. That can be interesting.

If nothing else than just telling us about how we’re recovering from day to day, HRV can be quite helpful for that. 

Dr. Eric: 

Did you say Woop? 

Laurie: 

Yes. 

Dr. Eric: 

What is that? I know what the Oura ring is. Is Woop an app? 

Laurie: 

Woop is similar to Oura, except you wear it on your wrist. It doesn’t have a clock or face that you look at. It’s designed for athletes, so you can do heart training with it on and not get it damaged. At least not as easily as your more delicate Apple Watch. 

It does have Bluetooth on the Woop as well. I’m pretty sure you can turn it off. That’s why I like Oura the best because it has airplane mode. 

There is the Woop. There is also Garmin, which has a pretty nice feature with HRV called the Body Battery. For someone who is just starting, it can be easy because it takes the data like HRV and heart rate and sleep and give you an estimate on how well recovered you are the next day. That can be a fun place to start for some people. But I do love the Oura ring the best.

Dr. Eric:

Are those the main two bio sensors you use? 

Laurie: 

I use those two. The other one I love is Heart Math Inner Balance sensor. Have you tried that? 

Dr. Eric: 

Yes, I do use it. I love it as well.  

Laurie: 

You get that real-time data when you’re doing the training to see the impact it’s having. Also, the improvement you’re getting when you continue to do it. 

Dr. Eric: 

All right. Do you rely on the CGM, or do you also look at blood sugar markers, like hemoglobin A1C, fasting insulin? 

Laurie: 

I typically recommend doing a fasting insulin. You could also do a hemoglobin A1C. Why not a fasting glucose. We can pretty much see that in no time using a CGM. The hemoglobin A1C is nice to have if you are going to go down the route of using CGMs. You can see where you start, so it’s a good baseline. After you have been wearing CGMs for a while, it also gives you an estimated HBA1C, which is similar to what you would get if you had the bloodwork done.

I do like fasting insulin levels as well as a baseline. I like to use these to test before and then use the CGM and make adjustments personalized to you as you try to do the work to balance your blood sugar levels and get your baseline levels down if you need to. As you do that, it’s nice to have that to check in on later. How is my insulin now after I have been doing this work? How is my HBA1C now? That can be quite helpful. 

Dr. Eric: 

What would you say the optimal ranges would be for hemoglobin A1C and fasting insulin? 

Laurie: 

As I’m saying this, I always have different numbers in my head. EU and US. I think that’s the same, under 5.1 for hemoglobin A1C. 

Dr. Eric: 

Yes. 

Laurie: 

You’re saying yes, so I must have that correct. 

Dr. Eric: 

Yep. I think 5.6 is the upper limit. If it’s over that, 5.7, you’d consider prediabetic. 

Laurie:

It’s the same EU and US. With fasting insulin, under 7. How about you? 

Dr. Eric:

I would agree. Dr. Mark Hyman says less than 5 for insulin. I’m with you. If someone is a 6 or 6.5, and if hemoglobin A1C is looking good, I think it’s okay. 

I don’t know if you ever see this. Insulin looks good, like insulin might be a 5 or even a 4, and hemoglobin A1C is in the upper end, so it contradicts each other. If hemoglobin A1C is 5.5, 5.6, but their fasting insulin is looking good, I don’t know if you’ve seen that. If so, do you rely more on one or the other in that scenario? 

Laurie: 

Yeah. It’s interesting with fasting insulin because I have also tested insulin throughout the day, and it can vary a lot. This is similar to glucose. 

I get curious when I see that number. Is that really telling me what’s going on in their body throughout the day? HBA1C is an average, so it’s more reliable, I think. That’s why I like to go look at what’s going on on the CGM with glucose levels.

If someone is able to achieve pretty regulated glucose levels, they’re in a healthy range, their baseline is in a healthy range, their insulin is 7, and they have been able to improve tons of symptoms and feel great, I would say that they’re doing all right. If they don’t have anything else going on. I look at that first.

Because of the rise in cortisol in the morning, and probably some other things going on in the morning, women’s blood sugar can be moving up a little bit. The rest of their glucose levels are stable and nice and beautiful and not creating symptoms for the rest of the day. 

I have also experienced where I have ridden my bike to go get my bloodwork done. Different factors will affect it differently. If you’re riding your bike, and maybe you’re a little bit stressed out. You’re quickly riding there through traffic. Your insulin level might look different versus if you were just sitting at home when you woke up that morning. 

I don’t really pay attention to it as much as I do with the CGM. This can give me a lot more information. 

Dr. Eric: 

I’m sure you get a lot of questions about fasting, intermittent fasting. How helpful can intermittent fasting be for someone who has a condition such as insulin resistance, type 2 diabetes? 

Laurie: 

Well, I think fasting can be helpful. And I have also seen it not be helpful. I have experienced that for myself when I was going through that thyroid journey, trying to figure things out. I had gained a bit of weight. I decided I wanted to try fasting. I tried keto. I tried several things. When I noticed that my blood sugar was very dysregulated, it made it even more dysregulated. There was a stress factor going on that I hadn’t quite yet recognized. Those things were creating more stress in my body.

Usually, I recommend it to people when I feel that they have gotten a little bit of a better control over their glucose levels and their stress, so we are not adding more stress. I usually like to use a CGM while they’re doing it, so I can see the impact that it’s having. Is it positive or negative? Fasting too long for women in particular, especially when they’re menstruating, we can see a lot of negative effects on the CGM. 

It’s very personal. The ones that tend to have more success in my experience tend to be the ones who are already on the healthier side in terms of metabolic health.

Maybe because we are on a thyroid podcast here, I’d love to know what you think. Also, I would say for those people who do have a history of thyroid health issues, I would find it much less supportive. How have you experienced that? 

Dr. Eric: 

Like you, I think it depends on the person. I will say I do work with people with Hashimoto’s, but I also work with a lot of people with hyperthyroidism and Graves’. 

When I dealt with Graves’, I lost 42 pounds. I definitely would not have wanted to incorporate intermittent fasting at that time. My adrenals were taxed. There were a number of reasons why I don’t think I would have been a good candidate for intermittent fasting back then.

Yeah, I would say it depends on the person. I do agree that some people do it extremely. I have had people do it on their own, where they are fasting for 20 hours, and they only have a four-hour eating window. The question is first of all, the stress that is putting on their body on a daily basis. Potentially on their thyroid as well. Also, are they getting enough protein? Nutrients overall? 

As far as a 16-8 fast, which is pretty popular, I think it depends on the person. I can’t say that I recommend for most of my patients to fast. If someone is in a good state of health, and they want to do it on a wellness routine, that’s one thing. 

If someone is healing, I can’t say it can’t help with healing. I’ve had Cynthia Thurlow and other fasting experts on the podcast. I’m sure many would say it will help with healing and autoimmunity. There is a time and place for that. 

I think it’s really individualized. It does depend on the person. You bring up a good point with the CGM. Just another way to see from a blood sugar perspective how their body is handling it. 

Laurie: 

HRV can be helpful, too. Is it increasing stress? Is it helping you recover? If it’s not getting better, if HRV is going down, then that’s a sign that healing is not going up. I do look at that as well. 

To your point about nutrition, absolutely. When women are fasting and trying to heal, and they are not getting enough nutrition, they are not getting the nutrients they need for that healing, fasting is not typically working very well. 

Dr. Eric: 

Yes, agreed. Before we wrap this up, one more question that you probably won’t be able to answer. I know you use HRV, but when are they going to come out with a continuous cortisol monitor? 

Laurie: 

I am looking forward to that. I think a continuous insulin monitor would be amazing. I heard recently that’s probably not happening for some reason, which I don’t remember. 

I do not know. That would be amazing. And at the same time, I think we’re getting into a period where these are going to become more available to us. I think it’s very cool actually. 

And I think it’s even better when you can work with a practitioner who really knows how to use these tools. A lot of us have access to HRV and other metrics on their watch, but they don’t know what to do with them or how supportive it can be. It is nice to go down the avenue of learning about it for yourself. 

Wouldn’t that be great if we had a continuous cortisol monitor? 

Dr. Eric: 

Maybe in the near future. It wouldn’t be a shocker with all the technology they have coming out. Stay tuned, I guess. 

For those who are looking to learn even more about balancing blood sugar, how to use CGMs, HRV, where can they find out more about you, Laurie? 

Laurie: 

My recommendation would be to take one of my quizzes. You can easily get to my site by typing in YourHormoneQuiz.com. Even better, YourBloodSugarQuiz.com. This conversation is about blood sugar. You might want to check out how your blood sugar is doing. Take the quiz, and you will get on my mailing list. You will get all of the details on how you can stay in touch.

You could also visit me at YourBetterBalancedBlueprint.com. You can find me there as well. 

Dr. Eric: 

Thank you so much. I’ve had other people talk about blood sugar, but this is the most we’ve gone in depth with regards to the CGM. It was great tying it into the HRV as well. This was a wonderful conversation. Appreciate you being on the show. 

Laurie: 

Thank you so much. Lovely being here. Wishing you and your audience all the best.

Dr. Eric: 

Thanks! Same to you, Laurie. 

 

Recently, I interviewed Stacy, and we discussed her diagnosis, the symptoms she continues to deal with, why she opted for a natural treatment approach, her dietary and stress management practices, the need for comprehensive functional testing, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Welcome to another Save My Thyroid audit. I am chatting with Stacy from Ohio. Thank you so much for joining us, Stacy. 

Stacy: 

Thank you for having me.

Dr. Eric: 

I’m looking forward to the conversation. Stacy has been dealing with Graves’ Disease. How long have you been dealing with Graves’? 

Stacy: 

I was diagnosed in March 2022. 

Dr. Eric: 

Have you taken any antithyroid medication since then? 

Stacy: 

I went the natural route, so I have done everything naturally. Just some herbal medicines. 

Dr. Eric: 

Similar to what I did. 

Stacy: 

Yeah. 

Dr. Eric: 

How did you find me? I think you’ve read both of my books? 

Stacy: 

Yes. When I was diagnosed, I did a search for Graves’ and found your book. That is actually what inspired me to treat my Graves’ naturally. I started researching what can I do, and that’s what inspired my journey to go this route. 

Dr. Eric: 

Wonderful. Any family history of Graves’ or any other autoimmune conditions? 

Stacy: 

Graves’, no. My mom does have the opposite as me. She has low thyroid. It does run in the family for thyroid. 

Dr. Eric: 

Okay. What are some of the common symptoms that you’re currently experiencing? 

Stacy: 

A lot of the symptoms in the beginning, those have subsided. I am still experiencing a little bit of heart rate. It will drop down into the 50s, and it will spike anywhere up to 150. That’s just from walking. The heart palpitations go along with that. Tired all the time. Insomnia. I can get out of breath just from walking every now and then. 

I feel a lot better, but with that, I started getting some bloating issues. I don’t know if it’s all related. Some symptoms have gotten better, and I have gotten some new symptoms. 

Dr. Eric: 

Some symptoms have improved; some other symptoms have come on. When was the last time you had a thyroid panel? 

Stacy: 

June. I had TSH, T3, and T4 tested. 

Dr. Eric: 

Did it show you were still hyper? 

Stacy: 

No. What is considered normal but not optimal. My TSH dropped; it is going back down. My T3 and T4 are going up. It wasn’t enough to cause alarm basically. 

Dr. Eric: 

This was a few months ago in June. 

Stacy: 

Yes. 

Dr. Eric: 

It sounds like the herbs are helping. Still not optimal in experiencing some of those symptoms you mentioned, like increased heart rate, fatigue, insomnia, out of breath, some bloating. Not all those necessarily relate to elevation in thyroid hormone. 

You’re taking specifically bugleweed and motherwort? 

Stacy: 

It’s been quite a while since I came off of that. Once my thyroid levels got back into the normal range, I came off of that. One of the ingredients was melissa. There is a whole bunch of other ingredients that I can’t read the names of. 

Dr. Eric: 

Lemon balm, it sounds like. Did it seem like it was helping? 

Stacy: 

Pretty quickly, from the initial, the TSH, which I guess is always the last to improve. My T3 and T4 almost immediately started to go down. 

Dr. Eric: 

How about antibodies? It sounds like you didn’t test them last time. But have you tested them in the past? 

Stacy: 

No. In the beginning, it was odd because my antibodies- I was only tested for TPO antibodies. Initially, I was diagnosed with Hashimoto’s. Then it was determined that I actually had Graves’. I was misdiagnosed, I guess. They were 321. I wasn’t tested again until almost a year later. They actually increased to 631. I’m not sure why the jump. It doesn’t seem to be as much of a concern. It is for me. 

Dr. Eric: 

The doctors usually don’t pay much attention to that. It sounds like you didn’t have the Graves’ antibodies tested. They diagnosed you with Graves’ based on the hyperthyroidism and having the TPO antibodies. Assuming if you had one auto antibody that you probably had the other one, but they didn’t test the other one. 

Any eye symptoms? Any symptoms of thyroid eye disease?  

Stacy: 

No eye symptoms. I actually asked my eye doctor because I visit every year. He said everything is great. My vision is actually improving. I’ll have an eye twitch every now and then, but I think that’s more along the lines of cortisol related. That is the only thing with the eye that I notice. 

Dr. Eric: 

Okay. How would you like your health to be 6-12 months from now, if you could paint a perfect picture? 

Stacy: 

Well, I guess I’ve never really paid much attention to my heart rate before until I was diagnosed. I could tell a difference when it varies, when it jumps. I guess it’s stable, my heart rate.

One thing I didn’t mention, in the beginning, I had gained over 30 pounds before I was diagnosed. I was one of the ones that didn’t lose weight during the Graves’ diagnosis. Having difficulty losing weight. I would like to be able to get that weight off, get my heart rate under control, and finally be able to sleep through the night and not be tired all the time. 

Dr. Eric: 

Those are of course really good goals to have. 

Stacy: 

Yes. 

Dr. Eric: 

In your opinion, what is the #1 thing preventing you from restoring your health? Is there a potential roadblock? 

Stacy: 

Not that I’m aware of. I do clean eating. I exercise. I’m at a loss as to what’s causing the symptoms. 

Dr. Eric: 

Let’s talk a bit about eating. Have you followed an AIP diet in the past? 

Stacy: 

Initially, when I first was diagnosed, I immediately went gluten-free and dairy-free. Then once I met with my doctor, he had me follow the blood type diet. Kind of similar to AIP, but I would call it more restrictive in the sense that there is a lot more things that you have to eliminate based on your blood type. 

Dr. Eric:

Are you still following that diet? 

Stacy: 

Yes. 

Dr. Eric: 

Diet isn’t everything. Obviously, it’s important, or else I wouldn’t have written an entire book on it, The Hyperthyroid Healing Diet. But that being said, there are some differences between the blood type diet. It depends on your blood type. There are different variations. There are some foods that are allowed on a blood type diet that might not be allowed on an AIP diet, and vice versa. We are going to talk about some testing and see what you might have done. 

If your diet hasn’t been working for you, not to say that it’s not offering any benefits, but there is still some work to do. It might be worth at least attempting for a month or two an AIP diet.

I wouldn’t combine the two; it would be too restrictive to combine an AIP diet with a blood type diet. You could try to do that, but I would probably recommend not doing that. Maybe just take a break from the blood type diet, follow an AIP diet for a few months ideally and see. 

You very well might need to go beyond that. Even in The Hyperthyroid Healing Diet, I focus a lot on diet, but there is a lot more than just diet that I talk about. 

This leads us to the next topic: stress. How has stress been over the last couple years? 

Stacy: 

Stress was actually probably one of my main triggers that brought the Graves’ on. I’ve done really well as far as management of my stress. I was in a pretty toxic work environment. I have since gotten a new job. Much less stress on day-to-day things. I don’t notice myself being stressed, but I very well could be, and it’s just not compared to what it used to be.

Dr. Eric: 

It sounds like it’s definitely better than it has been. Maybe there are some stressors you’re not aware of. Without question, it sounds like it’s improved. 

How about sleep? You’re experiencing insomnia. How long has that been going on? 

Stacy:

I noticed it come on after the diagnosis. It would get better. I’ll wake up at maybe 2am or 3am, sometimes 4am. It takes me a long time to get to sleep. It’s not as bad as it used to be. There were times I couldn’t sleep at all. It has improved, but I still wake up and feel exhausted. Definitely an improvement from where I was two years ago, but still not where I’d like to be.

Dr. Eric: 

Getting back to the blood type diet. Was that recommended by a natural health care practitioner? 

Stacy: 

Yes. 

Dr. Eric: 

You have been working with a functional medicine practitioner. Have you done comprehensive blood testing or just the thyroid panel? 

Stacy: 

Yes. I do get comprehensive blood testing done every year. 

Dr. Eric: 

You’ve done Vitamin D? Iron panel? Blood sugar markers, like hemoglobin A1C? I don’t know if you’ve done fasting insulin. Has everything looked good, or has anything been out of balance that’s significant? 

Stacy: 

Yes, I’ve done all of those. Nothing I can think of. Several years ago, my Vitamin D was very low. I’m thinking it was 17. I got it up. I think it was 80 this past time. I just had it done in March. I brought that up significantly. That’s the only thing I can think of that stood out.

Dr. Eric: 

You’re in northern Ohio, so you probably need some Vitamin D supplementation, especially in the fall and winter months. 

Stacy: 

Yes. 

Dr. Eric: 

Vitamin D recently looked good, and the other markers looked okay. Hopefully, they paid attention to optimal ranges. For example, iron saturation, if that’s on the lower side but within range, some doctors won’t really pay attention unless it’s out of range. Hemoglobin A1C, if it’s on the upper end, some won’t say anything unless it’s above the range, and someone is in the prediabetic- Hopefully, being a functional medicine practitioner, they will focus on the optimal ranges.

Has the practitioner done any other types of testing? Any functional medicine testing, like adrenal testing or gut microbiome or anything like that? 

Stacy: 

I’m supposed to be getting the DUTCH test, but we were waiting. I’m just coming off of birth control from being on it well over 20 years. He wanted to wait until I was off of it for a good four months, just to get a better reading. I think that includes the adrenals. 

Dr. Eric: 

Wonderful. Yeah. Diet-wise, we spoke about maybe giving AIP a try. 

Stress management, even if you feel stress isn’t a factor, if you’re not doing so, I would always block out time for stress management. 

Sleep is important, but the question is why are you having the sleep issue? Obviously, it’s not that you don’t want to get more sleep. It is better than it was a couple years ago, but still not where it used to be. 

The DUTCH test might show some things like having high cortisol. Low cortisol in the morning could also be a factor with adrenals. That looks at the sex hormones. It gives a lot of good information. Looks at melatonin, the DUTCH complete. If your melatonin is low, maybe you need that. A lot of people just take melatonin. If you don’t have a melatonin deficiency, typically melatonin won’t help with sleep. That’s a good test to do. 

It will also look at the B vitamins. Birth control can deplete those vitamins. It looks at the metabolite for B12 and the metabolites related to B6. That’s great you’re doing that test. 

You also said you experienced some bloating. Is it when eating certain foods or just randomly? 

Stacy: 

After my cycle, for an entire two weeks. Two weeks out of the month, I am bloated every day. After that, I’m fine. This started probably about three or four months ago. This was prior to coming off of the pill. I’m not sure what’s related to this, if it’s thyroid, gut, or something else. It’s definitely becoming an issue. 

Dr. Eric: 

Probably not directly the thyroid. Maybe the hormones. We’ll see what the DUTCH test looks like. Gut might be worth looking into. Another thing to consider, when I dealt with Graves’, I had the opposite problem of losing a lot of weight. Some people don’t lose a lot of weight, like you gained weight and didn’t take any antithyroid medication. Obviously, it wasn’t due to that. 

We need to look into other factors. Adrenals could be a factor. The sex hormones. The DUTCH test looks at the metabolism of estrogen, which could also relate to weight gain. inflammation overall. 

I can’t say I do gut testing on every single person. With a lot of your symptoms, it’s fair to do the DUTCH test first, but maybe if you’re not getting all the answers you need with that test and switching to an AIP diet, that might be another good test to look into, doing a comprehensive stool test, like a GI Map or GI Effects or something similar to see if you have imbalances. You need to have a healthy gut to have a healthy immune system. 

Also, if your doctor isn’t going to do it, at least on your own, I would test the TSI, just to get a number on that and see what that is looking like. When we have Graves’, that should be elevated. TPO antibodies sometimes will fluctuate. It has a greater tendency to rollercoaster back and forth. You said yours increased to 631, which is a pretty big jump going from the 300s. Definitely keep an eye. 

The TSIs sometimes will do that. Usually, you will see a more consistent decrease when things are heading in the right direction. If things are not heading in the right direction with either of the antibodies, or ideally both because long-term you want both of them to be normal, that tells us that something is missing. 

I do have an episode on the podcast, Episode #150, on lowering thyroid antibodies. I have a series of episodes that I’ll be coming out with. By the time this interview is live, it might already be out. I will have more episodes on antibodies because it is a hot topic. You read my book, so I talk about them in the book. A lot of what I mention in both books will help with antibodies. 

There’s diet. I always will recommend stress management. Get the TSIs tested. If you’re doing everything from a diet and lifestyle perspective, it can be helpful. You’re already doing the DUTCH test. Maybe a comprehensive stool test, based on the results of the DUTCH test. 

I’m sure you will be given recommendations from the ordering doctor. If things head in the right direction, great. If you’re losing weight, sleeping better, awesome. If not, then that’s when you might- That’s a challenge. If you do testing, and if things don’t go in the right direction, the question is to do more testing, or are there imbalances that were found then corrected? 

If you did a DUTCH test, and there were a lot of findings, you focus on those findings for a few months, and things don’t move in the right direction. We could say let’s do a comprehensive stool test. But I guess you could also say maybe to do a DUTCH retest, depending on what it shows. That’s what the functional medicine doctor you’re working with should guide you on. 

If you have problems with estrogen metabolism, a lot of times, that’s coming from the gut. It’s one of those things where maybe doing a stool test is a good idea. Maybe you don’t have to do it. Maybe you get the answers with the DUTCH test. 

I’m sure you knew what I was going to say because you have read my books and have been following me for a while. Still, I read the book on the blood type diet a long time ago. I say this in the book, too. I will be biased with the diets I recommend. I even say in the book that there is no one diet that fits everyone, which is why there are multiple diets in the book. If any diet is not working, in your case, the blood type diet, makes sense to switch to another diet and give that a try. I think there is a good chance you will have to go beyond the diet.

I’m glad to hear you are doing the DUTCH test. I hope that gives good information. It’s one of those catch 22s. You are spending the money because you want answers. You don’t want it to look really bad, but you want to have findings that you could correct. Hopefully, you do the test and get some good answers that the doctor will give advice based on that will hopefully help with your insomnia, weight gain, and energy levels. If not, you might need to dig deeper than that. 

Stacy: 

Yeah. All right. 

Dr. Eric: 

Well, thank you so much for agreeing to do this audit. It was great having this conversation. Thank you for reading my books. I really appreciate that. I hope everybody listening to this found this to be valuable. Look forward to catching everyone in the next episode. Take care, Stacy. 

Stacy: 

Thank you. You, too.

Recently, I interviewed Agnieszka, and we discussed the her journey with Hashimoto’s, symptom development, the various tests she has done, the changes she has made since her diagnosis, the main symptoms she’s continuing to experience, her experience with thyroid hormone replacement, my recommendations for dietary adjustments and testing, alternative thyroid treatment options, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Welcome to another Save My Thyroid audit. I am very excited to chat with Agnieszka here. She is joining us from Poland. Her health journey is with Hashimoto’s. Thank you so much for joining us. 

Agnieszka: 

Thank you so much. I’m really happy to be here.

Dr. Eric: 

I’m happy you’re here, too. You’ve been dealing with Hashimoto’s for a little over four years. Is that correct? 

Agnieszka: 

Yes, that’s right. I was diagnosed around four years ago. I don’t know how long before that I had it. When I was diagnosed, I didn’t really have any significant symptoms. I was just running a regular hormonal check-up. My sister also has Hashimoto’s, so I decided to check antibodies. That’s when I found out. 

Dr. Eric: 

I was going to ask you if there is a family history, and you just answered that question. Your sister has Hashimoto’s as well. Any other family members? 

Agnieszka: 

Not that I know of. My mother doesn’t have thyroid issues or autoimmunity. It’s just my sister that I know about.

Dr. Eric: 

You are taking thyroid hormone replacement, correct? 

Agnieszka: 

Yes, that’s right. I started in May this year, so around five months ago. I tried natural methods. I tried cleaning my diet and doing different things that I thought would support me, but symptoms started to appear and became stronger. In the end, my doctor decided to check if thyroid hormones could be helpful. So far, I haven’t noticed a big difference actually.  

Dr. Eric: 

You haven’t really noticed it helping much, being on thyroid hormone. 

Agnieszka: 

Unfortunately not. I also looked at the test results and confirmed one of the ones I had before. Apart from TSH, which lowered, my thyroid results of free T3 and free T4 are more or less the same. Hasn’t improved. 

Dr. Eric: 

You’re on synthetic T4, right? Levothyroxine? 

Agnieszka: 

Yes. 

Dr. Eric: 

You said it’s been about six months. That’s all you’ve taken. You haven’t tried anything else like desiccated thyroid. 

Agnieszka: 

No. It’s not available in my country. Only T4 is prescribed by doctors. 

Dr. Eric: 

For prescription, you can only get T4. In the United States and some other countries, they have glandulars that are not prescription. 

Agnieszka: 

I am trying to contact an Italian doctor, and hopefully I will be able to experiment with some other treatments as well. 

Dr. Eric: 

Hopefully that works out. Obviously, you want to try to address the cause of the problem and focus on the immune system since Hashimoto’s is more of an immune system problem. Some people do need to take thyroid hormone replacement as well. 

Before we have this conversation, I have everybody fill out a brief application and ask about some of the major health challenges. You put fatigue, brain fog, and hair loss. Wasn’t too long ago that you filled out the application, so I assume you’re still having these symptoms. 

Agnieszka: 

Yes. The most challenging is the fatigue and brain fog. It makes my life difficult and working difficult. It has a huge impact on the way I live and everything I do. 

Dr. Eric: 

I can imagine. One question I have been asking most people in this audit: How would you like your health to be six months from now, 12 months from now? Obviously, you want to be filled with more energy, you want the brain fog to be gone, and you want the hair loss to stop. Anything else that if you had to paint a perfect picture? Are those the main things? 

Agnieszka: 

What you said is the best summary of what I would want for myself. I would like to get my energy levels back and to be able to have a normal life and to enjoy it. I have always been an energetic person and doing a lot of things. Now, I find it sometimes difficult to get through the day when I just do my job. I work and don’t have much more energy for other things. I also struggle at work; I work as a teacher, teaching language. It requires mental clarity.

Dr. Eric: 

The fatigue is all the time then? It’s not worse at certain times throughout the day? 

Agnieszka: 

I have noticed that it gets worse around half an hour after meals. I try to eliminate the foods. Since the diagnosis, I have been gluten-free. I also try to limit dairy. I tried other products. I don’t eat red meat generally since I was 14. But I eat fish. I’ve tried to eliminate different products and see how I would feel. I haven’t noticed big differences. 

Basically, after a majority of my meals, I feel weakness and brain fog. That lasts around 2-3 hours after a meal, starting half an hour after. Then it gets better again. In the evenings, I also feel more fatigue as well. 

Dr. Eric: 

After any meal, whether it’s breakfast, lunch, or dinner, you feel fatigue about 30-45 minutes after. 

Agnieszka: 

That’s right.

Dr. Eric: 

Have you had your blood sugar checked? Not just glucose, but hemoglobin A1C and fasting insulin. 

Agnieszka: 

Yes. I had my glucose tested. I had my insulin tested. I haven’t had that test done. I’m not sure about its professional name, when you drink a lot of glucose- 

Dr. Eric: 

The glucose tolerance test. 

Agnieszka: 

Right. One of the doctors suggested that to me. I haven’t done it yet. Although he said that if it was connected with glucose, I would probably feel lower energy later, not so quickly after eating or having a meal. I haven’t explored that possibility yet.

Dr. Eric: 

How about weight? Is it pretty stable? Are you gaining weight, losing weight? 

Agnieszka: 

My weight is pretty stable. Let me think. I’m rather a slim person. I’m in Europe, so it’s other measurements. I guess it would be around 116 pounds. My height is 5’7”, I would say. I’m rather slim and have always been like that. I don’t see any fluctuations in my weight. 

Dr. Eric: 

That’s good. Any digestive symptoms: bloating, gas, constipation, loose stools? 

Agnieszka: 

Absolutely. Bloating after most meals. Maybe now it’s gotten a little better. I would not say I’m constipated because I’m quite regular, but the stool is hard. That’s something I’ve experienced for more than a year. It doesn’t come easily. 

Dr. Eric: 

How has stress been over the last four years since you’ve been diagnosed? Who knows how long prior to being diagnosed you’ve been dealing with Hashimoto’s. How is your stress handling? 

Agnieszka: 

For the past 2-3 years, I must say that it’s been really great. I feel balanced and peaceful. I meditate every day. 

Prior to my diagnosis, I had a very stressful period. I had a challenging long-distance relationship, so I suspect it might have been one of the triggers, if not the main trigger. I was trying to do my best using my tools, but I definitely was much more stressed back then.  

Dr. Eric: 

Sounds like stress might have been a trigger, or at least one trigger. More recently, over the last few years, hasn’t been as bad. You’re doing things to help with stress management, such as meditation. 

Agnieszka: 

Yes, that’s right. 

Dr. Eric: 

Have you done any type of adrenal testing, like saliva testing or DUTCH testing? 

Agnieszka: 

No, I haven’t. My cortisol was checked, but it was a single test, like one time. Of course it didn’t show the curve. 

Dr. Eric: 

The Circadian rhythm, yes. You just did a morning cortisol in the blood? 

Agnieszka: 

Yes, that’s right. 

Dr. Eric: 

How is your sleep? 

Agnieszka: 

I don’t sleep long. It’s around 6-7 hours. Now, I believe I sleep much better than I used to. Earlier, I had problems, and I would wake up at night around 4am, and I couldn’t fall asleep again. That was one of the first symptoms I started experiencing. After introducing some treatment and sleep hygiene, and I got rid of a parasite because I also received a diagnosis, I noticed changes, and it improved. 

Dr. Eric: 

Since addressing parasites, you noticed that your sleep has improved. 

Agnieszka: 

Yes, that’s right. 

Dr. Eric: 

You did stool testing. You put down GI Map. You did a mycotoxin test for molds and an organic acids test. Correct? 

Agnieszka: 

Yes. 

Dr. Eric: 

It was the GI Map that showed the parasites? 

Agnieszka: 

No, the GI Map was done afterwards. It didn’t show any parasites. It was early at the beginning of my diagnosis that I had a stool test. It was roundworm and ringworm that were discovered. I followed the treatment prescribed by my doctor. I did natural treatment and medicine. I retested. There were parasites again, so I continued the treatment. Then it was negative. 

I’m not sure if it is gone because I know these tests are not super reliable, and they often can be false negative. That’s what I did, and I think it took me quite a lot of time, almost one year, the whole treatment. 

Dr. Eric: 

You did not do the GI Map initially. That was maybe the last stool test you did. You did another stool test that showed that you had parasites. You underwent treatment and did a retest, and it sounds like it still showed parasites. You continued treating and did another one, not the GI Map. The GI Map was negative, but you did another test also, which was negative for parasites. Correct? 

Agnieszka: 

Yes, that’s right.  

Dr. Eric: 

With the symptoms, we’re not sure of the digestive symptoms as related to parasites. Did they improve at all after treating for parasites? Were they worse before you had the treatment? 

Agnieszka: 

The main symptom that changed was the improved sleep. It got better. Since then, I have been sleeping better.

As for fatigue and brain fog, I think they came a little bit later on, which might be connected with my age. I’m in perimenopause; I’m 45. I could see the symptoms start to get worse with time. 

Dr. Eric: 

What did the mold test, the mycotoxin test, and the organic acids test show? Anything significant? 

Agnieszka: 

The mold test showed stool strength of mold. I had the consultation with a functional medicine practitioner in the U.S. I didn’t retest after taking supplements. What was said was the numbers weren’t extremely high, but there were two strains of mold. 

Dr. Eric: 

Did you have your house tested for mold, too? 

Agnieszka: 

Unfortunately not. I’m renting an apartment. I don’t see any signs of mold outside, but I realize that things might be hidden somewhere. 

Dr. Eric: 

That is a possibility. Anything significant on the organic acids test? 

Agnieszka: 

No. Most of it looked okay. We were correcting these things with the other practitioner in terms of nutrients. There were no pathogens or anything like that. 

Dr. Eric: 

Getting back to diet, because you put this on the application, you’d like to try an elimination diet but are concerned about protein intake because you don’t eat meat, only fish sometimes. That’s why you didn’t do AIP. You made some changes like eliminating gluten, as you mentioned, and some other changes, like avoiding eggs. But you haven’t followed a strict AIP diet because you’re more of a pescatarian, not a vegetarian. 

When it comes to diet, there is no diet that fits everyone perfectly. Typically, with Hashimoto’s and Graves’, I will recommend AIP. It is more challenging if someone isn’t eating a decent amount of meat for protein. It’s not like it can’t be done. Regular paleo diet is a little bit easier because it allows you to eat eggs. You avoided eggs, but you currently eat eggs. 

Agnieszka: 

Yes, I currently eat eggs. I didn’t notice any particular changes when I stopped eating them. 

Dr. Eric: 

I know you said you went gluten-free. Have you tried avoiding grains altogether as well as nightshades?  

Agnieszka: 

No. I don’t eat a lot of grains because I’m on a low carb, high fat diet currently. Still, of course, there is some buckwheat or millet. From time to time, I eat rice. I haven’t tried avoiding them totally. 

Dr. Eric:

How about dairy? Have you gone dairy-free? 

Agnieszka: 

I can see dairy doesn’t serve me very well, especially things like cream or milk. I feel bloated after. There is some reaction. I try to avoid it in general. 

Dr. Eric: 

I would listen to your body. I would continue avoiding gluten and listen to your body with dairy. 

I mean, I think it’s worth taking a break from grains. I’m not saying that’s the magic bullet in your case, but there is a good book No Grain, No Pain. For some people, grains could be holding someone back from recovery. It could be harsher on the gut and sometimes cause inflammation, even gluten-free grains. That might be something to consider. 

And nightshades, too. If you haven’t taken a break from tomatoes, eggplant, peppers, and white potatoes, just to try. Not everyone has a problem with nightshades. 

There are reasons why those foods are excluded from an AIP diet. Even a paleo diet, grains are not allowed for the reason I mentioned, that they could be harsher on the gut. Grains aren’t a great source of protein. Same thing with nightshades. Those two, from a protein perspective. 

If you’re eating things like legumes, make sure they’re well prepared, pressure cooked, so they are easily digestible.

I agree with the mold. Maybe look into it. I know you’re renting. That’s challenging because you don’t want to spend a lot of money when it’s not your place. Even when it’s your place, you don’t want to spend a lot of money testing for mold. Like you said, you can’t always go by seeing mold. It doesn’t sound like it was too bad as far as the levels on the mycotox test. Something to keep in mind. 

When someone has mold, or even if someone doesn’t have mold, thinking about fatigue. A lot of things can cause fatigue. You mentioned brain fog. Those are your two main symptoms. The hair loss, which some of that could be thyroid hormone-related. Your thyroid levels are still not optimal. There could be other things like nutrients.

Maybe something to look into, adrenals. Doing adrenal saliva testing or a dried urine test that looks not only at adrenals but other hormones and metabolism of hormones. That could play a role sometimes in energy levels and cause other symptoms like hair loss.

Nutrients. I assume you probably had a full iron panel, looking at iron and iron saturation. 

Agnieszka: 

Yes, I had my iron checked. I had lipids checked. I had B12 checked. Some other ones. 

Dr. Eric: 

Were they looking good? Were they not the lab range but optimal range? 

Agnieszka: 

They look good. I supplement as well. I also supplement B vitamins. Not all the time but every couple of months. 

Dr. Eric: 

Iron, a lot of people are lower. The iron saturation should be between 30-40%. A lot of people are in the low or mid-20s, which for some people is enough to cause low energy. If that’s looking good, and B vitamins are looking good, like B12, that’s great.

Even though your nutrients look good, your gut seems to be an issue because you’re having bloating. Maybe it’s food-related. It may be worth eliminating more foods before diving even deeper. But going on an elimination diet, eliminating grains, nightshades, continuing to eat, whole, healthy foods. If those aren’t helping, you might need to dig deeper.

That is the challenge with parasite testing, like you said. The GI Map, I love it, but it only looks at 12 different parasites and worms combined because it uses PCR DNA testing, which is great, but there are limitations as to how many parasites it can look at.

The other test you did that showed you were positive was negative. Maybe that was a true negative. Maybe not. May be worth redoing that test again. If not, then there could be something else. 

It could be SIBO, when someone has bloating and/or gas. Maybe it could be too much bacteria in the small intestine. That’s something to look at. That could cause a lot of different symptoms, including fatigue, brain fog, and others. 

I’m not saying to do all of this. These are things to keep in mind. 

I don’t know if you looked into stealth infections like Lyme or bartonella. There are limitations with the test, too, if you just go to a regular lab. Lyme is often negative, even if you have Lyme. Not to say that you have it, but to keep in mind. I dealt personally with chronic Lyme, so I am more aware of the impact of these tick-borne infections. It can come from other places, too, like fleas potentially. You definitely need to dig deeper.

It sounds like stress is good. Sleep could still be better. You said 6-7 hours. Trying to get 7-7.5 hours at least because that will affect energy. Continuing to get more sleep. Sometimes, with sleep, you have to look at adrenals, too. That’s all you’re able to get on your own maybe, so you may need to look into adrenals and sex hormones and see if there are issues there. 

It sounds like you might need to dig a little bit deeper. You have done a lot, which is great. I know it costs money for the GI Map and organic acids test and mycotox tests. These are not cheap tests. That’s why I’m saying to make some of these dietary changes and see how you feel. 

If things are not heading in the right direction, maybe the adrenal saliva test or the DUTCH test. Maybe another parasite retest. Not necessarily the GI Map, but the one that was initially positive for parasites to see what it looks like. If that is looking good, maybe look into something like SIBO testing. If you absolutely have to, stealth infections. 

When I dealt with Lyme, there was no evidence of a tick bite, no rash. Everybody is different. I didn’t have fatigue; mine was more neurological symptoms. With Lyme, you often have other symptoms like migrating muscle and joint pain. If you don’t have that, it doesn’t mean you don’t have Lyme. I would look more into Lyme if you have pain that moves around. The fatigue and brain fog, a lot of different things can cause that. I’m just saying that’s something I wouldn’t overlook.

Those are some things to consider. I know it’s a lot that I threw at you. 

One more thing: optimizing thyroid hormone. When we want to address the cause of the problem. Your most recent TSH was 2.99, which is within the lab range, but not optimal, so you are working on that. The synthetic T4 is not a good fit for everyone. I know you can’t get desiccated thyroid, but you are working on getting the glandular. 

Everything else could play a role in the autoimmune response. There is a time and place for thyroid hormone, but if the synthetic T4 is not working for you, hopefully you can get something else in its place. 

Agnieszka: 

Yes, great. Thank you so much. You have given me a lot of tips and next steps. Honestly, I felt a little bit lost. I knew there could be a lot of root causes. Now I feel like I have a clear path and step-by-step things I can explore and look into. Thank you very much for that. 

Dr. Eric: 

You’re very welcome, Agnieszka. Have you read my book Hashimoto’s Triggers? 

Agnieszka: 

Yes. 

Dr. Eric: 

That goes into a lot of detail with different triggers. Thank you for reading that. Thank you so much for doing this audit. I really appreciate it. Hope you found it helpful. It sounds like you did. Hope everyone listening found it to be helpful. Thanks, everyone for tuning in, and catch you in the next episode. Bye, Agnieszka. Take care. 

Agnieszka: 

Goodbye.

Recently, I interviewed Nanette, and we discussed the  long-term medication use, her treatment with propylthiouracil (PTU), dietary changes, the importance of stress management, why we need to address underlying causes like insulin resistance and inflammation, my approach to testing and lifestyle modifications, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Welcome, everyone. I am very excited to do a Save My Thyroid audit. We are going to be talking to Nanette here on her experience and personal journey with toxic multinodular goiter. How are you doing today, Nanette? 

Nanette: 

I’m doing really well, thank you. Thanks for having me. 

Dr. Eric: 

It’s a pleasure. Looking forward to this. If you could give a little bit of your background. How long ago were you diagnosed with toxic multinodular goiter? 

Nanette: 

I’m 63. When I was 16, I had a nodule on my thyroid. My dad noticed it. This is 1978, and I had that removed surgically. I went 10+ years with no thyroid treatment at all. Then I hit 30, and I got another nodule. I had that one removed. I had most of my thyroid, but I had two surgeries with two nodules removed. At 30, they put me on some Synthroid. I had been back and forth for a little while taking the Synthroid. I was euthyroid. Then I was off all thyroid medication. 

Almost 20 years ago now, I had a change. I felt bruised, like I had been in a fight or something. I couldn’t figure that out. Then I went to the doctor, and they said, “Oh, I think you’re hyperthyroid.” I was moving at the time. It turns out for the last 20 years, I’d had toxic multinodular goiter. Really, only the last 10 years, I had been treated for that. 

I tried methimazole, which made me crazy, not crazy but really got my heart rate up and going. My local doctor didn’t want to try PTU, so I went down to Phoenix and found a doctor there who wanted to try PTU. I have been on that for five years now almost. 

I listened to one of your podcasts, which made me real nervous, that that’s not good. Just yesterday, I saw the doctor, and she said I’m really on a pediatric dose. Just enough to calm my thyroid enough. I’m actually feeling pretty good. 

Nicely, she said yesterday, “I really don’t want surgery on you.” A lot of doctors are resisting it because I’ve had two surgeries with scar tissue. That inadvertently saved my thyroid. I had more than one doctor say, “Too bad they didn’t remove your whole thyroid.” I still have it. It does work a bit. If I don’t take the PTU, my TSH goes really low, like .002. I get heart palpitations, which is really my biggest and only symptom. 

I’ve had sonograms every year. Yesterday, I had one. My nodules are stable. I will follow up in a year. I asked about the radio ablation. She said, “Well, you have at least three nodules we’d have to do that to, and that’s a little invasive. You’re doing well.” My liver enzymes have been well, so so far, I’m sticking with what I have. I’m hoping to learn from you.

Dr. Eric: 

Wonderful. Thank you for sharing your background. We were chatting a little bit before I pressed Record about the radiofrequency ablation, how they didn’t have that years ago, and that’s why you got the individual nodules removed. 

I also mentioned how they usually don’t do that, so you got lucky that they didn’t remove your entire thyroid gland. At least these days, I don’t hear much about doing even partial thyroidectomy, where they remove half the thyroid gland, let alone the single nodule. That’s not great that you had the nodules, but it’s great that they didn’t remove the entire thyroid gland.

As far as PTU, I mean, everything is risk versus benefit. When I talk about medication on the podcast, I try not to talk too negatively. Sometimes, I do get into the research about some of the negative consequences. Obviously, with both methimazole and PTU, it can put stress on the liver. Everybody’s different. That’s why there’s liver panels available to monitor that. I know you’ve been given the liver panels. 

You mentioned you’re on a pediatric dose. If you’re tolerating it well, you don’t want to be on that forever, but for now, if it means preserving the health of your thyroid gland while trying to figure out what you can do, which is why we’re chatting here. Some endocrinologists will recommend surgery or radioactive iodine right away if someone is unable to tolerate methimazole. It sounds like you had to go to Phoenix to get that prescription. They were resistant in your area to switch you to PTU. 

Long story short, I’m glad that you were able to get the PTU, so at least, it buys you time, and everything seems to be stable. Hopefully, I will give you some helpful advice to put you on that road to recovery.

As far as you know, you have been dealing with it for a long time. Maybe not toxic multinodular goiter specifically, but having nodules. That all started when you were 16. Do you know of any other family members with a thyroid condition? 

Nanette: 

Definitely. My grandmother, my dad’s mother, had the same thing. Multinodular goiter. Her daughter, my aunt Linda, she had thyroid cancer and had her thyroid removed. Then her daughter, my first cousin, she had free thyroid cancer and had her whole thyroid removed. She is a little younger than me. Family history there definitely. 

Dr. Eric: 

Okay. Has the PTU pretty much controlled all your symptoms, or are you experiencing any currently? 

Nanette: 

It has helped my symptoms very much. I have tried to wean myself off of it before with the doctor. My symptoms just came roaring back, or I feel my heart palpitations lying in bed, thinking, “Oh no.” I can’t hold a glass of water because it shakes. It definitely helps. That’s been my only symptom, the heart palpitations. I’m just thumping. 

Dr. Eric: 

Is it occasional or pretty much all the time? 

Nanette: 

Now I’m good. Occasionally, I feel my heart fluttering in my chest.

Dr. Eric: 

Before being on the PTU, that was the main symptom. 

Nanette: 

Yes. Tremors in my hands as well. 

Dr. Eric: 

Okay. I’m glad the PTU is helping with that. 

My next question, looking into the future, if you had a crystal ball, ideally, what would you like your health to be like six months from now? 

Nanette: 

I would like to be off the PTU totally. That would be nice. I have been trying your Level 3 diet. I am about five weeks into that. The doctor was familiar with that. My endocrinologist yesterday mentioned some people try that. She didn’t elaborate too much. 

I’d love for my nodules to go away and me to get off the PTU. That would be wonderful. 

Dr. Eric: 

Okay. The doctor was a little bit supportive of the diet, it sounds like. Many are not supportive and just say it’s a waste of people’s time. That was the endocrinologist that you’re seeing? 

Nanette: 

Yeah, down in Phoenix.  

Dr. Eric: 

That’s great that the endocrinologist wasn’t just dismissive of diet because many of them are. Obviously, it’s great that you’re following a Level 3, which is like an AIP, modified autoimmune protocol. You don’t have history of autoimmunity. On the application, you did say something about in the past Hashimoto’s, but all of your current antibodies seem to be negative, correct? 

Nanette: 

Right. I was told when I was first diagnosed at age 16, it was an autoimmune thing. Then I heard the word “Hashimoto’s” somewhere in the next 20 years. I really never paid attention to thyroid antibodies until you mentioned them. I guess I don’t have Hashimoto’s. If I did, it’s gone.  

Dr. Eric: 

It is possible. It’s also possible that they misdiagnosed you. The only way to know is by looking at the blood test years ago. If you had elevated thyroid antibodies back then, those are the antibodies for Hashimoto’s. It is possible that at least from what we see, you no longer have them. There is always the possibility of false negative antibodies, so the blood test is not perfect. That’s something to think about. 

Also, one question I almost forgot to ask you until now: How did you find out about me, Nanette? 

Nanette: 

I think I had signed up for a health summit, and I found Dr. Amie Hornaman. I looked at her website and sent her a note. She said, “I work with hypothyroid. You need to talk to Dr. Eric. He works with hyperthyroid people,” which is rare. Most people are hypo/Hashimoto’s. To find someone who concentrates on hyperthyroidism. That’s how I found you. I signed up for your Thyroid Boot Camp. I bought your book. Here I am. 

Dr. Eric: 

I’m glad Dr. Amie referred you to me, and you signed up for the live event that I had not too long ago, the Thyroid Healing Diet Boot Camp, and got my book. Wonderful.

My next question: Do you feel like there is anything preventing you from reaching your goals, from getting off the PTU, from restoring your health? Any roadblocks? 

Nanette: 

I don’t think so. The diet is a little tough. I miss potatoes and rice and bread. That’s harder than I thought. 

I don’t think so. It’s really hard to believe how much I have learned in the past month and a half. I’ve paid attention to my lab results. I’ve had thyroid problems for 46 years. I don’t think there’s anything stopping me from reaching my goals. 

Dr. Eric: 

Okay. Awesome. Have you done comprehensive testing at all besides getting thyroid panels? I’m sure you’ve gotten CBCs, metabolic panels, maybe lipid panels. I don’t know if you’ve had Vitamin D, iron panels, other types of blood tests. 

Nanette: 

Yes. Those are all good. I had follicular lymphoma 10 years ago. I was diagnosed with that. I don’t know where that came from; it just showed up. My bloodwork is followed closely, especially my liver, because the lymphoma was in my spleen and bone marrow. I was a bit nervous about taking some PTU because that can affect your liver. Everything has been very good. My panels are great.

My immune system is a little squished because of the chemo, which I had because my spleen was so enlarged. My bone marrow was affected greatly from the non-Hodgkins lymphoma. Besides having a low IgG level, my panels have been good on everything. 

I take Vitamin D. I’m out in the sunshine. I live in Arizona. I’m outside every day. I go for walks every day. I try to do all the good stuff. 

Dr. Eric: 

I’m sure they have done fasting glucose as part of a metabolic panel. Have you looked at hemoglobin A1C and fasting insulin in the past? 

Nanette: 

I don’t think I’ve ever had that done. My glucose has always been good. Did I get that done? 

Dr. Eric: 

Well, if you read some of the materials on my website as well as the podcast, when I speak about goiter and nodules, whether it’s multinodular goiter or just goiter without the nodules or just nodules without the goiter- In your case, it’s toxic multinodular goiter. There is a few different factors. 

One could be blood sugar imbalances, such as insulin resistance. Fasting glucose of course is usually tested as part of a metabolic panel. That is far from a perfect test. Hemoglobin A1C is the average blood sugar over 2-4 months. A lot of doctors do test for hemoglobin A1C, but most don’t test for insulin, which could also be helpful. 

If someone has maybe a hemoglobin A1C that doesn’t look too bad—it might be on the higher side but within range—then we want to see insulin ideally less than 5 in a fasting state. If we see that in double digits, or even an 8 or 9, and the hemoglobin A1C is creeping up, like 5.5, 5.6, which is still within range, but on the higher side, it’s not officially an insulin resistance or type 2 diabetes or prediabetes diagnosis until someone’s A1C is 5.7. 

Most endocrinologists, if someone has a hemoglobin A1C of 5.5 and a fasting insulin of 9, which they usually don’t test, they usually won’t say anything. That usually is not optimal when it comes to blood sugar. That could at least be a factor. Doesn’t mean it’s the only factor. That is something to look into.

Yeah, I would at the very least test those two markers and see what those show. Hemoglobin A1C ideally, you want that less than 5. Even if it’s 5.1, 5.2, that’s still really good. If insulin is less than 5 or even honestly 5 or 6, it’s still not too bad. If you see those numbers on the upper end, or at least hemoglobin A1C on the upper end of the range, 5.5, 5.6, and insulin above a 7, that’s when you might suspect blood sugar imbalances.  

Nanette: 

Okay, I’ll follow up on that, thank you. I never thought about it. 

Dr. Eric: 

You’re welcome. Another potential factor when it comes to nodules and goiter, problems with estrogen metabolism. I think you said you’re 63. It’s been a long time since you cycled probably. As we get older, both men and women’s hormones are going to decrease. 

You still have some estrogen. Even if you have a smaller amount of estrogen, which you do compared to 20/30 years ago, you still have to detoxify that estrogen. You still have to metabolize it. Some people have problems metabolizing the estrogens. 

Do you have any history of uterine fibroids, ovarian cysts, endometriosis, any breast cancer? I know you mentioned follicular lymphoma, but not breast cancer history or fibroids or cysts? 

Nanette: 

Not in me, no. I had some endometriosis toward the end. Didn’t bother me. I should check for estrogen metabolism? 

Dr. Eric: 

Something to consider. The problem with testing for it is you can’t do it through the blood. There is a dried urine test called the DUTCH test. There are a few dried urine tests; the DUTCH is the most well-known test that looks at adrenals, hormones, but the big thing is looking at how you metabolize your estrogen. With your history and background, you might want to consider doing that type of test. 

Nanette: 

Will do, thank you. 

Dr. Eric: 

There is more information. Even if you just do a random search, you’ll see a lot of practitioners who do that test. There is a lot of information out there. Those are two areas. Inflammation in general could be a factor.

There is the controversial iodine. Too much iodine isn’t good, but too little iodine can cause problems. This can lead to nodules and/or goiter. With toxic multinodular goiter, you want to be careful. Have you tinkered at all with iodine on your own? 

Nanette: 

No. It’s in a multivitamin I take. 

Dr. Eric: 

Sometimes, the iodine can worsen, like exacerbate the toxic multinodular goiter. That’s where you might want to consider working with someone if you look into that. Even doing something like DUTCH testing, maybe consider working with a functional medicine practitioner. 

With iodine, there is urinary testing if you were interested in doing that. Blood testing is not too accurate. Even urinary testing is not perfect. There is a lab, Hakala Labs. They have different types of urinary iodine tests. Iodine spot test is what a lot of people choose.

There is also the loading test, but that involves taking a 50mg tablet of potassium iodide, which many people do fine with, but some people might not. 

Usually, with patients, I start with blood sugar, problems with estrogen metabolism. Most of the people I’m working with have some type of inflammation. The iodine, it depends. Some people are gung-ho and hear a lot about iodine and want to look into it. Others, based on what I say, they might be a little bit nervous. 

I personally had a good experience with iodine, so I am not anti-iodine. I have worked with a lot of patients over the years, and I have seen both good and bad. You just never know how someone is going to respond. I can’t say it’s something I test for in everybody but wanted to make you aware of it. 

Nanette: 

Okay. 

Dr. Eric: 

Diet and lifestyle. You are following a Level 3 diet, which is more autoimmune-focused. It won’t hurt for you to do that. You said you have been following it for five weeks? 

Nanette: 

Yes. 

Dr. Eric: 

You can keep that up. A lot of times, for non-autoimmune thyroid conditions like yours, I might recommend AIP, if you’re having gut issues. Otherwise, a Level 2, which is a modified paleo diet. You have already followed it for five weeks, so if you want to continue for 2-3 months, like another 3 weeks, or make it a full 90 days, that’s fine. It won’t cause harm to do that. But if you’re finding it really difficult and challenging, and you wanted to transition to a regular paleo diet, a Level 2 diet, as I talk about in my book, you definitely could do that. 

Nanette: 

I get to move up then! Yay! 

Dr. Eric: 

There you go. You got my book and attended the Thyroid Healing Diet Boot Camp. If you do that, you might still want to do the reintroductions, which I talk about in the book, rather than just make the transition. Since you have already done it for five weeks, it’s up to you. 

Nanette: 

I’ll go back to the book. 

Dr. Eric: 

Diet and lifestyle for any thyroid/autoimmune thyroid condition is important. You’re already doing everything you can from a dietary standpoint, it sounds like.

Are stress and sleep okay on your end? 

Nanette: 

Yeah, I’m good there. My husband and I are retired. We do a lot of volunteer work. We do a lot of church work. I’m at a stress-free side of life. My kid is all grown up; he’s good. 

Dr. Eric: 

I can’t advise you to get off the PTU, but first of all, what we mentioned here, hopefully by addressing the cause of the problem, over time, you will see changes. 

It can be tough with nodules. I can’t say everybody who has toxic multinodular goiter, moreso the nodule part, all the nodules shrink and go back to normal on an ultrasound. But everybody is different. We do sometimes see some really good changes. Other times, we’ll see changes, but it depends on the person. 

We do get people with both Graves’ and toxic multinodular goiter to the point where they don’t need it. The only way to know is by incorporating these changes. If you don’t need the PTU, eventually the numbers on the thyroid panel should be hypo. Then the doctor should gradually wean you off. 

You might have heard me talk about natural agents like bugleweed and L-carnitine. Have you tried those at all? 

Nanette: 

I have not. 

Dr. Eric: 

That’s something to consider. It depends on the person. If someone is taking methimazole or PTU, and they’re tolerating it well, and they’re okay with taking it, there will be people who will continue taking it. 

Your situation is a little bit different because you have been on it for five years and are tolerating it well. If you have to take it for good, you will, but if there is an alternative, then you’d rather do that. 

The thing about bugleweed and L-carnitine. A couple things actually. They’re also not doing anything to address the cause of the condition. You would just be managing your symptoms naturally while still trying to address the cause of the problem.

Also, they don’t work for everyone. If someone is taking a medication, I can’t tell them to stop it. Even if I could, I wouldn’t tell them to do that because I don’t know if the bugleweed or L-carnitine would help. 

Commonly, what I tell people to do is if they are taking antithyroid medication and are looking to get off of it as soon as possible, I can’t tell them to do that, but I could say to continue doing what you’re doing. Let’s add some bugleweed to that, like half a teaspoon, twice per day, for example. The dose depends on the person and the levels. Some people might be a full teaspoon twice a day. According to the literature, 2,000-4,000mg per day of divided doses of L-carnitine tartrate. 

If it’s working, and you’re on PTU and bugleweed, then a few months from now, you do another thyroid panel, and it tends to be on the hypo side, then the goal is for the endocrinologist to say- If you don’t tell them what you’re doing, he/she might not know, but if you’re more hypo, let’s cut the PTU further. Eventually, if you continue that pattern, get to the point where you’re just relying on the bugleweed and/or L-carnitine.

As you’re addressing the cause of the problem, hopefully get to the point where you don’t have to rely on anything. That’s the ultimate goal.

If someone had to rely on a choice, where they were taking long-term bugleweed or long-term PTU, I’d rather them take bugleweed. Everybody is different. Some people would prefer the medication since it’s covered by insurance, whereas bugleweed is not. They are paying the money for that. 

Like I said, the ultimate goal with all these conditions, whether it’s Graves’ or toxic multinodular goiter or Hashimoto’s, is to address the cause of the problem. It’s different with Graves’ because Graves’ is autoimmune, and we’re doing things to address the autoimmune component. Even with toxic multinodular goiter, there is an underlying cause behind that. 

I gave the more common causes according to the literature and my experience working with patients. The insulin resistance, problems with estrogen metabolism, inflammation, sometimes iodine deficiency. Those are some of the things to look into.

I’ll wrap up by saying obviously, I will be biased because I am a natural health care practitioner. Some things you could do on your own, like the Level 3 diet. Testing the hemoglobin A1C, fasting insulin. You could get that through your doctor. 

As far as doing some of these other tests, one thing I didn’t mention is the dried urine test will look at estrogen metabolites, but also the gut plays a role in metabolizing estrogen. Some people could benefit from doing a comprehensive stool panel to see what’s going on. If they have a lot of imbalances in the gut, then they might need to do things to improve their gut health, even if they are not experiencing gut symptoms.

The point is, it can get complex. You try to do as much as you can on your own. Take advantage of my book and the information you gained from the boot camp. But if you feel the need, there is me and other functional medicine practitioners; consider working with them. 

Any questions on your end? 

Nanette: 

That was interesting about how I might have gotten this in the beginning. I grew up on a farm, inland, West Virginia. Maybe iodine deficiency, I’m not sure.

Dr. Eric: 

Could be pesticides. If you grew up on farmland, I don’t know your farm, but other surrounding farms, being exposed to the toxins that could also act as endocrine disruptors and could affect the metabolism of estrogen as well. There is a lot of possibilities. Maybe you don’t do this now, but drinking water out of plastic bottles for a period of time. Could get exposed to the xenoestrogens that way. 

This happened when you were really young, as far as the start of it, the nodules. It does seem like something happened prior to turning 16. 

Nanette: 

Right. Maybe some trauma, too. When I was about eight, I was pushing a chair into the table, and I slipped. I hit myself right here with the table. Maybe that was a little trauma. Certainly was trauma. Maybe that contributed over time. 

Dr. Eric: 

Yeah. That definitely could have caused inflammation. You formed the nodules when you were 16. Chances are the doctors that you looked at didn’t think about the cause. They just said, “You have a nodule. We need to remove it.” Then you got another nodule and needed to remove it. 

That’s the problem with most medical doctors, including most endocrinologists. They never ask what the cause is. That just comes down to the training in medical school. There are some who go on to focus a little bit on functional medicine and open up their minds. Unfortunately, that’s not the case with most doctors. 

Nanette: 

Things have improved. Of course, I want to know why I got this and where it came from. I will check for insulin resistance. 

Oh, you mentioned gut tests. I actually did do a gut test. For the most part, that was good. I had some high H-pylori. I took some mastic gum to get rid of that. I don’t know if it’s gone, but I did the mastic gum. I have been taking a lot of supplements to build up my gut. I am still doing that along with your diet.  

Dr. Eric: 

Wonderful. 

Nanette: 

I’ve been working really hard to get better. I would love to get rid of my nodules and the PTU. You don’t think that being on PTU at a low dose for five years is alarming? I seem to be tolerating that well. You’re not telling me to run away. 

Dr. Eric: 

I have an episode on my podcast on low dose antithyroid medication for a long time, talking about this. Most of the research out there is on taking lower doses of methimazole. There are people who have been on methimazole for 10-15 years, even longer, without a problem. It’s been a little bit since I put together the episode. 

There wasn’t a lot on long-term PTU. It really comes down to monitoring the blood tests. It’s not ideal. Even being on methimazole, if someone works with me, and the end result is them on methimazole, that’s disappointing to me because I want to get them to the point where they’re not on medication. That’s why they’re coming to see me, not for me to tell them to get off, but to get them to the point where their thyroid is working properly, and their immune system is working properly. Their endocrinologist, based on the results, will wean them off. 

It’s not ideal to be on PTU for five years or longer, but risk versus benefits. If you’re monitoring the liver enzymes, and if the white blood cell count is remaining okay, because sometimes the antithyroid medication will affect the white blood cell count. If your liver, white blood cell count, kidneys all look okay, and you’re on a lower dose, then let’s put it this way. 

If I was in your situation, and if I had to choose between low dose PTU and getting radioactive iodine or thyroid surgery, I am pretty confident I would be doing what you’re doing and staying on the PTU, as long as my bloodwork continued to look okay. I wouldn’t be happy that I’m on the PTU, but that’s why we’re having this conversation, too. If you were happy, you wouldn’t be doing this audit. 

From a risk versus benefit standpoint, yeah, if I had a choice, if the option was being on low dose antithyroid medication or getting surgery or radioactive iodine, I am pretty sure I would choose low dose antithyroid medication. 

Nanette: 

It’s nice to keep your thyroid. 

Dr. Eric: 

Exactly. That’s obviously the goal: try to help people save their thyroid. 

Thank you so much, Nanette, for doing this. I really appreciate this. Hope you found the feedback to be valuable. 

Nanette: 

I did. Thank you, Dr. Eric. 

Dr. Eric: 

Thank you. Take care. 

Nanette: 

Okay, bye.

Recently, I interviewed Dr. Nayan Patel, and we discussed the role of glutathione as a master antioxidant, its significance for individuals with thyroid conditions, and its impact on autoimmune disorders like Hashimoto’s and Graves’ disease, the benefits of N-acetylcysteine (NAC) for boosting glutathione levels, the limitations of intravenous glutathione, why a balanced diet and proper supplementation are crucial, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I’m excited to be joined by Dr. Nayan Patel, as we are going to have a comprehensive chat about glutathione. Really excited about this conversation. Let me go ahead and dive into Dr. Patel’s bio here.

Dr. Nayan Patel is a sought-after pharmacist, wellness expert, and thought leader in his industry. He has been working with physicians since 1999 to custom develop medication for their clients and design a patient-specific drug and nutrition regimen. He has been the pharmacist of choice to celebrities, CEOs, and physicians themselves. Not included in this bio, you have a book as well, so check out The Glutathione Revolution. 

Dr. Nayan Patel: 

That’s right. Thank you.

Dr. Eric: 

Thank you so much for joining us, Dr. Patel. 

Dr. Nayan:

It’s a pleasure. Thank you for inviting me.

Dr. Eric: 

Really excited to talk about glutathione, something that a lot of practitioners use in their practice in different forms. As far as understanding it and the general public, it’s more common, but you’re going to go into detail. 

For those who are unfamiliar with glutathione, can you talk about what it is? Why is it considered to be the master antioxidant? 

Dr. Nayan: 

Absolutely. Hopefully, you will get it by the end of the day today. The reason is because it is the most abundant peptide or molecule or any kind of component that is produced in the human body. It is ubiquitous with anything else that you can think about. Next to water, glutathione is the most abundant molecule there is. The reason that it’s produced there is because of all the things that it does for us. 

You just mentioned antioxidant. In the simplest terms, glutathione is a tri-peptide, which means it’s three amino acids coming together. Glycine, glutamine, and cysteine. It is one of the simplest forms of a peptide, so to speak. The simplicity is not something to be undertaken because the work it does, it’s way more than any other molecule inside your body. 

Dr. Eric: 

Thanks for the explanation. I need to ask you: What motivated you to start doing extensive research on glutathione, let alone write an entire book on glutathione? 

Dr. Nayan: 

If there is one thing that I can do that can change the complete course of a trajectory, what would that be in medicine? When I was doing my research, everything led to me asking, “What can we do to reduce oxidative stress? What can we do to help our body heal from inside? How could we keep the body clean from inside?” 

The body produces an abundance of glutathione. We have known of this product for about 140+ years. The thing is, nobody has ever figured out how to enhance it inside your body. Wait a second. We know something is good for us. We know this is the best thing there is. How come nobody has ever figured out how to get it inside your body? 

Let’s take it on. I have some spare time. I have nothing else to do. My business was not doing great anyway. We started working on this project very early on. Tried to figure out how we can get this inside our body. 

Dr. Eric: 

Okay. I’m glad you did. We wouldn’t be having this conversation otherwise. You wouldn’t have been helping all these other people with your research. Thanks for releasing the book. 

Maybe starting off with food sources, what sources of food can you get at least a precursor of glutathione? You mentioned some of the precursors, like glycine, cysteine, glutamine. Those are amino acids. I’ll let you take over from here.

Dr. Nayan: 

Before I talk about sources and where we get it from, I really want people to understand why we need this thing. It’s the most abundant molecule. Why do we need it?

The why is what will help you understand what to do now. If there is no why, people won’t do it. I will explain the why first if that’s okay. 

The why is because glutathione has two purposes inside your body. It detoxifies or neutralizes all the free radicals that you’re exposed to. If you’re breathing, you’re consuming oxygen, which is a free radical. At a low concentration, it is great for you because it is a source of energy and helps your body heal from inside. 

But excess amounts of oxygen can also cause what we call reactive oxygen species, and those are toxic to the human body. The body produces glutathione to quench all those free radicals, so oxygen stays low enough.

There is a second source of free radicals coming to the body, like sun, pollution, chemicals we ingest, chemical reactions that happen inside the body. Every single reaction that happens inside your body produces a byproduct. The byproducts are all reactive oxygen species. When you break down amino acids or proteins, it also creates what we call a reactive nitrogen species. 

All those things have to be neutralized every single day because you eat and breathe almost every single day. You have to have a system in your body to neutralize those things. That’s the first function. Sleeping, you’re awake, doesn’t really matter. Your body is working for you. 

The second part, which nobody talks about, which is as much or even more important, is it helps detoxify your liver. Your liver is the garbage disposal of your body, trying to process every single thing and dumping into the kidneys or your intestines. You can just get rid of it from your body. The processing requires chemicals. The most important one is glutathione because it helps bind to all these chemicals and hopefully get rid of them. 

Those two processes are very critical for us. That’s why we need to make sure our glutathione levels are high at all times. I don’t care if you’re 20 or two years old or 100 years old. Our needs are not going to decrease as we age. Our needs are going to be the same no matter what. 

If the needs are the same, and the body cannot produce enough, we have to make sure that we are doing everything possible to give our body a fighting chance to improve the levels, so it can keep our body clean from inside.

The question that you asked me earlier about how do we get glutathione in there? The #1 choice is always going to be food. Which foods can I eat to get the glutathione that I need? 

Your body actually does not have the receptors to accept glutathione by itself as is. That means we have to consume all the building blocks, which are the amino acids, and the body has to make it from there. The foods that have glycine, glutamine, and cysteine are going to be great for it. 

Let me tell you one more thing. Our body has enough glutamine and glycine coming from all the food we eat. The issue is we are not getting enough cysteine in our diet. If you just put in your favorite search engine “cysteine-rich foods,” you are going to get a list of, if you’re vegan or vegetarian or a meat eater, doesn’t matter. They have four choices in every category you have to consume those products to get the cysteine in your diet. 

Cysteine is actually getting used up by your body to produce glutathione. That’s the easiest way to do it.

Before you go into the diet, first of all, I would suggest reducing toxins. Reduce exposure to excessive sunlight. Reduce exposure to pollution. Reduce exposure to toxic chemicals that you may ingest knowingly or unknowingly. Alcohol depletes glutathione levels. Smoking can deplete glutathione levels. Avoid toxins. Reducing all these things can also reduce the need for glutathione to let your body use it for other purposes.

Dr. Eric: 

Makes sense. The two main purposes of glutathione are to help with free radicals, essentially reducing oxidative stress, and also detoxifying the liver, so that makes sense that you want to do as much as you can to reduce your toxic burden as well as excess sun exposure and some other things you mentioned. 

Food sources. Mainly focusing on cysteine-rich foods rather than food sources of glutamine and glycine, correct? 

Dr. Nayan: 

That’s right. In fact, we’re doing some brain trials. What we are finding out is even at the 70-year-old person, they have an abundance of glutamine. What we are suspecting is glutamine might be an issue as well, if it’s in the brain. Having a cysteine-rich diet can actually bind those excess glutamines and get them out of the body. Hopefully, that’s a good thing. Cysteine-rich foods is what we recommend most of the time. 

Dr. Eric: 

For those who have an increase in intestinal permeability with a leaky gut, would glutamine be beneficial for those people with gut support? 

Dr. Nayan: 

Absolutely. Even though glutamine may be too toxic in your brain, not enough glutamine can cause all kinds of leaky gut issues and permeability issues or cells not developing correctly. Having a glutamine source between 1-5g a day, if you have the problem, is a great idea. 

Keep in mind if you can enhance the glutathione levels in the body, it will do the same exact thing as well. 

Dr. Eric: 

Are there any other symptoms associated with glutathione deficiency? 

Dr. Nayan: 

What you mentioned earlier was oxidative stress. That’s the key component of what we are trying to reduce with glutathione. If you look at oxidative stress, what are the symptoms? 80% of all diseases known to mankind are related to oxidative stress. 

The key is do we want to wait until we get diseased, or can we stop it from getting into the cracks of it? The idea is we are not looking for symptoms at this point. All we’re looking for is do I optimize my lifestyle to the point that I am making sure that my glutathione levels are going to be high at all times? 

If we are looking for symptoms specifically, by the time you get diagnosed with, for example, having high insulin resistance or high triglyceride levels or Alzheimer’s or cancer or heart disease or anything else, it’s too far gone. 

The goal is to treat the problems or avoid the problems. If you want to avoid the problems, then you have to work on your lifestyle and your habits. 

If that’s the case, do I take glutathione supplements from the day I am born? The answer is no. I’m not saying that either. You cannot supplement your way out of all your problems. Having a better lifestyle is what I’m advocating. I want to make sure people are reducing exposure to known toxic chemicals and pollution and gas, things like that. 

The second part is having a healthier diet that encompasses all kinds of amino acids, not just cysteine, although cysteine is part of one of the most important ones. By all means, cysteine is not one of the essential amino acids to take every single day. Having essential amino acids coming from your eggs or meats or vegetables, having good source of proteins that your body can clear out and use the amino acids from inside is a key component. 

Symptoms-wise, if you really want to call out a couple of symptoms, at the age of 30 is where we first start seeing lower glutathione levels. That is the first time we see the body get fatigued and tired. In your 20s, you’re never tired, ever. At 30, all of a sudden, you’re not feeling fantastic anymore. The fatigue kicks in. 

Sleep patterns are not ideal. These are all oxidative stress markers. 

You have liver spots. Your skin may get discolorations. You can see visible signs. The forgetfulness kicks in. Keep in mind 20% of all the oxygen that you breathe in goes to your brain first. The brain is only 2% of the whole body weight, yet it consumes 20% of all oxygen. Your brain has the highest amount of oxidative stress in your whole body. After that is the liver. Then other organs. The first one is the brain. 

If your brain is getting taxed or has too much oxidative stress, it will show signs of memory issues and fatigue. You are not feeling yourself. 

All those signs and symptoms are not great, but don’t wait for those. Start doing things today to help yourself. 

Dr. Eric: 

Makes sense. Even if you’re feeling great, you could still have lower glutathione levels and have potentially a glutathione deficiency. The audience consists of mostly people with thyroid conditions, many of whom have autoimmune conditions. When you have autoimmunity, that’s associated with oxidative stress. Based on that, can we assume that people with autoimmune conditions of different kinds are more likely to need glutathione than others? 

Dr. Nayan: 

Patients with autoimmunity, their levels are actually below zero. It doesn’t exist in those people. They are constantly deprived of glutathione being available because the body is trying to fight a ghost. Patients with autoimmune conditions, their needs are extremely high. We have made a product just for those people with a higher concentration. Normally, I do not prescribe that to anybody else besides people with the needs that are very high. People with severe oxidative stress, especially patients with autoimmune conditions, their needs are extremely high.

The issue is if they have not had glutathione for a while, the body has become toxic. If I give a high dose of glutathione from the get-go, the patient will have a lot of detox reactions. The first month, I always say to go slow. Let’s slowly build up your levels, so you have no side effects from the product. 

Once they’re better, they can tolerate some levels, and they can go to a higher concentration. They can see the benefits in less than six weeks. 

The idea behind this is that it’s not going to get rid of autoimmune conditions at all. Autoimmunity is preventing your body from staying clean and agile all the time. Autoimmune conditions don’t stop there. The body is trying to fight this issue. Doesn’t know what it’s fighting. Opportunistic infections and diseases creep in again. 

I want to make sure people understand that autoimmune conditions are not the single focal point, but they are the gateway to major illnesses in the future as well. Having something like glutathione or a healthier lifestyle to support what our body needs is going to have a fighting chance to keep the conditions under control. Hopefully, reduce the load down, so the body can handle it. 

Dr. Eric: 

Okay. Chronic stress. Does that have a negative impact on glutathione? 

Dr. Nayan: 

When people talk about stress, there are two types of stressors. One is oxidative, as we have discussed. The second one is endocrine stress, which comes from cortisol and adrenaline. Those are regulated by the adrenal glands right above your kidneys. 

I wish our body was compartmentalized. That means nobody knows what the other parts are doing. Our body internally is all one giant fluid. It is crazy how things work inside the body. All those liquids are mixed together. 

When it comes to stressors, yes. Even though they are causing excessive cortisol production or adrenaline coming into the body, it has a profound impact on inflammation. It has a profound impact on cytokines, which are known products that help keep our body in check, like all the interleukins 2 and 12. I don’t want to bore everybody. The cytokines are released by the body to mitigate some of these problems. When we have those things, our body is in chaos. 

At that time, the need for glutathione also increases. Regardless of what stress you have, oxidative or endocrine or physical or mental, all those things will deplete glutathione levels. Some more than others, but they all have an effect on reducing glutathione levels. Having a proper lifestyle and diet and supplementation to improve glutathione levels is key in managing any of these conditions. 

Dr. Eric: 

Testing. What would you say is the best way to measure glutathione? Doing glutathione in the blood? There is also pyroglutamate through urine testing. 

Dr. Nayan: 

When you’re measuring pyroglutamate in the urine, that’s part of the metabolites. It’s not a true indicator of how much glutathione you have in the body. It’s an assumption of how much you have. I don’t do too much urine testing at all.

I do serum testing. Even the serum testing, there is a drawback there. By the time you draw the blood and put it in a tube and ship it to the lab, before it leaves the office, it’s already been oxidized. What you’re really measuring is the total glutathione levels and total offset glutathione levels. 

In theory, you would assume that if you’re otherwise healthy, 50% is oxidized and 30% is reduced inside your body. 

If you have autoimmune conditions or metabolic disorders or cancer, then what you have is too much glutathione and very little of the reduced form. It’s very hard to measure that part.

The true measurements of glutathione can come in lab settings or research settings, where you can draw blood, put the blood sample in the machine right away, and get results immediately. That is the only way to get accurate results from tests. 

We have done this part. We have done the study at the university hospital. Our study was med students and some professors. Most of the med students have a good ratio, 50/50, of reduced versus oxidized glutathione. 

The professors have way too much oxidized glutathione in the body. That tells us that even though they are healthy, they are professors at a med school, the oxidized glutathione is much higher than everybody else. Something is better than nothing. 

If you test, please test your blood levels. Don’t measure the whole blood. Glutathione in the plasma doesn’t have a good track record. Make sure you measure the red blood cells (RBC) level of glutathione. That is the true indicator of how much glutathione you should have in your body. 

Dr. Eric: 

Okay. You don’t pay much attention to urine testing. Blood, more RBC levels of glutathione. 

How about the impact of genetics? Having genetic polymorphisms, which are common genetic variations. That can definitely play a role in who might need more glutathione compared to someone else. 

Dr. Nayan: 

Yeah. Thank god genetic testing has gotten cheaper as the years go by. 15 years ago, used to cost $5,000 for a full genome testing. It’s gone down to $500 or less nowadays. It’s gotten very inexpensive, relatively to what it used to be. 

Because of that, over the last 15 years, the data has come out as to how many percent of people have gene mutations, what we call SNPs, that are not either able to produce glutathione, or their need for glutathione is extremely high. The gene SNPs are telling a lot of stories. 

If you have a gene problem to begin with, like they are born with it, early on, you will get a deficiency of glutathione, and you will see signs and symptoms of spectrum disorder most of the time. People either have autism or Asperger’s. Not all autistic or Asperger’s patients are glutathione deficient, but a lot of them are. 

If they are early on, you can figure out the issue. As we age, we get exposure to cosmic rays, UV lights, foods we eat, some of the gene mutations are happening afterwards. Those gene mutations can change the course of how much glutathione we actually need or that the body is able to produce.

For example, MTHFR is a common gene mutation that we see in a lot of patients. It’s not a gene mutation where your body cannot produce glutathione. What happens is because of MTHFR, there are not enough methyl groups, so you can’t detoxify a lot of chemicals. The job of glutathione becomes extremely difficult, and the need for it increases dramatically. Even though your body can produce, it cannot keep up with the demand.

If the audience is interested in that part, I would strongly suggest working with a physician who knows gene SNPs. I work with a couple of doctors myself. I am doing a presentation to a physicians group next week on gene mutations and how it’s affecting glutathione levels. 

The more we are finding out what the gene SNPs are doing, the better off we can prepare ourselves. We can’t change the mutations, but we can change how we respond to them. Working with a physician is critical. 

Typically, if you do a full genome mapping, it will take you months to go through each and every gene mutation to see what should I do with each one? It’s not a one-hour visit or 10-minute visit. It’s probably over time, maybe 5-10 visits to figure out every single thing about your body. 

Dr. Eric: 

Let’s talk about supplements. That’s a great interest to listeners. There are different forms of glutathione supplements. 

There are other ways to administer glutathione, such as IV. A lot of people get IV glutathione. I’d love to know your thoughts on IV glutathione as well, like liposomal glutathione. Even taking something as simple as NAC (n-acetyl cysteine), which is a form of cysteine, as you were talking about earlier when discussing food sources. 

Dr. Nayan: 

Supplementation is a very confused market. There is a lot of marketing going on, a lot of hype going on with not too much data behind it to back it up. I want to make sure the consumers are getting information and learning from here to see. Become a skeptic for yourself, and question every single thing. That way, you know you are making informed decisions. 

Just to let you know, first of all, your body has no receptor to take glutathione as is. In the last 140+ years that we have known about glutathione, there is one FDA-approved product to improve glutathione levels. That is NAC. It’s cysteine given in a capsule form. The body takes cysteine, combines it with glycine and glutamine, and produces glutathione. It works great.

As we age, our body is not able to keep up with the demand of gene mutations. There is always going to be a need for supplementation. Guess what? Let me inject it into the body. If I can get an injection into the veins, my job is done. 

A study was done in 1991, where they gave 2g of IV infusion of glutathione. What they found out was 100% of the glutathione was still in the plasma only. Nothing entered the blood cells. Zero. What happened then was they checked further out. Where is this plasma glutathione going? In 5-15 minutes, everything was in the urine. Really, IV glutathione is actually not sustaining the glutathione levels for long term.

They continued the study for another few hours. What they saw was the body broke down the glutathione into various amino acids. NAC was sitting in the blood a couple hours later. 

What the research basically concluded was when you infuse glutathione, the body breaks it down and absorbs the cysteine. The cysteine is being used to produce glutathione again. That is the conclusion the researchers came to. That was the research on IV.

Even today, it is very popular. I, as a pharmacist, am guilty of doing that as well. For 20 years, I was also making glutathione to sell to doctors’ offices to infuse into patients. That was the only option I had.

The second option that came to me was in 1999. Can you make some liposome form of glutathione? The researchers that hold the patents for this technology already had drugs in the market through the FDA approval process. They gave us the technology and asked me to make nutraceuticals like Vitamin C or glutathione or CoQ10 and things like that. Sure enough, we made some products and gave them back to the researchers. He sold the product to some other company. 

One thing he could not sell off was the glutathione because it did not work. They couldn’t figure out what was happening. It worked four weeks later but not right away. Something else needs to be happening.

In 2011, University of Texas did a study on 26 kids. They gave them a liposomal form of glutathione, both oral and transdermal. What they found out was again, same thing. Nothing was in the blood cells. 100% was in the plasma. The plasma will break it down into amino acids. We saw an increase in cysteine, glutamine, glycine, and other amino acids. 

The researchers came to the same exact conclusion. The body does not absorb glutathione. It breaks it down, absorbs the cysteine, and later uses it to produce glutathione again. 

All the research that is out there tells the same thing. When I started doing my research, I needed to figure this out. If the body does not have the receptor to accept glutathione, how do we get it inside the body? 

We figured out that your body has a receptor to accept dextrose sugar molecules. What I did was took the sugar molecules, made them into a ring structure, and put inside the ring a glutathione molecule. The body thinks this is a sugar. It takes it. inside is glutathione. I put a Trojan horse inside the dextrin molecule. 

Dextrin has no properties of glucose levels in your body. It’s not for that purpose. It’s a simple carb, but it doesn’t raise blood glucose levels at all. That’s our technology. 

When we discovered the technology for the first time in 2007, it was too premature. Now what? How much do I give it to you? How often? How am I going to do a study? It took me three or four years to figure that portion out. 

We figured out I can give it twice a day, 100mg. I got the results I was looking for. That’s what we did. 

How fast can I see the results? The absorption through your skin was within 15-20 minutes. At 45 minutes, we saw blood levels rise to high normal into the blood cells. That’s how we figured out. This was nuts. 

It took me another 13 years to figure out what conditions can I give it to? How often? In all my research before I released it to the public, all I was trying to figure out is if I improve glutathione levels, does it reduce oxidative stress levels? If I reduce oxidative stress levels, does it trickle down to all the major diseases? 

I have diabetes. Can I reduce blood sugar levels down? Just because I reduce blood sugar levels doesn’t mean the insulin load is gone. You have a huge resistance problem still. You will still die of some complications of diabetes. 

My goal has always been to reduce oxidative stress down, and if I do that on one end, is there a positive impact on major diseases? 

We have a couple of published articles. By reducing oxidative stress levels down, in fact, it will improve your immune system to get rid of infection, like bacteria. We already published that study.

Our goal has always been to not go after bad data. If I can fix the problem on the far back, can I see a positive impact on what the problem you’re facing today is? Yes, we can. 

Some things take time. Some things may take two days, and some things may take six months. 

Regardless, oxidative stress, if I can reduce it down, has a profound impact on every disease that is linked to it. That’s the technology that we have. The topical spray, that’s what we use it for right now. We launched the company in 2020. It was bad timing. The whole world was shut down, not just us. We just are back in business as of last year.   

Dr. Eric: 

Wonderful. Sorry about the timing. I’m glad you persisted. It’s great that it’s available. 

It’s a topical spray. With both IV glutathione and liposomal glutathione, it sounds like the glutathione actually isn’t getting into the cell. It’s more that the body is utilizing the cysteine. Your product would be the most bioavailable, the topical spray. Next to that would be NAC rather than spending the money on IV glutathione or liposomal glutathione. They are both pricey compared to NAC. 

Dr. Nayan: 

Exactly. If you are going to take NAC, just Google “cysteine-rich foods” instead. Make that part of your daily routine. You can only take a supplement once or twice a day. The supplement works as food. The food you see, you will eat anyway, so you might at least eat some avocado or Brussels sprouts or chicken or turkey. They all have cysteine. 

Dr. Eric: 

Do you personally try to do as much through food? With the topical spray, do you use it consistently once or twice a day on a wellness basis? 

Dr. Nayan: 

Yes, I do. I am in the age group of 50+. My needs for glutathione will always be there. Today, I’m in better shape than I was in five years ago when I first started taking glutathione. I am in much better shape than I have ever been. I have too much energy. I travel close to 37 weeks out of the year. I’m always on the road. I’m never tired. I get frustrated sometimes because going through TSA Precheck can be frustrating. Besides that, my energy levels are always very high. I perform. I talk. I lecture. I’m always full of energy. I take it twice a day myself. 

Besides that, I make sure my diet is full of amino acids that I need. There is nothing to replace diet. Please make sure that diet is good enough to get all your amino acids in. Then the supplementation is an extra bonus tool. 

Dr. Eric: 

Definitely agree with that. With supplements, can you take it with food? Do you take it away from food? 

Dr. Nayan: 

This is a topical product, so it doesn’t matter. Food has zero impact on it. In fact, since it’s topical, we always say to apply it on clean skin. Before you apply the product, make sure you clean the skin off. Make sure there is no debris in there. We want to make sure the product has as good a chance of getting inside your body without having to deal with some debris on your skin or dead skin cells. 

Dr. Eric: 

How about if someone takes NAC. I usually recommend taking NAC away from food. Is that necessary if someone took it with a meal? 

Dr. Nayan:

It should be okay. NAC is very easily absorbed. I would not worry about NAC at all. You can take it with food or without food or with drinks, coffee and tea. They won’t be an issue. 

Dr. Eric: 

It’s not so much the bioavailability. Some say if you take it with other foods with protein, it will compete with the other amino acids. I’m not sure. 

Dr. Nayan: 

No. The bigger issue we have today more than anything else is the pH of your stomach. Most Americans today are taking some sort of products to reduce acid reflux. Antacids or some other form. Or drinking alkaline water and increasing the pH of your stomach. 

The pH is supposed to be between 1-2 for protein. Then the enzymes to chop the protein off into various amino acids. If you’re taking alkaline water, if you’re taking antacids, the pH of your stomach is rising. Because of that rising pH, they can’t unfold the protein. If you cannot unfold the protein, you cannot chop down to absorb amino acids. That to me is a bigger issue than taking NAC with food. 

Dr. Eric: 

Okay. You want to have a lower pH for stomach acid. Very important for breaking things down. 

Getting back to your product. You mentioned for autoimmunity, you start people slower. You said there is another product. It’s also a topical spray, but a higher potency? 

Dr. Nayan: 

I’m sorry to give a shameless plug to myself. The product name is Glutaryl. We have Glutaryl and Glutaryl+. The + version is 1.75x stronger than the regular stuff. I would say all the work I have done, every single thing I have done, is in the regular Glutaryl. 

As you can imagine, I have patients that are suffering from chronic oxidative stress, which has led to multiple diseases or conditions that regular is not going to cut it for them. I had to make something stronger for them. 

The stronger version is good for 3-6 months, maybe a year. After that, they all switch back to the regular one for maintenance. That’s all they need to maintain the levels high enough in your body. 

Dr. Eric: 

Okay. Anything else that you want to discuss when it comes to glutathione? Anything that I should have asked you that I didn’t ask you? 

Dr. Nayan: 

I think you were pretty thorough in terms of your questions. One thing I would want to let people know is if you read glutathione in oxidative stress, it will sound like this is better than snake oil. It is. 

Keep in mind that it’s only as good as how you treat the rest of the body with the rest of the habits you have. If you have good habits to begin with, and you work on getting good habits, you work toward eating the right fruits and vegetables and everything necessary for your body to sustain life. Having glutathione levels to reduce oxidative stress, I believe that’s the best chance we have to improve our health span. Improving life span is only there if we can improve health span. 

The question I get all the time is: Do you consider glutathione a longevity drug? I say that the true longevity drug was penicillin. Penicillin in the 40s raised the life expectancy of 40 years to 55 years singlehandedly. Not only can you get rid of infections. By all means, it’s not a longevity drug. All we did was improve the health span of the health of the human being.

I’m saying that glutathione is not a longevity drug, per se. It is definitely going to improve your health span. In fact, I do that part. There is a potential that we can live longer, healthier without being in a nursing home. That’s my hope. 

Dr. Eric: 

Wonderful. Dr. Patel, where can people find out more about you, learn more about your work? If they’re interested in purchasing the Glutathione product? 

Dr. Nayan: 

My website is AuroWellness.com. I spend a lot of time and energy in writing blogs. Please subscribe to my blog. Get yourself educated. 

The idea behind this is I want to make sure that people make informed decisions for their life. I want to bring information to them. I am always doing some research. Anything new comes out in my database, so I will send it out through the newsletter. Subscribe to the newsletter. We send it 2-3 times a month. Hopefully, that’s good information for you to learn from. 

Dr. Eric: 

Really appreciate you taking the time to chat about glutathione. Really enjoyed this conversation, Dr. Patel. 

Dr. Nayan: 

Thank you very much.