Recently, I interviewed Paula, who was diagnosed with Graves’ disease and later fired by her endocrinologist when she chose to follow a natural treatment approach. We discussed why she decided to try natural treatments, her experience with the Autoimmune Protocol (AIP) diet and herbal supplements, the significant health improvements she’s seen so far, my recommendations for continued reduction of her symptoms, 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 Paula here, who is joining us from Sarasota, FL. Thank you so much for being here, Paula.
Paula:
Thank you for having me, Dr. Eric.
Dr. Eric:
I think this is going to be a great conversation. Your background as far as health condition, Graves’. Before we get into the conversation, can you let everyone listening know how you found me?
Paula:
By chance. It was so lucky. I actually was driving to the farmer’s market one morning, and I was listening to NPR, The People’s Pharmacy. I had been struggling with this diagnosis, and you came on. I was like, “Wait a minute.” I went to the farmer’s market and came home, and I pulled up the podcast and relistened to it. I wrote down your name and your book, and I bought the book same day.
I was so excited because you were the first doctor, anything who had a natural pathway. The fact that you put yourself into remission since 2009, I was hanging onto that because I thought you did it. I can do it. I am going to buy his book and follow it. It was just by happenstance. I was so lucky to hear that podcast on NPR.
Dr. Eric:
Wonderful. There is not a lot out there when it comes to hyperthyroidism/Graves’. A lot more when it comes to Hashimoto’s and hypothyroidism. I’m glad you listened to the podcast and heard me get interviewed. That’s great that you got the book.
Based on the information you filled out prior to us getting together, sounds like you have gotten some good results on your own. You were diagnosed with Graves’ in December 2023. Also had nodules. First, you were told you had hypothyroidism, and then you were told to take Synthroid before you were told that you had hyperthyroidism and were recommended to take methimazole, correct?
Paula:
Correct. When I went to see the endocrinologist, based on my symptoms, I gained weight overnight, 20 pounds. I was tired. I thought it was all menopause. I had no idea I had a thyroid issue. Then she said to me that I didn’t have nodules, that I had an inflamed thyroid. Based on what I told her, I had hypothyroid.
Then four or five days later, she didn’t call; her assistant called me and told me I had Graves’, and there was a prescription for methimazole waiting for me at the pharmacy. That was it.
Of course, I lost my mind. I had her call me back, and she and I got into a big fight. I had enough time to Google, which Dr. Google is a bad thing. I had enough time to go to Dr. Google and learn about methimazole and the side effects. I don’t take medications. I’m very active. I eat organic. I am not taking this drug.
She went from prescribing me 10mg twice a day to 5mg twice a day, in this one phone call, to 5mg every other day. I thought, what is going on? This was the beginning of December. I made a decision to wait until January 1 to take methimazole. That was my date.
In between that, I heard your podcast. I bought your book, which is highlighted and torn apart. I made the decision that January 1, because of your book, I was going to go on the AIP diet, and I was going to start with bugleweed and motherwort. That was my plan.
This is a hard thing to do when you have a doctor who is so mad at you because you’re not following her protocol. She kept calling me. She continued to call me to see if I started the medication. I kept putting her off and saying, “I’m getting a second opinion.”
Lo and behold, one day, my husband says to me, “You got a certified letter from your endocrinologist.” Sure enough, she fired me because she didn’t want to even talk to me about another pathway to healing.
I did get a second opinion. I went to the Mayo Clinic to appease my husband. He said the same thing. He said it’s an autoimmune disease, that you should go on methimazole. I asked if it helped the autoimmune component. He said, “Not at all.” I asked, “Isn’t there a 50% chance it will work or not?” He said yes. I said, “Is there any other way?” At that time, I was taking bugleweed. I didn’t tell him because I knew he would yell at me. He said, “No, that is the only way.” I was extremely frustrated.
But I continued on. Then I bought your other book, the thyroid healing book. That came out. I did the AIP protocol for four months. Really strict. Since then, I have been doing your diet #2 because occasionally I have eggs or nuts, like Brazil nuts and walnuts. I have been doing that since then.
It’s really hard when you have a doctor, and then you get a certified letter. My husband and my kids are like, “Mom, are you crazy?” I said, you know what? This doctor put himself into remission since 2009. This is how he did it. I am going to give this a try. If it doesn’t work, I promise I’ll go on the meds.
So fast forward, it’s September. My numbers, my free T4 and free T3 are normal. All of my thyroid antibodies are normal. My TRAB is still suppressed, but it is moving in the right direction.
Dr. Eric:
You mean TSH?
Paula:
Yes, TSH is suppressed. My TRAB is still high.
Dr. Eric:
So it is still high.
Paula:
Yes, but it came down from 2.51 to 2.07. I believe that my numbers are moving in the right direction. And I feel great, better than I have in a long time.
Dr. Eric:
That is awesome. Just for those listening, there is a time and place for antithyroid medication. If someone is taking methimazole or PTU- I didn’t take them; I took the herbs. A lot of my patients do, too. But I do work with patients taking antithyroid medication while addressing the cause of the problem.
That’s the thing. Most endocrinologists will say to take the meds, and that’s it. That’s the answer for 18-24 months. Let’s see if you miraculously get into remission. If you do, most people will eventually relapse because they didn’t address the cause of the problem.
It’s good you were able to avoid the medication, and you also took bugleweed and motherwort. Your antibodies are still a little bit high but are heading in the right direction. Your thyroid hormones are looking good. You’re feeling good, which is important. Feeling better is a good thing. That’s wonderful.
You mentioned you initially got my first book and then my Hyperthyroid Healing Diet book. You were following a level 2 diet, which is a modified paleo diet. Currently, what symptoms are you still experiencing? I think you wrote down anxiety.
Paula:
Anxiety is the biggest thing. I have never had heart palpitations. Your symptoms, what happened to you, did not happen to me. I did not lose a ton of weight; I gained a ton of weight. It was the complete opposite of Graves’ symptoms, which I thought was interesting. That’s another reason why I didn’t think I had Graves’. I didn’t have any of the textbook symptoms. I just had the bloodwork.
Now, my biggest symptom is anxiety, trying to keep myself calm and not anxious. I meditate every morning before the day starts. I do the breathing exercises. That’s the thing that gets me the most still. And knowing that I’m doing the right thing. I think I stress about that. Am I on the right path? Is this going to work? I worry that I’m not on the right path.
When I got this bloodwork back about a week or two ago, it was such a reassuring thing to see. That really helped me tremendously, to know that I’m on the right path. You know when you have everybody else telling you that you’re not on the right path. I went to my general, and she yelled at me because I’m not on methimazole. We have all these doctors telling you you’re not doing the right thing, even though my bloodwork looks really good, and you doubt yourself. That’s my biggest struggle.
Dr. Eric:
Okay. The anxiety, did it all start around the time you were diagnosed? Did you have anxiety prior to that?
Paula:
No. The endocrinologist who diagnosed me, she terrified me. She basically said I was going to have afib and stroke and all of these things. I was talking to her on the phone, saying, “I don’t have afib. I know what afib is, and I don’t have it. I’m tired.” At the time, I was heavier than I am now. None of this makes sense. She just kept saying, “You have to take the methimazole to avoid this catastrophe that could happen to you.”
I feel the route I took was the harder route because you have to be really strict with your diet. You have to be really careful. The bugleweed. You have to be really religious about all of it. It’s probably easier to take methimazole. It didn’t seem like a long-term solution.
The fact that you have been in remission since 2009, I can’t tell you how much I just run that through my head. That’s insane. That’s fantastic. I hang onto that a lot.
Dr. Eric:
You also mentioned that you had, in addition to anxiety- You didn’t have the classic hyperthyroid symptoms, the heart palpitations, tremors. You actually gained weight, whereas I lost a good amount of weight. Some people with hyperthyroidism do gain weight for numerous reasons. Obviously, you weren’t taking the medication; that’s one reason. Taking methimazole will usually lead to weight gain. There could be other factors as well, such as inflammation, imbalances in the gut microbiome, increased toxic burden, cortisol stress.
As far as some tips, because you still have some work to do. You want not only to decrease your anxiety but get your TRABs back to a normal level. Hyperthyroidism can cause anxiety, but your levels are currently normal. Even though your TSH is low, your free T4 and free T3 are looking good. Maybe that’s not the source of the anxiety.
Your adrenals, you could look at. You mentioned stress associated with working with an endocrinologist. Dealing with Graves’ by itself is stressful. Any thyroid/autoimmune thyroid condition. Doing an adrenal saliva test to look at the circadian rhythm of cortisol. Dried urine testing. The DUTCH test is the most well-known test, which also looks at adrenals as well as sex hormones.
The gut. We don’t think about the gut often. That could be a source. Most of the neurotransmitters are located in the gut, not in the brain. That also could play a role in the healing process. Normalizing the antibodies. Even if your gut feels fine, everybody is different. Some people have bloating, gas, other digestive symptoms. Others won’t have symptoms. They might have regular bowel movements. Everything seems fine with the gut. They might do a comprehensive stool panel, and something actually shows up that could be relevant.
It sounds like from a diet perspective, you’re doing great. Stress management, you’re doing meditation. You’re doing a lot of good things. Diet and lifestyle, it seems like you have tuned in. Maybe there is room for improvement, but overall, you’re doing a good job. When someone is already doing a great job with the diet and lifestyle—you did AIP for quite a while, too—that is where maybe considering some testing is something to think about. Adrenal testing, gut testing, to see what imbalances you have to get further progress.
Paula:
I wondered about adrenal testing and gut testing. I was on your Zoom thing that you did for those five days. You had talked about enzymes quite a bit. You actually have an enzyme that you sell. I was wondering would that be something that maybe I should incorporate into my diet? Taking the Enzymes Plus to see if that helps? I get confused when we start getting deeper.
Dr. Eric:
The truth is everybody is different. A lot of people benefit from probiotics and digestive enzymes. There are people who take either one of them—it could be a probiotic or a digestive enzyme—and they might notice a really big difference in how they feel digestion-wise. Then there are other people who will take one or both of them and not notice a difference.
With digestive enzymes, a lot of people could benefit from them, but especially if someone has a feeling of fullness pretty close after eating, it’s often low stomach acid, and Enzymes Plus has butane HCl. If it’s a few hours after eating, maybe digestive enzymes- If someone is not having that feeling of fullness, it doesn’t mean they can’t benefit from them, but those are obvious symptoms. Without having those obvious symptoms, the only way to know is to give it a try. A lot of people do have problems breaking down the proteins that they’re eating. Some people have issues with fats and carbs as well.
To answer your question, it could be worth a try. I definitely take supplements. I’m not afraid to take supplements. Some supplements are riskier than others. For the most part, the only thing is if you take Enzymes Plus, you want to take it with a meal higher in protein because it does have butane HCl.
If you’re taking a digestive enzyme even without butane HCl, you want to take it with food ideally. If you take it away from food, it’s working more as an anti-inflammatory, like proteolytic enzymes. If you take that away from food, you’re doing that to reduce inflammation typically. For digestive purposes, if you do try Enzymes Plus or something similar, you would want to take it with food.
The functional medicine testing isn’t cheap. Before spending a few hundred dollars on a comprehensive stool panel, it certainly would be less expensive to give the digestive enzymes a try and see if you notice any difference.
Getting back to functional medicine testing. It sounds like you haven’t done any. I know the endocrinologist isn’t going to recommend those tests.
Paula:
No. I did find a doctor in Sarasota who actually told me to take this Thyroid Calm with bugleweed and lemon balm combined. She did my bloodwork. That’s where she did the thyroid globulin antibodies. She did all of it because the endocrinologist doesn’t do any of that. I didn’t even know about it. I could go back to her and talk to her about adrenal testing.
Dr. Eric:
And a stool test.
Paula:
Yeah.
Dr. Eric:
That’s good that you got that recommendation as far as Thyroid Calm. Is bugleweed and motherwort a single formula? I know Herb Pharm has Thyroid Calming Formula. I don’t know if that’s what’s you’re taking.
Paula:
It’s a capsule that I take twice a day. It’s not a liquid.
Dr. Eric:
ThyroCalm Px.
Paula:
That’s it. I’ll go and see her. I wanted to talk to you first, and I’ll talk to her about adrenal testing and everything else. I think maybe in the meantime, I will try Enzymes Plus and see if that makes a difference, too.
Dr. Eric:
You never know. Like I said, everybody is different. Some people notice a huge difference with taking supplements. I’m honestly one of those people who if I take something, a lot of times I don’t notice a difference, even if it’s helping. The bugleweed and motherwort, that I knew. I had classic symptoms like elevated heart rate and palpitations. Even before doing the blood test, I knew they were working. A lot of other things, I don’t notice a difference. Sometimes, you don’t. Vitamin D, you won’t know if it’s working unless you retest Vitamin D.
Enzymes, probiotics, anything gut-related, if someone has gut symptoms, they might notice. In your case, if the anxiety is related to the gut, it may help, or it might not be a digestive enzyme problem as far as a reason you have anxiety. You might need to go deeper.
I agree as far as trying Enzymes Plus. See if you notice a difference. If not, definitely consider reaching out. Either way, you might want to consider the functional medicine testing for TRAB. My guess is taking the Enzymes Plus isn’t going to be the solution for normalizing the antibodies. Maybe it’s a piece of the puzzle. Maybe eventually you do some functional medicine testing to get more answers with what your triggers are, underlying imbalances, and take it from there.
Paula:
Yeah. I listened to your podcast on triggers yesterday. I have been thinking about it a lot, as I would like to be in remission by January 1. I am hoping my bloodwork will be close to normal by then. That’s my goal. I’m hoping I didn’t hit any roadblocks on the way.
Dr. Eric:
It’s a good goal. We’re recording this in September, so you have a few months to hit that goal. As long as things are heading in the right direction. Obviously, your body will heal at its own pace. You could definitely do things to speed it up. If January comes along, and the antibodies are still maybe a little bit high but better, I’m sure you’ll still be encouraged and moving forward. What other option do you have?
Getting back to the endocrinologist. It’s not the first time I’ve heard that an endocrinologist fired their patient. When you look at their perspective, that’s just the way they’re trained in medical school. There are only a few different treatment options when it comes to these conditions. In the case of hyperthyroidism or Graves’, it’s antithyroid medication, radioactive iodine, and thyroid surgery. If someone is not going to choose one of those three, then the only reason to see someone is to get the blood tests every now and then. They don’t want to order blood tests if someone is taking bugleweed and motherwort, which many are not even familiar with. Definitely can understand getting upset about that.
I wish they had more of an open mind. But most endocrinologists unfortunately don’t. I’m glad that you’re doing it on your own or with the help of my books, so I’ll take a little bit of credit.
In all seriousness, obviously, you’re the one who has cleaned up your diet, managed your stress, taking some of the supplements. I’m glad that you were able to successfully get your thyroid hormone levels within an optimal level. A little bit more work needs to be done, but I’m sure you’ll accomplish it.
Paula:
I agree. I credit your books. I just can’t say enough about it. Before I bought your book, I bought another book that some doctor wrote about not doing radioactive iodine. Okay, I’ll read this. He said to take methimazole judiciously but modify your diet. Then I thought, well, that’s not the answer I was looking for.
There is very little out about Graves’ there. It’s all horrible. When I was diagnosed, I had every symptom. I had heart palpitations. I thought I was going to have thyroid eye disease. I manifest everything. I had to calm myself down.
With my bloodwork, I had it done in June, I think. My TSH was undetectable/negative. When I saw two weeks ago that it was .02, that’s huge. That’s a huge move from completely undetectable to detectable. I was very excited about that.
Dr. Eric:
I agree. I test for TSH, but I don’t get too concerned. It could stay really low, even depressed, like undetectable for six months or longer in some cases. As long as the thyroid hormone levels continue to decrease and get to an optimal level, eventually, the TSH should increase well beyond what it is now. It’s always nice even when it budges a little bit to see that movement. I’m sure over time, it will increase and eventually normalize.
Same thing with the antibodies. Graves’ is more of an immune system condition than a thyroid condition. Ultimately, that’s what I focus on more than the TSH, is getting those antibodies normal.
Paula:
When you say antibodies, do you mean TRAB?
Dr. Eric:
Yeah. With Graves’, the TRAB. There is also TSI, thyroid stimulating immunoglobulin. That is a type of TRAB. Some doctors will do TRAB. Some will do TSI. Some will do both. Those are both antibodies.
You mentioned thyroid globulin antibodies. There is also TPO, or thyroid peroxidase antibodies. I don’t know if those were elevated, too.
Paula:
No, those are both normal. She tested those, and they’re both normal.
Dr. Eric:
Yeah, those are more closely associated with Hashimoto’s, especially those thyroid globulin antibodies. One less thing for you to worry about. I would just monitor the Graves’ antibodies, which are the TRAB or the TSI.
Paula:
Should I have her do TSI next time? I don’t think she did TSI. She just did TRAB.
Dr. Eric:
I like TSI because it’s more specific. There is a couple of different TRABs. There is a binding antibody, too. Usually if someone has hyperthyroidism in the presence of elevated TRAB, that is pretty much diagnostic of Graves’.
Yeah, I prefer TSI. The only challenge is you can’t really compare the TSI to the TRAB. When you do the TSI, whatever number it is, you won’t be able to say things are heading in the right direction. It will be a new baseline. If she is willing to do both of those, so you could see if the TRAB is decreasing and then get a baseline of TSI, and then the test after that, stick with the TSI.
Paula:
Okay, I can do that. I don’t need to worry about hypothyroidism. I saw on the Facebook page a lot of people go from hyper to hypo. That’s not something I need to be anxious about?
Dr. Eric:
In your case, I would say it is not as likely because you don’t have those Hashimoto’s antibodies. Unless someone has what’s called subacute thyroiditis, which is not the same as Graves’, if someone has antibodies for both Graves’ and Hashimoto’s, then there is a better chance of them becoming hypo. Because you don’t have those antibodies, I would say it’s a lot less likely that you become hypothyroid. I wouldn’t worry about that.
I would just keep up the good work with the diet, the stress management. Try the Enzymes Plus. Eventually, look into doing adrenal testing, the comprehensive stool testing. I don’t know for sure if you’ll find answers, but that is the goal of doing the test. A good chance of finding answers by doing testing and working with someone like this second practitioner. Things should head in the right direction.
Keep me posted. I’ll have other future events. You mentioned you attended one of my past five-day live events. Every now and then, I’ll have those. Feel free to keep me updated, Paula. Thank you again for doing this audit and reading my books. I really do appreciate it.
Paula:
Thank you for writing your books. They really made a huge difference in my life.
Dr. Eric:
You’re welcome. Thanks, everyone for listening. Hope you found this audit to be valuable. As usual, I look forward to catching everyone in the next episode.
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