Recently, I interviewed Alexandria, who’s antibodies were high, her gut was off and surgery was on the table. She was told she had the antibodies for both Graves’ and Hashimoto’s in 2017 and initially followed conventional advice, including methimazole. But after facing the possibility of thyroid removal, she explores deeper root causes. If you would prefer to listen to the interview you can access it by Clicking Here [1].
Dr. Eric Osansky:
I am excited to do another Save My Thyroid health audit, where we’re chatting with Alexa. Alexa, thank you so much for joining us.
Alexa:
Thank you for having me.
Dr. Eric:
Yeah, I’m excited. You submitted your application to do this audit. Diagnosed with both Graves’ and Hashimoto’s back in 2017.
Alexa:
I knew about the Graves’. That was what I was diagnosed with. I came to find out later it was also Hashimoto’s as well.
Dr. Eric:
All right. That was about eight years ago. Curious, when did you find out about me? I was around back then. I don’t know if you have been following me for a while or if you just came across me.
Alexa:
I was digging and digging, trying to find another option than removing my thyroid after the first few years. Maybe around 2019/2020 is when I found you online. It took a while because, and I know you have mentioned before, there is not as much info about Graves’.
Initially, I followed along with the doctors and what they prescribed for me to do as far as taking the medication. In my mind, I thought I was pretty healthy. I’ll probably be one of those people that it will just go into remission on its own. That didn’t happen for me. Of course, after a couple years of treatment is when they started suggesting permanently removing my thyroid. There has to be something else.
Dr. Eric:
There are definitely other options, which you know now. I’m glad you looked into other options. I’m glad you found me.
You have been on methimazole ever since 2017? I know you are taking it now.
Alexa:
Pretty much. I’ve had some gaps, where I was doing really well. They were able to wean me off of the medication. Then I had to go back on it because I wasn’t treating the root cause. There have been some periods, 4-6 months, maybe max, where I have been off of the medication. For the majority of these past eight years, I have been on it.
Dr. Eric:
Has it been a lower dose? What are you currently taking?
Alexa:
I’m currently taking 5mg four days, and 10mg for three days.
Dr. Eric:
5mg four days a week, 10mg three days a week. Also, you made some dietary changes. You recently cut out gluten?
Alexa:
Yes. I have done that a couple times as well. I have done AIP for some time. That is probably when I was able to lower my antibodies the most. Then I fall back into- I have a little bit of this and that here and there, and then it starts to creep back up.
Removing gluten, I just tried that during Lent the previous year, and I saw a change in the way I felt. I’ll still do mostly gluten-free throughout the years, but then this time around, I started a little bit earlier. I started right at the beginning of March, where I have been gluten-free. I try to be grain-free the majority of the time as well.
Dr. Eric:
How long were you following AIP for?
Alexa:
I want to say close to at least three months if not longer. I went from 18 or so with my thyroid antibodies down to about 2.19, I want to say.
Dr. Eric:
That’s really good. It’s not easy to stay on AIP. It’s not meant to be a long-term diet. Maybe you needed to be on it a little longer.
Are you grain-free because of what you learned about grains? Do you feel better when you’re not eating grains?
Alexa:
I feel better. My goiter has never been super large. I don’t know if you can see it. I feel like it goes down as well when I avoid grains. Particularly oats, which I was trying so hard to keep in. it doesn’t work for me. Then the gluten is hard. That’s the hardest one for me to give up. I do notice a difference.
Dr. Eric:
You’re still consuming dairy?
Alexa:
Yes, I do in smaller amounts. For years of my life, I didn’t consume much dairy because I always felt sick after eating it. Then it’s this weird tradeoff. If I am not eating grains to fill me up, then I am eating more dairy. Maybe that’s the next thing that needs to go.
Dr. Eric:
Everybody’s different. Usually, I have people take a break from the common allergens. You did do this with AIP. You avoided it. Possibly consider doing it again.
When was the last time you had your antibodies tested?
Alexa:
It’s been a while. My doctor doesn’t check for them that often. At least the last three times I have been, I haven’t had them done.
Dr. Eric:
Did you get it tested in 2024 at all?
Alexa:
Yeah, it’s been at least six months.
Dr. Eric:
You put down the three biggest challenges: gut issues, which you said they’re improving; shortened periods; and the goiter. Also with grains and gluten-free, it’s better. The gut issues are better. Is that with grain-free and gluten-free, too?
Alexa:
I believe so. I also saw a functional medicine doctor around 2021. I was taking butane HCl. I took something that clears out SIBO.
Dr. Eric:
The antibiotic Rifaximin?
Alexa:
Yeah. That did really well. I took colostrum to help heal my gut. That actually was probably about the same time, where my thyroid antibodies were going down as well. It was probably a mixture of all those things.
Dr. Eric:
You mentioned you saw a naturopath for the butane HCl. I was talking about the gut issues. You said that they were- That’s why you brought up the butane HCl and the Rifaximin. The SIBO relates to the gut.
Alexa:
That is probably when it was the best. Being mostly grain-free and gluten-free is definitely helpful, but I think I probably need to do some of those supplements as well.
Dr. Eric:
Did you test for SIBO? Did you do a SIBO breath test, or did you go by symptoms?
Alexa:
I did the breath test.
Dr. Eric:
That showed you were positive for SIBO.
Alexa:
Yes.
Dr. Eric:
Did you retest to confirm it was gone?
Alexa:
I did not.
Dr. Eric:
Any other functional medicine testing you did back then, like a stool test or saliva test?
Alexa:
I did the stool test. I did not do a saliva test. I felt like I did at least three. I did the blood test. IgG? IgE?
Dr. Eric:
Food sensitivity testing?
Alexa:
Yes. I did that as well. I avoided the top things on my list. It was flax seeds, chickpeas. For the most part, I still to this day avoid those things. I don’t know if I still am sensitive to those or not.
What I did find when I did AIP though was sensitivities to other things that did not show on that list at all. Gluten didn’t show up on that test, which I was so happy about at the time. When I decided to give it up, I saw changes in the way that I felt. I know you have mentioned that before. That test may not be the most accurate or helpful.
Dr. Eric:
You were eating gluten at the time you did that test?
Alexa:
The sensitivity test?
Dr. Eric:
Yes.
Alexa:
Yes.
Dr. Eric:
You need to be eating the food for it to be accurate. If you’re gluten-free for three months, we would expect it to be negative. If you were eating gluten, and it was negative. It’s definitely not a perfect test. People can have false negatives, false positives. There are other issues with gluten. It’s not just being sensitive. It can affect permeability of the gut.
Alexa:
Right. I think that’s what’s happening with me.
Dr. Eric:
It sounds like you had a lot of success focusing on gut health between AIP, taking butane HCl, colostrum, Rifaximin for the SIBO. Do you remember how long you were on Rifaximin for?
Alexa:
I felt like it wasn’t that long, but I don’t remember the exact time frame.
Dr. Eric:
30 days or something like that?
Alexa:
Probably.
Dr. Eric:
When you had SIBO, do you remember having constipation or loose stools?
Alexa:
Yes. I feel like especially then, I was having more sensitivities where I would have diarrhea. I haven’t had that at all in more recent years. Certain things would trigger. Soy was one of the first things I noticed that would give me diarrhea, so I stopped eating that. Then maybe some gas and bloating, but I didn’t think that was not normal. It wasn’t necessarily that I knew something was going on with my gut.
I’ll give you a bit of background. I always had stomach issues as a kid. They originally wanted me to start taking Omeprazole as a kid. I was maybe 10 or 12 years old. I have never been that person. I never want to take medicine for an extended amount of time. I wouldn’t take it, but my mom is a nurse. My mom was like, “Make sure you take it all the time. Then you won’t have these episodes” of what they thought was acid reflux. I probably had the exact opposite. I would never take it the way I was supposed to.
I eventually got to where I would only take Pepcid as needed. Even now, it took me almost 30 years to figure out that’s not the best thing to do.
Now, I’m doing more ACV. I’d like to get back on butane HCl or something like that to see if that helps. Again, I didn’t think those things were abnormal.
Dr. Eric:
That’s a big problem a lot of people have. They’re on acid blockers temporarily. A lot of people don’t need to be on them when people are on them for months or years. We need stomach acid, so it’s not fixing the problem. A lot of people have low stomach acid, and they might have symptoms that mimic high stomach acid. They are put on acid blockers.
In the past, you took butane HCl. Now the ACV, apple cider vinegar. It’s good you know what to do now. You took Rifaximin, but for those who are not familiar with it, it’s supposed to focus on the small intestine. It’s an antibiotic, but it’s not supposed to negatively affect the gut microbiome, like the large intestine, where most of the bacteria are. Even that isn’t as bad as taking a broad-spectrum antibiotic or an acid blocker/PPI.
Also, we should probably mention that one of your goals is you want to have another successful pregnancy?
Alexa:
Yes. That’s partially why I think this last time I fell off some of my dietary changes was I got pregnant then. I was taking the methimazole, which is not the best. They switched me to PTU for part of it. Then I was on a lower dose for the methimazole for the rest of my pregnancy.
I’m very thankful my baby is amazing. She’s perfect. Ideally, I’d like to have another successful pregnancy. Ideally, not on any type of medication, so I don’t have to worry about that risk.
Dr. Eric:
Yeah, I understand. Also, when someone is thinking about conceiving in the future, I talk about detoxification because you don’t want to do that while you’re pregnant. While you were working with a functional medicine practitioner, did they give recommendations to reduce your toxic burden?
Alexa:
No.
Dr. Eric:
Gut health is very important. That’s arguably even more important. Everything is important. Adrenals, gut health, liver health. You definitely want to focus on gut health. You’ve had a lot of success with that.
I always have patients do things to reduce their toxic load. A lot of it is environment, trying to do as much as you can through the food you eat; try to eat organic whenever you can; try to eat vegetables, especially cruciferous vegetables, like broccoli; try to support detoxification; try to use natural cleaners and cosmetics in the home as much as you can.
Alexa:
I do that.
Dr. Eric:
Purified water. Try to avoid tap water and water out of plastic bottles on a regular basis. I do sometimes recommend supplements like NAC, which helps support glutathione production. Sometimes, I’ll give other recommendations.
Some of it might depend on some of the testing we do. Even if you go all out from a diet perspective, the products you use in your home, which it sounds like you’re aware of that and are trying to use more natural products.
With gut health, getting back to that. In my book The Hyperthyroid healing Diet, obviously the book focuses on diet. I have a section that goes beyond diet and lifestyle. I do think it might be worth going back on AIP because you mentioned that’s when your antibodies dropped tremendously. Maybe going on it for at least 30 days, if not another two or three months.
In combination with that, if you should follow another SIBO protocol, I wouldn’t go on Rifaximin again. If you are experiencing any of those symptoms, which it seems like it’s been better recently. If you feel like SIBO might be an issue, you can always do another breath test, and either go back on Rifaximin, if it was positive, or herbal antimicrobials you can take.
You said you had a comprehensive stool test done also? Did that show anything significant as far as you remember?
Alexa:
I remember there was fat in my stool. I can’t remember anything other than that. There were no parasites. I went to the Dominican Republic a couple years prior and got sick. I am trying to go back and trace back to see when did I start having these gut issues?
Dr. Eric:
I’m sorry to interrupt, but was it food poisoning?
Alexa:
Potentially. It was not a parasite linked to that. Since I went on that trip, it felt like I had been having these gut issues. Maybe that was a trigger. Or maybe it was just happenstance. I’m not sure. There was no parasite there.
Dr. Eric:
When was this trip?
Alexa:
Dr. Eric:
Okay. A couple of things. First of all, I don’t do stool testing on everybody, but over the years, I have done a good amount of it. it’s not perfect. You could have parasites, even though it’s negative. That’s one thing to keep in mind.
Also, the reason I asked about food poisoning is because a lot of cases of SIBO, they found out a number of years ago was caused by food poisoning. There is an autoimmune process against the migrating motor complex, which is the cleansing wave of the small intestine. Because you don’t have that cleansing wave, that causes the buildup of bacteria. That is a possibility.
I am thinking probably either parasites, and it was a negative stool test, or potentially SIBO, especially since you were diagnosed with it, and the Rifaximin helped.
The hope is parasites because the problem with the migrating motor complex, I mentioned that as far as I know, there is no permanent solution once you get that damage. If it’s due to food poisoning, you can’t reverse it. You can treat SIBO.
There is what’s called prokinetics that someone can take to help with the motility, so the SIBO doesn’t come back. I guess that’s something maybe to look into. It’s ultimately up to you as far as if you want to do another in the future, whether go back to that functional medicine practitioner or go to someone else and do another SIBO test.
There is a test. It’s not a popular test. You can actually test to see if you’re having antibodies against the migrating motor complex. Dr. Mark Pimentel developed it. I forgot. I can look that up and let you know about that if you were interested in that.
Like I said, diet and lifestyle. AIP, since you were so successful in helping lower your antibodies with that. It makes sense to go back to that. If SIBO is an issue, and if it came back. It sounds like it’s not really bad as far as the symptoms. It’s one of those things.
You could always try AIP first and see how you feel gut-wise before spending money on testing. If you feel great with AIP, maybe you don’t need to do testing. If you’re still having some digestive symptoms, then maybe you might want to look into doing another SIBO retest and/or another comprehensive stool test to see what’s going on. If SIBO is an issue, then you do either the Rifaximin or an herbal approach.
Doing a stool test didn’t show that much other than the fecal fat, fat malabsorption.
Alexa:
There may be other things, but I don’t have it.
Dr. Eric:
It’s very common to have some dysbiosis, which is an imbalance in the gut flora. You might have some things that were high or low. That’s very common. It depends on what was high or low. It sounds like maybe nothing really significant that was red flagged on that test. Like I said, it’s a challenge because parasites could be negative.
I did an interview with Dr. Ami Kapadia on the podcast, and she spoke about another company called Parawellness that focuses on parasite testing. I have had a few people do that, where it did pick up parasites, whereas something like the GI Map didn’t. The downside is that is all it looks at. If someone wants an overall look at the large intestine, I usually recommend the GI Map. Like I said, for parasites, sometimes things don’t show up on the GI Map or GI Effects or whatever stool test someone does.
I would say your next steps would be think about going on the AIP diet again for at least 30-90 days. Maybe just do that, and see how you feel. If you’re still having symptoms, maybe look into some of the testing that you’ve done in the past, especially the SIBO test.
Alexa:
Sounds good.
Dr. Eric:
Thank you again for doing this health audit. It was great having this conversation. Feel free to keep me posted. Shoot me an email in the future. Let me know how things are going.
Thanks, everyone for listening. Again, hope you enjoyed this conversation. Look forward to catching everyone in the next episode.