In this episode, we take a closer look at seven (7) common gut-related roadblocks that can interfere with thyroid recovery. That includes foods like gluten, grains, and nightshades but also deeper layers like low stomach acid, gut infections, and hidden stress. You’ll also hear about environmental factors such as glyphosate and xenoestrogens that erode gut integrity over time.. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am going to discuss seven gut healing roadblocks that can prevent you from restoring your thyroid health. 

The first gut healing roadblock I’d like to discuss is eating gluten. Many people listening to this understand that they should be avoiding gluten while healing. One of the big reasons is because gluten is harsh on the gut. Research from I believe it’s 2015 shows that gluten can cause a leaky gut in everyone. That alone is reason to avoid gluten. 

There is what’s called the triad of autoimmunity for those with Graves’ and Hashimoto’s as well as other autoimmune conditions. According to the triad, which I have discussed before, there is three components necessary for autoimmunity to develop. 

There is a genetic predisposition, which we can’t do anything about. Then there is exposure to one or more environmental triggers, which we can find and remove. Then there is that increase in intestinal permeability, that leaky gut. 

Eating gluten as well as other factors we will discuss here is one of the things that can cause a leaky gut and set the stage for an autoimmune thyroid condition. Even if you don’t have an autoimmune thyroid condition, it can still cause a leaky gut, which is not a good thing. 

Gluten, at least while healing, should be avoided. There is an argument that we should all avoid it permanently. If someone is dealing with Celiac, then you definitely want to be strict about avoiding gluten, even avoiding cross-contamination. If someone has a non-Celiac gluten sensitivity, you also probably should be strict when avoiding it. Even if you don’t have Celiac or a non-Celiac gluten sensitivity, it’s still a good idea to avoid gluten, at the very least while healing. 

When you have restored your health, you could decide whether or not you’re going to reintroduce gluten, even if it’s on an occasional basis. Some people definitely choose not to reintroduce gluten on an occasional basis. Let’s focus on healing first. 

Sticking to the topic of gluten, some people wonder if the problem is really with glyphosate and not gluten. The reason they bring this up is because they might have traveled to Europe or have a family member or friend who traveled to Europe, and that person was able to eat wheat in Europe. Let’s say they went to Italy and had pizza and pasta that was not gluten-free, and they did fine.

I had Dr. Tom O’Bryan on the podcast, and I asked him this question. His response was that the reason why people do okay when they go to Europe is because in Europe, wheat is lower in FODMAPs. It’s a problem with FODMAPs. I discuss this in other episodes, for those who aren’t familiar. 

He was saying that even when you go to Italy or other countries, gluten is gluten. It’s going to cause an immune response. It potentially can cause a leaky gut. Glyphosate is definitely an issue. I’ll mention glyphosate later during another gut healing roadblock. Regardless of where you are, whether you’re in the U.S. or in Europe or somewhere else, you really want to, especially while healing, definitely avoid gluten. 

Let’s move on to gut healing roadblock #2: other foods that can be harsh on the gut. In addition to gluten, there are other foods that you want to at the very least take a break from while healing, or at least initially while healing. Some of the foods you are mentioning here, you might not need to completely avoid while healing.

This first one, I would say in most cases, is a good idea to completely take a break from until you have restored your health. That is grains, especially corn, but I would say other grains as well. I pick on corn a little bit because the research shows that corn can have a similar response to gluten. 

There is a reason why grains are excluded not only from an AIP diet but also a regular paleo diet. They can be harsh on the gut. 

I enjoy eating grains every now and then. Keep in mind I am in a state of wellness right now. I did avoid grains while I was healing when I dealt with Graves’ back in 2008-2009. Every now and then, I will have some gluten-free grains. 

I understand that it is difficult to follow restrictive diets, even though there is a lot of variety with fruits and vegetables. Some people are used to eating rice or oatmeal on a regular basis. I would say to take a break from grains. 

There is a really good book called No Grain, No Pain from Dr. Peter Osborne. If you want to learn more about the concerns with grains, you might want to check out that book.

Nightshades. This includes tomatoes, eggplant, peppers, white potatoes. Nightshades also have compounds including alkaloids and glycoalkaloids that could be harsh on the gut and cause inflammation. 

The purpose of an elimination diet is to eliminate foods that could potentially be inflammatory that people commonly react to. We are not eliminating nightshades because of the sensitivities. I bring this up because I have had people do food sensitivity testing and show me the panel and say, “Hey, tomatoes are fine for me to eat,” etc. Again, we are not excluding nightshades while healing because of sensitivities. They could be harsher on the gut.

Similar with grains. If you do a food sensitivity test, and it shows that you’re not sensitive to certain grains, especially gluten-free grains, you might think, “Hey, why not have some of these grains?” Again, that’s not why we’re excluding some of these foods I am mentioning here.

That also includes nuts and seeds. Nuts and seeds are paleo-friendly, but they are not AIP-friendly. When I dealt with Graves’ back in 2008, there was no AIP diet back then. They weren’t gut-healing diets, but I followed a paleo diet initially. I hit a roadblock in my recovery, and I wasn’t a big egg eater at the time. I cut out nuts and seeds, and then I saw improvement in my progress. That seemed to be a roadblock in my case. I didn’t exclude them for too long; it was maybe about three months that I cut them out. 

Just like nightshades, nuts and seeds have good health benefits. They are a good source of mono and saturated fats. They can be harsh on the gut though. Another reason to consider avoiding them. 

There are some people I work with, even those with Graves’ or Hashimoto’s, who choose to continue eating nuts and seeds. They might follow a paleo diet rather than an AIP diet, and some of these people do okay. Some of these people don’t do okay. They might hit a roadblock. That’s why I encourage people to follow AIP initially. If someone is absolutely opposed to following AIP, but they are willing to follow paleo, then let’s see how you progress just doing paleo. 

I do want to mention dairy. I haven’t come across research that shows that dairy specifically causes a leaky gut. Dairy can be inflammatory in some people. It’s a common allergen. If you are going to eat dairy, you definitely want to eat healthier forms of dairy, like drinking A2 milk or raw dairy, and not the pasteurized, homogenized dairy. Even while healing, it’s a good idea to take a break from dairy, mainly because it’s a common allergen, not because it will cause a leaky gut.

Like I said, the research is more clear with gluten as well as corn. 

I also wanted to bring up legumes. Legumes, like grains, are excluded from both a paleo and AIP diets. Legumes do have some really good health benefits. If someone is a vegan, they might not be able to get protein from other sources. 

In my book The Hyperthyroid Healing Diet, I talk about different types of diets. One is a level one diet, which is a modified Plant Paradox diet. A Plant Paradox diet is from Dr. Steven Gundry. 

If someone is a vegan, because otherwise they won’t get enough protein, I think it’s okay for them to have some pressure-cooked legumes. Legumes, lentils do have some good health benefits. They could also be a little harsh on the gut. Again, pressure cooking them properly will minimize that. 

This is one that is more debatable. I would say if you want to play it safe, avoid legumes while healing. If you absolutely want to have them, especially if you’re a vegan/vegetarian, then you might be okay eating legumes. 

Let’s move onto gut healing roadblock #3: drinking alcohol. Alcohol should be completely avoided while healing. Even after healing, you want to minimize it. A lot of people think about the stress that alcohol puts on the liver, which is true; alcohol does put stress on the liver, but it also puts stress on the gut. It can increase permeability of the gut.

Are there exceptions? For example, red wine, white wine. They have some good benefits. There is a little bit of controversy in the research. Some studies show that red wine can cause a leaky gut. Some show that the polyphenols can benefit the gut microbiome. I think red wine, without question, as well as white wine do have some good health benefits. It’s not all bad. But still the alcohol can increase permeability. I would say try to take a break if you’re a wine drinker. 

Same thing with other types of alcohol. Some people might like beer and ask if they can drink gluten-free beer. It’s not just the gluten we are talking about here; it’s the alcohol.

Another question I sometimes get asked is about alcohol from herbal extracts. With herbal extracts, these usually have such a small amount of alcohol. Even if it says 50% alcohol, if someone is taking a teaspoon, so they are getting 2.5ml of alcohol per serving, even if they are taking a few servings per day, it’s usually not going to be enough to cause a leaky gut. Everything comes down to risk versus benefits. 

You might wonder about an alcohol-free extract. Something that uses glycerin instead of ethanol. It’s an option, but the reason why ethanol is used is because it’s really a good solvent. It’s a lot better than glycerin. It does a better job of extracting the phytonutrients from the herb. In other words, if you’re using alcohol-based tinctures or extracts, you will get greater benefit from the herb you’re taking.

If you’re sensitive to alcohol, then take something that has glycerin, like a non-alcoholic extract. I wouldn’t avoid an alcoholic extract because of the concern that it might affect the gut. 

When I dealt with Graves’, I took bugleweed and motherwort, so I took two different liquid herbs that had alcohol. Everything turned out fine. Over the years, a lot of my patients have taken liquid bugleweed and motherwort or other herbs. Very small amount. It’s different than having a cup of red wine or other alcoholic beverages. 

Let’s move on to gut healing roadblock #4, which is low stomach acid. Keep in mind that some of the other roadblocks that I’ll be discussing will cause low stomach acid, which I’ll also discuss here. 

Low stomach acid is common. Stomach acid of course is important for digestion, helping break down nutrients, especially minerals. Also important for protein digestion. Also helps to keep harmful gut pathogens in check. You want to have healthy levels of stomach acid. There are other benefits as well. It helps activate digestive enzymes. 

The problem is that the symptoms of low stomach acid and high stomach acid can be similar. Also, not everyone with low stomach acid will have symptoms. If someone has symptoms such as heartburn or reflux, most medical doctors will associate this with too much stomach acid. As a result, they will recommend an acid blocking medication, so a proton pump inhibitor. If someone takes that on a short-term basis, if you could avoid it, great. It’s more of a concern when someone is taking it long-term. A lot of people take these acid blocking medications for months, even years. 

It’s a problem because I’m not saying there is not a time and place for taking it long-term, but some doctors will just give it to their patients long-term and never try to address the cause of the problem. 

A lot of times, it could be a low stomach acid problem, not too much stomach acid. That being said, you do need to be careful. It could be too much stomach acid, too. 

I like butane HCl; it’s in my digestive enzyme, Enzymes Plus. It has a smaller amount than what’s in a separate butane HCl supplement. Most people seem to tolerate it well. If someone has too much stomach acid, taking a separate butane HCl supplement might be too much and might cause heartburn or other symptoms. 

There is something called the butane HCl challenge. That actually involves taking butane HCl to see how you respond. If you take butane HCl or a digestive enzyme that has butane HCl, even though it’s a smaller amount, and feel heartburn, for example, that might mean that you have enough stomach acid. In some cases, too much stomach acid, and then you should back off.

With the butane HCl challenge, if you take a separate capsule of butane HCl and do fine, and you always want to do this with meals high in protein, at least 10-15g of protein. Never do this on an empty stomach. 

If you are fine taking a single capsule, according to the challenge, you’d want to take a second capsule. If you do fine with a second capsule, then add a third capsule. If you then get some heartburn, that’s telling you that’s too much, and you want to back down to the two capsules. Take two capsules of butane HCl per meal while trying to figure out what the cause of the low stomach acid problem is, so you don’t have to rely on butane HCl on a long-term basis.

There are other things you can do such as bitter herbs you can take. Ultimately, you want to try to address the cause of the low stomach acid. One potential cause is an underactive thyroid, so low thyroid could be a factor. This doesn’t mean if you have hyperthyroidism, you can’t have low stomach acid. Chronic stress could also cause low stomach acid, and a lot of people deal with chronic stress, including me when I dealt with Graves’. 

H-pylori could cause low stomach acid. H-pylori is very common in those with autoimmune thyroid conditions such as Graves’ and Hashimoto’s.

Let’s discuss gut healing roadblock #5. Speaking of chronic stress, that’s what this roadblock is, as well as imbalances of the parasympathetic nervous system. These two are related.

Chronic stress decreases secretory IgA, which lines the mucosal surfaces of the body, including the gastrointestinal tract. It’s not a leaky gut marker, but if you have low secretory IgA, usually relates to a leaky gut. 

I used to do a lot of leaky gut testing. I noticed that just about everybody who had a low secretory IgA also tested positive for a leaky gut. Secretory IgA serves as protection. You definitely want to have healthy secretory IgA levels. A lot of people deal with chronic stress. A lot of people do have lower or depressed secretory IgA.

Also, chronic stress causes imbalances in the parasympathetic nervous system, which is the rest and digest system. Having imbalances here can lead to digestive issues. It can also cause mood disorders, like anxiety. 

What can you do? No matter how good you are at managing stress, it’s always going to be a factor. The problem is most people don’t do anything to manage stress. Even if you block out time to manage stress, it still might be a factor, but blocking out time for stress management still could be greatly beneficial. 

I recommend blocking out five minutes per day to start. Even just doing some simple deep breathing. Walking, exercising. I know walking is relaxing. I’m not saying it’s not a form of stress management. You want things that really activate your parasympathetic nervous system. If you are doing cardiac exercise, like cardio exercise or resistance exercise, that is more of a sympathetic activity. 

Doing some deep breathing five minutes per day can help. Of course, longer than this is better. The goal is to get into the routine of stress handling. If you’re in the routine of blocking out five minutes per day seven days a week, you could start increasing the duration. 

Another thing you could do is incorporate Vagus nerve exercises. Mind/body medicine is stimulating the Vagus nerve. That’s a Vagus nerve exercise. Vigorous gargling is another Vagus nerve exercise. Singing out loud, either in the shower or in your car. It doesn’t matter where it is. That also stimulates the Vagus nerve. 

Cold showers. Cold plunges, too. I can’t say I’m a big cold plunger. I’m not a big fan of cold plunges personally; it’s something I don’t do, but I do cold showers. Rotate hot and cold showers. If you are willing to do cold plunges, that could also activate the Vagus nerve. Vagus nerve exercises can make a big difference as well. 

Gut healing roadblock #6: gut infections and overgrowths. I mentioned H-pylori. That’s something I commonly see. It definitely could affect the gut. I mentioned how it could be a factor with low stomach acid and could potentially increase permeability of the gut. 

Parasites also could affect gut permeability. There are other infections. I won’t name all of them here. I will say Yersinia enterocolitica is another one. Giardia is a parasite. There are a lot of infections that could affect permeability of the gut. Not all of them will.

If you do a comprehensive stool panel, and you see some dysbiosis, which is imbalance of the gut flora, it doesn’t always mean that you’re going to have a leaky gut, for example. It really depends on which and how many microbes are out of balance. 

Candida is not an infection, but you could have too much candida, so a candida overgrowth. That could affect permeability of the gut. 

There is also SIBO, small intestinal bacterial overgrowth. This can also lead to an increase in intestinal permeability. 

Gut infections and overgrowths are reasons why some people don’t heal. In most cases, testing is the best way. It’s not perfect. For parasites, you could do testing and have false negative results with all of these. 

I do like testing though. I know there are practitioners out there, including some who have been on the podcast, who don’t like testing. They just treat everybody for parasites and other things without testing. 

I realize it’s a catch-22. It’s not perfect, and the testing is not free. It can get expensive when you do functional medicine testing. If at all possible, I’d like to identify what is actually causing the leaky gut when it comes to gut infections and overgrowths. 

If we’re suspecting a parasite, and we do testing that comes back negative, at that point, I’m okay with treating the parasite. I usually like to confirm it. Admittedly, it can be challenging. Obviously, different perspectives out there.

The seventh and final gut healing roadblock I’d like to discuss is environmental toxins and toxicants. Certain environmental toxins and toxicants can disrupt the gut and/or prevent it from healing. 

I mentioned glyphosate earlier. It is the active ingredient in the herbicide Roundup. It can cause dysbiosis, which in turn could cause that increase in intestinal permeability. 

Xenoestrogens, including microplastics, act as endocrine-disrupting chemicals. They could directly affect the thyroid. They also have been shown to affect permeability of the gut. I didn’t know this until recently. I have done a lot of research over the years with xenoestrogens, but I didn’t realize the impact they could have on the gut barrier. Another reason you want to minimize your exposure to plastics.

Mycotoxins from mold can potentially affect the intestinal barrier. 

Certain heavy metals, including mercury, can also affect the intestinal barrier and the thyroid directly and the immune system in different ways. 

Medications of course. Antibiotics, we all know that they can cause a leaky gut. I mentioned PPIs before. These also can cause a leaky gut. Plus they block the acid, which breaks down nutrients, so you don’t have that ability or an impaired ability.

I mentioned stomach acid is important for keeping bacteria and other pathogens in check. If you are taking acid blockers, it will make you more susceptible to gut infections and overgrowths, which is another roadblock.

For those with hyperthyroidism, antithyroid medication also can disrupt the gut. Risk versus benefits. This doesn’t mean that you should not take antithyroid medication and never take antibiotics. There is a time and place for these. 

I have worked with a lot of people over the years who have taken antithyroid medication, such as methimazole or PTU, and were able to restore their health. It might take a little bit longer. Everybody is different. Depends on how high of a dose of medication you’re taking. Like I said, it’s all risk versus benefit. Without question, the research shows they can affect the gut.

These are the seven gut healing roadblocks that could prevent your thyroid from healing. As usual, I hope you found the information to be valuable. I look forward to catching you in the next episode.

Recently, I interviewed Dr. Tom O’Bryan, and he explains why autoimmunity and cognitive decline don’t start overnight and the early patterns for detection He also encourages how specialized tests like the Total Toxin Burden and Neuro Zoomer can uncover root causes that aren’t always obvious, especially when traditional labs come back “normal.” . If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with Dr. Tom O’Bryan. We are going to be having a comprehensive discussion on how you can fix your brain. Very excited to talk about this. Let me dive into Dr. Tom’s short but sweet bio.

Dr. Tom O’Bryan is considered the Sherlock Holmes for chronic disease and teaches that recognizing and addressing the underlying mechanisms that activate an immune response is the map to the highway toward better health. He holds teaching faculty positions with the Institute for Functional Medicine and the National University of Health Sciences. Welcome, Dr. Tom. 

Dr. Tom O’Bryan: 

Thank you so much. Pleasure to be with you, Dr. Eric. 

Dr. Eric:

 I’m really looking forward to this conversation. I think the first time I saw you was at the Institute for Functional Medicine many years ago. It might have been in 2015/2016. You have been doing this a long time, even before then. We are both chiropractors. Again, you really dive deep into autoimmunity. What led you down this path to write your books and doing what you’re doing currently? 

Dr. Tom: 

It started when I was in my internship. My wife at the time, we couldn’t get pregnant. I called the seven most famous holistic doctors I had ever heard of. I called George Goodheart, Jonathan Wright. Any of the famous doctors that I had heard of. I asked them all, “What do you do for infertility?” They all told me what they would do, and I wrote it all down. I put a program together. We were pregnant in six weeks.

Dr. Eric: 

Wow.

Dr. Tom: 

We had housing on campus, and my neighbors asked if I’d work with them. They’d been through artificial insemination, and nothing had worked for them. I said, “I don’t know if it will help, but I don’t think it will hurt you.” They were pregnant in three months. 

We’re now four months’ pregnant, and we’re hot to trot. We’re telling the world how excited we are and what we’re finding out. One of our friends would have a sister in Wisconsin. We were in school in Chicago. She would call and say, “Can I drive down and see you please?” I wasn’t seeing patients, but I couldn’t say no. They’d come to my dorm room, and I was treating patients out of my dorm room. 

The president of the college called me in one day and said, “We can’t do this.” I said I understood, and I kept doing it. I was hot to help people. 

We helped a lot of people with pregnancy issues, whether it was infertility or recurrent miscarriages or a history of premature births. We found that consistently, time after time, every single one of them had some common links.

First, we had to make sure that all the parts were working, that there was nothing organically that made it impossible for pregnancy. Then there was one consistent mechanism that was always there. Every hormone-related problem. 

At the time, I was realizing everyone has hormone-related problems has inflammation. They have lifestyle habits, which where they live, if they live in a moldy house or are eating foods that are triggering inflammation in their body, or they have high levels of arsenic or lead or some other toxin in their body. 

When we would address those triggers of inflammation, then they always felt better every single time. Most of the time, surprisingly, within a few months, we’re getting a call, “We’re pregnant!” 

That started me off. I opened my practice, already practicing functional medicine in 1980. I happened to be in Dr. Jeff Bland’s first talk ever in Chicago in 1978. I had heard these concepts about functional medicine. As I was learning all of the technical things about being a chiropractic physician, a nutritionist, I was absorbing them from the ideas of functional medicine, which means identifying the triggers of inflammation and getting those triggers out there. Watch and see if the body starts functioning better. The results have been just miraculous over the last 40 years. It’s a long time. 

That got me into all of this. My entire career has been based on understanding the principles and investigating to see what are the triggers of inflammation for each individual patient that comes in? They’re always different. There are some common ones, but it’s always unique to the individual. There is no shotgun package approach that you can do. 

That’s what the book You Can Fix Your Brain is all about: understanding there are so many triggers to the inflammatory cascade in your brain. Here is how you identify them. Here is what some of the clues are as to where to look. That’s what the brain is about, with 36 to-dos for the brain. 

I will just give you one example here. There are a number of studies now that show that when women have high levels of phthalates in their body—phthalates are chemicals used to mold plastic. 

I will give you an example of a study. 2016, Chicago, 136 women in the eighth month of pregnancy. They measure their urine for how many phthalates they have in their urine. It’s the residue from plastics. We have all heard about microplastics and now nanoplastics and how they are a big problem. 

They measured in the urine how much plastic chemicals they have. They put the results into fourths. The lowest amount in the urine, the next lowest, the third, and the highest amount. Then they watched the offspring of those pregnancies. 

When those children turned seven years old, the researchers reached back out and said, “Hi, it’s time now to do the Wexler IQ test,” which is the official IQ test. There is not much in medicine that is “all” or “every,” but every single child whose mother was in the highest category of phthalates in urine during pregnancy, compared to the children whose mothers were in the lowest category, every single child in the highest category, their IQ was seven points lower. 6.7-7.6 points lower. Every one of them. 

That doesn’t mean anything to anybody until you understand a one-point difference in IQ is noticeable. A seven-point difference is the difference between a child working really hard, getting straight As in school, and a child working really hard, getting straight B-/Cs in school. This child doesn’t have a chance in hell of ever excelling. Their brain never developed to its genetic potential in utero. 

When you learn that, and there are many studies that give that kind of information, looking from one way or another, when you learn that it’s the toxicity in Mom and Dad that has a huge contribution to babies’ brain function as they grow up, years and years after being in the womb, then you understand why I say every couple of child-bearing age that wants to start a family needs to be tested first to see how many toxins do they have in their body right now? If they’re high, you need to take the time to get those out of there before you try for pregnancy.

I will give you one more example. About 16 months ago, a paper came out of men at infertility centers. They found that the glyphosate level, which is a chemical used on genetically modified foods, in men’s semen was 400% higher than the glyphosate levels in their blood. You mean the semen that is made in the testicles, the concentration of glyphosate is 4x higher than in the guy’s blood? Yes, it accumulates in the testicles in men. 

The result is that the DNA gets damaged because of glyphosate. There are studies that show all that. The DNA gets damaged, which then damages the sperm that is in the semen, and the semen carries the sperm with ejaculation into the woman. The pregnancy, if it’s from a damaged sperm, puts the child at risk that they never develop to what their genetic potential could be. People don’t know this. 

Don’t believe me. Read my book. Look at all the studies. There are 346 studies in that book. “That can’t be true! My doctors, the experts at the fertility center,” who are charging you tens of thousands of dollars, never check this stuff. They don’t see it. They want to make sure the woman’s fallopian tubes are open, and she has the eggs and enough hormones. That’s all good. But that’s technology from 1990 that is not cutting-edge. You have to see if this couple is so toxic that the levels are accumulatively putting them at risk for damaging the sperm and damaging the eggs. We have never had a couple come back normal on a first test.

Dr. Eric: 

That was my question. I was going to ask you that. You said if they’re high, treat it. My question to you was have you ever done a test on a couple where it looked good? 

Dr. Tom: 

No, never. These tests are highly accurate. This world we’re living in today is more toxic than ever before in history. People are accumulating more toxins at earlier ages than ever before. Humans do not have the detoxification mechanisms to deal with all of these chemicals. 

Our immune systems are designed by what allowed our ancestors to survive. We carry the genes of our ancestors. The ancestors who survived and reproduced and produce the lineage that we came from now, their immune systems were designed to handle specific things that were risk factors to kill them: bugs, parasites, viruses, mold, fungus, and bacteria. That’s it. We don’t have any aspect of our immune system to deal with lead poisoning. We don’t have any aspect of our immune system to deal with red dye #42. 

When we get exposed to all of these things, the immune system operates in the only way it can when there is a threat. That means the immune system produces inflammation. The inflammation tries to kill this thing, but you can’t kill red dye #42. It just sits in your cell. There is not more inflammation; the damage is the cells around that. 

We know now from the Center for Disease Control (CDC) that 14 of the 15 top causes of death are chronic inflammatory diseases. It’s always inflammation, whether it’s cognitive decline, dementia, diabetes, atherosclerosis, heart disease, rheumatoid arthritis, autoimmune diseases. They all are inflammatory diseases. It’s an immune system that has been activated to protect you. The immune system isn’t going crazy; it’s trying to protect you. 

The question is what is it trying to protect you from? This is basic 101, common sense stuff that always has to be addressed. There is no profit in this, so it’s not taught in medical schools. I’m not challenging the students who went to the school and then became doctors, but this is what they have learned. They have learned that you do these tests to identify what they’re checking for, and then you write a prescription. Or you’re doing some other invasive therapy. But they’re not taught these basic 101 principles, so they just don’t know. 

That’s why you have such a successful track record working with infertility couples when you include this approach. I’m not saying only this approach, but you include this approach. You always test for this first. “How toxic are you, Mr. and Mrs. so-and-so?” When the test results come back, and you do an “Oh my god, I had no idea,” then you tell the patient, “Do not get pregnant until we get this stuff out of your body. Then you have a better chance of baby developing to their genetic potential,” whatever their potential is. You’re not going to put the emergency brakes on their development. 

You ever back out of a driveway, and you say, “What’s wrong with this car? It’s moving, but it’s not moving fast.” The emergency brake. You let go of the emergency brake, and you back up just fine. Toxicity is a huge emergency brake on brain function in general, which is what this topic is, but on infertility. It’s a huge emergency brake that you just have to rule out. 

You just have to do the right, simple tests to rule it out. A simple urine test will tell you, do you have too many toxins in your body? The urine test is called the Total Tox Burden. It looks at 87 different markers in one simple urine test. It’s just remarkable. It’s a highly accurate test. If you’re clean, great, go for it. Let’s figure out what else might be inhibiting you having a successful pregnancy. We don’t have to pause on your attempts right now. 

Dr. Eric: 

I like to play devil’s advocate. I’m going to ask you something, and I’m pretty sure I know what the response is. 

Dr. Tom: 

Sure. 

Dr. Eric: 

Since everybody you tested for tests positive for toxins, why do the testing at all? Why not just jump into detoxification? 

Dr. Tom: 

That’s a really good question. The answer is, you can do detoxification to begin with, and people start feeling better pretty quickly. If you don’t know that you had 24 different toxins, and now after your detox protocol, you have seven left, but you feel great. You still have this stuff going on that is not contributing to the lousy way you were feeling. 

You have a baseline. If you don’t have a baseline, you’re shooting in the dark. I call it “shotgun medicine.” We know detox always helps, so let’s just put everybody on a detox program. If you want, I guess it’d be hard to argue with, don’t try and get pregnant, do the detox program, then we will do the test and see what’s left. It is always better because you’re asking people to change their lifestyle, their basic food selections, living environment sometimes. 

You’ve heard now recently that the polyethylene materials in many of these athletic clothes that people are wearing, the gym shorts and bras, cause all kinds of hormone problems for people. But you don’t feel bad when you put on a pair of gym shorts, and you go out for a run or exercise, and you’re sweating. You’re opening up your pores, which means these polyethylene chemicals, toxins, and phthalates are coming in through your testicles or breasts. You don’t know that’s happening. You can’t feel that. 

If you don’t have a baseline, and then you recheck 2-3 months later, depending on what your detox protocols are and what your starting point is, you’re shooting in the dark. 

Dr. Eric: 

Makes sense. You get that baseline, and you can see exactly how many toxins you have, the levels they’re at. After addressing that, you can see the improvements. Hopefully, they will be greatly reduced, within the lab range. But you don’t know unless you retest. Maybe you have a few dozen. Makes sense.

Inflammation essentially, for those who aren’t taking this approach, it’s really starting in the womb, it sounds like. 

Dr. Tom: 

It really does. It starts pre-conception. My new book that I’m writing now, it will be a year before it’s out. The working title is Healthy Conception, Healthy Pregnancy, Healthy Delivery, Happy Baby. You have to deal with all four categories. This world we’re living in today, the statistics of the percentage of our children who not only are obese, but the percentage of our children with ADD or autism or on antidepressant or antianxiety medication is going through the roof. Only in the U.S. In other countries, it’s not as bad; it’s bad, but not as bad as in the U.S. It’s startling to look down the road and see what’s happening with our most precious treasure, our next generation, our children. 

Dr. Eric: 

We will have to bring you back on once you get that book released in 2026. 

Dr. Tom: 

Yes, thank you. 

Dr. Eric: 

When these chemicals affect the brain, they also affect other areas, including the gut. Can you talk a little bit about the relationship between the blood-brain barrier and the gut barrier? 

Dr. Tom: 

The blood-brain barrier is the most tight of any barrier in the body. Some things can get through, but most things can’t. That’s the blood-brain barrier. 

The gut barrier is the same. This is how you think about it. Your digestive tract is a tube that goes from the mouth to the other end. One big, long tube. 20-25 feet long. The inside of the tube is lined with cheesecloth. 

When you eat food, think of proteins like a pearl necklace. The acid in your stomach undoes the clasp of the pearl necklace. Now you have a string of pearls. It’s your digestive enzymes in your mouth and your gut that act like scissors to cut the pearl necklace into smaller and smaller pieces. They’re called peptides. Each piece gets smaller and smaller until you are down to each pearl of the necklace. That’s called an amino acid. We know those as the building blocks for new muscle cells, new bone cells, new brain cells. The amino acids are raw material to build new cells to keep us young and strong and healthy. 

When you eat a hamburger, most of us take 3-4 chews, and then we gulp down. We should chew it 15-20 times, but we don’t. We gulp. There is no way that ground meat can get into your bloodstream. There is no way. If it does, you might die. It’s not okay. It has to be broken down into each pearl of the pearl necklace down to the amino acids. Then they fit right through the cheesecloth and get into the bloodstream. 

Your bloodstream is just a highway. Everything is going in the same direction, but it’s like bumper cars going in there. They are all bouncing into each other. These are the raw materials to make new cells. That’s the job of the cheesecloth, is to restrict so only certain-sized molecules can get through.

When you get a tear in the cheesecloth, that’s called leaky gut. Now bigger molecules, called macro molecules, get through into the bloodstream before they should be able to get through. There is nothing wrong with them. It’s good food. They have to be digested down to each pearl of the pearl necklace. If you have tears in the cheesecloth, some of those macro molecules can get through before they have been digested completely. 

Now, they’re on the highway, these big clumps of meat in this example. The immune system says, “Whoa, what’s that? I better fight that.” You start making antibodies to beef or chicken or tomatoes or bananas. It doesn’t matter what the food is. if you have a leaky gut, and these molecules get through into the bloodstream, your immune system is trying to protect you from this threat and will make antibodies to fight that food. 

Those are the people who do 96 food panel tests and come back sensitive to 25 different foods. “That’s everything I eat!” Of course, it is. It’s your immune system trying to protect you from these macro molecules. You heal the gut, and two months, six months from now, whenever you retest, you are sensitive to two, maybe three foods. Those are the ones you stay away from forever. That’s the leaky gut.

The same thing happens in the brain. You have a cheesecloth around the blood vessels in the brain. Your brain is so important that about 2% of the body weight is the brain. At any time, the brain has 18-20% of the body’s blood inside it. There are thousands of tiny little blood vessels in the brain. They all have this cheesecloth on the inside of the blood vessel to make sure nothing gets into the brain tissue that is not supposed to.

When you have a leaky brain, that’s why checking your brain for inflammation is so important. I can’t find any science to validate this, but now I am telling you this is my opinion. Everything else I am telling you is not; that’s what they are teaching at Harvard Medical School. But this is my opinion: that’s why as a doctor, as a clinician, when you identify the inflammation in the brain, you’re identifying one of the earliest organs that is being damaged by too much inflammation. 

I’d like to show you a few slides if I can. It might put this in perspective. Would that be okay? 

Dr. Eric: 

That would be awesome. 

Dr. Tom: 

Perfect. Here we go. I am going to get geeky with you for a minute. This is Melissa Arbuckle. She works at the VA. She looked at one VA center for the number of people that were diagnosed with the autoimmune disease lupus, systemic lupus erythematosus. She found there were 132, I think it was, people in this one center. 

If they are in a VA center for treatment, they’re veterans. If they’re veterans, they were in the armed forces. When they were in the armed forces, when they were healthy in the Army, Navy, Air Force, Marines, they had their blood drawn many times over the years for one reason or another. What most people don’t know is the government has been saving and freezing most of that blood since 1978. They have tens of millions of samples of our servicepeople’s blood. 

Dr. Arbuckle knew this. She asked for permission to look at the frozen blood of the currently diagnosed lupus patients when they were healthy in the armed forces. She got that permission. What did she find? 

As she wrote here in the New England Journal of Medicine—there are seven antibodies for lupus—all seven antibodies are elevated years before a person has a symptom. They have no symptoms. They feel fine. I call it the “I feel fine” syndrome. “I don’t need to test anything; I feel fine.” The antibodies are elevated. 

By definition, when you have elevated antibodies, you’re killing off more tissue than you’re making. Every cell in your body regenerates every seven years. Some quick, some slow. How does that happen? Your immune system has to get rid of the old, damaged ells to make room for the new cells. That makes sense. 

How does it do that? The process is called autophagy, which means getting rid of the old, damaged cells to make room for the new cells. Antibodies are a part of that. 

You have a normal level of antibodies to your thyroid. I will use that as an example. In most labs, it’s about 36 antibodies. That’s normal. When you have elevated levels of antibodies, you’re killing off more cells than you’re making. By definition. That’s what elevation means.

Every single lupus patient had all seven antibodies elevated years before they ever had a symptom, killing off tissue while they felt “fine.” She did this graph. The zero line is not zero antibodies; it’s the normal level. You see all seven of them elevated five years before they ever have a symptom. Some of them were elevated 11 years. All of them were elevated at least five years before they ever had a symptom.

Then they hit that peak of killing off cells for 5-11 years. Then they start getting symptoms. Within a few months, they get the diagnosis of lupus. 

She put this drawing together. She just made this up. She said, “You have a normal level of antibodies.” Getting rid of old cells to make room for new cells. Then they have what she called benign cells. There were no symptoms, so she called it “benign.” Then you have pathogenic, meaning you are getting some symptoms now. Then you get diagnosed with a disease. 

It started way back at normal, going into benign. That is when it started. Right there in what we call the prodromal period, which means before symptoms. That is where it starts. I want you to remember that word “prodromal,” before symptoms. Here you see, and you understand, during this benign period, we are killing off cells. You don’t have any symptoms, so you feel fine. Yes, okay, that’s called the prodromal period. 

Let’s get to the brain. Back in 2017, most front pages of newspapers around the country said Alzheimer’s will bankrupt Medicare. This is a real problem. The numbers were really scary. They put a commission together of the world’s leading scientists for Alzheimer’s and said, “Figure out what we’re going to do about this.” Two years before they wrote their report. 

They published their report way back in July 2019. No one paid any attention to it whatsoever. This is when the virus came out that scared everybody and was on the front page every day in the newspapers. This never made any headway at all. 

I jumped up and down when I saw the drawing they put in here because it explains so much. Here it is. Notice there is a prodromal period in the development of Alzheimer’s. It goes for 20-25 years of elevated antibodies, killing off tissue, while you are in the “I feel fine” syndrome. 

Then it moves into the “Where did I park my car in the parking lot?” Short-term memory loss. “Where are my keys?” That goes on for 5-7 years. Now you’re 25-30 years into inflammation in your brain killing off tissue. Then you get diagnosed with mild Alzheimer’s, as if it came on yesterday or in the last couple months. It’s been occurring for 25 years. You just never knew it because it was in the benign period of killing off cells before you killed off so many cells that the tissue couldn’t function right anymore.

This comes from a Blue Cross/Blue Shield study in February 2020 that nobody paid attention to because of the virus. They said, “We have a problem here.” In a four-year period, there was a huge increase in claims for Alzheimer’s. This was the one that really scared me. A 407% increase in claims for Alzheimer’s in 30-44 years old. 407% increase. 

People are getting sick, inflamed in their childhood because there are so many toxins now. Nobody pays any attention to it, killing off brain cells. You get diagnosed with depression or Alzheimer’s. They give you medications for that. Nobody identifies the inflammation in the brain. Where is the inflammation coming from? 

This is the pandemic that no one is talking about. This is a test. It’s a simple blood test. You do this test, and it looks at 53 markers of inflammation in the brain. You pay $500 to do this test, and you find out if you have inflammation in your brain right now. It’s not good, but no one comes back normal on this test or on the toxin test. 

They don’t come back normal because everyone is being exposed to all of these toxins, and blood pools in the brain. The inflammatory markers are in the blood, sitting in the brain, causing more tearing of the cheesecloth. The leaky brain that is getting these macro molecules into the brain, activating the immune system, producing the antibodies that we’ve got. 

I’m hoping everyone will watch this once again. I know I just overwhelmed the hell out of you. I know I did. This is Ph. D level stuff. If I can get across to all of your listeners, Dr. Eric, that this is a basic, 101 concept, that 14 of the 15 top causes of death are inflammatory diseases, that inflammatory molecules sit in the brain longer than anywhere else in high concentration, and you can measure the inflammation in the brain, how many antibodies you have in your brain tissue that are elevated beyond normal levels, then you understand, “I really need to find out how I am throwing gasoline on the fire, causing all of this.” 

When you explore that and understand that, then you start noticing your brain is functioning better. You redo the test in about a year. Don’t do it beforehand because it will take a while to get the fire extinguishers to put the fire out. 

The first step is stop throwing gasoline on the fire. You have to figure out how I am throwing gasoline on the fire. A year later, you do the test. The first time, you had 19 markers elevated. Now, you have four. This means you’re on the right track. Keep it up. You’re doing great. No simple pill will ever fix this. 

That’s why I know of two drug pharmaceutical companies that closed their Alzheimer’s research departments. They realized they spent billions, but they will never find a pill to fix this. You can’t. It’s all of the different toxins and triggers. You have to identify all those and get them out of there. 

That’s functional medicine. That’s the work you do in your practice, why you have this thyroid podcast, so people can understand this stuff. What we’re talking about today is the real pandemic about brain function. 

There is a way to get through this. There is a way to identify where is the trigger, and what do we do about it?  

Dr. Eric: 

That was a pretty in-depth presentation. It was short, but still very detailed. The prodromal stage, that applies to all autoimmune conditions? With Hashimoto’s, they have that silent autoimmunity phase that could go on for 10-15 years. 

Dr. Tom: 

Every autoimmune disease goes through this spectrum. It’s called the spectrum of autoimmunity. Professor Yehuda Shoenfeld, one of the greats in the field, in Tel Aviv, Israel, he runs the immunology department at Tel Aviv University. 26, the last count that I know of, of the folks who received their Ph. D from him chair departments of immunology in medical schools in hospitals around the world. They’re his students. This is the godfather of all of it. He calls it the tautology of immunity. 

An easier word to understand it is the spectrum. It starts with normal levels of antibodies; benign levels; pathogenic levels; and the diagnosis of the disease. Every single autoimmune disease that they have examined goes through this same pathway. It’s no mystery anymore. 

Dr. Eric:

I want to clarify or reinforce what you mentioned. Your goal when it comes to auto antibodies isn’t to get them to zero, but to get them ideally within the range. If there are some antibodies present- 

Dr. Tom: 

They’re supposed to be there. They’re part of the autophagy process, to get rid of old, damaged cells. When you stop making new cells, you can’t make new cells unless you get rid of the old cells, or else you will blow up like a balloon. When you stop making new cells, you start aging really, really quickly because the old cells are dying off. You have more dis-ease. 

Dr. Eric: 

As far as who should do the testing. You mentioned with the toxin tests, anyone looking to conceive. Should everyone who has an autoimmune condition like Graves’ or Hashimoto’s also consider testing for toxins? Is that what you recommend in your practice, for everybody to do the total toxin test? 

Dr. Tom: 

Correct. I just saw a woman this afternoon with Graves’. I see one patient every two weeks or so by Zoom. I want five years of their health history before I ever talk to them. Every patient I see does a minimum of four tests. These are not specific just to your symptoms; these are specific to the inflammatory cascade; 14 of the 15 top causes of death are chronic inflammatory diseases. Doesn’t matter what you’ve got. It’s always inflammation. That’s the root mechanism.

Doctors sometimes talk about root cause. We did a genetic test. You have this gene, which is the root cause of your problems. No, it’s not. Genes are important, but they are not the cause. Activation of the gene is the cause. There is one root mechanism. 

What you want to do, Mrs. Patient, you have the gene for Alzheimer’s. That doesn’t mean you’re getting Alzheimer’s. Genes operate on dimmer switches. We want to dim that gene down, so it doesn’t express itself. We want to turn up the genes for anti-inflammatory brain function. 

For example, we knew back in the 1990s that one cup of blueberries a day in three years, your brain is working as well as it was 13 years earlier. One cup of organic blueberries because of the toxicity in today’s world. We knew that a long time ago. 

You turn up the genes for antiinflammation, and you stop throwing gasoline on the fire once you identify what foods and toxins you have in your body. You get those out of there. You give the foods to turn on the genes for antiinflammation and regeneration. People get better. 

Six months from now, you go to church and haven’t seen somebody in a long time. “What happened to you? You look like a million bucks.” 

I’ll tell you what happened to me. I found out that I had all these phthalates in my urine, and I had arsenic poisoning, and I was sensitive to gluten. I got rid of all of that stuff. 

I got rid of nail polish that doesn’t have phthalates. Phthalates go in your bloodstream in 4-5 minutes, which is what makes the nail polish hard. 

I got rid of all my plastic storage containers, and I got glass storage containers. My book tells you how to do that. Here is three URLs for glass storage containers. 

I got plants in my house. We got rid of all of this stuff. My kids are better in school. They’re doing great. They’re happy. I’ve lost X number of pounds. My energy is up. My husband is sweeter than ever. My life is great because I took the time to learn all of this stuff that I had no idea about. That’s what happens to most people if they focus and do this. 

First thing you have to do is test and identify how are you throwing gasoline on the fire? The four tests I recommend are a Gut Zoomer, the Neural Zoomer Plus, the Wheat Zoomer, and the Total Tox Burden. Those four tests will identify if you have a leaky gut, a leaky brain, inflammation in your brain, a sensitivity to wheat, and the toxins that you’re accumulating. Is it mold? Phosphates? Petroleum products? That test looks at 87 different markers of inflammation: chemicals and toxins and heavy metals. You do those four tests. As a matter of fact, Dr. Eric, is it okay if I say this? 

Dr. Eric: 

Yes, we were chatting before about me looking into doing the Total Toxic Burden test. 

Dr. Tom: 

When I’m on stage, talking to doctors, I always challenge them. I say, “There is nobody’s health better than your own and your spouse.” You know them better than anyone else. Do these tests on you. You’ll be surprised and startled by what’s going on in your brain and what toxins you’ve accumulated. Now, you learned what to do about it. In six months to a year, you redo the test, and see, “Wow, I feel so much better. This is gone. This is gone. Normal. Arsenic is a little high but much better than it was.” You’ll see. 

Dr. Eric and I were talking before we turned on the recording. I said, “Eric, why don’t you and your wife do these tests together and invite all of your followers to do the tests? I’ll come back on in a few months, and we’ll interpret the tests. We’ll talk about what to do.” What was your response to that? 

Dr. Eric: 

My response was, “I don’t know if I want to see what the tests look like.” Again, I do a lot. I do sauna three times a week. I try to eat organic. It’s just one of those things where I know no matter what we do, there will still be a toxic burden. 

Dr. Tom: 

Right. That’s very human. “I don’t know if I want to know.” You think you’re stuck. You’re not stuck. You’re missing something. For example, mold in your house. It might not be seen. You can’t see it. You can’t smell it. You’re breathing it in every day over the course of many months. 

I had one patient come in. He was the president of a bank in Chicago. His staff called me. This is when I lived in California. They asked me to fly to Chicago to see Mr. so and so. “I don’t want to go. He can come here.” He and his wife decided for a holiday to fly out to Los Angeles and drive the coast and see California, from San Francisco to San Diego. I lived in San Diego. I don’t have an office when I lived there. I meet people by Zoom. I met them at a coffee shop, and we are sitting there talking. It took me about three minutes to ask. 

His problem was his brain wasn’t working anymore. He couldn’t focus. He had to take a leave of absence from his job because he couldn’t focus. He had been to the world’s best clinics. They tested everything. They could find nothing. MRIs, CTs, photo scans, everything that they did, they could find nothing. He had sent me those test results beforehand, so I could see from the provisional tests they had done, there was nothing.

It took about three minutes. We’re sitting there, and we had just gotten our coffee. I said to him, “So, when did your basement flood?” He went, “How did you know my basement flooded?” “Well, when did it flood?” “About a year and a half ago.” “When did your symptoms start?” “About eight months ago. Could that have something to do with my symptoms?” 

I’m originally from Chicago, and he lived in Chicago. Sometimes, you get rains and basements flood. His basement had flood, and they brought a crew in to clean it all up. They put dehumidifiers down there. The drywall had absorbed the water up the wall aways. When they cleaned the carpets, they pulled them, but the drywall. 

If you go home and drill a little couple holes in your drywall, have a professional come in to do it. You will find there is black mold in the walls. And there was. When they remediated the black mold, when they got out of the house, I told them not to go back in the house. If he wanted to go to work, he needed to live in a hotel until it is remediated. Do not go back to the house until then. 

He was back to work in a few weeks. His brain was working better. They remediated the house, and he was fine.

It doesn’t matter how much money you have, and you see the world’s best. They’re not trained in environmental toxins. Mayo Clinic, they are not trained in environmental toxins. It’s rare. Sometimes, you will find a doctor who has gone through the functional medicine training, and they know this stuff and are starting to deal with it. It’s just not commonly taught.  

Dr. Eric: 

I agree. I’ll take you up for that challenge by the way. I don’t know if my wife will agree, but I definitely will run that by her. Either way, I will. 

Dr. Tom: 

Marvelous. I suggest you send an announcement out to all your followers. Tell them you will do the test, and if they do it, they will get a free interpretation from Dr. O’Bryan. You can find out. I promise you, it doesn’t matter what you find. It’s all reversible. The more problems you have. I’ve known this concept for a long time. 

When I had my office, people would come for their first exam. They’re nervous of course. We run some tests and make a general recommendation of a general diet to follow. Come back in two weeks. The test results will be here. They come back and are always very nervous. They will sit down, and I am looking at the results. 

I say: I have some good news for you. You’re a mess. Look at this. This is out. This is out. This is out. I’m smiling. This is so great. Now we know why you feel the way you do. Now we know. Now we’re going to fix it. This will take two weeks. This will take 4-5 months. This one will take a while, but you should feel better within a few weeks. It won’t take long, but you will have some relapses in there most likely as we’re working because you’ll cheat. You’ll go out to eat something you shouldn’t eat. You will feel sick as can be the next day. You will call me, and I will say, “Good, I’m glad you don’t feel well. Now you know. Don’t eat that stuff.” 

Dr. Eric: 

Agreed. 

Dr. Tom: 

This is functional medicine. You have to identify how you are throwing gasoline on the fire. When you do that, and you start to address that, you change the lifestyle. 

As clean as your lifestyle is, you’re still scared of what you find. That’s true. That’s true for all of us. When you find out, then you will put the time into learning what I do about it. Then you will start changing it.

Dr. Eric: 

Before we wrap it up, can I ask you one more question? 

Dr. Tom: 

Of course. 

Dr. Eric:

 You mentioned glyphosate earlier. You also mentioned the Wheat Zoomer. A common question people ask, and I’m sure you get this all the time, too. And you’re in Italy right now. I heard it’s fine to eat wheat/gluten outside of the United States, but not in the United States. Maybe because of the glyphosate that is within the United States. Especially with autoimmune conditions, but I know you recommend everyone to avoid gluten. Does it make a difference as far as gluten? 

Dr. Tom: 

I understand the question. Happy to answer it. A couple of things. First, I never recommend everyone give up wheat. What I recommend is if you have a health issue, just test to see if your immune system is fighting wheat. Do the right test. It’s called the Wheat Zoomer because you zoom in on a problem. That’s the first thing.

Secondly, glyphosate’s here in Italy. That’s not it. The reason people go to Italy or Europe and eat wheat and don’t have the symptoms they have when they eat wheat in the U.S. is primarily one reason. It is the FODMAPS, the fermentable carbohydrates in wheat, that cause the bloating, gas, abdominal cramps, and pain. When you eat wheat, you feel it. It’s the FODMAPs, not the gluten. 

Only 9% of people who have gas, bloating, and abdominal pain from wheat have a problem with gluten. 93% have a problem with FODMAPs in wheat, not the protein in wheat. The immune system fights the proteins. You may get the migraines. You may get the psoriasis. You may get the Hashimoto’s. But you don’t get the gut symptoms from the gluten. You do activate the immune system from gluten, but it’s the FODMAPs that activate the bloating and the gas in the gut. 

The wheat in Europe is lower in FODMAPs, but it still has the gluten. When you eat the wheat in Europe, you still activate the immune system and get more thyroid antibodies or brain antibodies or skin, whatever your vulnerability is. You still get all of that regression and activated immune system, but you don’t get the bloating. You think it’s fine to eat wheat in Europe. It’s not. 

That’s one of the kinds of detail that I have in my Certified Gluten-free Practitioner course that is online. When our doctors and health coaches take the CGP course, they have it down. They understand all of this. Here are the studies; here is the science. They get it. 

I recommend every healthcare practitioner take the CGP course. I always tell them, if there is anything you don’t like about it, if it didn’t give you more information than you ever could have found in the past, we’ll give you a refund. It’s okay. We have never had a request for a refund.

That one answer I just gave you will answer for so many people this concept of it’s safe to eat wheat in Europe. No, it’s not. You will bring back your MS symptoms if you eat wheat in Europe. 

Dr. Eric: 

Thank you, that makes sense. Thank you for this conversation. Looking forward to having you back after I and many of my followers hopefully do the testing to have you help with the interpretation. Where can people find out more about you, Dr. Tom? 

Dr. Tom: 

The website is TheDr.com. Don’t spell the word “doctor” out. 

Dr. Eric: 

Wonderful. Easy enough. Thanks again, Dr. Tom. This was great. I’m sure the listeners learned a lot, and so did I . 

Dr. Tom: 

Thank you, Dr. Eric. Great to be with you.

Recently, I interviewed Lucy Hutchings,  who is a Registered dietitian. In this episode she breaks down why perimenopause symptoms like brain fog, belly fat, and poor sleep are common but absolutely not something you just have to live with. She shares how nutrition, strength training, and simple daily habits can gently support your hormones without extremes. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Excited to chat with Lucy Hutchings, as we are going to be chatting about perimenopause, sugar cravings. Let’s go ahead and dive into Lucy’s impressive bio here. 

Lucy Hutchings is a registered dietician and the founder of Wellness from Within Nutrition, where she helps busy women, especially those in perimenopause, ditch belly fat, reduce inflammation, and feel amazing in their own skin without fad diets or intense restrictions. She has over 16 years of experience and a holistic, realistic approach. Lucy guides women toward sustainable results through nourishing foods, hormone balance, and simple lifestyle shifts. 

She is also the host of The Healthy Mama Podcast, where I was also a guest on her podcast. On this podcast, she shares practical tips and inspiring conversations to support women on their wellness journeys. As a busy mom of three, Lucy understands the real-life challenges her clients face and is passionate about helping them thrive in this season of life.

Thanks for joining us, Lucy. 

Lucy Hutchings: 

Thank you so much for having me. 

Dr. Eric: 

Looking forward to chatting about perimenopause and some other things as well. Let’s get a little bit more of your background. What led you to focus on perimenopause? How long have you had The Healthy Mama Podcast for? 

Lucy: 

Over three years now. It’s been a while. 

Dr. Eric: 

Close to mine. Mine is about 3.5 years as we record this. Very cool. Let’s get more of your background. 

Lucy: 

Sure. What led me to be working with women in perimenopause, a lot of it has to do with the fact that I’m 45. I think a lot of the things that I’ve been experiencing, and I see the clients I’m working with also experience is my heart goes out to those women who are my age and older that are struggling. That just kills me. It doesn’t need to be this way. We don’t need to suffer going through perimenopause and menopause. 

We’re not getting the best supportive information from our doctors, from social media, from our friends and family. We just get a lot of poor advice. That leads us down this path of suffering through perimenopause and menopause.

Our hormones are really not balanced, and we are now struggling with inflammation and cholesterol problems and blood pressure problems. The list builds and builds, and we don’t know what to do about it. There is not a lot of info out there. That’s where my passion lies: helping these women figure it out. 

Dr. Eric: 

It’s safe to say then that a lot of perimenopausal symptoms are common but not necessarily normal? 

Lucy: 

Absolutely. We think this is the way it’s supposed to be. We think we are just going to have brain fog, stubborn belly fat, fatigue, poor sleep, hot flashes, and sugar cravings. That’s just the way it is. 

Actually, we don’t have to have all those symptoms. There are so many things we can do through diet, lifestyle. That will help us have a smooth ride during this time. If we are supporting our body the right way, we don’t have to have these huge mood swings and irritability and the anxiety. 

The way our mental health works during perimenopause and menopause is it often seems like we are dealing with depression or anxiety or low mood. Some of it is just about our hormones fluctuating. We need to support our bodies and our lives a little bit better than what we’re doing right now. 

Dr. Eric: 

Definitely agree with that. Diet and lifestyle play a big role in helping these women. I’d like you to talk a little bit about stress. How much of an impact does stress have on hormones at least being a contributing factor when it comes to these symptoms? 

Lucy: 

Stress is a pretty huge one. So many of us are dealing with it between our job or our family. We are often at the peak of our career, so maybe we have a lot going on with our career. Maybe we have teenagers or kids who are getting older, so we are dealing with that. Some of us also are taking care of our parents. I am actually taking care of my 101-year-old grandmother. We have other loved ones in our lives we might be caring for. Caring for our house. I am still trying to be a good mom and wife. There is a lot of stress that can build up.

This stress increases cortisol. That leads to storing of belly fat. Also, stress brings us down. It makes it so maybe we don’t feel like we have time to spend time cooking a meal or chopping vegetables or going for a walk or getting the movement in that we need. The more stress we have that builds up, the more our gut health suffers. Our sleep suffers from the stress. Our mental health is suffering. Our mood is suffering. 

Then we have to figure out what is the root cause of the stress. Where is that coming from? Is it relationships? Is it our career? Is it our busy schedule? Once we figure that out, then we can move on.

I like to say our body isn’t broken. When we feel these symptoms, when we notice brain fog, stubborn weight, digestive problems, and bloating, these are messages from our body that things are out of whack. They are not in balance. We need to do something to improve that. 

Rather than feeling like “My body is broken, I hate my body, this is the worst time of my life,” we need to listen and say, “What can we do? What are these messages saying to us? How can I address it?” That’s how I like to think of it. 

Dr. Eric: 

I’m going to put you on the spot a little bit. You mentioned you’re 45 with three children. What do you do to manage stress? What are some of the things you do on a routine basis? 

Lucy: 

Great question. I’m right there with everyone, trying to raise my kids. We homeschool as well. We’re very involved. Plus I’m running a business and doing all the other things that I mentioned. It is a lot. Taking care of myself is really important. 

I never suggest to somebody that they need to live in a bubble and be completely stress-free. That’s not reality. That’s not how I want to live my life. That’s not going to happen. Then we have to figure out how to move ourselves out of that stressed state. 

How do we move ourselves from that sympathetic nervous system state to that parasympathetic nervous system state, where we are able to digest our food, rest, get good sleep, and repair and heal our bodies? All of that is so important.

Types of things that I do and I recommend for other people to do. Just take a minute or 30 seconds to breathe. Focused breath. Maybe it’s while you’re driving or in the shower or doing the dishes. You can take a moment and do some box breathing, circle breathing, whatever kind of focused breath you want, that help recenter you, so you are moving yourself out of that stressed state into that more relaxed state, letting your body know you are safe, even though your kid did something horrible or said something ridiculous, that you’re not actually in danger. You can allow your body to repair, heal, digest, all the things it needs to do. Breathing is an important one. 

Even short breaks, where you take a five-minute walk or a little bit of stretching. 

I also really protect my sleep. That goes hand in hand with stress. I make sure that I’m going to bed at a decent time, and I let myself get the sleep that I need. That really helps with stress as well. 

Dr. Eric: 

How much sleep do you recommend? 7.5-8 hours? 

Lucy: 

Exactly. You will know by the way you feel. Some people do need more than eight hours of sleep. Some people need less. I honestly feel pretty good on 7.5 hours. I don’t use an alarm. I let myself wake up naturally. Luckily, I am going to bed on time. I don’t have to be anywhere usually early in the morning since I work from home mostly. I’m able to do that. 

Other people need more sleep. You will know by how you feel. You shouldn’t feel horrible when you wake up. You should actually feel pretty good. I’m ready for the day. I’m not in pain. I’m not severely fatigued. I’m ready. Bright-eyed and bushy-tailed? Not always. But not horrible. 

Dr. Eric: 

Not dragging out of bed, taking a few hours, and needing four cups of coffee. 

Lucy: 

Yep, exactly. That’s another way to tell. If you’re really addicted or just reliant on caffeine to function and get through your day, then we really need to look at sleep. There may be reasons why you need caffeine so much. That will have a huge effect on your blood sugar, your insulin sensitivity, your hormone balance if you are not getting enough sleep. All that means is you will get that belly fat stored if you are not getting enough sleep. That’s the big thing that people think about. Now I am going to make changes because I won’t be able to lose belly fat until I actually get my sleep dialed in. 

Dr. Eric: 

I want to expand a little bit on the coffee. Since you’re a registered dietician, we will talk about food. If someone is sleeping okay, do you think it’s all right if the average person has a cup or two of coffee per day? I’m not a coffee drinker, so you won’t hurt my feelings if you say absolutely no coffee. I don’t know if you drink coffee. Overall, what’s your perspective on coffee and caffeine? 

Lucy: 

Good question. So many people drink it, so we need to know. I don’t have much against caffeine or coffee. There are a few recommendations that I do make. Make sure that you are not using it to get through the day. If you’re using it because you can’t function without it, we have to address that.

I also recommend good-quality coffee. I do prefer an organic coffee. There is less toxins and molds and things like that that we have to think about.

Also, the sweetener that goes in it. That’s another part of it. If you’re loading your coffee with artificially sweetened or sugar sweetened creamers, we have to talk about that. It won’t help inflammation or your hormone balance. 

In general, coffee isn’t much of a problem, but we have to notice how we are using it. No, I’m not a coffee drinker, but that’s because I’ve never really liked the taste very much. My husband is a huge coffee drinker. He sometimes gets a little bit addicted to it and uses it as a crutch. Then he has to reset himself. 

Dr. Eric: 

My wife also doesn’t drink a lot of coffee, but routinely, she has her morning cup of coffee. Like you, in the past, when I first was trying coffee as a teenager, a young adult, I would load it up with sugar the few times I had it. It’s good that I didn’t get into that routine of having coffee with a few teaspoons of sugar.

I do drink green tea, herbal tea. Over the last 10 years or so. It’s not something I have done all my life, but to get some of the benefits of that. 

Let’s go more into the importance of food when it comes to having healthy hormones. 

Lucy: 

This is a really important one. Sleep and stress may be top, but we do need to pay attention to our food. 

That is when I recommend more of an anti-inflammatory or hormone balancing type of diet. All I mean by that is a whole foods diet as much as we can. I’m a busy mom, and I understand that this doesn’t need to look perfect. This doesn’t mean I need to be in the kitchen every day all day long. There are lots of ways to make this a whole lot easier. That’s what I do. That’s my job and specialty, is to make this easy and doable for people. 

What we want to see is a lot of color. I do like to see a lot of veggies in someone’s diet. I do like to see plenty of protein. Often, we are not getting enough protein, especially earlier in the day, at a breakfast meal. 

I need to see healthy fats, too. That’s a tough one because so many of us have gone through the diet phases, the ‘80s and ‘90s and all the low-fat talk. When I talk to women about adding fats in, often it scares them. They feel like, “I’m trying to lose weight. I don’t want more fats in my diet. I don’t want more calories in my diet.” 

The important part of fat is it will help balance hormones, help with brain fog, help brain function, and help us feel more full. 

A huge thing is that it gets rid of sugar cravings. If you are dealing with sugar cravings, you want to have that protein and fat in your meals, like at every meal, so that you don’t have those sugar cravings leading you to that sugar in the ultra-processed foods. 

Dr. Eric: 

Makes sense. It’s really all about balance. A lot of people don’t eat enough healthy fats. A lot of people don’t eat enough protein. When it comes to protein, everybody is different, but is there a percentage? How much protein do you typically recommend to your clients? 

Lucy: 

Typically, we are starting with 25-30g per meal, around 100g in a day. That is a general guideline that most people can use. 

A lot of women actually need more than that. Just to get to that point can take some time and work. That is our first goal. There are calculations we can do to see how much more you need. If you are getting to 30g at each meal, 100g in a day, you’re doing pretty good right there. 

You will notice a difference. The women who I work with, when they start getting 30g at their breakfast, it makes a huge difference with their energy, with their cravings, how they feel throughout the day. That leads to weight loss in the end. 

If you’re getting enough calories, enough protein, enough healthy fats, then you’re not eating as many of the snacky foods and sugary and ultra-processed foods. You’re just not as hungry. You don’t need it as much. That’s a huge benefit. You can actually eat more food and feel more satisfied and still lose weight at the same time. It’s really quite incredible. 

It goes against so much of what we normally hear from the diet industry and what we have been taught growing up. It really is quite different, but I see it every day. Women are eating more protein and the amount of calories that they actually need, not a 1,200-calorie diet. They are actually eating enough to support their body, and the weight starts to come off. It’s pretty incredible. 

Dr. Eric: 

I can’t emphasize enough how important it is to get enough protein. You mentioned 20-30g per meal, about 100g per day. Does the type of protein make a difference, or does it depend on the person you are working with? There are animal sources of protein and legumes. I don’t know your stance on soy. There’s pea protein. There are other types. Are there any types of protein you don’t recommend for your clients to have? Or does it depend on the person? 

Lucy: 

It definitely depends on the person. But I do recommend animal proteins as much as possible for a good quality protein source. I do try and get really good quality animal proteins, too. For me, I’m buying the grass-fed beef, the organic chicken. If I can get it local, then I will do that. I happen to live in a place where there are a lot of farms around me. 

You can also order really good proteins online, too. I won’t list names. If you want to list names, go ahead. There are places where you can buy online and get grass-fed beef, wild-caught fish, organic chicken. The quality really does matter.

Now, I do have clients who are not going to eat animal proteins. They are vegetarian or have their own reasons. Yes, we are going to be getting that protein elsewhere. We will do it with legumes, maybe with some soy products. I am not a huge fan of soy, but sometimes if there is just not a lot of sources of protein in your diet, we do have to go that route. I would definitely recommend non-GMO, organic soy products. 

Eggs and fish for those who maybe aren’t going to eat red meat or chicken but will maybe eat fish. I do recommend wild-caught fish. I can get most of these things at the grocery store. 

I didn’t mention pork. Pork is one of those where for some people it can be inflammatory. I have not found a brand that I like at the grocery store. I usually reserve pork for the local farms or an online place that you know is good quality. I do happen to be able to get a lot of pork from the local farms around me. Luckily, I can do that. That is a little bit trickier. 

Dr. Eric: 

I’m with you as far as soy protein. It’s toward the bottom of the list. If they want to add additional protein with powder, I recommend hydrolyzed beef that is grass-fed. Usually, I have people go dairy-free, so I can’t recommend whey protein, but a good quality whey protein can also be a good source of protein as well. There are other ones, too. You have to be careful. With anything, you have to read ingredients. There are things other than the protein in these protein powders as well. 

Lucy: 

Absolutely. If someone can tolerate dairy, then I am recommending a grass-fed whey protein. But I am recommending something that is plain, unsweetened, unflavored. We don’t need that extra junk. I flavor it myself when I make my shake. I am usually adding a banana and some strawberries to make it taste good.

Right now, I am doing beef protein powder and experimenting with that. It’s great. It tastes good. No weird flavor. I’m loving it. For people who cannot do whey, because not everybody tolerates that very well, now we have a better option. Before, I had to go from whey to pea protein. I wasn’t super happy about that choice. Now I go from whey to beef protein and see if they can tolerate that. That’s definitely a good one. 

Dr. Eric: 

What are your thoughts on intermittent fasting? I hear about that all over now. Would love to get your perspective.

Lucy: 

Intermittent fasting has so many benefits. It’s very popular these days. A lot of people have had some success on it with weight loss.

The thing with intermittent fasting is it’s not for everybody. Sometimes, when you are going through perimenopause or menopause, it can increase cortisol a little bit. It is very much individualized. 

I would say most people should be going 12 hours overnight at a minimum. That usually just gets rid of any nighttime snacking, which is usually not the best choice. If we are going 12 hours, great. 

If I feel like a client is okay with something more like 14 hours, I will push there. Your body is getting some of the benefits of that intermittent fasting. It’s helping with detox and digestion and blood sugar. Those are all important. 

Not everybody can tolerate more than 14 hours. When we get to the 16-hour+ fasts, then I feel like a lot of women end up with more cravings, or they end up with their blood sugar not being quite balanced, or their mood isn’t balanced, or they are getting more cortisol reaction. 

The biggest thing is being able to fit all of your calorie needs, protein needs, healthy fat needs all into that short eating window. That can be a huge challenge for women. 100g of protein in a six-hour window is quite difficult. You’re not reaching your veggie needs or calories needs, and that can be an issue.

When I’m working with someone, I’m asking them, “How do you feel? Are you reaching your calorie and macro needs? Is this feeling stressful to you?” We take it from there. 

I guess I don’t have a flat answer for across the board for everybody. I take it individually. 

Dr. Eric: 

We’re on the same page. I’m not against it. I go at least 12 hours. I can’t say I do 18-hour fasts or 24-hour fasts. Usually, like minimum 12-14 hours. That’s pretty routine. Sometimes, I’ll do a 16-8. I can’t say every single day. I try to listen to my body. I’m not going to go 16 hours for the sake of going 16 hours if I’m hungry. 

I agree with you. The concern is getting enough protein during the eating window. Also getting enough nutrients, both macro and micro. I agree that I’ve had some patients extremely incorporate intermittent fasting, doing 20-hour fasts, 4-hour eating windows, or 18-6 regularly. I think that’s too narrow of an eating window. Very difficult in six or sometimes eight hours to get enough protein.

I’ve heard you talk about hydration and hormones on your podcast. Let’s talk about the importance of getting enough water. 

Lucy: 

Hydration is so important. I know how hard it is to get that water in. We need that water for our energy. If we are feeling fatigued or tired in the late morning or the afternoon, that 3pm hour, sometimes it’s not that we didn’t get enough sleep. Sometimes, we are just dehydrated. Instead of refueling with water, we are grabbing candy or something that is less than ideal that doesn’t support our body. 

Also, digestion. We really need that fluid to help keep the bowels moving, to help with detoxing. It’s such an important part of our health. It’s often forgotten about. That water is really key.

Also, ladies. If you’re worried about your skin, hair, and nails, we need water for all of that. Definitely stay hydrated. It can be a bit of a stress on your body if we are always in that dehydrated state. We need it to flush out our excess hormones, support digestion, keep your energy up.

One thing I do that has been working well lately is I have a very tall glass water bottle. I recommend you get what works for you. I love this one. I love the size; I love that it’s glass; I think that it’s pretty. I love my water bottle. I fill it up the night before. That’s really key. When I wake up in the morning, I already feel supported because my water is waiting for me. 

I have a goal of finishing that first 32 ounces by 10am. Set a goal for yourself. If you can figure out a time that works for you. For me, it’s 10am. Have that first one done. It actually gets easier throughout the day because you have at least 32 ounces in in the first part of the day. Now you have the rest of the day to get the rest of the water in. That has been really helping me lately. 

Dr. Eric: 

Another benefit of drinking more water earlier in the day and not doing that after dinner is if you do the 32 ounces after dinner, you might be waking up a few times in the middle of the night to use the restroom. That’s a pretty good strategy. 

Lucy: 

A lot of the women I am working with are saying, “I get to the end of the day, and I realize I haven’t had anything to drink all day. Now I’m guzzling it down.” That’s why if you start the day, even set an alarm, and the alarm will go off and let you know, “You’re supposed to be done with your water. Where are you at?” you can catch up early in the day. That way, it’s not affecting your sleep and disturbing you at night. That’s really important. 

Dr. Eric: 

Great advice. Definitely want to talk about sugar cravings. Anything else from a diet perspective? I know whole, healthy foods; anti-inflammatory foods. Are there any specific foods that you don’t recommend, or you do encourage your patients to eat? 

Lucy: 

I’m basically making sure that our diet is very limited in any kind of sugar, whether it’s refined sugar or artificial sugar. If we have a diet full of sweet things, that will make it very difficult for you to enjoy things like vegetables. It has an effect on our tastebuds. We are pushing out the sweetened things, the ultra-processed things, foods that have a long ingredient list by eating more of the whole foods.

I am watching the type of fats. We keep saying “healthy fats.” To be more specific, I am talking about coconut oil, olive oil, avocado oil, olives, avocadoes, fatty fish. 

If you have ever heard of SMASH fish, I am a big fan. That is Sardines, Mackerel, Anchovies, Salmon, and Herring. People make a face at some of those, but they are actually not that bad. Go try it. Get a can of wild-caught mackerel. It’s pretty good. You will get a lot of healthy omega-3 fats from that. 

We are just making sure that the fats are good and healthy fats. Sugar is limited, and processed foods are limited. We are getting proteins and lots of veggies. That is the formula right there. 

Dr. Eric: 

What are your thoughts about nuts and seeds as a source of fat? 

Lucy: 

I do like nuts and seeds. I should have mentioned those. Those are another great way to get fat. As a snack. I love grabbing a handful of almonds or pecans to hold me over if I need a snack. 

Dr. Eric: 

Talking more about sugar cravings. If you’re working with someone who has really strong sugar cravings, in addition to having them avoid refined sugars for example, do you also limit fruits? How do you navigate fruit? Do you eat lower-sugar fruit or take a break completely for a while? 

Lucy: 

Great question. Lately, I have been running a five-day no sugar challenge for free in my group. During those five days, I do encourage people to skip fruit. There isn’t anything wrong with fruit. I love fruit. I think it’s great. Lots of health benefits from it. The real reason we are taking a five-day break from it is to reset our tastebuds and challenge ourselves to figure out where the sugar cravings are coming from and address those sugar cravings. 

If I have a sugar craving, I could have a banana or strawberries or something sweet and satisfy that sugar craving, then we are not really getting to the root. That’s what we need to do. Are you having sugar cravings because you didn’t have enough at your last meal? 

Often, when women are starting to stay healthy and get on a healthy path, they tend to have a lunch that is maybe a little bit light. A salad with some protein on top. But they didn’t add any healthy carbs to it. They didn’t add enough healthy fats to it. There just wasn’t enough calories in general with that lunch. Now, a couple hours later, they are hungry because their body actually needs more fuel. The body is going to ask for the quickest source of fuel available, and that looks like sugar and sweet things or a bag of chips or something quick. 

We tend to have sugar cravings because our meal wasn’t big enough. That is one area to look at. That might be the root cause of your sugar cravings. 

It might be dehydration. You might just need to drink something. If we are avoiding all sweet things, like during that five-day reset, then we are not able to grab a sweet drink. We are avoiding artificial sugar, natural sugar. We are looking at water or herbal tea.

The other thing that it might be is our emotions. It could be stress. It could be that we are exhausted. It could be that something happened during the day to either cause some excitement or some kind of an emotion that we are going to use that sugar to cover up or as a tool, like a coping mechanism. 

Let’s face it: sugar is comforting. When you have a bite of chocolate cake or a cookie, it does feel good for a few minutes. Then it doesn’t feel good after that. It makes sense that our body would want to grab something sweet to comfort whatever emotion we are having. 

What we really need to do is get to the root of it. Stop and ask yourself, “What does my body really need right now? Does my body need fuel? Maybe I need a snack that has proteins and healthy fats in it.” 

“Does my body need hydration? I need to guzzle some water.” Maybe it needs electrolytes with that water, too, because that can cause sugar cravings if you need electrolytes. 

“Does my body need some support? Maybe I am so stressed out right now I need to call a friend or ask for help. Or I need to journal a few things about what just happened that stressed me out. Maybe I need to make some changes in my life. Something is happening with my job, my coworkers, my family.” There are so many things. Maybe we need to put more boundaries up.

If we don’t address those things, then we are going to keep getting sugar cravings. We can’t just do it by willpower. We can’t just say, “I’m going to get through today and not have any sugar.” That might work for a couple days, but you didn’t resolve anything. It will just come back. We need to get to the root of everything.

When I work with someone, we are not just talking about food. We are not just creating a meal plan. We are figuring the whole thing out. It’s the big picture.

Dr. Eric: 

Makes sense. Definitely check out Lucy’s five-day no sugar challenge. As you mentioned, you have those regularly. As of us recording this, there is a possibility you might not have that in the future, but for now, take advantage of it. Completely free.

How about exercise? What do you recommend from an exercise standpoint for someone who is looking to lose weight? Is it more cardio? Is it more resistance exercise? Is it a combination of the two? 

Lucy: 

Yes. With exercise, it is individual to each person. What I see most often is when women want to get healthy, they want to get on a healthy path. They join a gym. They start running on the treadmill. Maybe they have a treadmill and are putting their time in there. Or they are doing the elliptical. Or they are joining a HIIT class and doing some powerful workouts. Or aerobics classes. There is definitely benefit there to aerobic exercise, of course. 

What is really going to help you even more is strength training. It doesn’t have to take a lot of time. You can do that in 10 minutes. You can do a 10-minute workout, preferably most days of the week, and really see a difference. 

What we want to do is preserve our muscle, especially if you are losing weight. We want the fat to be lost, not our muscle to be lost. We really want to build muscle. We want to be doing things that require us to build muscle. Doing things like cardio, running, jogging, the elliptical machine. Those are not really building muscle. Great for your heart. There is benefit to it.

Sometimes, we go overboard. That is just producing more cortisol and more stress. When we really push ourselves at these hour-long classes that are HIIT or CrossFit workouts, those are pushing us too far, especially if exercise wasn’t your thing throughout your life, and you don’t consider yourself an athlete. You probably need to be doing more strength training exercises or yoga or Pilates. Those types of things are very beneficial as you age and are trying to balance hormones. Those are the types of things that we need to be focusing on. 

Dr. Eric: 

I’m glad you mentioned overdoing it. It’s common. When I was diagnosed with Graves’, prior to that, I was overtraining. You’re right. These classes can be intense. If someone is not ready for them, like you said, if they are an exercise newbie, not accustomed to exercising, you probably don’t want to jump into that. 

Even if someone is well trained, they can be pretty intense. If someone has compromised adrenals or other issues, they might think they can handle it, but their body might not be able to handle that type of intensity. 

Lucy: 

You have to think about your day. “What kind of balance do I have? Do I have the supportive times during the day where I’m really bringing myself into a parasympathetic rest and digest state? Am I pushing myself too often? How do I feel? Am I losing weight?” 

Stubborn weight is a sign. It’s just a message from your body that something isn’t balanced. Are you dealing with stubborn weight? Are you dealing with fatigue, brain fog? Those types of things, I would then question whether you should be continuing with the HIIT workouts. Maybe take a break and do an experiment. Change things up. See what changes happen to your body. 

Dr. Eric: 

Great advice. We covered a lot. Is there anything else that I should have asked you that I didn’t ask you? Anything else that you want to say before we wrap things up? 

Lucy: 

I think one thing I do want to say is the mindset piece of things. We did cover a lot. We talked about sleep and stress and food and movement, all the things. It can feel really overwhelming to hear all the different aspects of all the things you “should” be doing, and maybe the things you shouldn’t be doing. We can get in this overwhelmed state, where we feel like, “If I can’t do all of it, I won’t do any of it.” That’s the all or nothing mentality that comes from diet culture, the pressure from our culture to feel like if you’re not all in, then it’s not worth it. 

I just want to take a minute to remind you that every little tiny step counts. Every little thing that you do is important. It will add up. If you just start concentrating on your water and getting more each day, that’s going to have a ripple effect. It is actually going to count. 

Maybe you want to get a little bit more movement in each day. That will help. Even if you go to bed 10-15 minutes earlier, or turn the screen off a few minutes earlier each night, all these little things do add up. You don’t have to be all in for it to count. You can just do little things as you go, and it will add up. 

Take the all or nothing mentality, and throw it out the window. We don’t need it here. You don’t need to be perfect in order to make progress. That’s what I want everybody to hear today. 

Dr. Eric: 

Well said. This was an amazing conversation. I enjoyed talking with you about hormones and stress management and the impact of food. We covered so many things. 

Where can people find out more about you, Lucy? You have your podcast, social media, your school group with the free weekly performance coffee chats. Talk about that and other places where they can find you. 

Lucy: 

Sure. There are two places where I recommend going to learn more about me and get more information. The podcast is The Healthy Mama Podcast. You can find it on any podcast platform. It’s full of real talk, practical tips from me, a registered dietician and busy mom. I am teaching people how to make it work in a real way. There is three years’ worth of episodes there.

The other place is the school community called Radiance After 40. 

I am on social media. If you want to find me on Instagram or Facebook, that’s @LucyHutchingsRD. 

However, I am pulling away from social media and bringing my audience with me to the school platform. I think it’s really great. It’s not full of advertisements and the intensity of social media. It’s a little bit of a break. That’s really nice. 

It’s a free group called Radiance After 40. In that group, for free, we meet weekly for a virtual coffee chat, where we just talk about everything, whether it’s perimenopause and menopause, hormones, inflammation, life in general. We talk about it all in there. It’s pretty fun. 

Usually, I am running a monthly five-day no sugar challenge that is free in that group. If you’re interested in those challenges, definitely join that group. 

Dr. Eric: 

Thank you so much for having this conversation. I learned some things, and I’m sure my listeners did as well. 

Lucy: 

Awesome. Thanks so much for having me. It was really a pleasure. I loved it. 

Recently, I interviewed Jordan,  who was recently diagnosed with Graves’ disease. In this episode she opens up about managing symptoms like heart palpitations, bloating, and fatigue while following the AIP diet and taking calming herbs, iodine, and other targeted supplements. 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 health audit. I am chatting here with Jordan, who was diagnosed with Graves’. Thank you so much for joining us, Jordan. 

Jordan: 

Absolutely. Thank you for having me. 

Dr. Eric: 

Really looking forward to this conversation. You were diagnosed with Graves’ not too long ago. You put two weeks when you filled out the application for this audit. That was a few weeks ago, so I guess it’s been a little over a month since you were diagnosed now? 

Jordan: 

Yes. 

Dr. Eric: 

Any family history that you know of with Graves’ or any other thyroid or autoimmune thyroid conditions? 

Jordan: 

Yes. My mom was diagnosed with Graves’. My grandmother on her side had hypothyroidism, but I’m not sure if it was related to Hashimoto’s. There are definitely thyroid issues in my family. 

Dr. Eric: 

Just out of curiosity, how did you learn about me? 

Jordan: 

When I was first diagnosed, I knew right away that I wanted to do my best to reverse this naturally. I didn’t want to go on medication. My husband is a big podcast listener. We both went right at it, trying to research different methods to heal myself naturally. He actually came across your podcast, and we listened to it together, which started my journey. 

Dr. Eric: 

You said you read my book. You must have gone through them pretty quickly since you were just diagnosed. Did you listen to the audio versions? 

Jordan: 

I read them. I get pretty focused when I’m researching. I spent day in, day out researching how to heal. I read all the books I could as fast as I could to start right away. 

Dr. Eric: 

Wonderful. What you put down here on the application is you were actually being treated for a concussion. Then you were tested for TSH during a routine visit. You asked for the test because it wasn’t tested for over a year. The primary care doctor found it was low. You saw an endocrinologist, who did the diagnosis for Graves’. You started working with a naturopath, taking some supplements. Are you still following AIP? 

Jordan: 

I am. This will be my sixth week, I believe. 

Dr. Eric: 

As far as some of your challenges here, exercise due to heart symptoms. I don’t know if you’re still having bloating and stomachaches with AIP. You listed that as well as the supplements you’re taking. Are you still experiencing those same symptoms with AIP? 

Jordan: 

Yes, I am. I feel like it’s improved. I’ve gotten used to it. I still get stomachaches after my meals. My heart-related issues are the same. I am still getting palpitations pretty frequently. Getting heart rate spikes when exercising. They have improved since I started with AIP and some supplements, but they’re still there. 

Dr. Eric: 

Were you experiencing any digestive symptoms prior to following AIP? 

Jordan: 

I was. I have pretty much my entire life been living with bloating and stomachaches after every meal. I have eaten a very whole, organic diet before I was diagnosed. Didn’t really matter what I was eating. I was always bloated. 

Dr. Eric: 

Okay. Did the naturopath you are working with do any gut-related testing? 

Jordan: 

No. I had asked about that. He mentioned he doesn’t do any testing. He did an intake meeting, where we went through my symptoms and the timeline. He was pretty confident I have SIBO. He says he doesn’t recommend or do any testing himself. He is confident in it, and he is treating me for that. 

Dr. Eric: 

Okay. You are taking an herbal approach? 

Jordan: 

Yes, I believe it’s an antifungal. I have a pretty long list of herbs I am taking for it. 

Dr. Eric: 

Just for the SIBO itself? 

Jordan: 

For the SIBO itself and other digestive aids. 

Dr. Eric: 

It sounds like it very well might be SIBO. The treatment typically is either an herbal antimicrobial, or there is antibiotics. It’s called Rifaximin. There is also the Elemental Diet, which is the liquid diet that most people don’t want to follow unless it is really bad. The herbs usually work well. 

Have you noticed any positive changes? It sounds like it’s not as bad since you said you started AIP. I’m wondering if you think that’s at least in part due to taking the supplements. 

Jordan: 

I think it’s definitely been improving since my switch. I was eating a lot of grains prior and some gluten and dairy here and there. I do think it’s improved, but I can’t tell if it’s from AIP or the supplements that he is giving me. 

Dr. Eric: 

Okay. I try to be conservative with testing. In this case, usually I like to try to see if it’s SIBO or if there is something else going on. Since you already started on the protocol, it makes sense to follow it. If it is SIBO, that is a challenge. Most of the time, the herbs work. Sometimes, they don’t. If it doesn’t work, it would just be interesting to see what direction he goes in. Let’s hope it does knock out the symptoms. 

If it knocks out the symptoms, then the thing with SIBO is sometimes it could come back. You might not have spoken about this yet, but there are prokinetics that some people need to take to help maintain the gut motility even after getting rid of SIBO. 

The only way you know if you need those is to either go on them, and then eventually stop taking them, or some people don’t go on them at all and see if it comes back. 

The first step is obviously seeing if the supplements help with the digestive symptoms, which seem to be related to SIBO. You will see how that goes.

The AIP diet, it’s not common for someone to have those symptoms. If someone has another condition, like if they have SIBO or a histamine intolerance, then some of those foods are high in histamine that are AIP-friendly. Some of the foods that are friendly are higher in FODMAPs and could also aggravate SIBO if someone is dealing with it. 

The AIP diet usually won’t cause those symptoms, but it does sound like based on what you mentioned that eating those foods, if they cause those symptoms, which they did, a good chance it would be SIBO. Hopefully, those digestive symptoms subside, not only just improve, but completely go away. 

You said he doesn’t do any testing? Or just in this case, he doesn’t do any testing. 

Jordan: 

He doesn’t do testing with any of his patients. 

Dr. Eric: 

Okay. Everybody is different. I’ve had people on the podcast like that. I have had people on the podcast where they do the complete opposite. They go crazy with testing and recommend 5-6 different tests, which gets expensive. I usually try to go in between. Start out conservatively, and hopefully we don’t need to get aggressive with people I work. Sometimes, we do. It all depends on the health history.

The next question I have for you is are you taking anything to lower the thyroid hormones, whether it’s antithyroid mediation or herbs such as bugleweed? 

Jordan: 

Yes. I have a thyroid calming supplement, which is a mix of motherwort, lemon balm, and bugleweed. He has me on an additional dosage of bugleweed as well. I do feel like those are helping. 

Dr. Eric: 

Do you have a scheduled thyroid panel as well to see what changes are taking place? 

Jordan: 

I do have it. The order is in. I am unsure when to test, especially since I just had influenza, and I feel that all of my symptoms came back as they were on day one. I’m unsure when to test. 

Dr. Eric: 

If someone is sick, usually I recommend waiting at least a week after you’re feeling better, to do the testing. In a bad case of influenza, you might want to wait a little bit longer because that could throw off the numbers. Sorry you dealt with that.

When I dealt with Graves’, I took bugleweed like you did. You are also taking the thyroid calming formula. Is that by Herb Pharm? 

Jordan: 

It’s a tincture. 

Dr. Eric: 

Is the company Herb Pharm? Do you know the company name? They have one called Thyroid Calming Formula. 

Jordan: 

It’s called ThyroCalm. 

Dr. Eric: 

Maybe it’s something different. 

Jordan: 

It’s called David Winston’s Thyroid Calmpound. 

Dr. Eric: 

I haven’t heard of that. That’s the one that has all three? Then you are taking bugleweed separately. 

Jordan: 

Yes. 

Dr. Eric: 

It sounds like it’s working. When I dealt with Graves’, I took bugleweed by itself, and I felt my symptoms, my heart rate was lowering, palpitations were improved. I still experienced some palpitations, so I added motherwort. 

It sounds like you’re also noticing a difference when it comes to the symptoms. The only way to know for sure if it’s working is to do a blood test eventually. If you’re feeling the symptoms like I did, then it sounds like it’s helping, which is good. Some people need to take antithyroid medication, but when you can avoid it, that’s a good thing. Hopefully, you can continue to avoid it and have your symptoms managed by the herbs.

As far as exercise, with my patients, I usually recommend to take it easy, at least on the cardiovascular exercise. Try to do some light walking. Usually, I recommend resistance or weight bearing exercise because it’s common to lose muscle mass and bone density. You also want to listen to your body.  Do you know what on average your resting heart rate is? 

Jordan: 

My resting is about 83, so it’s not too high resting. It’s the spikes. If I start stretching, it can go up to 170. Even just doing yoga, it could go to 190. I’ve gotten the full cardiology signoff that everything looked fine in terms of my heart health and structure. It gets very high very fast with little exertion. 

Dr. Eric: 

That is a pretty high spike. The resting heart rate is not too bad. It’s a little bit high. I’d be more nervous about it going up to 170 or 190. You said that is not just exercise. If you’re walking or cleaning the house, does it get up that high? 

Jordan: 

It does. It depends on the day. Some days, I feel great, and it’s more managed. The next day, I might just be going up the stairs, and it goes up to 170, 180. I’m pretty active, and I was prior. It’s a huge change for me. It’s hard to limit those activities. 

Dr. Eric: 

Was that the case even before you dealt with influenza? 

Jordan: 

Yes. I had three days before I had influenza where I had no palpitations, no spikes, and I felt great. Then I had influenza. They all came back. About every two minutes, I am having a palpitation. Getting up from the chair, I can feel my heart rate raise pretty quickly. That was similar to when I first was diagnosed. 

Dr. Eric:

It sounds like things were heading in the right direction until you got the influenza. Then it went back to where it was. 

Jordan: 

Yes. 

Dr. Eric: 

Would you say you were 80%, 90% feeling better from influenza? Or not even that much better? 

Jordan: 

I would say I’m about 70% better. The fatigue is still there. I still have a cough. I haven’t had fever or body aches in a while. I can tell I’m on the up and up. 

Dr. Eric: 

That’s good. It sounds like that definitely set you back. As much as you might want to exercise, and I have been there, too, I am not going to say not to exercise, but listen to your body. Maybe for now, limit it to light exercise, light walking, light resistance exercise. 70% is better than 30%, but you might have at least a week or two, possibly longer, until you are feeling better as far as the influenza goes. 

Once you get to that point, wait another week, and then do a blood test. If it seems like 2-3 weeks go by, and you are still dragging along, and you are not feeling 100% yet, at that point, you might want to do it anyway. I wouldn’t wait 3-4 months to do a thyroid panel. When was the last test you had done?  

Jordan: 

That was in December. 

Dr. Eric: 

It’s been about two months or so, depending on when in December you had it. 

Jordan: 

Yes. 

Dr. Eric: 

I would say to give it another few weeks. If you’re feeling at that point where you are feeling 100% or almost there, wait an extra week. If you’re still not feeling where you feel you need to be, you might want to do it anyway and see what the numbers are. Sometimes, with these viruses and other things, it can take a while. 

I don’t know if I would wait four months to get a test. Hopefully, you don’t need to worry about it. In a week or two, you will make huge strides and feel significantly better with that. 

As far as taking the right supplements because that was another thing you put down. I give some general recommendations. I give a probiotic; an omega-3 fatty acid, usually in the form of a fish oil; the bugleweed or motherwort or lemon balm, things like that based on the symptoms and the thyroid panel.

As far as other supplements, a lot of it does depend on the testing. For SIBO, it sounds like he recommended a lot of things. Usually for SIBO itself, I might recommend 3-4 things to help with getting rid of it. Maybe he has recommended other things to help with supporting the gut and gut repair, things like digestive enzymes, which I would understand. Are you taking any other supplements that are not related to SIBO? 

Jordan: 

Yes. I’m taking seeds or vitamins. Acetyl L-carnitine. He has me taking two a day. An activated B. My Vitamin D was very low on the last test, so he has me taking a 10,000 IU Vitamin D supplement each day. I have a K2 probiotic, glucose balance. 

He is actually having me do pulsed iodine once a week. I know it’s opposite of what I would expect, just in researching and reading, but he has me taking two drops of iodine once a week to help with my thyroid to be able to regulate the iodine function. 

Dr. Eric: 

Okay. You know how much iodine two drops is? 

Jordan: 

Yes, I can check. I have it right here. It is the J. Crow Lugal’s Solution, 2%. 

Dr. Eric:

Lugal’s Solution? 

Jordan: 

J. Crow Lugal’s Solution, 2%. It says 4% potassium iodide and 2% iodine. I have two drops. 

Dr. Eric: 

Okay. As far as making the conversion, I know tablet-wise, lugal tablet is 12.5mg. I forget how many drops they give that is equivalent to that. You’re probably still taking mg. 

It’s controversial for sure. Some will recommend to completely avoid iodine with hyperthyroidism; others will recommend taking it. In some cases, iodine can lower thyroid hormone levels. 

When I dealt with Graves’, this was over 15 years ago now, I was taught that you want to test for iodine and supplement for iodine if you’re deficient in iodine. I was more on the iodine bandwagon. Now, I’m not anti-iodine. I do recommend getting iodine from food if someone has a multivitamin. I’m not concerned about that. I’m more cautious about people supplementing separately with iodine. Depends on the situation. Are you taking any selenium along with that? 

Jordan: 

He has me taking three Brazil nuts a day. It goes against AIP, so I’m cheating a bit with that. He would rather have me take Brazil nuts than supplement with selenium, and I asked. 

Dr. Eric: 

I have a podcast episode that I chat about that. I like Brazil nuts. I eat Brazil nuts. On a wellness basis, it’s a good idea to try to rely as much as you can on food. The only downside is you have no idea how much selenium is in each Brazil nut. You could be getting a good amount, or you might be getting a lower amount, depending on how much selenium is in each Brazil nut. I usually recommend selenium supplementation while someone is healing, so we know how much is in there. I’m not saying you should do that. 

What you’re taking sounds good. B complex. I usually like to see what someone’s adrenals look like before recommending a B complex. B vitamin is water soluble, so it won’t hurt necessarily to take it. 

The L-carnitine, you are taking acetyl L-carnitine, which I don’t know if he recommended for the thyroid or other purposes. 

Vitamin D, I can understand. It sounds like the K as well, the K2, to help guide the calcium into the bone. That makes sense. 

The iodine, not everybody would agree with. I can’t say I currently take that approach. In the past, I would give separate supplementation. I also based it on urinary testing. 

It’s all about progress. As long as you are progressing, that is what we want to see obviously. If your thyroid numbers improve, if you feel better, if your antibodies are heading in the right direction, that’s all great. 

If not, then that’s where more detective work needs to be done to see if the SIBO has been eradicated. In his case, he will go more by symptoms than testing since he didn’t do the testing. He will have his own approach. 

Does he do applied kinesiology, like muscle testing? 

Jordan: 

Not that he’s mentioned. 

Dr. Eric: 

He’s really going by symptoms and the blood test. He does pay attention to the blood test but not any muscle testing or functional medicine testing. 

Jordan: 

Correct. 

Dr. Eric: 

Okay. Every practitioner is different. You’re under his care. Just see how you’re improving. It’s not the approach I take, but just because I don’t take that approach, this doesn’t mean my approach is right and his is wrong. If you get really good results, that is what you’re hoping for, and that would be a good thing. If you get great results, you also did so without spending money on testing. Can’t complain about that. 

I guess as far as the next step, you’re working with someone. I would continue following their recommendations for SIBO protocol. It sounds like what you’re doing with the herbs to manage symptoms is helping, but the only way to know is by doing another blood test in the future. I wouldn’t wait too long before doing that. A little bit of a catch-22 because you are getting over the influenza. 

AIP diet, six weeks. It sounds like you’re doing a great job. 

The one thing I will say about AIP and SIBO, everybody is different with their approach diet-wise. As you probably know, you read my books and listened to my podcast. I like AIP. Usually, if someone is healing from SIBO, a lot of times I will follow that low FODMAP diet, which I talk about in one of my books. 

I also mention that I usually don’t combine diets. I don’t have someone do AIP and low FODMAP because it’s more difficult. If someone is following SIBO, we might prioritize low FODMAP while they are healing. Then make the switch to AIP. 

Again, as long as you’re not struggling too much with the diet, as long as you are not finding it too restrictive, and it sounds like you’re maybe not completely avoiding high FODMAP foods, you are just dealing with bloating and gas, it sounds like it’s helping the SIBO protocol. 

That is the approach I would sometimes take. Maybe have someone not do AIP right away if they are dealing with SIBO and follow low FODMAP instead. Then incorporate AIP later on.

If you are familiar with the 5R protocol, the very first R is Remove. That’s what you’re focusing on right now. Not to say you can’t focus on Replace, Reinoculate, Repair, Rebalance now. In the case of SIBO, sometimes you want to do that exclusively before incorporating some of the other components of the 5R protocol. 

Before we wrap up, any last questions you have, Jordan? 

Jordan: 

No, I really appreciate your time, thank you. 

Dr. Eric: 

You’re welcome. Overall, it sounds like you’re doing a really good job. Keep up the good work. Hope you get some good results.

Thank you so much for listening to my podcast, reading my books, and agreeing to do this audit. 

Jordan: 

Absolutely, thank you. 

Dr. Eric: 

 

Take care.

Recently, I interviewed Dr. Evan Hirsch, a fatigue expert who’s helped thousands recover from long COVID and chronic fatigue using his four-step Energy MD Method. In this episode we explore the “toxic five” hidden factors like mold, infections, and nervous system overload that often go unaddressed in standard care. He also explains why common treatments like IV ozone might backfire if your body isn’t ready, and why gentle nervous system retraining can sometimes be the missing piece. 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 Dr. Evan Hirsch. We are going to be talking about long COVID, tying it into chronic fatigue, of course talking a bit about thyroid health. Let me go and dive into Dr. Evan’s impressive bio here. 

Dr. Evan Hirsch also known as the Energy MD, is a world-renowned fatigue expert, best-selling author, and professional speaker. He is the creator of the Energy MD Method, the science-backed and clinically proven four-step process to resolving long COVID and chronic fatigue syndrome naturally. 

Through his best-selling book, podcast, and international online program, he has helped thousands of people around the world resolve their fatigue. Dr. Evan has been featured on TV, podcasts, and summits. 

When he is not at the office, you can find him singing musicals, dancing hip-hop, learning languages, and traveling with his family. Maybe we will get him to do a little bit of hip-hop during the interview. Welcome, Dr. Evan. 

Dr. Evan Hirsch: 

Thank you, Dr. Eric. Thanks so much for having me on. 

Dr. Eric: I

t’s a pleasure to have a conversation, talking about long COVID and chronic fatigue. You’re an expert when it comes to this.

Let’s start off. Pretty much everybody is familiar with COVID. What is long COVID? 

Dr. Evan: 

A lot of people don’t realize that sometimes, you can get persistent symptoms after you get a virus. Basically symptoms that don’t go away. If you get a viral illness, it could have been tested positive for COVID or not. The testing isn’t particularly good. If symptoms persisted for longer than a month or two, that can now be diagnosable as long COVID or post-acute sequalae or SARS-COV-2. 

The symptoms are disparate. You can have over 250 different symptoms. The most common ones are fatigue, brain fog, body pain, and sleep issues. Those are really the major ones. It really depends on where the infection goes in the body. That will end up determining what it ends up manifesting as. 

We do know that since COVID, there is an increase in cancer, autoimmune disease, dementia, Alzheimer’s. There is increase in a number of other illnesses that a lot of people are scratching their heads about, and a lot of people believe are potentially due to spike protein illness, which is the main protein that gets transmitted from the COVID virus. 

Dr. Eric: 

Before pressing record, we chatted a little bit. I mentioned how in 2020/2021, we had more people with autoimmune thyroid come in. You mentioned how there is an increased prevalence in autoimmunity and cancer since all this started. I haven’t seen the cancer because that’s not what I focus on. I have seen the increase in autoimmune conditions. 

As far as the percentage of people who get COVID, approximately how many people will eventually develop long COVID? 

Dr. Evan: 

According to the CDC, they say 20%. That means one out of every five people, two out of every ten. There are some studies that look at upwards of 30-35%. For people who are hospitalized when they got acute COVID, the numbers are even higher. 

What we’re seeing is one in every three people generally is going to get persistent symptoms, whether it’s the loss of smell or taste, or fatigue, or one of these other symptoms that I previously mentioned. 

Dr. Eric: 

Do you know why some people develop long COVID, and others don’t? I got hit hard with COVID in 2022. I got pneumonia. It was pretty bad for three weeks. I thought maybe my symptoms would persist. Thankfully, they didn’t. Everybody is different, I guess is the answer. Why didn’t I develop long COVID, yet other people might develop it? 

Dr. Evan: 

Fortunately, your immune system was functioning well, and you had a very strong reaction. The research supports that the weaker the reaction you have, the more mild symptoms you have, the research shows that five mild symptoms give you a greater chance of getting long COVID than what you had, which were really intense symptoms, like the worst flu of your life. 

Sometimes, the immune system can get rid of the virus. If it can’t, and a virus comes into the body and sneaks around the immune system, that is when it takes hold, and you get some of those persistent symptoms.

What’s underlying those people who end up getting it, what it looks like is that they have what I call the toxic five, which is a combination of toxins, infections, and nervous system dysfunction that builds up in the body over time. It’s a combination of heavy metals, chemicals, mold, infections, and nervous system dysfunction that you basically get from the moment you come out of the womb. 

There is research that shows over 300 different chemicals are found in baby’s blood. Moms are dumping all the good stuff and the not so good stuff into the babies. Then you grow up and have exposure to a number of different chemicals or toxins. Pesticides and herbicides in non-organic food. You get mercury fillings. You live in places that have water damage. Over half of the buildings in the world have water damage, and most of those have mold. You have exposure to people who are smoking. You get cadmium exposure that way. 

These toxins build up over time. They disrupt the nervous system and the immune system. All of a sudden, infections can come into the body, and the immune system is often left fueled. The infection can take hold, or it can stimulate other infections to come out. They can be more opportunistic. That’s what the big picture looks like. 

Why some people get it, and other people don’t is really based on is the stage set? A lot of people are fine until they get a viral illness or COVID. While that might have been the straw that broke the camel’s back, the stage was already set with the other toxic five, and it just took something really stressful in order to put you over. 

Dr. Eric: 

Are there some genetics behind it as well? For example, with mold, some people have more of a challenge clearing out mycotoxins from their tissues. We are all exposed to heavy metals and all these other toxins and toxicants. The good news is, it’s not just genetics. I assume that’s at least a piece of the puzzle. 

Dr. Evan: 

Absolutely. Genetics are always a piece of the puzzle. They’re generally about 10-20% of any diagnosis that somebody has. It is a small part, and it’s not something that I talk a lot about. 

I used to go down the genetics rabbit hole. Spent a lot of time, energy, and money working on that. It just didn’t move the needle the way focusing on the toxic five has done for my community of people with long COVID and chronic fatigue. 

Dr. Eric:

I’m with you. You can’t change the genetics. You can of course do other things, like adjust the toxic five that helps them modify the expression of the genes. It makes sense that you would focus on those factors.

From what I understand, you don’t do any testing. Just from your experience over the years, you just really assume that everybody has long COVID. We all get exposed to toxins. I guess the nervous system dysregulation, would you say that’s something that everybody with COVID experiences, or is that something that’s more specific to not only long COVID but these other chronic health conditions as well? 

Dr. Evan: 

Having done this for about a decade, I found that when I do testing about every three months, and I was measuring heavy metals, chemicals, molds, and infections, all of them ended up coming out over the course of 12 months. 

Some of this is because of the testing, if you do it initially, urine testing, and you don’t see anything, it doesn’t necessarily mean you don’t have the toxins in your body. The test is a test of excretion. The urine test is showing us how much you’re able to excrete. You may not be able to notice anything at month three. If you repeat it at month six or nine, all of a sudden, you’re opening up these pathways as we go through our process. Toxins are able to flow out of the body. You’re seeing a lot more excretion. That’s one thing I was seeing. 

I was fooled initially when I would do a test, and somebody wouldn’t show up with mycotoxins. I’d do a test six months later, and they had a whole bunch of mycotoxins. The question is what was happening here? That’s the first thing. It’s a test of excretion. 

The other thing is these toxins are all really bound up to each other. I call it a toxic matrix. The heavy metals, chemicals, molds, and infections are bound. When you start to remove one of those things, like heavy metals, all of a sudden, the rest of them also get released. We want to make sure that as we’re going through this process, all of those are being covered. 

What I found after doing this for almost a decade is the most successful cases that I had were people where I was addressing all of the toxic four at the time. I wasn’t doing nervous system retraining a decade ago. As I was removing those things, people were getting better. 

Even people where I was like, it definitely seems very suspicious that you have mold, but I am not seeing it in the urine, we will address it anyway. Sure enough, it would come out later, and I was glad we addressed it, so we could save them money, time, and energy.

About a year ago, I decided, you know what? I learned all this information. I am seeing this time and time again. It doesn’t make sense to waste money on testing. I will treat these, and we are having really great success doing that. We are leaving no stone unturned. 

That’s the biggest thing when people come to see me. When they finally find me, they have seen a dozen providers. They have been to long COVID clinics at Stanford and Mayo. I tell them, I want to make sure that we will be as successful as possible, and we will leave no stone unturned. We will address all of the potential causes you have. It won’t cost you more money. It will save you time, money, and energy. You won’t have to spend money on lab testing. I found that to be incredibly helpful.

A couple years ago, I learned more about nervous system retraining. I saw people get better faster when they did nervous system retraining, whether it was mindset work in combination with breath work and humming and gargling and all of these other different components that put the body into the parasympathetic and allow it to heal.

About six months ago, we created our own nervous system program. It’s a practice schedule, where it gives you an outline of what you should be doing during your day. It’s not as in-depth as the Gupta Program or Primal Trust or DNRS or other ones. It’s basic and allows people to step into it. They can step into a more advanced version that we have. They can go into some of these other programs if they want something more in depth. It allows people to get their feet in the door and start working on all of the toxic five without having to learn a separate program.

I’m always looking and tweaking the program to see how to get people better faster and for less expense. I’m constantly narrowing it down to what are the most important things that we address?

I think I answered both of those questions: why I don’t test so much anymore. There are a couple things I test for, like thyroid, B12, Vitamin D sometimes. Also, the nervous system retraining and how that is such a big component now of the work that we do. 

There is a quote. I am going to butcher it. The idea is you can’t solve a problem with the same thinking that got you into the problem. I think Einstein said, “The definition of insanity is doing the same thing over and over again and expecting a different outcome.” It’s this idea that we have to change more than just the physical. We have to change how we’re thinking, our emotions, and consequently, that means working on our nervous system. 

Dr. Eric: 

Yeah, that makes sense. It sounds like you had a lot of success when it was the toxic four. Incorporating that nervous system retraining that led to the toxic five just made it even more effective. 

Dr. Evan: 

Absolutely. 

Dr. Eric: 

Wonderful. There are other causes of chronic fatigue, right? How can one differentiate whether it’s long COVID or if there is another cause of chronic fatigue? Does it not really matter as long as you address the toxic five? 

Dr. Evan: 

It’s more of the latter, where it doesn’t really matter. In terms of figuring out if somebody has long COVID, if they have any of the symptoms that I mentioned—chronic fatigue, brain fog, body pain, sleep issues, or any other weird symptom, neuropathy, numbness and tingling, loss of smell and taste—since 2020, and potentially after a viral illness, whether they tested positive for COVID or not, they have to consider it. 

Before long COVID, there was CFS (chronic fatigue syndrome). A large percentage of people ended up having a viral illness that triggered that as well. Whether it was EBV or HHV6 or cytomegalovirus, these are all different viruses that can create a mononucleosis type of picture, where you’re tired all the time.

The process that we go through is pretty much the same. Getting rid of the toxic five, getting rid of micro clots and hypercoagulation, decreasing EMFs, supporting deficiencies, and working on lifestyle habits and then the nervous system retraining. All of those will be important to do whether or not somebody has long COVID or whether or not they have CFS. 

By definition, if you have the fatigue with post-exertional malaise, which basically means you exert yourself and feel worse, if you have the body pain, brain fog, sleep issues, and you have had it for longer than six months, that’s diagnostic for CFS or encephalomyelitis, which is what they call it across the pond in Europe and beyond. They’re the same thing. 

Essentially, long COVID is CFS, but the trigger is the spike protein. It does change a little bit about what we do with the protocol, but it’s really not much.

Dr. Eric: 

You mentioned the herpes family of viruses before. EBV, HHV6. Once you have those, from what I understand, you’re pretty much living in harmony with them. Is it similar with long COVID? Is it something where you are trying to get rid of it completely, or you are just trying to live in harmony with it? 

Dr. Evan: 

Great question for any of these infections we are looking at. In general, in this form as humans, we’re 90% bug cell and 10% human cells. It really is this compliment and relationship that we have that has been disrupted. 

When you have the heavy metals, the chemicals, the molds, the nervous system dysfunction, all of those things are going to hijack the immune system and allow infections to become opportunistic. You have antibiotics, and it disrupts your flora. All of a sudden, you have a bunch of fungus, or you have mold exposure. 

When it comes to infections, we are talking about viruses, bacteria, yeast, spirochetes, Lyme, and also parasites. All of those end up contributing to the CFS, and we really want to recreate the balance. We are trying to get rid of them as much as possible. 

100% getting rid of them isn’t really necessary. It’s more about when people get their energy back, and they get 8, 9, 10/10 energy, they don’t really care whether or not there is still some infection left. It’s more about creating that balance. That is always the goal. Oftentimes, it’s more about getting the immune system back online, so it can bring those infections back into balance. That comes from addressing the heavy metals, chemicals, molds, and nervous system dysfunction. 

That is always very interesting. I get so many people who come to see me who have done different spike protein protocols, FLCCC. A lot of those people can get better. Oftentimes, if they are not getting better from going directly at the spike protein, it’s because they have all these other causes that need to be addressed in order for them to free up the immune system to bring everything back into balance. 

Dr. Eric: 

I was diagnosed with chronic Lyme, bartonella, and pretty sure you were, too. In 2018, when I got tested, I was symptomatic. I wasn’t really symptomatic. It wasn’t debilitating fatigue or severe pain, but I had more neurological symptoms, enough where I did things to address the Lyme and bartonella. Then I retested six months later. There was no change, but I felt great. It was one of those things where do I really want to keep retesting it? 

Again, I’ve had Lyme experts on, and they say, since it’s intracellular, you won’t get rid of Lyme and bartonella. Like you said, you want to reduce your infection burden as much as you can, but you will still always have microbes. As long as you’re doing things to optimize your immune system, it sounds like you agree. I don’t know if you ever retested yourself also when it comes to Lyme and bartonella. 

Dr. Evan: 

No. My story was very similar. I had CFS for five years. It just about destroyed my life and relationships and business. I finally had to go on a journey after napping underneath my desk for thousands of days of figuring out what the causes were and then addressing them myself. I wrote a book about it. Now it has become my mission in life.

I absolutely agree. I talk quite a bit about how testing is highly imperfect. If you are looking at the test looking at the immune system’s reaction to something, this is the IgG or IgM blood test, probably what you got. That test is dependent on an intact immune system. If you have heavy metals, chemicals, mold, other infections, nervous system dysfunction, your immune system won’t be functional or accurate. Consequently, you are asking a dysfunctional immune system to give you an accurate read on a blood test. It just won’t happen. You won’t get good data. 

When we’re looking at other testing in terms of the urine tests for heavy metals, chemicals, and molds, like I mentioned before, those are tests of excretion. The more toxins you have in your body, the more clogged those detox pathways are and the less you can excrete. Consequently, when you are excreting, that is a better sign. That is not really a test of your total body; it’s a test of excretion.

The last thing I’ll say on this is sometimes people will say, “What about PCR testing?” It’s a DNA test looking at the DNA of an infection. If you are looking in the urine, if the infection does not live in the urinary tract, you won’t see it. If you are looking at it in the blood, and it doesn’t live in the blood, you won’t see it. 

Oftentimes, these are intracellular. They are in the muscles. If you want to see if bartonella is causing your muscle pain or fibromyalgia or planar fasciitis or Morton’s neuroma or your calf pain or calf muscle cramps, you’d have to do a biopsy of your muscle, which is incredibly painful, and nobody will do that for you. If you’re not looking in the right place, the testing will be imperfect, which is one of those reasons why I will hedge my bets. I will address all of these things and make sure we leave no stone unturned. 

Dr. Eric: 

It’s important to have this conversation because in the case of Lyme, a lot of people do Lyme testing. They will do a western block for example, and it comes back negative. Then their doctor says, “You don’t have Lyme.” It could be a false negative. 

There are other strains of Lyme, not just Borrelia burgdorferi. Bartonella often gets overlooked. When you go to regular doctors, if they are willing to test for Lyme, usually they are not bringing up bartonella, babesia, all these other coinfections. 

Even the stool testing, which I admit, I still do some stool testing on patients. You mentioned the GI Map, which is a DNA-based test. Even that is not perfect. A lot of people show negative for parasites. Maybe many of those people don’t have parasites, but it’s safe to say that some people who have parasites will have false negatives on any stool test, not just the GI Map. 

Dr. Evan: 

Agreed. We now know parasites can digest themselves outside the body. I have had people come into my office when I had a brick and mortar. “Look at this parasite I found in my stool.” It sure looks like a parasite. We send it off to the lab, and the lab says, “Why did you send me an empty container?” We did that probably about a dozen times before we decided not to do that because they will just give us this report. I never realized that until I heard somebody speak about it, and they said they can digest themselves. I thought that was fascinating.

One thing I do want to touch on also is people may think it’s irresponsible to address all these things at the same time. They may think I am using antibiotics. Everything I do now is natural. I’m 100% online. It’s all herbal. When we are using these herbs, we are doing double, triple, and quadruple duty. I am able to use a couple of herbs that end up addressing all of those different infections. It’s not like we’re going after things with antibiotics, where it will have a lot of negative side effects. 

Dr. Eric: 

That’s great. I’m the same way. I don’t have prescribing rights. Since you’re acting more as a health coach, you’re a medical doctor, but the way you practice, you’re also relying on the herbs. The herbs are very powerful and can be very effective. They don’t have the same side effects more importantly as the antibiotics. That’s great that you’re taking more of a natural approach when it comes to these infections. 

I know you do more than herbs because you do nervous system retraining. There are also things like ozone therapy, IV ozone, and hyperbaric oxygen, when it comes to infections. Frequency therapy. Do you incorporate any of those? Is it really just you focus on what you do, and you have had a lot of success in what you do, so you stick with your treatment options? 

Dr. Evan: 

It’s the latter. I am always looking at other things we can implement. With ozone therapy, I used to do that when I had my brick and mortar. We did MAH chemotherapy. You take the blood out of the person, mix it with ozone, and put it back in. 

Ozone is definitely a big antimicrobial. It’s prooxidant. It can kill a lot of infections. It can boost mitochondria by 400%. What I saw, and I see that with ozone therapy and not so much hyperbaric oxygen but IV Vitamin C, some other natural antimicrobials that are IV. They are indiscriminate. They are killing a lot. They cause a ton of dieoff. It makes the person worse and sometimes for months. It’s really hard for them to recover.

When I saw that in my brick and mortar, I immediately got rid of that therapy because it was more than I was willing to handle when I saw some people start to have mental health issues from killing off some of these infections like Babesia and bartonella that can cause anxiety and depression. You kill them and end up having die-off, which can cause some of those symptoms. 

In terms of managing die-off, a Jarisch-Herxheimer reaction, which happens when you kill some of these infections, the body likes small changes. We use tinctures. When someone feels worse, we are able to navigate, pivot, give them more die-off support. Then they can continue to move forward. It’s so much more graceful than utilizing a sledgehammer like an IV. 

That’s some of my concerns. I just saw someone recently who had done EBOO therapy, which is a combination of sauna and ozone therapy and something else. It was just very intense. It set her back months. For some people, these therapies can be good, and for some, not so much.

With hyperbaric, I find that the oxygen is not enough to kill infections. If it is going to kill something, it’s a small layer that is usually not that significant for folks. It can boost mitochondrial function. You can also get just as much support when taking the right mitochondrial supplement. That’s ozone and hyperbaric and IV Vitamin C.

In terms of frequency therapy, I do like the idea of this. I have had a couple of people use it peripherally. I am familiar with some of the practices and practitioners. I just haven’t seen a lot of success with it. 

Some of it also comes from being focused on one thing. Like I mentioned before, you cannot get rid of infections if you have heavy metals, chemicals, mold, and nervous system dysfunction. You just can’t. If you are doing frequency therapy for a particular infection like Lyme, and you haven’t addressed all these other things, you aren’t going to be successful. 

It’s possible the frequency therapy could be successful if you have addressed these other things as well. Or if the frequency therapy can address these things, it addresses them in the right order, then it potentially can work. But I don’t know enough about it. 

Dr. Eric: 

Wouldn’t that also be the case with IV ozone and hyperbaric oxygen? You would still want to address the toxins and toxicants first? 

Dr. Evan: 

Yeah. Whenever people come to see me, or we are on the free call to see if we are a good fit to work together, I am always looking for what’s missing. I have never met anyone who have addressed all of their toxic five completely and hasn’t gotten better. They are always missing something. Ozone therapy is not going to address your heavy metals, chemicals, or molds. That is something people have to keep in mind. 

Dr. Eric: 

What approach do you take when someone is sensitive to supplements? If someone has MCAS for example, and they are really sensitive, do you microdose? Do you do the nervous system retraining initially? 

Dr. Evan: 

That’s exactly right. Oftentimes, I am at the point where people come to talk to me, and if they are really sensitive to supplements, I say if they haven’t done a nervous system retraining program yet, do a nervous system retraining program for six months, and come back. If you are not all the way better, we can get rid of the causes that you have.

The nervous system retraining really is the absolute best thing for MCAS. I have seen it work so many different times. I have been amazed by it time and time again. There is something that clicks when people are committed. They are doing the nervous system retraining in earnest. Potentially other things that are moving them toward the parasympathetic.

What we do for folks who are more sensitive, or if they can’t get all the way with nervous system retraining and are still sensitive, I often like to use things that will bypass the gut. 80% of our immune system is in the gut. Anything that you put down there, whether it’s food or supplements, people can react to who has MCAS or are more sensitive.

I really like the tinctures for this. We are doing drops on the hands. They can rub them in. You are getting about 20% of a dose, which is really perfect for someone who is more sensitive. Oftentimes, we are also pivoting away. We have a four-step process that we take people through. 

Step two is replacing deficiencies, vitamins and minerals and lifestyle habits. Step three is opening up drainage pathways. Step four is removing the toxic five. Often, we will skip step two and go directly to step three to try to open up these pathways in order to be able to get them to remove. You just have to remove a layer of toxin for folks in order for them to decrease their sensitivities. 

Often, people who are more sensitive can only eat a couple of foods. When you start to remove the toxins, all of a sudden, the immune system is less reactive, and they can open up their palate and start consuming more foods, taking more supplements, etc. 

The nervous system retraining is the biggest bang for the buck. They are not expensive. It’s really great for folks who are more sensitive. 

Dr. Eric: 

Can you spend a little bit on opening the pathways? You mean like supporting lymphatics? Can you talk more about that? 

Dr. Evan: 

When we look at all the ways we get toxins out of the body, we are looking at what I call the exit pathways or drainage pathways. People sometimes call them detox pathways. We are looking at the liver, a couple of phases in the liver; the kidney; the lymph, which is the garbage system of the body; the lymphatic system or the neurolymph, which is the garbage system of the brain; gallbladder; biliary tree; and the intestines. 

All of these pathways have to be open in order for you to get toxins out. Just by opening them, oftentimes, you can start to release some of the toxins. If you remember what I said previously, I was talking about how the more toxic you are, the more clogged these pathways are. Often, that is when you’re not showing up with excreting things in the urine. You really have to open up these pathways in order to be able to then be successful at removing the toxic five out of your body.

Generally, when I give people an image of this, I talk about a funnel, where essentially, the bottom of this funnel is the drainage pathways, or these exit pathways. If you are dumping toxins, you’re pulling heavy metals out of the tissues, you’re putting them into the lymph system, if it’s clogged, it will go right back into a different compartment. We do want to make sure that bottom of the funnel is patent, opened, so you can get the toxins out. 

In step three, we are opening them up a little bit, just to prep the body. There is this pivot that ends up happening, when you’re in step four. Everybody detoxes at a different rate. We want to find the rate at which a particular individual detoxes. We want to detox at a rate that they can tolerate. 

We wanted this to be more of a drip system than blood. We can pivot back and forth between step three and step four, so we can keep opening up these exit pathways, so there is more of a flow. Ideally, there is a nice flow that’s working its way through if you fill up those pathways. You end up feeling worse. You end up having die-off. You have to stop. You have to decrease your dose a little bit. Pivot to step three. Increase die-off support. Pivot back to step four. Keep moving forward.

I tell people this is really a process of three steps forward, one step back, where you just have to recognize that so much of this process is pivoting. That’s one way that we personalize this whole process for people. 

Dr. Eric: 

Awesome. I definitely want to talk about your four-step Energy MD Method. Before that, when you were talking about long COVID, you mentioned helping people with micro clots. Do you use things like proteolytic enzymes like Nattokinase? Is it more advanced as far as breaking up microclots?

Dr. Evan: 

That’s definitely what we’re using. Nattokinase and Serrapeptase and Bromelain, depending on the person and where they are in the world, we can get them different products.

The microclots, for those who don’t understand, we used to call this hypercoagulation before COVID came around. It’s essentially the fact that having the toxic five, especially infections, ends up increasing the clotting in the body. It decreases the flow of oxygen to the tissues. You’re also decreasing the flow of the waste products out of the tissues. When you have these microclots, you end up with a lot of symptoms, depending on where the clotting is happening. 

I like to listen to sports commentary before I go to bed. It changes my brain. I was listening recently. There was a basketball player who was just coming back from having some clots in their legs. I was curious whether or not the spike protein or if there was something that triggered it besides a more conventional standpoint. 

With the microclots, we want to decrease the amount of clotting. We also want to digest the clots. In that one, increasing the blood flow and the oxygenation to the tissues. 

There are some therapies. There is one that called apheresis, which is mainly being done in Europe, where it’s kind of like dialysis. They are pulling the blood out of the human, running it through a filter, getting all the clots, and putting the blood back in. People are reporting significant improvement. Doesn’t seem like it’s lasting. They are noticing significant improvement when they go through that process initially. A lot of that has to do with getting rid of the microclots from the body. 

Dr. Eric: 

Very interesting. Let’s talk about that four-step energy MD Method to help with CFS and long COVID. 

Dr. Evan: 

The first step is figuring out what is causing an individual to have this. With someone who has long COVID or CFS, we are always going to be addressing the toxic five. We will be addressing microclots and hypercoagulation. We will address adrenals and mitochondrial function. I am not always sure whether or not we will address thyroid or sex hormones or B12 deficiency or different lifestyle habits, depending on the individual. This is the first way that we personalize our program. 

We create a personalized program for people based on the causes that they have. There is over 30 we are looking at. 

When we are looking at deficiencies, these are things not in our body that are supposed to be, and toxicities, things in the body that aren’t supposed to be. A lot of people spend a lot of time, energy, and money working on the deficiencies. They optimize their hormones, adrenals, mitochondria, vitamins, minerals, lifestyle habits. They have done a great job of that. But then they plateau and are still not feeling optimal. That is because these deficiencies are caused by the toxic five. 

In step two, we start by replacing deficiencies. We do want to optimize them because it does make the person more resilient. It decreases inflammation. It recreates their circadian rhythm, so their sleep is better. It gives them a little bit of an uptick in energy in about 50% of people we see.

The magic really happens in step three and four. That’s what this process is all about. It’s preparing the body for removing the toxic five. You can do nervous system retraining while you’re doing this. It’s the other toxic four that we’re talking about. 

We are replacing the deficiencies in step two. Part of that is when we start to remove the toxins in step four, it can be stressful on the body. Having the adrenals and mitochondria and thyroid, etc. optimized, that ends up allowing you to deal better with stress and function better as you’re going through the process.

Step three is opening up the drainage pathways that we talked about: liver, kidney, lymph, etc. 

Step four is removing the toxic five. I really like to do it in the order of heavy metals, chemicals, mold, because of what we talked about previously, where you really can’t get rid of the infections if you’re still having heavy metals, chemicals, and mold present .

That’s the four-step process that we take people through. The two major tests that I require people to get as part of the program are a test to determine whether or not they are living in mold. If they are living in mold, it’s very hard to get better. 

The other one is whether or not they have any hidden infections in their mouth. It’s very hard to get people better if they do. That generally comes from any sort of tooth extraction, whether it’s a wisdom tooth or otherwise. It can be a root canal. Any sort of history of having an abscess in the mouth. Those are the main potential causes that would indicate that people have hidden infections in the mouth. Then they are just leeching that inflammation and toxin and infection. It’s just dripping into the rest of the body, causing inflammation. It doesn’t allow you to get better.

I gave you more than what you asked for, but I talked about the four-step process. I wanted to talk about those two major tests I think are most important. 

Dr. Eric: 

With the infections, do you recommend for them to get a cone beam? 

Dr. Evan: 

Yes, the dental test will be the cone beam CT. You do want to make sure it’s done by a biologic dentist, and it’s read correctly by someone who knows how to read these tests. 

The testing for the mold, I prefer the EMMA Test by Real Time Laboratories. It’s an environmental mold and mold assay. It’s a combination of looking at mold spores as well as mycotoxins. Really important to make sure you are looking at both of those. Sometimes, mycotoxins aren’t present, but mold spores are. 

Dr. Eric: 

You’re not talking about urinary mycotoxins. You are looking at testing the home for mold spores and mycotoxins. 

Dr. Evan: 

Correct. Testing the home. You are cleaning different places in the house, getting a dust sample about the size of a cotton ball. 

Dr. Eric: 

I’m familiar with Real Time Labs. I know they have urinary mycotoxin testing. I didn’t know they tested the home. Is that an ERMI type test? 

Dr. Evan: 

The ERMI is the mycotoxin side of things. It’s called an EMMA. For those interested, they can go to EnergyMethodMD.com/EMMA. It will take them to our online store, and they can order it. It’s about $350. Definitely worth it. All tests are imperfect, as I mentioned, including any sort of mold testing of the house. This is the best one I’ve found. 

Dr. Eric: 

All right. Before we wrap things up, anything else that I should have asked you that I didn’t ask you? Anything else you’d like to discuss? If not, how do people know if you can help them with their long COVID and/or CFS? 

Dr. Evan: 

One thing that we didn’t talk a lot about with nervous system dysfunction is it’s essentially caused by any sort of stressor that you’ve had in your life, whether mental, emotional, or physical. We have been talking about the other toxic four (heavy metals, chemicals, molds, infections). Those are all physical. 

The mental and emotional ones are traumas, whether it’s big T trauma, like having some sort of significant abuse, or little T trauma, or more mild, like I had. 

My parents were loving and this and that, but I still was trying to navigate getting my needs met from these imperfect adults. Then I had siblings who were also imperfect and trying to get their needs met. Then I was at school, and I was rejected by peer groups, from these kids who are all trying to get their needs met. Then I had relationships and breakups and college and medical school and residency and all these mental and emotional stressors that eventually led in part to the toxins that I ended up accumulating in my body. This ended up causing my CFS.

It’s always important to note that anything that changes the way that you look at the world- If you start to see the world as a more negative place, when you go through that transformation, you’re happy-go-lucky as a kid. That shift ends up happening. Often, that can be part of the reason why people end up with CFS or long COVID. I would say that’s part of it.

Another component of that is the mindset work. We have a four-step mindset practice that is really important. Focus on gratitude and envisioning your ideal day. Asking yourself empowering questions. Looking at negative beliefs that you have and flipping them into empowering beliefs. That all goes along with the nervous system retraining.

The way I know I can help people is I get on these free calls with people after they watch my master class. This is all on my website. I am always looking for how you address the toxic five. If you haven’t. You also have the characteristics that we are looking for success. That is when I feel like we are a good fit to work together. I tell people that’s the case.

About a third of the people I get on a call with, I tell them I think we’re not a good fit to work together for one reason or another. I try to be really honest with people. I only want people joining my program who are going to be successful. 

If people are interested, the best place to find me is at EnergyMDMethod.com. On there, you will be able to learn all about the work we can do. You can watch my latest master class; it’s 40 minutes if you watch it on normal speed. 20 minutes if you watch it on double speed. You can get on a free call with me and see if we are a good fit to work together.

Thanks for having me on. I appreciate it. 

Dr. Eric: 

Also, your podcast. Make sure they check that out. Your book, Fix Your Fatigue. Can they find you on social media as well? 

Dr. Evan: 

I am on all of those places. It depends on where they are in the process of learning and educating. If they want to get to the goal fastest, it’s getting on a call with me and seeing if we are a good fit to work together. 

Dr. Eric: 

Awesome. This was a wonderful conversation, Dr. Evan. You shared so much valuable information. I learned some things, and I’m sure my listeners did as well. 

Dr. Evan: 

Thanks for having me on, Eric. 

This episode breaks down which nutrients matter most and how to get them affordably. You’ll also hear tips on lowering daily toxin exposure, improving sleep, and making smart swaps at the grocery store. These are practical, doable steps even if you’re working with limited time and money.  If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

In this episode, I am going to discuss how to eat healthy and restore your thyroid and immune system health on a budget. If you have been diagnosed with hyperthyroidism or Hashimoto’s, I don’t need to tell you how overwhelming the journey can feel. I have worked with so many people who are trying to heal while also feeling stretched financially as well as emotionally. Hundreds or even thousands of dollars on labs or a drawerful of supplements only to feel stuck. 

That’s why in this episode, I want to break it down and simplify the process, especially if you are on a tight budget. I will walk you through what to focus on first, where micronutrients come in, and what to do if you are feeling like you’re drowning in information or expenses.

I have seen it so many times: those who want to heal naturally but are financially burned out from chasing complex protocols. They are juggling work, caregiving, and their own symptoms. On top of that, they’re being told they need a dozen lab tests and 15 supplements just to get started.

Don’t get me wrong, it’s without question I recommend tests and supplements to my patients. This is true with most functional medicine practitioners. This isn’t about doing everything. It’s about doing what matters first. You don’t need to spend a fortune to start moving a needle in your health. 

If you’re deficient in key vitamins and minerals, it’s like trying to rebuild your house with no materials. Micronutrients play a role in calming the immune response. They can support thyroid function. Even help with detoxification. The good news is you don’t need to take dozens of supplements to address these micronutrients.

Sure, there is a time and place for supplementation such as magnesium, selenium, Vitamin B12, Vitamin D. I do commonly recommend these as well as other supplements to my patients. But you also need to incorporate the foundations, which include eating whole, healthy foods. That’s where you want to start. You always want to start with whole, healthy foods. 

A question that a lot of people have is do you absolutely need to eat organic? I do recommend trying to eat as many organic foods as possible, but obviously, organic food does cost more. If you’re on a budget, you might need to prioritize.

If you eat meat, I would try to eat organic. If you eat red meat, but you can’t afford organic, grass-fed, grass-finished beef, I would at least make sure, even if it’s grass-fed, grass-finished but not organic, that’s still good. Arguably, that might be even better. 

If you had a choice between organic but not grass-fed, grass-finished, or non-organic, grass-fed, grass-finished, grass-fed is a priority. Even in that situation, would it be the end of the world if every now and then you ate beef that is not 100% grass-fed, grass-finished? Not the end of the world. You want to try to do your best. 

It’s similar with fruits and vegetables. When it comes to fruits and vegetables, for the most part, I’m eating organic. You could always refer to the Dirty Dozen and the Clean 15 lists from the Environmental Working Group, which you could check out by visiting EWG.org. 

If you’re not familiar with these lists, the Dirty Dozen list is the top 12 fruits and vegetables with the greatest amount of pesticides. The Clean 15 lists the top 15 fruits and vegetables with the least amount of pesticides. They’re not perfect. There is no perfect list out there. 

If you’re on a budget and can’t afford to purchase all organic fruits and vegetables, then you would at the very least want to try to avoid the fruits and vegetables on the Dirty Dozen list and stick with the fruits and vegetables on the Clean 15 list. 

At least the allowed foods. If you have read my books, you know I recommend either an AIP diet or a paleo diet. Not all of those foods on the Clean 15 list are AIP or paleo-friendly.

Besides food, don’t overlook the importance of stress management and proper sleep. These are the foundations. Eating whole, healthy foods; avoiding refined foods and sugars and fast food; stress management; and proper sleep are all extremely important. 

Sometimes, you might need to work on other aspects of your life to get proper sleep. For example, it’s easy to say, “If you’re not sleeping at least 7-8 hours, start getting that much sleep.” Sometimes, it’s not that simple. You might need to correct blood sugar imbalances, which could relate to diet that we just spoke about. I didn’t get too specific with the diet because I discuss this in other episodes and my books.

Also, minimizing blue light at night. If you’re on your phone at night an hour or two before going to bed, or on your computer, or watching TV, that could cause problems with sleep. At least an hour before going to bed, try not to go on electronic devices. I can’t say I always do that. 

If you are struggling with sleep, you want to do everything you can. This doesn’t cost any money, not to go on your phone or your computer. We’ll talk about what you can do on a budget. Honestly, I recommend for everyone to do that, even if you are not on a budget, to avoid blue light before going to bed. 

If I am conducting a webinar at night, I might not follow that rule. There are other times I am guilty about not following that. I try not to go on my phone right before going to bed or in bed. 

A lot of people will bring their phone into bed and surf the internet or text some people right before going to bed. I would try to get out of that habit if that describes you.

Getting some morning sunlight whenever possible. I realize not everybody can get morning sunlight every single day. When there is morning sunlight, going outside first thing in the morning for a few minutes, getting sunlight, that could help reset your circadian rhythm. That really can make a big difference. 

Should mention grounding. Going outside barefoot for a minute or two even. If you’re doing it for longer than that, that would be great. You can get a grounding mat. The basics is what I’m talking about here.

Let’s talk about supplements. How can you prioritize nutritional supplements? Supplements definitely can get expensive. As I mentioned, I do recommend supplements for my patients. I’d be a hypocrite if I said, “Don’t take any supplements. Just rely on diet and lifestyle.” If you can’t afford supplements, either way, you want to focus on diet and lifestyle. I do think supplements can be helpful. 

I focus on nutrients first. The reason for that is because you can have, for example, an omega-3 fatty acid deficiency, but you can’t have a turmeric deficiency. There are great things about turmeric, curcumin, helping with inflammation. I commonly recommend not always in supplement form but even through food to get turmeric. Either way, turmeric/curcumin is great. Like I said, you’re not going to have a deficiency in turmeric, but you definitely can and often do have a deficiency in omega-3 fatty acids. 

Many people have a Vitamin D deficiency, which is more of a pro hormone than a vitamin. The point is, you want to focus on nutrients first, nutrients that you can become deficient in. 

When it comes to basic supplements that I recommend to many of my patients, fish oils, or if you are vegan/vegetarian, then algae oil. An omega-3 fatty acid supplement. You can also do an omega-3 index, which involves more money. If you’re on a budget, you might not want to spend the money on that. There is a company, Omega Quant. It’s $55-60 to do that test. You could do a more comprehensive fatty acid profile. If you really want to see if you are deficient, you can test. 

If you’re not taking fish oils or an omega-3 fatty acid supplement or eating fish at least three times a week, you probably are deficient. If you want to test, that option is out there. 

Vitamin D. Most people, if they’re not supplementing with Vitamin D, are deficient. There are some people who are able to have healthy Vitamin D levels by getting regular sunlight. I recommend testing either way. That’s the only way to know for sure. If you are getting regular sunlight, you can’t assume your Vitamin D levels are optimal, not just within the lab range. 

You would want to test Vitamin D, selenium, magnesium. Those are the ones I commonly recommend to patients. 

I also recommend probiotics. You can try to get as many probiotics as you can through fermented foods like sauerkraut. It’s great to rotate them. The problem with fermented foods is most people aren’t eating them every day. If they are, many times, they are eating the same fermented foods. If they are eating sauerkraut, that’s what they’re eating every day. Maybe they are eating unsweetened coconut yogurt. They might not be getting enough probiotics from that, or even sauerkraut. 

I recommend doing both. If you’re willing to eat fermented foods, great. Probiotics are expensive. That is one thing I do commonly recommend.

Prebiotics are something that I can’t say everybody needs, especially if you are getting prebiotics through diet by eating fiber-rich foods, especially vegetables. There are some good quality, inexpensive prebiotics. I don’t like Now Foods for all their supplements, but I do like their prebiotics. They have certified organic inulin and certified organic acacia fiber. Those are prebiotics I personally add to my smoothies. They’re cost-effective.

Digestive enzymes are something I commonly recommend. The one I recommend also has butane HCl because a lot of people have low stomach acid.

To reduce your toxic burden, the biggest thing is to minimize exposure to environmental toxins in your home. Eating organic can help with that, or at least avoiding the Dirty Dozen list. 

Trying to use natural cleaners and cosmetics. I realize that can also become expensive. At least prioritize the cleaners and cosmetics you use on a day-in, day-out basis. Try to make those natural. 

If you are using a cleaner in the house, use a natural cleaner. You don’t have to spend $20 on a natural cleaner. You can get a good natural cleaner spray for $5, for example. If you’re using the conventional sprays, like 409 or Clorox wipes, I would minimize- I’m not saying there is never a time and place for these. The products you use on a daily basis, I would try to make them natural. 

For supplement purposes, NAC is great for detoxification. It’s a precursor to glutathione, which is the master antioxidant and helps support phase 2 detoxification. I also have a product supplement, Hepatommune Supreme, which has NAC. It is a little bit on the pricey side. NAC is a really good option for a lot of people.

Sweating. Sauna is great. If you don’t have a sauna, you can sweat in other ways, like exercise. You do want to be careful with exercise, especially if you have hyperthyroidism and an elevated resting heart rate. 

The point is, there is a lot you can do to reduce your toxic burden without taking a lot of supplements.

Let’s talk about testing. Basic blood tests, thyroid, TSH would be the most basic. TSH is actually a pituitary hormone, not thyroid hormone. There is a company, Direct Labs, that offers a comprehensive wellness panel that has a TSH, CBC, comprehensive metabolic panel, lipid panel, and a few other markers. The regular price is $100, but they have sales for $60-70 every now and then. 

I really do recommend a thyroid panel, not just TSH. Looking at T3, T4. I prefer the free hormones, free T3 and free T4. If you are paying out of pocket, it can get expensive to test antibodies on a regular basis. I would say if you can, at least do a thyroid panel. A TSH, free T3, free T4 every other month. If you have to do antibodies every other time you do a blood test, which would be every four months, you can only do what you can do. 

You might hear me and others talk about reverse T3. If you have hyperthyroidism, most of the time, reverse T3 will be elevated, so you don’t need it. Honestly, I wouldn’t say it’s absolutely essential with Hashimoto’s. It’s great to have, but is it a must? I would say in many cases, no. Don’t feel bad if you can’t afford reverse T3.

Vitamin D, I would try to get. I recommend an iron panel, not because a lot of people are deficient, but that is one reason why. Some people have elevated iron levels, so they might have hemochromatosis or other reasons why iron is elevated, which is not good. If you have too much iron, that will cause oxidative stress. 

Obviously, if you have too little iron, that’s not good either. You don’t want to randomly take iron. If you do that, and you happen to have hemochromatosis, which you can’t go by symptoms necessarily, that could make things worse. 

There are other blood tests I like, blood tests that look at blood sugar imbalances like hemoglobin A1C, fasting insulin, inflammatory markers. 

I am trying to keep it basic. You can only do what you can do. If you can do a thyroid panel, Vitamin D, iron panel. The more you can do, the better, but doing those are pretty important. 

When it comes to functional medicine tests, I have always been more on the conservative side when it comes to functional medicine testing. There is a time and place for comprehensive testing, and it really depends on the person. I’m not saying I will never recommend comprehensive testing because there are times where I do. I won’t recommend thousands of dollars’ worth of tests for anyone.

When I dealt with Graves’, in addition to comprehensive blood testing, I did an adrenal saliva test, a hair mineral analysis test, and that’s it. I didn’t do a comprehensive stool panel or organic acids test or mold testing or mycotoxins. Some people do need those tests. 

It’s perfectly fine to start off with the basics, to start off conservatively. That’s what I did. A lot of my patients also start off conservatively. Sometimes, I’ll look at someone’s health history and suspect mold or gut issues. I won’t recommend a comprehensive stool panel or urinary mycotoxins test or another type of test. It really does depend on the person. Don’t think you need to spend thousands of dollars on functional medicine testing. Many times, that’s not the case.

For the most part, that’s all I want to discuss here. Getting back to the toxic burden, I would assume you’re toxic. Hair mineral analysis looks at heavy metals such as mercury and aluminum. There is urinary testing for heavy metals and mycotoxins testing. 

With testing for toxins, you can’t test for all toxins anyway. There are too many toxins to test for. You could always assume you’re toxic because we are all toxic. We all just have different toxic burdens. 

Do things to reduce your toxic burden. Try to do as much as you can through diet. Cruciferous vegetables are really good for supporting phase 2 detoxification. I spoke about cruciferous vegetables in previous episodes. A lot of controversy with cruciferous vegetables such as broccoli and thyroid health. Most people, it’s fine to eat them. 

Of course, you want to stay well hydrated. Drink plenty of water. I mentioned NAC. If you want to take a supplement.

I also should mention some free or low-cost resources. Of course, there is this podcast and my YouTube channel. I have a few websites. SaveMyThyroid.com is my newer website that has been out since I launched my podcast in 2021. I also have one, NaturalEndocrineSolutions.com, which has been out since 2010. That is where I have hundreds of articles and blog posts related to thyroid health, both hyperthyroidism/Graves’ and hypothyroidism/Hashimoto’s. Also, the transcripts to the main Tuesday podcasts are on that website. I have a new newsletter called “Healthy Gut, Healthy Thyroid.” You can check that out by visiting SaveMyThyroid.com/Newsletter.

I have three books, which aren’t free but are lower in cost. Natural Treatment Solutions for Hyperthyroidism and Graves’, which is now in its third edition. Hashimoto’s Triggers and The Hyperthyroid Healing Diet. You can check those out on Amazon.

It’s great to have information, but there is also some free or low-cost support. My Facebook groups, there is a lot of people with thyroid and autoimmune thyroid conditions in there. I can’t say I’m too active in there because I have a lot of things besides working with patients, trying to keep up with the podcast. There is only so much time I have. 

There are a lot of people in there dealing with thyroid or autoimmune thyroid conditions. Of course, you need to be careful to take medical advice from these people who are not practitioners. It is nice to be in a group where others are going through the same thing that you are.

I do have occasional Facebook Lives. They used to be live streamed directly in the group, but Facebook doesn’t allow that anymore. Now, when I do a livestream, which I do to my Facebook page, my YouTube channel, and Instagram. I just got on last year in 2024 after years of not being on Instagram. I guess I’ll just do it. Sometimes, I’ll do those lives, where I’ll answer questions. Be on the lookout for that. If you’re on my email list, you will typically get those alerts.

I also have live events a few times a year that are either free or low cost. Typically, I have a few five-day challenges or boot camps. When they are paid, usually they are less than $100. Sometimes, there are exceptions to that. I try to make them affordable, so be on the lookout for those. If you are in my Facebook group, I do post them. 

The problem with the Facebook group is when I post something, everybody sees them. In one group, I have 9,000 people. in the other group, 20,000 people. 

Definitely get on my email list. You can do that by visiting SaveMyThyroid.com or NaturalEndocrineSolutions.com. On the first one, there is a quiz you can take, and then you will be on my email list. On the second one, there is a free guide, where if you request it, you will be on my list. Those are ways to be informed of when I do a livestream where I answer questions, or a live event, like a 3-5-day live event, where I provide information and answer questions. 

That is really all I want to discuss here. Hopefully, you found this to be valuable. You definitely could eat healthy and do things to restore your thyroid or immune system health on a budget. 

Can it be more challenging with some people? Yeah, it definitely can be. You can only do what you can do. I just wanted to make you aware that there are things you can do. 

Some people feel like they need to spend thousands of dollars to restore their health. I realize not everybody is in a position to work with me or another functional medicine practitioner. Functional medicine is not cheap. I understand that. I wanted to put together an episode where I give you some information as well as some of these low-cost resources and support. 

Hope you found this episode to be valuable. Thank you so much for listening. I look forward to catching you in the next episode.

Recently, I interviewed Malka, who opens up about her ongoing battle with thyroid eye disease. She talks about her challenges, unexpected setbacks, and the constant search for solutions. We also talk about the lifestyle changes she’s made, the risks of different treatments, and the tough choices she faces while fighting to preserve her vision. 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’m very excited to chat with Malka here, as she has been dealing with thyroid eye disease, cataracts, and other vision issues. Malka, thank you so much for joining us. 

Malka: 

Hi, thank you for having me. I appreciate it. 

Dr. Eric:

I’m sure this will be a really interesting conversation. I work with a lot of people who have thyroid eye disease. Definitely want to hear your background. You have been dealing with Graves’ itself for- 

Malka: 

A long time. 

Dr. Eric:

20+ years, correct? 

Malka: 

When my 21-year-old son was a baby, that is when I started feeling off. I lost a lot of weight. I was only 25. They said, “This sometimes happens,” and they put me on PTU. I took it for 18 months. It came, it left, we’re done.

One of the other things I found after that, the glare started bothering me. I didn’t connect it to anything else. After that, I was okay. 

Then I had twins in 2009. When 2009 came, I started not feeling well. Having trouble breathing. They said that hyperthyroidism could come back when you have twins. I said that was interesting. I didn’t know that. I went on another 18 months of PTU. It’s twins. It’s a separate thing. 

It came back again. One of my doctors mentioned, “By the way, you have steroid cataracts.” I have never taken steroids. I don’t have asthma. I said, “Okay.” Keep an eye on it; just wear glasses. Wear sunglasses.

In 2020, I had a very stressful thing happen in my life. I started losing weight. I would go to the couch and be out of breath. I lost a ton of weight; I lost 20 pounds. When my thyroid came back this time, they said, “This is Graves’.” Once it comes back this third time, it’s become autoimmune rather than just coming and going. 

I went on methimazole for about 18 months-two years. I went back. Something came. I had another stressful event. I came back again. 

It was interesting. When I was in remission, I looked at the bloodwork. When the doctor said I was at goal, I started having on my eyelids eczema. It was very strange. My eyes were very dry. I went to the eye doctor, and the eye doctor said, “This is thyroid eye disease.” When I went to go check, he said, “I can’t correct you to 20/20. You need cataract surgery.” I’m 45 years old. I wasn’t expecting to need it that quickly. I waited for a second opinion, and the doctor said at that point, my eyes were very bad. They did cataract surgery a few months ago. 

Now that my bloodwork was back at goal, now, I started having another issue. This was about six months after my cataract surgery. I started seeing this shiny image in my eye every so often. I went to the doctor in August. She said my optic nerve was very swollen, and she was worried. She told me to go for an MRI. I had already done one. Both times, they said there is nothing wrong with the brain. 

At this point, I still haven’t seen a neuroophthalmologist. They gave me an appointment in October and in January, so I am still waiting. It happens to be my eyes have gotten worse in the last two weeks. At first, it was just that. Now, over the last week, there is gray. I can’t see so well. It’s a little bit scary. I really can’t see so well out of my right eye. My left eye is fine. It’s almost worse than when I had the cataracts. 

Even when I did the cataracts, you couldn’t compare one eye to the other because you get one eye done and then the next one. Thank goodness I have two eyes because one is doing most of the work right now.

I had gone to one of your sessions. These last few months, I had the second thyroid eye disease. That is when I decided to go on AIP. Even though I’m at goal, I wasn’t quite sure exactly. Let’s see if I can get rid of it by diet. 

I have been almost two months now on AIP. I am eating tons of greens and trying all this different stuff. You had mentioned some vitamins, so I got Vision to the Max. It has a lot of the stuff you mentioned, like green tea extract, turmeric, and zinc. They are all in this one thing. 

It is just concerning at this point. I have an appointment coming up in two weeks in October. I will hopefully see if the pressure is less. It’s not your typical thyroid eye disease response as far as I can tell. That’s where it’s been a little bit concerning. That’s what pushed me to go speak to you and see what you have to say. 

Dr. Eric: 

You said you chatted with me through one of my sessions. Was it a Facebook Live? 

Malka: 

It was one of the classes. 

Dr. Eric: 

One of the five-day events. 

Malka: 

I asked you a question. I asked you about SDIT to see if you had ever heard of that being helpful. I did six months of that. Overall, I feel so much better in general. My health is better. One of the side effects is constipation. I always had constipation. 

I say the irony of Graves’ is when you’re losing weight, it means you’re sick. When you start gaining it back. All the weight I keep trying to lose, it all comes back. Now, I have been able to lose weight in a healthy way. Overall, I do feel very good on this diet. It’s very hard to find stuff sometimes. I worked it out. 

I also have a gallbladder issue, separately. I can’t eat a lot of meat. That also took a lot of the stuff you could eat, like whole meat and anything fatty. I can eat eggs, but I can’t eat avocadoes. I find oily foods really aggravate my gallbladder. I have had a few gallbladder attacks. I have to be careful. 

I’ve heard there is a connection between hyperthyroidism and the gallbladder. I don’t know if that’s connected. At one point, they wanted to take my gallbladder out. I said I wasn’t doing that. I have just been hyper-careful about what I eat. It’s very hard. I like meat. It’s hard not to eat it. I’m careful with my diet. 

I did hear about you, so I asked you in one of your last lives. 

Dr. Eric: 

As far as the gallbladder, listen to your body. The problem with the gallbladder is it mainly is a bile metabolism problem. It’s not really the gallbladder itself. Just addressing the bile metabolism. I do have some information on my website, NaturalEndocrineSolutions.com. I also have a few interviews on my podcast where I interviewed a few practitioners about the gallbladder and bile metabolism. 

Some people could benefit from bile salts. There are numerous supplements to help support the gallbladder, or the bile metabolism. 

Problems with estrogen metabolism could affect bile metabolism. How do you know if you have problems with estrogen metabolism? Sometimes, a history of ovarian cysts, uterine fibroids, thyroid nodules, a family history of breast cancer could be some indications. Endometriosis. 

There is also a test you might have heard me or others talk about called the DUTCH test. It’s a dried urine test that looks not only at the hormones but the metabolism of the hormones, including estrogen. Something you might want to look into. If you have had numerous gallbladder attacks, try to figure out what the cause of that is. 

Malka: 

Okay. Good to know. It’s secondary, but I think it’s all connected. I personally feel the cataracts are connected. It was interesting because I was looking up on the thyroid eye disease website. What are your risks of having thyroid eye disease? One of them was cataract surgery. Really? I would never have connected that. I feel like my eyes got worse right after my first session. 

I had these experiences where the reflection of the sun on something would bother me so much. Everyone would be like, “It’s totally fine. It’s a fence. Why is that bothering your eyes?” “I don’t know, it’s killing me.” I do think there is a connection. Otherwise, I can’t figure out why I would have cataract surgery at such a young age. I have seen connections between thyroid eye disease and cataract surgery. 

Dr. Eric: 

I have had a few people with cataract surgery and thyroid eye disease. I can’t say it’s a large sample size. This is a little bit unique as far as what I usually work with. 

I know you said neuroophthalmologist. That’s the one in two weeks? 

Malka: 

Yes. The regular doctor- I’ll tell you what was interesting. My first doctor who told me I needed cataract surgery was a doctor who knew about thyroid eye disease. That’s why I went to him. I wasn’t comfortable with him doing my surgery. I wasn’t comfortable with the office. 

I found a separate doctor who was a cataract doctor. I think what happened was when I went in in August, she panicked, and I panicked. I forgot to tell her that I have thyroid eye disease. Had she known, she was looking at it from a cataract point of view. She was just looking to see if it was a dislodged retina. That was her main concern in the beginning. 

When I came home, there is a thyroid issue also. They were very hard to reach. I was waiting to see how I went health-wise to try to see- I wanted to make these appointments. This was a neuroophthalmologist. They said, “You are not a current patient. We will see you in the new year.” January is a long time to wait when my doctor says I needed to be seen yesterday. 

That’s been my struggle. I haven’t been able to make an appointment. There are only five in my area, so it’s hard to find. My regular doctor was like, “You’re going to the neuroophthalmologist. They’ll deal with it.” I haven’t been to the regular eye doctor either. I have an appointment on October 16, so I will hopefully get that pressure checked and see if there has been any improvement. 

Dr. Eric: 

They did say the retina is intact, right? It’s all just swelling. 

Malka: 

Swelling of the optic nerve. 

Dr. Eric: 

That’s good about the retina. They haven’t done anything as far as steroids, prednisone. Not that I’m telling you to take that. 

Malka: 

No. That’s why I’m also not running. When I spoke to my endocrinologist, he called me up to talk to me about it. I called her and told her I was struggling. I was very scared. It was very nerve-wracking. She said that there is this medication. I think it’s called Tepezza. 

Dr. Eric: 

Yep, Tepezza. 

Malka: 

You have to get a shot for eight weeks. I’m looking at the side effects. This is not where I want to go. Even for the things it says it’s for, it says it’s for eye bulging. I don’t have that. I am not having a lot of the symptoms that are typical. The thought of going that way is also what pushed me not to call them every day and ask for an appointment. I don’t want to go on that type of medication. 

I’m okay with going on medication when you need to, but for me, this feels like it’s not going to solve the problem. It will just make 100 other problems. I’m straddling between regular medicine and trying to be more of a naturalist. I’m between the two, I would call it. 

Dr. Eric: 

I agree with the Tepezza as far as, usually, it’s for bulging. Sometimes for double vision. I haven’t had a lot of people take it, but it seems to go well for the bulging. Double vision, hit or miss. For swelling of the optic nerve, I don’t know if that is the approach I would take. For me, it wouldn’t be the approach I’d take. I think it’s wise to speak with the neuroophthalmologist and see what they have to say in a couple weeks.

In the meantime, my guess, I could be completely wrong. Feel free to shoot me an email after your appointment. I’m thinking they are going to give steroids to reduce the inflammation. There is definitely a time and place for that. 

You have done the AIP diet, which is great. It hasn’t completely helped. It helped partially. You’re still having vision problems. There are other natural agents that you could take. Some you might be taking. You’re doing the vision supplement, which is fine. 

As far as helping with the inflammation associated with eye disease, the eye supplements probably are going to have minimal impact. I would say within the next couple weeks, there is definitely some things you could do. We’ll talk about these to help potentially lower the inflammation.

Like I said, there is a time and place for steroids. I don’t love them. You probably don’t love them. Most people don’t. 

Malka: 

Especially now since they told me that I got cataracts from steroids. 

Dr. Eric: 

I understand. 

Malka: 

Keep me away from them. I haven’t been on them yet, and they caused me all these problems. Every doctor I have spoken to doesn’t know why I had cataracts, but the steroids equal cataracts to me. That was already a trauma in and of itself. 

Dr. Eric: 

I understand. You don’t want to play too many games with the optic nerve. 

Malka: 

That’s true. If they tell me I have to do it because it’s getting worse, then I will have to do it. 

Dr. Eric: 

I am not telling you to jump to the steroids. If I were you, I would try to do other things as well. I’m just saying the optic nerve is affected when there is a lot of inflammation, it’s perfectly fine to do things naturally. If things don’t help naturally, that is when you might- Maybe I’m wrong. Maybe they won’t recommend steroids. I’d be surprised if they don’t. 

I don’t think they’ll jump to Tepezza. Like you said, it’s getting infusions every few weeks for a total of eight. They will want to do something quickly. You would have to get approved with your insurance. It’s very expensive if insurance doesn’t cover it. I could be wrong, but I don’t think they will recommend Tepezza. It will be something like prednisone.

As far as what else you can do in the meantime, the basics, which you are already doing as far as eating well, AIP diet. Try to do a good job of managing stress. Try to get sleep. 

Malka:

I am working on sleep. I don’t get a lot of sleep, but I am working on it. I have been trying to exercise. I have been doing smoothies. Mostly green smoothies. Lots of green vegetables. I have changed completely, eating—my favorite food is cake—to enjoying vegetables. I have really tried everything. 

I have been having selenium. I have been eating Brazil nuts to get selenium. I really run the gamut. As far as what I could find on my own. I am ready to write down whatever else you think would be helpful. I am really looking to do whatever will work. 

Dr. Eric: 

Before I forget, exercise. Make sure you don’t overdo it with exercise. You don’t want to overtrain. 

Malka: 

Don’t worry about that. All I do is walk. The truth is, even when I exercise, I always have to watch my thyroid. Even a little bit too much, and my heart starts racing. Even when my thyroid is good, I always have to watch my exercise. If I push too much- I’ve had a few times where my heart started beating very fast, and I couldn’t slow it down. I was really struggling to get it back to normal. I’m always very careful that I don’t do too much. I really listen to my body. 

Dr. Eric: 

Wonderful. Sounds like you’re doing great with that. 

Vitamin D. Make sure you have healthy Vitamin D. If you haven’t tested for it, I would say 25 hydroxy Vitamin D, you want it to be at least 50. Ng/ml is the units. 

Malka: 

Is that D3? 

Dr. Eric: 

D3 is what you would take if you’re deficient in it. D3 with K2. Doing a 25 hydroxy Vitamin D test. If someone is deficient- 

Malka: 

I’m always deficient. I have never not been deficient. 

Dr. Eric: 

Make sure you get those levels above 50. The only way to know is by testing. Some would even say higher for autoimmunity, like 60-80.

Omega-3 fatty acids. I don’t know if you eat fish or take an omega-3 supplement. 

Malka: 

The problem I find with them is they are oily, and I am worried about my gallbladder. The oil part of it is- 

Dr. Eric: 

I get it. 

Malka: 

I can’t eat salmon. I had salmon years ago, and I got salmonella poisoning. Every time I have tried it since then, my body is like, nope. I get sick from it. My body remembers. That was even before Graves’.

I have been having flaxseed, but that’s omega-6, right? Not omega-3.  

Dr. Eric: 

It’s some omega-3. Flaxseeds and walnuts, for example. Chia seeds. They have to convert into EPA and DHEA, which they’re not very efficient in doing. There is also algae oil. Some companies have algae oil supplements, which doesn’t have as much EPA and DHEA as a fish oil but is still better than nothing. At least until you support the bile metabolism. 

Malka: 

That would be the better thing. If I handle this, I could go back to that. 

Dr. Eric: 

There is a company called Omega Quant, where you could do an omega-3 index or a more comprehensive fatty acid panel. You ideally want the omega-3 index to be at least 8%. A lot of people, if they are not eating fish or supplementing, they will be at 4-5%. That is also something to look into. 

The selenium that you mentioned is important. The only thing with Brazil nuts, first of all, they’re not AIP. You are straying a little bit with Brazil nuts. 

Malka: 

Oh really? I thought it said they were on there. 

Dr. Eric: 

No nuts and seeds if you are following strict AIP. 

Malka:

I am not doing AIP. I am doing one of the ones on your list. I am not doing strict AIP. 

Dr. Eric:

From The Hyperthyroid Healing Diet? 

Malka: 

Yeah. 

Dr. Eric: 

You must be doing level 2. 

Malka: 

I am doing one of them. It’s not the real AIP, but I am doing one of them. 

Dr. Eric: 

I eat Brazil nuts. I eat organic Brazil nuts that I get from Costco, and I do like them. But you don’t know how much selenium you are getting from Brazil nuts. Usually, for thyroid eye disease, I will recommend selenium supplementation, so we know how much someone is getting. 

Malka: 

200? 

Dr. Eric: 

Typically, I will recommend 200mcg of selenium. In some cases, I will recommend 400mcg. I won’t put someone on it for too long because of selenium toxicity concerns. The selenium is important. 

There is alpha lipoic acid, which also helps to decrease oxidative stress. NAC can also help with that. I don’t want to make this about pitching my products, but I don’t know if you have seen my thyroid eye disease bundle. 

Malka: 

It’s all the things you recommend basically. 

Dr. Eric: 

Pretty much. It’s at TEDBundle.com if you want to look at it. It has SMT BerbALA, which has berberine and alpha lipoic acid. Alpha lipoic acid helps reduce oxidative stress associated with thyroid eye disease and in general. Berberine has a lot of different properties. There is research studies with both alpha lipoic acid and berberine and thyroid eye disease. Berberine can support the gut microbiome and help with thyroid eye disease. 

There is another supplement called SMT Immune, which also has different ingredients, like curcumin and resveratrol and proteolytic enzymes. If you want to take that, you want to take it away from food, on an empty stomach. That really helps with inflammation. 

SMT BerbALA also helps with inflammation and oxidative stress, as they go hand in hand. It’s not addressing the cause of the autoimmune component associated with thyroid eye disease. Obviously, the prednisone that they will probably recommend isn’t doing that either. It’s just helping to lower inflammation. 

The goal would be either to take the Thyroid Eye Disease Bundle or something similar that is good quality, and see how you do over the next few weeks. See if the pressure reduces. If things are heading in the right direction, maybe you don’t need to take the steroids if that is what they recommend. I can’t tell you not to take them. That would be a decision you have to make. That is the approach I would take. 

Of course, you have attended my five-day events. You’ve read my book. You know it’s about finding and removing triggers and healing the gut, which goes deeper. As far as the short term, trying to get that inflammation down. Those are some things you can do in the meantime. 

Malka: 

I haven’t quite found my trigger. On this diet, I have tried the coconut milk because all the other milks are off. Coconut makes my stomach hurt every time. It’s interesting. You’d think this diet is so limited, but even in there, I can’t handle the coconut milk. I can handle a little bit of coconut, but every time I put coconut milk in something, I get a bad stomachache. I am wondering if that’s a sign of a trigger. I have eliminated 90% of what I usually eat, and this one thing still gives me a stomachache every time I eat it. 

Dr. Eric: 

It’s probably not a trigger. It is a source of fat, so it could be related to the metabolism. Many times, people have to go beyond diet. Even in The Hyperthyroid Healing Diet, the focus is on diet, but there is a section that talks about going beyond the hyperthyroid healing diet. Diet and lifestyle is where you want to start off. It’s great that you have done that. 

If someone is still having autoimmunity, those auto antibodies, the TSIs in the case of Graves’, then they want to do things other than the diet. Not to say to go back to eating the cake that you love, but still to eat healthy and follow the level 2 diet. You can continue following that. 

In addition to that, you might have to do other things, like reduce your toxic load, maybe do some functional medicine testing. You said stress was a big factor when this started in 2020. Maybe do some adrenal testing. I talk about this in great detail. 

Malka: 

Adrenal testing. My numbers are good as far as the doctor is looking at. She says I’m at goal. Everything is within normal range. I don’t know if my numbers of the regular thyroid stuff will even come up. They’re saying I’m fine. I started out at goal. 

My 11-year-old son was just diagnosed with Celiac. When I got my last set of bloodwork done, I asked them to test if I was Celiac. In order to test for Celiac, you have to eat wheat. Once I found out I do not have Celiac, I was able to go on the diet. I didn’t want to go on the diet until I tested my blood to make sure I didn’t have Celiac. Once I found out I don’t have it, then I went on the diet. I have been off of wheat and all this stuff. My numbers are fine. There are other numbers that if I did more testing, you would probably find other stuff.  

Dr. Eric: 

I am talking more about the antibodies in the thyroid. TSH, free T3, free T4, it sounds like those are looking good. I am wondering about the TSIs. If they are still elevated. If not, that’s great. I would think with the thyroid eye disease still being an issue, those would still be- 

Malka: 

I am saying I see the free T3. I am looking through some of my tests. TSH? 

Dr. Eric: 

No, that’s different. It would either be TSI or TRAB. 

Malka: 

Would they have tested that automatically? 

Dr. Eric: 

Not every single time. A regular doctor usually won’t. Usually it’s an endocrinologist, and they won’t test it all the time. 

Malka: 

I think she didn’t test them because she was testing for the Celiac. She didn’t want to do too many tests. She tested my cortisol for me because my friend mentioned cortisol. She said cortisol was also fine. 

Dr. Eric: 

Maybe next time ask about TRAB or TSI. I like TSI better. It’s more specific.

I would focus that Vitamin D. Get the Vitamin D tested. Make sure you have healthy Vitamin D levels. 

Some of the things we mentioned, like you don’t have to take specifically the products in the thyroid eye disease bundle. Just show you have another brand of selenium, which is fine. As long as it’s good quality. 

Those agents that I mentioned, those supplements, the alpha lipoic acid, the berberine, the natural agents that help reduce inflammation, like the curcumin, the resveratrol. I just mentioned a few. I would look to take that approach. Hopefully, that helps with the inflammation. It might not completely resolve it, but if you see it heading in the right direction, hopefully you will be able to avoid the steroids. 

That’s a conversation for you and the doctor to have in a few weeks. Definitely keep me posted. Feel free to shoot an email once you have that consultation. 

Malka: 

Thank you so much. I really appreciate it. 

Dr. Eric: 

You’re welcome. Thanks, Malka. Appreciate you doing this audit. Hope you learned some things. Look forward to hearing from you in the near future. 

Thanks, everyone for tuning in, especially those with thyroid eye disease. I hope you found this to be valuable. Even if you don’t have thyroid eye disease, there are some things you can take away from this. Either way, thanks for tuning in. As usual, I look forward to catching everyone in the next episode. Take care, Malka. 

Malka: 

Bye, thank you.

Recently, I interviewed Sara Raymond,  who invites us into the subtle, powerful world of hypnotherapy, where transformation starts beneath the surface. In this episode we discussed her autoimmune struggles coupled with anxiety and addiction has empowered Sara to learn and share how personalized, gentle hypnotherapy can open a door to deep, sustainable healing. You’ll also hear why healing too fast can backfire and why safety and self-compassion matter more than ever.. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky:
I am super excited to chat with Sara Raymond. We are going to be talking about hypnotherapy. I am excited about this conversation. As I was telling Sara, I actually was searching for a hypnotherapist. I can’t say I was searching too hard, but I wanted a hypnotherapist and didn’t know who to have on the podcast. Glad to have Sara here.
Let me go ahead and go over her impressive bio here. Sara Raymond may just be the compassionate support you’ve been searching for on your healing and personal evolution journey. A hypnotherapist and trauma-informed transformational coach, Sara combines over 20 years of experience as a Pilates, yoga, and meditation teacher with a deep passion for helping people reconnect with their inner wisdom and embrace their inherent fullness.
As the co-founder of the Mindful Movement, Sara has cultivated a global community, offering free meditation and self-hypnosis practices to over 900,000 subscribers on YouTube. Known for her compassionate and authentic approach, Sara brings a wealth of personal and professional insight as a recovering overachiever and perfectionist, creating a safe space for growth and transformation.
Her new book You Are Not Broken: A Compassionate Guide to Uncovering Inner Wisdom and Transforming Your Life with Hypnotherapy provides readers with the tools to release self-doubt, reframe limiting beliefs, and create sustainable, meaningful change. Welcome, Sara.

Sara Raymond:
Thank you. I appreciate it.

Dr. Eric:
If we could dive a little bit more into your background. What led to you first of all becoming a hypnotherapist and then eventually writing your book?

Sara:
I was teaching Pilates and yoga for many years before diving into the world of hypnotherapy. I found myself on the hamster wheel of looking for more training and more credentials and more education to be confident. I wasn’t an impostor in the field. At that point, I had been teaching for at least 10 years. I had lots of experience and lots of training. Logically, I was experienced, and I was good at my job, but the limiting beliefs, the subconscious patterning, had me seeking more and more and more. I couldn’t have told you that at the time.
It had me looking for a way to feel more confident and had me looking for a way to understand myself a little bit better and some of those patterns that had me striving and looking for the perfection and the overachieving tendencies.
At that stage, it really led me to find the answers that I was looking for. This started with meditation and then led to hypnosis. I am just a teacher by nature. What I do and what I find valuable, I typically will end up teaching and sharing with others.

Dr. Eric:
If you could give a definition of hypnotherapy and maybe talk about what differentiates hypnotherapy from other types of- I don’t know if you would refer to hypnotherapy as a type of mind/body medicine like meditation or yoga. If you could define it and distinguish between those.

Sara:
I would put it in the category of mind/body healing. I do take a bit of a somatic approach to hypnotherapy because of my background with working with the body and working with the mind to inform the body. I think there is a lot of wisdom in the body that can be accessed through hypnosis and hypnotherapy.
If I could give a definition, that’s a hard one because it’s kind of broad in that we’re in a therapeutic relationship. Hypnosis is a way to bypass or set aside the logical, conscious, thinking mind, which is where we mostly live as adults. It allows you to access the inner wisdom of the subconscious, of the emotional side of your experience, which is where all of our beliefs live. They live in the subconscious and drive our actions and drive our behaviors.
In order to change a behavior and action, you have to first change the belief that is driving it. Long-winded answer to tell you that the hypnotic or therapeutic experience, it’s giving you the opportunity to access your subconscious mind, to make change.

Dr. Eric:
I assume hypnotherapy, the person has to be a willing participant. You can’t really hypnotize someone if they’re not willing to be hypnotized.

Sara:
Yes and no. Yes, in that if you want to use hypnosis, you have to want to make the change. I couldn’t send my husband to a hypnotherapist to say, “Load the dishwasher differently” because he doesn’t want to do that. People will get in touch with me and say, “I really want my husband to stop drinking. Can you help him?” The answer is no, if he doesn’t want to change, then this won’t work.
But the reason I was saying that you can be hypnotized without wanting to is that when you’re watching a show that has an emotional quality to it, essentially, that is a form of a hypnotic state. When you’re driving home from work on a very familiar route, and you get home and say, “I don’t remember making those last three turns,” you’re still aware, and you’re still safely driving your car, but you’re in a different brainwave state than a highly alert brainwave state. Essentially, there is a bit of hypnosis in there.

Dr. Eric:
That makes sense. Good point, in bringing up alcohol. You have to want to be motivated to give up alcohol. Same thing with smoking. I heard hypnosis can help with smokers, but if they don’t want to quit smoking-

Sara:
And with those in particular, it can be a little tricky because we may say we want to because that’s what we think we should do. If underneath the surface, you really don’t want to, then it still will be really challenging to use hypnosis as a tool to quit smoking or drinking in that case.

Dr. Eric:
What kind of people do you work with? Do you have some people who come to you who want to quit drinking alcohol? Is it more focused on people with stored trauma? Is there a population you see more of?

Sara:
I get a wide variety. Because I offer the free content on YouTube, lots of people find me. There is so much broad content that is available on the channel. Because it is free, and it is available to everyone, it has to be somewhat broad. It can’t be very personalized.
I do get a wide variety. I get a lot of folks who are healing some physical ailment or emotional challenge. I get a lot of anxiety.
If I do get people who are wanting to quit drinking or smoking, it’s usually associated with something deeper. It could be associated with wanting to have a child and having infertility, I should stop drinking because it contributes to the infertility.
Or the drinking could be more related to anxiety, like a coping strategy for anxiety. The real issue is the anxiety. When we can work with the anxiety, then you may not need that coping strategy of drinking alcohol. That’s the approach that I take with some of the clients that come in wanting to quit some substance.

Dr. Eric:
You work with a wide array of people. Do you have a favorite type of client? This person comes in. Obviously, everybody is different, but still. That category of person comes in. I feel really good about being able to help you compared to other categories.

Sara:
I like working with clients who are vested. The clients that really want to do the work, and they are willing to be vulnerable and willing to be brave throughout the process. It’s not one particular issue or situation that I would call my favorite client, but it’s the approach that they take when working on themselves or when trying to help themselves.

Dr. Eric:
You know that my audience consists of those with thyroid conditions. A lot of people with autoimmune conditions. How can hypnotherapy benefit these people?
I talk all the time about blocking out time for stress management, mind/body medicine, incorporate things like meditation, yoga. Some of these people have anxiety, and hypnotherapy can help with that.
Sometimes, anxiety is because of hyperthyroidism. We need to address the hyperthyroidism and lower the thyroid hormones. Also, a lot of these people have stored trauma. Obviously, a lot of people in general have stored trauma. I guess that’s one way that maybe it can help a lot of people who have these chronic health conditions.

Sara:
Absolutely. I think the approach has a lot of layers to the benefits. When I work with clients individually, they all receive a personalized recording. It’s very specific to their needs, their desires, the beliefs that they want to be embodying, the feelings and the qualities. The hope would be that there would be a consistent practice of that recording. It would support, like you said, the stress management. Taking time for yourself to be still, to be quiet, to calm your nervous system. All of these things are happening with the use of the personalized recording. There is that benefit.
I also think that with autoimmune, what I see a lot is, I don’t want this to come off as me blaming or saying it’s someone’s fault. There tends to be lack of self-care at times, which is sometimes around feeling worthy of the time it takes to care for yourself.
I have also experienced thyroid issues, and I have been diagnosed with Hashimoto’s. I am familiar with that. I have an experience of prioritizing work over my self-care and other people’s needs over my self-care. I know that it’s a common tendency.
What I’m getting at is that when you take the time to work through this practice on a daily basis, it’s showing yourself that you are worthy of taking care of yourself. There is this layer of developing- It’s not developing because I believe worth is inherent. We are all humans; we are all worthy. It’s remembering the worth by taking care of yourself and taking the time and prioritizing yourself.
Additionally, we can look at the innate wisdom of the body. It may sound silly in this logical, alert state we are in now, but to close your eyes, be in a calm, relaxed state, and even just ask, what does my thyroid want me to know? You approach it from a very biological way. The physiology of the thyroid. That is important and valuable. You couldn’t manage thyroid without that.
I think the innate wisdom or the messages of the body can also support and bring another layer of healing into the equation that wouldn’t come from the medical world. It’s not a replacement in any way. It’s a support, and it’s another way to be informed.

Dr. Eric:
I agree. I also agree with what you said about prioritizing yourself. That is a question I ask on the questionnaire. A lot of people actually choose that they take care of others before themselves. They don’t prioritize their own health. You really need to do that if you’re going to get better. I’m glad you mentioned that. I think that’s important.

Sara:
Absolutely.

Dr. Eric:
You said you made a personalized recording for everyone. Obviously, you have all the YouTube videos. When someone works one-on-one with you, it’s different because they get that personalized recording rather than just the general videos, which can be helpful. Could they work one-on-one with you remotely, or is it better to work with you in person?

Sara:
Right now, I am only working with clients remotely. There are pros and cons. One of the biggest pros is that safety is so important, and the feeling of safety is important to allow this process to unfold in an effective way. When you can be in your own home, or you can be in a safe place, and I can be on the other side of the screen, I think there is more value in that. It can be very valuable; I wouldn’t say “more value.” It can be very valuable to have that feeling of safety to allow you to go deeper perhaps and understand or uncover more.
Whereas if you had to come into my space, and you have never been there before. Maybe there are noises you don’t recognize or the chair’s not comfortable or whatever it is. It can make things a little bit more challenging for you. Then you have your own space. You can feel safe and really go a little deeper into what’s below the surface.

Dr. Eric:
By working remotely, you can also help people not just all over the country, but all over the world, which I’m sure you do. That’s a great feeling.

Sara:
It’s always fascinating to sit in my home in Maryland and meet with someone in Spain or England or wherever they are. It’s pretty interesting.

Dr. Eric:
Same here. I do telemedicine calls, and it’s always nice. Sometimes, I’ll work with people who are local, but a lot of people from different parts of the country and the world. It’s pretty neat.
Session-wise, this probably also varies depending on the person. Is there a minimum number of sessions people should expect to go through when working with you? Or is it just let’s see how the first session goes and take it from there?

Sara:
Everyone is different. I do have a lot of clients who end up working with me one time. The initial package that I have is a two-hour session, so we talk a lot about past history. We talk a lot about triggers or things that are reactivating old feelings or wounds. I like to get a lot of background information around relationships and family upbringing and dynamics. Within that two-hour session, there is a process that we go through together. It’s a client-centered conversational style of hypnosis. That is all looking at the past, looking at what happened that caused this pattern of behavior or this anxiety or the feeling that you’re experiencing, the issue at hand.
Then there is a healing process that we would go through depending on the individual, what their needs are. Might be some amount of letting go of old beliefs. It may be some amount of self-forgiveness. It could be working with the inner child. Lots of different strategies and approaches for that depending on the individual.
After that, the personalized recording is really looking at moving forward. It’s very forward-looking. It focuses on the beliefs that you do want to have and the feelings and emotions that you want to embody, the qualities that you want to live by. That is meant to be used every day, so you start to have some consistency and repetition of these new beliefs. You’re having to nurture them to fully adopt those beliefs and feelings.
There is a follow-up interaction that we have with some coaching that is a bit of either closure on the topic or that might be a catalyst for the next step, which might look like more hypnotherapy or more coaching. The coaching, I will incorporate some process-oriented techniques. Just depends on the individual.
Lots and lots of people come and work with me for the one package, and they find, not freedom, but a sense of lightness from the issues at hand and the shift they feel happy and content with being enough.

Dr. Eric:
To confirm, the first appointment is two hours. After that appointment, you put together the recording. That is something they will listen to every day. Most people go through a follow-up call with you. After that, it might depend on the person. Some people might be good to go. Some people might need additional support.
Just out of curiosity, is the recording five minutes? 30 minutes? On average.

Sara:
It depends. People always ask me what time of day should I listen? What is the best length of time for a practice? The answer is what is going to be effective for you and what you’re able to consistently commit to. If you came to me and said, “I want a personalized recording,” and I made it 30 minutes because that’s what I wanted. You only set aside 15 minutes a day. You will look at it and say, “I don’t have time for that today,” and keep putting it off. It’s dependent on what each individual can commit to and be consistent with.
I’m sure you give some type of dietary advice or exercise advice when you’re working with patients with thyroid issues. One size doesn’t fit all for those situations. If you were to give a strict vegan diet to everyone, there will be some amount of people who just can’t live like that, or it doesn’t work for them. You have to work with what’s best for that person and what they can commit to.

Dr. Eric:
Is there anybody who wouldn’t be a good fit for hypnotherapy, other than those people who don’t want to make change in their life? Anybody else who wouldn’t really be a good fit?

Sara:
That’s a good question. There is probably lots of mixed opinions about this in the psychology and counseling world. In my experience, anyone who has a tendency to dissociate, that can be very challenging and problematic.
Someone who has a really significant traumatic past, that might be out of my scope of practice. I might pass it along or refer to a psychologist or someone who has more experience with that. Everyone in some capacity has had some thing that we might call “trauma” these days. It’s a very popular phrase, meaning a lot of different things.
My approach is very compassionate. It’s very much intending to meet the person where they are and take a pace that they’re ready for. If you try to heal too fast, or if you try to do anything too fast, or too much, that is essentially another form of trauma. It can reactivate old wounds and old patterns, and that is the last thing we want to do. Healing can be slow. It can be nonlinear. It generally is nonlinear. I tend to take a very slow, compassionate approach, where it’s very client-centered. I want to meet you where you are and move at a pace that is just right for that person.

Dr. Eric:
If someone goes through that initial consultation because you obviously can learn a lot from the person in two hours, and you just feel like, I’m sure, even in advanced cases, you can still offer some value, but if you feel like it’s maybe better for them to work with someone else, I’m sure you would refer them out somewhere.

Sara:
Yes. During this time, my language is always trying to be safe and giving permission to slow down or take breaks. The client is always in the driver’s seat. They are in control of the pace and depth and the direction that they go. If something doesn’t feel comfortable, or something feels unsafe, we are going to stop and work with whatever is available.
In my other profession, in my other side of my career, I work with physical bodies. We are doing movement. The invitation is always to work in a pain-free range of motion. Sometimes, that’s teeny-tiny. Sometimes, it’s much bigger, and there is no pain. If you work through pain, it can cause more pain or more injury. The same is true with the mind.

Dr. Eric:
Makes sense. I will ask you this question. A little bit personal. You’re a yoga instructor, meditation instructor, hypnotherapist. How much time do you personally spend weekly or daily on stress management? Maybe not as much because of your background, and you don’t feel like you need to. I’m just curious if that’s the case. Maybe you only spend a small amount of your time, or maybe because you focus on that, you spend more than the average person.

Sara:
It fluctuates. A fluid amount of time, I would say. Sometimes, if there is more stress in my life, I might need to pull back from work a little bit, or spend more time on my self-care and stress management. Over the years, I guess all of the practice that has been done is building capacity for me. It’s building the ability to recognize when I am in a state of stress or feeling overwhelmed or I have taken on too many things, which is definitely a habit of mine (to say yes to too many things).

Dr. Eric:
Same here.

Sara:
Most podcast hosts who are doing this as a side gig have that tendency. It’s part of your career, not a side gig.
The practice of building awareness of my own nervous system responses and my own stress responses are really important. Years ago, I don’t think I would have recognized that I was feeling stressed or going in the direction of being stressed before it was too much. I think I can see that happening sooner, and I can take steps to manage that.
To answer your question, I don’t have a specific amount of time. I like to do a lot of movement. I like to make the things that I really enjoy practices of mindfulness. I spend a lot of time in the garden, or I have a lot of plants. Obviously, I have a lot. It’s a very calming practice to take care of them and be with that experience. Some of that is my self-care.

Dr. Eric:
Makes a lot of sense. It really varies, depending. If you’re under more stress, it would make sense that you do more from a stress management perspective. It sounds like you’re always doing things and taking care of plants, also very calming, I can imagine. I can’t say I take care of plants on a regular basis.

Sara:
What do you do for stress management? What’s your go-to?

Dr. Eric:
Good question. You’re probably familiar with Heart Math?

Sara:
Yep.

Dr. Eric:
I do deep breathing, and I do sauna. I use the Inner Balance from Heart Math. Can’t say I do yoga. Haven’t really tried it. I tried Pilates actually. I did it years ago. It’s mainly deep breathing, meditation, and Heart Math. I have used apps in the past, like Headspace. I can’t say I do that these days.
Most of my patients don’t use Heart Math. They might do meditation or yoga. Some might do tai chi. Depends on the person. A lot of people just do things like incorporating prayer and walking and other things that are very calming, which is great. I try to do that, too. I get out in nature. Probably need to do more than that.

Sara:
Just being able to recognize what the needs are in that capacity. Sometimes, the self-care is more calming than trying to bring the nervous system into the calm state. Other times, some people will get stuck in that calm state. It’s more of a freeze response. They may need something more high intensity in terms of the movement. It might need to be more vigorous, like kickboxing or jumping on a trampoline or lots of different needs. Being able to recognize what that is is part of the self-care process.

Dr. Eric:
Before we talk about your book, is there anything else that people should know before working with a hypnotherapist?

Sara:
Make sure you feel comfortable with the person. You have some amount of trust, even if you haven’t worked with them specifically before. If there is some way to build rapport, build trust, that would be important to go into the experience feeling safe. Ask as many questions as you need to make sure you can feel safe. Trust that person has the capacity to hold space for you and what you’re going through.

Dr. Eric:
Wonderful. Sara, definitely want you to take a couple of minutes to talk about your book and what people can expect when reading it.

Sara:
The title really is the premise of the book. You’re not broken. The underlying message is one of compassion and acceptance. Not to say that whatever you’re going through will always be. I will just give up. It’s more this is the reality. Let go of the judgment of the reality. With that, the release of the judgment, the release of the feeling broken, is where the healing can take place.
It’s not to say that you have to feel broken or have to have some judgment of your experience in order to take action to do something. You can do that from a place of acceptance and compassion. The healing will be more effective that way.

Dr. Eric:
Is Amazon the best place to get that? Your website?

Sara:
Amazon is great. Any bookstore. You can go to Barnes & Noble. A lot of independent bookstores carry them. Sometimes, they charge a little more because they have higher overhead. Anywhere you buy books, you can usually order it.

Dr. Eric:
What are some ways people can find you? You have a YouTube channel and the podcast that I was a guest on recently.

Sara:
The YouTube channel is a really good starting place. It will give you an opportunity to get to know me, even though we are not meeting face to face. As a practitioner or listener of the videos that I offer, you can start to see my style and energy. It’s really important to build trust with the person you’re working with. This can be a stepping stone to that.
Whether or not you ever work with me, that doesn’t necessarily matter. Starting to build that relationship with me and with yourself is a good place to start. It’s all free. There is 500-some videos to choose from.

Dr. Eric:
All right. Sounds great. Can they also follow you on social media?

Sara:
Most of the content is on YouTube. I’m on Instagram and Facebook, but they’re not the most engaging places where I spend time. TheMindfulMovement.com also has a lot of free resources. There are a couple free courses that are available on that website. Lots of articles that can be useful. Various topics and so forth. There is a lot of information. When did we start? 2016, I think. Years of information to sift through. You will find something that you might resonate with.

Dr. Eric:
Check out Sara’s book. Visit the YouTube channel. Also, TheMindfulMovement.com.
Thank you so much for this conversation, Sara. This was amazing.

Sara:
Thank you. And thank you for taking the time to be on our podcast as well.

Dr. Eric:
That was a lot of fun. Thanks again. Have a wonderful day.

Recently, I interviewed Sandy Kruse,  who endured a total thyroidectomy and survived the exhausting struggle of hyperthyroidism. In this episode we discussed about her difficult recovery, and the moment she realized that truly listening to her body was the key to healing. From experimenting with medications to refining her nutrition, Sandy’s experience offers powerful lessons on navigating thyroid health and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am looking forward to chatting with Sandy Kruse. We are going to be talking about thyroid cancer, which is something I have not spoken about on this podcast. This is going to be an amazing conversation. Let me give Sandy’s short but sweet bio here: 

Sandy Kruse is a registered holistic nutritionist, a certified metabolic balance coach, and the podcast host of Sandy K: Nutrition and Lifestyle Queen, now just under 1.4 million downloads. Sandy educates on how we can all age better through living a life of balance, body, mind, spirit, and soul. Welcome, Sandy K. 

Sandy Kruse: 

Thank you so much, Dr. Eric. I’m so happy to be here. 

Dr. Eric: 

I’m happy you’re here as well. This is going to be an exciting conversation. Can’t wait to get into your backstory, which we’re going to do now. I really want you to jump into your background a little bit more. Of course, lead into your thyroid cancer journey. 

Sandy: 

I think it’s important to talk about it from where it began. I do believe that genetics or epigenetics always has a part in everything as it relates to our health. What can trigger these genes to actually express? 

With me, it started when I had my second child at age 35. The first baby was the easy one, and the second one wasn’t. I had a trauma birth. It was really stressful because I wasn’t well, and here I was taking care of a newborn and a toddler. I had a spouse that traveled almost weekly and a baby that had colic and all of the things that a lot of new moms deal with. 

You go to see your general physician, and usually, they check on the baby. What was missing: “Hey, how’s the mom? Is the mom okay?” I really wasn’t okay. I had lost so much weight so quickly. 

It’s difficult to pinpoint exactly when thyroid issues began for me. I kind of had an idea that I had postpartum thyroiditis which was never diagnosed. I had all of the symptoms. I was very different from my first delivery and first pregnancy. I didn’t have enough breast milk. I wasn’t sleeping. I was extremely stressed. I could tell there was something wrong, but I didn’t know what was going on. 

Then fast forward quite a few years later. My baby was five. She was diagnosed with a soft tissue sarcoma. It is a malignant tumor. I can’t even explain what it’s like to have a sick child, but it wasn’t a good time for our family. 

Almost exactly one year after that, I was diagnosed with thyroid cancer. My daughter and I actually had, it was her second surgery and my first surgery to remove my entire thyroid gland and two lymph nodes, one year apart. It was October 2010 and October 2011. 

Then the story begins with what happened afterwards. It wasn’t the simple Here, take one pill, and you will just be great. You will be fine. You don’t need the gland. It definitely wasn’t that. 

Dr. Eric: 

I assume it was a papillary thyroid cancer? 

Sandy: 

Yes. 

Dr. Eric: 

You got the ultrasound. That didn’t confirm the cancer. You got the biopsy after getting the ultrasound. That is when you found out you had thyroid cancer. 

Sandy: 

It was an incidental finding. What happened was I had a migraine with aura. It was the first time in my life. You’re a doctor. Most people who have migraine, usually it starts at around puberty. It’s something that a lot of people deal with their entire life. I had never had one. 

I had a migraine with aura before I was diagnosed, before they did any kind of testing, and I thought I was having a stroke. I was 41 years old. It was visual aura. 

I also had this weird thing. When you research symptoms, a lot of times, a doctor will say, “No, no, there’s no correlation.” I always had this coughing or choking or gagging. I remember even stopping the car once. I had both my kids in the car. You know when it feels like you have saliva that goes down the wrong way, and then you can’t stop coughing? I had so many of those incidents. 

I had a family doctor that wasn’t really big on testing, but he was actually on vacation, and it was a substitute doctor. She was a female doctor. She said, “You know what? It’s weird that you’re having your first migraine ever at 41. Let’s do some testing.” They did do the carotid artery ultrasound to make sure there were no blockages or anything in the brain. They did the MRI. The carotid artery ultrasound, they said it was all clear, but they found five nodules in the thyroid. They were bilateral, so that means on both sides, and only one of the nodules was actually cancerous. 

The way they found that out, which was also rare, as people who have had fine needle biopsies know that they often come back inconclusive. When they did the fine needle biopsy on me, they immediately said “suspicious for papillary carcinoma.” In a way, that was lucky. I know many people who have many of these biopsies that come back inconclusive. You probably know that. 

It was actually pretty quick. It was all within two months that I had my thyroid removed. They suggested to remove the entire gland because in western medicine, they don’t believe you can do things to shrink nodules. Maybe I would have done something different now with what I know now. Having known that only one of them was malignant. They suggested I remove the entire gland because the nodules were bilateral. I had a lumpy thyroid. 

Dr. Eric: 

Very rarely these days do they recommend a partial thyroidectomy. Now there is radiofrequency ablation. Not sure if you’re familiar with that. They can target specific thyroid nodules. When that first came out, I wasn’t really for malignant nodules. Now apparently, some cases of thyroid cancer, at least one of the conversations I had with Dr. Angela Mazza on the podcast, pretty sure she said it could actually help with some cases of papillary thyroid cancer. Back when you got it, I don’t think that was an option. Now potentially in some cases. 

They removed the entire thyroid gland. How was the recovery time? How did you feel after the surgery? A few days later? A few weeks later? 

Sandy: 

I should note that I was with one of the top endocrinologists. I had a neck surgeon at Toronto’s Mount Sinai Hospital. I was there for three days. Now, I think it’s like boom, bam. You’re in, you’re out. I was there from Wednesday-Friday.

The recovery, it’s crazy. The way that they want to give you all of these pain meds. I got home. I was taking extra strength Tylenol, to be truthful. I didn’t think it was such a big deal. Then they gave T3 to me to begin. I actually felt pretty good after I had my thyroid removed. Then they made me go off everything to do the Thyrogen injections. There was a nurse that came to my home to give me two injections from what I recall. I don’t know what the process is now. It’s to test to ensure that none of the gland, none of the tissue is left, that they removed everything. 

That was when the struggles began. They put me on T4 only. They put me on Synthroid. The only reason they put me on T3, which we all know is the active thyroid hormone, right after the surgery was because it has such a short half-life. It exits the body very quickly. Once I was ready to do the Thyrogen injections, I would have none of this hormone left in my body. T4, it can be 4-6 weeks.

Dr. Eric: 

A couple things. Backtracking. You said you saw one of the top endocrinologists, which is important to mention because if someone needs any type of surgery, not just thyroid surgery, again, you probably want to go to someone who has done a lot of the surgeries. I know everybody has to begin somewhere, but still. If I was having thyroid surgery, I would do my research and try to find an experienced surgeon. 

I’m glad you mentioned that. You randomly didn’t choose anybody, or your primary or someone else. Maybe your primary gave you some guidance. Sometimes, they let the endocrinologist just make the decision for them.

I also wanted to ask you, as far as making sure that there was no thyroid tissue left, did you receive any radioactive iodine in addition? You did not? Sometimes I’ll give radioactive iodine after the thyroid surgery. 

Sandy: 

I didn’t need it because I only had the one nodule, and it was small enough that they said you don’t need to have it, thank god. 

Dr. Eric: 

I’m glad you didn’t have to get that. You started with T3. You felt okay. Switched to Synthroid. From there was downhill. 

Sandy: 

It was really downhill. Really bad. I had all the symptoms of hypothyroidism. You name it: hair loss, no energy, weight gain. I had edema, swelling. I could go on. The biggest thing that I’m going to say to anybody who experiences hypothyroidism is this extreme loss of vitality. It’s like the essence of who you are as a person is gone. Everything in your body slows down. I started to experience a lot of that. 

I was hypothyroid for a while, but I kept getting the, “Well, you’re within the healthy range.” We all know that range can be pretty vast. Everybody is so individual. When they made me go off of everything, the last time I had bloodwork, I was at a 32 TSH. I had little kids. That was when I was like, I have to start researching what’s going on in my body. 

This is well before I went back to college for holistic nutrition to understand how all this is interconnected. I was told that I just need one pill. Then I learned about T4, T3. I learned about T1, T2, T3, T4, calcitonin. The thyroid produces so many more hormones than just T3 and T4. It all began with me getting the book Stop the Thyroid Madness. Have you heard of this? Everybody has. 

Dr. Eric: 

Yeah. 

Sandy:

It’s a patient advocacy book. That’s where I began. My stress might be affecting my ability to convert that T4 to the active T3 that I need. Then it was this light bulb moment. I went back to this endocrinologist who is like this well known worldwide- You need to give me T3. He was kind of shocked because nobody was talking about this, and nobody knew about this. Probably 95% of his patients were on T4 only. Then things started to change when I was on a combination of both. 

Dr. Eric: 

Did they even test for T3? You mentioned that your levels were within the healthy range, which the healthy range isn’t the optimal range, as we both know. Many times, they will just do TSH. Sometimes, they will do a T4. Did they all along monitor the T3? 

Sandy: 

They did. I actually checked on this today, on what bloodwork I have access to. I can only go back as far as 2016. They did at Mount Sinai a full panel. They would regularly check thyroid globulin (TG), which I know is important for people who have had thyroid cancer. You want to have almost undetectable TG. If you have TG, that means it could be back. 

Yeah, they did check. In Canada, I know this can be a problem in the US as well. TSH is like all they will check if you go see a general practitioner. If you go to an endocrinologist, with a thyroid problem, if they’re good endocrinologists, they will check TSH, free T3, free T4, TG, other antibodies, depending on what your thyroid issue is. 

Dr. Eric: 

That’s good. When you said that reluctantly he gave you T3, I assumed at that point, they would have done a T3 test. I didn’t know if prior, but it sounds like they did all along. Many times, T3 will be on the lower side but within that lab range. They will still ignore it even though it seems obvious that there is a problem converting T4 to T3. You were on T4, and then both. When you were on both, you felt a lot better. 

Sandy: 

I did. Except I was looking at some of my levels from 2016. For about five years, they suppressed my TSH. I would be at undetectable levels of TSH, so 0. It would be 0. But then there were times that I had pretty severe symptoms of hyperthyroid because of that suppression. There were times that my free T3 levels were above 7. 

Now I’m telling you this. I don’t know if the US labs are the same. It was very high. For a good five years, I had some anxiety and other stuff going on. 

I always find this so funny when they say people lose weight if they’re hyperthyroid. I gained weight. I gained weight because I had so much of that nervous energy that I would constantly be eating. It didn’t matter. I have had some struggles with weight since then, regardless of whether I’m hypo or hyper. 

Dr. Eric: 

You think you were in a hyper state for about five years? 

Sandy: 

About that. My endocrinologist said it was really important during that time, and I don’t know if they do that anymore. As you know, women who are in perimenopause, who are in a hyperthyroid state for too long, can have pretty severe bone loss. 

Dr. Eric: 

That’s what I was going to bring up, if you ever got a bone density scan. Being on that dose for quite a while. 

Sandy: 

Yes. I started to work out. They took me off the higher doses of thyroid meds. They just said that if I’m in a more suppressed TSH state, there is less likelihood that the cancer would come back. That is why they did it. I think they read somewhere that they changed that since for people who have had thyroid cancer because of the bone issue. Yes, I do get bone density tests pretty regularly. I’m still okay. It didn’t do any damage. 

Dr. Eric: 

Glad you get your bone density tested regularly. That’s good. 

I’ve listened to some of your other interviews in preparation for this podcast. Obviously, your background is as a nutritionist, so I want to talk about some of the recommendations as far as protein, for example, intermittent fasting. You also have experience with proton pump inhibitors (PPI), being on the acid blockers. 

Sandy: 

Yeah. It’s a very sore spot for me because I feel, and I have written about this, like I was harmed by being put on those. I started to have infections that wouldn’t heal. I don’t even know if I want to talk about it here. They sent me to a gastroenterologist. This was shortly after I was on T4 only. 

Remember how I was saying everything in the body slows down when you’re in a hypothyroid state for a long time. Healing slows down. You can have a lot of weird things go on in the body because your body is not able to heal. Everything is just downgraded. 

I was sent to an endocrinologist. I never had GERD or any kind of heartburn or anything. They put me on a PPI and said I had too much acid in my stomach without any kind of tests. I became addicted to this PPI. There is something called a rebound effect. I have been on it probably for about 10 years. I went through states where I was borderline anemic. I had ferritin levels as low as 6. For those of your listeners who know what ferritin is, it’s your iron stores. 

I had such a severe rebound effect that I thought I was having a heart attack. That was when I started to have severe GERD. It was only after I was trying to get off of the PPI. I did everything I could. I went off of it for a year. When I did, and they did the scope, they said I had Barrett’s esophagus. Then they told me, “You better get on that PPI again. Otherwise, now, having had thyroid cancer, you’re at risk for esophageal cancer.” I went back on the PPI.

By the way, I had done everything as it related to diet, lifestyle, all of those things to get rid of the heartburn when I went off of the PPI. None of it worked for me. Nothing. I tried weaning. I tried everything that was recommended. Nothing worked. There are some genetics in there that I think might play a part in this. I have family members who have similar issues. 

When I went back to college, which I was 46, it was with the Canadian School of Natural Nutrition. I then started to wean off but so slowly. Still today, I am on an over-the-counter dose of 20mg of Nexium. But I was on very high prescription doses. I consider that a win. 

The way that I prevented becoming anemic all those years was by, I call it faking my own digestion. I started taking digestive enzymes with butane HCl. Then I started to take additional butane HCl. 

Of course, we know there are contraindications. This isn’t advice for anybody. If you have an ulcer, you can really exacerbate your issues. I didn’t. I had very low stomach acid. Still to this day, I take high doses of HCl, and I take a digestive enzyme with every protein meal. That’s how I’m keeping my mineral balance. We all know, without stomach acid, things can go downhill over the course of- I have been on PPIs for about 10 years or more. 

Dr. Eric: 

That’s a long time. You said at one point your ferritin was a 6? 

Sandy:

Yes. 

Dr. Eric: 

I assume you monitor your iron levels. More recently, they are a lot better? 

Sandy: 

When I was doing the butane and still menstruating- This is important for your female listeners. If you are still menstruating, that has a big effect on ferritin. I had other issues with estrogen dominance. I had so many things that were going on in my 40s, and I had no one who could really help me. That is one of the reasons I went back to college. 

While I was still menstruating regularly, I would probably sit at about 15-16. If I got up to 20, that was a real win for me. Now, I actually just did bloodwork. I’m sitting at a 39. I’m now in menopause. One year of no periods, technically textbook, now I’m in menopause finally, at 55. 

Dr. Eric: 

You have never been vegan, vegetarian. Even when your levels were low, you were always eating meat? 

Sandy: 

Well, yes. I was always eating meat. This is all relating to the weight side of it. What the heck? I didn’t even know my body anymore. I’m a small person. I’m only 5’2”. What’s happening? I can’t eat this way. 

I think for me, it was almost like this double whammy of perimenopause and no thyroid gland. It was a double whammy for me. There was a time that I thought, oh, maybe raw food is the answer. Maybe becoming more vegetarian. I was never vegetarian. Never. But I avoided more animal protein at one time. These are all little stints. 

I have done many diets. I have done low carb, keto, intermittent fasting. I have done a lot of these things in the end. It’s all about the balance. 

Dr. Eric: 

Agreed. Definitely want to chat with you about intermittent fasting because that’s a hot topic these days and over the last few years. I don’t have anything against intermittent fasting. Sometimes, it can get extreme. Even sometimes 16-8 fasts are too much for some people, let alone 18-6. I’m talking about regular people who are doing it on a daily basis. “I am going to go 20 hours and have a four-hour eating window or six-hour eating window.” I’d like to hear your thoughts on intermittent fasting. 

Sandy: 

The biggest thing I’m gonna say is I became insulin-resistant while I was intermittent fasting. How is that possible? I was 52. This was the first year that I went from regular cycles to I only had four periods that year. That was the year that estrogen dropped, that I started to experience hot flashes. I was still intermittent fasting, listening to the Maniverse. Sorry, no offense, Eric. I call it the Maniverse. 

Dr. Eric: 

No offense taken. 

Sandy: 

You know, I’m like, I was treating my body almost in a robotic way as opposed to listening to my body. If you go back to my history, I have some issues with cortisol. Maybe my resiliency to the stress it was causing me is not as strong as your resiliency. We’re also bioindividual, and we just need to listen to what makes sense for us. 

I think intermittent fasting is fine for some and not fine for others. Now, the only thing I will do is 12 hours overnight. I don’t eat late at night. I don’t snack. 

As you know, I became a certified metabolic balance coach. The reason I did that was they said, “You do the program. You’re recording with us. You gotta learn.” Okay. I did, and I learned so much about what was going on with my insulin sensitivity right in the latter stages of perimenopause. Then I learned this isn’t suiting my body. 

Of course, I started to research my own genetics and predispositions for type 2 diabetes. I have quite a few. I don’t have a thyroid gland to boot. I really have to look at all the variables. 

I hope people don’t get confused by this. When you really tap into what makes sense for your body, you can thrive. No matter what, without a thyroid, with a thyroid that is maybe not working so great, but you can. 

Dr. Eric: 

I definitely agree. I love what you say about listening to your body. I’m sure there are people who are doing intermittent fasting and are thriving. There are also those who don’t feel good. Maybe they should eat at 7am and do a 12-hour fast. Stop eating at 6pm/7pm. We are not saying to eat at 10pm. 2-3 hours before going to bed, I would recommend not eating. If you’re hungry first thing in the morning or an hour after eating, I agree with you. 

No snacking. Even that, it’s different. I’m more with you. A lot of people snack for the sake of snacking. If someone is dealing with hypoglycemia, or if someone is hungry, that’s a sign that they are not getting enough protein. If you really feel like you need a snack, that’s not a different conversation because it is tied into this, but there could be a reason why some people feel like they need a snack in between meals. I think we’re on the same page.

Sandy: 

This was when I was 47 or 48. I’m getting close to menopause. Better start working out. I started working out. I would lift pretty heavy at times. Then I was very much into taking in a lot of protein. 

That’s the other thing. You hear a lot of these doctors saying, “You must have this much protein in every single meal,” or “this much per day,” or whatever. How can you say that? How can you say that when you have no idea what Sandy Kruse is doing? How can you say I need this much protein? That’s why I’m always about the balance. Yes, we need protein, but we need protein to suit our body and our needs and our lifestyle. I do think too much protein is not great for longevity. 

Dr. Eric: 

Like you said, it depends on the person. Hopefully everybody who is listening to this is on the more active side, exercising. Those who can do resistance training. Some might be healing and not ready for that yet. There is a time and place for more protein. But I agree. 

There are people who are not getting enough protein. On the other side, there are people who are overloading and struggling to get enough protein. There are different units of measurement, but experts talk about 1g of protein per lb of body weight. If someone weights 120lbs, which isn’t really heavy, they would need to eat 120g of protein. If someone is 180lbs, they would need to get 180g of protein, which is a lot of protein and not easy to do. 

Sandy: 

There are ways you can do that. I remember when I was working out more heavily, I would do amino acids. Not protein powder because we know a lot of protein powder has a lot of garbage. It is hard to find a really clean protein source.

You know what I am starting? Collagen. I am starting to take that every day. A big thing that happens to a lot of women when your estrogen starts to decline is you start to get a lot of these aches and pains and joint problems. You know this. Menopause can really trigger a lot of these not so great things that go on with the joints in your body. I am doing a collagen powder, but a very full spectrum collagen. 

Dr. Eric: 

Okay. Like a whole-body collagen? 

Sandy: 

You know the one I’m doing is Dr. Josh Axe’s Ancient Nutrition. I like it. 

Dr. Eric: 

I’m not familiar with the ingredients, but I know he has his bone broth powder. 

Sandy: 

Yeah, it’s clean, and he uses a marine collagen. He uses a bovine, very clean. He doesn’t use erythritol. I am not a fan of erythritol as a non-caloric sugar replacement. No thanks. 

Dr. Eric: 

Do you like any sugar substitutes, like stevia or monk fruit? 

Sandy: 

I think I have been damaged honestly. I used to be so robotic in everything I did, to be truthful. It never served me. When I was keto, I would only take in Swerve. Do you have that in the US? 

Dr. Eric: 

Doesn’t ring a bell.  

Sandy: 

It’s a mix of erythritol with other non-caloric sweeteners. Then I would take in erythritol. I don’t mind stevia. I don’t like monk fruit. I feel like a lot of these non-caloric sweeteners are more processed than just having- I prefer to use a raw organic coconut sugar. It’s better for your glycemic index. Less processing than erythritol. I know a lot of people like monk fruit, but my gut can’t take it. I think that’s the key. Sugar alcohol can kill you as it relates to the gut. It depends.

I remember I was baking. I can’t eat sugar, so I’d be baking almost every day. What am I going to bake today with erythritol? It wasn’t good for me. Now, I will use date sugar. I have used coconut sugar. I will use raw unpasteurized honey, or I will use pure organic maple syrup. Those are the things I will stick to.

Then if you need a granulated sugar, a raw turbinado sugar, something like that. That’s it. I’m not going to use all of the non-caloric stuff. It doesn’t make me feel good. Not that I eat a lot of sugar anyway.  

Dr. Eric: 

Makes sense. I agree with especially the honey and maple syrup in moderation. Not everybody, but for many people, good option. When I have green tea, herbal tea, I was guilty years ago of adding stevia to it. Now, I just have them plain. I don’t add anything. I don’t even add honey or maple syrup. I just have it like it is. 

Sandy: 

Me, too. If I have some sort of flu or something going on, then I will have a teaspoon of honey. Who cares? Sure. It will raise my blood sugar, but I won’t worry about it because my body needs it. 

Dr. Eric: 

There you go. Hopefully you don’t have to do that too often. 

Sandy: 

No. 

Dr. Eric: 

Before we wrap it up, I did want to ask you about spore-based probiotics, Akkermansia. I heard a conversation you had. I am more of a Lactobacillus/Bifidobacteria person as well. I am still skeptical a little bit with spore-based probiotics. 

As far as the research, there is more research with the Lactobacillus and Bifidobacterium. When someone is exclusively taking a spore-based probiotic, to me, it’s because they heard another practitioner but also the company hype them up, which I understand. If they sell them, I get it. It’s a business. 

I’d like to get your thoughts on spore-based probiotics as well as Akkermansia. There are now supplements available. I think it’s just one company that offers it. 

Sandy: 

Pendulum. 

Dr. Eric: 

Yep. 

Sandy: 

Here is the interesting thing about spore-based. I am born in Canada, but my parents are Croatian. They lived on the farms. My dad is going to be 88. We are talking old-school. My mom will be 79. I love to listen to their stories. How they grew up on the farm. What they did. How they lived. How they grew their crops. How they reared their animals. All that kind of stuff. I find it fascinating. it’s like looking at the blue zones and coming up with a modern way to live.

If you look at how farmers lived, sure, they would get spore- and soil-based probiotics. Usually, it would be entered through the air when they’re doing their farming. Maybe there would be some residue left on their produce. They’re not ingesting giant amounts of spore and soil-based probiotics normally. 

The way that I look at it, in my little brain, Eric, it doesn’t make logical sense to me. I don’t care about the company that is doing all these big advertisements. I truly don’t care. I look at what is logical to me. Maybe getting a little bit is okay. What do we have in our gut? What is it, a trillion different bacteria in our gut? Give me some of the human strain that I may be lacking because of the environment that I live in and maybe the food quality that I have access to. Give me some of the human.

The other thing is proliferation. From what I have researched on spore-based, they can really proliferate in the gut. 

Dr. Eric: 

Can they? I know the Lactobacillus and Bifido, you have to keep on taking them. 

Sandy: 

Right. But spore-based, I believe the research, and you can check on this because I am not definitively saying, pretty sure they can proliferate. Do I want that? Let’s look that up to confirm. I’m not 100% sure. 

Dr. Eric: 

I will do some research. 

Sandy: 

We all know the Lacto, Bifido, those are transient. I have done some research on L. reuteri though. Apparently there is more to come on L. reuteri. I don’t know if you have ever made your own yogurt. I tried, and it was a fail. I will try again. Some strains can proliferate, but a lot of these human strains that we are taking from the bottle don’t. They are transient. 

As for Akkermansia, I took it for a short period of time. It’s all in this marketing stuff. I have no loyalty to any of these supplement companies that we’re talking about. I took Akkermansia according to- I think it was a two-month protocol that I did. Some of the advertising that is out there saying it acts like a GLP1 and can help with your weight. I saw nothing, zero. Maybe there is other factors in there. We don’t know for sure. I saw nothing. 

The research that I did on Akkermansia is that you don’t want too much of it. It can actually do the opposite for your intestinal barrier that you want. 

Too much of anything, I’m like off of it. I did do a protocol. Have you heard of Vitract? It’s a gut test. 

Dr. Eric: 

I don’t think so.  

Sandy: 

I think they test for Akkermansia. I think the GI Map does, too. 

Dr. Eric: 

It does. 

Sandy: 

I do know that they often will recommend to test your gut for Akkermansia first. Too much isn’t good. What can I do? How about I eat fermented foods? My parents still ferment their own cabbage, like very old school, in a big barrel. They do it every winter. I just tell my mom to make me some cabbage rolls. It’s the best. 

So eat it. Preferably eat it. Eat prebiotics. Eat postbiotics. Eat probiotics. The way you do that is to eat a variety of foods. Then supplement with a human strain. That is very simple, but that is how I do it. 

Dr. Eric: 

There you go. I love it. Very helpful. We covered a lot of different topics here. Is there anything else I should have asked you that I didn’t ask you? Anything else you want to say before we wrap it up and tell people how to find out more about you? 

Sandy: 

I don’t know if you have a lot of female listeners, but it’d be useful. 

Dr. Eric: 

I do. 

Sandy: 

You do? We might have to do another episode on menopause when you have thyroid issues. I have done a ton of research. This will be too long for me to get into. We are talking about how estrogen affects the thyroid. I just came off a very hyperthyroid state, which I haven’t been in for so long, just because I took seven keto DHEA. It was recommended to me for cortisol regulation. There is a lot.

I think this was a good place to start. I think that people have to know that there is a way to come back. When you get in touch with your own body and go, “I don’t feel right,” you have to learn how to advocate for yourself. 

I am on four different thyroid meds. Three different thyroid meds, four different doses. I work with my endocrinologist just to make sure that my balance is optimized.

Dr. Eric: 

Makes sense. I didn’t ask you, or maybe you brought it up. Have you taken desiccated? 

Sandy: 

I am on it. 

Dr. Eric:

You said you have four different doses. T4, T3, and along with that, are you rotating that with desiccated? 

Sandy: 

I am on two different doses of T4, and it changes. Recently, it changed again because of the whole DHEA debacle. We won’t get into that here. Yes, I take two different Synthroid. I take Cytomel. I take a desiccated every day. 

Dr. Eric: 

Sounds like it’s working for you, which is great. You’re feeling better. I’m sure your numbers are looking a lot better. We will definitely have to get you back on the show to talk about menopause and share your story as well. Would love to have another conversation with you, Sandy. Thank you so much for being on.

If you could let others know where they could find you. You have your own podcast and also a Substack. 

Sandy: 

For my podcast, just go to SandyKruse.ca. There, you’ll find all the links to my podcast, where you can find it, where you can listen. My podcast is now over five years. It’s all about wellness as we age. It’s really body, mind, spirit, soul because I am a big believer that we are not robots, and we all need to understand our bodies better in order to age better. The goal is really how can we optimize that and try and not get one of these nasty diseases that a lot of people are getting in their midlife years? That’s my podcast. 

I am a writer as well. I released my essential thyroid guide last year. That was self-published on Amazon. It’s called The Essential Thyroid Guide. It is 100% not a clinical guide. It is a patient advocacy guide. It’s simplified, so you can understand all the factors that can affect your thyroid health.

I also have Substack, where I write a lot of short explorative essays, where you can think about things as they relate to your own health. You don’t make mistakes. I have made a lot of them by listening to all of these health gurus out there. You really need to decipher resonance for yourself. 

Dr. Eric: 

I agree. I told you before we started, I signed up for your Substack and listened to your podcast. I also was interviewed by you. Highly recommend the podcast, the Substack, and definitely check out her essential thyroid guide on Amazon. 

Again, thank you so much, Sandy. This was a great conversation. Really appreciate you sharing your journey with thyroid cancer. 

Sandy: 

Thank you so much, Eric. I really appreciate meeting you and you having me here today. 

Dr. Eric: 

Same here. The feeling definitely is mutual. 

Sandy: 

Thanks. 

Recently, I interviewed Jenny,  our thyroid health audit participant, who shares her journey with Hashimoto’s and secondary infertility, two challenges that often go hand in hand but are rarely talked about together. In this episode we discussed how addressing root causes, not just lab numbers—can open new possibilities for healing and conception, 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 Jenny here. She will talk a little bit about her health journey. How are you doing today, Jenny? 

Jenny: 

I’m doing well, thank you. Appreciate the opportunity to meet with you. 

Dr. Eric: 

Thank you as well for doing this. We were chatting a little bit before this, and you filled out the application I have everybody do, so I can get an idea of your health challenges. 

You were recently diagnosed with Hashimoto’s. The biggest challenge is dealing with infertility. Can you give a little bit of that background? When were you diagnosed with Hashimoto’s? As far as the infertility, you received IVF as well, so if you could talk about that. 

Jenny: 

Certainly. My spouse and I are navigating secondary infertility. We were able to have one child naturally. We went to try to have a second child and were not able to. After a while of trying, I had reached out to my OB to get some potential bloodwork done. They look at your ovarian reserve, your TSH, and something else. 

At that point, my TSH was in the normal range, but from my understanding, it was higher than what they wanted to see for somebody who was trying to conceive or pregnant. From what I learned, that range may not be the most accurate range in terms of TSH functioning. 

At that point, I was put on levothyroxine. I took that with hopes that maybe that would be the magic thing to get my TSH down, and then I could get pregnant. Unfortunately, that didn’t happen. 

We eventually got referred to a reproductive endocrinologist. At that point, we did a lot of bloodwork. Within that wasn’t a full thyroid panel, but it did include TSH again and TPO antibodies, which were high. That was a little over a year ago. 

No one told me, “You have Hashimoto’s.” No one said there was any concern with my thyroid. They just said something like, “There has been a little damage to your thyroid. That’s all. It’s unlikely that your thyroid is impacting your ability to conceive.” 

We continued to do interventions. We did several IUIs. They were unsuccessful. We went to do IVF as well. That was unsuccessful. That’s another topic, and it was really devastating. We realized we must be missing something. Something was off. 

I had done a lot of research on thyroid through this process. Was it worth introducing supplements, working to get rid of toxins, changing my diet, stress management. As you can imagine, it’s really hard when you’re doing IVF. “Don’t be stressed,” but it’s one of the most stressful things ever.

I met with an endocrinologist this summer. Pretty off the bat, she was like, “You have Hashimoto’s, mild hypothyroidism.” I also have a family history of this. My dad has Hashimoto’s. My paternal grandmother. I don’t know if she was diagnosed with Hashimoto’s, but there were issues with her thyroid. She had a goiter, so I’m pretty sure she had Hashimoto’s. 

Then I went into a deeper dive. I have to figure this out. What can I do to support my thyroid? Consulting with some of your work, some other folks and their work as well. 

Dr. Eric: 

When you did your research, is that how you came across me? Did you come across my website or book? 

Jenny: 

I came across your book and website around the time I did that initial bloodwork with my OB. They were talking about thyroid. I was like, “Okay.” My mission is to have a baby. I have to do everything I can. My dad pointed me in your direction. He has an extensive library of thyroid books and resources. 

Dr. Eric: 

Glad he found me and referred you to me. 

When they first tested TSH, sounded like it was within the lab range but higher than optimal. They didn’t look at thyroid hormones. They just put you on levothyroxine based on the TSH alone. Eventually, they retested the TSH. It sounds like they still didn’t do a full thyroid panel, just TSH and TPO antibodies. Then they saw the TPO antibodies were high. Do you know if they tested the TG antibodies, which are also associated with Hashimoto’s? 

Jenny: 

No, I don’t have any bloodwork for that. I haven’t had a full panel done. I had asked my endocrinologist about that and was met with just looking at the TSH and TPO antibodies. They didn’t feel like we needed to test T3 or T4. 

From some of my more recent research, and maybe this is a question with you, I am hoping to do a bit more advocacy for myself to try to get a full panel done. I feel like that would be helpful, even if they are not considering it on their side of things, just for me to have an understanding of where I’m at and with a strong desire to reduce my antibodies. 

Dr. Eric: 

When it comes to testing TG antibodies, I could understand why they’re not doing it. It won’t change their approach. They will give thyroid hormone replacement regardless, the levothyroxine. 

I think it is crazy for them not to look at thyroid hormones just because maybe you’re taking the levothyroxine, which is T4, but T4 has to convert into T3. It’s not always reflected with the TSH. The T4 influences the TSH more. For all we know, the T3 might be on the lower side, even if the TSH is looking better with levothyroxine. T3, being the active form of thyroid hormone, if that is on the lower side, that definitely can affect conception. 

If you can’t get it through your doctors, I would pay out of pocket. I realize you have already spent who knows how much money on the IVF. Depending on where you go, if you go to some walk-in labs, they might charge you over $100. If you shop around, you can get it for like $30-40, TSH, free T3, free T4. Not a full thyroid panel with antibodies, but at least a look at the thyroid hormones. 

Make sure that T3 is optimal. I do see a lot of people with Hashimoto’s where that T3 is on the lower side. Definitely want to look into that. 

Like I said, the TG antibodies, for the sake of what they do, I could understand not testing. Actually, on the podcast, I interviewed a few healthcare practitioners who talked about fertility. Based on my own research, too, when you have low thyroid, that could affect conception. The antibodies could also increase the likelihood of having a miscarriage. It doesn’t mean that you will have a miscarriage, so it’s nice to get those antibodies tested to see. 

Maybe you just have TPO antibodies, and TG antibodies look fine. If that’s the case, you won’t need to retest those again necessarily. If they’re both high, and the goal is to eventually normalize them, which is my goal when working with someone, then I would say it’s a good idea to retest. But test it first, since you haven’t tested it at all yet. 

The priority would be T3 and T4. Then same thing. If you had to, you could pay out of pocket for the TG antibodies as well. It’s unfortunate that most doctors, including endocrinologists, will just look at TSH. Some will do a TSH and T4. As I just mentioned, you do want to make sure you are converting T4 to T3. 

You might have heard of reverse T3, which sometimes can be helpful, too. Like I said, I realize you have already spent a lot of money. Reverse T3, some people really think highly of it. Everybody with Hashimoto’s should get reverse T3, they say. I do try to include it. 

To me, it wouldn’t be the priority. When we prioritize the blood test, TSH and thyroid hormones are the priority. Antibodies are important. Reverse T3, kind of on the back end. If you can get that done, great. If you can’t get that done, usually we could look at the other numbers and get a good idea of what’s going on. 

Jenny:

If my T3 is lower, the recommendation would be to shift what medication I am on? 

Dr. Eric: 

Yes. If you are having a problem converting T4 to T3, ultimately, you want to try to address the cause of the problem. While doing that, you might choose to take T3. 

There are a few different options. They probably would recommend synthetic T3, something like Cytomel. There is also desiccated thyroid. A lot of doctors aren’t big fans of that, especially during pregnancy. Things like Armour or NP Thyroid, which have T3, T4 as well as T1 and T2, which are less well known. They would probably recommend synthetic T3. 

Another option is compounded thyroid hormone. You go to a compound pharmacy and get T4 and T3. 

You would want to address the cause of the problem, too. Approximately 60% of the conversion from T4 to T3 takes place in the liver. Another 20% takes place in the gut. 

Sounds like you have already done some good things for your health, like working on diet. Stress also could affect that conversion. Having higher cortisol could impact the conversion of T4 to T3. If you have to take the T3 to help with the conception, that is fine. You want to ideally identify the cause of the conversion problem and then address it. 

Jenny: 

Certainly. That’s where I feel like I’m so close yet so far away at the same time with figuring out the root cause. My TPO antibodies went up by 400 over the last year. I thought I was doing all the stuff I needed to do to help support my thyroid. Granted, I was under a high level of stress. I was taking a lot of medication for infertility reasons. They were working to reduce inflammation, but I still had a lot of inflammation happening because of all of that. 

I was really disheartened when I asked to get my TPO antibodies rechecked recently and saw they had increased by 400. I was so hoping the opposite. 

Dr. Eric: 

It can be challenging to lower and normalize the antibodies. It’s not uncommon for them to rollercoaster back and forth, which can make it challenging. Let’s say you test antibodies again in a few months. If they decrease greatly, again, sometimes can be misleading. Obviously, that’s what we ultimately want to see. 

It sounds like something might be missing. Diet and lifestyle, very important. It’s a piece of the puzzle. If you have my book Hashimoto’s Triggers, there are a lot of triggers. Food is one. Stress is one. There are a lot more, too. It could sometimes take some extensive detective work, depending on the person. That’s the next question: Have you done any functional medicine testing at all? 

Jenny: 

No, I haven’t done any functional medicine testing. I’m interested in that. I was in such an urgency to have a child and wanting children close together and got pushed in a variety of directions into the more medical route. I do feel like that would be beneficial for me, and I’m hoping to do that. 

On my own, I have really worked on foods I’m eating or not eating. One big thing has been balancing my blood sugar. I was always super hangry, and that has gotten a lot better.

I am taking a lot of supplements. Some of that is good; some of it is frustrating. I don’t want to move through my life taking this many supplements. Some of them I don’t even know if they are doing anything or not. Either they were recommended for infertility reasons or suggested in some thyroid resources I found. 

I’ve had gut issues throughout my life. They’re a lot better now. I don’t experience that as frequently. I feel like I’ve had a lot of growth there. 

I have no idea how my liver is doing. I know the liver functioning is important, and there can be a lot of buildup there. I wonder about that. 

I feel like I’m going off from your initial question now about functional medicine. Here I am telling you all the things I am trying to do so far. I’ll stop here. 

Dr. Eric: 

No, that’s okay. Getting back to the liver. When you do a basic blood test, like a comprehensive metabolic panel or hepatic panel, they are looking at liver enzymes, AST, ALT, sometimes GGT. That doesn’t really look at the function of the liver. 

If those levels are low, that is what you want. If they’re higher, that means there is some type of damage. I see that more with my hyper patients when they are taking antithyroid medication for example. The levothyroxine wouldn’t do that. 

That doesn’t tell us how you’re detoxifying, what your toxic burden is. There is really not a great test to look at our toxic burden. You can do testing to look at heavy metals. You can do other tests to look at other types of environmental toxins. 

In that respect, I would say definitely do as much as you can to minimize your exposure to environmental toxins. Even without knowing levels of heavy metals and other environmental toxins, they might do liver detox, and that is hugely harmful. Sometimes, it can cause certain side effects, like die-off effects. 

The supplements, I definitely recommend supplements, but that is one reason I do testing. There are some general supplements, like omega-3 fatty acids, probiotics. Depends on the person. We want to do testing to see what imbalances someone has. My guess is you probably had at least some blood testing, like Vitamin D. I’d be surprised if they didn’t look at Vitamin D levels. 

Jenny: 

I did have Vitamin D. That’s fine. Vitamin D, iron, B12, magnesium. 

Dr. Eric: 

How did your iron look? Another challenge is hair loss, which could be related to the thyroid but also nutrient deficiencies. I don’t know if you remember your iron numbers. Like the thyroid, they might be within the lab range but outside of the optimal range. 

Jenny: 

I don’t have the specific numbers in mind, but I believe it was fine, within the lab range. I also had some resource that I was consulting, more functional medicine. It seemed like it fell in that range, so that wasn’t a concern.

My B12 was really high. 

Dr. Eric: 

I assume you’re not a vegetarian, that you eat meat? 

Jenny: 

Yeah, I do. 

Dr. Eric: 

If you ate a meal higher in B12, whether it was beef or something else the night before. If you are taking a B12 supplement, you probably are taking a prenatal? This has not only folate but B12. 

Jenny: 

Yes.  

Dr. Eric: 

I usually don’t get too concerned when I see B12 high. It is common on a blood test. When that is low, that could be an issue. When it’s high, it’s usually because you are getting exposed to it either through the diet or supplementation. 

There is another marker called methylmalonic acid, which is a better indicator of B12 status. Usually not tested by most doctors. That might be something to look into if you’re concerned about that.

With diet and lifestyle, what you’re doing as far as trying to eat a whole, healthy foods diet. 

The stress is huge. I know you’re doing things to manage your stress. I would continue on an everyday basis. That doesn’t mean that you have to spend an hour per day on stress management. Consistency is important. Just because some people will maybe do yoga 2-3 times a week, and that’s it. You really want to be in the routine of stress handling. 

How is your sleep at night? 

Jenny: 

My sleep is generally okay. That’s one of the areas that I’m more recently focusing on. I have to acknowledge, I didn’t sleep as great last night because I was nervous about this conversation and being recorded. I kept waking up thinking about what I was going to say. Generally, I can fall asleep fine. 

I do think with balancing my blood sugar, at least a piece of it has supported me in waking up not as groggy. I don’t know for sure. I think just energy-wise, I am feeling better. 

I do have a Fitbit that tracks my sleep. I always have a very high level of light sleep and not much deep sleep.  

Dr. Eric: 

Okay. A lot of light sleep and not enough deep sleep. That’s something to work on. You haven’t had your adrenals tested, I assume? 

Jenny: 

No. 

Dr. Eric: 

Also something to look at. There are a few options with that. Saliva testing is really good for looking at adrenals. 

A lot of functional medicine practitioners would recommend DUTCH testing, if you are familiar with that, for someone who is struggling with fertility. That looks at adrenals, sex hormones, and the metabolism of the hormones as well as some other things. That might be something in the future that you want to look into. Have you heard of DUTCH testing? 

Jenny: 

I’ve heard about it. I don’t know too much about it. The name is familiar to me. 

Dr. Eric: 

Especially if someone is focusing on fertility, most practitioners of functional medicine recommend a DUTCH test. Not everyone. Some might just recommend saliva testing for adrenals and testing sex hormones in the blood. The thing is, you can’t look at the metabolism of the hormones in the blood. Still, I can’t say the DUTCH test is absolutely necessary, but the more information you get, the better. I would look into that. 

You have already done some tests through the blood. You mentioned iron and B12 and magnesium. Magnesium in the blood, they often look at serum magnesium. RBC magnesium is better than that. Sometimes, you have to take what you get if you are running it through insurance. I understand that. 

You mentioned the gut. You said the gut used to be a big problem, but not as problematic. Maybe you don’t need to do gut testing, like a comprehensive stool panel. You could always start conservatively. It’s really up to you. Some women understandably, especially if they have gone through IVF and want to do everything they can- 

I tend to be on average more on the conservative side with the testing. Not to say that you need to spend thousands of dollars on functional medicine testing. In this situation, since you did have a history of gut issues, and you can’t always go by symptoms, you might want to dig a little bit deeper. If you do decide to do functional medicine testing, maybe consider the DUTCH and a comprehensive stool test. 

Jenny: 

I would be open to that. I wonder if there is something there still. It was so bad for a large chunk of my life. I am grateful that it’s better. Big impact on my life. That’s what prompted me to go- I have been gluten-free for 14 years. That was what helped me a lot. Still didn’t resolve it all, but it helped a lot. I would be interested in doing a comprehensive stool panel. 

Dr. Eric: 

I think the next steps: Continue with the diet. Gluten-free is great. I usually recommend paleo or autoimmune paleo for Hashimoto’s. If you are concerned about AIP being too restrictive, paleo is still pretty healthy. It eliminates the common allergens, the refined foods and sugars, unhealthy oils.

Stress management, we spoke about. Just continuing to work on sleep. Reducing your toxic burden. Trying to minimize cleaners, cosmetics in your home. Try to eat as organic as possible. 

The functional medicine testing. Just to fill in the gaps. If you feel like you have done everything from a diet and lifestyle standpoint. Maybe you haven’t. Maybe there is still some improvement in that area. Even if you have done 100%, you want to make sure that everything goes according to plan with conceiving. 

I would recommend doing the functional medicine testing. Some type of adrenal testing, maybe digging deeper and doing the DUTCH test, possibly a comprehensive stool panel. 

That would be your homework for things to work on. Hopefully, you give me an update in a few months with some really good news. It’s not easy. I know it’s very stressful, very emotional. Even for those who aren’t having fertility issues, taking a functional medicine approach and trying to lower and normalize antibodies usually is not an easy process. I commend you for doing what you’ve done so far. I definitely would look into the functional medicine testing and give me an update in the future. 

Jenny: 

Thank you. I will definitely look into the functional medicine testing. I hope there is a good update. At the very least, I want to be able to be the healthiest version of myself and reduce some of these other symptoms that I have. If there is a baby, that would be beautiful. I hope there is an update for you. 

Dr. Eric: 

Hopefully you get the best of both worlds. You optimize your health, and you give good news of pregnancy and having a healthy baby. 

The good news is that there are still things you can do. It’s not like you have exhausted everything. If you had said you had done all the functional medicine testing, even diet and lifestyle, there is room for improvement. I think you can continue to work on that. Consider functional medicine testing.

I’d like to be optimistic and confident that in a few months, you will shoot me an email with some good news. Definitely do so. Again, thank you so much for agreeing to do this audit, Jenny. 

Jenny: 

Of course. Thank you for your time and speaking with me. 

Dr. Eric: 

Thanks, everyone for taking the time to listen. I hope you found this conversation to be valuable. I look forward to catching everyone in the next episode.