Recently, I interviewed Julie Olson returns to talk through what’s really going on behind hair loss and the confusion around biotin. We get into why true biotin deficiency is rare, how high doses can interfere with other nutrients, and why it’s so important to step back and look at the bigger picture things like gut health, inflammation, toxin exposure, and hormone balance.  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 a return guest. Julie Olson is a triple-certified, evidence-based nutrition expert. She specializes in female hair loss, gut health, and gluten issues. Julie is known to skillfully investigate, discover, and communicate root cause resolutions to naturally regrow hair and regain health. 

With more than 10 years’ experience collaborating with functional and integrative practitioners along with her training in functional medicine, Julie has transformed over 700 women’s health and hair. She creates personalized health and hair rebuilding programs for clients that are realistic and sustainable for long-lasting results. This process empowers clients to take control of their own health. Julie’s program restores women’s luscious locks naturally by getting to the root causes of their health and hair loss, so they look and feel their very best. Welcome back, Julie. 

Julie Olson:

Thanks, Eric. That’s a little bit of an older bio. I didn’t realize you had that one, but it’s all good. 

Dr. Eric: 

I did ask you. You said in the email when we scheduled this that I already had your bio. The good thing is it said more than 10 years’ experience. Whether you have 15 or 20, it still applies. 

Also, this just happened. You have an abstract that’s been published in Integrative Medicine: A Clinician’s Journal on biotin supplementation, which we will be talking about. 

Let’s jump into that topic. I don’t know if you’d say biotin is very controversial in thyroid health because most people probably don’t think it’s controversial. Most people think biotin is something we take when we’re losing hair. There are people who are aware that it can interfere with lab results, not just thyroid labs, which we’ll talk about. 

Your research explains that it is controversial. Biotin, in the case of a deficiency, you might want to take possibly. So many people are just randomly taking biotin. Many of these people arguably don’t have a deficiency or don’t know if they have one because they haven’t tested for biotin. I’ll let you take over. How did it become one of the main supplements for hair loss? 

Julie: 

It earns its reputation from early case reports showing dramatic regrowth in cases with severe biotin deficiency. People with rare biotin deficiency is rare. It’s rare in developed countries. National Institute of Health says it’s very rare among individuals in general because you get biotin in your food every day. You get enough. The RDA is 30 mcg. They’re selling 10,000mcg. 

Let me tell you who gets a biotin deficiency. It’s a very rare genetic disorder called biotinase deficiency. Long-term antibiotic use or long-term TP independence, which is IV feeding. Antiseizure meds cause that deficiency. Alcoholism or liver disease. IBD as well. 

Dr. Eric: 

Crohn’s or ulcerative colitis? 

Julie: 

Yes. You can see it’s few and far between when people have a deficiency. Taking too much causes a plethora of problems. Do you want me to go into that? 

Dr. Eric: 

Yeah, let’s talk about what too much is. How much is too much? What problems can taking too much cause? 

Julie: 

Anything over 4,000mcg. Keep in mind, it is a B vitamin. People think, “I can just pee it out. It’s not fat soluble.” Taking too much does cause a toxic reaction. There are safety measures. It gets the body out of balance with nutrient interactions and deficiency. It interferes with the absorption of B5, B6, B12, alpha lipoic acid, and ferritin, if it’s iron. It can cause metabolic disruption, kidney and liver strain. It can alter glucose metabolism. It can exasperate hyperglycemia in diabetics. It can mask important regulatory mechanisms that can potentially cause stress on the kidney and liver function. 

Interesting that it’s marketed as a beauty vitamin. Early case studies. The beauty industry just ran with it, like they do with other things. Biotin does trigger skin problems in some people. High doses provoke acne, cystic acne even. I even had a client where that happened to herself and her cousin. Allergic reactions and rashes. It also disrupts the dysbiosis and skin microbiome at high doses. 

For instance, Costco is selling 10,000mcg of biotin. No one would know that’s 300x the daily requirement. 

It also interferes with over 200 lab tests, including labs for thyroid markers. Do you want me to run through some of those? 

Dr. Eric: 

Yeah, let’s talk about the tests. You can run through them first. I also want to know how much biotin does it take to interfere with the results? If someone is taking a biotin supplement or a multivitamin with biotin, should they stop taking it a few days or a week before? Let’s talk about that, too. Whatever order you want. 

Julie: 

Sure. You want to stop 5-7 days before taking any labs. Not only thyroid labs, but it interferes with these other lab markers. Vitamin D, 25 hydroxy Vitamin D, estradiol (the E2 test), folate, progesterone, testosterone, thyroxine, T3, B12, insulin, anti-HAV IgM, cancer antigen, creatine kinase. This is on my website on a blog. 

Dr. Eric: 

We can add a link to this. 

Julie: 

FSH, ferritin, HCG, agglutinizing hormone, NT-proBNP, prolactin, prostate specific antigen (PSA), thyroglobulin (TG), troponin, which is a marker for cardiovascular. 

Dr. Eric: 

Probably should have just asked you which markers does it not interfere with. That may have been a quicker list. It interferes with a lot of labs and markers. You said to stop 5-7 days prior. Is that at any dose? If someone is taking a B complex that has 400mcg of biotin, for example, should they stop taking biotin for 5-7 days? 

Julie: 

I think to be safe. From all the literature I’ve gone through, that would be the safest way to get the best test result. 

Dr. Eric: 

Regardless of if they are taking higher doses separately versus lower amounts in a B complex or multivitamin, you would say to play it safe, to get it out of your system. I didn’t realize it could cause liver and kidney strain. 

Julie: 

Yeah. 

Dr. Eric: 

I would imagine that’s at really high doses, right? 

Julie: 

Yeah. I was surprised when I got to researching this. I know we talked about it years before I even researched it. Once I dove in, it was just alarming. That’s why I wanted to talk to you and your audience about it. Don’t waste your money. It does more harm than good, taking so much biotin. 

Dr. Eric: 

What would you say to someone who is taking biotin, and they swear it’s helped with their hair? Does that mean they were one of the rare ones who had a deficiency? Could there be another reason?  

Julie: 

Good question. Probably some of the precursors got into better balance. They grew some hair. Some of the other nutrients for hair, like amino acids, zinc, iron, those cofactors properly. It helps grow their hair. That’s why they see the baby hairs. 

Dr. Eric: 

I’ll be honest. I don’t test for biotin. Some of the tests that we both do have biotin markers. I know you do an organic acids test, which has metabolites for biotin. If it’s elevated, typically one has a biotin deficiency. Do you do DUTCH testing? 

Julie: 

Yes. I do NutrEval, which tests biotin. 

Dr. Eric: 

Are those your go-tos? Do you ever test for biotin in the blood? 

Julie: 

No, not in the blood normally. I use the blood test version and the urine version of the NutrEval. It will look at it both ways. Doing other labs to see where their inflammation is, where their deficiencies are, where their toxins are. 

I mentioned to you before, with your specialty, there is a lot of causes, but the five root cause categories I have put hair loss into are inflammatory, hormonal, gut, which includes nutrition, toxins, and stress. I make sure that we remove any of those, especially stress and toxins, before even going further and trying to repair their gut. First, getting out all the toxins and stressors. Sometimes, it’s not in their body; it’s in their environment. It takes a long time. Some people get frustrated. 

Dr. Eric: 

Definitely a work in progress with both stress and toxins. We are always dealing with stressors. We are always dealing with toxins and toxicants. You’re right.

You mentioned toxins. I always think about reducing toxic load, things like cosmetics and cleaning products. Some of these cosmetics, getting back to biotin. The shampoos, don’t they have biotin in them, too? Should someone look at their hair products and also- 

Julie: 

There’s not enough in shampoo.

Dr. Eric: 

To affect the labs? I just wanted to make sure. If they are taking it in other ways, it’s mainly orally that is a concern. Good to know. 

You mentioned some other testing in general, not just for biotin. When someone is dealing with hair loss, you take that root cause approach and look at all the different things you mentioned, starting with stress and toxins, but also inflammation, gut health, and hormones. Thyroid hormone imbalances can cause hair loss. Too much thyroid, too little thyroid hormone can cause it. 

Are there certain tests you do from a functional medicine perspective in everybody? Do you do a comprehensive stool test on everyone, an organic acids test on everyone? Does it depend on the person, their health history? The NutrEval, you also mentioned. I’d like to know what tests you do on everyone, or at least most of the clients you work with. 

Julie: 

Good question. I do have my favorites, which you just mentioned. It depends on the individual and their budget. 

Dr. Eric: 

If someone can only afford one functional medicine test? 

Julie: 

It would be a tossup between the GI Map and NutrEval, depending on how they present. 

Dr. Eric: 

That’s what I wanted to hear. You have to dive into their health history and see. If they have a lot of gut issues, maybe the GI Map. They could show a lot on the NutrEval, too, because that looks at some dysbiosis markers and yeast. That’s why you have to look carefully at the health history and determine what testing. 

Do you do any SIBO testing? 

Julie: 

If they present, yeah. I’ll do it if they think they need it. 

Dr. Eric: 

Do you also do, if necessary, mycotoxin testing? Cool. We do a lot of the same tests. I’m like you, too. If money wasn’t an issue, let’s do all of them. Obviously, finances is still an issue. Even if it isn’t an issue, it’s like you can’t afford everything. In that case, I want to make sure to do the priority tests. If someone absolutely insists on doing more testing I recommend, that’s up to them. Usually, it’s more the opposite, where someone might only be able to afford one or two, and you have to pick and choose.

Are there any common findings you see with your hair loss patients with some of these tests, like the GI Map for example? Any of these functional medicine tests. 

Julie: 

I see a lot of the Streptococcus elevated. That is a potential pathogen. It’s a bacteria that can- 

Dr. Eric: 

Opportunistic.  

Julie: 

Yes. I see that in almost everyone I test. I see a fair amount of H-pylori. Of course, inflammation in the gut. Low elastase. If I do the zonulin marker, that’s often elevated. Beta glucuronidase. A lot of dysbiosis. Low Akkermansia. Is that what you’re finding? 

Dr. Eric: 

Streptococcus, I agree. Most of my patients, when they do a GI Map, usually that shows up. Akkermansia is pretty commonly lower or less than detectable limits. The pancreatic elastase. Beta glucuronidase, it depends. Definitely more than 50% show low pancreatic elastase. Probably low Akkermansia. Definitely the elevated Streptococcus. I would probably say less than 50% of my patient base has elevated Beta glucuronidase. I wouldn’t say it’s like most of the people I work with. Secretory IgA is one that is commonly low. Sometimes high, but many times, low. 

Julie: 

Oh okay. More times low with you? Okay. 

Dr. Eric: 

Yeah. Probably 80% of the time, it’s on the lower side. Sometimes- You see a lot of elevated secretory IgA? 

Julie: 

Yeah. I see low, too. I equate that to they live in a paper thin house. They have no walls. 

Dr. Eric: 

Exactly. The mucosa, yeah. H-pylori, that’s definitely common. The GI Map is different than other tests. Most other tests just say you’re positive or negative. That uses a quantitative PCR, so it puts a numerical value on it. I find most people at least have it. It’s not always elevated. Most of the time, it’s detectable. Sometimes, not detectable at all. 

Interesting test. I like the GI Effects from Genovva, too. I do the GI Map more frequently. 

Those are the main factors when looking at hair loss. I was going to ask if there was anything else, any other nutrient deficiencies tie into what we’re talking about. Gut health. Toxic burden using up more nutrients. 

Julie: 

Parasites. 

Dr. Eric: 

Exactly. We are talking about Elizabeth Yarnell. Shoutout to her. She was on the podcast talking about parasites in the past. That’s one thing with the GI Map. I’m glad you brought that up. You and I like GI Map. If we ask Elizabeth, she would be like, “No, why test for parasites? They’re not completely accurate,” which I agree. They’re not perfect. 

Julie: 

I agree. 

Dr. Eric: 

Her argument is you can have parasites elsewhere: in the brain, other areas of the body, not just in the gut. For our purpose, we are focusing on the gut here. 

I will say GI Map, I can’t say 90% of people I test for GI Map come out positive for parasites. When it’s negative, you can only go with the findings. If the person still has symptoms, maybe do further investigation. There are other companies like ParaWellness that focus more on parasites. 

It’s interesting how different practitioners test. Some would not do the GI Map at all or any other stool test. We have a similar approach. They’re not perfect, the testing. Guessing is not perfect either. Just saying, “Let’s assume everyone has H-pylori or parasites or elevated Beta glucuronidase,” we want to try to get as much information as we can from the tests. 

Everyone has a different approach. Different people have success taking different approaches. It’s not to criticize other approaches, but it’s nice to speak with someone who shares the same perspective when it comes to doing these tests. 

Julie: 

From my experience, for my first six years, I was a nutritionist for National Grocers, a national health food store with 250 stores nationwide. I couldn’t give labs. It’s so much easier for the client and the provider to say, “Look, you do have a gluten problem. Look, you do have parasites.” Instead of saying, “You have all the symptoms for it.” I get better compliance. “Look here. You do have dysbiosis. You do have H-pylori.” 

Dr. Eric: 

Yeah, that’s an excellent point. I test adrenals also. I like adrenal testing. We can make the argument that most people have adrenal issues. Stress is a big problem. 

When I dealt with Graves’, and I have told this story a number of times on the podcast, but for those who haven’t heard this story, my adrenals were in the tank. Everything was low. Cortisol, DHEA, secretory IgA. I was very surprised, not because I didn’t think stress was an issue, but I thought I did a good job of managing stress. I convinced myself that I knew stress was a factor, but I was doing a good job of managing it. 

Back then, I did an adrenal saliva test. If I didn’t do that test, maybe I wouldn’t have recovered, just because I needed to see how bad my adrenals were to really take action and block out time for stress management. I took some supplements to support adrenals. Then I retested. That was also equally important in my case because everything was low. A few months later, I retested and saw the improvements. 

You’re right. It’s not to say you have to do every single test out there. If you don’t do any tests, then you could go by symptoms. Some people will get better that way maybe. If not, what direction are you going to go? 

I think it’s fair to say try to do everything you can from a diet and lifestyle perspective. You could give up gluten even without doing testing to see if you’re sensitive to gluten. Even if you’re not sensitive to gluten, you should give up gluten because it has other effects, like on permeability of the gut.

I agree with you. Seeing usually leads to better compliance. 

Julie: 

In the long run, they’re going to also be able to retest and see the improvements. That can be helpful, too. 

Dr. Eric: 

Exactly. With hair growth, what are realistic expectations? Someone is losing a lot of hair. You find a number of different factors. Maybe there is some hormone imbalances going on, but there are also some gut issues. It’s multifactorial, like hair loss. 

It’s different with men than women. Most of the people I work with are women. It could be distressing when they lose a lot of hair. What’s a realistic expectation as far as stopping hair loss and growing hair back? I know every case is different. You can’t say in every situation, it will be six months. But it takes time. It’s not three weeks, and their hair loss will stop and grow back.

Julie: 

Yeah. I did have a client who grew her hair back in three months. You could really see it. Some other women, more have more. The diffusive thinning and maybe some bald spots where you can hide it and so forth. 

The usual time is minimum of six months. Maybe a year or even more. Some women get really tied up because if you’re losing more than 100-150 hairs a day, day after day, month after month, as I was, and then it got so bad you could see my scalp as clear as day. This was when I was 38 years old. I’m 62 now. 

A lot of women get stressed just with losing very little. They send me pictures. You can’t stress about that. That’s normal. My hairdresser said it’s normal to lose that amount every day, and it is. It is normal to lose hair. You do lose hair every single day. 

When women have longer hair, it looks like more. You also lose hair with the seasons changing. I guess I’m answering your question the long way, but those are the time frames. 

Dr. Eric: 

It could take a year or longer to fully grow it back? The hope is that women will start seeing results well before then. Not that it would take a year to see the changes that are taking place, but to really get back to where they once were, where their hair once was. 

I’m sure you have this question from people working with you. “I came across this product.” An example is Nutrafol or another hair loss supplement. Forget about the biotin. There are other things out there. I forget if Nutrafol has biotin. I know it has other things. Regardless, when someone brings up Nutrafol or another hair loss supplement, and they ask if they should give this a try to see if it will help assist in hair growth. 

Julie: 

Yeah, sure, if you want to try it. It’s not the magic bullet. If it was the magic bullet, everyone would take a hair supplement, and their hair would grow. I turn around every day, and someone else has a new hair supplement. 

I won’t call out Nutrafol because I used to partner with them. They got bought out by Unilever. That’s why you see ads everywhere. They are produced and created in China. They have this proprietary blend. I was not comfortable with it. I’m sure it can do some good. It’s really expensive. 

If you don’t get to the root cause of the hair loss, and you start piling on- That’s what women do. That’s what I did. You pile on supplements. You use products and do procedures. If your gut is a mess, or if you have toxins, you won’t absorb those supplements anyway. Maybe a little, so they will help a little bit. It’s like picking a scab and not letting it heal. If we just start layering on a bunch of supplements before you clear out the noise, the stressors, the toxins. 

What I have come up with, and I want to ask you, are mercury fillings. I have a gal I just started working with, and she had a hair transplant. It only works for a couple years. Only 49% of hair transplants work long-term. 

Anyway, she has mercury fillings. I prefer to get those removed before you start detoxing. Alpha lipoic acid, it will make it worse. Some of the detox nutrients make you sicker if you start detoxing someone with those mercury fillings. What’s your take on that? 

Dr. Eric: 

In a perfect world, I agree. If you have mercury amalgams, you would want to get those out asap by a biological dentist or someone who is taking proper precautions, not your general dentist, who probably won’t take proper precautions. I can’t say all my patients do that, or even most. 

I say this. Mercury definitely can be a trigger for autoimmunity. It could even affect permeability of the gut, which I didn’t realize until a few years ago doing some research. I knew it was bad. So many things affect the gut microbiome. Didn’t know that was one that affects the intestinal barrier. We know mercury is not good. 

I will say that a lot of people I work with have restored their health, even with the mercury amalgams. It’s not like it’s always preventing them from restoring their health. 

But I only had one mercury amalgam, and I got it removed. I also had a root canal, which I got extracted and replaced it with a ceramic implant. Root canals are more controversial. We know for sure mercury is a toxin. 

We could have another discussion on root canals. With mercury, I would agree. For an optimal health perspective, yes, you need to remove it. Even in some cases, there will be some people who don’t remove mercury amalgams. They are hitting that roadblock, where their antibodies aren’t normalizing, and they will remove mercury amalgams. That will be the missing piece of the puzzle. 

I haven’t seen that with root canals. I have had patients remove root canals in an attempt to lower antibodies. So far, I haven’t seen that. It’s a small sample size. I can’t say I’ve had hundreds of patients remove their root canals. Mercury, I have seen have that effect. 

I have also seen people normalize antibodies even when keeping mercury amalgams. It doesn’t mean they weren’t doing any harm. It just means it wasn’t creating an immune response, not to the extent where it was affecting those antibodies.

From a detox standpoint, you do want to be careful. If you’re detoxifying, the first thing you need to try to do is minimize your exposure to those environmental toxins. If you have mercury amalgams already, you are constantly being exposed to mercury. In a perfect world, you would want to remove them. 

Not everybody is in a situation where they’re ready to do that, financially, because it is more expensive. If someone has eight mercury amalgams, and they will get them done by a biological dentist, it will cause thousands of dollars to get it done. They won’t want to do all eight at the same time. This is an extreme example. 

If someone has two mercury amalgams, that’s more reasonable. We can make the argument that they should ideally remove the mercury amalgams before improving their health. 

In the case of a Graves’ patient, they might get into remission without removing them. In your case, with someone with hair loss, they might be able to stop hair loss, grow it back, even if they keep their mercury amalgams. If they don’t, time wasted and money spent when they could have done it in the first place. 

I do agree with you. Not everybody ends up removing them. I would like to think even those who don’t remove them and get good results will still consider removing them in the future.  

Julie: 

Agreed. Maybe they’re not having problems with the mercury now. According to the research, it’s just a matter of time. You might as well do it now. 

Dr. Eric: 

Agreed. In my situation, I only had one, which I thought I had more. That’s the thing. I had multiple fillings when I was younger. For whatever reason, and I did go to multiple dentists. Apparently, only one of them- I have been going to biological dentists for a number of years. This is my second or third biological dentist. Like I said, I thought I had multiple years ago. I was told I just had one. No complaints. I was glad I had just one. 

Like I said, I had a root canal as well. That was more controversial. Wasn’t an easy decision honestly. I am not a big fan of root canals. The location. I just decided to get the root canal removed. Got the implant done. 

Honestly, the implant, at least in my situation, I don’t want to say it was easy peasy. When I got the tooth extracted, I waited almost a year before getting that implant. I wasn’t fearful of the implant. I had extractions. I had a root canal done. I’ve had different dental procedures. I heard some nightmare situations with implants. After I got it, I wish I would have done it sooner. Sorry to go off. 

Julie: 

It’s interesting. I had eight. 

Dr. Eric: 

Mercury amalgams or root canals? 

Julie: 

Mercury amalgams. 

Dr. Eric: 

I assume you have none now. 

Julie: 

None now. I found a biological dentist here in Denver who used insurance. I got lucky. 

I had some decavitations done by Dr. Nunnally in Marble Falls, TX. That’s all he does all day. Takes out mercury and decavitations. People come to him from all over the world. I refer my clients to him. They have a whole system that is not expensive. It’s three times less than some of the biological dentists here in Denver. That’s all they do. 

Dr. Eric: 

Sounds like a no-brainer. Since you’re saving money, get a ticket to TX if you don’t live there already. Maybe stay a night. I imagine for that mercury removal, you could probably go home same day if you really wanted to. 

Julie: 

No, you have to stay the night. You have a special hotel rate. They serve really clean gluten-free, dairy-free soup. 

I have sent some women to him. It’s still a hard sell. Women don’t understand what their mercury has to do with their hair loss. 

Dr. Eric: 

How about gluten? How firm are you when it comes to people avoiding gluten? “You absolutely must avoid gluten if you work with me?” 

Julie: 

I test them on it. I can say you need to get off gluten until you’re blue in the face. When I worked as a nutritionist for Natural Grocers, I gave gluten-free testing fairs. Still some people would get off of it for a while. 

Dr. Eric: 

What do you test for? 

Julie: 

It didn’t matter. I do food sensitivity testing for it. When I can see it, and they can see it, they have a sensitivity. Some people are even Celiac and don’t know it because there’s silent Celiac. I test for it. 

Dr. Eric: 

You’re not just testing for gluten? You’re doing a food sensitivity panel that looks at gluten? 

Julie: 

Yeah. 

Dr. Eric: 

Maybe it’s rare, but what do you say if someone comes back negative for gluten? 

Julie: 

I still tell them that I’m the wrong person to talk to because I don’t think anybody should be eating gluten. I’m not as adamant about it if they test negative. 

Dr. Eric: 

This is where we differ. I can’t say I do food sensitivity testing on most people. The saliva test I recommend for adrenals. I recommend the Adrenal Stress Index from Diagnostics, and they look at gliadin. Gliadin is a gluten marker. Some people test positive. I can’t say that most people have an elevated gliadin. I don’t do the saliva test for gliadin. It just happens to be on there. If they test positive, obviously, I point that out and tell them to avoid gluten because they’re reacting. 

Even if they’re negative, it’s not just about the sensitivity. It is also how it affects their gut. There is proof that it increases gut permeability, causes a leaky gut. If you do food sensitivity testing, and you test positive for gluten, that’s strong evidence that you want to avoid it long-term. Even if it’s negative, maybe you’re not reacting to it, but it doesn’t mean it’s not hurting you in other ways. Avoid it. 

Julie: 

They test for that, the anti-gliadin on the GI Map. 

Dr. Eric: 

True. I don’t know how accurate that is. Most people who do that test test negative. 

What I was going to say, and this is important. A lot of people, when they work with me, they are already gluten-free. It will be negative if they have been avoiding gluten for a few months. It’s negative because they aren’t producing the antibodies for gluten. 

If someone does a GI Map or food sensitivity testing- you do the IgG, right? You spoke about it before. Regardless, it doesn’t matter which test it is. If they have been gluten-free for three months or longer, we don’t know if they will react to gluten. Even if they have Celiac, if you avoid gluten for three months or longer, you won’t produce the antibodies. 

I pretty much recommend everybody avoid gluten. Doesn’t mean that 100% will do that. Some people will do it 95%. You have to tell them even some small amounts of gluten, even once a week, it might be enough not to heal the gut. 

It’s one thing if someone has a healthy gut already. Maybe they can withstand gluten every now and then. If someone is trying to heal their gut, and they are eating gluten once or twice a week, it might be enough to prevent their gut from healing. 

Julie: 

The fingernail amount of gluten creates the same damage, same result, reaction. I certified through Dr. Tom O’Brien’s Gluten Free Practitioner program. 

Dr. Eric: 

Yep. 

Julie: 

I have all these case studies. He said a fraction of a fingernail of gluten causes the same response. It’s all or nothing with gluten, whereas with other food sensitivities, not so much. Unfortunately. 

Dr. Eric: 

Agreed. This has been a great conversation. Before we wrap up, anything else you want to say? Any last words for those who have been struggling with hair loss for a while? Tried some things on their own. Maybe worked with a practitioner. What would be some next steps to take? 

Julie: 

Don’t fall for marketing myths. Test, don’t guess. Always look for the root cause instead of reaching for the next supplement. Your hair is speaking to you. Your hair is not the problem. Listen to it. Be grateful that it’s giving you some symptoms and clues that you need to dig deeper. 

Dr. Eric: 

Wonderful. Julie, where can people find out more about you? 

Julie: 

They can go to my website, FortitudeFunctionalNutrition.com. Search my name, JulieOlson.com, and it goes there, too. My social media handles are JulieOlsonFN, for Functional Nutritionist. 

Dr. Eric: 

Awesome. Thanks so much. This was really great. We spoke a lot about biotin initially and hair loss. We spoke about other things. Everything was tied into hair loss. Testing, mercury amalgams, all of this is important. If you have increased toxic burden, unhealthy gut, nutrient deficiencies, which can be related to the things we just mentioned, all this ties in together. 

Julie: 

If I could add. I have an updated quiz on my website. It looks for those five root cause categories. The quiz scores you. Is your highest burden hormonal? Is it inflammatory? Is it toxins? If the y go to my website, they can take that free quiz. 

Dr. Eric: 

Wonderful. Another reason to visit Julie’s website. Julie, this was great. Glad to have you back. I’m sure we’ll have you back again in the future. 

Julie: 

Thank you, Eric. It’s always great talking to you. I appreciate you being here. Thanks so much. 

Dr. Eric: 

Agreed. Take care. 

Julie: 

You, too.

***

Dr. Eric: 

Great having Julie back on the podcast, talking a little bit more about biotin. She mentioned how you want to stop biotin before all blood tests. Not that it can affect every single blood marker, but she named a lot of different blood markers. Not just doing a thyroid test.

She said wait at least 5-7 days no matter what form and dosage, even if you are taking it as part of a B complex or multivitamin. If you’re taking a low dose, I don’t know if you have to wait a full week. Some sources say 3-5 days for a lower dose. Maybe to play it safe, five days.

Also spoke about biotin’s effects on the liver and kidney. High dose biotin might put stress on the liver and kidneys, which I didn’t know. Most of the B vitamins are safe. B6, you want to be careful about high doses. Biotin, I didn’t know. 

We also had a conversation about removing mercury amalgams. I’m not sure if she recommends for everyone to remove them. I think it’s a good idea. Usually, I bring it up. I just learned over the years that most people aren’t, unless I say you absolutely have to remove them to get into remission. I haven’t found that to be the case. 

From an optimal health perspective, you want to remove all your mercury amalgams. I only had one, and I thought I had more but was told by biological dentists I just had one. Got that removed. If I had more, I would have gotten the other ones removed. 

I know some people are not in a financial position to do that. Like I said, if it was absolutely necessary for people with Graves’ and Hashimoto’s to get into remission, I would recommend it. In some cases, people might not choose to. Their thyroid antibodies aren’t normalizing, so we find that it is related to the mercury. 

When detoxifying, which she also brought up, you want to be careful. You could still detox with amalgams, but there is controversy when using agents that potentially could chelate not just synthetic chelators like DMSA or DMPS or maybe alpha lipoic acid potentially. In a perfect world, you would want to remove amalgams before detoxing. 

Of course, not everybody is in a position to remove those amalgams. If you have them, eventually you do remove them hopefully, but you want to make sure you go to a biological dentist or someone who takes proper precautions. To search for one, visit IAOMT.org, which is the International Academy of Oral and Medicine Toxicology. 

Testing versus guessing. We both like to do functional medicine testing. I brought up Elizabeth Yarnell. We both know her. Both are in Colorado, so they know each other well. Elizabeth has been on the podcast a few times.

One thing I didn’t mention is Elizabeth does like MRT. It’s not like she likes no testing. She is a big proponent of MRT, which is a food sensitivity test. 

When it comes to parasites, she doesn’t like to do stool testing because they are not 100% accurate. She is also not just trying to treat parasites in the gut but in other areas of the body. 

Testing for gluten. She uses food sensitivity testing. She doesn’t use MRT. I remember her telling me in the past she uses an IgG test to determine if someone has other food sensitivities. She uses it for gluten, too. 

Not a big fan of food sensitivity tests, which you know if you listen regularly. I usually recommend an elimination diet. 

If someone is hitting a roadblock, it’s something I’ll consider. If someone insists on doing food sensitivity testing, sure. But it’s not something I recommend for most people.

After our conversation, I did ask her about hair dyes. I didn’t want to put her on the spot because I didn’t know if she dyed her hair, which I told her. I assume if she did, she would use something natural. I’m not a hair dye expert or hair coloring expert. 

She said she uses a washout dye, which has very little peroxide. It sounds like she is using a little bit of hair dye, minimally. 

I asked about henna because that is more of a natural alternative. She used it, and it dried out her hair. It sounds like there is no great alternatives for hair dyes, which I was trying to figure out. She said herself she uses a washout dye. She uses little peroxide. It sounds like it’s not a perfect solution. There probably isn’t a perfect solution out there. 

Anyway, that’s all I wanted to cover here. Always great to catch up with Julie and talk about hair loss. If you’re experiencing hair loss, check out her website and resources. 

Hope you found our conversation to be valuable. Appreciate you listening. Of course, look forward to catching you in the next episode. 

Recently, I interviewed Dr. Ben Weitz, who fractured his femur and was told it might never heal, he turned to the same principles he’s used with patients for decades: ‘root cause, functional medicine’ thinking. In this conversation, he shares how he designed a bone-healing protocol that combined targeted nutrition, vitamin K2 and vitamin D optimization, growth factors, and the right kind of exercise stimulus.  If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Welcome back to the podcast! 

Dr. Ben Weitz: 

Thank you so much, Eric. I wanted to talk about my health crisis. I think it’s interesting that a lot of people in the functional medicine world, including yourself, who got into functional medicine, partially because you had your own health crisis in your case with hyperthyroidism. I have spoken to a lot of other functional medicine practitioners who had stories about their health crisis. I’ve gone to discussions about how to be a good speaker and how to tell your story. I always felt like I didn’t have that health crisis. I was always generally somewhat healthy. Never necessarily ate healthy, did the wrong things, but never had a health crisis. 

Now, I’ve had my health crisis. On Halloween 2023, I was in my home with socks on on a wood floor. I was handing out Halloween candy. I had a bowl of Halloween candy in my right hand. My dog who is very energetic, I had his leash around my left arm. My dog pulled, my leg slid, I went down on my hip, and I fractured my femur. It was an emergency situation. I was taken to the ER. The next day, I had surgery to repair my proximal femur. They put two steel rods inside. It was a whole thing.

I started doing rehab. It’s my nature to be very much into exercise. I’m very aggressive with rehab. Initially, they talked me into going into this rehab place that they said was very aggressive. I was going to get 3-4 sessions a day. Of course, it didn’t quite work out that way. I didn’t stay in there too long. I think I was in there for four days. I decided to go home and do my own rehab. 

About a week after the hospital, I was in Gold’s Gym with my walker. I had a PT coming to the house. I started doing even more research on bone health. What I knew already, even though I had done several episodes about osteoporosis and had looked into medications, supplements, diet, lifestyle, and exercise factors related to bone density, I now had a renewed interest in making sure my femur could heal. 

I started taking high-dose Vitamin K2, the MK4 version. I got my Vitamin D levels up to the 60-80 level. I added boron, calcium magnesium. I even did some strong DM citrate. I was taking collagen, glucosamine. I was making sure I was eating foods that would be beneficial for bone. I addressed my microbiome with probiotics and prebiotics and fermented foods. 

Unfortunately, it wasn’t healing the way it was supposed to. I kept going in for an X-ray every month. There was a gap. 

What was supposed to happen is after the surgery, the two parts of the bone are supposed to be flush against each other. In my case, after the surgery, there was a gap. It was difficult for the body to bridge that gap with new bone. 

At some point, after about three months, I got a CAT scan. It showed that there was some fibrous healing, but there was still no bone. There was this gap where the bone was just not forming. 

After four months, it was termed a non-union, meaning that it was not going to heal statistically. I sought advice from several orthopedic surgeons, both of whom recommended that I get revision surgery. That means the two steel rods I have right now in my femur crisscross and are inside the femur. I can’t really feel them. It was a good surgery, but they recommended they pull those rods out, which would not be an easy thing. The bone I’m sure is already formed around them. They probably have to chisel them out. After that, I would have a hole in my femur. Unlike a construction project, they can’t fill it in with cement. 

Then they recommended this revision procedure, where I have a rod down the outside of my femur and screws all the way down. I decided there was no way I was going to do that. I had this one prominent orthopedic surgeon say, “You need to do this revision surgery.” I said, “I’m not doing it. I have made some improvements. There is some fibrous tissue that’s been forming.”

 The question is, is fibrous tissue a precursor for bone to form? Or is it potentially in the way? I talked to several doctors about that. A friend of mine is the head of physical therapy at USC, and he said it’s a good thing I had fibrous tissue. The collagen is the basis for bone formation. The body is trying to bridge the gap with fibrous tissue, so it can turn it into bone. 

Some of the other doctors said when you have a non-union, the fibrous tissue is in the way, so we have to scrape it out and shove the bones together again. 

I decided to come up with a plan to get my femur to heal without getting another surgery. Besides the healthy diet, supplements, and rehab, I decided to get a prescription for a drug called Forteo. Forteo is one of the few drugs for osteoporosis that stimulates new bone formation. In other words, it stimulates osteoblasts.

For those who are not familiar with bone physiology, we have two main types of bone cells. We have osteoblastic cells that build new bone, and we have osteoclast cells that break down bone. There is a constant balance between building up and breaking down. 

You might ask yourself, “Why would the body break down bone?” It’s kind of like the cleanup crew. Normal activity, as you go through your life, especially if you exercise or do physical things, you break down your muscles. Working out is not an anabolic process; it’s actually a breakdown process. Then the body rebuilds it stronger. 

Same thing happens with bone. You go through a normal day of activity, and you’re actually breaking down a certain amount of bone. Then you need the osteoclasts to come in and clean up that junky bone, so the osteoblasts can lay down new bone. This process occurs throughout your life. 

We used to have this concept that all the bone formation occurs by age 20 or 30 or something like that. After that, you just lose bone. We had this same concept about brain cells. You can have all the brain cells you are going to have by a certain age. After that, you just lose brain cells. 

We have learned that’s not true. The body continues to have this balance between growth and breakdown throughout your life. It’s just that when you’re younger, the balance is tipped toward growth. When you get older, it tends to tip toward breakdown. 

But both of those processes continue throughout your life. In order to tip the process toward more osteoblasts, more bone buildup, I started taking daily injections of this medication called Forteo. Forteo is one of the few anabolic bone drugs that actually stimulates the osteoblasts.

The other drug that is on the market that is even more commonly used than Forteo is called Evenity. Most of the people who have osteoporosis take drugs that block bone breakdown. They block the osteoclasts. 

The most common category of drugs are drugs called bisphosphonates. Phosphomax. There is a whole series of those. These block the bone breakdown. You end up with more bone. 

The problem is without the cleanup crew, you’re not getting rid of the junky bone. That is why these drugs have been somewhat disappointing in terms of helping to prevent fractures, which is the main thing people are concerned about with loss of bone density or osteopenia or osteoporosis, which is the more severe form. You end up having less bone density. Because of less bone density, you have a higher risk of fracture. 

Most people are using these bisphosphonates. Unfortunately, that’s why you’re seeing some unusual side effects in some cases, where people get bone that is weaker, so there is actually spiral fractures of the femur, osteonecrosis of the jaw, and some other side effects that can occur. You’re blocking the osteoclast activity. 

Dr. Eric: 

You just took the Forteo, and you didn’t take any of the bisphosphonates, like Phosphomax? 

Dr. Ben: 

No. What I did was also used measurements to see what was going on. As you know, in functional medicine, we often do testing to see exactly what’s going on, like with thyroid. We want to know the whole picture. We want to see exactly what’s going on. 

The medical profession generally just gets the minimal amount of testing necessary. “Here’s your medication. See ya.” Nobody is monitoring. Is it doing what it’s supposed to do? 

Ideally, if you’re working with a patient with bone issues, osteoporosis, a failed fracture that is not healing, you would want to know A) What is the level of bone growth? B) What is the level of bone breakdown? These can be measured through blood tests. Probably the best test for bone breakdown is CTX, and the best blood test for bone building is called P1NP. It’s useful to do both of those to see what’s going on. 

When you use a drug like Forteo, one of the things that can happen is it increases the bone building. When you stop, you can get this big increase in bone breakdown. I made sure I monitored mine. If it looked like my osteoclast activity was ramping up, I would have considered following the Forteo with a bisphosphonate or Prolia. I didn’t see that big of a ramp-up, so I didn’t do that. That’s a scientific way of figuring out exactly what’s going on.

In addition to taking Forteo—I took daily injections for five months—I also got Human Growth Hormone. The use of it is controversial. The surgeon who prescribed the Forteo, after I showed him some studies that HGH was effective for non-union, he wasn’t willing to prescribe it. I felt like I needed it to put my body into anabolic, so it could ramp up the healing. I took a modest dosage. I did two IUs, five days a week, for five months as well. 

I also used a bone stimulator that works through ultrasound. I put it directly on my hip in the area of the fracture. I did it for 20 minutes, twice a day.

I did those three things plus the supplements plus the rehab plus the healthy eating. After five months, my femur healed, and the gap was closed. After a nine-month ordeal, and now I am another year out after that, my femur, my hip are 100%. I have no pain, no limitations. I have gotten my strength back. I continue to make sure I exercise in a way that will increase bone density or at least maintain as much bone density as possible.

Dr. Eric: 

Squats and deadlifts? 

Dr. Ben: 

Exactly. Squats and deadlifts. I also do some ballistic activity. There is a physical therapist from Australia whose name is Dr. Belinda Beck. She has published the only studies that have shown an increase in bone density with exercise. Her studies are the LIFTMOR trials. Part of her program involves that you need to jump in the air and land and have that ballistic loading on the femur. 

Obviously, you have to be careful. You have to start out very slowly. You can possibly risk a fracture, but that ballistic loading has been shown to be very beneficial for stimulating new bone. 

I now get up on a 24-inch platform and jump down. In her study, she has people jump onto a pullup bar, pull themselves up, and then drop down. 

You can start out by doing hill drops and jump off the ground. Going in the air and landing, that ballistic loading of the bone has been shown to be very beneficial for stimulating bone formation, bone strength. There is actually something called bone strength in addition to bone density. 

Dr. Eric: 

Bone strength versus bone density. 

Dr. Ben: 

The best way to measure bone density is with a bone densitometer test. It’s basically some X-rays of your spine and hip and sometimes your wrist. This is a way to measure the bone density. 

There is something called the T score, which measures your bone density compared to a healthy 30-year-old. There is your Z score, which measures your bone density as compared to someone your age. If the lab also has additional software that will measure trabecular bone score, TBS, you want to ask the lab and your doctor who prescribes the bone density test to include the TBS. 

When you have a bone, you have the cortical bone. Inside, you have the trabeculi, which are these crisscross hatches. These are really important because the TBS is a measurement of bone strength, the bone’s ability to withstand stress. TBS is even more directly correlated with fracture risk. You want to have good bone density, but you also want to have good bone flexibility or TBS. That’s something that’s important to monitor. That allows the bone to withstand loading and different kinds of stresses. 

Dr. Eric: 

Can you have low bone density but a good TBS? Do they go hand in hand, where typically if one is low, the other will be low? 

Dr. Ben: 

Yes, you can have a low bone density with a somewhat better TBS. That means you’re less at risk for fracture. 

Let me explain why some patients who have very low bone density on their T score. The way the T score goes is if you have up to -1, that is considered osteopenia. If you’re -2.5 or more, that’s called osteoporosis. 

If you have someone with a T score of -4, which would be a significant amount of osteoporosis, but maybe they don’t have a fracture because they have better TBS. Unfortunately, it’s usually not measured. You have to make sure the lab has this software. They don’t actually have to do another test. They just do an analysis. 

By the way, if you’re getting your bone density score, or you’re a doctor or a practitioner who is taking a look at a patient’s bone density, ask for the complete print-out of the bone densitometer results, not just the results. 

What will happen is you will get this sheet that will just give you the T score and the Z score, or maybe just the T score and something about a fracture risk. You really want the full print-out because unfortunately, patients aren’t always positioned the exact right way. They don’t necessarily always collimate it exactly the right way. 

If a patient has scoliosis, if they have increased or decreased curvature in their spine, if their hips aren’t positioned the proper way, it can change their bone density. If they have significant osteoarthritis, it can look abnormal because you have these spurs. If they have scoliosis, it might look like they have less bone because you can’t see it head-on, as there is a curvature in their spine. Those things need to be taken into consideration, and they’re often not. 

Dr. Eric: 

How would you know? I didn’t know this honestly, as far as getting the complete print-out. It sounds like the complete print-out talks about the positioning of the person. How would you know if they’re not properly-? Is it a matter of them not being properly positioned? Or if they are properly positioned, but they have something like scoliosis or osteoporosis, it could lead to false results? 

Dr. Ben: 

Absolutely. When it comes to the positioning, you have to ask the patient, were their feet put against something that puts their hips slightly internally rotated? Was their back flat? When you get the print-out, it will have a diagram, and it will show which part of the hip and also which part of the spine. Usually, it’s enough where you can see if they have significant osteoarthritis or scoliosis. You can also see if you need to get a separate lumbar spine X-ray and look at that. 

If they have osteoarthritis, then they’re more likely to have spur formation that will make it look like they have extra bone. If they have osteoporosis, typically, it may look like they have less bone. 

Dr. Eric: 

Okay. Osteoarthritis might have spur formation, which looks like there is excess bone, more bone formation. 

Dr. Ben: 

Yep. 

Dr. Eric: 

Even if someone has osteoporosis, but they also have osteoarthritis, that might actually increase the- If their T score is -3.5, it might actually look better than it is if they have osteoarthritis. 

Dr. Ben: 

Exactly. We know there is a significant percentage of people who have osteoarthritis. Unfortunately, they don’t always position the collimator properly. It’s really important that they do the exact same part of the lumbar spine and the exact same part of the hip. Sometimes, they do both hips to compare. 

Dr. Eric: 

I have a question. Did you get a DEXA scan prior to- 

Dr. Ben: 

No, I didn’t. Unfortunately, men typically are not asked to get a DEXA scan. It’s just assumed that there is a low likelihood of men having osteoporosis. Unfortunately, there is probably a much higher rate of low bone density in men that we don’t know about, simply because we don’t test. 

So many other things are like this. I’m sure you know from being in functional medicine and doing the additional testing that is not often done, you find out all this stuff that you wouldn’t have ever known. 

Dr. Eric: 

I know from my personal experience, you had one of the bone experts on your podcast, and I was listening to him. I got a DEXA. I showed up with low bone density, which was surprising. Looking at my history of hyperthyroidism and also not getting enough calcium, I was in denial. “Oh, I’m getting enough through plant-based foods.” I wasn’t keeping track of how much calcium. 

With the history of hyperthyroidism, they should have given me a bone density scan. They didn’t. I asked. I’m getting ready to turn 55. This was in 2024. I’m the one who had to ask, “I have a history of hyperthyroidism. Never got a bone density scan. Could I get one?” I rarely go to a primary care doctor, but my wife talked me into going to one for a check-up. I’ll go with her. Teachers’ insurance. I asked. Surprisingly, he ordered one. 

Sure enough, I didn’t know at that point about the TBS. Honestly, I didn’t ask. I didn’t get a TBS. Who knows? 

I was also surprised because I have been active all my life. I go to the gym. I haven’t been doing squats and deadlifts. I haven’t been doing the right exercises for my lower back. I was doing back extensions. It wasn’t like I wasn’t doing any back exercise. Not putting the compressive load on the spine and the hips. 

Dr. Ben: 

It’s understandable. A lot of us are afraid of compressing the spine. You have experts out there advising against doing those exercises. A lot of us have had some episodes of back pain in the past and are cautious about not doing those things. 

Unfortunately, as Belinda Beck has shown, you have to do heavy weights with those basic exercises that load the spine and hips if you want to have good bone density. She has the people who follow her program do five sets of five reps on deadlifts and squats and overhead press. 

Dr. Eric: 

Five sets of five reps of heavy weight. 

Dr. Ben: 

Max, yeah. I don’t do five sets, but I’m doing heavy deadlifts and squats when I can tolerate it. 

Dr. Eric: 

I do four sets. The first one or two are warm-ups, especially that first one. I don’t want to jump into it. 

Dr. Ben: 

I do the same thing. I am probably on deadlifts only doing two super heavy sets. I had stopped doing deadlifts years ago because I felt like they were aggravating my back, and I didn’t think I could tolerate it. 

Dr. Eric: 

Now I understand. Same thing. Well, I just never did them honestly; it’s not that I thought they were aggravating my back. I just never did squats or deadlifts. I did other weight-bearing exercises. 

I was going to ask if you ever did cold laser or anything. You mentioned you did bone stimulators. 

Dr. Ben: 

I did some cold laser. But I used this bone stimulator. There are two on the market. There is one that works with electrical that you need to do for a pretty long period of time. There is one that works through a pulsed ultrasound. The surgeon preferred the pulsed ultrasound, so I went with that one. 

They recommended doing it once a day, so I did it twice a day. I spoke to the rep about doing it three times a day, and she said twice a day probably will give you slightly better benefits, but three times might be too much. I don’t recommend doing it three times a day. Of course, I would have easily done it three times a day. 

Dr. Eric: 

My guess is yes because you have done a lot of research in the past and currently: How about vibration plates? Weighted vests? 

Dr. Ben: 

Yes, I did vibration plates, especially at the beginning because I couldn’t do that much weight loading. I got a vibration plate. I started using it at the home. I thought that was helpful at the beginning. Once I was able to do the heavy loading and everything else, I fell off doing it.

Dr. Eric: 

You did it initially. 

Dr. Ben: 

Yes. 

Dr. Eric: 

For a few months? 

Dr. Ben: 

Yes, I did it for probably 4-5 months. 

Dr. Eric: 

You mentioned the Forteo. Any medication could potentially have side effects, but the Phosphomax, those are notorious as far as known for their side effects.

Dr. Ben: 

There are some possible significant side effects with Forteo. Rat studies have shown bone tumors forming, osteosarcoma. It hasn’t been shown in humans. 

The current understanding is if you do it for two years or less, you have a very high rate of safety. After that, if you’re causing your body to produce more bone, you put it in that anabolic stage for too long, I could see excessive bone forming. Some of that could be cancerous. It would make sense. 

The new thinking about how to treat osteoporosis is that you do a drug like Forteo or Evenity, and you do it for a year or two. Then you follow it with a bisphosphonate. 

Dr. Eric: 

What happens if you don’t follow it with the bisphosphonate? 

Dr. Ben: 

That’s the whole thing. Once again, it’s great that they’re rethinking the way we use drugs. Why not test? For some reason, the medical profession just doesn’t want to spend the money on testing. 

The idea is that when you ramp up the osteoblasts, and you stop, the body ramps up the osteoclasts, and then you will lose bone. 

Dr. Eric: 

Yeah. 

Dr. Ben: 

Why not test to find out if that’s really the case? That’s what I did. I didn’t see a big ramp-up of osteoclastic activity. Otherwise, I would have asked to be put on a bisphosphonate. 

Dr. Eric: 

You determined that by testing the CTX and P1NP? 

Dr. Ben: 

Yes, exactly. 

Dr. Eric: 

Interesting. 

Dr. Ben: 

The CTX is measuring the rate of bone breakdown, and the P1NP is measuring the rate of bone formation. 

Dr. Eric: 

Also, I was wondering why, maybe it wouldn’t make a difference, but if you are taking Forteo every single day, and if it’s ramping up the osteoblast production, if you abruptly stop, which would affect the bone breakdown, rather than do the injection every day, after a year or a year and a half, do it every other day? Gradually? 

Dr. Ben: 

I kind of did that, not as careful as I could be. Basically, I stopped after five months, but I was getting tired of doing it. I was feeling better. I don’t have time to do it today, so I’ll do it tomorrow. The last three weeks or so was kind of like that, where I did it less consistently and then just stopped. 

Dr. Eric: 

Another question I have. Yours was a unique situation. Yours was a trauma. Then it was labeled as a non-union. You had a choice: get another surgery, which you didn’t want to do, or let’s try this other approach with the Forteo, HGH, stimulation. 

For someone who just has osteoporosis, because osteopenia, typically especially if it’s mild, they won’t recommend the Forteo, maybe not even a bisphosphonate. Maybe they will with osteopenia. With osteoporosis, no doubt. If someone has osteoporosis, a T score of -3.0 or -3.5 or -4.0, how do they know should they- Is it a good idea to take Forteo? Is it a good idea to try to do everything naturally? Maybe do another DEXA scan in a year or two after doing things naturally? 

In your case, I understand why you did it because it was a unique situation. For someone where time seems to be on their side- Now you never know. You could fall like you, and then you’re in trouble. That’s the argument to getting the medication. The potential side effects… For some, it could be a difficult decision. Same thing with anything. With Graves’, you could say to take antithyroid medication or not. You could always take antithyroid medication if the natural approach doesn’t work. Same with surgery, which would be a last resort. 

What’s your opinion as far as when they should consider Forteo? 

Dr. Ben: 

First of all, the bisphosphonates have been used as the only drug in a lot of cases. I think that doctors are starting to rethink that after some of the side effects and the fact that we haven’t seen a dramatic decrease in fracture risk that we want with the bisphosphonates.

Currently, they only recommend a drug like Evenity or Forteo if they think you’re at very high fracture risk. It’s hard to know that. A very low T score. Maybe you’ve had several other fractures in the past. 

I think it makes sense to consider doing a drug like Evenity or Forteo first for a year or two, possibly followed by a bisphosphonate rather than just take a bisphosphonate. It makes a lot of sense than just blocking that bone breakdown. You have to make sure you’re doing all the other things first. Be on a healthy diet. You don’t want to be leaching calcium out of your bones. 

I see too much emphasis on the dangers of calcium. Most of that is just complete nonsense. The reason why everybody is afraid of taking calcium, and I even got caught up with that. 

Dr. Eric: 

Same here. 

Dr. Ben: 

There were a number of studies over the years showing that taking calcium supplements, having higher levels of calcium was beneficial in reducing hypertension, cardiovascular risk, death from heart disease. Then a couple of studies came out that seemed to show that calcium increased your risk of heart disease. 

The thought was that when we talk about heart disease and the risk of heart attack, the big process we’re thinking about is atherosclerosis, which is the formation of plaque buildup in the arteries that over time starts reducing the flow of blood and oxygen through your bloodstream, and in particular, through the arteries in the heart.

If you have a heart attack, usually, that means one of those plaques ruptures and then completely blocks that artery. The part of the heart muscle supplied by that artery suffers damage. If it suffers enough damage, you can die. If not, you just damage part of your heart. 

The fact that these plaques get calcified, the thought was, hey, if we have calcium, you will have an increase in calcified plaque. There were a few studies that seemed to show this. It turns out that those were not really good studies. The participants were not using Vitamin D and Vitamin K. 

The reason why it’s so important to take Vitamin D when you take calcium is Vitamin D grabs hold of the calcium and says, “Come over here into the bones. Don’t get into the soft tissues.” Vitamin K in particular says, “No, don’t get into the soft tissues. Just get into the bone.” It’s really important in my opinion, and I think the data shows this, to have a good, healthy level of Vitamin D. That requires testing, supplementing, and retesting. 

Too many patients have low Vitamin D. The doctor says, “Take 1,000 or 2,000 Vitamin D,” and maybe doesn’t even test them again. Or tests them in a couple of years and says, “It’s still low. Oh well.” 

The reality is, most of the time, if you have really low levels of Vitamin D, you probably need more than 2,000 IUs; you might need 5,000 or 10,000. Some people respond really well, and their Vitamin D might ramp up to 120. A lot of people don’t. You need to test. You need to supplement appropriately, and you need to retest. 

Whenever you’re taking Vitamin D, you want to make sure you’re taking Vitamin K. There are three different forms of Vitamin K on the market. We have Vitamin K1, which is found in green leafy vegetables. 

We have two forms of Vitamin K2. We have MK4 and MK7. Today, there is a lot of hype around the MK7. It is the newest one. It’s been promoted a lot. It seems to have some benefits. Most of the studies on bone density were all done with MK4. A lot of these were done in Japan. Really significant increase in bone density and decrease in cardiovascular risk taking the right amount of MK4. 

Most of the supplements on the market for K2 involve 150mcg. The studies that have shown the most benefit use 45mg of MK4. That’s what I’ve been advocating for patients who are concerned about bone density. There are a few companies that offer that now. I think it’s really important.

Getting back to the calcium thing. There are a few poorly done studies that seemed to show that taking calcium supplements was associated with increased heart risk. The reality is for a modest amount of well-absorbed calcium, and as you know, when it comes to supplements, we want to make sure they are well absorbed. You don’t want to use calcium carbonate, which is limestone, because it’s not that well absorbed. You want to take it a few times a day with meals, so you have stomach acid to break it down. You also want to have good hydrochloric acid production, or you won’t break it down.

When it comes to calcification of the plaques, it turns out we shouldn’t be so worried about calcification of the plaques. We should be worried about having any plaque formation. If you are going to have plaque in your arteries, you’re better off if that plaque is calcified. Calcified plaque is stable. Uncalcified plaque or soft plaque is unstable. When you have a heart attack, 70% of the time, that is because you have soft plaque that ruptures and forms a clot.

Dr. Eric: 

When you do a calcium score, that is looking at the hardened. You will have to do an angiogram or something else? 

Dr. Ben: 

Yes, the best test is the CT angiogram with artificial intelligence through a company called Clearly Health. You can look around. There should be a lab in your area that offers that test. A CT angiogram with artificial intelligence. That test will show the soft plaque as well as the hard plaque. That can be very important. 

You can have a younger guy who has some plaque and say the coronary calcium scan is not that high, but they can have a lot of soft plaque. Usually over time, the plaque will tend to calcify.

If you take a statin, statins tend to calcify the plaque. Some people think that that’s a bad thing because you might see an increase in the calcium score. Once again, you don’t want any plaque in your arteries. If you are going to have plaque, you’d rather have it be calcified than soft and unstable. 

Dr. Eric: 

Makes sense. 

Dr. Ben: 

To take a modest amount of calcium with magnesium, as long as you take the Vitamin D and Vitamin K, is safe and beneficial. I think it’s really important for bone density. 

Dr. Eric: 

All right. Wonderful advice. I have a calcium score, which was thankfully zero. Like you said- 

Dr. Ben: 

Mine, too.  

Dr. Eric: 

I have not gotten the angiogram. 

Dr. Ben: 

It’s a little more invasive. You have to take some radioactive iodine. It is a CT scan. 

Dr. Eric: 

Radioactive iodine or just iodine contrast?

Dr. Ben: 

It has to be radioactive, right? It’s iodine contrast, but it has to be picked up by X-rays. You don’t want to get it done a lot. I think it’s worth getting it once or twice. You want to make sure you go to a lab that has the most modern CT scan. The modern CT scans use less radiation than the older equipment. 

Dr. Eric: 

That’s good to know. I’m just thinking, again, dealing with people I work with as well as the people listening to this have thyroid conditions. There is good and bad with iodine. 

Dr. Ben: 

Right, I totally understand that. 

Dr. Eric: 

If anybody is thinking about that CT angiogram, I can’t say it’s risk-free for someone with hyperthyroidism. 

Dr. Ben: 

Absolutely not. I understand that. I know about the iodine thing. I have Hashimoto’s. 

Dr. Eric: 

It’s still good to know. If you get a calcium score, that’s great, but it’s incomplete. 

Dr. Ben: 

If you have a calcium score of 0, that’s pretty good. That means you will unlikely have a higher score on the CT angiogram. 

Dr. Eric: 

All right. This was a lot of great information. I learned some things. I will definitely inquire about the TBS. It sounds like not every facility offers that. I might have to look it up. 

Dr. Ben: 

They have to have the software. If you have your DEXA scan done at a lab that has the software, they could go back and reanalyze your previous test. 

Dr. Eric: 

I wouldn’t necessarily need to get another DEXA if the facility I went to offers that. They could go back and still use it? 

Dr. Ben: 

Yes. 

Dr. Eric: 

Even if it was a year ago? 

Dr. Ben: 

I think so. I’m sure they have a digital copy of your data. 

Dr. Eric: 

Yeah, I’m sure they do. I might have to inquire and see if the radiology place that I went to offers that. 

Dr. Ben: 

Most doctors don’t know about it, so they don’t often order it. It makes sense. 

Dr. Eric: 

It makes perfect sense. If you have a good TBS, even if you have osteopenia or osteoporosis, especially osteoporosis, you still want to do some of the things you mentioned, but still, there is at least some reassurance. You might not be at great risk of getting a fracture. 

Dr. Ben: 

In a similar vein, if you measure LDL particle size and number, somebody can have a higher LDL, but if they don’t have a lot of small, dense LDL and larger LDL particles, you are really not at that much risk. 

Dr. Eric: 

Dr. Ben, thank you so much for sharing this. I’m glad that protocol worked for you, non-union is no longer an issue, and you got that bone formation. Thank you so much for sharing that. Can you remind people where they can find you? 

Dr. Ben: 

You can go to my website, DrWeitz.com. You can call my office in Santa Monica at 310-395-3111. Please check out the Rational Wellness Podcast, which is available on all the audio platforms: Apple Podcasts, Spotify. There is also a video version on YouTube. 

Dr. Eric: 

Awesome. Thanks again. This was a really good conversation. I’m sure a lot of people benefited. The bone density is widespread, not just in the thyroid space, but really everywhere. Like you said, not enough doctors are recommending it, mainly for women, and they are waiting until they already have it. 

Dr. Ben: 

It’s crazy to wait until they have osteoporosis. Why not check it at 40? Let’s be proactive. That’s one thing about functional medicine. If we find out about these chronic diseases, which are these long processes, let’s find out down here, not way up here. We tend to wait until someone has a severe case. 

Dr. Eric: 

I agree. Thank you. This definitely will bring more awareness. Always enjoy chatting with you. We’ll definitely have to have you back when you get that longevity book. You have to make it a goal in 2026 to finish that book. 

Dr. Ben: 

Thanks. 

Dr. Eric: 

Take care, doc. 

Dr. Ben: 

Thanks, bye. 

***

Dr. Eric: 

Awesome conversation. It was a little awkward reading his bio. It was his fault because he didn’t give an updated bio. When I have a repeat guest, if they don’t include an updated bio, I will just read the old bio. I didn’t realize he mentioned that he was writing the book a few years ago. As I read it, I realized that was a few years ago. Did he finish writing the book? He didn’t. Lesson learned on my part: even if it’s a repeat guest, maybe don’t read the bio if they haven’t updated it. 

Dr. Ben unfortunately fractured his hip. He was handing out Halloween candy and holding his dog on his other hand. Traumatic. We’re recording this a little bit before Halloween. I wanted to ask him if he, when handing out candy, is it more natural candy, or is it just the regular candy, like M&Ms and Snickers? If someone is a naturopath or chiropractor, you’d think they would go to Trader Joe’s or Whole Foods and buy more natural candy. 

I find it’s better not to give candy. If you want to give out natural candy because I can understand not wanting to give junk. At the same time, the kids usually don’t want natural candy. They want Snickers and M&Ms. It’s different with your own kids if you’re raising them to eat natural stuff, like snacks without artificial flavorings and colorings. Just wanted to bring it up since it might come out after Halloween. I’m not sure. It’s being recorded right around this time.

Should you get a bone density/DEXA scan? I asked Dr. Ben if he got one prior to his fracture, and he didn’t. Most people don’t get one. I got one only because I asked for one, or else I still wouldn’t have one. 

I should have asked for one a long time ago because I dealt with Graves’ in 2008. I probably should have had a bone density scan sometime in my 40s or right after that. It was 2008 when I turned 38. 39/40, I should have had a bone density scan. I waited years after that. 

A lot of people have osteopenia, osteoporosis and don’t know it. I’m not a big fan of scans, but everything is risk versus benefit, especially if you have hyperthyroidism. It doesn’t make a difference. There are people with osteoporosis who don’t have thyroid conditions but have gut issues. They are not properly digesting or absorbing the nutrients they need. There are numerous reasons for low bone density. If you haven’t had a DEXA scan, something to consider.

TBS looks at bone strength compared to bone density. I mentioned how that’s not something I got. I have had other bone experts. I should have relistened to some of these. I should have done research before doing the DEXA scan. Quite frankly, I was surprised. I did it. I didn’t think I would have low bone density. I figured I’d do it, and it would be fine. Maybe I’ll go back and still potentially get the TBS if they offer it at the radiology place. I need to remember to look into that. 

If you haven’t had a DEXA scan, or if you plan on doing another one in the future, get the TBS. Eventually, I will do another one and make sure to get that done if I can’t go back and get it done for the DEXA scan I did previously. 

When to consider bone density medication? This might seem a little odd of an episode because he was talking about taking the Forteo, taking HGH. The big thing is the Forteo. I don’t love medication for bone density. The bisphosphonates are worse. You are supposed to follow up Forteo with bisphosphonates. 

He had a bit of a desperate situation. It was either get the surgery or try something different. If I were him, I don’t know I would have thought about doing that, but it was brilliant taking the Forteo and HGH. He went all out. Five months, which most people take Forteo for osteoporosis for two years. 

It’s not an easy decision. I know for some people listening, they might think it is an easy decision. “I just won’t take the medication.” That was my perspective when I dealt with Graves’. Easy decision. I will just start with bugleweed and motherwort. If I need to, I can take antithyroid medication. 

There are always risks. There are risks when you don’t take antithyroid medication. If you have severe osteoporosis, and you slip and fall, you could potentially be in a lot of pain for a long time. Then you have to weigh the potential side effects. 

It’s up to the person. If someone has really severe osteoporosis, I understand if you decide to take the medication. Regardless, whether you take the medication or not, you want to do everything else. As Dr. Ben mentioned, you want to eat healthy, do proper exercise, make sure you have healthy Vitamin D levels, take Vitamin K2, which we’ll talk about K2 in a minute. 

Vibration plates. I have been using a vibration plate three days a week for 10 minutes a day typically. I don’t think you’re supposed to use it every day from what I’ve read.

I also have a weighted vest. I don’t use that every day either. 

I will usually do everything on the same day. Not sure if I should be doing that. I figure I’ll do my squats, deadlifts, vibration plate, and weighted vest three days a week. The other days, I will give my body a rest. Maybe it’s better not to put that stress on it every single day. That’s the approach I take. 

With the vibration plates, I read you’re not supposed to use it every day. The weighted vest, it might be fine to do it daily. I wouldn’t use it for squats and deadlifts every single day.

Vitamin K2. He spoke about the difference between MK4 and MK7. Most studies out there are using MK4. He said that the amount included in most supplements is low, and you should be taking 45mg, which is a lot. 

I have done research with Vitamin K2, and I know higher doses seem pretty safe. I am not concerned about taking 45mg. You figure most supplement companies do their own research, and they would know. He said there are only a couple companies that offer supplements of Vitamin K2 in MK4 that offer it in 45mg dosing. I did do a little bit of research. Meant to ask him, but I forgot. Life Extension is one of them. I don’t know what the other one is.

I wanted to finish up by mentioning what type of calcium should you take? He mentioned not to take calcium carbonate but didn’t say what you should take. You want to try to get as much as you can through food. You want to get 1,000-1,200 of calcium per day. I have to check the units. I should know this, but I’m blanking. 

Thorne Research’s Advanced Bone Support is really good. They use calcium malate. The only thing is that calcium can be constipating. If that’s the case, calcium citrate is pretty good also for bone health. If you’re on the sluggish side with the bowels, calcium citrate may be better. Calcium malate is also an option. 

Of course, try to get as much as you can through food. I don’t eat fish with bones. If you do, that’s an excellent source of calcium. Sardines, for example. I do get some plant-based sources. 

More recently, I have been drinking goat milk kefir. I don’t recommend this while someone is healing, especially if someone has an autoimmune thyroid condition. I recommend a break from dairy while healing. Since I have been in remission for a long time, I haven’t been dairy-free all these years. I haven’t been drinking milk. Goat milk kefir. That’s what I’ve been doing from a calcium standpoint. I supplement with some calcium, too. 

That’s pretty much all I wanted to chat about. As usual, I hope you found this episode to be valuable. I look forward to catching you in the next episode.

Far too many people are living with misdiagnosed Graves’ or ignored hyperthyroidism and they don’t even know it yet. In this episode, I explain why these oversights happen, what red flags to watch for, and how to ask for the right labs. You’ll also hear how small clues like heart palpitations or low cholesterol can point to a bigger thyroid problem. My goal is to help you recognize the signs early and feel confident advocating for your health.  If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

The other day, my wife got a call from a friend. I am friends with this friend’s husband. She said that her husband was diagnosed with elevated TPO antibodies. She wasn’t sure what TPO antibodies were and wanted to know if I could explain it to them. The doctor did some blood testing. All I really knew at that point in time was that the husband got TPO antibodies, and they were 135, something like that. I actually didn’t even look at the report. They didn’t send it to me. They just wanted to talk to me. 

I ended up speaking with the husband. When I think about elevated TPO antibodies, a lot of people with hyperthyroidism do have elevated TPO antibodies. If that is the only thing they’re mentioning, I am thinking more hypo. My friend probably had elevated TSH, and they did TPO antibodies and found them to be elevated. He probably has Hashimoto’s. 

I was speaking with him. One of the first things he mentioned was he was diagnosed with hyperthyroidism. At first, I wasn’t sure if he said “hyper.” If you say “hyper” and “hypo” fast, they sound similar. I repeated, “Did you say hyperthyroidism?” He said, “Yes, hyperthyroidism.” He was mentioning that he was fatigued. He knows from his research or what the doctor told him that fatigue is more common with hypothyroidism, but he has had a lot of fatigue. He isn’t losing weight. Essentially, he went to his primary care doctor, who ran some blood tests and told him he was hyper.

What I wanted to bring up is he also mentioned that he had blood tests about a year ago. Those blood tests apparently also showed that he was hyper, but they dismissed it. The medical doctor that he just saw mentioned that his last numbers were also hyper, but for whatever reason, they didn’t do anything. 

I figured I’d have another episode focusing on hyperthyroidism just because with Hashimoto’s, it definitely does get misdiagnosed. Someone could have fatigue and weight gain, and maybe they do a TSH, and it’s within the lab range, but not optimal. It’s higher than it should be, higher than the optimal range. Without question, people with Hashimoto’s often get misdiagnosed or maybe not diagnosed at all. 

Many times, doctors will just dismiss it and run the TSH. TSH might be 3.5, which is within the lab range. I can’t really say it’s misdiagnosed because that’s the range they use. It just gets ignored essentially for many years until the TSH gets to the point where it’s out of range, or the person goes to another practitioner, maybe even a functional medicine practitioner. 

Anyway, my friend went to a primary care doctor. He didn’t get the Graves’ antibodies. He has another appointment in a couple of months, not until January 2026. I am recording this in mid-October 2025. Probably won’t be released for a little bit. He is waiting a couple of months to get the blood test, and then he has his follow-up appointment in January. 

It sounds like he is on antithyroid medication. I asked him if it was methimazole or Tapazole. He wasn’t sure. He was out and about, but that is what I am thinking he is on. I told him he probably has Graves’ because if he had it last year, something like subacute thyroiditis will disappear. It could be Hashitoxicosis. That’s a possibility as well. He hasn’t had a thyroid ultrasound or seen an endocrinologist yet.

The point is that Graves’ can get misdiagnosed. Hyperthyroidism can get misdiagnosed. It can get overlooked or ignored. I wanted to bring up a few situations here. 

There was a case report showing that a patient with a thyroid storm was actually misdiagnosed as having a panic attack because symptoms overlap heavily. That’s pretty scary. If someone goes to the ER, and they’re presenting with a thyroid storm, but they are told they have a panic attack. This is an extreme situation. I would imagine most of the time, a person who is experiencing a thyroid storm won’t just be told that they are having a panic attack. 

The background is: “Graves’ is characterized by hyperthyroidism, and its symptoms often overlap with those with panic disorder, which may make it difficult to distinguish between the two conditions. In this report, we describe how proper diagnosis of thyroid disease in patients with mental illness can lead to appropriate treatment.” 

They encountered a 34-year-old woman. Thyroid crisis from Graves’ was misdiagnosed as a panic attack. The patient was being managed as a case of panic disorder and bipolar disorder in a psychiatric outpatient setting. 

About six months before the presentation, she had lost about 16kg in weight. A month before presentation, she developed several unpleasant symptoms as her condition worsened. Several weeks before, she had severe palpitations, tachycardia, discomfort in her throat. She visited the ER on a Sunday morning, presenting with nausea, severe tachycardia (elevated heart rate), fever, restlessness with anxiety, and we treated her as panic disorder with fever. Then noticed proptosis, bulging of the eyes. Considered the possibility of Graves’, and thyroid function tests were performed, even though data from her clinic was not available because it was a weekend. 

In this situation, if it wasn’t for the woman’s eyes being suspicious, who knows? She might have been dismissed and labeled as having a panic disorder. Really scary. 

I can’t say this happens a lot. I have had patients I have worked with with hyperthyroidism who have been to multiple practitioners. On average, hyperthyroidism does get diagnosed a lot quicker than hypothyroidism, but there are definitely exceptions. People get the runaround and have to go to multiple doctors. 

I also wanted to bring up this other one from March 2025. Talking about how Graves’ therapies really haven’t advanced much. The abstract says up front, “Current therapies for Graves’ primarily aim to manage hyperthyroidism through synthetic antithyroid drugs, radioactive iodine, or surgery. However, these approaches are often limited by their incomplete efficacy, and the risk of inducing hypothyroidism.” 

They talk about other potential treatments that are up and coming. At least they’re experimenting with them. They’re medications, not addressing the root causes. That’s another issue. 

Same thing with Hashimoto’s. For many years, Hashimoto’s treatment was levothyroxine when you go to a medical doctor or endocrinologist. No different with hyperthyroidism. For many years, it’s been antithyroid medication, radioactive iodine, or thyroid surgery. If you bring up diet and lifestyle changes to most doctors, including endocrinologists, they will dismiss it as not being helpful. Very discouraging appointments. 

A reminder that the goal of this podcast. There are a few goals. One is we are spotting misdiagnosis stories. Teaching listeners the red flags that can often get dismissed as anxiety, panic attacks, or other symptoms. 

Another area which I need to focus more on is underdiscussed populations. I don’t talk a lot about children and teenagers because most of the people I work with are adults. I do see some children and teenagers as well. I have some episodes on that. I am not saying that should be the main focus, but probably something I do need to talk more about. There are other populations and things I should focus on more on this podcast. 

Going over the science. Recently, I released an episode that spoke about L-carnitine and selenium in combination with methimazole. If you take those two with methimazole, you might need less methimazole, which is always a good thing. That was also a recent study. Always trying to keep up with the latest research in thyroid health and thyroid autoimmunity. 

Now, what I’d like to do is talk about how to reduce the risk of misdiagnosis as a Graves’ patient. Hyperthyroidism without an autoimmune component, like toxic multinodular goiter. Of course, we need to know the symptoms that mimic other conditions. We just gave panic-like symptoms, anxiety. It’s sometimes difficult, and we will talk about other things you can do, like testing. 

Anxiety, racing heart, tremors, sweating. That could be mistaken for panic attacks. Depression, fatigue, sleep issues, irritability, may be labeled as a mood disorder. Having weight loss and high appetite might be brushed off as having good metabolism or someone’s dieting. 

When I dealt with Graves’, I lost a lot of weight and had a higher appetite. I was dieting, detoxifying, overtraining. Eventually, I saw a doctor because I developed a tachycardia. If I saw a doctor sooner, they might have said it was due to the dieting and exercising. That’s what I thought, too. I was intentionally trying to lose weight and figured because I was restricting calories—I wasn’t doing smart things back then—that’s why I had increased appetite. 

Post-partum changes sometimes are written off as new mom stress or depression. It could be post-partum thyroiditis. We do need to pay closer attention to the person’s symptoms. The problem is with many medical doctors, they just don’t spend enough time with the patient. They of course have them fill out a comprehensive health history, or they should. Even then, they might probably just spend a minute or so skimming through that, going through that quickly. 

Quite frankly, most medical doctors aren’t seeing a lot of people with hyperthyroidism walk into their office. When they have certain symptoms, that is probably not the first thing to come to mind.

You also need to do appropriate lab testing. TSH is usually what doctors start off with. I mentioned in the case of hypothyroidism, a lot of people are above the optimal range but within the lab range, so they are dismissed. 

Hyperthyroidism is different. If someone has Graves’, TSH many times will be depressed. If the doctor or whomever orders the test and sees depressed TSH, if they haven’t ordered thyroid hormones, they should. Many times, they will just do a T4. Sometimes, TSH isn’t completely depressed. Sometimes, it takes time for that to happen. It could happen real quickly but not always. 

You really want to do a full thyroid panel. At the very least, TSH and free T4. That is not a full thyroid panel. Not just TSH. You want to do TSH, free T4, free T3, antibodies. If you are suspecting Graves’, do TSI. I prefer TSI over TRAB. Still, that is better than not testing any antibodies. 

In this case, even though my friend was hyper, he just had TPO antibodies tested. That is a drawback of seeing a conventional medical doctor. They are even less likely to see hyperthyroid patients. They just default to those TPO antibodies or sometimes TPO and TG antibodies in everyone, even if someone presents with hyperthyroidism. 

Definitely want to do the right antibodies. If you want to do all three antibodies, nothing wrong with that, especially if someone is presenting with hyperthyroidism. Many misdiagnoses happen because only TSH is checked. TSH doesn’t tell the whole story. 

Another thing is to be familiar with the red flag combinations. If you have rapid heartbeat and weight loss, I could understand where if you go to a primary care doctor, they might not catch on that it’s hyperthyroidism. 

That’s also why you want to look at other aspects of one’s health history and do appropriate testing. If that same person has rapid heartbeat, weight loss, and some eye changes, especially bulging of the eyes, in that case, that was what made the people at the ER realize it wasn’t probably just a panic disorder but a good chance it was Graves’.

If someone is in post-partum, and they are having sudden mood swings and other symptoms, maybe the milk supply drops. If they are having tachycardia. Test the thyroid. Do some testing. Don’t assume it’s stress or mood related. 

If someone does a lipid panel, and they see low cholesterol, which is very common with hyperthyroidism. I wouldn’t rely on the lipid panel because some people have elevated cholesterol with hyperthyroidism. Very common for people with hyperthyroidism to have low cholesterol, less than 150. LDL will also be lower. Most medical doctors don’t pay attention to low cholesterol, just high cholesterol. 

If you go through a physical, and maybe they don’t do TSH at all, but you are experiencing symptoms. You have low cholesterol, and you’re probably going to have some other symptoms as well. Just low cholesterol would not justify doing a thyroid panel. There is a reason for low cholesterol. It could potentially be genetic, but it could be something else as well.

Advocate for imaging if needed. When I went to an endocrinologist back in 2008, I was already diagnosed with hyperthyroidism. I was referred to an endocrinologist, where I got the official Graves’ diagnosis. We could see I didn’t need an ultrasound. An ultrasound is not going to diagnose Graves’. 

If you’re hyper and have positive TSI antibodies, that is pretty much diagnostic of Graves’. If you have hyperthyroidism and bulging eyes, you probably have Graves’. Some people do a radioactive iodine uptake test, which in many cases is unnecessary, especially if TSI is elevated in the presence of hyperthyroidism. 

I asked for an ultrasound because I wanted to see if I had thyroid nodules. She palpated my thyroid and didn’t think I did. I still wanted that ultrasound. That’s why some will do the uptake test, if they want to see if the nodules are hot or cold. If they’re cold, there is a greater chance of them being malignant, but still only a 5% chance. It won’t confirm if someone has malignant nodules or not. 

Also, don’t be afraid to seek a second opinion. Do so sooner than later. If you’re experiencing all these symptoms and they dismiss them as anxiety, panic attack, and if you don’t agree, or maybe you agree because they’re the expert, but they could be wrong. You might want to consider getting a second diagnosis. 

Endocrinologists are not perfect, especially if you are looking for a natural approach. Usually, they do a good job of diagnosing. If you go to one GP, and they just say you have anxiety or panic attacks, you could go to another GP. Might want to see an endocrinologist. 

I know it’s challenging because they might not even bring up thyroid. Why would you go to an endocrinologist if they are not thinking thyroid, and you aren’t thinking of thyroid? It could be challenging. If you have to go to another GP, then go to another GP. Hope that they do the appropriate testing. 

Don’t be afraid to offer to pay for it. If they say your insurance might not pay for a thyroid panel, it comes down to diagnosis codes. If you have insurance, and they are putting in the right diagnosis codes, that they are suspecting it might be, that’s the thing about testing. You don’t know if it’s thyroid or not. That’s why you’re doing testing. If you knew, you wouldn’t have to do testing. Insurance isn’t going to deny the claim because the doctor ordered a thyroid panel, and it turned out to be normal. They did it to rule it out, to make sure. 

I shouldn’t say that the insurance company won’t deny because they do crazy things. It comes down to proper diagnosis codes and all that good stuff. 

Of course, look beyond thyroid labs. I mentioned some other symptoms are still important, even though you don’t want to rely on symptoms. If you get a bone density scan and have osteopenia or osteoporosis, there could be a lot of reasons for that. Could be hyperthyroidism. Maybe you had hyperthyroidism in the past. I would argue that most people who have low bone density don’t currently have hyperthyroidism. 

The point is you need to keep an open mind. You need to really work with a practitioner who is not just going to rush you in and out. Trust your instincts as well. 

If you are working with a natural healthcare practitioner, choose one who has experience with hyperthyroidism and Graves’. Doesn’t mean that has to be the main focus, like myself. It doesn’t have to be their #1 focus. 

I would at least call the office or visit their website, and if they don’t have anything on their website about hyperthyroidism, that’s a big red flag. If none of the testimonials on their website talk about how they dealt with hyperthyroidism and restoring their health, that’s another red flag. 

You could speak with an office worker and ask them some of the top conditions that the functional medicine practitioner works with. If they just say “thyroid,” I would dig deeper and ask about specific thyroid conditions. If they say “hyper” and “hypo,” then see what they have to say. If they just say, “hypothyroidism and Hashimoto’s,” another red flag. 

The main purpose of this is to bring more awareness. That is the purpose of this whole podcast and other things I do. Hopefully, you found this to be valuable. 

Also, I have been talking recently about my Healing Graves’ Naturally community. Living with Graves’ or other types of hyperthyroidism, you can feel incredibly lonely. You go online and search for answers, and most of what is online is about Hashimoto’s. 

If you do see an endocrinologist, they will typically just tell you to take antithyroid medication or do radioactive iodine or surgery. Nobody explains why you have hyperthyroidism or Graves’. If you have Graves’, they don’t talk about what your antibodies mean. They might only test them a single time. It could be really confusing or overwhelming. At times, it makes you feel like you’re the only one going through this. 

I do have a couple of Facebook groups. The problem with Facebook groups is they are so large. I don’t trust Facebook. They could shut down my groups at any time. They sometimes will randomly delete people’s comments. I still have my Facebook groups, but I also created a new community specifically for Graves’ and hyperthyroidism that is not on Facebook. It definitely is something I recommend checking out. 

Inside this community, we focus on the answers you can’t find elsewhere. Right now, it’s smaller, and that’s the goal. The engagement is really great. Definitely would check it out. The name of the group is Healing Graves’ Naturally. A number of different benefits of being part of the community. Hope beyond the standard three options recommended by endocrinologists. 

There is a time and place for antithyroid medication. A lot of people I work with are on methimazole, carbimazole, or PTU. Some like myself take natural agents like motherwort, bugleweed, or higher doses of L-carnitine. Obviously, the focus isn’t going to be on medication, radioactive iodine, or surgery. It will be on finding and removing triggers, healing the gut. You will obviously get guidance from someone who has been there in myself. It’s not exactly the same. You are not working with me one-on-one. 

In the Facebook groups, I am just not present. Sometimes, I will do a random Q&A. I do some commenting, but I don’t spend a lot of time in there because in my hyperthyroidism Facebook group, as of recording this, there are almost 25,000 people. It’s just too big. 

If I do post something, which I do regularly, they are very basic. Only a small amount of people see them because that’s Facebook’s algorithm. Anyway, you will get some support and guidance in the group. There is a lot of engagement from others in the group. Of course, evidence-based natural solutions as well. 

Also, just to let you know, the group is free. I want to help as many people as I can. Eventually, my plan is probably going to become a paid group. I want to keep it small. The goal is not to keep it super small. I don’t want 10,000-20,000 people in the group. I think that’s too big. My perspective maybe will change. Today, you can join at no cost. 

When you join, you also gain free access to my brand new Graves’ Survival Road Map Training. If you are interested, click in the show notes. Become part of the community that finally puts Graves’ and hyperthyroidism at the center of the conversation. I’m sure you’ll be happy that you did. 

I am going to continue to spread the word. The interviews that I do will focus on both Graves’ and Hashimoto’s because most people I interview aren’t familiar with hyperthyroidism. You will see that not all but more of the solo episodes will focus on hyperthyroidism. 

Hope you found this episode to be valuable. Look forward to catching you in the next one. 

Recently, I interviewed Dr. Erin Ellis, a naturopathic doctor whose own health journey from Non-Hodgkin lymphoma to Hashimoto’s completely reshaped how she approaches healing. We talk about her path from cancer survivor to women’s hormone specialist, and how she uncovered the deeper connections between thyroid autoimmunity, toxins, and genetic vulnerability.  If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Let’s talk about your background. The non-Hodgkin’s lymphoma, I’m sure, a big surprise. Thankfully, you were able to restore your health, and that’s what motivated you to become a naturopathic doctor. You focus on hormones. Do you also help people with cancer, too? 

Dr. Erin Ellis: 

I don’t. I usually refer people out to board-certified naturopathic oncologists for alternative medicine. I will support patients post-cancer trying to get to the root cause of why they had the cancer in the first place because that’s what I’ve discovered for myself over the last couple years. Why does this keep happening to me? No, I don’t directly treat patients with cancer. 

Dr. Eric: 

What led you to start focusing on women’s hormones? 

Dr. Erin: 

When I graduated from med school, I wanted to do cancer care. Then I was like, no. The reason I wanted to do it is because I could relate. I had been in their shoes. I decided it wasn’t for me. I really found the need to help women and women’s health. 

I hated women’s health when I was in school because it’s hard. Hormones are hard. Everyone is different. You don’t want to do anything that’s really hard, right? Then I felt the need.

I really became infatuated with menstrual health. The lack of information and education out there for women’s health is awful. It’s really broken for women. They’re left feeling dismissed and suffering and having these atrocious periods. They’re entering perimenopause and menopause, and they lost their life. They don’t feel like themselves. They’re being dismissed by their doctors and feeling hopeless, doing all the cardio in the world and gaining weight left and right. 

That’s why I decided to help restore hope in women that their symptoms are real. We can help them. We just need to give their body the chance to heal and give it what it needs, and they can get their life back. That’s how I got into women’s health. I love it. It’s fun. Every day is different. 

Dr. Eric: 

Every day is different. Every woman is different. You were also diagnosed with Hashimoto’s. Can you give that story? When were you diagnosed? 

Dr. Erin: 

I had the cancer diagnosis in 2010. I went to medical school, starting in 2013, graduating in 2017. Right around graduation, I did lab work and had this underactive thyroid. I had hypothyroidism. I was on natural desiccated thyroid for years. Then I do my labs, trying to do them twice a year, maybe once a year. 

The fall of 2020, I had an antibody response, and I’d never had antibodies show up on my labs before. I would draw them every time. I all of a sudden had this Hashimoto’s diagnosis. I did labs after I had a 42-day cycle, which is very rare for me. I’d never had a long cycle. I was always clockwork, every 28 days. I decided to do my labs and check on my hormones. Then I had this antibody response. Holy cow, I have Hashimoto’s. 

I’m not entirely sure what was the driving factor. It might have been the pandemic as far as the stress of it. I had just opened my own practice, Hope Natural Health, in January 2020, not knowing that the pandemic was happening. Even though the pandemic didn’t affect my practice at all, still, it’s that world of uncertainty that we were living in for so many months, not knowing what the hell was going to happen. I’m not sure if that was the driving factor.

Or what I discovered later in these last couple years is it could have just been a compounded effect of all this poor cellular health I had had for all these years. Maybe the chemotherapy and all the stress that the medical treatments had done to my body that was put through this antibody response.

That’s how I discovered it, through routine labs. The only symptom was the prolonged cycle. I didn’t have any other thyroid symptoms. I was on medication. That’s how it all started. Back in 2020 with Hashimoto’s. 

Dr. Eric:

Five years prior, hypothyroidism. Then you were on desiccated thyroid. It wasn’t until 2020 that you first tested positive for antibodies. 

Dr. Erin: 

Yep. 

Dr. Eric: 

Any family history of Hashimoto’s? 

Dr. Erin: 

No. My dad has hypothyroidism. I think my grandma might have. Nobody that we know of has Hashimoto’s. As you know, it’s not really tested so much in mainstream medicine. Who knows? They could have had it and not even known it. 

Dr. Eric: 

Are you still taking desiccated thyroid? 

Dr. Erin: 

I had a real aha moment probably last spring. I see a chiropractor regularly. In 2010, I was diagnosed with cancer. I have been cancer-free since, as far as the non-Hodgkin’s lymphoma. I was diagnosed at age 31. The form I had was very rare, typically found in older men. 31 and a female, so I did not fit the criteria. Otherwise healthy. I didn’t think I was unhealthy. That really changed my life. It changed my outlook on health and wellness. 

I became healthier. I started eating vegetables. I guess I wasn’t that healthy, but I was a standard American. I didn’t know what I didn’t know. I didn’t know any of this until I went to med school.

I continued on with life. In 2022, I had a really rough year. I’m 47. I started doing my breast imaging at age 40. We also have other cancer in the family. My mom’s had breast cancer twice. She’s also had endometrial cancer. We have done all the genetic testing, and I don’t carry any genes for anything. nor does she. 

In 2022, I had some stuff show up on my left breast, which is atypical lobular hyperplasia. I had a lumpectomy. Right after that, I was diagnosed with malignant melanoma on my back. I had surgery for that. Right after that, I had squamous cell carcinoma on my arm. That was a really rough year. 

2023 was. Fine. I had all my scans. Everything was clear. 

In 2024, in the beginning, I went for my MRI for my breast. Something else came up in two spots. They It ended up being the ALH again plus some DCIS, which is ductal carcinoma in situ, which is basically pre-cancer. 

I had been going to my mom’s breast surgeon because I trusted her, and she knows my family history. She said, “Erin, I’m really worried about you. You’re like a ticking time bomb.” She told me it was a matter of time before I developed breast cancer. “You should really consider doing a bilateral mastectomy, preventative, with reconstruction.” 

She put the fear into me, “Oh my god, I’m going to get cancer again. I don’t want this to happen.” For someone who has already had cancer, it is very triggering. You also put a lot of trust in doctors because that’s their specialty. I am not trained in oncology or surgery or breast health. 

I had gone to my chiropractor, and I told her I had gone to see a breast surgeon for breast reconstructive surgery. I had gotten all the estimates for cost. I had a potential surgery scheduled. I was thinking about it. She didn’t ask me. Well, she did ask me, but she made a nice, interesting comment. “A surgeon’s job is to do surgery. Have you ever thought about why this is happening to you?” 

You might agree with me, but doctors are the worst patients. I help women every day get to the root cause of why they have their symptoms. I never really thought about, “Erin, why are you having these symptoms? Why is this happening in your body?” 

She gave me a name of a lady I should have checked out. I listened to a podcast. It’s Dr. Jen Simmons. Light bulbs went off. Holy cow. This is fascinating. I cancelled everything. I am going to get to the root as to why I had non-Hodgkin’s lymphoma, why this stuff is happening in my breast, why I had skin cancer. Why can’t I get healthy? Why is all this stuff happening to me? 

I have never been healthier, right? I do all the things. I stopped drinking alcohol. I take all the supplements. I exercise, I sleep, I meditate, I cold plunge, I sauna. I do all of the things. I do way more than the average person. 

I started working with another naturopathic doctor. I am not managing my health. I don’t want to. I had done tons of testing. She put it all together for me. 

Moral of the story is I do have a lot of SNPs or genetic dispositions that essentially put me at a disadvantage. I have been at a disadvantage for a very long time, which made the ability for the cancer to grow in the first place. Cancer really is a normal response to an abnormal environment. I had an abnormal environment that developed this cancer. I haven’t fully restored myself since then. Any time I get “assaulted” by environmental toxins, pesticides, stress, you name it, it’s literally like I’m getting attacked. I have to work a lot harder than the average person to heal myself. 

I went on a really strict detox protocol. I have been doing glutathione pushes because I also found out that I have a genetic disposition to glutathione. Glutathione, for anyone that doesn’t know, is our body’s most potent antioxidant. I burn through mine. I need more. Who would have thought I needed more? 

I give myself intravenous pushes once a week. I was doing them twice a week to boost myself. I was doing a lot of cellular health. I did an oxidative stress test on myself. It said I had the cells of a 68-year-old person basically. At that time, I was 45, I think. 20 years older than what I should be. 

I did a lot of cellular repair and restored mitochondrial function. Really cleaned up my diet. Watched pesticides. Ramped up my sauna use because I had to work a little bit harder. I was doing the things, but I needed to do more of the things. 

I was on this strict supplement protocol for about six months. Meanwhile, I decided I was not going to do any more mammograms or MRIs, yet I still had this DCIS in my left breast. I had had the imaging in April 2024, and then I went for a QT scan. I learned that from Dr. Jen Simmons, this qualitative transmission test for the breast that is 40% more sensitive than a breast MRI. We are lucky enough to have one here in Arizona. I went and did it. They compared my MRIs and mammograms from March. There was nothing there. 

What I had done had completely reversed or reduced or got rid of whatever they said I was a ticking time bomb for and wanted to remove both of my breasts and go through this extensive surgery. I would have these antibiotics and disrupt my gut and put me through more of a disadvantage than I already had if I had done this surgery.  

I just did testing last Monday, and my environmental toxin markers have gone way down. More importantly, my antibody response has gone from my Hashimoto’s. I have no more antibody response.

I went off my medication. I honestly didn’t need to go off my medication. It wasn’t intentional. I ran out. My refill didn’t come in in time. I decided to see what I feel like not taking it. Your body truly has the innate ability to heal itself. If I’m healing and doing all of the work inside, maybe I have healed my thyroid. Sure enough. My thyroid labs aren’t much different than they were when I was on the medication. I feel no different from being off the medication than I did taking the medication. And my antibodies have now been negative for over a year. 

That is pretty much my health journey in the last year and a half with Hashimoto’s and getting to the root cause of probably that and the cancer diagnoses I’ve had. 

Dr. Eric: 

That’s an awesome story. That’s great about the QT scan being negative as well as those antibodies coming back negative, not having to take thyroid hormone. You said it’s been a year since your antibodies? 

Dr. Erin: 

I have also been taking LDN. I have been doing that at 4.5mg. I am pretty sure that might have a role in reducing the antibodies and the inflammation in my body. I am still taking that. That is the only medication I do take. 

I believe it was October 2024 that I had no antibodies. Then I tested again here in September, and they’re still negative. 

Dr. Eric: 

How long have you been taking LDN? 

Dr. Erin: 

Since July 2024. 

Dr. Eric: 

If that is the case, is it better if you have to take LDN, which is suppressing thyroid antibodies, or thyroid hormone replacement? We could argue that LDN is a better option because it is preventing further damage to the thyroid. If you take thyroid hormone, it’s not doing anything for the immune system component. 

Dr. Erin: 

I never saw a reduction in the antibodies with taking MP thyroid. The other thing I also do is I don’t eat gluten. That was the first thing I pulled from my diet when I found out I had Hashimoto’s. I’ll eat it every once in a while. I feel like it’s less aggravating to my thyroid than it was. If I used to have a bit, I could feel it. My thyroid felt mad and angry. I didn’t feel good. Now I can tolerate a little bit. 

I still don’t eat it. I don’t like it. We’re human. Sometimes there are instances where there is gluten, and I’m not going to starve. You’re at a family dinner, and you’re not going not to eat because Mom made you pasta with gluten. That’s the other thing I do avoid. 

I still eat dairy. Dairy doesn’t seem to aggravate me. To each their own. Everybody is different. 

Dr. Eric: 

You mentioned an oxidative stress test. Can I ask you about that? 

Dr. Erin: 

There is an oxidative stress panel through Vibrant America. It’s newer. I did that. I haven’t gotten my latest results back yet. It basically said my cells were in a war zone. I was doing a lot of phospholipid health, trying to restore the cellular membranes, so I could restore mitochondrial function that I think I was at a disadvantage for. That’s why I was getting assaulted, and bad things were happening. 

Dr. Eric: 

That’s a urine test? 

Dr. Erin: 

Yep. What I hope I can inspire people to see is there is always a why. You don’t get these things because of bad luck. There is always a reason why these things happen in our body. 

One of the things I discovered is non-Hodgkin’s lymphoma and glyphosate. I had high glyphosate levels. I still do. They’re not as high. They’re now in the low end of normal. They were really high. Glyphosate is found in most pesticides; Round Up is the most common one. 

This probably was a reason why I got the non-Hodgkins’ lymphoma. I don’t know any other reason why. If it’s found in older men, and I am a 31-year-old woman, why did it happen? I had these levels. My body wasn’t able to get rid of it because of that poor detox pathways I have. Working on that has been able to get some of these toxins out. I thought that was a fascinating correlation, too. 

Dr. Eric: 

I tested for glyphosate. I did an organic acids test, and I had a glyphosate panel in 2016 was the first time. it wasn’t crazy high, but it was there. I did things for supporting detoxification. I did a retest, and it was still there, but it was lower. I can’t say I test everybody, but I don’t know if I have ever seen zero glyphosate levels because it is so widespread. 

Dr. Erin: 

I was going to say most everyone has BPA and glyphosate. Those are the two. My BPA is still high, and my glyphosate is still high, but not as high as it was. I have to continue to do the work is what I’ve learned. I might get to a point where I don’t have to do the work. 

I also have these genetic SNPs, these issues genetically that I can’t do certain things. My body doesn’t do it. It’s how I was born. I probably will still have to work hard for the rest of my life. 

Dr. Eric: 

Do you still do IV glutathione pushes once a week?  

Dr. Erin:

 Yep, I still do once a week. The good thing is my partner is a paramedic. He pokes me. I don’t mind doing them. It’s monotonous, but if it will keep me healthy- 

That’s why I love testing. You see the progress you’ve made. It makes what you’ve been doing so much- You get validation. What I’m doing is working. It doesn’t matter. I don’t mind doing it if I know it’s working. Maybe I can go every other week. 

I took oral glutathione when I was on vacation. It’s okay but not as effective as doing IV glutathione. If that’s what’s going to keep me healthy. I am fortunate enough to be able to do it myself. I’ll continue to do it. 

Dr. Eric: 

You mentioned sauna to help sweat out toxins. Anything else to support your detox pathways? 

Dr. Erin: 

I do coffee enemas every once in a while. I do vibration plates. I do lymphatic massage. I had lymphoma. I had cancer of the lymph node. Your lymphatic system is how we detox anyway, but it’s the only system that doesn’t move. We have to move it. That’s why we always preach moving your body. Manual lymph drainage is good. 

I actually had developed (I still have it; it’s incurable) lymphedema in my right leg from the cancer. I had a tumor by the bladder. Over time, I developed this. It didn’t happen until six years after cancer. I have lymphedema and swelling in my right leg, so I do lymphatic massages to get stuff moving on a manual basis and to help my detox pathways. 

What’s interesting is I started doing those earlier this year perhaps. I took a round of four or five. Then I went on vacation. I was behind on them. I try and go every six weeks now that I’m on a maintenance schedule. I went over two months. I just had one a couple weeks ago, and she goes, “You were pretty stuck.” It goes to show me that these things work. I need to keep up on them. 

Plus I was out of my routine. We were on vacation and traveling. I didn’t have my sauna or vibration plate. I tell that to my patients. If you don’t think that the supplements you’re taking or what you’re doing is working, then stop them. I guarantee you that you will feel different. Yeah, they were working. Sure enough, they said they felt better when taking supplements, or their labs looked better. 

Like I said, it’s validation that what I’m doing is working, so I will continue. I am trying to think what else I do. Mainly a few supplements. I do some detox supplements. I have been doing a lot of gut work, even though I don’t have issues with my bowel movements. Those are healthy. I have been doing a gut healing protocol. I have done parasite cleanses, candida work. Everyone has that to an extent. I have been working on my gut lately and my stress levels. 

Not necessarily stress, but- I posted about this on Instagram. I am not stressed. Yeah, I own a business, and I’m busy, but I’m not stressed. My Oura ring would tell me I am stressed, and I couldn’t figure it out. I was sitting there watching a mindless reality show that isn’t stressful, and it was saying I was stressed. 

This has to do with my healing process. My body is under a lot of stress. It’s trying to heal. I swear within the last month or two, after I have been working on this stuff for over a year, and now the gut stuff, my stress levels are way down. My HRV levels have gone way up. I really feel like I have turned a corner as far as my body’s actually working again, which is really good. 

Dr. Eric: 

HRV, for those who aren’t familiar, is heart rate variability, which is from the Oura ring. 

Dr. Erin: 

Yeah. I used to have readings in the 20s and 30s. I look at my patients’ Oura data all the time. “You have some good HRV. What’s wrong with me?” Now I’m in the 70s. It’s awesome. 

Except the luteal phase. Women, if you have an Oura ring and have crappy readings in the luteal phase, that’s pretty normal, especially right before your period. It’s okay. 

Dr. Eric: 

Good to know. How frequently do you do sauna and the vibration plate when you’re home? 

Dr. Erin: 

Another thing I do is red light, but that goes with everything. I try to do sauna four times a week. There is research that if you do it four times a week for at least 20 minutes, you have a 40% all mortality reduction, which is pretty awesome. We just got a puppy, so my routine has been not normal. 

I go to the gym, come home, turn on my sauna, make my breakfast, do my vibration plate, do the red light in the sauna, take a shower, then do the cold plunge after that. I try and do this four times a week. Sometimes, I try to do a vibration plate every day because it’s only 10 minutes. I have been out of my routine lately.  

Dr. Eric: 

You do a cold plunge four days a week? Sauna, shower, cold plunge? 

Dr. Erin: 

Yep. 

Dr. Eric: 

Okay, cool. I have not done cold plunging yet. I do cold showers, which I know is not the same. One of these days, maybe I’ll be brave enough to do a cold plunge. 

Dr. Erin: 

Unfortunately, in Arizona, we don’t get cold showers because our water is too hot. Maybe in the winter. The cold plunge feels real good here in Arizona. Mine is outside in our patio. It’s good. It’s only two minutes. 

Dr. Eric: 

I was about to ask, I assumed a couple of minutes. 

Dr. Erin: 

Two minutes in the cold plunge. I only keep it at 50. Women don’t need it much colder than that. Not much more than two minutes. Maybe three minutes. I just do two minutes. 11 minutes a week is where the research is. Maybe I’ll throw in an extra day of cold plunge there. I like it. 

Dr. Eric: 

During your health journey with cancer, Hashimoto’s, did you do any functional medicine testing other than oxidative testing? Did you do stool tests or adrenal tests? Did you mainly do oxidative stress?  

Dr. Erin: 

With cancer, no. I didn’t know anything about naturopathic medicine when I was diagnosed with cancer. I met a naturopathic doctor after I had been deemed cancer-free. I didn’t do any functional testing during my diagnosis. 

I have probably done every test out there throughout my eight years of being out of school. I never really did anything about it. I would get the results and say okay. We’re the worst patients. I didn’t do anything about it.

Most recently is when I did all of the environmental toxin tests. I have done an OAT. I have done neurotransmitter testing. I have done heavy metal testing. I have done stool testing. I have done cortisol, awakening response, the four point salivary testing. I have done DUTCH testing. I wanted to do DUTCH testing for my estrogen metabolism for cancer. That’s the urine test for hormones. I just did another stool test, so I am waiting on that. 

Dr. Eric: 

When you treated for parasites, did you treat based on the findings of the stool test? Were the stool tests negative for parasites, and you did a regular parasite cleanse? 

Dr. Erin: 

I did the parasite cleanse because at the place I do my lymphatic massage, he does muscle testing. I went to see him to learn a little bit more on a measurable scale. I tested for parasites through him. And some candida. 

I did the cell core parasite cleanse. Do I notice that I have passed anything? Not necessarily. Did I feel any different? No. I’m sure it did good. If you have a heartbeat, you have a parasite. I don’t recommend everybody going out and doing parasite cleanses without talking to your doctor first. 

Dr. Eric: 

Good advice. You deal a lot with hormones with your patients. What type of testing do you recommend? DUTCH testing? Blood testing to look at hormones? 

Dr. Erin: 

I like it all. I start with blood. The reason I start with blood is because I am looking at the whole person. I can get way more information on blood than I can on pee. 

If I don’t get anywhere with blood testing as far as hormones, which I usually do, I’ll go to urine testing, like a DUTCH test. I just ordered a DUTCH test for a patient who is struggling with her hormones. We have been doing a lot of work and not getting anywhere. Let me see how she is metabolizing, which I can get through DUTCH. I typically do blood because I can get way more information, way more labs. 

Dr. Eric: 

Do you test thyroid in most people? 

Dr. Erin: 

Oh yeah. Hormones, full thyroid panel with antibodies. Adrenal function, like morning cortisol through blood, and a full reproductive hormone panel, in addition to blood sugar, vitamins, cholesterol, iron. 

Dr. Eric: 

You mentioned Dr. Jen. She was on my podcast. Has she been on your podcast yet? 

Dr. Erin: 

No, but I would love for her to be on my podcast. 

Dr. Eric: 

You should reach out to her. She’s great to chat with. I told you about the conference I am going to. She was there last year. She did her book signings. 

Dr. Erin: 

Yeah. Breast cancer is such a thing. I really wish it wasn’t a thing. If anybody is listening that is going through breast cancer or knows someone who has been diagnosed with breast cancer, get her book, The Smart Woman’s Guide to Breast Cancer. I didn’t have breast cancer, but I had DCIS, so I bought it. It made me feel so much better. I went down a rabbit hole with her podcast, Keeping Abreast with Dr. Jen. I just gave it to a patient today. You can learn so much from her. It really just made these light bulbs go off in my brain. 

There is a reason why. All the imaging I had done in 2022 for my breast. In the lumpectomy and the biopsies. Did that play a role in this stuff happening in 2024? Did it? Who knows? Things that make you go hmm. 

It’s unfortunate that nowadays, we truly as a society have to be our own advocates and come armed with questions to our doctors. Is there a better way? You’re afraid to bring it up because they might think you’re nuts. I don’t want to do a mammogram anymore. I am not going to do surgery. All right, well, best of luck to you. You’re an idiot for not doing it, right? That’s the standard of care. We don’t have to abide by the standard of care. It’s your body. You can do whatever you want. 

Dr. Eric: 

You do a lot of things, which is great. For some of the listeners, this might be overwhelming. I don’t know if I can do sauna and cold plunges and vibration plates. 

When you work with someone with Hashimoto’s, let’s say, someone with thyroid autoimmunity, what would you say to start out with? What tips can you give to someone who is new? Should they start out with diet and lifestyle? It’s a good idea to work with a practitioner. I assume you don’t like the first consultation, talking about sauna. Maybe you do. 

What advice would you give someone who was either recently diagnosed or maybe even dealing with it for a long time and decided, “Hey, I want to address the cause of the problem?”  

Dr. Erin: 

I usually start with the basics, the foundations. If those aren’t in play, we have to start there. All of those are in play. I had gone to medical school. The foundations are sleep, hydration, movement, and diet. That is where we’ll start. Sometimes, people have two out of four things dialed in. Maybe they have zero out of four things dialed in. We will dial them in one by one. 

If you are only drinking one glass of water a day, let’s work up to two. Then three. Let’s make a goal. If you’re eating processed foods, let’s replace at least one meal with a homecooked meal. Teach them. 

There is a thing that came out from my naturopathic school, the naturopathic organization about nutrition and how naturopathic doctors get over 155 hours of nutrition in our medical school, whereas medical doctors only get 19 hours. We know what we’re talking about with nutrition. 

We’ll usually start there. Food is medicine. We can get a lot of good medicine from food. Nobody knows how to eat. That’s why we’re such a diabetic pandemic here, and everyone is obese. It’s a mess. We don’t know how to eat. It’s not anybody’s fault. Nobody teaches us how to eat. I’m going to go to McDonald’s and get this happy meal. It’s not food. It’s not good for you.

With diet, it doesn’t have to be hard. Shop around the perimeter of the grocery store. Maybe abide by the clean 15 and dirty dozen. It’s the Environmental Working Group’s lists every spring. They put it out in the summer this year. It’s the top 15 foods that are clean that you can purchase conventional. The dirty dozen are the top 12 foods that are treated with the most pesticides and chemicals, so you want to buy those organic when possible. Abide by that. If you start there, you’re doing something. 

Movement. Start by going for a walk for 10 minutes. You don’t have to do a 10k. Just move your body if you haven’t done movement in a while. 

Sleep. I think sleep is where I start with a lot of my patients. They’re not sleeping well. Your body can’t restore or repair. You will feel like garbage. You won’t have energy. Then you don’t want to eat well or move. If I get you to sleep, then you will have more energy, and you will eat better and want to move.

If those things aren’t dialed in, then sauna, cold plunge, any of that is not going to be helpful anyway. 

Dr. Eric: 

Great advice. I agree. Definitely want to start with the foundations. If someone is eating inflammatory foods, if they’re stressed out all the time, if they’re sedentary, it will be difficult to heal. Not getting sufficient sleep, like you said. Start with the basics. 

Later on, once they do that, maybe they can incorporate some of these other things like red light, sauna, cold plunges. All of these could be great options as well.

Before we wrap things up, anything else that you’d like to share, Dr. Ellis? 

Dr. Erin: 

My best piece of advice would be you know your body best. Don’t stop at no. If you aren’t getting the answer that you deserve and want to hear, keep asking. 

When I was diagnosed with cancer, I had this symptom and this swelling in my groin, and I knew something was wrong. I kept getting dismissed. My doctor said it’s nothing; I was too young to have cancer. It just got worse. Something wasn’t right. Can we get more imaging? Can you send me somewhere? What is going on? 

Finally, we got somewhere. Not the answer I wanted. If that never happened, I wouldn’t be sitting on this podcast with you. Life happens for a reason. 

Your symptoms are messages. Your Check Engine light is going off in your car. Same in your body. Something is not right here. Let’s figure it out. 

You should have energy in the day to do the things you want. You should be sleeping soundly. You should be having daily bowel movements. You shouldn’t have headaches, stomach pain, diarrhea, crappy periods. If those are happening, something is not balanced in the body, so let’s figure it out. You can heal and feel like yourself again. 

Dr. Eric: 

Well said. Where can people find out more about you? I know you have a hormone quiz. Feel free to share. 

Dr. Erin: 

I have a hormone quiz. You can find it on my social media and my website. I am very active on social media. Most active on Instagram, so come find me over there, @Dr.ErinEllis. Give me a follow. I usually shout out all my new followers in the DMs. Social media, website. 

I have a podcast. I am on a break now, but I have 3-4 years, over 200 episodes to watch. I should be back at the beginning of the year. 

Dr. Eric: 

Awesome. This was great. Thanks for coming on, Dr. Erin, sharing your story with both the cancer and the Hashimoto’s healing journey. I found it to be fascinating, and I’m sure the listeners did as well. 

Dr. Erin: 

Hope so. Thanks so much for having me, Dr. Eric. 

Dr. Eric: 

You’re welcome. Thanks again.  

A new study may have just changed how we think about two nutritional supplements that can benefit those with Graves’ disease. In this episode, let’s discuss how this combination may help lower thyroid antibodies, improve symptom control, and even reduce the total dosage of methimazole.  If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Hello, everyone. Welcome to another episode. In this episode, I am going to discuss a recent study on Graves’. This journal article came out in August 2025, a few months ago. It discussed how taking L-carnitine and selenium can be beneficial for Graves’ patients who are taking methimazole. 

Even if you are not taking methimazole, I think this study is important, as it still demonstrates the benefits of combining selenium and L-carnitine. There have been separate studies showing the benefits of selenium and thyroid autoimmunity. There have also been a few studies showing that L-carnitine in larger doses—2,000-4,000mg—can block the entry of thyroid hormone into the cell. In some cases, it can be used as a substitute for antithyroid medication. I am not specifically telling you to use L-carnitine as a substitute. 

This is the first study, I’m pretty sure, that looks at combining selenium and L-carnitine in Graves’ patients. This does involve patients taking methimazole, too, essentially increasing the effectiveness of methimazole. It still is worth exploring the possibility of taking selenium and L-carnitine by itself.

I’ll talk more about this because it’s not like I haven’t been recommending selenium to most of my Graves’ patients. L-carnitine, I can’t say I recommend it across the board. I definitely recommend selenium more frequently, but I have a number of patients who take L-carnitine, too. 

Let’s talk more about the study. Again, I have the study in front of me, which I’ll make sure to include the link. I won’t read the study verbatim. Essentially, the trial asks: Can adding a combination of L-carnitine and selenium to standard methimazole therapy improve outcomes in new Graves’ patients? 

It involved 60 patients with newly diagnosed overt Graves’. They were randomized into two groups, one with methimazole alone and another group with methimazole and a supplement containing L-carnitine and selenium. 

The research is measuring thyroid hormones: free T3, free T4, TSH. It also looked at TRABs. I don’t think specifically the TSIs. You could test the TSIs in a blood test, but you could also test the TRABs. They looked at the TRABs. If you’re not familiar, TSI is thyroid stimulating immunoglobins, which is a type of TSH receptor antibody. 

It also looked at symptom scores for every two months for up to 24 months. Patients also filled out the questionnaires about classic hyperthyroid symptoms, such as increased resting heart rate, tremors, heat intolerance, and irritability. 

Let’s discuss some of the major findings. As far as what did not change significantly, the time for TSH, free T3, and free T4 to normalize was not significantly different between the two groups. In other words, by adding L-carnitine and selenium, it didn’t seem to speed up the normalization of thyroid hormone levels compared just to taking methimazole alone.

What did improve in those that took L-carnitine and selenium along with methimazole? First, the antibodies turned negative sooner, which is great. I mentioned before that there are a lot of people who take just methimazole. Most people are just taking methimazole. Some are taking selenium on their own. It’s not like people have to go full-out taking a natural approach. 

The point is, methimazole is focusing more on the thyroid than the immune system, but there have been a good number of studies showing that selenium can influence the antibodies, which makes sense. It helps to reduce oxidative stress.

It’s not addressing the triggers. If you have other triggers, I could talk more about this. I don’t know of any studies showing that L-carnitine normalizes antibodies. In those taking L-carnitine, selenium, and methimazole, the TRABs turned negative sooner. That suggests the supplement they took may help with the autoimmune component of Graves’. That’s a big finding.

Also, another positive finding is those taking the supplements had a lower methimazole dosage, so they required less methimazole on average. Their total lifetime exposure to methimazole was significantly lower. That is another benefit. 

If someone is on higher amounts of methimazole, let’s say 20mg, which is like a medium dose. 40mg is a higher dose. Perhaps a combination of that methimazole along with L-carnitine and selenium might allow the person to take a lower dose of methimazole. 

Again, it’s not a surprise because L-carnitine has some antithyroid effects by blocking the entry of thyroid hormone into the cell. Selenium can affect positively that autoimmune response. It’s not addressing removing triggers or healing the gut, but it helps to reduce oxidative stress. 

It makes sense that the combination of selenium and L-carnitine along with methimazole could result in less methimazole needed. I wish there was a study of bugleweed with selenium or bugleweed with L-carnitine or maybe all three. That study is not out yet. 

A higher rate of remission is also another benefit. The supplement group had substantially higher frequency of going into remission without needing surgery or radioactive iodine. 

We don’t know the relapse rate. We see that all the time with people who are just on methimazole. Months go by, and then the doctor mentions that the person is in remission. Then they are taken off the methimazole, and then perhaps a few months later, sometimes, longer than a few months, many times, if not most of the time, they will relapse. 

The person could take lower amounts of methimazole, which is always a benefit. Methimazole commonly causes side effects. It also does affect the gut in a negative way. The less methimazole you can take, the better. Better symptom management as well. 

There were some limitations of the study. It was not a blinded study. There was no placebo control. Patients and doctors may have known who was getting the supplements. This can influence symptom reporting or expectations. The symptom questionnaire that was used was not fully validated. The supplement dose and form matters.

It’s also worth mentioning that only 83mcg of selenium was taken, and only 500mg of L-carnitine was taken. I say “only” because I commonly recommend 200mcg of selenium, as do a lot of other practitioners. When it comes to L-carnitine, the other studies show that between 2,000-4,000mg of L-carnitine is what’s needed to block the entry of thyroid hormone into the cell. This study only used 500mg of L-carnitine. It would be interesting if different doses were used, too. 200mcg of selenium along with higher amounts of L-carnitine. 

I also should mention that over the years, I’ve had a lot of people take selenium. The majority of people eventually take selenium. If you just started working with me, I don’t always give it after the first consultation. If I didn’t recommend it right off the bat, usually, I am recommending it by the second consultation. 

L-carnitine, I don’t always recommend. From a symptom management standpoint, I’ve had a lot of success with bugleweed over the years. I typically recommend bugleweed initially. It depends. Some people do take bugleweed along with L-carnitine. Some people switch to L-carnitine after bugleweed doesn’t seem effective.

Even though not everybody takes selenium and L-carnitine in my practice, I have had a lot of people over the years take both. In higher doses, too, than what was used in the study. Again, it doesn’t always result in normalization of the antibodies. It’s something that people can definitely try. Keep your expectations in check. 

Taking selenium and L-carnitine alone, they’re not addressing the underlying cause of the problem. You still want to do everything I talk about on this podcast. Many episodes talk about diet and lifestyle. Looking at other triggers, like infections, environmental toxins/toxicants, mold, heavy metals, microplastics. 

This was encouraging. Don’t get me wrong. I’m glad they have this study. Like I said, it would be amazing if they released a similar study with bugleweed instead of or in combination with L-carnitine. I don’t know if that will get done unless I put it together, which I have never done. I would need some assistance doing that. It would be very interesting to see that combination. 

Just wanted to share this new research study. It is specific to Graves’ patients. If you have another hyperthyroid condition, like toxic multinodular goiter, again, it’s not autoimmune toxic multinodular goiter. Some people with that condition can have an autoimmune component, but typically, they don’t. The L-carnitine might help with thyroid hormone. Of course, a lot of people with toxic multinodular goiter are also told to take methimazole. We wouldn’t be modulating the immune system like this study succeeded in doing. 

I wanted to share this study. I found it interesting. Hope you found it interesting as well. 

Also, I wanted to mention that if you’re dealing with Graves’ or a different hyperthyroid condition, it can feel incredibly lonely. You go online searching for answers. Most of what you find online is about Hashimoto’s. Most of the information is hypothyroidism. Most podcasts, too. This is the only one that has an emphasis on hyperthyroidism and Graves’. 

When you go to your doctor, of course, they’re saying three things: take antithyroid medication, do radioactive iodine, or have surgery. No one explains why you have hyperthyroidism. For those with Graves’, they don’t explain what your antibodies mean. They might test you one time, and it might be a struggle to retest. Could be confusing, overwhelming. At times, it makes you feel like the only one going through this. 

That’s one of the main reasons why I created a new community specifically for Graves’ and those with other types of hyperthyroid conditions that is not on Facebook. No one should have to walk through this alone, confused, unsupported. Inside this group, we focus on answers you can’t find elsewhere as well as give support that can make a big difference.

The name of the group is Healing Graves’ Naturally. Even if you have a different type of hyperthyroid condition, I think you can still benefit from joining.

I do have a hyperthyroid-related group on Facebook. But it is really large, which might sound appealing. It has close to 25,000 members as of recording this. To me, it is overwhelmingly large. I wanted something smaller. I wanted something off of Facebook because Facebook could close my group at any time. 

As far as some of the benefits of this group, which is on a platform called School, it gives hope beyond the standard three options. You’re not going to hear about antithyroid medication, radioactive iodine, or surgery. Not to say others might not bring them up in the group, but the goal is to go beyond those three treatment options with natural root cause approaches. 

Of course, you will get some guidance from someone who’s been there. I have been in your shoes. As you may know, I personally overcame Graves’. I know the fear of the rollercoaster of symptoms. I know what works and what doesn’t work. 

I also talk about my process of the Save My Thyroid method I have been using to help people all over the world. For many years, I have been in remission since 2009. I have been working with other people ever since then.

Evidence-based natural solutions. That is what this episode was about: giving some updated research, practical science-backed strategies, nutrition, lifestyle, functional medicine insights. 

Right now, the group is free. My goal is to help as many people as I can. At the same time, I don’t want it to get as big as Facebook. My plan is it will become a paid group eventually. It won’t be within the next few weeks or months, but it will most likely make the transition to a paid group.

Those who join for free will not have to pay anything. Once you’re in the group, you’re in. It won’t be a massive charge, but you might as well join for free while you can. 

Also, as an incentive to join, you will also get free access to my brand-new Graves’ survival road map training. It’s not just a single video. This is almost like a course. I should call it one. It has eight modules. All you have to do is click a link in the show notes to join the community. You’ll be happy that you did. 

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