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

Dr. Eric Osansky: 

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

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

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

Thanks for joining us, Lucy. 

Lucy Hutchings: 

Thank you so much for having me. 

Dr. Eric: 

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

Lucy: 

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

Dr. Eric: 

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

Lucy: 

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

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

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

Dr. Eric: 

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

Lucy: 

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

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

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

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

Dr. Eric: 

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

Lucy: 

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

Dr. Eric: 

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

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

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

Lucy: 

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

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

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

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

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

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

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

Dr. Eric: 

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

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

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

Lucy: 

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

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Eric: 

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

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

Lucy: 

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

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

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

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

Dr. Eric: 

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

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

Lucy: 

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

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

Dr. Eric: 

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

Lucy: 

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

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

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

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

Dr. Eric: 

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

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

Lucy: 

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

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

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

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

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

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

Dr. Eric: 

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

Lucy: 

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

Recently, I interviewed Jordan,  who was recently diagnosed with Graves’ disease. In this episode she opens up about managing symptoms like heart palpitations, bloating, and fatigue while following the AIP diet and taking calming herbs, iodine, and other targeted supplements. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Welcome to another Save My Thyroid health audit. I am chatting here with Jordan, who was diagnosed with Graves’. Thank you so much for joining us, Jordan. 

Jordan: 

Absolutely. Thank you for having me. 

Dr. Eric: 

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

Jordan: 

Yes. 

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

Were you experiencing any digestive symptoms prior to following AIP? 

Jordan: 

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

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

Okay. You are taking an herbal approach? 

Jordan: 

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

Dr. Eric: 

Just for the SIBO itself? 

Jordan: 

For the SIBO itself and other digestive aids. 

Dr. Eric: 

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

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

Jordan: 

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

Dr. Eric: 

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

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

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

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

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

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

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

Jordan: 

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

Dr. Eric: 

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

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

Jordan: 

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

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

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

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

Jordan: 

It’s a tincture. 

Dr. Eric: 

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

Jordan: 

It’s called ThyroCalm. 

Dr. Eric: 

Maybe it’s something different. 

Jordan: 

It’s called David Winston’s Thyroid Calmpound. 

Dr. Eric: 

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

Jordan: 

Yes. 

Dr. Eric: 

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

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

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

Jordan: 

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

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

Was that the case even before you dealt with influenza? 

Jordan: 

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

Dr. Eric:

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

Jordan: 

Yes. 

Dr. Eric: 

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

Jordan: 

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

Dr. Eric: 

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

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

Jordan: 

That was in December. 

Dr. Eric: 

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

Jordan: 

Yes. 

Dr. Eric: 

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

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

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

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

Jordan: 

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

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

Dr. Eric: 

Okay. You know how much iodine two drops is? 

Jordan: 

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

Dr. Eric:

Lugal’s Solution? 

Jordan: 

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

Dr. Eric: 

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

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

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

Jordan: 

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

Dr. Eric: 

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

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

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

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

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

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

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

Does he do applied kinesiology, like muscle testing? 

Jordan: 

Not that he’s mentioned. 

Dr. Eric: 

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

Jordan: 

Correct. 

Dr. Eric: 

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

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

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

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

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

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

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

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

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

Jordan: 

No, I really appreciate your time, thank you. 

Dr. Eric: 

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

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

Jordan: 

Absolutely, thank you. 

Dr. Eric: 

 

Take care.

Recently, I interviewed Dr. Evan Hirsch, a fatigue expert who’s helped thousands recover from long COVID and chronic fatigue using his four-step Energy MD Method. In this episode we explore the “toxic five” hidden factors like mold, infections, and nervous system overload that often go unaddressed in standard care. He also explains why common treatments like IV ozone might backfire if your body isn’t ready, and why gentle nervous system retraining can sometimes be the missing piece. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am excited to chat with Dr. Evan Hirsch. We are going to be talking about long COVID, tying it into chronic fatigue, of course talking a bit about thyroid health. Let me go and dive into Dr. Evan’s impressive bio here. 

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

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

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

Dr. Evan Hirsch: 

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

Dr. Eric: I

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

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

Dr. Evan: 

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

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

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

Dr. Eric: 

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

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

Dr. Evan: 

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

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

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

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

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

Dr. Eric:

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

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

Dr. Evan: 

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

Absolutely. 

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

Dr. Eric: 

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

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

Dr. Evan: 

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

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

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

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

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

Dr. Eric: 

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

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

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

Dr. Evan: 

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

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

Dr. Eric: 

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

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

Dr. Evan: 

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

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

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

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

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

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

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

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

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

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

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

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

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

Dr. Eric: 

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

Dr. Evan: 

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

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

Dr. Eric: 

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

Dr. Evan: 

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

Dr. Eric: 

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

Dr. Evan: 

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

Dr. Eric: 

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

Dr. Evan: 

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

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

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

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

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

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

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

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

Thanks for having me on. I appreciate it. 

Dr. Eric: 

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

Dr. Evan: 

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

Dr. Eric: 

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

Dr. Evan: 

Thanks for having me on, Eric. 

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

Dr. Eric Osansky: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Recently, I interviewed Malka, who opens up about her ongoing battle with thyroid eye disease. She talks about her challenges, unexpected setbacks, and the constant search for solutions. We also talk about the lifestyle changes she’s made, the risks of different treatments, and the tough choices she faces while fighting to preserve her vision. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Welcome to another Save My Thyroid audit. I’m very excited to chat with Malka here, as she has been dealing with thyroid eye disease, cataracts, and other vision issues. Malka, thank you so much for joining us. 

Malka: 

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

Dr. Eric:

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

Malka: 

A long time. 

Dr. Eric:

20+ years, correct? 

Malka: 

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Eric: 

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

Malka: 

It was one of the classes. 

Dr. Eric: 

One of the five-day events. 

Malka: 

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

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

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

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

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

Dr. Eric: 

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

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

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

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

Malka: 

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

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

Dr. Eric: 

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

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

Malka: 

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

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

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

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

Dr. Eric: 

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

Malka: 

Swelling of the optic nerve. 

Dr. Eric: 

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

Malka: 

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

Dr. Eric: 

Yep, Tepezza. 

Malka: 

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

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

Dr. Eric: 

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

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

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

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

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

Malka: 

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

Dr. Eric: 

I understand. 

Malka: 

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

Dr. Eric: 

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

Malka: 

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

Dr. Eric: 

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

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

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

Malka:

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

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

Dr. Eric: 

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

Malka: 

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

Dr. Eric: 

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

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

Malka: 

Is that D3? 

Dr. Eric: 

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

Malka: 

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

Dr. Eric: 

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

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

Malka: 

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

Dr. Eric: 

I get it. 

Malka: 

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

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

Dr. Eric: 

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

Malka: 

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

Dr. Eric: 

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

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

Malka: 

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

Dr. Eric: 

No nuts and seeds if you are following strict AIP. 

Malka:

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

Dr. Eric:

From The Hyperthyroid Healing Diet? 

Malka: 

Yeah. 

Dr. Eric: 

You must be doing level 2. 

Malka: 

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

Dr. Eric: 

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

Malka: 

200? 

Dr. Eric: 

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

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

Malka: 

It’s all the things you recommend basically. 

Dr. Eric: 

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

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

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

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

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

Malka: 

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

Dr. Eric: 

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

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

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

Malka: 

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

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

Dr. Eric: 

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

Malka: 

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

Dr. Eric: 

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

Malka: 

Would they have tested that automatically? 

Dr. Eric: 

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

Malka: 

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

Dr. Eric: 

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

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

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

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

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

Malka: 

Thank you so much. I really appreciate it. 

Dr. Eric: 

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

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

Malka: 

Bye, thank you.