Recently, I interviewed Corie, who was diagnosed with thyroid eye disease and Graves’ disease and who found that improving her diet greatly helped with her condition. We discussed her path to diagnosis, the symptoms that have resolved and those that continue to linger, the impact of an anti-inflammatory diet, the challenges of being a caregiver for an elderly parent, the role of stress management, the interconnectedness of diet, stress, and thyroid health, and more. If you would prefer to listen to the interview you can access it by Clicking Here.
Dr. Eric Osansky: Welcome to another Save My Thyroid audit. I have with me Corie, who is joining me from Washington State. Corie, thank you so much for joining us. How are you doing today?
Corie: I’m doing good. Thank you for asking me and for having me on.
Dr. Eric: You are welcome. I’m really looking forward to this conversation. You have been dealing with thyroid eye disease. You wrote that it took them a long time to diagnose this. You have had some godo results following an AIP diet. How long ago was it that you were diagnosed with thyroid eye disease?
Corie: It was last year. It took them forever. It actually started in March. My mother had just passed away. I got this big bags under my eyes. I just thought it was from being outside, mowing the lawn without wearing a hat becusae the sun is pretty intense here. That was all the beginning of it.
At the end of July, I started with the double vision. I had that for at least two months before they actually sent me to an eye specialist who said, “You have thyroid eye disease.” At that time, I had seen an endocrinologist, but he wasn’t even sure that I had thyroid eye disease. Anyway, he had ordered all the tests, and they came back positive for Graves’. After the professional eye specialist said that about the TD, then he agreed with it.
Dr. Eric: You had the TSI that was elevated. The TRABs. You’re on methimazole, 2.5mg?
Corie: I was, yes. My endocrinologist only ordered it until each time I was going to go back and see him, so I had run out of it. I put in a request to have it refilled because it wasn’t time yet for me to see him, and that’s when he found out he was gone. They hadn’t notified me of that. He had ordered the repeat labs already, so I had those done. They told me I could go ahead and have them done even though he wasn’t there. My TSH was six something. When my attending went ahead and reordered the methimazole, I did not go back on it.
Dr. Eric: Your TSH was 6 when you were on the methimazole?
Corie: Yes.
Dr. Eric: Wow. 2.5mg, very low dose. That was probably a good indication you didn’t need the methimazole any longer. Your antibodies have improved, but they’re still elevated?
Corie: Yes. The TRAB is now 3.96, and the TSI is down to 260%.
Dr. Eric: 260%. The range is less than 140% on that lab?
Corie: Correct.
Dr. Eric: The TRAB is probably 1.75. They are definitely elevated but not as high as they were. The double vision has improved. You’re no longer experiencing that?
Corie: Yes. After about five or six months, just before I went on the AIP diet, it cleared up. It started fluctuating t first. I had gone ahead and gotten the prism glasses because I couldn’t drive or anything because I couldn’t see well enough. Everything was raised above the other. My eye doctor wasn’t very familiar with it. He had told me if I went that route, I wouldn’t be able to go back to normal glasses. It turned out he was wrong. I was able to easily go back to regular glasses once the double vision cleared up.
Dr. Eric: You went on AIP after the double vision cleared up. Diet had nothing to do with the double vision improving.
Corie: No, not the double vision, but it greatly improved all the eye swelling I had. That really ewnt down. In fact, I had been sent to another rspecialist because I had considered doing that medicine that they do for the thyroid eye disease. He was the only one in the area that did it.
Dr. Eric: Was it Tepezza?
Corie: Yes. When I went to see him, it was the university of Oregon, they were doing some kind of study. He offered me to be included in the study group of this experimental drug they were doing. While I was debating it, I had gone on that AIP diet. Everything greatly improved. When I went back to see him, he was impressed with how less everything was. I still had the fat that builds up around your eyes and the bulging, but mine wasn’t quite as bad as some other people who have had a lot of trouble with that. Everything was put on hold as far as that. I was glad. When he told me the percentage of people who have a recurrence of the thyroid eye disease after Tepezza, and some of the other ones, I didn’t want to go that route. Plsu you can have hearing problems with it, and I already had hearing problems from a childhood tumor. I didn’t want any more.
Dr. Eric: I agree. With Tepezza, hearing loss is one of the potential side effects. tinnitus, ringing in the ears, another one. Some people do need more than one round. If those who are not familiar with Tepezza, it’s infusions. You get eight infusions three weeks apart. I believe it’s still like that. Some people might go through the 24 weeks and might need additional treatment with Tepezza. The side effects can be a little scary. I’m glad you also didn’t need to take Teepzza.
Do you know what your antibodies were previously? You said your antibodies decrease.d I don’t know if you have handy your previous numbers.
Corie: Yes, the TRAB started at 11.59.
Dr. Eric: Okay.
Corie: My TSI originally was 356%, but it went up to 446% and then started coming down after I went on AIP.
Dr. Eric: It was originally 356 and went up to 446.
Corie: Right.
Dr. Eric: Now it’s 260. Wonderful. You’re no longer following AIP. You followed it for three or four months?
Corie: I still pretty much follow it. I definitely don’t do any of the gluten. I stopped that. I try and stay on it. My worst thing is Diet Coke. When I was on the strict AIP, I was good about it. I did the paleo diet several years ago, but ecause of the weight I lost, it bottomed out my blood pressure, and my heart rate was up. I have no idea. They told me I wasn’t drinking enough and eating enough salt. I slacked off on that. I still kind of follow a paleo diet but not as strict.
Dr. Eric: How frequently do you drink Diet Coke?
Corie: Probably a couple times a week. I used to have it in the house. that was my main drink. I don’t keep it in the house at all because otherwise I wouldn’t drink anything else.
Dr. Eric: Otherwise, you said you’re gluten-free. Are you dairy-free as well?
Corie: I was dairy-free. It was one of the things I reintroduced. It didn’t seem The only thing it ever did with me was a runny nose. I have found that since I did the AIP, everything almost makes my nose run. I can eat an apple and get a runny nose. I’m never sure exactly what causes it.
Dr. Eric: Might have some histamine issues. How is your gut? You can’t always go by symptoms, but do you have any digestive symptoms? Do you have regular bowel movements, or do you have more constipation or loose stools?
Corie: No, I have regular bowel movements. If I try to eat some of the retirndouced foods, like gluten free, I might have more trouble being regular. I make a raw sauerkraut. As long as I remember to have some of that every day, I’m usually pretty good. I don’t have a lot of trouble with that. That’s why it was hard for me to say, “Yeah, I had leaky gut” when I never really had any major gut symptoms. The only thing I ever had was kind of a sludge gallbladder, but that’s gone back and forth. Sometimes, they tell me I have it, and other times, they tell me I don’t.
Dr. Eric: All right. Any other not necessarily digestive symptoms, but any other symptoms? Are your energy levels okay? Do you have any other symptoms that bother you?
Corie: I do have fatigue. I also get up very early, and I don’t always get in the eight hours of sleep I would like to get. We take care of my 95-year-old mother-in-law who has Alzheimer’s. If I want to get anything done, I like to do my Bible reading and prayer time in the morning. I have to get up early. Otherwise, she is wandering around. I don’t always get enough sleep, so I never know if that’s why I’m tired a lot of the time, or if it actually is food-related or Graves’-related.
Dr. Eric: Could be any of these. Not getting enough sleep is a common cause of why a lot of people have fatigue. Eating the wrong foods could be a factor as well. Reacting to foods. Graves’ itself If someone has high thyroid hormone levesl due to Graves’, that won’t necessarily cause fatigue, but the inflammation associated with it. it can also have a negative effect on mitochondria, the energy powerhouses of cells. Sometimes, in some people, Graves’ will cause fatigue. When I dealt with Graves’ back in 2008, I didn’t deal with fatigue. Over the years, working with a lot of people with hyperthyroidism, some people do for the reasons I mentioned and other reasons as well. Nutrient deficiencies could be an issue. I’ve had patients and one audit people have lower nutrients such as iron. The only way to know is by testing. This person post-menopause, so she wasn’t cycling. She was actually following more of a carnivore-based diet. She was getting enough through diet. But in her case, it was gut-related. Obviously, everyone is different. My point is nutrient deficiencies could also sometimes cause fatigue.
Is everything else okay? Is it mainly just low energy levels? Are you experiencing any pain, like joint pain or muscle pain?
Corie: I already had back problems. I think I told you I was an ICU RN. I hurt my back at work. I had surgery. I have chronic back problems. I also have in the past I’ve had hip problems because of mindalo injury. It goes down into your hips. Most of that has been eliminated with the anti-inflammatory diet. I used to be on Aleve all the time. When I read what it does to the gut, I stopped it again. When I went on paleo, I was able to get off of it because it took care of all the inflammation at that time. when we stopped doing the strict paleo, then I ended up back on it because I was getting hip pain again.
Anyway, with this, when I read all the stuff that it does to your gut, I stopped taking it. I haven’t really had any trouble except for my elbow. It bothers me. Probably from gardening stuff.
Dr. Eric: Just your elbow. Sleep could be better, which is understandable hwy it’s not, with your mother-in-law. I’m sure that’s a little bit stressful, too.
Corie: Oh, that’s the major stress I have. I’m convinced that’s what kicked me over into Graves’. I think I had mentioned that I had been on thyroid medicine because I had gone to a nurse practitioner who told me, “Most people feel better at a higher level.” I think I was 2. Something. She thought I would feel better at a different level. I can’t remember now since it was back in 2013 if she meant lower or higher than what I was. She put me on the medicine.
I have a strong family history of Hashimoto’s. everybody just assumed I had Hashimoto’s. I don’t know whether I did or not because they never did the antibodies at that time. they didn’t do those until later. My Hashimoto’s antibodies were all negative.
Dr. Eric: Probably not if they were negative years later, they probably were negative back then as well. Just the TSI and TRAB recently, those were the only ones positive?
Corie: Correct.
Dr. Eric: One question I have is how would you like your health to be 6-12 months from now? In your opinion, what is the #1 thing from preventing you from restoring your health, from getting your antibodies to be normal? Is there a potential roadblock? Maybe it’s the stress we spoke about.
Corie: I’d like to be like you, where I was able to put the Graves’ into remission. that’s what I would like. Have all my labs normal.
It is a big stress factor with my mother-in-law. You’d think as a nurse, I could handle this, and I would be okay and know how to deal with it. But I’m not very good at it. She is sweet, too. It’s not like she is a terror to take care of or anything. It’s the constant repetitive reminding her to do this or that or not do this or that. Right now, there is no other option for her, so I’m trying to be better at it. I’m not doing really well at it.
I didn’t realize about the Graves’ rage. I just saw your podcast on that. I didn’t realize it was a thing. I often wondered. I have a temper because my dad had a temper. We grew up with that. I had hoped, giving me an excuse, that the Graves’ had something to do with it. I was having a lot of trouble controlling, suddenly getting mad about something that was little or stupid. I’m working on that.
Dr. Eric: Okay. The Graves’ rage. I probably should have come out with that episode sooner. I didn’t experience Graves’ rage when I dealt with Graves’, but a lot of people do. It does affect mood and makes some people more angry and irritable. Pretty common.
You want to get into remission, which is everybody who listens to this podcast. they want to restore their health and get the antibodies normal. I have some podcast episodes onantibodies. I do have an episode #150 where I talk about lowering antibodies. You did a lot of things with diet, which is great. It goes beyond that. I also will have a series of podcast episodes talking about lowering antibodies, so look out for that.
Have you read my most recent book Hyperthyroid healing Diet?
Corie: I have both of them. I’m in the middle of that book, on page 300 almost.
Dr. Eric: I should have asked you. How did you find out about me originally?
Corie: There is a girl back home who contacted me after my sister-in-law had told everyone I had Graves’, and she had Graves’. She had it far worse than me because she had blood pressure and high heart rate. She told me about Dr. Amy Meyers’ book. Then she said, “And there’s this other book here with this guy, but I haven’t gotten that one yet.” When I saw it, I ordered both your books. Your first one, I read right away. I loved it. It was very down to earth and easy to read. All your tips were very easy to implement. Nothing was hard about it. nothing seemed daunting. When you’re first going through this kind of stuff, everything can seem daunting, but your book was very easy to read. I really enjoyed that. I enjoyed hers, too, but hers took me longer to go through than yours. She actually gets into more technical stuff, which is noting wrong with that. Your second book goes through more technical stuff, so that’s why it’s taking me a little longer to get through.
Dr. Eric: Dr. Meyers. Years ago, around 2015, she had a thyroid summit, so I was part of that. I was the only speaker on hyperthyroidism. That is the only erason why I was part of the summit because she oculdn’t find anybody else. I sent her a copy of my book, and she invited me on the podast to talk about hyperthyroidism. You can find it on her YouTube channel now. She spelled my name wrong, “Erik,” and it’s “Eric.” I think she posted it in 2023, but it’s from 2015.
You want to normalize your antibodies. Stress is one of the biggest roadblocks. Obviously, you can’t eliminate the stressor. You’re not alone. A lot of people are caretakers. My dad had some health issues. He’s in his mid-80s. He doesn’t live with me, so it’s a difffernet situation, but it’s still a stressor. With you, it’s a bigger stressor because your mother-in-law is living with you. Dealing with Alzheimer’s is challenging. It’s good she has a good personality. Even though you can’t change this situation, you still have to try your best to work on stress management. Try to get as much sleep as you can. If you can, maybe take mini naps. I don’t know if she takes naps during the day. It might seem like an opportunity to do things if she does that, but you also want to take care of your health. If you are only getting 5-6 hours of sleep, and you’re waking up to try to get things done, or staying up late, it will be hard to recover. Definitely try to get another 30-45 minutes of sleep, whether it’s at night or with naps. Block out tiem for stress management, even if it’s 5-10 minutes, doing some deep breathing. Do adrenal testing, which I recommend to everybody. Probably you have adrenal issues. I usually recommend adnreal testing, so we can see what imbalances someone has. Have you done any functional medicine testing or just typical blood testing?
Corie: I did do the adrenals. The regular MD ordered it, so it was all blood testing.
Dr. Eric: Just cortisol in the morning, DHEA, maybe?
Corie: Right. I do have those. The ACTH was 7. The AM cortisol was 10. He did a DHEA sulfate, and that was 19.
Dr. Eric: Hmm. That seems low. Depends on the range of DHEA sulfate. They must have used a different range.
Corie: They all said they were within normal range, but some were on the lower end of normal.
Dr. Eric: Even cortisol in the blood, 10 is within the range, but sometimes the blood tests spikes up the cortisol. Either getting the blood draw itself. Sometimes, it will make it higher than it looks. If someone is a 10, to me, you might be a 10, but you might be lower than that. The advantage of saliva testing is looking at the circadian rhythm of cortisol. Cortisol fluctuates throughout the day. Should be at the highest level in the morning and gradually decrease throughout the day. Some MDs are starting to recommend saliva testing, but most do blood testing. DHEA or DHEAS, ACTH as well, which is a pituitary hormone, kind of like TSH for adrenals.
Getting back to thyroid eye disease. AIP helped. Have you done anything else, like taking selenium or Vitamin D? Have you had Vitamin D tested and supplemented?
Corie: I don’t think I’ve had Vitamin D tested. I have been on selenium for a long time, years. We have been taking that. D3. I had someone tell me that everyone in the Pacific Norhtwest needs to take Vitamin D because we don’t get as much sunshine as everybody else. We take 5,000 Ius of D3 a day.
Dr. Eric: I take 5,000 Ius per day. Not to say everybody needs that. I would say ask your doctor in the future to do a test just to see what it shows, just to make sure you’re not taking too much. Who knows? Maybe you need more. You don’t want to take too much where your levels are over 100 or are still not optimal. Are you taking Vitamin K2 with that?
Corie: No.
Dr. Eric: Make sure next time- You can either take it separately. A lot of Vitamin D3 supplements come with K2. Vitamin D increases intestinal absorptoion of calcium, and the K2 helps to guide the calcium into the bone. I would say to take some K2 with that.
You’re doing some great things. The AIP diet. I know you mentioned in the form the reintroductions. You have already done some. Diet Coke wouldn’t be one of the first ones I would have recommended. Dr. Sarah Ballantyne, I mentioned this in my book, so you should know how to do reintroductions because I have information on doing that. Dr. Sarah Ballantyne also has stages of reintroduction, which I mentioned. I usually recommend following something like that. Eggs would be the first thing, or egg yolks would be the first thing to reintroduce for most people. going down the list for different stages. Ideally, if you are going to introduce foods that aren’t as nutrient-dense or healthy like Diet Coke, that would be later on the list. I know you already reintroduced those. you want to reintroduce things one at a time. How do you know if you are getting a reaciton? one at a time, every few days. It’s not prefect, but usually if you get some type of reaction, you’re just focusing on one food at a time. you’ll notice a difference. Diet can make a big difference with Graves’ and thyroid eye disease. The Vitamin D, selenium, having healthy omega-3s. if you’re eating fish two or three times a week, great. If not, maybe consider supplementing with fish oil.
Just like I talk about in my books, besides diet and lifestyle, sometimes you do need to go beyond that and look for other areas for triggers. Finding and removing triggers, doing things to reduce your toxic burden, sometimes looking at infections. I know things can get pricey and add up. It doesn’t mean you have to spend thousands of dollars on testing, but that’s also omething to keep in mind.
In your sitatuion, the #1 thing right now is focusing on diet and lifestyle. It’s still not optimal. You are following AIP. I will say to stop the Diet Coke because the impact it could have on the gut microbiome potentially. There is some controversy over that. Some of the artificial sweeteners might negatively affect gut microbiome. If anything, follow a regular paleo diet if you don’t want to follow AIP.
The stress and sleep. It’s easy to say let’s do a bunch of testing. If you don’t have the diet and lifestyle in order, which is what The Hyperthyroid Healing Diet is about, it will be hard to recover. You have gotten some great changes with those antibodies so far. Before you do a lot of future testing, you might not need to do that, bear down on the diet and lifestyle, the stress management, the sleep. I know you’re doing a lot, but you could maybe do a little more under the circumstances. That is whatI would work on. I do recommend saliva testing and looking at nutrients and heavy metals. Sometimes, I’ll do gut testing. In your situation, it makes sense, not that you can’t do some of those other tests, but definitely focus on trying to do your best t ohandle stress and see if you can get more sleep.
Corie: Okay, thank you.
Dr. Eric: All right, you’re welcome. Thank you so much for doing this, Corie. Appreciate you getting together for this audit. Hope you found this to be valuable. Hoep the listeners found this conversation to be valuable. Hope you’er finding these audits to be helpful. Look forward to catching you in a future audit and a future episode. Take care. Thank you so much, Corie.
Corie: Thank you very much.