Recently, I interviewed Inna Topiler, and we talked about common and uncommon causes of thyroid autoimmunity. If you would prefer to listen to the interview you can access it by Clicking Here.
Dr. Eric Osansky:
I am very excited to chat with Inna Topiler, as we are going to discuss common and uncommon causes of thyroid autoimmunity. Before we do this, let me give Inna’s impressive bio: Inna Topiler Mooney is a Board-certified clinical nutritionist with over 17 years of experience in clinical practice. She is the founder of an integrative practice Complete Nutrition and Wellness. She is also the host of the podcastHealth Mysteries Solved: Thyroid and Hashimoto’s Revealed and the educator behind the Thyroid Mysteries Solved step-by-step program.
As a health detective, educator, thinker outside the box, and Hashimoto’s rebel, Inna loves getting to the real root of hypothyroidism and Hashimoto’s. She has helped hundreds of people balance it. She knows you are struggling, and she is here to tell you that you are not alone and show you as many possible answers as she can, starting right now. Thank you so much for joining us, Inna.
InnaTopiler:
Thank you so much, Dr. Eric. I am so delighted to be speaking with you today.
Dr. Eric:
Yeah, I am as well. I am really excited to chat with you about some common and uncommon causes. Before we do that, let’s get into your background. How did you start helping others with Hashimoto’s?
Inna:
Like probably a lot of practitioners, it started with my own health issues. They say if you have been in it and lived it, you can really, truly understand it. I know the very similar goes for you as well.
For me, it started in college. I was just having a lot of issues: skin issues, digestive issues, fatigue. I went on to work on Wall Street after college. It was a really fun, glamorous job. However, I did not feel glamorous at all. I was having more of the same.In addition to the fatigue and digestive issues, I started getting brain fog, a lot of hormonal imbalances. You name it, and I had that symptom. I was only 22 at the time. I did the rounds of doctors. I saw different primaries. I saw anendocrinologist, a gastroenterologist, a gynecologist, and a dermatologist. None of these doctors were speaking to each other. Instead, they almost blamed me. I blamed myself. There were no answers.
Finally, after rounds and rounds of doctors, I was diagnosed with Hashimoto’s. I thought hallelujah, this is fantastic. I actually have something that they know versus your labs are “normal.”“There is nothing we can do.” And I am feeling crappy. Great, what do we do now? Doctors said, “Well, your thyroid itself is actually okay now, so we do nothing.” I said, “What do you mean we do nothing?” “Well, your labs are in range, so we wait and see. We’ll wait and see until eventually the Hashimoto’s will destroy your thyroid because that’s what happens, and then at that time, we will give you medicine, and you will have to take it forever.” As you can imagine, I was not very stoked about this.
At that point, I didn’t have much of a background. I went to school originally for finance. While I did have a lot of science background, I didn’t have the functional medicine background. Even then, without that, I knew this didn’t make any sense. Why would I wait and see for my thyroid to get destroyed?
That’s when I started looking at a functional approach. I saw a clinical nutritionist who was able to show me so much of what was happening. We saw that even though the endocrinologist said my thyroid was “normal,” it was really not in the optimal range at all. My TSH was a little bit on the higher end. It was still within the lab’s range, but the lab’s ranges are so wide. I’m sure you talk about this quite a bit on the show, so your audience knows. My TSH was in the 4s, and ideally you want to be under 3. My T4 and T3 weren’t optimal. In addition to that, I had parasites, candida, mercury toxicity. I had 16 amalgam fillings. Every time I say that to people, they almost can’t believe that’s possible. Yep, I had 16 amalgam fillings. I had all types of hormonal imbalances, adrenal insufficiency, and copper toxicity.
As we found those things, most people would say, “Oh my goodness, there’s so much stuff.” I was excited because there was something we could do. This doctor I worked with really explained, “This is because of this. This issue is because of this. This is how we solve it.” For the first time, I felt there was something I could do.
We started working on all of these things. Diet was a big piece. I had a gluten sensitivity, which I refused to accept for a while, but I got around to it. I had one of the Celiac genes. Hewas able to put all of this together, so I could see this bigger picture, like a bird’s eye view.
As I started working on each one by one, things got better and better and better. I don’t want to make it sound like it was all roses, and everything was perfect right away. It was a journey, and it took time. A lot of times, in healing, you take one step forward. Sometimes, it feels like two steps back. There was a lot of learning and figuring out. Either way, there was this goal of where I needed to be.
With every trigger, as each got better, I saw improvements both in my labs and how I felt. It took a couple of years; it wasn’t overnight. But I saw such tremendous success. I’m 44 now. I started this journey at 22. I feel better now at 44 than I did at 22. It was really phenomenal.
From there, I started to help some friends. They told their friends, and I helped their friends. Then I decided, what am I doing here in finance? This is really what I want to do. I went back to school and did a few different programs. I did a master’s and some continuing education. Then I started my practice and never looked back.
Dr. Eric:
When you mentioned the 16 amalgams, that’s mind-blowing. That’s pretty much half your mouth having silver fillings. I need to ask: did you remove all of them correctly, like going to a biological dentist?
Inna:
I did. Thankfully, I realized that the fillings were an issue when I started to look into the functional medicine approach. I was then guided by this doctor on exactly how to do it. If I had found out before knowing, I probably would have gone to a conventional dentist, and then who knows.
I still think in hindsight that I did remove more than what my body could handle at a time. Knowing now, I think I would have in the past removed maybe one or two at a time versus doing a whole quadrant. I probably would have done more prep work. But they did it in the best way they could at the time.
Dr. Eric:
That was going to be my next question. How many did you get removed at a time? It sounded like four at a time.
Inna:
It was three or four, yeah. There were many sessions of that.
Everyone is different. It’s really important to optimize all the detoxification pathways before removing them. I was so shocked as to how many I had. I didn’t even think I realized I had that many. Coming to the realization that I have all of this mercury in my mouth, and it’s been in my mouth for at that point eight or nine years. I was just horrified at that thought, so I wanted them out as soon as possible. I think I myself rushed it a little bit because I wanted it out.
I am amore sensitive person, and I find in general, people with autoimmunity, whether it’s Graves’ or Hashimoto’s, we’re the more sensitive people. Pushing isn’t always the best. A little bit at a time, I find, tends to go better.
Dr. Eric:
When it comes to common and uncommon causes, would I be right to say that environmental toxins and heavy metals such as mercury are one of the more common causes?
Inna:
Absolutely. I like to divide the causes in buckets. There are many things within the buckets. The way I look at it is we have the food bucket, the things that we’re eating that our body may not like for whatever reason, whether it is because genetically, we are not predisposed to processing it, or there is another sensitivity going on.
Another bucket will be toxins, whether that is toxins from the environment, food, water. These are things like heavy metals, pesticides, and any other toxins our liver has a hard time processing.
When we think about toxins, it’s not necessarily how many toxins someone has or how big of a load it is, but it’s what is their detoxification capacity? You could take two people with the same amount of exposure. Say they eat the same type of fish the same amount of times a week. Yet one person can have more mercury than the other. Same with fillings. It’s what the body can handle. That would be the other bucket.
There is also a bucket for infections. These could be all types of infections from chronic viruses to EBV to gut infections (candida, parasites, bacteria, H-pylori). Not a common cold, but other kinds of infections.
The fourth bucket is stress. We can have five podcasts on this, I’m sure. That’s what our nervous system is doing. If our nervous system isn’t regulated, which is all of us, for the most part, that is going to affect us.
We also have to remember when it comes to stress, it’s not just emotional; there is physical as well. It’s foods, infections, and toxins; they are creating that physical stress. When we have blood sugar dysregulation, that is a huge stressor on the body that is physical.
Then there is the emotional piece. It doesn’t mean that people have to change their lives, or they have to quit their jobs. It’s more about finding ways to manage things on a daily basis. I always tell people it’s not about, “Oh, you’re really stressed. Let’s have a spa day.” You don’t want to wait until you are so stressed that you are about to burst from the pressure. It’s about maintaining a level and continuing to lower that nervous system. Once you lower it, there is always a new threshold.
I remember I was a lot more stressed than I am now. Now, I look back and I’m like, “This is nothing compared to 10 years ago.” Yet there is still more here. With every bit we downregulate, there is always that next level. It’s striving for that.
Dr. Eric:
I agree with you as far as doing something every day. Do you recommend mind/body medicine, like doing yoga or meditation or deep breathing on a daily basis?
Inna:
Yes, all of those things. It’s really important to try to find something that you personally like. Yoga is amazing, but not everyone is into yoga. If you’re doing something that your body doesn’t feel comfortable doing, or you don’t feel comfortable, it could be more stressful.
I like breathing a lot. Breathwork can be really powerful. There are so many ways of doing it. As long as we’re breathing in a more full way, and not very shallow, just from the chest, that’s going to have a natural stress reducing ability to it. There are many different workshops on breath work, but there are simple things like a box breath, for example, where you breathe in for a count of five, hold for five, breathe out for five, and hold that for five. Most people have probably heard of that. But when asked, people will say they are not doing it. Every time you go to the bathroom, you could do that. It’s pairing this with something else. If you don’t make time for it, it’s not going to happen.
One of the things I personally started doing in the more recent years is waking up a little bit earlier. I do the Miracle Morning. Are you familiar with Hal Elrod?
Dr. Eric:
I am.
Inna:
I love doing this. If you’re not familiar, he has a book called The Miracle Morning. He talks about six things that overall have proven to be beneficial and doing each of those six things for a few minutes in the morning. It’s meditation, journaling, reading something that is going to stimulate your mind, exercise, affirmations, and I forget the last one. Do you remember?
Dr. Eric:
I don’t.
Inna:
I don’t do all of these things every morning. Sometimes, I focus more on one versus the other. Even if I don’t do those specific things, waking up before my kids is like being on offense instead of being on defense. Your day goes better.
I am a fan of looking at what I want my day to be or what I want something to be like, sort of like that happy end result, and really focusing on that. Yes, I do the breathing and the journaling, but for me personally, what has worked is to be mindful of how I use my imagination.
Very often, most of us will focus on what we don’t want. We’re not purposefully thinking about it; it just happens. Say that we’re in traffic. It’s very common for our minds to start thinking, and even possibly visualizing pictures, of ourselves being really late for work. Our boss is getting angry at us. People looking at us like, “Why are you here 10 minutes late?” Thinking, “I will be late. I will get in trouble. If I get in trouble, I won’t get this or that.” Most things we worry about don’t ever come to pass, but our imagination is working in that way, where we’re actually spiraling down.
If we take that and think more about happy end results, or what it is that we want, when we are stuck in traffic, yes, we could sit there and be worried and have this tension in our stomach. Or we could say, “What do I want? I want to make it to work on time. What would it take for me to make it to work on time?” It sounds much lighter than “I will be late.” “What would it take for me to make it when I make it and for everything to be okay when I get there?” Sometimes, the traffic won’t go your way. It’s a different kind of energy. Naturally, the pictures that are going to circle around in our brain are going to be these more positive pictures.
What I like about this is it’s a little bit different than affirmations. With affirmations, you are saying positive things. There is nothing wrong with affirmations. I find that if you say a positive statement, and it doesn’t resonate with you, then you feel like you’re lying to yourself. If someone is able to feel their own energy and focus, then it feels heavy.
If you’re dealing with a health issue, say you’re feeling tired, which is a common thing for people who are dealing with thyroid issues. If you’re really exhausted, and you have autoimmunity with joint pain and some other symptoms, you’re told to say an affirmation that you’re healthy. Someone would sit down and say, “I’m healthy. My body is strong.” It’s a nice thing to say, but your mind or subconscious mind is going, “No, you’re not.” Then it’s this heavy energy, like you’re fighting with yourself. I find that not to be helpful.
If you say something in a different way, there are a couple ways. “I am committed to eating in a way that is going to make me feel more energized today.” Sounds a little lighter. Or “What would it take for me to feel energized today?” You don’t necessarily have to have an answer to that question. Saying it that way feels like, “Let me open it up to see what comes and how I could be in that energy of flow versus that ‘Oh my gosh.’”
Dr. Eric:
I love it. It’s important to reinforce blocking out time, even if that means waking up a few minutes early, like you do. That’s a big excuse people have: “I don’t have the time.” We’re not saying to sacrifice an hour or two of sleep. Maybe you could make up for it on the back end. We want you to get your sleep, but we don’t want you to have an excuse not to block out time for stress management.
What I tell people is even if you start with five minutes a day just to get into the routine. I’m like you. I recommend doing it every single day. If someone thinks they need to do it 20-30 minutes every day, that’s great to do, but it could be overwhelming, too. If you can start with five minutes, everybody can find five minutes. If they can’t, they really need to block out the time for stress management. Get into the routine of five minutes a day. Once you’re in the routine, you can gradually increase. At least that’s what I tell my patients.
Inna:
Absolutely. Once you’re in a routine, you could be mindful of what you’re feeling throughout the day. That’s almost the next step. If you start to feel tense, then you can actually stop yourself in the moment and see what are the thoughts that are coming up.
I’ll give you an example. This morning, I had a lot of things to do. I was rushing around to finish emails and notes and get my kids to school and get here for this wonderful conversation with you. It’s Monday morning as we’re recording this. Mondays are Mondays. There are always things to do.
I had a lot of beef with Mondays back in the day, which I’ve really worked on clearing. I realized a lot of that came from my parents. “The week is coming. You have to work hard.” Blah, blah, blah. I cleared those beliefs because they are all beliefs you pick up as a child before you even have a logical mind. These are beliefs you pick up from other people’s mannerisms. They are not your own. I did a lot of clearing on that, so I feel better on Mondays overall.
But I noticed this tension in my stomach. I’m answering my emails. What is happening? Why am I so tense right now? Let me stop here for a second. What’s the belief here? I think the belief is that I need to get all of this done before 12pm, or else. I have to think, okay, or else what? What’s going to happen? Let me just clear any of this belief that something has to be done, or else. Then look at what it is that I want? What I want is to be able to answer the emails, so people feel supported by my answer, and do it in a way that is easy and has flow to it. When my body is so tight, I am not probably writing the responses that are going to give those people the energetic answer that they need. It’s seeing that in the moment and shifting the thought.
As you shift your thoughts, it’s amazing what physically happens in the body. That energy controls your physicality as well.
Dr. Eric:
Yep, I agree. It’s not just about spending time in the morning, but mindfulness is important.
Inna:
Starting with something is great. Starting in the morning just to get in routine. Then you will have a very clear picture of what’s calm and what’s not. When you do have tension, you will recognize it. So often, people are all tense, and they have no idea because they don’t have a baseline for what relaxed is, or a new baseline. They may have an old baseline when they were more stressed.
Dr. Eric:
Let’s hit the food bucket. You mentioned gluten. I don’t want to spend too much time on gluten because a lot of listeners already know about it. I really want to get your opinion about other foods that might be problematic. Maybe there are certain foods across the board besides gluten, be it dairy. Maybe there are foods that depend on the person. Maybe you do food sensitivity testing. I really want to hear your thoughts on foods other than gluten.
Inna:
Agreed. We all know about gluten and the Celiac genes. We don’t need to belabor that. It does depend on the person with other foods.
I typically find that dairy is an issue for a lot of people. Not everyone. Some people can tolerate raw dairy. I do use food sensitivity testing, but not a ton. I find there are so many labs and tests that it’s not that they’re not accurate, but they are not looking at all the pathways. We can respond to a food in many pathways. If you are just checking one pathway, like IgG, and it’s negative, that doesn’t mean you can’t be responding on an IgA pathway or from a cell mediator response. That’s where it’s tricky.
I also think we can do a trial. I also refused to believe in the beginning that dairy was an issue for me because I loved dairy. What I have come to figure out—it took me a little while, and I so wish I had figured this out earlier—is dairy would react very poorly on my skin. I mentioned earlier that one of the biggest things I had was acne. I had many issues, but that was the one that bothered me the most because I was in my early 20s, living in NYC, and I looked like I was a teenager. I tried this cream, so maybe this cream made me break out. Or maybe it’s my period. It never occurred to me that dairy was this common denominator until I did some testing and saw dairy was an issue, but I still refused to believe it. Then I took out my dairy out. I used a cream with oil, yet my skin was still okay without dairy. Doing a trial, if someone isn’t able to afford to do a test or is not sure if their test is accurate.
Typically, I like for people to give 3-4 weeks. Less than that is not enough time because that food has to leave your system. You can see how you feel. It’s not always direct. I was looking for more digestive issues, and I didn’t see any changes with or without dairy. I was getting gas and bloating, but that was more of the candida and some of the other issues I had. Not eating dairy, I was still bloated at the time because I hadn’t treated other gut issues. But with my skin, it was a night and day difference. It could be joint pain or brain fog or another symptom, so I think it’s worth a try.Typically, with autoimmunity, a lot of people do react in some way that is more negative to dairy.
Lectins is another biggie. Lectins are found in grains, legumes. It’s impossible to take out all the lectins because they’re everywhere. Nightshade vegetables are high in lectins. For both myself and many of the people I see, doing a lower lectin diet is helpful, especially in the beginning.
The other thing with food is we have to be careful about eliminating too many things for too long. We were in the culture, especially probably 10-15 years ago, where people would go on a very strict diet and stay on it for a long time. We know it’s important to diversify the foods we eat because that helps in terms of diversification with gut microbes we have, having that nice variable microbiome. It’s not about taking out all foods and staying off of them.
If you’re newly diagnosed or in a flare-up of Graves’ or Hashimoto’s or any autoimmune disease, it helps to be a little bit more strict and be extra clean. That’s where the lectins play a really big role. Then we slowly introduce them back in as we look at some of the other triggers. Usually, when we’re in a flare up, it’s not just one thing. There are usually a few different triggers happening at the same time. It almost overflows the bucket.
The food helps. Maybe there is mold or heavy metals or H-pylori or another type of gut bug. As you work on all of those, you stay on a stricter diet. As those things are gone, you can start to open it up.
It is important to open things up. I unfortunately have people who have been on a very restrictive diet, and they only have nine or ten foods that they eat. 10 years later, doesn’t help issues. We have to start to very slowly open it up for them. Long-term, you don’t want to be so restricted.
Dr. Eric:
I agree. I typically recommend an elimination diet as well. It’s not a permanent elimination diet. I want people to reintroduce foods.
For those who aren’t as familiar with lectins, what foods have them? Nightshades, legumes, grains. Do you have people eliminate all of those initially?
Inna:
Initially, not for everyone, but if they are in flare-up, or we are trying to get things down, yes. It could be nightshades—tomatoes, peppers, eggplants—and grains. There are some other foods, like anything with seeds technically has lectins. Cucumbers, squashes. But those, I feel like we could be more lenient about. You can take the seeds out. I will scoop the seeds out of cucumbers and just eat them outside.
Beans also. But if you pressure cook your beans, the lectins are destroyed. Beans have some protein and good fiber, so there is benefit there. I always recommend to my clients to get a pressure cooker if you can. They are like $50 on Amazon. You can buy dried beans and soak them for a couple of hours and put them in a pressure cooker. The lectins are gone, and you can enjoy them.
It’s another way to add carbs.When you’re taking out grains, you’re very limited on carbs. While some people can be on a very paleo diet, depending on your metabolic rate, some people don’t do well with a high protein, high fat diet with no carbs. They may need the carbs. Beans are good for that. Sweet potatoes and cassava are good, too.
Dr. Eric:
How do most of your clients deal with eggs? Do most people do okay?
Inna:
It depends. This is where I like to test and see if there is an issue. There are a couple labs I use. Sometimes, I use the Egg Zoomer from VibrantWellness. They look at IgG and IgA. They look at different metabolites of different proteins of the egg as it breaks down in the body. Some people are totally fine with it, and some people have every marker flagged. What about you? What do you find with eggs?
Dr. Eric:
I agree with you that initially, for a number of people, I do have them avoid eggs as part of an elimination diet. It’s usually one of the first foods I’ll have them reintroduce because they’re nutrient-dense, and I find a lot of people are able to tolerate them.
I have never heard of the Egg Zoomer. I have heard of the Wheat Zoomer, so that’s interesting. There is a test that focuses on eggs?
Inna:
Yep. They have the WheatZoomer, the Dairy Zoomer, a Nut Zoomer, a Grain Zoomer, and an Egg Zoomer. There is a seafood one. I think there are nine or so.
Dr. Eric:
I didn’t know. I was not familiar with the others besides wheat. I have had a few patients do that one. Vibrant America?
Inna:
Yep.
Dr. Eric:
I did look into them, but I didn’t look enough to see the other Zoomer tests. That’s interesting. Anything else with food before we move into the next bucket?
Inna:
I would say gluten, dairy, and lectins are probably my go-to’s. With Hashimoto’s specifically, we also look at high iodine foods, which can be problematic, especially initially, if there is a flare up. Those are the biggest.
Of course, sugar. No one really should be eating a lot of sugar that is in the processed form, so we try to limit that when we can.
I’ll give you a personal example with my antibodies. My antibodies have gone up post-partum with both my kids, but especially with my son because he was my first. There was a lot of stress and other stuff going on. I have been gluten-free the whole time. That didn’t change. I was gluten-free while pregnant with him and post-partum.
My antibodies shot up very high. My TPO antibodies were over 1,000. At that point, the lab didn’t show where they were, but I knew it was over 1,000. Within a week of lowering lectins, they were 600. They went down 400 points. But who knows, maybe more, because it was over 1,000. It could have been 1,200 or 2,000. There was a drastic improvement there, and I have seen that with a lot of people that I work with.
Dr. Eric:
Very cool. What are some of the more common infections or microbes? Candida, I don’t consider an infection. To me, it’s more of an overgrowth. Same thing with SIBO. I don’t know if those would fall in the more common category. Let’s hear what you find in your practice.
Inna:
If it’s overgrown enough, those things can create a stress on the body and immune system confusion. H-pylori is a biggie. I see that quite a bit.
On the virus side of things, EBV is a really big one. I don’t know if you find it as much in Graves’, but in Hashimoto’s, there is a big relationship.
Recently, in the last couple years with COVID, there has been so much more EB reactivation. I have never seen this much reactivation in my practice ever than I have in the last couple of years. Thankfully, there are a lot of things we can do with a natural antiviral protocol and stress reduction that can bring those viral loads down.
Mold. Lyme. I see them often, but I think because a lot of the people I see are coming to me specifically for hypo and Hashimoto’s. They may be coming from other practitioners who may be more general that they have seen. They have started to address some of that, so they may have that handled before seeing me. Sometimes, they haven’t, so we address it.
What do you find?
Dr. Eric:
I dealt with chronic Lyme. To me, Lyme would be one of the more, from what I have seen, uncommon. It’s hard. EB, to answer your question with Graves’, just like Hashimoto’s, most people have it. It doesn’t mean it’s always a problem. I agree that since COVID happened, we see more reactivation.
COVID itself, especially a few years ago, directly impacted people with both Graves’ and Hashimoto’s. In my practice, I see more people with Graves’, so I saw a lot of people who seemed to have a trigger with COVID.
I would say viruses are common. I really think about viruses as more of a side effect. You mentioned stress. I think of other things dragging down the immune system, not to say I never use antivirals. If that’s all someone does, like all they do is put someone on an antiviral protocol, but they don’t address stress, and they are still eating inflammatory foods, and other things are dragging down their immune system, they won’t get optimal results. You could make the same argument with Lyme and other stealth infections.
Recently, I interviewed Evan Brand, who I’m sure you’re familiar with. He was saying in his practice, and he focuses a lot more on mold. 80-90% of people. I can’t say I’ve seen that in my practice, as far as it being a factor in autoimmunity, where I have addressed the mold and needed to do so for people to get into remission. As far as my clientele, I don’t know if I would say that. To me, Lyme and mold are not rare, but I won’t classify them as more common causes.
Infections, yes. H-pylori, I see a lot of people with that. Parasites, definitely a little bit controversial. I see them, but it’s one of those things where the stool tests are not perfect. You could have false negatives. You could also have the opposite, where you have a parasite that is not a problem. Sometimes, it’s hard to know if it’s a problem or not.
When it comes to infections, the gut microbes are more common from what I see in Graves’ patients. SIBO, you would figure is more common with Hashimoto’s because there are numerous causes of SIBO, but when you have lower thyroid hormone, that could affect the migrating motor complex. I see a lot of people with hyperthyroidism who also have SIBO. Different mechanisms as a cause, but SIBO and candida overgrowth are common.
The stealth infections like Lyme and bartonella. Maybe they’re there. Just because I don’t test everybody for them. We are improving the health of other areas. It’s almost like a side effect, where we help with that.
Mold, I definitely see. I see more of that now than I did years ago. I still wouldn’t rank it in the top three. Technically, I don’t know if you would classify it as an infection. I think of it as a mycotoxin.
Inna:
More of a toxin than an infection, yeah.
Dr. Eric:
How common do you see stealth infections and mold? Do you see a lot of that in your practice?
Inna:
I do, but also, I’m in the Northeast. We are Lyme country here. It’s more common. It’s common everywhere, but possibly more common here. I don’t test every single person for it because the testing is expensive. It depends on their history and if it warrants testing.
What you said is that it’s all about looking at it as a whole. Usually, it’s not one trigger. It’s usually 5-7 triggers. Can you get to all seven triggers? Maybe. But maybe not. If you think of it as this bucket, and if there are seven triggers, and the bucket is this full, if we take out three of the triggers and work on the stress, now the bucket is half full. Can the immune system get to a point where it can work some things out on its own? Maybe. I’d like to think so.
Sometimes, it’s not about figuring out every little thing. It’s a very fine line. I really see myself as a health detective. I know you really do as well. The work that we do, we are trying to put this puzzle together. We want to look at all the different pieces and how they fit. In some cases, we can see it. It’s very specific. In other cases, it’s more vague. We do what we can. It’s like the lowering of the nervous system, the downregulation that we help the patient do. Then their body can take care of the rest.
Dr. Eric:
I agree. I also don’t test everybody for Lyme. Do you test everybody for mold? Do you do a urinary mycotoxin test on everyone?
Inna:
No. If they have a history of living in a place that had water damage. With mold, you don’t necessarily have to have respiratory symptoms. But for people who do, like the sinus stuff, if I feel something in their history matches that, then we do.
The mycotoxin test is a little bit iffy, too. The foods we eat also produce mycotoxins. That doesn’t necessarily mean it’s the environment. Either way, if it’s there, we work on changing the diet and making sure they have clean air and live in a place where there is less moisture in general.
Dr. Eric:
Agreed. That’s a good point. Just because you have a positive finding on a urinary mycotoxin test doesn’t mean it’s coming from the air. It could be coming from the food that you eat. I’m glad you brought that up.
Are you familiar with Medical Diagnostic Laboratories, MDL?
Inna:
They do the Lyme testing, right?
Dr. Eric:
They’re not too bad. You’re probably familiar with IGeneX because they are the standard, and they are pricey.
Inna:
Very. I just did one for my son, and it was $1,400.
Dr. Eric:
They are the gold standard for a lot of practitioners. When I was dealing with chronic Lyme, I was thinking about IGeneX. I worked with a practitioner at the time who mentioned we could do the IGeneX, but let’s do MDL first, which looks at Lyme and bartonella and other coinfections. Sure enough, it picked up the Lyme and bartonella. It was a couple hundred dollars.
Inna:
Much more affordable.
Dr. Eric:
Still, something I don’t do on everybody. If I am suspecting it, that’s the first thing I’ll look at. If it’s negative, but we are suspecting something still, you could do IGeneX. Figured I’d bring that up.
I know we touched on chemicals with mercury. Are there other common chemicals or heavy metals? I don’t know if you test for heavy metals or other environmental toxins.
Inna:
Sometimes, I use the Mercury Tri-Test or Heavy Metals from Quicksilver.
I do hair testing a lot. I don’t think that hair testing is the best for metals because some people don’t excrete things. Hair testing shows you what you excrete. But what I find is after a few hair tests, if you do one every six months and do some detox, you will see them come up if they’re there.
I also like hair testing for mineral levels and copper. That’s something I find more so in women than men although I see it in everyone. Copper is an essential mineral, but when it’s higher than optimal, it almost acts as a metal. That’s something I’ve dealt with. It can have a lot of different symptoms and relate to a lot of different things. Because of high copper, you could have low zinc. For thyroid especially, zinc is so important as well as for the immune system. I like to rule that out.
Dr. Eric:
I like hair testing, too. I agree about copper. It doesn’t always correlate with the blood. You might see copper toxicity in the hair, and the blood might look good.
Inna:
Yeah.
Dr. Eric:
Do you test for adrenals? Getting into stress, do you do any salivary or dried urine testing?
Inna:
I’ll do Dutch, not for everyone. I used to test adrenals much more. Unless I’m really wondering, “Is the cortisol low at night, or is it high at night?” for most people, I can tell from what they tell me in their health history. I really put in a lot of mind/body techniques from the beginning. Especially if someone doesn’t have an unlimited budget, that wouldn’t be a test where I would allocate a budget if we really need to find a specific bug. I can almost tell here.
I do use Dutch sometimes. Lately, I have been doing a lot of cycle mapping tests for my perimenopause women because that can create a lot of shifts very quickly in the body. I have a couple of adrenal formulas that I’ll use.
I have to say over the years, for myself and in my practice, I’m using less and less adrenal stuff, if you will, and herbs, and really going more toward mind/body. I used to try to depend on ashwagandha because I was feeling low. Yes, they help, but I feel like it’s a little bit of a Band-Aid. Some of the adaptogens are good because they help balance, but it’s still nothing compared to what we can do with our minds. Taking an adrenal supplement when we’re going crazy stressing about it, it’s like it’s this tiny bird that we are trying to give to the person versus addressing the big pink elephant in the room.
Dr. Eric:
I agree. I like adaptogenic herbs. I think they have their place. I like more calming herbs for adrenals sometimes. I agree that it’s not a substitute. If you had to choose one, you would want to choose the lifestyle, stress management, perception of stress, mind/body medicine, along with diet and sleep. There is a time and place for supplements, and I recommend them. But if we had to choose between one or the other. I’m sure you see it, too. Someone walks into your office, in person or remote, and they have 20-30 supplements for the very first consultation, and they are not eating an ideal diet or managing stress. I would rather see the opposite.
Inna:
The one supplement I do use if I see high cortisol or suspect it is phosphatidylserine, because I think it’s so calming. People really feel a difference, especially people who wake up in the middle of the night between 1am-4am and stay awake for more than 15 minutes, where it’s hard to fall asleep. That really helps, so I use that a lot.
I’ve found for myself personally, too many herbs don’t work well for my body. I’ll break out. With autoimmunity in general, herbs are wonderful, but we just don’t know. They could stimulate more TH1 versus TH2. I know there are certain studies that show these things, but how do we really know where we are? It changes with our immune system, so it won’t always be the same.
In general, I tend to err on the side of caution with herbs for autoimmunity for that reason. Some of them may not have a specific study. I have seen it myself and some of my sensitive people, as I have a lot who I work with.
Dr. Eric:
That makes sense. Anything else you want to cover? Anything that is more common or uncommon that we didn’t talk about?
Inna:
Here is one that is uncommon but maybe common with Hashimoto’s specifically and maybe with Graves’. I’m curious what your thoughts are on that. But Botox. It’s very popular. Even for people who are more into functional medicine, they say, “I wouldn’t want to put a toxin in my body,” but they do it anyway. We all do. We know it’s a toxin. Your liver will process it.
It’s interesting. There was a study that showed it can affect the way the immune system works and the thyroid. It was more specific with Hashimoto’s antibodies going up. I don’t know about Graves’. I’m curious if you have any experience with that. That’s always something I tell people about. “Listen, it’s your choice. I can’t tell you what to do. But it’s something you probably may not have heard of from your dermatologist or whomever does your Botox, and it’s something to keep in mind.”
Dr. Eric:
I am familiar with the research, but there is nothing I have seen related to Graves’. I don’t think I have seen anyone in my practice where that has been a trigger. If it was, maybe I missed it. I would agree that if it is a trigger in those with Graves’, it would be a lesser common trigger.
Inna:
It depends on what else is going on. If there’s a lot of other stuff, this could be that little bit that skewed them over the edge possibly.
Dr. Eric:
Yeah, I agree. I was going to say one lesser common trigger as well, and I’ll get your feedback after I say it: breast implants. It could be a trigger. I have seen it. But it’s not 50% or even 20-30% of my population who has breast implants as a trigger. I don’t know if you have seen that in your practice.
Inna:
I don’t have very many people with them that I know of, but I have a few people who have had them taken out, thinking it was creating issues for them. I don’t think I have a big enough pool to speak as well about it. But there’s certainly a huge movement with taking them out and the different health implications, be it autoimmunity or toxicity. In general, anything that creates toxicity is going to have a possible effect on autoimmunity, depending on what our pathways are doing.
Dr. Eric:
I agree.
Inna:
Just speaking of beauty stuff, another thing that can be a trigger for some people is fillers, specific types though. I interviewed a dermatologist who was a little bit more functional, and she was saying that the cross-linking fillers, like Voluma, and I forget the other brands. It’s the ones that cross-link, so they stay in the body longer. It’s like hydrofluoric acid that they cross-link with something else. I’m not sure of her exact wording. She feels like there could be something with that. If someone does get fillers, maybe ask the person who does your fillers if this filler you’re using is a cross-linking one or not.
Dr. Eric:
Interesting. Anything else that you want to share? Anything that I should have asked you that I didn’t ask you that you want to talk about? If you want to summarize some of the things you mentioned?
Inna:
Of course. When you are dealing with autoimmunity, it’s about looking at it from a whole-body perspective. Whether it’s Graves’ or Hashimoto’s or another autoimmune disease, of course there will be nuances of what we do. I think a lot of those are more specific even to addressing the thyroid function itself. The things you do obviously for hyperthyroid will be different from what you would do for hypo. If you do have hypo, there are a lot of different thyroid types, as I call them.
What I find is when you’re dealing with thyroid autoimmunity, it’s this two-fold approach of supporting the autoimmunity while at the same time supporting thyroid function. Obviously, it’s different how we would support hyper versus hypo. You want to make sure you are supporting it for you and looking at those optimal ranges of where you want to be while you are doing all of the things to help balance the immune system.
I like to look at the immune system as this very intelligent thing that knows what to do. However, when bombarded with a lot of different things, it naturally loses its footing a little bit. It’s not about, “Oh no, my immune system is kaput.” No, we don’t want to say that. Your body is so intelligent and amazing. It’s just clogged with these different things. It’s not about let’s get rid of everything because we sometimes don’t even know what it is, but let’s calm it. That’s why this nervous system stuff is so important. I don’t want to belabor the point.
I am going to say it again: Anything you can do on a daily basis to be proactive. You want to make sure you’re in a place of balancing and relating in the body versus reacting. You don’t want to react to stress; you want to be ready for it to come. When it comes, you can handle that versus reacting afterwards.
The calmer the nervous system, the better your immune system is going to function. The more of these other triggers that you take out, think of it as taking the burden off. Think of this intelligent being, which is your immune system.
I almost imagine it as walking in ski boots, but not on the ski slope. It’s really hard. “Let me give you a hand. Let me take this boot off, and then this one. Let me show you how we could do it easier.” The immune system is like, “Okay, cool, now I can do this.” It’s not about rewiring it. It’s about slowing things down and helping it along, so it can come back and do its job and not be so hypervigilant. We don’t want to be in that state of “Let me shoot now and ask later.” That’s what happens in most cases with autoimmunity.
Dr. Eric:
Very well said. Where can people find out more about you, Inna? You can bring up your podcast and website. I think you have a program for Hashimoto’s.
Inna:
The best way to connect with me is on Instagram. I’m @InnaTopiler there. My podcast is HealthMysteriesSolved.com. All of the information about that is there. I also have a Hashimoto’s program for those listening who have it, where we get into that support and specific thyroid support. We made a special link for you guys. It’s ThyroidMysterySolved.com/DrEric. On Instagram, I answer all of my messages and am happy to connect.
Dr. Eric:
Thank you so much for this conversation. I really enjoyed chatting with you. I’m sure the audience learned a lot about common and uncommon causes.
Inna:
Thank you so much. I was really excited to be here and connect with you again.
