Recently I interviewed Dr. Sabrina Solt, and we chatted about the carnivore diet. If you would prefer to listen the interview you can access it by Clicking Here.

I am excited to chat with Dr. Sabrina Solt about the carnivore diet. Dr. Sabrina is a naturopathic doctor located in Scottsdale, Arizona. She practices regenerative and anti-aging medicine and uses carnivore and animal-based diets as part of her treatment protocols to heal everything from autoimmune disorders to chronic pain. Welcome. Thank you so much for joining us, Sabrina.

Dr. Sabrina Solt:

Thank you so much for having me.

Dr. Eric:

Definitely one of the shorter bios. You get right to the point, just the important stuff. I appreciate that. Why don’t we start by diving into your background? How did you get into the carnivore diet? I actually did some research. I heard that you weren’t always carnivore; you loved your salads. Why don’t you talk about how you made that transition?

Dr. Sabrina:

It was a really interesting journey for me. As you said, I’m a naturopathic doctor. I went to naturopathic medical school, which is all about how plants are the greatest thing in the entire world, everything from putting your patients on plant-based/vegan diets, getting enough fiber. Then there is the botanical medicine aspect of it, too. All plants can technically be medicine. It was driven home in our education that there is no harm in consuming plants. I say that with quotations. We know now, and of course we know in general, that there are some plants that are harmful to human beings.

Let me backtrack a little bit. I’ve had digestive issues almost my entire life. It just became really debilitating over time. My diet became so severely limited. I had removed pretty much everything: gluten, dairy, soy, every grain. I had gotten down to basically vegetables and meat and some other fats. I would do nut butters. I still never got better.

As an MD, I had access to every gut-healing protocol you can imagine. I did all the bio hacking. I did the stem cell stuff. I did it all, over the course of my career. I still never got better. In fact, a lot of things were worsening as far as my symptoms went.

Fast forward to about a year ago. My husband came across another physician named Dr. Anthony Chaffee on YouTube. He is a neurosurgeon based in Australia who has been carnivore for about a decade, if not longer. He is a huge wealth of information on the subject and is one of the most strict. He preaches the meat, salt, and water variation.

My husband had some stuff he was going through at that time, and he dove in headfirst. He is crazy like that. I thought he was completely insane. “You’re going to make yourself sick! You need fiber and vegetables. You will die, and I will pick up the pieces.” Then he didn’t. He got better. His skin texture improved. It was brighter. The whites of his eyes were brighter. He had more energy. His mood was more even. He didn’t lose his temper at the kids anymore. It was pretty wild to see. Ok, there’s something to this. Maybe I need to be more open-minded about what the possibilities could be.

I started first by eliminating my salads I ate for lunch every single day. I literally ate a salad every single day for lunch. After lunch, I would not feel good. My pain in my upper back and neck would light up. I would get some brain fog. It was no good. Cut that out. Those things started to go away. That little bit of lower belly fat that I used to have just went away on its own, too. Maybe there is something to this.

It took me a few months, but I eventually got rid of the grains in my diet. I was still consuming oats and white rice. Those all went away as well. I started to improve. My digestion that had been a problem for so many years, I went through a period of time where I was using some digestive enzymes because the high fat I was eating wasn’t digesting as well as it should have been.

Of course, the other aspect was prior to that, what set everything off really terribly was back in May 2021, we went on a trip to Mexico. I picked up a parasite there. That parasite had really destroyed my gut over the year I had it after that.

Carnivore did save me, I feel. It saved me from what I was going through. Healed the gut stuff. Got rid of my anxiety. My sleep improved. I take almost no supplements now. We used to have two big cupboards of supplement stuff, full of things I have taken in my life. I have become the most low maintenance in my health I have ever been. It’s been amazing.

Dr. Eric:

Great story. Just to be transparent, and I mentioned this prior to recording, I don’t follow carnivore. I recommend vegetables. I have my morning smoothies. I am obviously not opposed to carnivore, or else I wouldn’t be interviewing you. I am very open-minded.

The reason I am chatting with you is because I heard stories about carnivore helping people with chronic health conditions, including autoimmunity. I work with people with Graves’ and Hashimoto’s. To be transparent, I’ve had patients who don’t seem to tolerate vegetables. I would say a lot of them on the surface seem to, but there are those that obviously they will try to increase their vegetable intake, which is what I have been recommending for years. They experience some bloating and gas. We may need to heal the gut, get rid of potential SIBO or other things like that. But hearing success stories from people who are in similar situations, they just changed their diet, and that seemed to resolve things. I decided to get someone who is an advocate and more of an expert on the carnivore diet, and that’s why we’re chatting.

Can you explain how this differs from the more popular diets like ketogenic? There is overlap with carnivore and ketogenic. And paleo is popular. AIP. Like you said, there are different levels of carnivore, where you could be strictly eating meat, but there are variations where you can add eggs and dairy. Is that correct?

Dr. Sabrina:

Yeah. There is some variation on this. Carnivore diet in general can exist on a spectrum. The actual term “hypercarnivore” refers to an animal or person who consumes about 70% of their food intake from an animal source. That can include eggs and dairy as long as the person tolerates it. Preferably, we like to get most of our nutrition from things like fatty ruminant meats. Some people do pork, fish variations, seafood. Some people do chicken.

The biggest variation between carnivore and keto, although there is some overlap, is keto emphasizes doing the high fat. You want to make sure you are existing in ketosis. That is not so much the focus of carnivore as it is just getting in the fatty meats and food from animal sources.

For a lot of people, carnivore is actually preferential over keto. I talk about something called the doctor bias, meaning most doctors are biased to what walks in their office as far as pathology goes. Many years ago, when keto first became popular, my bias became that I was seeing a lot of women who were middle-aged who started to do keto in order to lose weight. After about three months, yes, they lost weight initially, but then they plateaued, and their hormones tanked. I was left cleaning up the mess from that. I was jaded on the keto thing because of what I saw walking into my office.

What I came to realize is these women were undernourishing themselves in regard to protein. They were eating so much fat and not getting enough protein to support all of the needs their body has for it. Protein is a super essential nutrient. I would argue the majority of people walking around are severely under proteined. Dr. Gabrielle Lyon has a wealth of information in this area for ensuring people get adequate amounts.

The general recommendation for most people is 1g per pound of body weight, which seems like a lot. I am 110 pounds or so; that is 110g of protein. That is a pound of meat or more per day. I have no problem consuming that, and I feel so much better for it. A lot of people have difficulty because they are also eating other things, which is where the other diets come in.

Paleo still allows room for certain plant matters. Anything that would grow in the Paleolithic era is okay to eat in that diet. A lot of the plants we have today likely didn’t exist back then, due to the simple hybridization that we do in our current agriculture industry.

A lot of people compare carnivore to Atkins diet because it’s a high protein diet and severely limits carbs. That would probably be the closet comparison to a popular diet that still mainly is avoiding vegetables. Ultimately, a lot of people on this diet are avoiding pretty much all plant matter in general. That includes nuts, seeds, and vegetation, of course.

Some people will still consume fruit because arguably, when we are talking about avoiding plants, we are discussing the fact that plants contain antinutrients that can be more harmful to somebody’s health than the benefits you might get from consuming that item. When it comes to fruit, we can argue that technically, the plant wants you to eat its fruit so you will go poop out the seeds and start a new plant so it can reproduce a lot better. That’s why fruit is very sweet and appetizing to humans. It makes you want to continue to eat that. Ultimately, we want to make sure we are staying away from all the other antinutrients.

Like you were saying, there are some people who can definitely tolerate eating vegetables. There are a lot of us who have just been sick for so long and have done so much damage to our gut and our body that we have completely lost that ability.

Do I think this diet is for everybody? You can argue that we are all carnivores, and this is how we should be eating. There is a lot of complexity to the human being. We have this ability to be creative with our food sources as they come to us in the environment and to ferment things. We have learned how to cook things. We are not just relegated to eating animals in the raw and in the wild. I think there is something to be said for that, too.

Dr. Eric:

You mentioned protein. I have had other guests talk about protein. Cynthia Thurlow agreed as far as the 1g of protein per pound. One thing though when it comes to spacing out the protein, do you personally have breakfast, lunch, dinner, and then have 30-40g per protein per meal? Do you incorporate intermittent fasting, like Cynthia does? Try to have two meals per day.

Dr. Sabrina:

Honestly, I just go by my hunger cues. That was one thing that became interesting, was learning when I am actually hungry. A lot of people miss out on that. They never got a chance to learn what it feels like to wait for their body to simply want to eat something.

Some days, I will start my day with bacon and eggs in the morning. Most days though, I eat my first meal sometime between 11am and 2pm. It depends when I am actually hungry. My first meal is usually a one-pound ribeye with a bunch of butter and salt on it. It’s delicious. Dinnertime, sometimes I will eat burgers or ribs. I might do bacon and eggs again. Then a dessert for me is usually a small cup of some full-fat, sugar-free yogurt. Interestingly, I think I mentioned earlier that I used to be dairy-free. Carnivore got me back my ability toeat dairy. I can now eat cheese, yogurt, heavy cream. It’s pretty spectacular. I no longer react to dairy.

Dr. Eric:

You eat certain types of dairy, like raw dairy. Do you just make sure it’s organic?

Dr. Sabrina:

The yogurt I like is a conventional dairy. I just love the texture of it. It’s like ice cream. Most of the time, we have gotten raw dairy. We get organic stuff whenever we get it. None of it bothers me anymore at all. It’s phenomenal.

Dr. Eric:

There is no threshold. A lot of people are lactose-intolerant, so they might be able to tolerate smaller amounts of dairy, but it doesn’t seem to make a difference with you.

Dr. Sabrina:

Nope. Oh my gosh, I went through this phase when I was going into carnivore. I think my body was just trying to do a bunch of repletion from years of me being so deficient in stuff. Looking back, I never had a great source of calcium in my diet. I entered this phase of carnivore where my body was just craving yogurt. It was the only thing I wanted. I went through probably a month where I ate one of those big containers of yogurt almost every single day. It felt so good. It gave me so much energy. There is no sugar added to it. It was completely plain as day. I just devoured them. It was my body trying to catch up from all of the deficit.

In addition to the gut stuff, there was the adrenal stuff and stress stuff and thyroid stuff. You just set your body up for mineral deficiencies existing in that state for so long, especially consuming the vegetables I was consuming. Regardless of if a person tolerates vegetables or not, they are still going to contain oxalates and lectins and phytic acid. All of those things are not only going to be a mineral tax on your body, meaning your body needs minerals to break those things down and metabolize them, but they are going to block and blunt mineral absorption from the foods you are currently eating, too.

One thing I work on with my patients and myself is rampant mineral repletion for a lot of people.

Dr. Eric:

Can you talk more about that? You recommend for them to supplement with minerals separately.

Dr. Sabrina:

Yeah. The ones I really like to use are the Quinton ones. They come in glass. They are sourced from a plankton bloom that has been around for hundreds of years. This product has been around for a very long time. They used to use it to restore blood volume loss in soldiers. It has a wide spectrum of pretty much all the micro and trace minerals we need in addition to the macro ones like magnesium. It’s a great product.

Dr. Eric:

I think you mentioned fiber earlier. That is one of the concerns when it comes to carnivore and ketogenic. If you’re not eating your veggies, where are you going to get your fiber from? I’m sure you have a response to that.

Dr. Sabrina:

The short version is we actually don’t need fiber for our digestive system to run smoothly. There is another doctor who wrote an excellent blog post that debunks all of the reasons why we actually don’t need fiber.

The way I simplistically break this down in my reasoning for the carnivore diet is a couple of things. What we are made of is technically muscle meat and saturated fat. Our fat is solid at room temperature; it’s saturated. If we are going to consume food to repair things in our body that break down, it’s the whole you are what you eat thing, or you should eat what you are. The consuming of the animal proteins and animal fats is what is actually going to replete any of the damages in our animal proteins and animal fat.

Additionally, no part of us is made of cellulose. We don’t actually need that fiber in our diet to bulk up our stool. I joke that I am going to start a subscription page where I just post pictures of my daily poops to prove they are perfect. There are no issues with that whatsoever.

The other side of that is there is no essential nutrients that humans require that have to be consumed in plant form. All the nutrients that we need are actually the most bioavailable in animal protein. In fact, there are a great deal of nutrients that are only available in animal protein, meaning you can’t get them from plant sources, things like B12, carnitine, certain fatty acids.

Dr. Eric:

I’m glad you brought up pooping. I was going to ask you about bowel movements. Do you find that people making the transition, let’s say from a standard American diet or even they are eating a healthy Paleo diet and make a transition to carnivore, is there a transition period where they may be constipated initially?

Dr. Sabrina:

There is a transition period where you don’t want to trust a fart. Your stools get looser because there is simply no fiber blocking the transit. The fiber bulks up your stool, slows down the transit. When you remove that out of the way, it cures constipation. There was a study done that said a low or no fiber diet actually cures irritable bowel syndrome (IBS).

Dr. Eric:

Interesting. How about meat preparation? Is there a certain way you recommend preparing meat? More rare or medium well.

Dr. Sabrina:

You’re going to get the most bioavailability out of the nutrients, especially with iron, if you cook it on the medium rare to rare side. Then again, it’s up to the person. Whatever they like, whatever they enjoy.

We have something called an Otto grill. It’s a type of grill they use in restaurants where it’s a burner on the top, and you cook steak underneath, and you lift it up as a gradient. We also use a pellet grill. Arguably, pellet grills burn really clean versus using something with coals or gasoline. We try to reduce any risk that could come from the idea of charring your meat.

Dr. Eric:

Those are called Otto grills and pellet grills?

Dr. Sabrina:

Yeah, that’s a brand. I have no affiliation with them. It’s just the one we have. There are other companies that make similar types of grills. A pellet grill uses wood pellets to create a heat source that cooks your meat. They burn really clean, so you are very dramatically reducing any sort of risk of things like carcinogenic material.

Dr. Eric:

A lot of people follow ketogenic because when you get into ketosis, they do it for weight loss. I imagine with carnivore, a lot of people will lose weight because you’re not eating carbohydrates.

Dr. Sabrina:

Yeah, you’re completely changing your response to insulin by switching to a diet that really contains almost no carbohydrates, which is good for most people. My husband and I were having this discussion with somebody not too long ago. When humans are born, we are born into ketosis. As long as we are nursing from our mothers, from being breast fed, we maintain ketosis. You could argue it’s the preferred state for humans because of all the things it allows the body to heal. We see so much research on keto is this cure for this disease, and it treats this disease. Well, is keto the cure for those diseases? Or is ketosis the natural state humans should be existing in, and those diseases are a result of us leaving that state? It can go both ways.

I would argue that being in ketosis is simply a favorable state. You can get to that without doing a keto diet, but by simply doing a variation of intermittent fasting. I definitely do like intermittent fasting personally. I don’t actively practice it because I know I will be in it no matter what simply because of how I plan my meals and how I eat my meals. I usually only eat a couple of times a day at most. I ultimately end up fasting by default.

I really think there is something to be said with making sure that you are in ketosis. If you think about it, the wide majority of Americans or people likely haven’t been in ketosis since they were born. They are missing out on all the benefits that are going to come with that.

Dr. Eric:

I mentioned earlier a lot of the listeners have either Graves’ or Hashimoto’s. With Hashimoto’s, a lot of those people will want to lose weight. With hyperthyroidism, it varies. When I dealt with Graves’, I lost 42 pounds. A lot of people lose weight. There are people with hyperthyroidism who gain weight.

Let’s bring up the situation of someone with hyperthyroidism who is losing a lot of weight. They are concerned with getting enough calories from eating meat. Before getting into this, of course you want to lower the thyroid hormone levels. That’s the reason why the person is losing weight. No matter how much meat you eat, you might not gain weight; you might maintain or still lose weight. Is there a concern about eating too much meat?

Dr. Sabrina:

I haven’t seen it, honestly. It’s so interesting. People will say, “You eat so much meat. It will hurt your kidneys.” I had a patient not too long ago who had multiple things that came up, one of them being low thyroid function, low hormone levels, high stress levels. I believe she actually has an underlying autoimmune disorder. I say all that to set the stage with the recommendations I gave her.

Her kidney function when she came to me, her EGFR was just below 70. I actually told her to switch her diet to carnivore. Her EGFR two months later went up to over 80. What she did was stop eating carbohydrates that she was eating. She switched to a carnivore-based diet. That allowed her kidney function to heal and repair.

Protein does not damage the kidneys. It’s carbs that damage the kidneys. You really can’t eat too much protein because your satiation signals, your hunger signals are going to start to work properly, and you can’t simply overeat it. You can put a big piece of steak in front of someone and put a potato next to it. If they are eating the steak with the potato, the carbohydrates will interfere with your proper hunger signaling and cues. If you give the person just the steak, and they only eat that, they will eat it ravenously until their hunger cues start to catch up, and then they will stop.

People actually eat less on this way of eating because their hunger cues are so on point. They actually get feedback when they are full versus eating the carbs combined with the meat. This leads to something else.

A lot of people aren’t taught this, even providers: the Randall Cycle. Professor Bart Kay has a really wonderful, detailed explanation of how the Randall Cycle works. The short version is that if you are eating carbohydrates in combination with fat or protein, you’re actually not going to get almost any energy absorption from any of those because of how it activates something called the Randall Cycle. You will almost always store those carbs as fat when you are eating them in combination. Ultimately, carbs don’t exist in nature combined with fats or protein, whereas protein and fat exist in nature very well. You can eat those together. You will get proper satiation signaling, and you will get great energy absorption.

If a person is concerned about someone getting enough calories, extra fat is going to be the thing. People on the carnivore way of eating will sometimes snack on butter, and it helps you stay full, satiated. It is an easy thing to do, upping those fat levels.

Dr. Eric:

Interesting what you said about the kidneys, the EGFR increasing when switching to carnivore. You might not know the answer to this, but if you had to guess, were oxalates damaging the kidneys, and that’s why when they switched to the carnivore diet, the kidney function improved?

Dr. Sabrina:

For this patient, I do think oxalates played a role, but I think it was mainly the carbs ultimately. This is something that will apply to pretty much every American. Your kidneys do not like having to clear excess sugar from your blood. This is why diabetics have to go on dialysis. All that excess sugar intake causes that kidney damage and sets them up for kidney failure.

Dr. Eric:

Have you seen patients of yours get into remission with autoimmunity, where they are flaring up, and they are on the Paleo or AIP diet. Then they switch to carnivore, and everything calms down? Gradually over time, or quickly, they get into remission.

Dr. Sabrina:

100%. Predominantly my rheumatoid arthritis patients seem to respond the absolute best to carnivore. I think it’s because we are finally taking away the oxalates which are going to build up to deposit in joints. If you look at an oxalate under a microscope, it’s basically a ball with spikes. You can cause an oxalate-based arthritis syndrome on top of a rheumatoid arthritis syndrome. The body is already attacking the joints, depositing more crystals in there because your immune system doesn’t know how to clear them as well as the average person from the body. That has made the biggest difference.

Dr. Eric:

For those who are concerned about saturated fat and the effects of meat on cardiovascular disease, that also has been debunked. We also should say before I forget that I assume you are recommending healthier forms of meat, like grass-fed, pasture-raised, not just eating conventional-raised meat.

Dr. Sabrina:

Yeah. I tell people even a conventionally raised piece of meat is going to be way better than the crap you are previously buying. Purchase what you can in a way that is affordable for you and things you like to eat, and it will still be good. When you are eating the meat, you bank on the animal and their ability to excrete the toxins and process them before it makes its way into its own meat and gets to you.

There have been studies done that there is a variation of things like the fatty acid composition as far as Omega-3s versus Omega 6s in grass fed versus grain fed or conventionally raised animals. For the most part, it won’t make a big difference in a person going from a standard American diet to carnivore. Again, we want this to be manageable and affordable for people to do. If all they can do is conventional burgers, for example, go for it. It will still be way better than a packaged TV dinner they might have eaten before.

As far as saturated fat and cardiac concerns go, this is so interesting. From what I have seen, the experience I have had with my patients, and what I have read in the literature, it’s not necessarily saturated fat that is the problem. It is more the polyunsaturated fats and the high sugar. The combination of these two things is what I believe is the underlying cause of most cardiovascular diseases.

We are mainly made of saturated fat. It is our preferred source to rebuild things like joints, fatty tissues, the mild sheet that is surrounding every one of our nerves, the cushioning within our joints. It is our preferred source. The polyunsaturated fatty acids, things like canola oils, grapeseed oil, cottonseed oil, peanut oil, these are more detrimental to humans because they are not what we are made of. When a person is eating these, their body is taking them in, and it’s saying, “Ok, this is the building block that we have to do healing and repair. It is not necessarily what we prefer, but this is all we have to use. We are going to use it, and this is what we are going to use to rebuild tissue structures.” This is how we end up with cellular dysfunction. Our body used a building material it shouldn’t have used in the first place. It was making do with what it had.

This is where we will see changes to people’s cardiac pictures or cardiovascular system. We might even start to see things like cancer growth, tumor growth, the body behaving how it shouldn’t. This is actually the reason why, like you had seen in our Facebook group, the sunburn thing, why a lot of carnivores don’t actually get a sunburn. It’s because our cells have been made with that really strong saturated fat.

Every single cell has something called the lipid skin barrier. It’s two layers of fat surrounding it, and it’s supposed to be saturated. That is what makes the cell very strong. A lot of carnivores won’t get sunburned simply because our cells are made properly, and we can actually withstand the UV rays and properly handle them in our systems.

For example, over the summer, my daughter is the fairest-skinned child you have ever seen. She has blonde hair, blue eyes, super fair. Swam in the pool every single day all summer in Arizona. She did not burn once at all. We never put sunscreen on her. Same with our son. He is a little darker skinned than she is, but neither of them burned at all.

Once you’re removing those bad oils from the diet, and you’re actually focused more on saturated fat, you will see how things improve. I tell people to experiment with it. Give it 30 days. Give it 90 days. If you absolutely hate it, you can totally go back, but it might just change your life.

Dr. Eric:

That’s very interesting about not getting sunburned. I agree with everything you said about saturated fat. I also want to play devil’s advocate. If someone is working with you and following the carnivore diet, and maybe you don’t see this, but if someone were to do a lipid panel, and they have a total cholesterol of 230/240, LDL a little bit on the higher side, is there any concern with that?

Dr. Sabrina:

This is so good. We’ll talk about my husband. He won’t care we’re talking about him. He and I did a video on our YouTube channel, where I broke down all of his labs that he’s had for the last year. His cholesterol shot up over 400.

Dr. Eric:

Wow.

Dr. Sabrina:

Yeah. I don’t just do cholesterol panels. I run expanded cardiac monitors. We will look at the PLA2 enzyme, MPO, oxidative LDL, small density LDL, lipoproteins(a) and (b), CRP enzyme. It’s about as detailed as you can get as far as cardiac goes.

We ended up sending him for a CAC score as well (coronary artery calcium scan). He actually has a calcification in his left anterior descending artery. Knowing my husband’s history, which he had some really bad habits prior to carnivore- That was one of his reasons for pursuing it: How do I get rid of all the bad things in my life? He used to eat a conventional, store-bought oven pizza. A seed oil, gluten, and dairy nightmare with nightshades sprinkled on top. He was not treating his body very well.

When he switched to carnivore, all of a sudden, everything spiked. His cholesterol was over 400. His MPO was over 3,000. PLA2, which is the marker for the plaque repair, was super high as well.

What we realized after we saw this trend, and we kept checking, was that the cholesterol was increasing on purpose. We have to think about cholesterol. Cholesterol is something our body makes. Why would our body make something like that, where its only job is to do harm? It doesn’t make any sense.

Cholesterol is the starting molecule for all of our sex hormones. Cholesterol is the repair molecule in the body. If something gets damaged in the body like a blood vessel due to something like high sugar going through and causing some damage, the body is going to send cholesterol in there to patch it up. It’s not necessarily a bad thing. It’s the whole idea of the fire truck being the cause of every fire just because it’s at a fire. Cholesterol is not the cause of the plaque in the artery; it’s there to repair. The body will then place a calcification over the top to protect it from breaking off and running into circulation and causing things like heart attacks or strokes.

In his situation, he had this issue. He was eating vegetables before. Maybe that was keeping his cholesterol low because of the fiber transit in the body. Was this beneficial in his situation? He gets on carnivore. Everything spikes up. Then everything starts to decline and improve. I am thinking to myself, Wow, did we actually just let the body make enough cholesterol to do what it wanted to do as far as healing and repair goes?

This then becomes my argument for all my patients who come in with high cholesterol. It’s usually the picture of the middle-aged person who is coming in with it. Very rarely do we see younger people. What do we know happens in middle age? Things start to break down in the body, and hormone production starts to decline. Is it not then logical that your body is going to try to make more of that initial molecule to help feed that pathway to make more hormones? Of course.

But what happens in a traditional office? The doctor prescribes a cholesterol-lowering medication. Give it three months, six months. What happens? They come back, and things are worse. Their joint pain is worse. Men get ED, and we are giving a prescription to manage the side effects. It’s not understanding this basic thing, that cholesterol was there to help in the first place.

Dr. Eric:

Has his cholesterol remained elevated over time? Has it gradually decreased?

Dr. Sabrina:

It is decreasing. His MPO was over 3,000. It’s now 50 points away from being normal. His PLA2 enzyme is completely normalized. His apo proteins have improved. His triglycerides are super low. His HGL is nice and high.

I should caveat that. LDL, total cholesterol are a problem and worth looking at in the presence of a low HDL and high triglycerides. If LDL is high and total cholesterol are high in the presence of additionally a high HDL and a low triglyceride, likely not problematic, but still worth looking at. HDL is going to be what is actually bringing cholesterol back to the liver to be eliminated by the body. Triglycerides are probably the most menacing thing on that cholesterol panel right out the gate because they are the fat bound to the sugar and the thing that’s most inflammatory. That can lead to liver disease, etc.

Dr. Eric:

Where do you like to see triglycerides? Less than 100? Less than 75?

Dr. Sabrina:

Less than 100. If I am being generous on someone in their healing journey, I might say up to 130. Definitely below 100. Mine sit at 60 currently.

Dr. Eric:

What are your thoughts on organ meat as well as drinking bone broth? When I dealt with Graves’ in 2008, there wasn’t all the bone broth powders. When you go into the grocery store now, there are a lot of brands of bone broth. There is a lot of talk about bone broth for gut healing, which I think is valid, but I’d like to get your thoughts on it.

Dr. Sabrina:

I never really ate the organ meats. I did some organ capsules at the beginning part of my carnivore journey for extra energy. I stopped those; I don’t take them anymore. I don’t think they’re necessary. I think they can be used strategically if you have a lot of nutrient deficiencies to correct, and you want to do it quickly. They are a good choice for that. But they are not necessary. If someone says they can’t do carnivore because they can’t eat nose to tail, don’t worry about it. I have never eaten a piece of organ meat in my life, and I am totally fine with that.

I love bone broth. I think it’s great. For a lot of people, it can be a really good addition to making things exciting. If you are cooking a piece of meat in a crockpot, and you want to add some bone broth to help cook that, that’s awesome. If you want to use it to drink a cup of something in the morning instead of coffee, a lot of people do that, too.

Make sure that you’re getting one that is as high quality as in the budget for you, and also make sure you’re not getting one with a lot of extra things like spices added to it, especially if you are super sensitive going into this. Those spices will be made from peppers, which are nightshades, which have those antinutrients we are trying to avoid.

Dr. Eric:

I know both you and your husband are physically fit. I’m sure carnivore plays a role in that, but I’m thinking exercise as well. Do you recommend resistance exercise? Can you briefly talk about that?

Dr. Sabrina:

The main thing I recommend for my patients is resistance training, and you don’t need a lot of it. 20 minutes, three times a week, moderate weightlifting. It will be super easy for people to put on muscle and strength eating carnivore because of the high protein you’re taking in. Your body will use it to heal and repair.

I recommend people walk. There is research that walking is the best exercise for maintaining longevity and increasing movement. I never really recommend high intensity cardio training or anything like that. You can get the biggest body composition changes in a way that is manageable for most people and doesn’t make them hate exercise by doing light walking and three days a week of resistance training.

Dr. Eric:

Okay. Three days a week, 20 minutes. Walking every day for like 30 minutes or an hour.

Dr. Sabrina:

Yeah, if you can, get 20-30 minutes a day. If you can only get in a few days a week, that’s great, too. Ultimately, the important thing is to have functional movement in our bodies, especially as we start getting older. Not every person needs to be learning how to do certain types of squats or bicep curls. Most people, it really comes down to how can I just continue to move my body in a healthy way so that I stay mobile as I get older? At least that’s what I see a lot in my practice. I get a lot of people coming to me with joint issues and whatnot.

Dr. Eric:

One important question I need to ask you: You mentioned pizza before. Your husband used to have the conventional pizza. Now, do you not eat pizza? Do you make modifications? Again, you could have dairy. You could have mozzarella cheese and the meat. Any pizza over the last year since you made this transition?

Dr. Sabrina:

I made a carnivore pizza. I have a reel on my Instagram, @DrSolts. It will say “The Viral Carnivore Pizza.” We totally made a pizza, and it was decent. The crust was made of shredded chicken and eggs and some parmesan cheese. We made an alfredo sauce. It was pretty good. It’s certainly not an everyday thing. We have only done that once.

What I actually learned with this way of eating is that I really just like eating one thing at a time. It is so much more satisfying for me just to have one thing on my menu versus all of these other different flavors. My body doesn’t like that as much.

Dr. Eric:

Thanks for sharing. Anything else? I’m sure there is a lot more you could share. Is there anything really important that I didn’t ask you that I should have asked you? Anything else you’d like to discuss before we wrap things up?

Dr. Sabrina:

Ultimately, just letting people know that this is simply an option. If you are like me, who has tried everything else and has nowhere left to go, and you have really limited your diet, and you’re still not healing. I tell people initially, I gave myself 30 days. If I don’t like it after 30 days, I can always run back into the warm embrace of kale. That didn’t happen clearly. I’m a year into this, and I’ve never felt better. Give yourself time to ease into it.

My husband and I run a Facebook group. We have 3,000 people in that group right now, and it’s only been around for about six months. In that group, we share a lot of information. We have a lot of people who will coach. My husband coaches people on the carnivore diet, too. He is a certified carnivore coach through a company called Revero, which is a company started by Shawn Baker. He is the author of the original carnivore diet book. He is a former MD, I believe. Join our group. We are Carnivore – Harder, Happier, Healthier. You can also check out our oyster supplement.

Dr. Eric:

Let’s talk about that.

Dr. Sabrina:

My husband and I, we get oysters from Whole Foods pretty much every Friday. They are only $1 an oyster. It’s our favorite thing to do because it’s the best deal ever. Every time we do this, we post about it on social media. People comment, “I don’t like oysters.” “I wish I liked oysters.” “I can’t get oysters near me.” Honestly, if you know anything about oysters, they are the most underrated superfood ever as far as their mineral concentrations. They are fantastic as a food.

“How can I get oysters to people?” I’m not sure if you use Full Script. It’s this online dispensary full of thousands of different products. There is no oyster supplement on there. I started looking on Amazon. All the ones on Amazon were gimmicky. They had low concentrations and fillers. They couldn’t guarantee they were being tested for heavy metals.

I went on a search and found this guy in Ireland who is a marine biologist who has a company. We actually source our oysters from him. We imported them directly from Ireland. They are all third-party batch tested for heavy metals and show what the nutrient levels actually are. Every serving contains roughly seven large oysters. There are about 12 pounds of oysters per bottle. It’s called Oyster Boom. You can find it on our website HarderHappierHealthier.com. If you use the code SOLT, you will get a discount on it. We have a Subscribe and Save, too.

They are amazing. People who take them, we see women’s breasts get more plump. Men’s erectile function improves. Some guys notice a change in size. Overall energy. I literally feel electric when I take them because so many minerals come in. They are the only supplement I take right now if I am being honest.

Dr. Eric:

Thank you so much, Dr. Sabrina for sharing your insights on the carnivore diet. I definitely learned a lot. I’m sure those listening will also gain a lot of value.

Dr. Sabrina:

Thank you so much for having me. This was fun. I hope your listeners enjoy it, too.

 

Recently I interviewed Annabel Bateman, who hosts another thyroid-related podcast called “Let’s Talk Thyroid”.  If you would prefer to listen the interview you can access it by Clicking Here.

I am excited to interview another host of a different thyroid-related podcast, Annabel Bateman, who is a Hashimoto’s patient, author, advocate, and coach. She has learned in 25 years of living with Hashimoto’s that the key is developing a lifestyle that supports and doesn’t stress her thyroid health. Drawing on skills learned in previous years as a lawyer, life coach, family law mediator, and author, Annabel seeks to empower, educate, and encourage women with thyroid conditions to develop their own thyroid-friendly lifestyle approach to their health so they can thrive, not just survive.

As I mentioned, she hosts a successful podcast, Let’s Talk Thyroid, which seeks to spread thyroid awareness and information. She is active on social media to spread positive, practical thyroid-related information. Annabel’s latest book Let’s Talk Thyroid: Positive and Practical Thyroid Health is all about how to live a thyroid-friendly lifestyle. While there is no magic happy thyroid formula or protocol, you have to start somewhere. This book is that somewhere.

Annabel lives in Brisbane, Australia with her husband and three teenage sons. Thank you so much for joining us, Annabel.

Annabel Bateman:         

Thank you for having me, Eric. I just had you on my podcast, which is being released soon. I am looking forward to being on the other side of the microphone today.

Dr. Eric:

Same here. You made a note that I should also let listeners know that the Let’s Talk Thyroid book was published under another name, Kiss and Make Up with Your Thyroid.

Annabel:

That’s right. For most people now, you’ll find it under the name you gave. That’s what it’s called on Amazon. For people buying locally in Australia, I still have copies with the original cover. Same book, new title. Trying to keep the Let’s Talk Thyroid thing simple.

Dr. Eric:

Makes sense. Why don’t we dive into your history? Why did you decide to write your book and create your podcast, which obviously relates to your journey with Hashimoto’s?

Annabel:

Let’s go back to a bit of my story. I was diagnosed when I was 22/23, back in 1996. At that point, I look back and think I was struggling for a long time. I suspect that puberty was one of the key triggers for me. Going back to around that 12ish mark. By the time I got to the end of my degree, which is when I was diagnosed, I had all the classic hypothyroid symptoms. The hair was thinning, frizzy, falling out. I was puffy. I gained a lot of weight and couldn’t lose it. I was tired. My muscles were fatigued. I couldn’t hold my arms up to wash or blow dry my hair. That was the final sign.

I was lucky in a lot of ways. It had gone so far that it was very easy to diagnose. I didn’t get the runaround that a lot of thyroid patients get. Went to see my doctor. “Your TSH is 185. You need to go see the endocrinologist tomorrow,” which I did. The endocrinologist said, “You’ll be fine. Just take a pill for the rest of your life.” I sat in the car and cried, thinking, I am 22, I don’t want to be on medication for the rest of my life.

That started me down the traditional hypothyroid management path of taking medication. I needed that, and I still need it. I still take thyroid medication. I am always someone who has been fairly open to natural things. I remember seeing naturopaths early on in the journey and taking different supplements. I still largely managed it fairly traditionally. I took the medication. That was probably the core thing I would say I did.

Around the five-year overlap, I was probably starting to hear about diet and lifestyle changes but not really wanting them to be true. I dabbled for a few years. I tried going gluten-free. Then I would give up because it would seem too hard. I didn’t know if it was making a difference. For the last 10 years or so, I got to the point where I was going to give the diet thing a really good go. I went paleo pretty hardcore for 30 days about 10 years ago. I didn’t know I could feel like this. The bloating went away. I am not just greedy and lazy; I thought I was greedy and lazy, and that’s why I felt six months pregnant every time after I ate. I was able to start to feel different and better with the diet. Over the last 10 years, there are a lot of other things like stress and mindset and reducing toxins that I have done. That’s 25 years in a nutshell.

I guess I’m the sort of person that when I find something that works, I like to share it. I like to talk about it to other people. When I started changing my diet, I started a food blog, which was called What Annabel Cooks. It was more of a way of recording what I was cooking. Instead of writing in an exercise book like my mom and grandma used to do, I thought I would start a blog. That sounded like fun. And it was fun. It spread a bit, and it spread a bit more. One of my friends said, “You should write a cookbook.” I thought that was a good idea, so I did.

Getting to the Let’s Talk Thyroid book and podcast has been a process of sharing what I am learning along the way. Realizing that it is this holistic approach. There is never just one thing. While the diet was massive, it’s not the whole story. I had the idea of writing another book that encompassed everything. It was the food, the lifestyle, how to reduce your toxic load, how to deal with mindset. It was a lot of different things.

A few years ago, when I had that idea, my husband said, “Don’t start anything new. You’re always starting new things.” Fine, I’ll have six months where I won’t start anything. In that six months, I planned to start the podcast first. I thought I would do that first. I’ll meet new people, get more content for the book. About 2.5 years ago, I started the podcast. It’s been fabulous. Last year, I wrote the book. This year, I’ve been trying to do a bit of both. Get the message out there.

Dr. Eric:

That’s an awesome story. For the first 15 years, you didn’t do much from a diet and lifestyle perspective. It wasn’t until 10 years ago that you finally made changes, followed the paleo diet, noticed improvements. Then you started incorporating other lifestyle factors. That led you to write your blog first, it sounds like, and then the diet-related book before finally rolling out the current book and podcast. Is that correct?

Annabel:

That’s a really good summary. There are all sorts of waves and twists we take in life, but that is a good summary.

Dr. Eric:

With the thyroid hormone replacement you are taking, has that stayed consistent over the years? As far as the type you are taking and the dosage. Are you taking levothyroxine?

Annabel:

Good question. Over the years, I have tried a number of different thyroid medication options. I have ended up back on the levothyroxine. We call it oroxine here. I have been on a pretty stable dose for a long time now. That’s why I started gradually increasing the doses. I have tried the natural desiccated thyrone. I have tried slow release T3.

The other options just didn’t work well enough for me. They weren’t that light bulb moment that they are for some people. While I don’t know that the levothyroxine is brilliant either for me, I have spent a lot of time working on some of those conversion pathways and getting my gut right and making my body about as healthy as I can within the limits of life to allow some of that T4 to T3 conversion. For me, it’s been a lot of trial and error over the years. The different forms of medication never really were that amazing for me to stay on them, so I have ended back on the standard.

Dr. Eric:

Everybody is different. There are people who switch to desiccated, and they feel a lot better. They feel a big difference. There are people who make the change to desiccated and don’t feel any different. Some people even feel better on the synthetic T4, the levothyroxine. A good example of why you need to listen to your body, which you did. You did try different things.

Annabel:

I have had a really good doctor for the last 15/16 years. The trialing of different medications, that’s what attracted me to her in the first place. I knew through someone else that she was open to prescribing different forms of thyroid medications. I am really glad I tried that. Maybe I will again at some point in the future, I don’t know. For a while now, I’m back on the standard treatment.

This is where I guess I say it’s the medication plus. It’s the holistic thing. If I wasn’t doing the diet and lifestyle things, maybe I would still be exploring thyroid medication options. I don’t think just the standard synthetic T4 replacement is enough for me. It’s everything.

Dr. Eric:

With that being said, why don’t we dive into some of the aspects of your book, including the four core lifestyle pillars that you talk about?

Annabel:

When I looked at all of the core categories of the different diet and lifestyle factors that both have helped me- When I have talked to different experts around the world and done lots of reading and courses and other things we do, I don’t think there are four core pillars that are unique to me. I think they are pretty consistent. When we were chatting the other day on my show, I thought we were on the same page.

I have broken it down into mindset first. I put it as the first pillar because it helps to have both a long-term approach and a curious, hopeful approach to our thyroid health. We are in it for the long haul. This isn’t something that will be fixed in 30 days or six months. Even if we are able to get our thyroid back into remission and feel great, you can’t just abandon everything that got you there. I think having that mindset of “This is long-term. This will take some experimentation. There is always something I can do.” Having that attitude and approach from the beginning is the first pillar.

The second pillar is what I have called unwinding, which is that positive spin on stress management. Stress is critical, that we learn how to manage it. I wanted to call that “unwinding” because that’s what we have to learn how to do.

The third one is food. Obviously, food is important. Food is the first place a lot of people start. I didn’t want to put it as the first pillar because I think sometimes people get stuck there and don’t move on.

My approach to food generally is about being anti-inflammatory. It’s removing the things that for my body are inflammatory. That’s ultimately going to look slightly different for everybody. A lot of core things.

The final pillar is low tox living. Reducing that day-to-day chemical exposure as much as we can. There are lots of great products out there—cleaning to skin care and makeup—to make it so much easier than it used to be.

Those are the four. There are other things I have fit into there, like sleep and exercise are in there as well. They could be their own pillars probably as they are really important, too. Part of what I am trying to do is keep it super simple. That is my principle. Keep it to four things.

Dr. Eric:

Makes sense. When it comes to mindset, when you work with someone, is that something where you find people could change? Do they already have to come in with that natural mindset? I could address the cause of this condition. My experience is most people probably already come in with the proper mindset, but there are some people who just don’t. A lot of people have the natural mindset, but some people are just trying to-

In my case, I deal with a lot of hyperthyroidism. They are trying to do everything they can. They are more desperate to avoid radioactive iodine or thyroid surgery. In the case of Hashimoto’s, some don’t see it as big a deal to take thyroid hormone replacement. My guess would be is most people already have that natural mindset who see you. I figured I’d ask since it’s the first pillar you discuss.

Annabel:

As you said, there is a bit of both. Even to be open to looking at diet and lifestyle requires an element of that mindset. A lot of what I hope that I do, both in my programs and even on the podcast, is to catch the people that are new on their journey. From the get-go, understand that there is more that you can do than just take the thyroid pills. Even if they are not making those changes straight away, just be aware right from the beginning there are other things.

Also, the people who may have been taking their thyroid replacement for 10-15 years without any real thought that there is anything else they can do, but still trudging through life. Part of what I am trying to do is spread that awareness to get that mindset. “I just thought I had to take my pill. I didn’t know there was anything else I could do.”

Once people get to wanting to work with people like you or I, they do have more of that. They are open to making some changes. Obviously, there is a broad range of people. Some are really ready. Some are desperate. Some will give it a go, probably a bit like me, more of that five-year overlap. “I’ll give it a go, but I’m not sure it’s going to work. I don’t know if I want it to work. It sounds too hard.” It takes a long time to change that mindset and be open to long-term diet and lifestyle change. Just even accepting that you have to deal with this forever in a reasonably active way, there is a lot of grieving that I think can go along with that.

I have to remind myself sometimes that this is me 10-15 years down the track. It took me a while to get there. It does take a lot of people time to get there. For other people, it’s like “Bang, done.” There is a variety.

Dr. Eric:

What do you currently do about stress management? Do you block out time on a regular basis, whether it’s yoga or meditation? What do you do? What do you recommend to your clients or as part of your programs?

Annabel:

I’m a constant work in progress when it comes to this. One of the things I have tried to do over the years is not have an overscheduled calendar. I am reasonably good at that, I think. I don’t make myself available all the time.

My kids are older, and that’s helped a lot. When they were little and needed a lot more of my time and attention, even the fact that they can get themselves home from school now, that helps. I have found for me that I need time on my own. I get a lot of that. I work from home. The kids are largely at school. My husband is at work. I get some of that naturally now. Perhaps in years past, I didn’t. I can also be deliberate about that.

I am not a great meditator. I have tried all the apps. I will do that from time to time. just go listen to one minute, two minutes. I am not very good at the long things.

When I really need to unwind, I’ll get out a big jigsaw puzzle; that is my preferred way to meditate, is to do a puzzle. There is enough tuning out of everything else to find where this piece goes. That gives me that calm state of mind.

I use my essential oils a fair bit to unwind. I’ll put something in the diffuser or roll something on my wrist and take a few big, deep breaths. I have a few favorites for unwinding.

Dr. Eric:

Can you name some of your favorite essential oils?

Annabel:

My favorite for when I need to calm down is neroli. That is my favorite one. There is a blend I use called Balance that has a lot of those earthy oils although neroli is a flower. There are trees that ground me. I like Siberian fir and lime as a blend in the diffuser. Probably my go-to, just to put on me, would be neroli, when I am feeling stressed.

Dr. Eric:

You said you use it every day. You put it in your diffuser typically?

Annabel:

I use essential oils across the day in all sorts of different formats. If I am really aware that I am wound up and need to calm down, having something in the diffuser. I will just grab something and roll it on and take a few deep breaths. Put a drop of an essential oil on my hand. Sometimes taking that minute to stop and take a couple of big, slow, deep breaths in and of itself, even without the essential oil. I find myself sighing a lot when I know I need to unwind.

In terms of the oils, either diffusing them or putting them on. I use them in my cooking and other ways. In terms of that, reducing stress, yeah, either on me like a perfume or in the diffuser are my favorite ways.

Dr. Eric:

Then food. You said you followed a paleo diet. Do you follow a similar diet currently?

Annabel:

I describe my diet as paleo-ish. 100% gluten-free. I am 99% dairy-free these days. That took me much longer to get to, but I do feel a lot better without dairy.

When I first went paleo, the gluten, grains, dairy, sugar, legumes, the whole thing. I definitely feel best when I am following that quite strictly. Life comes and goes and ebbs and flows. I suppose over time, what I have found is as long as I am 100% gluten-free, that gives me a little bit of leeway with some of the other things. Less and less leeway with the dairy over time.

For example, I had a wedding anniversary this week. We went out for dinner as a family. We went to a Chinese restaurant that does gluten-free which in and of itself is a miracle here. I don’t know what Chinese is like in America, but to find one that does gluten free is next to impossible. I did have a small amount of rice, and I was fine. If I ate rice all the time, then I would feel bloated. That’s why I say I am paleo-ish.

I am now super strict with dairy. I don’t do well with dairy. I found great alternatives now. That’s what takes a bit of time. I switched out the milk in my coffee for almond milk. I found some nice ice cream for that occasional treat that tastes good. It’s finding those replacement foods that have helped. The gluten is pretty easy once you know where to find and what to do. The dairy, I did find harder. Paleo-ish would be my diet now.

I run a Kickstart Your Thyroid friendly lifestyle program a couple of times a year. That’s around all of these things we are talking about, but diet is core. We follow that paleo diet. When I am running that, I will do that, too. It’s a good reset for me.

I let things looser a little bit. I know when I have to rein things in a bit, too. For me, that is part of maintaining that long term. It is still a lifestyle. I am not throwing everything out. I won’t eat gluten at all. Increasingly, over time, I guess I’m not deviating as much because I just feel better when I’m eating closer to paleo.

Dr. Eric:

I would say I’m similar. I eat modified paleo, pretty close to paleo, most of the time. I stray from the diet sometimes. I have to have my pizza! Usually it’s gluten-free pizza, but it’s not dairy-free pizza. I have had the Daiya, dairy substitute, but I usually don’t eat dairy-free pizza. How is the pizza in Brisbane? That’s an important question.

Annabel:

Interesting question. I have one son who delivers pizza for Pizza Hut. He has the youngest on a trial shift this week. Three teenage boys who love their pizza. I haven’t enjoyed pizza personally for a long time. Gluten-free pizza, there is some decent ones now. By and large, as soon as I eat pizza- I think it’s the tomato, which isn’t great for me. There is lots of great pizza in Brisbane.

I am probably happier not to bother these days. I would rather have something completely different. It’s just not worth it. We have pizza in the house often. I will just have a piece, and then I feel bloated and get reflux. I think it’s the combination of the grains, even though it’s gluten-free; the cooked tomato sauce; and the dairy. I think that dairy-free cheese is just vile. It’s artificial anyway. I’m with you. It’s hard to find.

Dr. Eric:

I assume you stay well hydrated, too. Do you drink purified water or spring water? What type of water do you drink?

Annabel:

This is one of those things that took us years to make a decision on a filter for our tap at home. I have been drinking purified water for years. For a long time, I was buying it in casks because we couldn’t decide on a water filter. The water filters take out all the minerals. You have to remineralize. I didn’t want the fluoride. We got stuck in overwhelm of researching water filters.

Cut to a few years ago. We have to make a decision. Let’s just get one. We did make a decision. We have a water filter, one that filters out core chemicals from the whole house. In the sink, we have one that does a bit more and takes the fluoride out as well. It’s interesting. Recently, I bought a set of those really fancy scales that tell you about your body.

One of the things I discovered is that even though I drink a lot of water, my body is not properly hydrated. It was ranked really low in the body water component according to these scales. That’s something I just had a meeting with my doctor this week about. I think I’m dehydrated even though I am drinking a lot of water. We are working on that at the moment.

Dr. Eric:

Interesting.

Annabel:

It is interesting.

Dr. Eric:

When you urinate, it’s not a lighter urine? That is one sign that you usually are hydrated.

Annabel:

My urine isn’t really dark. I drink plenty of water. I suspect that my cells aren’t hydrating properly. It’s going through, but I don’t know. That is a work in progress. I do drink a lot of water. I don’t drink a lot of other things. I have one cup of coffee a day. I’m not saying these scales, they’re off Amazon. But I was quite low, so I am going to start taking a few electrolytes and see if that can help rehydrate from the inside.

Dr. Eric:

That sounds like a plan. You mentioned there’s Pizza Hut, but you also mentioned coffee. Do they have Starbucks in Brisbane?

Annabel:

Starbucks hasn’t been very successful in Australia. I don’t even know if we have Starbucks in Brisbane. Having traveled to America a couple of times, you might do pizza better, but we do coffee better.

Dr. Eric:

I am not a coffee drinker, so I am just curious. I don’t go to Starbucks or eat at Pizza Hut. I have never been to Australia, so I was just curious.

Annabel:

We have a lot of small coffee shops, espresso coffee. You can get all the flavored coffees like they do at Starbucks. I would say generally in Australia, we are probably more about the espresso, the cappuccinos, without all of the pumpkin spice latte flavoring. Less sugary, and more small brewers and roasters. We have a very competitive coffee market here. I do like my one cup of coffee a day. I don’t know if it always likes me, but I like it.

Going back to the unwinding thing, for me, we have a coffee machine at home. It grinds the beans and makes a good coffee. That’s part of my morning ritual actually. I’ll take the kids to school, come back. I will have breakfast. Make myself a coffee. Just sitting down with my cup of coffee, I do Wordle. I don’t know if you know about Wordle. Anyway, it’s an online word game. I do Wordle for the day. Then I will read the Bible and journal. I have half an hour with my coffee just to set the day up. I think it’s more about the ritual and the time than it actually is about the caffeine.

Dr. Eric:

Same with my wife. I have never been a coffee drinker, but my wife has a cup of coffee per day. It’s not because she is addicted to the caffeine, but she really enjoys it. Now I have become an herbal tea drinker. To me, I do it for the health benefits, but I enjoy it. Years ago, if you told me I’d be drinking herbal tea on a daily basis, I wouldn’t believe you, but I actually enjoy it. It sounds like it may be similar. It’s part of your routine and your unwinding, like you said.

Annabel:

Yeah, I think so.

Dr. Eric:

You mentioned fluoride, which falls under the toxin category. What other things do you do as part of your low tox living, the fourth pillar?

Annabel:

This has taken years to figure out good products. 10-15 years ago I gradually started to remove some of these products that we are using on and in our bodies every day. I started switching to natural makeup and skincare. That was one of the very first things I did. Finding different brands that didn’t have all of the toxic stuff in them. That was harder back then. Now, here at least, you have choice. There are lots of brands that are making good makeup.

If you think about all the stuff you’re putting on your skin, a good place to start is what are you putting on and in your body that contains chemicals? A lot probably. Makeup, skin care. Food, not wanting to eat food that is full of chemicals and processed food. Water without the chemicals. Not drinking out of plastic is important, too. Skin care and makeup is something that you can replace one item at a time over time.

Same with household cleaning products. That’s another one I have changed a lot. Use natural products. Every time you spray the kitchen counter, I am not breathing in a lot of chemicals. I don’t have scented candles in the house. I don’t use air fragrance sprays. Those sorts of things, I have over time been replacing in the house. That is something we can just do. When the surface spray runs out, make yourself one or buy one from a natural brand that doesn’t have all of the toxic stuff in it.

Dr. Eric:

Agreed. We do the same thing. If someone is getting overwhelmed by hearing this, saying, “I have all of these cosmetics and cleaners.” You can just finish your current supply and then swap it out. Anything you are using on a regular basis, I would recommend try to make the switch to natural.

It’s going to be more expensive. When you eat organic food, that does add up because you are going through the food pretty quickly. With the products, if you spend a little bit more for something that cleans your counters, it takes us a month or two to go through that bottle. I don’t keep track. Same thing with makeup. I don’t really use makeup, but I imagine most makeup will last a while. It will last a month or two if not a few months.

Annabel:

More than that probably.

Dr. Eric:

Alcohol.

Annabel:

There’s another toxin.

Dr. Eric:

I wanted to bring up alcohol. I listened to your solo episode on alcohol. Haven’t covered that on the podcast yet. I wanted you to talk about alcohol. If you want to talk about the effects it has on thyroid health. Wherever you want to go with it, I’m cool.

Annabel:

It was a topic that I had been wanting to cover on the podcast for a while, too. Generally, as a patient advocate, not as a medical practitioner of any qualified kind, I like to bring on the experts. That’s one of the things I love about the podcast. I get to talk to different experts who bring the expertise. I certainly don’t have the qualifications for- You can know a lot without being qualified as well.

The alcohol is something that kept coming up in conversations with different people. Increasingly, I was finding my personal tolerance to alcohol- I would describe myself now as intolerant. I haven’t quite found the right person to bring on, so I decided to do some research and do a bit of a talk on it.

What I found was interesting. This is a big topic. If you listen to that podcast episode, I called it an introduction. There is probably a lot to it that I don’t even understand and haven’t delved into. It made me realize that alcohol is complex, isn’t it? There are so many different things associated with alcohol.

What I got from that was it really can impact thyroid health in a lot of ways. It can impact the thyroid gland itself. It can impact the gut. When we have a leaky gut, that’s not going to help the autoimmune response. Obviously, it impacts the liver. The liver is a core place where that thyroid conversion takes place. I don’t have a gallbladder. I haven’t had one for 15 or 16 years, which is reasonably common in Hashimoto’s patients. I have always been aware that my liver needs extra support. Alcohol impacts the liver. It’s going to be another thing. It’s another layer of inflammation.

In the end, everyone has to make their personal decisions about alcohol. For me, it’s just taken a gradual decline. I have never been a big drinker. I went back to decades of dieting, and I would rather eat my calories than drink them, is what I used to say. I like food more than I like alcohol.

I wouldn’t say I don’t drink. I do enjoy a drink, but I don’t enjoy the aftereffects, which usually for me is I have trouble falling asleep, even just with one. It doesn’t take a lot. I think I am pretty intolerant, or super sensitive at least. I don’t think it’s just me. I have worked out from talking to lots of different people in this thyroid space, it often doesn’t agree.

There are things we can do. There are better forms of alcohol than others, I suppose. Your super sugary cocktails, probably not a great idea because of all the sugar and cream and other things that go along with those. Clean spirits generally seem to be better tolerated even than wine. That was probably the first one. I don’t think I’m enjoying wine. I think it’s the sugars.

There are lots of things you can do now without alcohol. I don’t know what it’s like in America, but Australia has a big drinking culture. That’s another conversation. I have started to see there are more non-alcoholic  drink options being promoted  in the alcohol space. Alcohol-free gins and whiskeys and things. There is a place for that obviously. I like kombuchas and water kefir and things like that. I don’t drink those all the time, but having something special on a Friday night or going out with friends sometimes, it’s nice to have something that’s not just water. That’s my take on alcohol. There is a lot to it.

Dr. Eric:

I’m not a drinker either, but I bring it up just because like you mentioned, coffee. A lot of people have a difficult time with coffee. There are people who want to have at least once or twice a week a glass of red or white wine. Sometimes other alcoholic beverages, but wine is a common ask. Usually initially I am telling people to completely avoid alcohol while healing, but once you’re in a better state of health, every now and then, I don’t see it being a big deal, having a glass of wine or even other types of alcohol sometimes. I just wanted to get your opinion.

You’re right about the impact it has on the gut, potentially increasing the intestinal permeability, at least being a contributing factor to leaky gut. It’s a big reason I don’t want people to consume alcohol. There are a lot of things. You mentioned gluten. We want to avoid all those foods and beverages.

Annabel:

Beer. A lot of people don’t know that beer has gluten in it.

Dr. Eric:

Even the gluten-free beer, while regaining your health, I would say to avoid the alcohol. I assume they have gluten-free beer in Australia.

Annabel:

Yep, we do.

Dr. Eric:

Any additional tips for those dealing with thyroid or autoimmune thyroid conditions? Is there anything I should have asked you, or you want me to ask you, or you want to chat about?

Annabel:

The biggest thing I like to say is there are lots of things you can do, but try not to get overwhelmed by those things. When we feel overwhelmed, we end up doing nothing. You are better off just doing one thing and developing that into your lifestyle. Then pick another thing. Some of us, when we are making changes, some of it does depend on our personality and approach, whether we like to dive all in or just do a little bit at a time. Whatever is going to work in the long term for you, then do it that way.

If you’re listening, and you’re new to thyroid health issues, and you think all you have to do is take medication, you’re cheating yourself. You’re cheating yourself out of feeling much better than you could. That is probably what I would say. There are things you can do. Just take it bit by bit. You don’t have to do everything all at once, but you are going to have to make some changes if you want to feel great. The medication will get you somewhere, but probably not everywhere.

I think we all want to be feeling as good as we can. We all want to get as much out of life as we can. We want to contribute to our communities. The better we can feel, then the more we can be of benefit to our communities around us. You can do it.

I am a words of affirmation person. I tell myself all the time, “It’s okay. You can do it, Annabel.” If I can do it, you can do it.

Dr. Eric:

Well said. Annabel, where can people learn more about you? There is your podcast, Let’s Talk Thyroid, which you interviewed me on recently. You can find my interview as well as other great interviews there. There is also the book with the same title. What’s your website?

Annabel:

I have just made everything Let’sTalkThyroid to keep it simple. Brand new website, LetsTalkThyroid.com. You will find everything there. That is the simplest thing.

My social media, I am pretty active on Instagram and Facebook. That’s Annabel.Bateman.Wellness. Everything else is Let’s Talk Thyroid.

Dr. Eric:

Thanks, Annabel. It was great chatting with you again. It was nice diving into the pillars and talking about alcohol. Didn’t expect to talk about Pizza Hut and Starbucks, but it was nice chatting about that, too. It truly was a pleasure.

Annabel:

Thank you so much for having me on your show. It’s been really lovely to connect with you. That’s one of the loveliest things about this whole thyroid health space is connecting with like-minded people around the world. Thank you.

Dr. Eric:

I definitely agree.

 

Recently I interviewed Lloyd Burrell, and we chatted about electronic pollution.  This was actually a two part episode, and so if you would prefer to listen the interviews you can access it by Clicking Here and Here

I am excited to introduce Lloyd Burrell, as we are going to chat about electronic pollution. I have been following Lloyd for a number of years now, as he is the creator of the EMF Health Summit and the Healing with Vibration Summit. He is the best-selling author of the book Healing with Vibration; author of The EMF Practical Guide; and the founder of ElectricSense.com, which has had four million visits since its inception in 2009. He is passionate about educating people about the dangers of man-made electromagnetic fields (EMFs) and sharing solutions and helping people reconnect with the healing forces of nature. Thank you so much for joining us, Lloyd.

LloydBurrell:

Thanks so much for the invitation, Dr. Eric. It’s a real pleasure to be here.

Dr. Eric:

It’s definitely a pleasure having you. Like I said, I don’t know how many years ago I found Electric Sense and then watched your summit. I learned so much from you. As I mentioned in the opening, I am very excited to pick your brain and have you share your knowledge with my audience.

I want you to start off by telling everyone how did you get interested in EMFs and electronic pollution?

Lloyd:

It’s not that I found EMFs; it’s more that EMFs found me. I had a reaction to my cell phone one day in 2002. I answered my cell phone, and the blue gave me an initially unpleasant sensation, which quickly turned into an unbearable sensation. People said to me, “How did you know it was your cell phone?” It was really painful. It was what I call “hot ear,” “hot head.” I have these terms for it now, which is really common. It was an intense pain, which came on very suddenly from one day to the next. Literally, within a few short days, I couldn’t use my cell phone anymore; it was just too painful.

I was running my own business at the time. Wife, you take the cell phone, and I’ll go do something else. She was very obliging and sweet. I started reacting to mycomputer, the TV, the radio in the car, even the corded telephone. It just got to nowhere to run, so nowhere to hide, that kind of thing. I joke about it when I say it got too bad that I went to my doctor. I’m not one to go to the doctor. I never had a sick day or anything like that.

It was this journey that it put me on. I learned so much out of this journey. It took me about 10 years to get my health back on track and to understand this. I can say I have pretty much understood it now. There is a lot to this. That’s really how it all started with me. It’s been an amazing journey. It was some difficult times because it seemed like there were no solutions, but there are.

One thing I want to say up front is I felt it, but what the science shows really clearly and what this led me to do was to research the science. I was not interested in researching the science. I just wanted to get on with my life. But I had to deal with this to be able to get on with my life.

What the science shows really clearly, and this is what I want to share, is that EMFs affect everybody. This cell phone radiation, which is a kind of EMF, and I can elaborate on that, these EMFs affect everybody. Whether you can feel it or not, they are impacting everybody, these man-made EMFs.

Dr. Eric:

In a way, it might be a good thing if you feel it just because you know the impact it has, where if you’re not feeling anything, it’s easy to dismiss the negative impact that EMFs have on your health.

Lloyd:

Exactly. That’s why it was a blessing in disguise. There is no way I would have gone to all of these lengths to protect myself from these frequencies, these fields unless I’d gone through all of this pain. Unfortunately, that’s kind of how it is with a lot of people. That’s been my mission. That’s what kind of drives me about this.

I don’t just talk about EMFs. I also talk more broadly about energy and leading in good consciousness. That’s my next summit. I’m talking about the science of healing and consciousness because it’s all connected. It’s a long story, which I don’t have time to get into today.

The thing to understand is when I say EMFs, what I’m talking about is electromagnetic fields, or more precisely, man-made EMFs. What a lot of people ignore is we are actually subtle energy beings. Right at the very fundamental level, our cells are communicating via electrical charges, which are energy fields, differences in potentials, which is about energy. This cellular communication, which is so vital in our body, at a cellular level, it’s being disturbed by these man-made EMFs. Then my research more laterally is this energetic level and how we are actually composed of energy fields.

There is a top-down impact as well, which is even more insidious and more difficult to get your head around because people are thinking, well, that sounds a little bit woo woo, energy fields and all of that. No, actually, there is some hard science behind this energy field thing. Ancient civilizations, talking about this for thousands of years. They call it different names, like the aura. We have this official term recognized by the National Institute of Health called bio field. It’s this field of energy that surrounds us and is part of us and is this bridge between the mind and the body. This cell phone radiation impacts, disturbs, destroys this communication.

We are a bit of a communication system. The irony is we are using cell phones to communicate, but they are actually destroying, inhibiting internal communication, which is way more important than any cell phone conversation you might have.

Dr. Eric:

You no longer have a cell phone. You said years ago, you gave it to your wife.

Lloyd:

I do.

Dr. Eric:

You do have a cell phone?

Lloyd:

I went 19 years without a cell phone. This happened in 2002. I’ve had this cell phone for just over a year, simply because I’m not this person who is saying, “Down with the cell towers. Cell phones shouldn’t be allowed.” Cell phones are here to stay. It’s more about well, okay, our world revolves around this technology now. How do we use this technology safely?

I’d like to share some solutions. People are not even interested in the solutions, unless they begin to understand just how big a problem this is. It really is a big problem. That’s what the science says. There is a lot of science around this. You’ve seen my website. It’s all about the science with podcasts. I am interviewing scientists. I have interviewed 250-300 experts on this. It is overwhelming. There are decades of science behind this. We are talking about peer-reviewed science.

It is difficult for people to understand. I guarantee today might be the first time some people have ever heard somebody suggest that a cell phone might be dangerous still. Here we are in 2022, and people are still in the dark about this. How can this be?

Dr. Eric:

Can you discuss why it’s a concern? Even maybe when it comes to cell phone use, does it make a difference if you’re talking on your cell phone on speaker phone, or the type of headset that you use? I know you get into more of the solutions, and we can talk about shielding. It first maybe makes sense to explain why it’s a concern.

You mention how it made you feel bad. From what I understand, it goes far more than just symptoms. It could be a factor potentially, obviously not with everybody, but maybe with cancer or other chronic health conditions.

Lloyd:

Listen to what the science is saying. This is exactly it, what you just mentioned, cancer. The thing to understand is these EMFs impact on many different levels. They impact primarily on the energetic level. We are multidimensional, or we exist in so many different ways, more ways than conventional medicine is really ready to accept. We are more than this physical body. That’s what I’m saying, to put it simply. It’s impacting us first at this energetic level.

Then at a physical level, the cellular level. Obviously, that’s what the majority of the science is on this. Talking about how it’s impacting notably the cell membrane. We have a very clear mechanism, which is- I don’t want to get too much into that because it’s heavy.

Dr. Martin Pall, professor emeritus at Washington State University, his work on the voltage-gated calcium channels. We have this cell membrane. This cell membrane is super important. It’s like the key part of the cell. That’s what we know now. We thought it was just the outside covering, but it’s like mission control. The EMFs impact this mission control, a particular aspect, which is this voltage-gated calcium channel, the VGCC. It’s letting the calcium in and out. It’s no big deal. But it is a big deal. There is a lot of downstream effects from that.

That’s just one bit of science. A very clear mechanism which explains how we get this imbalance in free radicals and all the damage that comes from that. The chemical cascade from that, oxidative stress and adverse biological effects. There are hundreds, maybe thousands, of biological effects. Breaking a single double strand of DNA, stem cell damage, very fundamental building block effects, like chipping away at those building blocks. Let’s explain it like that. Everything stems from that.

Symptoms, which can be varied. Very common ones are:

• brain fog
• What I had with the head symptoms
• Neurological symptoms
• Headaches, extremely common.
• Prickly skin, extremely common.
• This side of the face burning.
• When you’re texting, prickly sensations in the hand wherewe are holding the phone.
• The hot ear, the hot head
• Dizziness
• Sensitivity to light

I experienced most of what I just cited.

• Fatigue
• Anxiety, depression.

I went through that as well. It upsets your neurotransmitters. It gives you chemical imbalances. We have science on that. Dr. Martin Pall is not the only one who has worked on this; there is a lot of great research on this.

• Weight loss. Weight gain. I went through all that.
• Leaky gut. Years after, when I thought I was okay, that came on after.
• Body wide aches and pains.

Just a mish mash of neurologic, immunologic, psychologic complaints.

Then the downstream from that, the symptoms turn into possibly very serious diseases, all kinds of autoimmune conditions, cancer, cardiovascular disease, links to Parkinson’s, Alzheimer’s. You name it.

It sounds like I’m pulling this from the top of my hat, but I’m not. There is hard science behind this. BioInitiative Report, a very big report that reviewed 30 years of science published in 2012 the first time. Republished subsequently multiple times.

Ever since we had electricity, Tesla was doing experiments on this with another chap. They did very rudimentary experiments, but they noted differences in perspiration, respiration, and body weight. They were experimenting with electricity also. There is so much going on here. It’s not even just this little thing.

What people need to understand is the wireless. When we say “wireless,” we are talking about radiofrequency microwave radiation. When we say wireless and Bluetooth, all that sounds sexy and great and fun. When you start talking about radiofrequency microwave radiation, then alarm bells start going off. Radiation, what you mean, like, Chernobyl? Hiroshima? Yeah, well, not exactly, but similar. That is what they call ionizing radiation.

All these devices, all of this wireless, which the industry wants us to use this term, this Bluetooth, this smart, they are all ways of not saying what it is, which is radiation. It’s not ionizing radiation. There is less energy there. The end result is basically the same. That’s the same terms of the damage done to your body, but it’s a 24/7 chipping away kind of damage rather than something which is very noticeable. That’s how they manage to get away with it. It is more subtle, but it’s a long-term thing, and we are exposed to these man-made frequencies 24/7. They are growing, growing, growing.

5G, all these different devices in our home. People living in these smart homes and proud of it. I can understand it’s a lot of fun. I love gadgets. I’m the first one to love gadgets. We need to know about the danger.

There is this wireless, this radiofrequency microwave radiation. Then even more astounding to people is that we can have dangerous EMFs from wires. How can that be? A wire? If it’s in a wire, then we’re safe, aren’t we? No, unfortunately. What’s in a wire, electrons. They do not stay in the wire. They permeate out into the room, into you. We have science behind this.

There are three kinds of EMFs involved here: magnetic fields, electric fields, and dirty electricity. This is a big subject. When your people are hearing this for the first time, they are like, whaaat.

Dr. Eric:

A bit overwhelming for some people.

Lloyd:

It is a bit overwhelming.

Dr. Eric:

You mentioned 5G and dirty electricity. When it comes to 5G, is the big concern that you get an enhancement of the EMFs, just greater exposure?

Lloyd:

With 5G, it’s almost been a good thing in the sense that it’s made people talk about it. I have been talking about this online since 2009, as you mentioned in my introduction. The 5G has made people talk about this.

The 5G was really a bit of a marketing exercise for the cell phone industry. They are always wanting to invent that bright, shiny, new object, so people go out and buy it and create a demand. It’s through that they are able to develop these technologies. It’s a vicious cycle they create. An ongoing demand, an ongoing supply of money for these technologies so they can develop it.

People are wanting it. It’s not putting the blame on them. The blame is with us users who keep buying into this technology, if there is blame to be put anywhere. With the 5G, they sold it as something which was so much better than the previous technology that we were going into these new frequencies and all these faster download speeds.

It’s all these generations. G just means generation. We started off with 1G. We had 3G for ages. Now, pretty much everywhere, we’re onto at least 4G. We are introducing 5G, and 6G and 7G are already in the pipeline. Probably the 8G elsewhere. That is their business model.

The 5G nearly never really quite came off as they had said because we talked about this in 2018 when I did my first summit. It was these millimeter wave frequencies. It is being rolled out, but not nearly at the speed that they wanted. It requires a lot of capital investment. 5G is the satellites in space, which is happening, over 100,000. 5G is these millimeter wave frequencies in some parts of the world, not everywhere.

Millimeter waves are short wave lengths. Why are we doing that? All of the other frequency bands are saturated. There is so much going on that they are going off the electromagnetic spectrum, which is just how we understand it. All life is on the electromagnetic spectrum because all life is electromagnetic. All living things. In fact, pretty much everything has a vibration. Even a rock. Even a chair. All living things on this spectrum.

The existing cell phone frequencies are saturated. Let’s give them some more frequencies. They are always needing money. Let’s sell off more frequency bands. They are selling off these higher frequency bands. 20, 40, 60 and higher gigahertz. That’s where the 5G is going. It depends where you live in the world as to what frequency they are using exactly.

The concern for me anyway which I don’t believe are necessarily founded, but the real concern is it’s a novel layer of man-made EMFs, which we have already got decades of peer-reviewed research, which is clearly linking these exposures to many, many symptoms, adverse biological effects, and a long list of serious diseases, including cancer, autoimmunity. I know a lot of your audience is interested in that.

There is science on how these frequencies impact the thyroid gland. I can share that very briefly if we have a moment.

Dr. Eric:

Yeah, let’s do it.

Lloyd:

We have three bits of science here very quickly. This is out of my book. It was easy for me to find. I have a 2016 Israeli study that collected human thyroid cells from healthy patients and then subjected them to this cell phone radiation. They found clear evidence of changes in thyroid cells. The study’s authors noted that the rise in thyroid cancer cases in Israel over a decade correlated with the rise in the use of cell phones. Correlation does not mean causation. I know.

Secondly, we have a study from the Hardell Research team. These guys are really good. It’s a Swedish research team who have been working on this for decades. It’s really high-quality research. In Sweden, that’s where the birth of the cell phone is. That’s where it all started. There is a reason they have been doing the research. There are some nasty things happening with regard to cell phones in Sweden before elsewhere in the world. Hardell found that in recent years, there has been a substantial increase in patients diagnosed with thyroid cancer in Sweden as well as in other Nordic countries. They concluded that this increase coincides with the growing use of smart phones.

Thirdly, we have this 2019 Iranian study. They reviewed 161 research papers. This is not just one paper. They reviewed a ton of studies. They found that cell phone radiation affects the thyroid gland follicles and the volume of cells in the gland. I don’t think I need to explain anatomy to people. People know where the thyroid gland is.

Just look at me here. I never use a cell phone like this. Never, ever. I did at one time, but never anymore. Here, look where your thyroid gland is and how far away they are. This is not a particularly big cell phone. This whole device is emitting radiofrequency microwave radiation, and it’s also emitting magnetic fields. It has a battery in it. It has a small magnetic field. That is a problem. This proximity to all of these very vital organs and glands.

Dr. Eric:

Definitely a good reason not to hold the cell phone to your head at all. Obviously, the more frequent exposure, the greater the risk. If someone is doing it on an everyday basis, holding their phone close to their head for an hour or two or longer, increased risk.

Maybe I’m not doing the right thing. When I speak, I’m usually on either speaker phone, or I’m using a headset. I know there are different types of earbuds. I don’t use the wireless earbuds. I know there are also different types. The tube type.

You do use a cell phone. How do you talk when you’re on a cell phone? Do you use speaker phone or earbuds?

Lloyd:

My primary means of communication is my landline, which I’ve taken off the hook. You can see perhaps on my desk here. That’s it. It’s not my cell phone. My cell phone is to go on my online banking and things like that. I have this job where I’m in this little office a lot. It’s quite easy for me. I created this. It’s not by accident. Because of what happened to me. I know a lot of people who need to use a cell phone more than I do.

I’m not using it like this, never ever. The reason is the way that these man-made EMFs, this radiofrequency microwave radiation propagates in space, a very small increase in distance between you and the source of the radiation exponentially reduces your exposure.

I’ll put that into plain English. That means distance is your friend. Because of this exponential, and people are a bit mathematical, they know what that means, it’s non-linear, it’s this very small distance between you and the device. In this case, a cell phone. Literally, a few millimeters can reduce your exposure thousands of times. A few millimeters. If we are like, here, holding it, arm’s distance away, it’s significantly less. That’s what I recommend: holding it as far away from this really vital part of our body, which is why we’ve got this skull and everything protected in that skull. As far away from my body as possible.

I recommend text, don’t talk. I’m not saying texting is safe. If you do want to talk, then I recommend the speaker phone, as you mentioned.

Or if you want to keep your conversation private, I recommend using an air tube headset. That looks like a regular wired headset, but it’s got a big air tube, a bit of tubing with no wire in it. That makes it much safer because otherwise, that wire acts like a kind of antenna, and it can bring in ambient radiation in the environment, whatever environment you happen to be in, directly into your brain. That’s why we don’t want to be using a regular headset.

Those are a few tips. There are others, like a really basic one. If you look at my phone here, you can see it’s on airplane mode. When we’re on airplane mode, then that is a way of disconnecting all wireless connectivity. We need to make sure that we have deactivated the cellular, the Bluetooth, and the WiFi. That is not always the case on all of these phones.

That is why I recommend at some point that you go a step further. I have my book of tricks here. I recommend getting something like this, which is an EMF meter, which can tell you if this device is switched on or not. I can give you a little demonstration if you’d like.

Dr. Eric:

I actually have one of the older ones, a Cornet. It’s probably time to upgrade.

Lloyd:

I just switched it on. You can hear it. That’s connecting, and it’s making a noise like a counter. It’s giving some figures on there. That is the only surefire way of knowing if you are on airplane mode. That is the only way to carry a cell phone on your person, is on airplane mode. Otherwise, it’s just ping, ping, pinging to its heart’s content, exchanging data with the nearest cell tower.

If you’re in a moving vehicle or in a building with thick walls or underground car park, things like that, it’s really having a hard time maintaining that connection. What I really mean is it’s emitting significant amounts of radiofrequency microwave radiation. I keep repeating this. When I say “significant,” these devices are amazing. We are talking between, the lowest power setting, a million times less than at full power. That’s how smart they are. It does all this itself without you knowing it.

Those are some tips. The other thing to do is look to make sure that you have all those little bars at the top when you switch the thing on. If you don’t have the full bars, that’s where you’re getting these million times more exposure than if you just got the one bar. If you have the one bar, then you don’t want to be using it, even at arm’s length. Only in emergencies. Make sure you have the full bars.

Avoid using it in a car. It’s like a sealed metal enclosure. Not good. You have to work really hard. That’s the one thing that can protect you from all this.

Those are some cell phone tips.

I’m not sure if shielding is effective, but even if it is, is it unnecessary if you have it in airplane mode?

Lloyd Burrell:

If you have it in airplane mode, well, it depends what you’re shielding from. There is no point in having a cell phone and then shielding and then going into the shield. You will trap it in. It is going to want to communicate out, and it will trap that radiation in. Like a microwave oven, it will cook you, not a lot. You will be exposed to that. You have people who are creating Faraday cages to sleep in. There is a whole misunderstanding about Faraday cages. I am not a big one for that level of shielding.

My approach, you can’t outsmart Mother Nature. As I said at the beginning, we are electromagnetic beings on an electromagnetic planet in an electromagnetic universe. Why do you want to go into a Faraday cage from the cell phone towers, the neighbor’s WiFi? You will shield yourself from all the other beneficial, necessary frequencies. That is a mistake. That’s why shielding is always a last resort. I can share some other tips with you about things we can do to reduce our exposures.

With this thing, so much of it is in our control. It requires a little bit of effort, but the thing is, you won’t make the effort unless you begin to understand, yeah, maybe, could be that which is giving me this brain fog, which is not making me sleep so well, which has made me put on all this weight recently, which is whatever symptom. There is no bodily system, no bodily organ that goes unscathed from these man-made electromagnetic fields.

Dr. Eric:

I agree with you about the Faraday cage. There are some people who might wonder, should I get shielding for my router, or if they have a smart meter, and they have problems getting it turned off or taken out? Should I get a shield over my smart meter? Will those things be helpful at all?

Lloyd:

Right. I get those kinds of questions all the time. There is a way to deal with this which is very simple. I don’t pretend to be an expert on this. What I am really an expert on is my own journey dealing with this. I have learned a few things about energy and stuff like that. I’m not an EMF consultant. I have written several books around this topic. I let people decide, here is what I have to say. I am not looking to be called an expert.

There is a way of going about this. You shouldn’t just listen to anybody, “You have a smart meter, so you need to do this.” What you do need to do is the following, and I call this the UMM, like how the Buddhists say. My UMM.

The U is Understanding. Unless you begin to understand a little bit about this, and by the way, this is way worse for kids. Children are more vulnerable. Understand this.

The first thing is to understand what this guy with this weird accent from England who is in France is talking about here. Is he making any sense? “I don’t believe it.” Ok, don’t believe me. Go do your own research. Environmental Health Trust has a great website. They have some great resources on this. My website Electric Sense, a lot of science on there. Go do your own research. Try to understand this thing.

I have thrown out a few technical terms. I keep going on about this radiofrequency microwave radiation. That is one kind of EMF. I have mentioned magnetic fields. That’s another kind. I have mentioned electric fields. That’s another kind. I have mentioned dirty electricity without explaining what it is. It’s understanding what all of that is. Rome wasn’t built in a day. There is a slight learning curve here.

Once we understand, the next thing to do is Measure. If you don’t measure, why would you go and do what Lloyd tells you to do or what any other EMF expert tells you to do? Only listen to an EMF expert if you talk measurements. Only take action if you have taken measurements. You know about this, Dr. Eric, because you have the meter. It’s the meter which enables you to get the information, which enables you to understand your exposures.

Once we have understood the exposures, then the third M is to Mitigate, to deal with that. There are three ways we can mitigate. We can turn the darn thing off. Cell phone, airplane mode, for instance.

The other way to mitigate is to increase the distance. Distance is your friend. Really simple.

The third way is to shield. The shielding is the last resort. That’s where people get topsy turvy. “Oh my god, I have this smart meter. I didn’t even know. They didn’t even ask me. I have this smart meter. Now I have these symptoms. Then I went online. It said it was this and this, and it could do this, and it could give me cancer. What do I do? How do I shield that?” Whoa. One step back. Take a deep breath.

What kind of EMF is it? A smart meter is a smart meter. There are some smart meters that give off cell phone type radiation. There are others that are giving off dirty electricity. Dirty electricity is a kind of pollution on our electrical wiring. What’s on the wires does not stay on the wires unfortunately. We have links to cancer notably and all kinds of symptoms around this. It’s understanding what it’s doing.

Getting measurements with this meter. This meter won’t measure the dirty electricity; you need a different kind of meter for that. You want a dirty electricity meter to measure below 50; otherwise, you take action. Smart meters can cause that kind of electrical pollution, or they can cause radiofrequency electrical pollution. That’s why you need to know. Otherwise, you’re wasting money shielding, and it’s not even shielding to any effect. You may as well just throw your dollars in the bin.

Having this little UMM protocol is having a method and being methodical. That is the way to go with whatever it is you’re dealing with, whether it’s the WiFi or the cell phone or a smart meter. I can guarantee pretty much everybody listening to this, unless they have gone through and measured with a meter like this, they have got man-made EMF exposures in their home which are impacting their health.

Let’s put it like that. It’s the impact over time. There is no such thing as safe and not safe. We don’t know what’s safe now. I don’t know. I have been talking about this and studying this for 20 years. I am not the person who knows the most. I know a fair bit. Anybody who says they have .0003 microwatts per square meter is perfectly safe, they don’t know. We are trying to get as low as possible. We know what’s dangerous. That’s the thing. We are trying to minimize our exposures. That might sound a bit vague, but it’s the truth. There is no safe because we are electromagnetic beings. Our cells are being impacted. Our energy systems are being impacted.

This is a softly over time adverse effect. It’s working hand in hand with all the other toxins. You know the toxic barrel? It’s feeding into that. Not only is it feeding into it, but it’s got this synergistic effect. It’s not 2 + 2 = 4 with EMFs. It’s the EMFs and the pollution in the air, the pesticides in the food we’re eating, the chemicals in the soaps and shampoos that we’re putting on our skin. n It’s not EMFs are the problem in and of themselves, it’s the EMFs and everything else. It’s this synergistic effect, which is just boom.

You’re okay, you’re okay, you’re okay. One day, you’re not okay. The problem is you don’t even know why you’re not okay. You go to see your doctor, and he’s never even heard of EMFs. He might have read a study on it maybe. There’s been another study out there put out by the cell phone industry saying it’s all safe. There is a lot going on here in the background to keep people in the dark.

Dr. Eric:

I agree that it’s not just about the EMFs. We live in a toxic world. We want to do things to reduce our toxic load overall. We live in a very stressful world, so we want to do things to improve our stress handling skills. Eat whole, healthy foods.

That being said, getting back to reducing exposure, how great of an impact does it have to unplug devices at night, like the WiFi? Would you say those are worth doing?

Lloyd:

110%. I know some people are in short term accommodation, renting a property for a few months. I have dealt with this sort of situation. “I can’t shield and all of that because it’s not my home.” “I’m sharing with somebody else.” There are so many excuses that people can find for not dealing with this. But there are so many ways to deal with this. I agree, if it’s not your own place, it’s a bit harder. It does take a bit of effort. All this is hard-wired. There are wires allover the place here. It’s a choice. All of this is a choice. You’re not going to make the choice for the wires and the effort it takes to do whatever to make your home safer if you don’t understand just how bad this thing is.

With regard to unplugging the WiFi at night, of course, it’s a yes. Who needs WiFi when they are sleeping? How can you be on your computer when you’re asleep in bed? If you do wake up, you should not have that cell phone in your bedroom. Your cell phone should be as far away as possible on airplane mode when you go to bed, people. “Then I won’t know what time it is.” Yes, you can know what time it is. There are things called watches and clocks and battery-operated things, which do not emit radiofrequency microwave radiation.

Nighttime is when your cells regenerate, rejuvenate. We have all these hormonal reactions. Melatonin is a very important hormone viewed by many to be the master hormone, which has got all of these properties and antioxidants and protection from cancer. You can’t get enough of this stuff. We know the science tells us that radiofrequency microwave radiation, and other kinds of exposures, too, at night inhibit our ability to produce melatonin. That is only one bit of the puzzle.

It’s exposing yourself to the WiFi when you can just unplug it. I do tell people to unplug it. Don’t be clever and think you can go in the settings and automate it because as soon as there is a system upgrade, it will switch back on. Unless you have one of these meters, you won’t even know if you have really switched it off because most WiFis have a public signal and a private one. When you switch off the private one, it’s still emitting a public signal that is a radiofrequency microwave radiation.

The other thing people are thinking, “Well, what’s the point? My neighbor has WiFi. What difference does it make?” It makes a difference. Why? Distance is your friend. It’s these exposures which are in close proximity. What’s outside your home, go speak to your neighbor. But deal with what’s inside your home. There are so many things you can and should do to reduce your exposure, notably in your bedroom. That is the most important place to focus on. That is where you get the biggest bang for your buck in terms of protecting your health, these nighttime exposures.

Dr. Eric:

Before we wrap things up, can I get your thoughts on earthing?

Lloyd:

Direct physical contact with the physical earth, the most obvious way to do this is take your shoes and socks off, and get out there in your garden, if you have one, or in a green space. If you are fortunate enough to live on the coast, the beach for instance. This skin contact with the earth enables these negatively charged electrons. Funnily enough, the earth, just like our cells, on the outer surface has these negatively charged electrons. These are tremendously beneficial.

The simplest way of explaining this is it has a normalizing effect. That almost downplays it because it sounds normal; it’s nothing special. But it is tremendously special. To get normal is not something you can get out of a pill. A pill will correct this, but it will have a secondary effect here. Earthing doesn’t do that. It’s Mother Nature’s medicine. It’s this connection. It’s absorbing these negatively charged electrons, and it’s discharging these positively charged AC (alternating con) electrons. It all has this normalizing effect. It’s a detox quite simply. That’s another way of thinking about it.

There is not science on everything I talk about. Most of it, there is. There is some really good science on this, 20+ peer-reviewed studies. Not thousands, but 20+. Why is there not more? Someone has to pay for these studies. That’s the problem with all of these studies. Same to show these detrimental effects of magnetic fields and cell phone radiation. Who is paying for it? The cell phone industry is very happy to pay for studies that show that there are no effects. That’s really so easy. They have shown how they could influence the science to show that it’s safe.

What’s incredible is that your autonomic nervous system relaxes almost immediately, 1-2 seconds. Almost immediately. You tell me a pill you can swallow where you get relief in 1-2 seconds. Acute inflammation is improved in 20-30 minutes. Improved sleep, accelerated healing of injuries, increased heart rate variability (an important indicator of health), reduced clumping of red blood cells. Another thing which the science tells us, these exposures cause what’s called a ruler effect. They cause our red blood cells to clump. The clumping means blood is less good at oxygen transportation, and it’s bad news. This reduces that clumping. The earthing is win-win.

The only controversial bit of this really is earthing indoors, which is another way. There are companies that do this. The controversial side is where we do this. Is there a net benefit?

Dr. Eric:

What would be your response? I assume there is no studies on indoor earthing.

Lloyd:

Here’s my recommendation. 100% earthing outdoors. Everybody doesn’t agree with this. We have building biologists who say, “That’s dangerous. In North America, you shouldn’t go barefoot.” I say listen to your body. Listen to me, and make your own decision. I say, don’t listen to me or Dr. Eric or any guy in a white coat. Listen, but then make your own decision. Listening to your own body is most important. You try it for seven days outdoors, and see how it works.

Indoors, same thing. If you can’t prioritize earthing Mother’s Nature way. Go swim in the sea. That is the most powerful way to earth. Wet, moisture conducts, water conducts superior conductivity, faster effect. Like I said, it’s almost instantaneous, some of these effects. Multiple times a day, getting out there for not long, a few minutes.

Don’t take your cell phone and multi-task. Get out there, listen to the birds. All of that is Mother Nature’s frequencies. It’s tremendously healing. Listen to nature. If you are fortunate enough to be able to go in a park or have a garden where you can hear the birds, oftentimes, it’s a choice. You don’t even think about listening to the birds unless somebody says, “Can you hear those birds?” We are too busy doing I don’t know what to listen to birds.

That’s the first priority with regard to earthing. Beyond that, if you live on the 42^nd floor, then you’re looking for other solutions. There are other solutions. That is earthing via your electrical system. That is a little bit more technical. There are some downsides because you can be connecting to dirty electricity, electric fields, and so on. You need to spend a bit more time understanding this and how to protect yourself. We even have devices now, like the NCB, for protecting from this ground current, which is pretty much everywhere, certainly in North America, when you’re using earthing. There are lots of solutions.

Start with the simple ones. It’s the UMM. People have said “Umm” until this moment here. This is a big topic. It deserves a little bit of time, reflection, and then taking action.

Dr. Eric:

Well said. You brought up an excellent point. If you go outside and do earthing, or even just go outside and get some sun, leave the cell phone behind while doing that. Get the benefits of the sun exposure. Get the benefits of the earthing. Like you said, listening to nature. You don’t need to be on your cell phone for even 5-10 minutes. If it’s 20-30 minutes, leave the cell phone behind.

Lloyd:

Absolutely. There are so many benefits to consciously engaging with nature. You could just go out there and have your cell phone, and you would get some benefit from the earthing. You would get some benefit from the exposure to natural light, even if it’s not sunny. The sun is still there. It’s coming through the clouds. We are still getting the UV benefits from natural light, which by the way is an EMF which we need. It’s much better for us than all of this artificial lighting, which are these frequencies. It’s such a big subject, CFLs, LEDs. The science behind all of this. If there is anything else you want me to share, then I am happy to with the time we have left.

Dr. Eric:

That’s up to you. I know we’re already over. Like you said, there are so many different things. One other question, since you brought it up, is the blue light. What could people do indoors to minimize their exposure to the blue light? Should they go out and get incandescent lights? On the computer, there is f.lux.

Lloyd:

Blue light is great. The sun is the most potent form of blue light. It fits in with our Circadian rhythm. It’s part of our biology. We have evolved around this day/night cycle. You get up in the morning, and then we are getting the blue light. There is less blue light as the day goes on. That’s what we need. We are designed to synchronize to that. What we do is we watch TV, go surfing on the internet on our computers, look at our amazing cell phone at all hours. Then we go to bed, and we can’t sleep. We know you can’t sleep because you’re programmed to be awake with this blue light stimulating you.

Blue light at night is the problem. We want to avoid blue light at night. We want to avoid screens. You can’t even see this blue light, but it’s there. All of these screens have it. We have free software called f.lux, which you can use to make your screen automatically dimmer. The Macs have this software. They do dim. You can go a step further and wear blue light blocking glasses. That is highly recommended. But you may not want to be walking around in your own home with glasses on.

Then it’s making intelligent, informed choices about what kind of lighting you have in your home. If you have an LED or CFL or regular fluorescent in your garage or utility room, that’s one thing. But having that in your bedroom, that’s the last light you see at night. That is not good news. You might sleep fine. There will be other symptoms though. It’s not like you have this blue light; therefore, you get cancer the next week. Doesn’t work like that. It’s a cumulative effect.

That’s the other thing. The studies show, and I said this at the beginning, is these EMFs are impacting everybody. You can’t feel them, so it doesn’t mean they’re not impacting you. They show these exposures are cumulative. If you’re okay today, it doesn’t mean you will be okay tomorrow. Therefore, now is the time to take action and start softly taking steps to minimize your exposures.

Dr. Eric:

You mentioned the shield. They could get the tri-field EMF meter.

Lloyd:

I’m not saying this is the best meter. Cards on the table, I work with a company called Less EMF. They have loads of stuff. I have a little shop, a selection of things which I recommend. You can get that from my website. When you buy from me, you buy from them. It’s shipped from the U.S., and I earn a small commission from what you buy from that shop.

Tri-Field, TF2, I’m not saying it’s the best one. But it’s a really good compromise because it can measure these three types, Mag (magnetic), Elec (electric), and RF (radiofrequency microwave radiation). It costs under $200. It’s a great investment. You can use this for years. You can lend it to your kids, your neighbors. It’s fun. Honestly, you will be shocked, not just surprised, by what you find.

Dr. Eric:

The air tube, they could also get those on your site.

Lloyd:

Another website I like to recommend is ShieldYourBody.com. He is really good. It’s Martin Blank, who was one of the pioneers in this field. They create their own products. Everything is their own. They have some really good, different ways, not just the air tube headset, but they have a way of converting a regular headset to an air tube headset also, which is very inexpensive.

Most of this stuff is not big bucks. It’s just a bit of effort. Then you have to invest in a meter. I have this little dinky thing here that is not a meter because it’s not giving us a reading. It gives a flashing light when we are in the vicinity. This is smaller than a cigarette pack. I don’t have big hands, but it’s tiny. I believe it measures up to 10gh, if not 20. There are constantly solutions coming out for this. There are a lot of good people working in this field.

Dr. Eric:

Thank you for sharing all of your knowledge, Lloyd, with regards to EMFs. Appreciate your website, ElectricSense.com. Your book Healing with Vibration, too. Can you briefly talk about the upcoming summit?

Lloyd:

The Science of Healing and Consciousness is a free event, January 16-22, 2023. What’s that got to do with EMFs? Everything. Consciousness is an EMF. It’s an electromagnetic energy. Ultimately, that’s what we are. Consciousness, we all stem from it. It’s a big subject. If you’re that person who has had struggles, health troubles, challenges in your life, and you are feeling a bit lost in this world, it’s getting a bit crazy, isn’t it? There is a lot of nonsense out there. You switch on the TV, and it doesn’t make sense anymore. It’s making sense of all of this, and it’s connecting with what’s important.

This is where all of this has led me. It just became very clear to me, my journey. I was fortunate. I had this reaction. I realized I was sensitive to EMFs, and then energy. We are energetic beings. Therefore, consciousness is what is behind all of this. If we can learn to work with consciousness, then this is the key to the door.

Dr. Eric:

Excited to tune into that in January. Thank you so much for taking the time, going over time, to dive into blue light. I learned a lot, and I’m sure everyone else did as well.

Lloyd:

Thank you so much for the invitation. I enjoyed it.

 

 

Recently I interviewed Dr. Neil Paulvin, as we chatted about low dose naltrexone and peptides.  If you would prefer to listen the interview you can access it by Clicking Here.

With me, I have Dr. Neil Paulvin, who is an innovative physician in the study of functional medicine, integrative sports medicine, regenerative medicine, osteopathic manipulation, and craniosacral therapy. He works with patients not only to treat but to find the root causes of autoimmune issues, thyroid and hormone imbalances, digestive and gut disorders, as well as a number of inflammatory-based conditions, uniquely combining osteopathic manipulation and functional medicine to fast-track healing, recovery, and biomechanics to progress athleticism. Thank you so much for joining us, Dr. Paulvin.

Dr. Neil Paulvin: Thanks, great to be here. Should be fun.

Dr. Eric: Look forward to chatting with you about low-dose naltrexone (LDN) as well as peptides. Before we do this, can you give a little bit of background? How did you get started maybe doing functional medicine and prescribing LDN to some patients as well as peptides?

Dr. Neil: Sure. I got into a lot of this initially because I was dealing with a lot of chronic illness patients, Lyme, fibromyalgia, autoimmune issues. There wasn’t a lot of traditional medicine that always worked that didn’t have a lot of side effects associated with it. I went down the rabbit hole of some more alternative treatment that had some good data behind it. That’s how I found out about LDN, which has been studied in a lot of conditions as well as peptides, which I learned over the last two or three years have incredible benefits for multiple conditions.

Dr. Eric: Why don’t you start out by, for those who are not familiar with LDN, explaining what that is?

Dr. Neil: Sure. LDN is a derivative or breakdown product. It’s a medicine that has been used for years in patients with opioid abuse or alcohol use disorder. That is usually a much higher dose, 250mg. They found even at those doses, there were some other benefits that come along, like with so many other medicines, found by accident, serendipity. What they found was that those medicines would potentially help with immune issues, weight loss, and inflammation. They didn’t want the side effects that those higher doses could achieve. Doctors went lower and lower and lower to find out where that happy place was, where we could “microdose” it but still get the benefits that naltrexone can provide. It can be given via pill or dropper. There are some nose sprays, but mostly common in a pill form, and taken at bedtime. That is when it works the best. Via the mechanism that it works. That’s where it comes from.

The one thing that people need to know is you can’t take it if you are on some type of narcotic medication like Percocet or oxycodone because it will put you into withdrawal. That is the one downside. Otherwise, minimal side effects. It works over a broad swath of conditions.

Dr. Eric: Can I ask how long you have been using it in your practice approximately?

Dr. Neil: Good question. Probably close to 10 years or so. 8-10 years.

Dr. Eric: Wow. You have been using it for quite a while then.

Dosing. As you mentioned, you start with low doses. How low do you start? 1mg or .5mg?

Dr. Neil: The preface for all of this is low dose is kind of an art. It’s not that everybody takes the exact same dose. We start at a low dose, anywhere between .25mg-1.5mg usually. A little bit lower in patients who have autoimmune issues, especially things like Hashimoto’s because as part of resetting the immune system, it can affect the thyroid hormone. You may need to change their medications around. You don’t want them crashing or going hyper on you, one or the other. You want to take some baby steps with it.

If you are doing it for pain or weight loss, you usually are a bit more aggressive with it because there aren’t as many side effects. That is usually the sweet spot in terms of where we start the dosing at.

Dr. Eric: Do you gradually increase the dosing with everybody? If they start on 1mg, and they are doing okay, would you keep them on that?

Dr. Neil: It depends on the symptoms. Usually, I will keep pushing for a little bit to find out where they will get the max benefit with minimal side effects. Very few people I just keep on the maintenance dose, less than 5%.

Dr. Eric: Okay. How frequently would you on average increase the dose? Would it be something like every two weeks, or every month or two?

Dr. Neil: It’s usually 1-2 weeks. Depends on the patient. Patients who are more sensitive or we are more worried about, you would go slower, every 2-3 weeks. Patients who you are progressing quickly and don’t have side effects, you’d do every week to 10 days.

Dr. Eric: Okay. What is the highest dose that would really be considered LDN still?

Dr. Neil: That keeps going up and up. There are no rules now on it. Other doctors hit low double digits. You want to make sure you are working with someone who is experienced at handling it, and they are doing it for the right reasons. There is prescription medication out there called Contrave, which is LDN, 8.5mg, twice a day. That’s 17mg a day. For the weight loss, you are pushing higher. I am all about what I call the delta. If I put someone on 7mg, are they going to get a much bigger benefit from me putting them on 12-13mg? Usually, it’s not a huge difference. You will get more side effects than benefit usually. My top is right around double digits, like 10mg. A couple patients might be higher, but that’s not common, at least for me.

Dr. Eric: How about a typical autoimmune patient? I know it will vary. Would they at times exceed 5mg?

Dr. Neil: Not usually. If it’s just an autoimmune patient, usually lower is better. With them, it’s such a domino effect of so many other things going on that I don’t see much benefit beyond that, unless I am trying to treat something else.

Dr. Eric: The reason I ask is because I have been used to, over the years, when other practitioners have recommended LDN, probably the max dose would be 4.5-5mg. Recently, I had a patient who was taking 7.5mg, which was the highest I’ve seen for one of my patients. I hear you saying that in some cases, maybe not autoimmune, but other cases, they might take in double digits. You mentioned the 8.5mg twice a day in that certain situation. It sounds like autoimmunity, you tend to keep them on the lower end.

Dr. Neil: Yeah. We tend to keep them on the lower end to limit side effects. We also have the buffer where we know we’re giving it 6-10x the dose. There are not many issues with it. Now that the prescription meds are out there, and that’s given without many side effects, we have a pretty broad swath to go for.

Dr. Eric: Have you seen any difference with different types of autoimmune conditions? I am guessing you probably see a good amount of Hashimoto’s patients. Do you see similar effects with people with rheumatoid arthritis (RA) or multiple sclerosis (MS)? Are there some autoimmune conditions where it doesn’t seem to be as effective?

Dr. Neil: No. Everybody is different. Some people could have inflammation. Some people may have a mast cell issue. Some people may have brain fog or cognitive issues. Everybody is different. It is very hard to compare A to B. I have seen improvement throughout the spectrum in all of my autoimmune patients. I have adopted what I branded the Safety Deposit Box method, meaning you have to turn all the keys at one time on all of these patients. It’s not just about regulating the immune system, but you also have to deal with inflammation or cognitive issues. It works better that way and keeps you on lower doses of certain medications. It’s definitely worked in pretty much all of them.

Luckily, Hashimoto’s usually has less systemic complaints than MS or RA does. RA is much more noticeable. At least half of my Hashimoto’s patients don’t even know they have it until I tell them. Most patients with RA or MS unfortunately know there is something going on. Those symptoms are usually unfortunately more life-altering than Hashimoto’s, at least from what I have seen. I have patients all over the world who come to see me for these things. Hashimoto’s is usually by itself a little bit simpler to treat than MS. That is the broad category. It can help any of them, and they will all usually see some improvement.

Dr. Eric: I’m glad you mentioned that you don’t just give LDN. It sounds like you do a lot more. If the person has a leaky gut or other gut issues, or if they have cognitive issues. You pretty much do what a functional medicine practitioner is supposed to do, which is try to address the triggers and underlying imbalances.

Dr. Neil: Exactly. We are looking at their labs, hormones, lifestyle, sleep, exercise. We’re doing all of those things. It’s definitely not just one thing in most patients. It’s doing a bunch of different things, working from the ground up. Start at the foundation, and they have one or two things, then you take it step by step. If you try to do 100 different things, it doesn’t work.

Dr. Eric: Do you put pretty much all your autoimmune patients on LDN? Does it depend on the person?

Dr. Neil: I would say a majority are on it, just because I find that it works. What I like to do is find things that work on a lot of their complaints. It will help their immune system, their pain. We know it can help heal the gut. It does so many things with minimal side effects. I love it because it checks all those boxes.

Some people don’t like the side effects. Some people are on narcotic pain medications and can’t take it. Ketamine has become more prevalent in my area, so that makes it a bit of a contraindication. Most patients who can use it do.

Dr. Eric: You said some people don’t like the side effects. From what I understand, there are not a lot of side effects. One of them is sleep issues. If they are taking it at night, they may have to take it during the day. Can you talk about any side effects people should be aware of?

Dr. Neil: The main three are problems with sleeping the first day or two. That is because of the way it affects the cytokines in the brain and the other hormones it works on. It may affect sleep. But some patients say, “I slept the best I’ve ever slept.”

There is occasionally some nausea. If you dose it the right way, I very rarely see that.

The other one I’ve gotten a decent amount of times, probably 1-3%, is you get dreams like you are on some type of psychedelic. That tends to go away over the first day or two as the brain adapts to it. I have had one patient have to stop it just because the dreams didn’t go away. That’s out of thousands of patients on it.

Dr. Eric: How about headaches? Are they a common symptom of LDN? I think I have had a couple patients who said headaches. I can’t say it’s common, even though I can’t also say that I have a lot of patients on LDN since I don’t personally prescribe it.

Dr. Neil: I’ve seen it. It’s not- Chicken or the egg is not the right expression. Is that from the medicine? Is that something else? I don’t know. I’ve had less than two handfuls of patients have that symptom. If you look at the side effectsof anything, you can get one person who gets this, but I don’t really see it.

Dr. Eric: The big one is sleep, but not everybody experiences sleep issues. Some people take it, and they actually sleep better.

Dr. Neil: The other one I have seen occasionally, and I know it’s reported in groups, and it’s usually because of other reasons, is weight gain, even though it’s used for weight loss. What is happening in those patients is it’s regulating the hormones and immune system. The other doctors are not getting on top of the hormone part, so there is some weight gain associated with it. That’s the other side effect I have seen sometimes, but that’s it.

Dr. Eric: For your Hashimoto’s patients, I know you mentioned earlier where they might be able to lower their dose because the effects of LDN on the immune system. Do you have people who are able to completely get off of thyroid hormone replacement by taking LDN?

Dr. Neil: The answer would be yes, I guess. In a lot of cases, I am not as aggressive with the thyroid medicine initially unless their numbers are horrible. The majority of patients that I see, their antibodies are worse than the thyroid hormone is. If you look at their thyroid numbers specifically, they are not bad. I tend not to have them on thyroid hormone.

If there is a double there, where they are both on LDN and thyroid hormones, it’s a mixed effect. Maybe 25% come off their meds. Is there something else going on? The patients that are just Hashimoto’s can sometimes come off the medicines because it’s not a hormone problem specifically, it’s an autoimmune issue. If we fix the autoimmune issue, they can regulate themselves.

Dr. Eric: I know that LDN can also help with Graves’ just like it can with other autoimmune conditions. Have you seen other Graves’ patients who are on LDN?

Dr. Neil: I have a couple. It’s kind of its own beast. I tend to be more delicate with that because you can crash really quickly or have a thyroid crisis with it. It depends. Are they on some type of prescription med that will help them calm down their thyroid storm, or symptoms they are having? I use it, but I go really small doses with them. I also make sure that if they are seeing an endocrinologist, that their endocrinologist knows what they’re doing because otherwise, that could get sticky. It’s the one thing I have seen the least success with, but it does help. I use other tools in my toolbox more than LDN, at least initially.

Dr. Eric: When someone is on LDN, can most people eventually get off of it? Is the goal for you to work on other areas and then for them to get off the LDN like six months or a year later? Is that something where it’s part of your wellness plan? On average, I know it differs.

Dr. Neil: In the big picture, what happens? I would say it’s almost 50/50. Patients are like, “I feel so much better on it. I have no side effects. It’s not expensive. I might as well stay on it.” It’s 50/50 for a patient to come off of it.

I have patients usually on it for 3-6 months. I tell them from the get-go that they should expect to be on it for six months; otherwise, there is no point in doing it. I literally have a ton of patients who I see them every six months. They are feeling great, so why make them get rid of it? Now there are some other studies coming out on LDN in terms of anti-aging and longevity and other things. It will probably switch more to that as the studies come out.

Dr. Eric: I think I heard you say earlier Lyme disease. Do you give it to Lyme patients? Or did you say you work with Lyme patients? Is LDN something you would recommend for someone with Lyme or bartonella?

Dr. Neil: Yeah, Lyme is an autoimmune issue. It helps with pain and brain fog and resets the microglia, which any patient with Lyme who has cognitive issues works with. I use a lot of it with Lyme. I use it with any type of chronic illness patient, just because it hits so many broad stroke things. It makes it so useful. With Lyme patients, it’s part of an overall program. I have Hashimoto’s patients who are just on LDN, and they get better. Most Lyme patients, it’s not going to work that way.

Dr. Eric: Before we move on to peptides, is there anything else that I should have asked you about LDN? Is there anything else you want to say that you think is urgent for people to know?

Dr. Neil: The main thing I would say is understanding that most patients are going to ask when they will notice benefits. It’s 4-6 weeks for most patients. Some of the data will say three months.

The other thing I want people to know is I am pretty aggressive with it and comfortable with it. I have been dealing with it for many years now. If you are on steroids long-term, not just acutely or on some type of autoimmune medication, like Methotrexate or Remicade, you do want to let the doctors prescribing it know about it because some people who want to be aware of that will want to stop it or at least will talk to me and ask, “What’s the deal? I’ll monitor that, and you monitor this. We’ll go from there.” It used to be a lot more restrictive on what you want to use it for, but now we keep pushing the boundaries to see that there is not a huge issue.

Dr. Eric: Thanks for sharing that about LDN. Let’s move on to peptides. Can you explain what peptides are and when you use them in your practice?

Dr. Neil: Let me try to summarize it in a paragraph here. It’s really hard. Peptides are small groups of amino acids. They exert their effect at a specific hormone, a specific enzyme system, a specific location, which makes them very efficient because it’s more specific than taking an Ibuprofen. They can be used now for almost anything. We use them now for anything from brain fog to erectile dysfunction to fatigue to rotator cuff tendonitis. They have a broad scope of what you can use them for. Now they are pretty much available in any form, everything from hair gel to injection to IV to creams to nose sprays. It used to be injection or nothing a couple years ago.

Dr. Eric: How do you typically administer them? Do you administer them in both ways, or is it usually mostly oral or injection?

Dr. Neil: it depends on what they’re talking and what they’re taking it for. Some of them are only available in injection or orally. If there is multiple choices, we usually recommend injection, as it’s more absorbable but passes the gut. There is a group of them that are available both orally and injection-wise. We will help people do the injection if they feel comfortable doing that. Two, three years ago, most patients didn’t love doing injections. Now, patients are like, “I inject myself all the time. I feel comfortable doing it here, here, here.” The field has definitely changed in terms of patients self-administering meds, which wasn’t common a couple years ago.

Dr. Eric: You answered one of the questions I was going to ask you, which is do you administer the injections in your office, or do they self-inject? It sounds like maybe initially they go to your office, and you show them how to inject them. Then from that point on, they can do it on their own.

Dr. Neil: I have maybe two patients who come to the office and get injected. I have patients all over the world, so it doesn’t make sense for them to come here. It’s not that hard; it’s just an insulin syringe. So most patients will inject themselves. We have a couple that are needle-phobic. There are other forms, like creams or pills. You can pivot now. Otherwise, I have patients injecting 3, 4, 5 a day. It’s gone the other way from what it used to be.

Dr. Eric: They are fairly safe, I assume? Are there any side effects that people should be aware of?

Dr. Neil: That is the elephant in the room at this point, not in the sense that some are known to be safer than others. If you took LDN or prescription medications or supplements, there are some good studies out there. There aren’t as many studies on peptides long-term.

The ones that we get a little bit concerned about because there is the theory of cancer are the ones that boost growth hormone, even though there is no specific study that shows it. We know that any time growth hormone gets increased, there is a chance for increasing risk for any type of cancer you may have. We will discuss that with the patient. We will often do a max of three months at a time with those peptides, which is called a cycle. You are not doing almost any of the peptides in perpetuity to limit that risk.

There are also ones that work on the thymus. It’s never been proven. It used to be prescription medication. We do it for three months. That is called thymogenalpha-1, which doesn’t exist anymore because it hasn’t been approved by the FDA, not because of side effects, but because of false promises. People were promising the world with it, and it wasn’t true.

This is another issue. People on social media tend to say that things can do things they can’t, so they get everybody in trouble. The bad kid in school. There is also one called TBC and TB-500, which is for inflammation mostly. That is mostly a Reddit thing. It’s amazing watching the Reddit groups and Facebook groups. Some people find some study done on some rare animal that showed one thing, which has nothing to do with humans, and they will put it out there. There is the supposition that it may happen. There is no human data or mouse data, which is a step below that we tend to look at, that it may cause cancer. It’s out there, and people will find that one Reddit group, and they will show it to me.

We are doing those for three months, and that’s it. Patients are aware of those side effects. That sounds scary, but there is no evidence with any of those peptides that it happens. I have prescribed them for years with thousands of doctors prescribing them, and there is not really a reported case of it. Unfortunately now a lot of people do the Dr. Google thing, and they find things. We have to explain to them, or they just move on, and we do other things.

That’s a long-winded answer. Most of the other ones are pretty safe with minimal side effects. The main thing we are concerned about is the reaction that you can have to anything. You can have a histamine reaction to something. You may feel a little nauseous when you get an injection, but that can happen with LDN, supplements, and prescriptions. That is usually the big question that we get. Somebody will see it on a podcast or a Reddit or Facebook group. The paradigm has flipped, where most patients are doing their own research, and they are coming to you and saying they want to do this or that, as opposed to asking what they should do. It’s been interesting over the last couple years.

Dr. Eric: Are peptides similar to LDN in that you’re not just giving the person peptides, but you’re also doing other things from a functional medicine perspective?

Dr. Neil: It depends. Are we doing functional medicine? I also do a lot of sports medicine, as you mentioned in the intro. If I have somebody who has a rotator cuff tear that hasn’t improved, I may just do the peptide and some physical therapy. If I am doing a peptide series in a Lyme patient, in that case, I am doing the whole package deal, not just one thing. It depends. What’s great about the peptides is they treat so many different things. If it’s a chronic illness patient, yes. If it’s somebody who just has hair loss, we’re not doing as much, which is what makes them really great.

Dr. Eric: That makes sense. Most people listening to this have a thyroid or autoimmune thyroid condition. What would be two or three of the top peptides you would give someone with Hashimoto’s or Graves’ or a non-autoimmune thyroid condition?

Dr. Neil: In terms of autoimmune, a Hashimoto’s patient, we are going to work on the immune system first. That will be thymulin, which is related to the thymosin that doesn’t exist anymore. Thymulin is its cousin that we use that works pretty well.

Beyond that, we’d use a peptide called BPC-157 since a lot of gut and immune issues overlap. Many autoimmune issues connect with gut infections. I’m sure you’ve dealt with that. That is probably our second goal with it.

We use a peptide called KPV, which will help heal the gut but also has been shown to help with mast cell issues, for patients who don’t do well with histamine. Sometimes that overlaps on all autoimmune conditions depending on what school of thought you are. More and more studies are coming out about the mast cell giants. There is a huge connection between the mast cell and the immune system and autoimmune issues.

Those are probably the two or three I tend to use if there are no other complaints. Then we will go from there if there are other overlying issues.

Dr. Eric: Just like I asked you with LDN, with peptides, is it something that people will continuously take on average? For someone with hair loss, for example, will someone only take it for three months or six months, and their hair grows back? For autoimmunity, is it temporary or more of a long-term thing?

Dr. Neil: Like I mentioned earlier, usually, we do what are two terms of a use for it. One is we are doing cycles, usually 3-4 months of any peptide. Then we also do stacks, which means we are combining more than one peptide together to get a better benefit than we would with each one individually.

We are also cycling through. For the first two months, I may do BPC and thymulin, and then I may stop that and switch to KPV for the next two or three months. In most cases, patients are not on peptides in perpetuity. They are taking breaks for the reasons I described. You can get in theory what we call tachyphylaxis, meaning you won’t respond as well in the fifth month as you are the first month. That benefit is slim.

They are not cheap. LDN, depending where you are, you can get for $40-$60. Some peptides could be $800-$900 a month. Unless you’re not seeing a big benefit, most patients are spending $800-$3,000 a month on medicine that isn’t helping them.

Usually, it’s two or three months. The only things that I will tend to do longer for is patients who have complaints, and we are trying to clean things up. The rotator cuff, you are treating to the end, and it’s a finite end. Some of these autoimmune things, you’re going on and off.

Dr. Eric: It sounds like LDN is more longer-term. Part of that is the cost, but also autoimmunity, it’s not something that will be resolved within two or three months, whereas peptides, a combination of the cost, and even besides the cost, you said it’s three or four-month cycles. You usually won’t have someone on peptides for six consecutive months or longer, but that wouldn’t be uncommon with LDN.

Dr. Neil: Also, in a functional kind of method, the one I use is sometimes If you have a little back pain, and you take Ibuprofen for a month every year just because it acts up when you are shoveling snow or raking leaves, if your shoulder pain comes back or your bloating comes back, you can hop back on for two or three months and then go on with your daily lifestyle regimen.

LDN is usually a longer-term medication. LDN is like Vitamin D or testosterone. It doesn’t save up. If you stop it, it’s gone, and you have to start all over again. The peptides are usually causing more of a result, and that may be more life lasting. I guess I can put it that way.

Dr. Eric: That makes sense with any medication. Typically, if you stop taking it, you will lose the benefits. Some things like antibiotics, you take for an infection for hopefully a short amount of time, although that can be a longer time for something like chronic Lyme. Thanks for explaining.

Is there anything that you didn’t mention on peptides that you think is important for the listeners to know?

Dr. Neil: I think we hit almost everything. Two or three things I would mention. First of all, be careful about ordering peptides. There are so many sites out there that are not regulated by anybody. They may be cheaper, but buyer beware. They are getting product that is out of the country. If you are getting it from a pharmacy, you know it’s regulated by a state or local government. They are being screened. You know what you’re getting. It has to have certification with it. That’s the first thing I would mention. Especially everything in the supplement community, things become the wild wild West. you want to get products from a quality source.

You want to work with someone who is experienced because there is a lot of nuance to a lot of this stuff. I have a lot of patients who come in and say, “I’m on these five peptides at this dose.” These doses make no sense. Whoever prescribed them had no idea what they were doing. For LDN, it’s pretty hard to mess up. Peptides have more of an art to them of knowing how to implement them.

The last thing I would say is when you talk to the doctor about them, make sure you answer these few questions. What is your goal with the peptides? They will have a dramatic effect. Make sure if you are willing to do only one or two, that the doctor knows. I have some patients who come on five or six different ones, and they feel horrible because they are on too many.

Make sure you understand the cost and you will be on them for multiple months. If the patient can’t afford them every month, they need to try something else. The peptides aren’t going to work for you in two weeks usually. It’s something you will usually do for two or three months. If you can’t embark on that journey, let me know now. I have 700 things in my toolbox. We may switch you to LDN, which is cheaper and can do a lot of the same things and get the benefits you want without you having to worry about a needle and stuff like that.

Dr. Eric: That was very helpful. Before we wrap things up, I have a question about craniosacral therapy. I know you do that in your practice. I have been fascinated by it. They have some techniques in chiropractic that are related to craniosacral. Who in your experience would be a good fit for craniosacral? This might be a broad category. If someone is having brain fog or cognitive symptoms in general, or is it more like specific conditions?

Dr. Neil: I’m trying to think how to answer that. When I started doing it 15-17 years ago, there was no LDN or peptides. There was no hyperbaric chambers or gut chambers or discussions about gut health. It wasn’t there. The paradigm has totally changed.

It definitely is a much slower and steadier progress. It’s not something where in most cases, you’re like, “Oh my god, this is better.” What it still has a really good niche to is someone who had a concussion, a head or neck injury, who have EDS. That is an A to B situation. If I hit my head on the car door, I was a little dizzy. I was treated, and I felt 100% better. It’s great for an injury situation.

In terms of brain fog or fatigue, it’s definitely a help, but it’s not going to be a home run usually for most patients. It’s a nice add-on. It’s gotten harder and harder to find good providers, at least in Manhattan, where I am. It’s something to look into. It’s much gentler. There is no medication involved. Something it’s really good for, because there are allergy issues where I am, are sinus issues. Those are really where it has a good niche for it.

Dr. Eric: That’s good to know. A lot of people do have sinus issues, so that’s great. Thank you for sharing this, Dr. Neil.

Where can people find out more about you? You have a practice in Manhattan, but you also work with people throughout the world. Can you share your website and anything else?

Dr. Neil: The simplest way to find out about me now is the website, DoctorPaulvin.com. I have a lot of information on there. We are redoing it to get some newer things on there. The YouTube channel is Dr. Paulvin, as is the Instagram channel. Those are the easiest ways. We have a newsletter. Depending how much of a deep dive you want, we have a lot of information on there. It may take a while. That is a good way to reach out to me in terms of what we do and if you have any questions about seeing me virtually or in the Manhattan office.

Dr. Eric: Thanks again, Dr. Paulvin. Appreciate you sharing your knowledge when it comes to LDN and peptides and a little bit on craniosacral.

Dr. Neil: Thanks for having me.

 

Recently I interviewed Dr. Angela Mazza, as we chatted about radiofrequency ablation.  If you would prefer to listen the interview you can access it by Clicking Here.

I’m really excited about this interview here. I have Dr. Angela Mazza, who is a triple Board-certified doctor in endocrinology, diabetes, and metabolism as well as internal medicine, anti-aging, and regenerative medicine. Dr. Mazza’s broad medical background includes significant research in both basic and clinical realms of endocrinology. Dr. Mazza is the founder of Metabolic Center of Wellness in Oviedo, Florida, where she spends a great majority of her time caring for persons with autoimmune thyroid disease, thyroid nodules, and thyroid cancer.

Highly regarded for her individualized approach to patient care, Dr. Mazza empowers each person to achieve their unique goals by providing education, lifestyle management, and support. Dr. Mazza believes that hormonal changes that happen in men and women as they age play a huge role in their overall health, longevity, and quality of life. Her passion is helping her patients achieve metabolic and hormonal balance. We are going to be chatting about radiofrequency ablation (RFA). I’m really excited. Thank you for joining us, Dr. Mazza.

Dr. Angela Mazza:

Thanks so much for inviting me. I’m happy to be here.

Dr. Eric:

I gave your background, but how did you start helping people with radiofrequency ablation? There still aren’t a lot of doctors that do this in the United States. I know you are currently the only one in Central Florida who does this procedure. If you could talk about how long you’ve been doing it and how you started incorporating this into your practice.

Dr. Angela:

I have been taking care of patients with thyroid nodules for years. Up until a few years ago, this therapy of RFA wasn’t even available or FDA-approved in the United States. Before that time, I was having to send patients to surgery for nodules that couldn’t otherwise be treated. Unfortunately, going into surgery, oftentimes they’d end up on thyroid hormone replacement for something that should have been so easy to treat.

RFA has been used for years even here in the United States for different tumors like liver, lung, kidney, or even in the heart and varicose veins. It wasn’t until 2012 that it started to be used for thyroid nodules in South Korea by Dr. Baek, who is the father of RFA for thyroid nodules. It took that long with all of the data that was happening, all the proven benefits that were going on, for the United States toapprove it.

Once I started hearing about this exciting research that was ongoing all over the world, I knew that once this was FDA-approved, I totally wanted to be able to provide it for my patients. I was doing thyroid biopsies, thyroid ultrasounds. Unfortunately, I didn’t have any choice for some nodules but to go to surgery. Once it was available, I was like, “Yes, I have to provide this.”

Dr. Eric:

I’m sure a lot of people listening are familiar with thyroid nodules, but I’m still going to ask you if you could explain what they are, how common they are, some of the common causes.

Dr. Angela:

Sure. Thyroid nodules are super common. About one in three persons sometime in their life span will have some sort of thyroid nodule. That is how common theyare. There are nodules that have different characteristics. Some nodules are more cystic; they become fluid-filled. Some nodules are more solid, and they are hard. Some are a mix of both; we call them complex. There are nodules that are more concerning or cancerous.

That is agood question. What causes thyroid nodules? Up until recently, we threw it off to iodine deficiency. That is an unfair blanket statement to say that all nodules are caused by iodine deficiency because they are all a little bit different. That doesn’t make sense. What we are finding is the thyroid is so sensitive to inflammation. Sometimes, these nodules can be a result of inflammation in the body and can in turn cause inflammation in our thyroid.

Different nodules behave differently. These cystic nodules sometimes keep filling up with fluid, and they become a problem. Sometimes, nodules are small and don’t cause any issue, and we leave them alone and watch. Every nodule, it’s important to be able to characterize and say, “These are ones we can watch. These ones are causing issues. These ones are suspicious.” I hate to say thyroid nodules are like snowflakes, but they kind of are. They are all a little bit different. It’s a tough question to answer.

Dr. Eric:

When you do an ultrasound, and you detect thyroid nodules, it sounds like maybe not all of them require follow-up. It depends on the characteristics.

Dr. Angela:

That’s a good point. If some are tiny cysts with just fluid, and they have certain characteristics that we can see on the ultrasound, they may not be worth following up on because they are so benign. There is a grading system that has been developed to look at the concerning characteristics. What are ones we have to follow more closely? What are ones we have to biopsy? What are the ones that need to be addressed as far as surgical removal or some sort of more proactive therapy?

Dr. Eric:

In my practice, I see a lot of people with both Graves’ and Hashimoto’s, but I focus more on the hyperthyroid side. Other than Graves’, we do see some cases of toxic multinodular goiter. Can you talk a little bit about toxic nodules? We will get into RFA. Can it help with it? What are they? Also, for those who are unfamiliar with the term “hot nodule” versus “cold nodule.”

Dr. Angela:

Toxic nodules are essentially overactive nodules. These are nodules that are starting to make their own thyroid hormone and not listening to the signals to stop making thyroid hormone.

Toxic nodules have a distinctive look on the ultrasound. They are really hypervascular. That is what feeds into these nodules to make them keep being overactive. In certain cases, they can be quite large.

The difference between hot and cold nodules is hot nodules are considered toxic because-There is certain imaging we can order. I don’t usethis imaging as much anymore. It’s not needed. There used to be these scans called radioactive iodine uptake scans for toxic nodules. If someone shows up with a nodule, we are not really sure what it is, so before biopsy was around, we would send them for these radioactive iodine uptakes. If it was a hot nodule, it would glow, so they would call it “hot.”

They used to say that nodules that didn’t take up anything were cold, and they were suspicious. They might be cancer. We got away from calling non-functioning nodules suspicious for anything because we know that’s not true. You do a biopsy, and most of the time, they come back fine. Hot nodules light up, so we can use that term still. It also means toxic or hyperfunctioning.

Up until recently, the only treatments we had for hot nodules werewe could put people on antithyroid medicine. To cool off that overactive nodule, especially if it’s causing problems like symptoms of hyperthyroidism. If someone is feeling hyperthyroid, they are feeling hot, shaky, are having trouble sleeping, palpitations, all the symptoms that go along with overactivity. The medicine can cool that off.

But when we are talking about toxic nodules, sometimes we can get people off antithyroid medicine, as they don’t tend to shut down on their own with that type of medicine.

The second treatment is radioactive iodine. Just like that radioactive iodine uptake scan, a different amount of radioactive iodine is used to be taken up by that nodule and shut it down or essentially turn off its machinery. Sometimes that works, and sometimes it causes a whole thyroid to become underactive, which is the downside. Sometimes, these people need another dose of radioactive iodine, but it is radioactive iodine, so that carries with it its own concern.

Surgery would be the other option, to take out that side of the thyroid or the whole thyroid. Until recently, radiofrequency ablation has been a treatment option available for persons with overactive thyroid nodules. It’s a new tool in our toolbox for hot nodules.

Dr. Eric:

Which is awesome. We are going to dive into that. One thing I want to ask you, you mentioned the radioactive iodine uptake test. I still notice a lot of endocrinologists use that. It sounds like you stopped using it in your practice.

Dr. Angela:

I can’t even tell you the last time I ordered one. It’s been almost 10 years, I think. That’s why ultrasound is so great. I have an ultrasound in my office. You have nodules; let’s take a look at the ultrasound. If I am looking at the thyroid gland, and I see a nodule with super vascularity going on, it’s a toxic nodule. End of story. You don’t even really need to biopsy a toxic nodule because they are 99.9% benign.

Dr. Eric:

I’m glad you mentioned the ultrasound and biopsy. Some will justify using the radioactive iodine uptake test to give hints if it’s cancerous. Like you said, even if it’s a cold nodule, it doesn’t mean that it’s cancerous. Most of the time, it won’t be. Why not just do the ultrasound, and then depending on the characteristics of the ultrasound, determine if someone needs a biopsy? It sounds like that’s the approach you take in your practice.

Dr. Angela:

As a skilled ultrasonographer, you just get used to seeing these nodules. You can see different characteristics. Those radioactive iodine uptake scans are a pain for the patient, and they are oftentimes not accurate. It’s not worth the time and energy.

Dr. Eric:

I’m glad you mentioned that. I have been saying that for years.

Dr. Angela:

You were right.

Dr. Eric:

I try not to knock other endocrinologists who use it, but I’m not a big fan. I just don’t understand why. Another reason some will use it is to diagnose Graves’. If someone has hyperthyroidism in the presence of elevated TSI, we know they have Graves’. They don’t need the uptake for that. There are different reasons they give for doing the uptake test. To me, it just has never made sense.

Dr. Angela:

You have a case for thyroiditis versus Graves’. Even then, you will see different shades on the ultrasound. You don’t need the uptake scan.

Dr. Eric:

Let’s get into RFA. If you could describe what it is, when is it indicated.

Dr. Angela:

Sure. I mentioned that RFA has been used for years for other things. RFA is great for benign and toxic nodules, or hot nodules. Essentially, it’s using an electric current to go directly into the nodule, causingtissue- I don’t want to say damage. Essentially, it’s agitating the tissue, and it causes long-term ablation in the nodule itself. It’s great because it leaves the rest of the thyroid completely intact. You’re only working on the nodule itself.

Surgery is great for some things, but this is done in the office. There is no anesthesia. There is no downtime from work. There is no thyroidectomy scar. It’s a nice alternative that we never had until recently here in the States.

Dr. Eric:

You mentioned just before that it could help with toxic nodules, which is great.

Dr. Angela:

Right. Some nodules are more challenging than others for RFA and may require more sessions. Toxicnodules, depending on the size, because they are so vascular, oftentimes require more than one session. Still, it beats surgery and all that goes along with possible risks of surgery.

Dr. Eric:

Like a single toxic nodule will sometimes need multiple treatments.

Dr. Angela:

Depending on the size of nodules in general. I have been seeing some very large nodules and really can only ablate for a certain amount of time. You want to keep them in safe time periods because you are dealing with electric current within the nodule. You don’t want to overablate. Most nodules can be taken care of in one session.

Dr. Eric:

One of the questions I had, which I think you kind of answered, but I’ll ask it anyway: If someone comes in with not a toxic nodule but larger, benign nodules, maybe like 2-3cm or greater, and they are currently seeing an endocrinologist that is saying, “You have to take the thyroid out,” if they need to get more than one nodule removed, typically, it would be like one nodule per visit per session? Would that be fair to say?

Dr. Angela:

It depends upon the size of the nodule and the positioning of the nodule. If they are on one side, you can try to do more than one at a time. if they are on both sides or bilateral, generally, depending upon the size of the nodule, I will do one side, then the other. It’s a procedure.

We are trying to be cautious of the patient’s comfortability. The patient is awake during the surgery. I usually give a little bit of anxiolytic beforehand just because it’s nerve-wracking. You hear the generator going.

We talk to the patient during the procedure. That serves two purposes. It lets me know they are doing okay. Plus it also helps me monitor their voice during the procedure. Surgery as well, one of the things is there is a risk of damage. Very low compared to surgery. As long as we monitor the voice, it’s a good gauge of how things are going. Plus it gives me an idea of how comfortable they are.

Dr. Eric:

Should someone who goes through the procedure expect to experience any discomfort at all?

Dr. Angela:

Well, it’s kind of like the biopsy but a lot longer. If you have ever been through a biopsy, your neck is extended. Unlike a biopsy, there is a lot of numbing medicine to the area. We give about 10ml of lidocaine. That serves a number of purposes. The thyroid itself doesn’t have nerves, but the thyroid capsule has nerves. Its surrounding tissues have nerves. We inject the lidocaine. The lidocaine not only numbs the capsule, but it also separates the structure from the neck out. It separates out the carotid artery, protects the laryngeal nerve. It serves multiple purposes.

To answer your question, the patient should not have discomfort during the surgery. Pressure is normal. I am leaning on your neck with an ultrasound for up to 30-40 minutes. We take breaks. I’ll ask if they are all right, if they want a break.

Patients often comment on this. We are using a probe, not unlike aneedle that is done for a biopsy. The probe, as I am using it, I am going systematically to different parts of the nodule and ablating each area. Sometimes, they will feel a pop. That is the thyroid tissue being ablated. It’s a weird feeling. It’s not a pain, but it’s unexpected if you’re not aware of it.

Dr. Eric:

On average, how long does the procedure take? I’m sure it varies depending on the person.

Dr. Angela:

In whole, from the start, when we do a baseline ultrasound, to the end of the ablation, an hour to an hour and a half.

Dr. Eric:

Okay, that’s not too bad. Once the ablation is done, and they have just a single nodule, and they only needed that single visit, do they typically need follow-up visits after that to monitor it?

Dr. Angela:

Yes. Right after the procedure, the patient doesn’t usually have restrictions. They don’t want to do heavy lifting for a day. As far as follow-up, I recommend doing an ultrasound about two months after with some repeat thyroid function tests, at six months, then at least at 12 months.

We have a lot of patients who come from out of town for this procedure. I rely upon other ultrasound reports and ultrasound images to do follow-up on those cases. It’s nicer when I can do my own ultrasounds for follow-up. Since this is a new procedure, a lot of the radiologists aren’t used to reading what a nodule looks like after it’s ablated. It can look actually suspicious to them because some of the markers that go along with suspicious nodules can look similar to where areas have been ablated within the thyroid. That can cause a little confusion. That’s why I like to do my own if I can. As long as I have the discs to look at the images, that’s part of the follow-up.

We tend to see the best results right around six months to 12 months. Even though we’ve ablated tissue during the procedure, that can be tough to see if you are continuing to ablate tissue within the nodule up until that time period. The two-month follow-up is just so I can make sure everything looks like it’s going in the right direction.

Dr. Eric:

Makes sense. Speaking of suspicious nodules, I don’t think yet RFA is indicated for suspicious or malignant nodules. We were chatting about this a little bit earlier. I have done my research. I am sure there are a lot of studies I haven’t read. I’m pretty sure I came across one or two studies that showed it can potentially help with malignant nodules as well, at least in the research studies.

Dr. Angela:

Right. The ongoing studies are super promising. They are just looking at low risk papillary cancer. Papillary cancer is the most common type of thyroid cancer. They are looking at smaller, 1.5cm or less nodules in RFA. It’s been found to be as safe, if not safer, than surgery. A potential therapeutic option. The results thus far have beenreally good.

Dr. Eric:

Is there any chance or risk of the nodule growing back years later after removing it with RFA?

Dr. Angela:

Yes, there is a potential risk. We are trying to get everything within that nodule. Success defined as far as the research study is a volume reduction of 75% at 6-12 months. That is considered success of the RFA. That holds with it, if there is a little bit of thyroid tissue left, especially if it’s one of those more vascular nodules, there ispotential for the nodule to grow back and require another session downthe line. That’s the good thing of doing serial ultrasounds. Even doing an ultrasound once a year, you can stay ahead of this. It will be less of an RFA procedure down the line.

Ideally, that’s not the goal. I always let my patients know there is potential for some of it to grow back, especially the toxic nodules, as theyare the most challenging.

Dr. Eric:

Everything comes down to risk versus benefits. I know if I was facing thyroid surgery due to nodules, I am pretty confident I would go the RFA route. I am not saying that just because I am interviewing you. The name of my podcast is Save My Thyroid, so that’s my goal. Just like you, you try to save thyroids.

If I happen to have a nodule removed, I would hope it wouldn’t grow back, but still, if it did, I guess I would consider having it again. You have to consider the potential consequences of thyroid surgery. A lot of people who have thyroid surgery, they do okay. As you said, there is the risk of the damage to the laryngeal nerve, the parathyroid glands. Not that there is absolutely zero risk with RFA, but in comparison to surgery.

I still think in many cases, I don’t know if I should use the word “no-brainer” because I know it’s not an easy decision when choosing for some people between RFA and surgery. We were also chatting about where currently in most cases, insurance doesn’t cover it, so they might have to pay out of pocket for it. In the day of high deductibles and being on thyroid hormone replacement permanently after getting surgery, you have to look at the long picture. Even if someone’s thyroid surgery is completely covered by insurance, it’s easy to say that. I’m not in that situation, but still, I am pretty sure I wouldn’t go for surgery even if it was 100% covered, and I had to pay out of pocket for the RFA, just because of potential consequences surgery can have.

Dr. Angela:

Replacing your own thyroid with thyroid hormone replacement is tricky. Not everybody feels great on the same thing. It’s a quality of life thing after. Sometimes, people make the decision to do the surgery and get rid of the nodule and take thyroid medicine for the rest of their life. They don’t think about the long-term consequences. You know what I mean? Even the best thyroid combination, not everybody feels great afterwards.

Dr. Eric:

A question that just came up: experience. If someone does undergo thyroid surgery, they probably want to choose a surgeon who has a lot of experience. You have now been doing RFA for a while. Do you think that plays a role, too? The longer someone has been doing it, the better.

Dr. Angela:

It’s definitely a learning curve. Even from when I first started doing biopsies in fellowship, it takes a while to get good at it. Fellowship was a long time ago. The more you do them, you know what to look out for. You know potential issues during the procedure, whether it’s the generator issue or something else. There are so many steps involved that to say you are an expert right out the gate is very naïve. We have been doing them here in my office since 2019. It definitely is a learning curve, like with anything.

Dr. Eric:

I understand. Any other risks or side effects that people should be aware of with RFA?

Dr. Angela:

The most common side effects right after the procedure include tenderness. We have been working on an area of your neck up to 30-45 minutes. It is going to be a little tender. Some temporary hoarseness is not uncommon. I am not talking voice loss. Some bruising in that area. It shouldn’t be bruising all over your neck. Just some localized bruising that may extend up and down the length of your thyroid area. Sometimes, patients have a little bit of a burn mark there because of the electro going into the thyroid itself. Those are the most common side effects.

Very rare side effects include the laryngeal nerve injury. Also rare is something called capsule rupture. That happens where people are overablating a nodule for too long. The capsule gets disrupted. That is why we don’t keep the ablation time above a certain time period.

Dr. Eric:

In your office, do you do ethanol ablation?

Dr. Angela:

Yes.

Dr. Eric:

There is ethanol ablation. There is laser ablation. Can you compare the different types? Ethanol ablation is more for cysts, I think. Is that correct?

Dr. Angela:

Percutaneous ethanol injection, or PEI, those are mostly cystic nodules. Those are nodules that mainly are filled with fluid. Essentially, with the PEI, we drain out the fluid. Oftentimes, people who have had cystic nodules know that these nodules will fill up. They will have been through this before. They will have been through a biopsy, where they aspirated everything, and it grew right back. These are people who work really well for PEI or even just fluid-filled nodules.

With the PEI, we also use the ultrasound for guidance. We drain out the fluid as much as you can. Oftentimes, I will leave a little pocket because that is where I am going to put the alcohol in.We use a special kind of dehydrated alcohol. What that does is it fibroses the inside of that nodule down so it does not fill up with fluid again. That is a pretty quick procedure. That one probably is closer to the time, even less than a biopsy. Plus it’s super simple.

We might need to do another PEI if it does fill up a little bit. Some of these really large nodules, you think you got as much as you could out as far as aspiration. They find a way to fill up a little bit more. Sometimes, you have to redo it. It can sometimes burn a little bit, depending upon where the nodule is at. That’s about it.

As far as laser, laser is great for larger nodules. It’s a little more cumbersome than RFA. RFA, we are using a probe. It’s a fine needle tip that can go right into each and every section of the nodule. Laser is more like diodes. There are a few diodes that go into the nodule. You don’t have as much control.

I don’t do laser. Some people do really well with laser. When we look at head-to-head studies, RFA is still superior in efficacy than laser.

Dr. Eric:

I don’t see a lot of research, at least compared to RFA. It seems there is a lot more with RFA and thyroid nodules.

Dr. Angela:

Not as much. There are practitioners who do laser, and they have good results. At our clinic, we only do PEI or RFA.

Dr. Eric:

With the PEI, that is just for cystic nodules. If someone has a solid nodule-

Dr. Angela:

It doesn’t work as well. There are studies on more heterogeneous or complex nodules. It’s just not as good. You can instill as much alcohol into those nodules, but it’s just going to laugh at it. Nah.

Dr. Eric:

All right. Is there anything else that you’d like to discuss, or anything I didn’t ask you that I should have asked you?

Dr. Angela:

Probably some people ask, “Who is a good candidate for RFA? Who would not be a good candidate?” Candidates that are really good are people who have a nodule that’s bothersome, whether it’s cosmetic, you see it from the outside; whether it’s compressing. Sometimes, people can have large nodules that can press on the windpipe and can make breathing or swallowing difficult. Some of those nodules, when they are very large, when you are lying flat, you can’t breathe or have trouble exercising because they are pressing on the windpipe. These people are great candidates for RFA.

People who have pervious thyroidectomies, they don’t want to damage or lose the remaining function of the thyroid they still have. This is being looked at for recurrence of thyroid cancer. That is something to consider.

There are people who are really afraid of surgery or just don’t want to have surgery. These are people who are good for RFA.

That’s the list of potential good candidates.

People who aren’t ideal candidates are people who have pacemakers or defibrillators or have severe heart disease. People who are on blood thinners that can’t be stopped for a couple days before the procedure. Patients who are pregnant. As of right now, those are probably not the best candidates.

Dr. Eric:

It sounds like if someone has a partial thyroidectomy, and they have some nodules on the thyroid that’s left, they can undergo RFA rather than get the other half of the thyroid removed.

Dr. Angela:

Yeah. That thyroid is working well, so you want to preserve what you have and save the rest of your thyroid.

Dr. Eric:

This was wonderful. I was really excited to chat with you about RFA. I’m sure we will hear more about it in the future. Now, it’s a really good option for a lot of people who are potentially facing thyroid surgery just because there are still a lot of endocrinologists who aren’t aware of it. Is it safe to say that the average endocrinologist is not aware of it, or maybe they are aware of it but aren’t too familiar with it, so that’s why they are still going to recommend the surgery route?

Dr. Angela:

It’s kind of mixed. I honestly think that a lot of endocrinologists don’t know about it. I think some endocrinologists are waiting for more data although there is a lot of data already, but they are not convinced because they haven’t seen enough patients go through it to say, “I had this patient do RFA. They did great.” The more we get the word out about it, the more we educate other providers about it, I think it’s going to be more acceptable because they will see the results are really good. If patients themselves had an option, I think they would prefer not to have surgery rather than have it if at all feasible.

Dr. Eric:

I agree. I hate mentioning it here, but I think I feel the need. You would hope that in many cases, endocrinologists are going to do what is best for the patient. My guess is also surgery is a lot more profitable than RFA. You would hope that’s not why they are recommending surgery. As RFA becomes more popular, you will see more and more endocrinologists incorporating it or referring out. Still, I’msure there are some who- I don’t know how much the average surgery is, but compared to RFA- Anyway, I wanted to bring that up to say that most endocrinologists have that motive to make money off the surgery. That’s why they recommend radioactive iodine-Radioactive iodine probably isn’t that profitable. Surgery, I imagine, is.

Dr. Angela:

If you’re in a hospital-based practice, maybe they don’t do referrals. If you are coming to an endocrinologist, we should be able to give all the options. If you are going to an ENT or surgeon, they will recommend surgery.

Dr. Eric:

That’s what they do.

Dr. Angela:

Yeah. As I mentioned, too, when we were speaking earlier, right now, this is all very patient-driven. Patients who are being proactive about their health and wanting other options, these are the patients that are going for the RFA. They know that surgery is not what they want. They want other options. Even when their doctors are telling them to get the surgery, they are finding more research.

Dr. Eric:

Thank you so much, Dr. Mazza. Where can people find out more about you? I know you also have your own podcast.

Dr. Angela:

Our website is MetabolicCenterForWellness.com. We do have a podcast once a month. It’s me and my friend Dawn, who is a friend as well as a patient. She gives a patient’s perspective. It’s called Thyroid Talk with Dr. Angela Mazza. We try and make it fun, as fun as certain topics can be.

Dr. Eric:

I’ve listened to a few episodes. I enjoyed it.

Dr. Angela:

It’s a little silly sometimes. What are you gonna do? I have a YouTube channel. It’s just Dr. Angela Mazza.

Dr. Eric:

It really was a pleasure chatting with you about RFA.

Dr. Angela:

Thank you so much. I really appreciate the invite.