Recently I interviewed Dr. Kasia Kines, as she discussed the Epstein-Barr virus, including how it can be a factor in thyroid autoimmunity. If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:

With me, I have Dr. Kasia Kines. We are going to be discussing Epstein-Barr Virus (EBV). How are you?

Dr. Kasia Kines:

Hello! I’m doing great. No sun here so far, but a good day.

Dr. Eric:

Good. Let me go ahead and give your bio. Then we will have you give a brief intro. Dr. Kasia is the CEO and founder of Global Epstein-Barr Virus Institute. She is a leader in recovery therapy for chronic Epstein-Barr Virus, an author, a wellness expert, a highly respected Doctor of Clinical Nutrition, and a graduate of the prestigious Bastyr University. Since 2005, Dr. Kines has built an international reputation as a functional nutritionist, from being sought after by Johns Hopkins University to her groundbreaking Amazon bestseller book Epstein-Barr Virus Solution, which I have read. I read her book a few years ago. When was it released?

Dr. Kasia:

2018. Time is flying.

Dr. Eric:

Wow. Definitely check out her book. I will talk more about it later. Dr. Kasia has developed an international, proprietary, evidence-based methodology to EBV recovery and a successful EBV recovery program for those suffering from EBV. Also, she trains other practitioners in her methodology and clinician EBV training and certification program and an EBV practitioner workshop. We could talk more about this later, especially your recovery program. Dr. Kines is on a mission to bring the truth about EBV and solution to one million people globally, so no one needs to suffer needlessly from this misunderstood virus and its complications.

Currently, she lives with her husband and their companion animals in Kingston, Washington. We were chatting before starting the interview, and she said she is going to be moving soon to Wisconsin.

Dr. Kasia:

The Madison area, yeah.

Dr. Eric:

Thanks for joining us, Dr. Kasia.

Dr. Kasia:

My pleasure. So happy to be here with you.

Dr. Eric:

I interviewed you about a year and a half ago, and that interview is on YouTube. If you could give a brief introduction for those who don’t know you. How did you start focusing on Epstein-Barr?

Dr. Kasia:

As the medical literature says, if your patient is on a protocol, has chronic issues with health, and is not responding to the protocol as expected, you should check into testing chronic EBV. My journey, just to simplify it, is a couple of things. I lost a very good friend to complications of MS. I was always asking the universe and the higher powers why her? What happened? Why couldn’t I help her? It was devastating. She was fighting it for almost 20 years. The student is asking the teacher. There were a lot of circumstances that came.

The last one was when a couple of my patients asked for my educated opinion on a book. If one asks you to read a book and you don’t have time, you can brush it off. But when a couple others do, you have to read it, whether you like it or not. I didn’t have time. It was Medical Medium. I read it on a plane to a conference. I almost fell off the chair just because I saw-When you do functional medicine or nutrition work, if you do your job, you keep attracting more and more complicated cases. Sometimes you will help so many people, but there are a few you just can’t, you hit the wall. You probably know that, too. You get so frustrated because instead of focusing on everyone you can help, you can’t sleep over those who have been struggling. Nobody knows why. You’re doing everything right. That was my pain. The longer I was in clinical practice, the harder the cases were. I lost hope. We did everything right, and it wasn’t happening.

When I was reading that book on the plane, it struck me that this was my population. These are the people who did not respond. I don’t know if you are familiar with that book, but it’s a man saying the spirit of compassion tells him all this information. The claims in the book were that the majority of chronic conditions were immunity problems like Hashimoto’s, chronic fibromyalgia, MS, are driven by this one virus. Here I am, so many years in practice, best training I could get in the country, and I had never heard of it. If half of this is true, I have to look into this.

From that point, I jumped into medical literature, and I never stopped. The rest is history. What I discovered blew me away. There is so much evidence and medical literature. It’s right there. I was able to pinpoint protocols and create them. Then I watched in my practice people coming back to life sustainably, long-term. Magic was happening.

That’s why everybody was telling me I had to write the book. What book? I had never written the book. I don’t have time. I don’t have a life. Including my husband. So I sat down and wrote the book. I think I’m just the messenger. When the time comes you’re called to do a job, if you don’t say yes, somebody else will be asked.

I think I needed to bridge the gap between the medical medium claims and where the medical community is. There is this vast ocean between them. That’s why I was methodical with medical literature. I wanted to make sure that was the foundation. Then we can add spirituality and stress and emotions and all kinds of things. I started from there. That is the story.

Dr. Eric:

Before you mentioned Medical Medium, I was going to ask you about if someone was choosing between your book and Anthony Williams’ book, what would you say is the difference? Even though it’s great he brought awareness to EBV, they are two completely different books. Yours is more scientific-based.

Dr. Kasia:

I would say that. Another thing is I have most of his books, and I love the recipes, the wisdom. He doesn’t have a nutritional background, so some of the recommendations he makes for detox, people take too extreme without being educated on balancing things. Sometimes they lose too much weight. Sometimes they spiral in all directions. As a clinical nutritionist, I have to coach them in that process, reverse-engineering, and educate them on actually balancing meals or adrenals. What does that mean in the context of the day? That is very important. Of course, he doesn’t provide that because that’s not his background. That’s the missing part.

Every supplement that I recommend is a multi-performer. Very far in research. There are some that are good in research but don’t perform that well. We drop them. We don’t use them. They are fine theoretically, in studies, but they don’t perform in the community. We don’t need them. It’s very fine things, being strategic, also having that clinical nutrition background. Whether they have a virus or not, it’s balanced.

That would be the difference. It’s a good combo. He opened the door and made people realize that what they eat really matters. There is spirituality to food. That is all beautiful.

I think when you write a book for masses, you make blank statements that are black and white. “Everybody has EBV.” “Everybody will be helped with celery juice.” With celery juice, some people love it. Some people hate it. Some people said it’s like a miracle. Some people said it doesn’t work. It’s a mix. Everyone is different. That’s how we are. I think his job on this planet was to get our attention. Honestly, without that book, how would I know? I emailed him and thanked him because that’s how I started. I think we complement each other.

Dr. Eric:

He talks a lot about celery juice. I know he has a book dedicated to celery juice.

Dr. Kasia:

All the celery juice. I know.

Dr. Eric:

He talks about other things diet-wise obviously. We know the importance of food and eating healthy. I’m guessing most people who are drinking celery juice are also making other changes to their diet. It’s hard to pinpoint it to the celery juice since most people aren’t probably drinking celery juice yet going to McDonald’s and other fast-food restaurants. Hopefully they are cleaning up their diet. There may be exceptions, but hopefully they are making other changes. He doesn’t just recommend celery juice.

Dr. Kasia:

It’s all good. I know that certain things he claims may not be researched fully on that yet. I have seen a little bit of research on celery juice. We may catch up with him later, and that’s fine, too. I agree withyou. Some people in our community are doing a program, and they are still juicing celery just because they feel it supports them. They are happy about it and committed. That’s perfectly great.

Dr. Eric:

You mentioned supplements. There are certain supplements you have tested out that don’t work. Do you remember which ones? People aren’t taking those supplements. Maybe I’m recommending those, so I should stop.

Dr. Kasia:

Proteolytic enzymes are one of them. They looked great in some studies. You would have to pop 25-30 capsules a day. We have other tools. That didn’t deliver. Literally there is one or two companies that provide this product.

In my opinion, lauric acid or monolaurin are not worth it. There is a lot of problems with them. They are just not worth it. They create a lot of havoc in the body. They do not provide that multi-tasking support that other things in our protocol do, like selenium. They don’t provide antioxidant support or nutrients that are missing in the diet. They just kill. Our protocol doesn’t tend to kill. It immobilizes the virus and turns it off, which is much safer. When you kill any pathogen, you are creating havoc. People have to detoxify it.

Sometimes the dead DNA is as detrimental as when the pathogen is alive. That is really not worth it. That is why people have die-off effect with headaches and malaise. That is not a healing process. It is a crisis that you don’t need to do. For some people, it doesn’t work. For some people, they just have a die-off effect. I don’t think it’s worth the money.

We only recommend it if you have co-infections because it is effective for H-pylori and fungal infections. If you have combinations, I might consider it, but it wouldn’t be my first choice.

Cat’s claw. Cat’s claw is pretty hard on the liver. It’s a pretty heavy-duty herb. Again, it doesn’t provide antioxidant or nutrient value in the way of things like selenium, NAC, or lysine provide. It will build your collagen. Botanicals don’t do that well. They have some qualities, but I stay away from botanicals. We use them as teas because we have to drink. That’s a win-win. It’s inexpensive and available, and you can pick the tea according to the bonus effects. Maybe you need iron or vitamin C. There are particular teas that can provide additional benefits.

The only herb I use in the primary protocol is licorice. That’s worth it.

Dr. Eric:

Licorice root. That is supposed to have antiviral properties.

Dr. Kasia:

Yes, that’s the big hitter. That’s worth it. You want to be strategic because people are so sick and brain fogged. Every time they open their mouth, we want to cut corners and go fast and strategize on supplements. You can take a lot of supplements and not be successful with EBV for years.

Dr. Eric:

I think it’s important to mention with licorice root, if someone has high blood pressure, they probably don’t want to take it because it can potentially increase blood pressure. Whenever taking in my opinion any type of herb, it might be a good idea to be working with a functional medicine practitioner. Most people don’t. Certain supplements, like nutrients, as long as you are not taking too high of a dose, you’re probably fine.

I know selenium, speaking of, safe dosage, you usually recommend a higher amount compared to most people. Most practitioners recommend 200mcg. You typically recommend 600-800mcg.

Dr. Kasia:

Yes. In the book, I walk people through counterindications. If you are a bigger built person, 800mcg. If you’re tiny, maybe 600mcg. Make sure there is no selenium in other supplements you are taking because you can overdo it. If you start losing hair, for example, having some symptoms, you may be overdoing it. Sometimes people overdo some of these supplements, and they need to pay attention to the doses. Or sometimes they think it’s 500mg per capsule, but it’s 900mg per capsule. Then they start spiraling with some new symptoms. Always pay attention to your dosages. Cross-reference. If I wasn’t working with a functional doctor, I would check with a pharmacist. Pharmacists have quite a lot of knowledge. They can provide counterindications if a person is not sure. Not a medical doctor. They are not trained in nutraceuticals.

Dr. Eric:

All the minerals and vitamins, fatty acids are important. Selenium, you focus on. That is one of the primary nutrients. Everything is important. You don’t want to be deficient in anything. But are there ones you focus on more than others besides selenium?

Dr. Kasia:

Specific to EBV?

Dr. Eric:

Yeah, EBV. There is research on Vitamin D.

Dr. Kasia:

Vitamin D is a given. It’s not even part of your initial protocol because I assume it’s in there. If it’s not, then yeah, Vitamin D3/K2. Licorice, as I mentioned. NAC is very important. Lysine is very important. Zinc is very important. Vitamin C and Vitamin E. That would be the initial protocol is just those seven. That can start shifting and moving the needle if you have potencies that are high enough.

You can’t patch holes in your life with just a bunch of supplements. It’s a bigger picture. You have to address where the bucket is leaking. Eventually you will replace the bucket with a new bucket. Your WiFi is blasting on you, which is not good when you have EBV. There’s your mold blasting at you, which is not good when you have EBV. You have poor diet, and you go to fast food restaurants because you’re in a bind. You have those holes in the bucket.

These supplements are amazing, but if you want to get out of that continual EBV reactivation, you have to build a new house with brick, so to speak, so you are invincible. Once you get to that point, EBV is not a problem. If it starts reactivating, you can know exactly why. You will start to anticipate it because of your circumstances. You will know exactly what to do. Within 24-48 hours, you will turn it off.

That’s exactly what I did in the fall. I reactivated here in this house when we moved. I was able to pinpoint and tested it. I developed vertigo out of the blue. I turned it off within 24-48 hours because I knew why. It was a new house. We had a smart meter. I am waiting for it to be removed. We were unpacking and positioning our desk in the wrong place with all the technology. Then I started going down the stairs and going, “Woooo.” I jumped on the protocol and moved the desk. You become literate in what happens with that virus. We had mold, so that’s another reason. Mold is unkind and will reactivate EBV. That is more of a priority before you tackle EBV: to get rid of the mold.

Dr. Eric:

That’s a good point. You have to address any source dragging down the immune system. I look at it more as an immune system problem than a virus problem. When you can’t get rid of the virus itself, you can improve other areas. Try to stop the replication of the virus. The mold, that’s a big reason you’re moving to Madison, Wisconsin.

Dr. Kasia:

Yes. We had four consecutive homes with mold. Much of it was missed by mold inspectors or started after the mold inspector checked. People don’t take care of buildings. They are cutting corners. It’s all sad. We have a lot of rain here in the Pacific Northwest.

Another thing about the virus—it’s such a teacher—is if you are a good caretaker of your body, spirit, and soul. You are in alignment with who you are. You love what you do. You are of service. You help others. It’s like a symphony with beautiful colors around you. You are living your life the way we came here to live. Most people are not in sync with that. 80% of people in the States hate their job.

Dr. Eric:

I don’t know the stats, but it wouldn’t surprise me if it’s that high.

Dr. Kasia:

I had a job I was not supposed to do for five months, and I was ready for therapy. I had to walk away. It was killing my spirit. I was physically so uncomfortable. I was an assistant at a local government office. It wasn’t for me. But people live this way. There is the physical level. But there is also the emotional/spiritual level. There is emotional pain from losses or betrayals or not being heard.

All this hits women harder. I find that the majority of people with chronic EBV who are really taxed and sick are women. I have seen more men now, too. We have a joke in our community: Welcome to the international, overeager, overachiever, type A personality, anonymous club. These are givers, healers, people with their heart on their sleeve. You are so vulnerable to a lot, and you overgive. You lose your boundaries, and you don’t listen to your voice. Maybe people take advantage of you. It’s taking effect. It’s easy for a virus to reactivate in circumstances like that because you oversleep, you are overworked, you may not be able to say no to your boss about Friday night work. Even building that personal muscle helps.

The virus in that sense is a big teacher. Once you are congruent with who you are, and are aligned, you turn it off. It’s just there in the background. That’s it. We all have it.

Dr. Eric:

A small percentage don’t, but it’s like 90-95%. I wanted to switch gears and talk about blood testing. Most people who see you probably have already done the blood test for EBV either on their own or through another practitioner.

Dr. Kasia:

The notorious test, yes.

Dr. Eric:

I don’t know how much you rely on the blood test. Could you talk about your experience, whether you want to see all the tests? There are four different markers. Either way, I’d like for you to talk about the different markers and which ones you feel are more significant. We did discuss this during the last interview, so I know already.

Dr. Kasia:

It’s never enough. I have talked about it millions of times, but it never gets old. Pretty much everybody asks me about the labs. People email me, DM me on social media, or text me. We have an entire page on our website about it so people can interpret those labs. We even have a link to a 50-minute Facebook Live where we had a white board and colored markers, and I discussed this. It’s the beginning of a journey for people. You can be trapped in a wrong interpretation for years and continue to deteriorate. It’s because of one lab being misinterpreted.

There are four markers available by labs. If you ask a medical doctor, they will order a lab. If you don’t tell them anything, the lab will only include two or three typically, not four. You have to make sure that you ask the doctor to add all four. The most important one is not part of the panel typically. We will talk about that. That is the first step.

People spend 1-2 years going from doctor to doctor asking to be tested. Medical doctors are resistant because they know there is no cure, in their opinion. If you had mono, that’s it, you’re done, you won’t have EBV anymore. In their belief system, they won’t test you because it’s irrelevant. Even if you had it, there is nothing you can do. Plus they misinterpret it. Most of the time, the misinterpretation is negative for EBV, and that’s probably inaccurate.

You asked me if I recommend testing all the time. Not that much. The most important thing is the context. Have people tried different therapies and failed? That’s typical for EBV. Whether they have a history where they had all kinds of different presentations over their lifetime, idiopathic, juvenile arthritis, maybe mono at the university, maybe strength depressions by stress, and then they would spiral. Maybe they have Hashimoto’s or lupus. You look through the story, and you find out there is something causing all of this. The body is not just creating havoc because it has nothing else to do. There is always a reason. I ask people to pay attention to the context.

You can do testing again and again if you know when to test. Test first when you feel the best. Test during the first week where you feel like you have been hit by a truck. That is a typical expression. It’s the worst of the worst. You don’t want to wait. It’s hard to test when you feel so miserable, but that’s when you want to test to see if the markers are showing. If you wait a couple weeks, you will miss the markers. That is a pitfall. Depending on when you test, you can miss the logic of where EBV is in the context. That is a problem. Does that make sense?

Dr. Eric:

Yes. Most panels don’t have that early antigen. If you test when you’re not feeling badly, that might come back negative, but if you are feeling badly, it is more likely to come back positive.

Dr. Kasia:

Yes. There are certain irregularities in people. If you look at statistics, there is a case where a person can have everything negative. Is the lifestyle, history, medical history, complications, and symptoms consistent with EBV? Are they even producing antibodies at this time? In that case, I feel like a medical doctor has a responsibility to test total IGG, total IGM, total IGC to see if those immunoglobulins are even produced. Sometimes that is the reason why things are normal. Then you can recalculate if they are producing, what would it be.

Early antigen. There are three IGGs in the test and one IGM. Medical doctors, because they don’t know, they assume IGM is current infection, and three IGG is past infection, and that’s it. That’s where the first error is. That’s not how it works. IGM is VCA. It looks like it should be current infection. Statistically, empirically, from hundreds of people and tests and presentations, I can tell you it only reactivates and it’s positive from the first infection. Often times, when you reactivate, the VCA-IgM will not show. It will be normal. In a chronically infected person, we expect it to be normal, and that’s where the confusion is. Sometimes it’s elevated constantly with every time you test. This is very weird, but it happens.

Dr. Eric:

I have one patient who no matter what I have done, and she has seen another practitioner, gotten ozone treatment, the IgM keeps on coming back positive, which 99% of the time, it’s negative. The VCA IgG and the nuclear antigen are commonly positive.

Dr. Kasia:

It could be molecular mimicry. It could be co-infections. It could be other things like a tripwire. It’s rare, yeah. What I would say is keep testing. Do stool tests. See what other infections you have. Don’t live by your lab. Live by your symptoms and quality of life. Are you improving? That’s the one VCA IgM.

Then there is VCA IgG and EBNA IgG, those two you mentioned, are the big mamas. They will be elevated for the life of the host. Typically, what we don’t expect is to bring them to normal. If it’s triple digits, then we have a problem. When we say normal range, it’s from 0-19, let’s say. If you have 235, those are in triple digits. It’s multiple times of what it should be. You know it’s affecting your health; this virus has implications in your life.

It’s even worse when your levels say more than the current range. More than 600. More than 750. It could be 2,000. The lab doesn’t give you the number; it’s just above. As you’re getting better, the numbers may be dropping for both of them, but they are still above that range. Maybe it’s 2,000, and now it’s 800. If you have those still beyond the range, but you are feeling you are recovering, I don’t want any of your listeners to get depressed and say it doesn’t work. You may be dropping and dropping. At one point, you may drop into that range. Maybe it will be 480. You want to anticipate and not get depressed. People get depressed about that.

These two will be elevated. If you repeatedly test, you will notice that when you reactivate your early antigen, those two will go higher. When you feel better and don’t have early antigen elevated and feel your symptoms are better, they will start sliding a little bit. They come and go. Some were there.

The last one is early antigen EA IgG. That is the one that pops in during two or three weeks when you reactivate. You want to catch it when you feel the worst. It doesn’t live long. The virus goes in and out. Like I said, mine reactivated because of the combination of WiFi in the corner, mold, and stress. We had to move because of the mold. We moved into a place with mold. And we had mold inspections.

Dr. Eric:

That happens a lot unfortunately.

Dr. Kasia:

Yes. That is the trajectory. You want to have a context. You live in your body, so you know how you feel, and you know where you have been. Paying attention to that gives you empowerment, knowledge, independence. You can do those labs for $150-$200. You get that lab once in a while independently. You get a report. Go to our website or read the book. There is a whole chapter on lab interpretations. You can understand where you are. That’s all you need. You don’t have to beg the doctor and be frustrated that you waited two months to see the doctor, paid all this money, and they missed the marker, so they tell you there is nothing they can do. I don’t want people to waste their energy that they don’t even have because they are sick.

Dr. Eric:

I’ll say it again: Check out her book, not only for the testing, but it does give a lot of information about treatment, supplements, and foods. We won’t get into great detail here because it’s all in the book.

Dr. Kasia:

All 600 pages.

Dr. Eric:

It’s bigger than one of my books. One of mine is over 500 pages.

Dr. Kasia:

I beat you to it.

Dr. Eric:

Final question I want to ask you is the relationship between EBV and thyroid health, whether it’s not autoimmune, but especially autoimmune. There is some evidence in the literature showing the connection with both Graves’ and Hashimoto’s. Have you seen that, too, where it seems like EBV is a trigger or at least a contributing factor?

Dr. Kasia:

Yes, both, all of the above. Most women lean toward hypothyroidism, Hashimoto’s, autoimmune. Not so many with Graves’. But the virus can go either way. We also have specific thyroid tumors. I have seen the tumors removed, and I have seen radiation of the thyroid. Women are still miserable, and this is not addressed. The thyroid is such an issue.

EBV is one of the driving forces triggering Hashimoto’s thyroiditis. Graves’, too, but Hashimoto’s more so. Sometimes if we just focus on the EBV protocol, we can normalize the antibodies for the thyroid and normalize the symptoms. That sustains. Women know what to do if it reactivates. If it starts going down, they jump on the protocol aggressively. Like I said, in my case, I turned it off quickly. You don’t have to be sick or miserable. It is a possibility.

There are other factors like gluten, H-pylori, uricemia. There are other infecting agents. Environmental toxins. Those would be the triggers, I would say. Wouldn’t you agree?

Dr. Eric:

One of the books I wrote is Hashimoto’s triggers. It’s pretty comprehensive. I do talk about viruses, including EBV. I am not anti-iodine, but iodine can be a trigger. Gut infections. H-pylori. There is a case study on blastocystis hominis, which is a parasite. Foods like gluten and dairy. There is more than that.

To focus on Hashimoto’s triggers, you can check out my book. To focus on EBV, get Kasia’s book.Where can people learn more about you, Dr. Kasia?

Dr. Kasia:

We have a whole website. It’s my name, KasiaKines.com. It’s a huge website with all kinds of resources. EBV specific, we created a website called EBVHelp.com. We have symptoms, lab interpretations, consumer direct labs. We have programs. We have a masterclass series now. As we speak, we are going to talk about mold and EBV next week. We have EBV transformational workshops. An EBV challenge. We are trying to create space for everyone on the journey and be of service. We have a complete EBV recovery program for consumers. If people are sick and ready, we got it.

Dr. Eric:

Can you talk a little bit about that? They can get a lot of information from the book. Some people get the book and receive amazing results from the book alone. Why would someone want to join the program? Some people do need the 1:1 support.

Dr. Kasia:

The way we design it, and we have run it many times, and it still seems to be working. The one thing that people struggle with and really appreciate is in the transformational workshop, there is a community of people just like them. They are so isolated and lonely, and they don’t talk to anybody who shares their experience. When you have breakout rooms on Zoom, many times during that particular workshop, to get people connected. It’s an aha moment. Our students in the recovery program have a big Facebook community.

We also have monthly Q&A calls. Sometimes it’s two hours or two and a half hours. We talk and talk and talk, and I answer questions. We used to do it every week, so we have a vast library of those. If people are very sick, they can listen to the audio and get a sense of the virus. That gives people so much empowerment. It’s just a virus. We can zap it. We can turn it around. It’s not this big monster that people are so afraid of.

It’s a self-based online program with tons of support and materials. There are videos and reading and action steps to do. We are going through different areas of life, including spirituality and joy; supplements; and kitchen. A lot of practicality. This has to be practical. We have an initial protocol for supplements right from the start, so people within the first three weeks can start feeling better. They have their focus and less fatigue so they can continue implementing other things.

We added a health coach specializing in my methodology. We are building a team, so they are supported. We created small groups focusing in particular areas in the program with a coach.

They have an opportunity to schedule a 1:1 with me. For our students, I have a robust discount that they can schedule with me and do it as often as they need. Some people have SIBO. Some people have co-infections. My 1:1 practice is closed, but I am a consultant, so I can guide them and review labs.

We have protocols and so much support for SIBO. We have a full protocol for H-pylori that was successful in my clinical practice. There is a module on mold. We talk a lot about that. There is a module on WiFi. There are co-infections, hydrochloric acid, other labs they should test, traveling with EBV. Antibiotics, Vagus nerve, lymphatic systems, what to do with it, what exercises are okay to do or not.

You have access to it as many years as you need. We don’t restrict it. You have access to me as long as you need every month. We have a great community with beautiful people.

Dr. Eric:

You also offer a free discovery call. It sounds like there are a lot of options, not just that program, but some other ones, too.

Dr. Kasia:

Yes. On both websites, you can schedule a clarity session with Rachel, our operational manager, who came to me from that community, or with me. We had to put a price tag on it because we had no-shows when it was free. We do have to hold the place with a fee. It’s up to 30 minutes, and there is homework. The person has an opportunity to write the diagnosis, what they have done, what they haven’t done yet, what they need, where they are, their dreams, their pain, everything. I review it and reframe it and put it in my notes. I spend some time on it. When we talk, I understand where this person is, and I can guide them toward the next right step for them. They can ask questions. I really enjoy that because I get to know people and direct them and possibly invite them to our program. It’s the solution. We have it there.

Dr. Eric:

I forgot to mention earlier that for anyone who joins the program, I have a special code, where you can get 10% off. If you visit the website and are ready to do that, they can do that. They can also read the book first or do the discovery call.

Thanks, Dr. Kines. Appreciate you doing this interview again. It was a pleasure. Looking forward to part three of this in the future as well.

Dr. Kasia:

Part three, part 10, sign me up. Keep doing this wonderful work. It’s so needed.

Dr. Eric:

You, too. Go get her book! The Epstein-Barr Virus Solution.

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Recently I interviewed Dr. Tara Scott, as she discussed the relationship between sex hormones and thyroid health. If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:

With me, I have Dr. Tara Scott. She is known as the Hormone Guru. Dr. Scott helps people find the cause of their symptoms and get back to optimal health. With over 25 years of experience and three board certifications in OB-GYN, functional medicine, and integrative medicine, Dr. Scott has helped thousands of patients struggling with hormone issues. This includes endometriosis, breast cancer, weight gain, and other conditions. Dr. Scott has been speaking, including a TEDx talk, and educating for over 10 years and has taught doctors her approach in over five continents. For her expertise, she has been featured on The List TV, Women’s Health, Shape, Newsweek, Authority Magazine, and on numerous podcasts. Thanks so much for joining us, Dr. Tara.

Dr. Tara Scott:

Thanks for having me.

Dr. Eric:

When did you do that TEDx talk?

Dr. Tara:

It was last October, 2021. It’s still in final editing. It’s not up on their page yet.

Dr. Eric:

Before we start diving into the questions about hormones, I’d like you to briefly discuss your background. How did you become known for helping people with different typesof hormone imbalances?

Dr. Tara:

I am a traditionally trained MD and OB-GYN. After residency and training, I was in a very busy practice delivering a lot of babies. Then I had my own struggle with infertility and had my own hormone imbalances. I wasn’t ever able to get pregnant without fertility drugs. Thankfully, due to that, I did get pregnant. After that, when you have a hormone imbalance, you are either trying to get pregnant or prevent it. There is nothing in between to help balance it.

I became interested in women’s hormones. I first became a certified menopause practitioner with the North American Menopause Society. Then I did a lot of studying of bioidentical hormones, perimenopause, and menopause. The more you learn, you find out the less you know. I went ahead and did a functional medicine fellowship and was able to sit for my integrative medicine boards from the American Board of Integrative Medicine as well. I really have focused on women’s health for the most part and have expanded it to integrative medicine. We are talking about all things that affect women and their health, including the gut, thyroid, adrenals, metabolic issues. They are all connected.

Dr. Eric:

When it comes to hormones, a lot of people have low sex hormones (estrogen, progesterone, testosterone). Why do so many people have low sex hormones?

Dr. Tara:

One of the biggest reasons today that people have low sex hormones is the effect of stress. Men, your testosterone can decrease as the effect of chronic stress. DHEA is made in the adrenal gland, and that is a source for men and women of hormones. If you were stressed before the pandemic, you capped it out. Our lives are changed now. We also have environmental stressors. All the endocrine disruptors in our environment are affecting us. Which came first, the chicken or the egg? The environment changed, which gave everybody issues. The obesity epidemic, which certainly is connected to your hormone issues. It suppresses ovulation and theway your body gets rid of estrogen. It’s like a vicious circle.

Dr. Eric:

Would you say that low progesterone is the most common hormone imbalance in terms of lower sex hormones?

Dr. Tara:

For women, that’s very common. You are born with so many eggs. So many eggs are obviously released first. We all know that when you’re trying to get pregnant, over 35 is called advanced maternal age because you have an increased risk of chromosomal problems because the eggs aren’t as good quality. Even though we’re not trying to get pregnant potentially, it still would transfer. If those eggs are not as good quality for pregnancy, they are not as good quality for hormone production. It’s very normal over the age of 35 and certainly 40 for your progesterone to decrease. But there exists the phenomenon that stress can affect ovulation and deplete your hormones and hormone precursors. It can prevent ovulation, which would prevent you from producing progesterone and estrogen. That all can be tied in.

Dr. Eric:

Like you said, stress is huge with all the hormones. Not just progesterone, but estrogen, testosterone, adrenal hormones, like DHEA, cortisol, etc. How about elevated sex hormones? Estrogen dominance, elevated testosterone levels. What are some of the causes of those?

Dr. Tara:

For a female, estrogen dominance happens when either 1) you don’t have a lot of progesterone as you age, or 2) you just make a lot of estrogen, and that is common in perimenopause because these old eggs can’t hear. The brain is sending out a signal called FSH to stimulate the egg to grow. When the egg is old and it can’t hear, it requires more of that pituitary hormone, the FSH, and LH. What you have then is an increase in estrogen as you get older, and also an increase in testosterone at that particular time. But you don’t have an increase in progesterone that follows because those eggs ovulate, and you still have poor quality follicles, so you have low progesterone.

You can also see high testosterone in younger women who are not ovulating for the same reason. FSH and LH are increased, and it’s that LH that stimulates the production of testosterone. You get high testosterone as in PCOS or someone who is not ovulating. Then it’s a vicious cycle because high testosterone prevents ovulation.

Dr. Eric:

Also, with high testosterone, one of the potential causes or at least factors is insulin resistance, like PCOS. Is that correct?

Dr. Tara:

It is definitely related. There is no agreement as to what the inciting hormone imbalance is with PCOS. Some say it starts in the pituitary. You have abnormal pulsations of the gonadotropins.

The second theory is it starts with androgens. The theory to support that is you will have high androgens in two different cell lines. You have high DHEAS and high testosterone, which comes mainly from the ovaries, not the adrenals. A lot of girls who are young will have higher DHEAS.

The third theory is it comes because insulin is high. You have high insulin, so you get insulin resistance, which suppresses ovulation and causes the vicious cycle.

Dr. Eric:

You mentioned DHEAS. I’m glad you said that. I’ve seen some of my adult patients with elevated levels of DHEAS. Two questions: 1) Can you explain for those who are not familiar what the difference between total DHEA and DHEAS is? 2) What are some of the potential other causes when you see DHEAS elevated on a test?

Dr. Tara:

DHEAS is the sulfated form of DHEA. It’s the most populous hormone in our human body, men and women. There is the most quantity of it. DHEA is made in the adrenal gland and gets sulfated in the liver. DHEA is the unconjugated form that is made, and it’s a much lower quantity. We always monitor DHEAS.

I always explain to my patients: Think of your ovaries as your monthly paycheck. You’re getting a little bit of estrogen every month and some progesterone. Your savings account is your DHEA; that’s your adrenal gland. When you retire, when you stop getting paid by your ovaries, you will live off of that bank. Your DHEA is highest in your teens and 20s, and then it decreases as you age.

It would increase when everything is upregulated in times of stress. The brain doesn’t know if you’re running from a bear or if you have a deadline at work or if you have just lost your job because of the pandemic or COVID. The physiological response to stress is the same. Cortisol up, blood sugar high, to feel your muscles so you can runfrom the bear. The result and increase of cortisol is like fire. DHEA will compensate to try to be a teeter-totter of catabolic/anabolic in your adrenal gland and your homeostasis. DHEA will go up as a response.

Here is the difference between cortisol and DHEA. There is a feedback loop with cortisol back to the brain, but there is not with DHEA. What eventually happens is DHEA goes up at first from stress. If stress is prolonged over time, it will decrease. There Is no signal that goes back to the brain, saying, “DHEA is low. Let’s make some more.” There is for cortisol and testosterone and estrogen, but not for DHEA. A lot of people will have DHEA that is decreasing, and nobody really checks it in the traditional world. In the functional world, we check it.

Dr. Eric:

I should mention that most of the time, when testing for DHEA or DHEAS, it’s usually on the lower side. There have been situations where I see it elevated. I work with a lot of hyperthyroid patients. I have a history of Graves’ Disease as I mentioned when we were chatting earlier. With hyperthyroidism, a lot of people lose weight, though some people do gain weight. I also work with Hashimoto’s patients, who also have more of a tendency to gain weight. Of course, it could be many different factors when it comes to weight gain. Can you talk about the relationship between some of these hormones and weight gain?

Dr. Tara:

That’s a main thing that I think is overlooked. A lot of women go to their providers, and they say, “I have put on weight. I’m exercising and eating less.” The providers sometimes dismiss them because they think all that has to do with weight is calories in/calories out. I can tell you that for a woman, if you’re not hormonally sound, that will not work.

We do know from some studies out of the University of Colorado that around menopause, your basal metabolic rate will drop. Exercise does not counteract that. A lot of women around the time of menopause will start to see weight gain in that visceral area and their abdominal area. In those studies, they try to increase exercise, and it did not counteract this drop in basal metabolic rate and weight gain in the abdomen. They then did another arm where they gave estradiol(bioidentical estrogen), and that did counteract weight.

All of your hormones are kind of like Goldilocks. Too little is not good, and too much is not good. It’s on a bell curve, but the symptoms on either end can be similar. We also know that estrogen is a growth hormone, so it makes everything grow, including tissues like breast and hips for women. Having too much estrogen without that balancing progesterone can be another factor in weight.

You mentioned low androgens, low testosterone. Think about a man and his body fat. Where does a manbdistribute his fat when he has low testosterone? He usually gets man boobs and a big pregnant belly. He either has low testosterone, and his balance between testosterone and estrone, which has just one enzyme dividing them called aromatase, that is usually how they distribute fat.

Men with a normal amount of testosterone are going to naturally have lower body fat, whereas women don’t. We have to grow a baby and store fat for that. Estrogen’s job is to get you ready for a pregnancy. Without that balancing progesterone, you can gain weight. With low DHEA and androgens, you gain weight. With high cortisol, your body is constantly trying to get the blood sugar up. Cortisol goes up, blood sugar goes up, and insulin goes up. They start fighting each other. Your insulin stops working, and you become insulin resistant. That is another hormone that can be off.

You can certainly have functional hypothyroidism. You know that as a thyroid expert, TSH is made in the pituitary gland. T4 is made in the thyroid. T3 is the active form. It’s like clocking your hours. That’s your TSH. Your paycheck would be your T4. Then you have the cash. You can’t walk into Walgreen’s with a paycheck. You need cash. T3 is what you need. These hormones are tightly bound to binding proteins, which estrogen will manipulate. If you have too much estrogen, it will increase the binding protein. You will have less free hormones available at the receptor.

In addition, there is that enzyme that has to be cashing your check, that 5-deiodinase. If you don’t have enough iron or Vitamin D, if you have too high or too low cortisol, which most of our population does now, you won’t convert that T4 to T3. Instead, you will convert it to reverse T3. That’s like taking your paycheck and putting it all in your 401(k). You have the money, but you can’t get to it. It’s reverse T3. That is what is missed a lot with women patients and potentially men, too. The effect of estrogen on cortisol, on insulin, on thyroid is really predominant.

Dr. Eric:

It’s all really interconnected. As far as knowing whether or not it’s a hormone problem, I imagine the only way is through testing.

Dr. Tara:

Yes. You can take a history. If someone comes in with weight gain in a specific area, and they have really heavy periods, more than likely it’s estrogen if they’re 42. But you’re right. It’s always hard to guess and know what the hormones are. It’s always better to test.

I don’t know why there is such resistance in the traditional community, my traditional colleagues, who are saying, “You can’t test hormones. They fluctuate every day. There is no validity.” Yet we test male hormones all the time with pre-testosterone placement, post-testosterone placement. We have no problems testing hormones when you’re going through fertility treatments. I went every day for estrogen levels when I was having my IVF. We tested progesterone levels. It was valid then. Why is it not valid when you’re not trying to get pregnant? It’s really confusing. We can test hormones, even if you’ve been told we can’t.

Dr. Eric:

As you mentioned, things like T3, the active form of thyroid hormone, many times they don’t test that. When they do test, it’s usually in the blood, which for thyroid, that’s the way I test. Not to say blood doesn’t have value when testing for sex hormones, but dried urine testing, the Dutch test, is one way. Even saliva testing, which I don’t use- I used to use in the past for adrenals sometimes. I actually used that for sex hormones in the past, too.

The point is many times, when you go to a regular medical doctor, they don’t look at the complete picture. If they are willing to do any type of testing, they might just do a TSH test for thyroid alone. Sometimes they will do a TSH and free T4. It depends. There are some medical doctors who do the entire thyroid panel. Same thing with sex hormones. Many times, they are resistant to do any testing at all. When they do, they will try to get away with the bare basics.

Dr. Tara:

In places like Canada or the UK, where they have the NHS, they are limited. They are not allowed to order the reverse T3 or T3 generally. We don’t have those limitations that I know of in the United States. I have been an employed physician with a hospital system, and they never told me not to order certain things. They may not be covered by insurance.

Thyroid isn’t as controversial as far as how to test; it’s just what to test. We all agree that blood is the best place. Thyroid hormones are large peptide hormones. They are not lipophilic, steroidogenic hormones. They are peptides. It’s a little bit different in the blood. They are bound of course, but we do have the assays to do free assays. We don’t for sex hormones. We have free testosterone. Sometimes I have seen a free estradiol, but it’s not that common. With progesterone, you don’t know if you’re getting a free assay.

Dr. Eric:

I have actually seen Labcorp, I think, where they do offer the free estradiol or even free progesterone. I have never seen doctors order the free tests other than testosterone or thyroid hormones.

Dr. Tara:

We do have now an ultrasensitive estradiol that seems to be a lot more accurate. If you order the LC-MS, it’s supposed to be more accurate also. I know if you order progesterone LC-MS and estradiol ultrasensitive at either Quest or Labcorp, those are getting a little bit better. There is some data coming out of the North American Menopause Society about those lab assays as well.

Dr. Eric:

I don’t know if you can answer this, but when it comes to blood testing and sex hormones, I have noticed in some patients, and I don’t know where I started testing for total estrogens. Sometimes estradiol will look fine, and total estrogens are elevated. There are multiple estrogens, including estradiol, estrone, estriol. Would that be your explanation: If total estrogens are elevated, but estradiol is looking fine, it could be more related to estrone, for example?

Dr. Tara:

First of all, estriol is very hard to measure in the blood because it’s a metabolic byproduct of estradiol and estrones. It’s not made and circulated in the blood; it’s only made during estrogen metabolism. Then we’re talking about estrone and estradiol. 95% of your estradiol comes from the developing follicle and the ovary. Estrone is made in a lot of places but mostly with aromatization from DHEA or testosterone. There is a bidirectional enzyme, 17beta HSD, that you can make estradiol into estrone, and vice versa.

When we are talking about blood, you have to think about what you’re measuring. Where is it coming from? If you’re measuring blood levels on somebody who is having a menstrual cycle, their ovary is producing those hormones and putting them out into the blood. If you’re measuring someone who is postmenopausal, it’s not coming from the ovary. It’s happening in the periphery, in the muscle and fat. DHEA in the periphery is converting to either estrone or estradiol.

You wouldn’t expect to see high estradiol in somebody either postmenopausal, not on hormone therapy, or someone with no ovaries. That would be like if my 20-year-old daughter said, “Mom, I’m going to the library tonight to study.” She left the house in sweats. I thought, “I’m so lucky. She’s such a great kid.” She gets to her friend’s house, pulls off her sweats, and reveals a tank top and miniskirt. She pulls out her fake ID and goes clubbing. I am never going to see that conversion because it happens outside of my house.

The estradiol to estrone, testosterone to estrone, DHEA to estrone, that all happens outside of the blood. I don’t know how accurate that estrone is in the blood. Yes, I will see it high if it’s so high that it’s recirculating. That bidirectional enzyme.

I have seen those assays of the total estrogens. I don’t prefer them. I would prefer to do the estrone LC-MS and the estradiol ultrasensitive. Again, if you’re somebody who is menopausal, I have seen estrone go up almost to compensate because your estradiol is low because your ovaries are not working. Sometimes, if we give them an estradiol patch, that may drive the estradiol up. You will see the estrone come down because those hormones act differently at the receptors. The concentration is important.

Dr. Eric:

Dried urine testing, such as a Dutch test. It’s one example. There are a few other labs that perform that. One of the big advantages of the Dutch test is looking at the estrogen metabolites. Would that be the main advantage? If you were just wanting to look at estradiol, estrone, estriol, progesterone, would you say there is an advantage looking at the levels in the urine compared to the blood?

Dr. Tara:

I think that the Dutch test is a great test. We do a lot of it. I kind of analogize it to like if you came to me and said, “I’m bankrupt. I can’t pay my bills,” I would wonder if you’re not making enough money or spending all of your money. What is the problem? Maybe you make a lot of money, but you spend it. When people have a lot of estrogen, it’s good to know if they are making a lot or just not getting rid of it. It’s like charging a credit card and not paying off that balance. Cut up that credit card and never use it, and you would still be paying a finance fee if it went on long enough. I see that in women.

The Dutch test for the dried urine is all your hormones that are being excreted. It’s like me looking at your receipts and seeing how you spend your money. My accountant doesn’t care what my bank balance is. He wants to know what I spent on rent, payroll, supplements, salary, etc. He wants to see how I break it down. That’s what we see in the urine. It’s also a great way to look at your cortisol because you get your cortisol and cortisone metabolites. What is going on with that lone betaHSD? Are you favoriting conversion to cortisone? You can see how you metabolize your androgens. Do you have a 5-alpha or 5-beta preference? That’s really helpful.

I think one of the reasons we really missed the boat on hormone therapy with a lot of people is this estrogen metabolism problem. They can have genetic SNPs that affect estrogen detox. Or their environment or lifestyle choices affect those enzymes as well. Giving one person a dose of estrogen with good estrogen detox, they pay their bill every month, they might be fine. The other person might get the exact same dose but accumulate estrogen.

Dr. Eric:

Sticking with the topic of estrogen metabolism. If someone on a Dutch test is showing higher levels of the 4-hydroxy metabolite, which is the—I hate calling it the bad estrogen because they are all important, but you don’t want this one to be too high. Let’s say that’s above the range. It’s showing low methylation. You mentioned the genetic variations, the SNPs. Would you dig deeper and recommend genetic testing for COMT, MTHFR, for example?

Dr. Tara:

We do in many of our patients, especially my patients with breast cancer. There is data that says that a high 4-hydroxy estrone has been isolated in breast cancer patients. If it’s not detoxified, it can intercalate and agonize DNA and cause rapid division. There haven’t been a lot of studies that looked at it because it’s just not a focus. I found quite a few that do reinforce that.

Dr. Eric:

You mentioned breast cancer. If someone has elevated 4-hydroxy metabolites, could that also be a factor with other conditions such as endometriosis or uterine fibroids?

Dr. Tara:

Endometriosis is a tricky disease. There is an abnormal hormone response, but also we’re finding out so much more, that it also involves inflammation, an altered immune response. Yes, it is driven a lot by estrogen.

Fibroids are different. It’s a different tissue. Endometriosis is a tissue of the uterine lining or endometrium that responds to estrogen and quiets down with progesterone. Fibroids are a different cell line. They are part of the muscle.

There is data that shows both estrogen and progesterone play a role. I haven’t been able to pin down the authors and say, “Is it progesterone or progestin?” That also stimulates the growth. I just did a talk at the World Congress on Fibroids, so I looked into this data. I was surprised to hear that progesterone may play a role in fibroids. Because it’s a different cell line, it acts a little bit different than endometriosis. Endometriosis is also an altered immune response and inflammatory. Fibroids also, but not quite as much as endometriosis.

Dr. Eric:

You’re saying that as far as the estrogen imbalances, endometriosis would be a great factor when compared to fibroids. I know you said for endometriosis, there were other factors, too, like the immune system.

Dr. Tara:

I do see that at least with myself, I have estrogen metabolism issues. I had endometriosis for many years. That seemed to be the case for me. Once I fixed my methylation, you gotta fix the gut. I don’t have issues with it now.

For fibroids, it’s not as common a thing, so I can’t say I have done quite so many Dutch tests on people with fibroids. I had one patient that had rather large fibroids. She did seem to have lower progesterone, but it wasn’t terrible. Her estrogen detox was flawed. What the studies are showing is it’s almost like estrogen primes the growth, and progesterone also contributes to the growth. I am not sure that’s clearly understood as far as the mechanism and the connection to hormone issues with fibroids right now.

Dr. Eric:

I have seen research studies when it comes to thyroid nodules showing potential problems with estrogen metabolism as well as other factors like insulin resistance. I don’t know if you have seen any of the research or in your patients because I know you also work with thyroid patients. Have you seen any connection there?

Dr. Tara:

I haven’t seen any data on thyroid nodules. You’re talking about hot nodules or cold nodules?

Dr. Eric:

It just said “thyroid nodules” as well as uterine fibroids. It actually mentioned estrogen in those. None of the studies I saw mentioned specifically what type of nodule.

Dr. Tara:

There is definitely that relationship we discussed with estrogen and thyroid, so I would not be surprised if there was a connection there.

Dr. Eric:

And you mentioned breast cancer. Whenever one of my patients has a history of breast cancer in the family, or if they personally had breast cancer, then I would recommend doing a Dutch test. I’m guessing you also recommend it probably in all of these conditions.

Dr. Tara:

These are all conditions that I think the Dutch test is extremely beneficial for.

Dr. Eric:

How about cycling women? That’s another advantage of the dried urine testing. They can look at the hormones throughout their cycle and not just a single snapshot, which is what you’re getting through blood testing. Would you recommend certain cases? The question is would you recommend for all cycling women to get the cycle map?

Dr. Tara:

That’s available in both salivary and urine. There is a company that does it in salivary; I think it’s Genova.

Dr. Eric:

Diagnos-Techs also does it.

Dr. Tara:

I don’t love their assays. Genova does a cycle map. ZRT and Dutch for the urine. Gosh, if everything was free and the same price, I would have everyone do it. It’s not. The cost is really prohibitive. I’m in middle America. It’s over $400 to do that test. I guess that makes sense. There is a lot of collections. Mark Newman from the Dutch was telling me how hard it is to process those tests because there are a lot of things. If somebody wanted to do it, I would love that information. In the patients who have had the resources to be able to do it, it’s been extremely valuable information for us.

Dr. Eric:

How about a fertility case? Would that be a good reason to do that? If they are doing IVF, they are spending who knows how much money on that. When you compare the cost- But I agree, the average person, I don’t recommend the cycle map testing either. Just in certain situations.

There is a lot more we could talk about testing. As far as balancing out the hormones, different treatment options. Earlier you mentioned bioidentical hormones. When is it time for bioidentical hormones? When is it time for using herbs and other more natural methods?

Dr. Tara:

My protocol would be everybody really should start with diet, exercise, lifestyle, stress management. You can go pretty far from cleaning up your diet, getting off inflammatory foods, decreasing your alcohol and sugar, taking the plastics out of your environment.

For a patient who is younger, in her teens and 20s, I am more likely to try something like Vitex, which is an herbal supplement. Look at their estrogen detoxification and see if we can foster enzymes. Sometimes it’s a problem with phase one detoxification, so we will work with that.

When you are getting an older woman who has a lot of estrogen, my concern is the health of the breast and the uterus and the increased risk of breast cancer with all that estrogen. We know that estrogen upregulates its receptor, and progesterone will downregulate its receptor. I more feel compelled to use progesterone in somebody like that because I know that progesterone will cause apoptosis or cell death, which is what we want. We don’t want that unregulated cell growth.

When you are talking about the indications for menopausal hormone therapy, it’s individualized. The FDA suggests the indications are vasomotor symptoms, prevention of bone loss and osteoporosis, and vulva/vaginal, which they call genitourinal symptoms of menopause (GSM). Those are the FDA indications.

Although there have been studies that show a 19% reduction in diabetes, we can’t say that it will reduce your diabetes. We can’t say that it will prevent heart disease although there is a lot of data saying it has a favorable effect on your cholesterol and does reduce the risk of heart disease. We can’t say that because it didn’t get the indication for that.

More importantly, there are some studies out of the Women’s Alzheimer’s Translational Research that they looked at over 400,000 women taking hormone therapy. They saw a 60% reduction in neurocognitive disorders, including Parkinson’s and Alzheimer’s. That’s a pretty steep reduction. There is a lot with estrogen and brain health that we still are trying to find out. Estrogen in the older age.

There is all of the vanity symptoms. We talked about weight and the studies out of University of Colorado. Yes, bones. Yes, heart. Hair, skin, mood. There are a lot of studies about depression in midlife because of low estrogen. Anxiety, those kinds of things.

It is an individual choice. I don’t think every single person needs to take hormones. I think every single person needs to be told of the risks and benefits and alternatives and given that option.

Dr. Eric:

It sounds like obviously you’re going to recommend dietary changes, lifestyle changes. As you mentioned, when someone is younger, less likely that you recommend hormones. I’m sure there is a time and place sometimes even in younger people. With the bioidentical hormones, when you do recommend them, it’s mostly in women postmenopause. Like you said, not everyone postmenopausal will get bioidentical hormones.

Dr. Tara:

That’s not my practice pattern. I know some places are like, “Take your hormones, and your skin will be-“ The Suzanne Somers approach of “Still have periods at 80. It’s good to have your periods. It’s good to have all this estrogen.” I’m not really in that camp.

Dr. Eric:

I agree. I can’t prescribe bioidentical hormones, but if I could, I don’t think I would recommend it to everybody. I would try to do things to optimize their adrenal health and gut health. There is a time and place, just like there is a time and place for thyroid hormone replacement.

You mentioned Vitex. If a younger woman, a woman of cycling age, if she had low progesterone, would you automatically recommend that? Or in certain situations, would you work on adrenal health first?

Dr. Tara:

We are always working on adrenal health, diet, and stress. Some of them might start with something called seed cycling, which is a regimen where you do certain types of seed in the first half of the cycle to boost your estrogen and a certain type of seeds in the second half of the cycle to boost your progesterone. That’s an alternative.

The Vitex is not progesterone. Does not cause apoptosis. Doesn’t have the benefits of downregulating the estrogen receptor. Somehow, it works with the HPG access to try to foster your own body to have better quality ovulation. I don’t really know what the exact mechanism is. Somehow, through the HPG access. It’s not progesterone. If I am worried about at the cellular level upregulation or downregulation of estrogen receptors, or hyperplasia or apoptosis, then I am more likely to go with progesterone.

Dr. Eric:

Sounds good. What are your thoughts on maca root?

Dr. Tara:

I can’t say I am an expert in maca root. I have looked into the data on it. What I have seen is it’s mostly helpful for libido. It’s an adaptogen. I know some hormone preparations that have a lot of stuff in it might have that in there, plus Vitex and some other things. I don’t have a lot of experience with it myself.

Dr. Eric:

I was just curious. Figured I’d pick your brain on that. There is so much more we could talk about. Is there anything urgent that I didn’t bring up that you thought I should have asked you?

Dr. Tara:

I jump at the chance to educate people because I want to validate women out there. The people who are struggling, the people who have been dismissed, the people who have had these symptoms and don’t really know who to go to. They are thinking their PCP should know. They are not trained. They are thinking their OB-GYN should know. As a traditionally trained OB-GYN, we do not get this kind of training. They don’t know who to go to. They are told, “We can’t check hormones.” They should be checked. People should have the option. Doesn’t mean everybody needs to take something. We discussed many options from food to lifestyle to herbs to hormones.

I want to encourage anyone who is struggling, if they have their gut feeling telling them something is wrong with their hormones, they may have gone so far as gotten a doctor to order hormones, and they say they are normal because they don’t know how to interpret them. It’s frustrating. That’s my message and my megaphone. It’s why I spend time on social media and try toeducate. I want to advocate for people and educate them.

Dr. Eric:

Thank you so much. You’re right. If someone does a Dutch test on their own, and if they were to bring it to their medical doctor, most medical doctors wouldn’t know what to do with it. Some might be interested, but most of them probably would be like, “I don’t do that type of testing.” Maybe they will recommend something in the blood or to go to someone else. It’s probably a good idea, to go to a functional medicine practitioner, someone like yourself.

Dr. Tara:

Hopefully that would be what they do instead of slamming it and saying- I have had providers saying, “Anyone who talks about the Dutch test, unfollow them immediately.” Those providers get money from the Dutch test. Do you get any money from the Dutch test? I don’t. It’s just crazy.

Dr. Eric:

I deal a lot, especially with the hyperthyroid patients seeing endocrinologists who don’t want to hear anything about diet or lifestyle changes. It’s all about taking medication or getting radioactive iodine or thyroid surgery. Same with Hashimoto’s. Take your thyroid hormone replacement. Nothing else is going to help. Similar here.

Where can people find out more about you, Dr. Tara?

Dr. Tara:

They can follow me on TikTok. I’m @hormoneguru. On Instagram, it’s @revitalizemed. I have an online course at hormone-guru.com. We have a lot of free programs. We have some courses for sale as well that they can enroll in at their own pace. Usually, we are doing workshops and things like that as well. Those are the main things. My YouTube is Tara Scott, M.D. I am also trying to upload things there. It’s easier to search there than in the TikTok format. I am trying to get caught up on that as well.

Dr. Eric:

Thank you so much for doing this interview. I learned a lot. I’m sure the listeners did as well. Appreciate you taking your time to share your knowledge with others.

Dr. Tara:

Thanks for the time you’re putting into this. It’s your time as well to try to educate people.

Recently I interviewed Dr. Damiana Corca, as she discussed effective sleep strategies for those with thyroid and autoimmune thyroid conditions. If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:

With me, I have Dr. Damiana Corca. Today, we are going to be talking about effective sleep strategies. Dr. Damiana is a holistic sleep specialist with training in acupuncture, Chinese medicine, and functional medicine. She is committed to supporting people who struggle with sleep issues by helping them discover the root cause of their sleep issue so they can get good sleep and continue to do so for the rest of their lives. She also has a local private practice in good ol’ Boulder, Colorado. She serves her clients worldwide through private telemedicine consulting as well as group programs. She is also the founder of the Corca sleep Method. Thank you so much for joining us, Dr. Damiana.

Dr. Damiana Corca:

Thank you for having me.

Dr. Eric:

You’re welcome. Why don’t we start out with your backstory? How did you start helping people with sleep issues? Did you personally have a sleep issue?

Dr. Damiana:

I’ve had sleep issues on and off. About a decade ago, I noticed that a lot of my patients have sleep issues, even if they didn’t come in for that. Even if they had a different complaint, I noticed that if they don’t sleep well, they don’t recover well. If I can help them sleep better, everything gets better. That got me thinking. I started focusing more and more on sleep issues. I realized how many people don’t sleep well. Sometimes we settle for less. We don’t know what really good sleep is. That’s what I’ve been doing.

Dr. Eric:

Why is it important to get good quality sleep? Everyone knows it’s important, but in your words, why is it important?

Dr. Damiana:

First and foremost, it feels so good, doesn’t it? Just to go to sleep and sleep for seven, eight, nine hours. You wake up in the morning and feel so refreshed. It feels like a new day. When you don’t sleep well, you wake up more anxious, depressed, tired. You have a harder time focusing. You have to go for caffeine in order to have energy. It’s been correlated with bigger issues like increased risk of dementia and many other problems that I sometimes don’t even want to talk about because a lot of people I work with want to sleep. They just can’t. As opposed to people who push themselves and choose not to sleep.

Dr. Eric:

There are some people who would love to get sleep but can’t fall asleep, or they wake up in the middle of the night. Then there are those people who intentionally stay up late and neglect their sleep. Even with those people, it’s challenging. If someone stays up to midnight or 1am, it might be challenging for them to get into the habit of going to sleep at 9pm or 10pm.

Speaking of sleep times, what would you say is the ideal sleep time? Someone will say you want to go to sleep at 9pm. Some will say between 10pm and 11pm. In your opinion, is there a specific time or time range that most people should go to sleep?

Dr. Damiana:

Definitely somewhere between 9pm and 11pm is a good time. Everyone is a little different. We are made differently. We also have different schedules. Having a routine is important. Noticing if you do a little bit of a winding down process and prepare for bed, what is your natural time that you feel sleepy? If you prepare a little bit and allow your body to relax instead of pushing yourself too much or working too late. It can vary.

Many people say 10pm is a very good time to sleep because it helps with the detox process and helps the body during sleep to take care of all these different functions that cannot be done while we’re awake. A little bit of flexibility there. More important is to watch your body to see what it wants, noticing when you feel sleepy or groggy. Of course, if you tend to stay up late, you will say, “I only feel sleepy at 1am.” That’s not a true assessment because it’s already delayed for some reason. That’s a bigger story on how to shift that and work with that. If you only get sleepy at 2am, that doesn’t necessarily mean that’s not perfect. It can be for some, especially if that’s how your work schedule works. But typically, earlier in the night is best.

Dr. Eric:

I typically go to sleep between 10pm and 10:30pm. I have been trying to go to bed a little earlier than that. Maybe it’s not necessary because I am trying to go to bed before 11pm. As far as duration of sleep, I strive for seven or 7.5 hours of sleep. That’s another question. Do you believe people should be getting a certain number of hours of sleep? The magic number seems to be eight hours, but as you said, everyone is different. Would some people be okay with seven hours? Some people might need more than eight hours. What is your input there?

Dr. Damiana:

As you pointed out, everyone is a little different. When we sleep well, we tend to sleep in hour-and-a-half chunks. We have about five of those. The minimum is 7.5 then. It takes a little bit to fall asleep. Maybe you wake up a little bit during the night. That goes to the magic number of eight hours. I sleep most of the time 7.5 hours. In the winter, or if I go through a lot of mental work or emotional challenges or physical challenges, sometimes I can do nine hours. It feels really wonderful. I add one of those hour-and-a-half chunks in a sense.

If we sleep well and go through the sleep cycle correctly, it’s in those chunks. When you wake up in the morning and realize you have half an hour before your alarm goes off, and you try to go back to sleep, if you feel you’re already awake, it’s not worth pushing it because you go into a deeper sleep. Then you will wake up really groggy in half an hour. Half an hour ago, you felt so good.

Also, people feel anxious if they can’t fall asleep. Their body says, “No, it’s time to wake up.” It doesn’t allow you. Having this concept in mind about these hour-and-a-half chunks can serve you well on how to organize your sleep but also not to push certain things because it’s not helpful.

If you want to sleep longer, I always tell people to go to sleep earlier but keep the wake-up time consistent. That is more important. Not sleeping in, but finishing work earlier, eating earlier, winding down earlier, and noticing when your body feels sleepy. It should feel sleepier if you feel you need more sleep. Then you can wake up at the same time.

Dr. Eric:

Most people listening to this have a thyroid or autoimmune condition like Hashimoto’s or Graves’. Do people with certain health conditions need more sleep? Or does it depend on the person? Even if someone has an autoimmune condition, they might still be okay with seven hours.

Dr. Damiana:

With Hashimoto’s being hypothyroid, I have seen it both ways. Theoretically, you should be tired and should be wanting to sleep a lot, but it doesn’t work like that. It’s an autoimmune problem, so there are more consequences. Of course, the people who come and see me have insomnia, so I see those people. But I do see a lot of people who have Hashimoto’s and insomnia. It’s a problem because they feel so tired, yet they can’t sleep. They need to rest in order to recover their adrenal glands to support the stress system, so the thyroid can recover, yet they can’t sleep. With Graves’, there is insomnia there. In both cases, it would be wonderful to get more sleep, but it often doesn’t happen, which makes matters worse.

Dr. Eric:

Ideally, it would be nice to get more sleep, but if you’re struggling to fall asleep or stay asleep throughout the night- With Hashimoto’s or Graves’, it sounds like they might benefit from longer than eight hours of sleep. The problem is a lot of those people have insomnia, so they might be lucky to get three or four hours of sleep let alone nine or ten hours of sleep.

Dr. Damiana:

Exactly. As you know, we can only do so many changes in outside habits. It’s more figuring out working with the autoimmune issues, looking at the root cause and why this is happening so then the sleep gets better. That is the deeper work. Sometimes people get frustrated when they do all the right things. They have the perfect bedtime routine and already avoid caffeine, yet they still can’t sleep. Sleep is connected with so much, including autoimmune issues and the thyroid. It takes longer. These good habits that you perhaps already have are helpful, but additional layers are needed, and it can take longer. You will get to that place where you can sleep, which will help the healing process.

Dr. Eric:

Like all my guests, I do research, and I listen to other interviews. I heard you talking about different types of insomnia. Can you discuss those different types?

Dr. Damiana:

Yeah. The way I look at them is inspired by Chinese medicine. I am going to give you a couple of examples. Let’s say you have trouble falling asleep. Typically, we think trouble falling asleep is just trouble falling asleep, and that is all. There is typically not much variation to it. But in my mind, there is.

The two main types I see are the anxious type and the overthinking type. Those can overlap sometimes. The way I ask people questions, you can see how they are different. The way it shows up in anxious insomnia, they are wide awake and can’t fall asleep. The overthinking type manifests more in they almost doze off, they toss and turn, they think they weren’t sleeping but then realize they had a dream. It’s different. Even now, it might sound very different, but the root causes aren’t different.

The easiest way to explain this is the overthinking type is related to digestion. We digest food, but we also digest thoughts. When we have trouble digesting thoughts—it comes hand in hand—it causes insomnia where you can’t fall asleep. You are too tired to read a book. You’re frustrated. For some people, it’s not worrying. They just get stuck on certain thoughts or a song. After a while, if you keep having that, anxiety will kick in, but the root cause is different.

The other folks with the anxious type, they never doze off. They are wide awake. They typically try to read something. They get sleepy and put the book down. As soon as they turn off the light, they are wide awake again. That can happen for a few hours sometimes. Even just an hour. There is this subtle difference.

The overthinking type leads more to digestion issues. The anxious type is more related to a very stressed, dysregulated nervous system that more than anything points to cortisol issues and adrenal gland issues. It can go into hormones and the thyroid. Does that make sense to you? Do you have any more questions to help clarify this?

Dr. Eric:

It makes sense. The overthinking type definitely makes sense. As far as the anxiety, for example, a lot of my patients with hyperthyroidism have anxiety. Of course, that’s due to the elevation in thyroid hormone. A lot of people have the anxiety type who don’t have hyperthyroidism. The one thing I didn’t understand: Is it the anxiety type that over time leads to adrenal issues? Or are the adrenal issues causing the anxiety?

Dr. Damiana:

Very initially, I believe it is the stress in a person’s life that causes the adrenal issues. Thenif the cortisol production gets dysregulated, then it can be too high at night. You are telling yourself it is time to sleep. Your body says, “No, we’re not going to sleep.” You get that sensation of being aroused or wired and tired.

The thing is, when I came up with this concept, it was from the Chinese medicine perspective. In a way, the treatment wasn’t all that different if it was high thyroid hormone or high cortisol. The body is too activated at the incorrect time; hence, you can’t fall asleep. It is a survival mechanism. When you get too activated at night, the body says you have to stay awake and deal with this problem. Many times, you can’t deal with it. It’s not something you can do right then and there. That’s the underlying message. It’s not fully safe to surrender.

It’s very vulnerable to fall asleep. Yes, we live in houses with locked doors. We’re pretty safe. But if you think about it, we are lying in bed and lose awareness and consciousness of our environment. A certain level of relaxation has to happen in order to fully fall asleep. The stressor could be something outside emotional. It could be too much thyroid hormone or other reasons.

Dr. Eric:

How important are lifestyle factors, like diet and stress management, when it comes to overcoming these types of insomnia?

Dr. Damiana:

They are very important. Let’s say you don’t have real insomnia, just some sleep issues here and there. They’re not really bad. You notice making certain changes helps. Those lifestyle changes are amazing and very important. Likely, that’s all you need to do to sleep well.

For the people who have tried those things and it still doesn’t make a difference, it doesn’t mean that those lifestyle changes are not important or valid. It just means there is more work to be done. You have to look deeper. How are all the organs functioning together? You mentioned the thyroid or digestive issues or hormone imbalance. I always tell people: You are doing the right things. Don’t get frustrated and give up on them. Just look for help. There are probably things you’re not aware of. That’s why we’re trained in this, to help you figure out and understand what is happening. If we understand it is the thyroid or the hormones, then we can further help you make further changes that will really make an impact on your sleep. Then you feel the efforts you do are very targeted rather than working so hard and not really seeing the results.

Dr. Eric:

They probably don’t know they have this until they get tested, but let’s say they have elevated cortisol levels, which would be revealed by an adrenal saliva test or dried urine test. If someone makes dietary changes- Either way, whether it helps or not, it’s important to eat well. It’s important for most people to practice some type of mind/body medicine since most people are stressed. As you’ve said, if that’s not helping, that’s where they would need to seek the advice of someone, or maybe get testing for adrenals. Based on that, they can come up with a plan to address the adrenals. Would that be correct?

Dr. Damiana:

That is correct. Just to make acorrelation between- Stress often affects the cortisol levels. In time, too much cortisol will occur in the evenings. Then you can’t sleep. That is just one scenario. But the correlation with food, let’s say you eat more carbs, too much sugar. There is a very close relationship between cortisol and sugar. By eating healthier and balanced meals that have plenty of protein and healthy fat and less carbs, it keeps the blood sugar in balance, which is very closely related to cortisol. That helps you heal in time.

If you do the opposite, it makes it worse. If you’re sleep-deprived, and your blood sugar falls, the brain says, “Give me food quickly. Give it to me in the form that gets absorbed the fastest.” That’s usually sugar, like a cookie. Once you get into that pattern, it makes things harder. If you get into that stable place, where you eat three times a day- I am a big proponent of when you go through a lot of stress when we don’t sleep, eat three times a day rather than not because it can support your body so you don’t get into this stress mechanism that makes things worse generally.

Dr. Eric:

If someone eats too late, that could also cause sleep issues. Do you recommend for most people to stop eating at a certain time?

Dr. Damiana:

6pm or 7pm would be great. At least three hours before going to sleep. There are a couple different reasons for that. First, you want to digest your food so then your body can shift its resources to falling asleep. We think about this concept of falling asleep as a passive concept. It’s not. Falling asleep takes a fair amount of energy, as does staying asleep. It takes the same amount of energy in the brain as we’re awake. It’s just different. It doesn’t feel like that to us. You want to eat and digest food with plenty of time before you go to bed.

The other thing is if you eat too late, and there are some blood sugar imbalances, it can either prevent you from falling asleep, or it can wake you up depending on how close you ate that meal to when you went to bed. It can create a bunch of problems there. It’s a bit of a complex mechanism as to why that happens, but it’s very much so correlated and very closely related. That’s why it’s so important.

Dr. Eric:

Thanks for sharing that. I’d like to talk about supplements now. I don’t know if you recommend supplements at all for sleep, but if so, what are they? I’d also love to get your thoughts on melatonin and CBD.

Dr. Damiana:

Sure. I do use supplements in my practice. This is always a tricky question because it has to be tailored to the individual based on the person and their problem and tests.

You mentioned melatonin. I get that question a lot because a lot of people try it and ask me if they should take it or not. I would say in my experience it’s generally safe. People tend to take too much of it for sleep purposes. Our bodies only make about .5mg of melatonin. We make the most melatonin as teenagers. At its highest point, it can be at .9mg. When people take 5mg and 10mg, I don’t know if it’s necessarily doing much more than taking 1mg or 3mg. Of course, melatonin has other benefits, such as anti-inflammatory. Some people take even higher dosages for different reasons. But to support sleep, smaller dosages is plenty, up to 3mg if it’s to be helpful.

I especially recommend it when people travel across many time zones, and they try to get into this new time zone. It can be helpful to support the body to give it the message that we’re on a different part of the planet. It does feel to the body very jarring and disturbing to travel many time zones so fast.

As far as CBD, I also typically don’t recommend it to my patients just because we’re trying to figure out why exactly they’re not sleeping and solving the issues at their root. If they need something along the way because it takes a while to heal those sleep issues, and it helps with anxiety, then it can be super helpful. A lot of my patients already know about it and take it. There is a different extract called CBN. A combination of CBD and CBN is supposed to be more helpful for sleep issues.

Dr. Eric:

How about herbs such as Valerian or kava?

Dr. Damiana:

They can be helpful. You could try them. I rarely use them. Sometimes they are in some of the combinations I use. You can pick those up at the health store and see what happens. They can be very helpful for some people. Usually, I use them in combination with something else rather than just trying to give someone an herb to see if it helps.

Dr. Eric:

Rarely would you give Valerian root or kava by itself, but you might give a combination formula that has a smaller amount of that herb as well as other herbs.

Dr. Damiana:

Correct. In Chinese medicine, I do give herbs. That’s different. We look at the patient and give a certain diagnosis based on patterns. That’s when we give herbs. Even then, it’s not a single herb; it’s always a combination of herbs that keep each other in check and make each other more potent. It’s usually five or ten herbs in a capsule or tablet or strong tea. Sometimes I use herbs like that, but rarely individual herbs, unless it’s something like lemon balm. Maybe I did a test, and I can see they need to support GABA and glutamate. It has to be a specific thing I know is going to help them because of a test or something they told me.

Dr. Eric:

Speaking of GABA, do you ever give that directly, or do you usually give the precursors?

Dr. Damiana:

GABA is one I sometimes do use directly. I do it if I do a urinary neurotransmitter test. If I see it’s super low, I do a precursor + GABA and then eventually drop the GABA if they are feeling better, just doing the precursor. But if it’s really low, and their symptoms really fit with someone who would benefit from 5-Htp, then I will use some 5-Htp.

Dr. Eric:

Do you do urinary neurotransmitter testing on most of your patients?

Dr. Damiana:

Not most, but a fair amount of people. It depends what exactly is going on with them. Let’s say it’s really obvious that it’s perimenopause. There is a lot of hormonal issues. I will do a test to look at their hormones. The urinary neurotransmitter test is fairly common; it’s one of the most common ones I use in my practice. It’s not a perfect test. I wrote an article about it recently. The levels of our neurochemicals in the brain don’t always reflect what is in the urine, but it gives us a general idea. Over and over again in my practice, following supplementation recommendations based on that test shows me there is value in them, even if they are not as exact as far as reflecting what our brain is using as far as GABA or serotonin goes.

Dr. Eric:

When it comes to high cortisol, what are your thoughts on phosphatidylserine? And ashwagandha? I know you might not give them individually, but those are also two common ones. Ashwagandha is common. Phosphatidylserine, a lot of people will recommend it for high cortisol.

Dr. Damiana:

Ashwagandha, I use quite commonly but rarely by itself. I usually combine it with rhodiola or holy basil or a combination formula. As far as phosphatidylserine, I really love it for the right person. I rarely give it to people without seeing a test. It’s very good if you have high cortisol in the evening. I also want to see how much cortisol your adrenal glands are producing overall so I don’t give too much. It can backfire and cause more insomnia. It can be very useful if we know exactly how much and when exactly the person needs it and for how long. If you’re working holistically, you don’t have to take phosphatidylserinefor a long time, not longer than a couple of months generally. They’re wonderful products.

Dr. Eric:

I agree about the testing, especially with the phosphatidylserine. I wouldn’t recommend it unless someone has high cortisol levels.

When it comes to melatonin, do you have any strategies for increasing it naturally without having to take a supplement of it?

Dr. Damiana:

Trying to think here if I do. I was thinking more physiologically. Avoiding screens in the evening. Allowing plenty of time to be in that quiet place. No bright lights. No blue lights like cell phones or computers. Some people use these apps where you can make the screen darker, but I still tell people it would be better if you read a book on paper and put a candle on and took a hot bath. That simulates for the body relaxation. It tells it, “It’s all good” instead of using an app on your phone that makes the screen yellower. You’re still exposed to the energy from the news or an email. That also stunts the melatonin production.

When you have too much cortisol, melatonin has to go down. When you have cortisol, it’s not a bad thing; it gives you energy and tells your body there is something you need to address here. If you are reading a work email in the evening, and your body is getting upset, your body doesn’t know it’s an email. All your body knows is there is something upsetting, so you need to stay up. The cortisol goes up, and the melatonin goes down.

Sometimes it doesn’t help right away. It may not work the first or second night. You have to do it for a few weeks. There is a learned stress response that you have to undo, which takes time. You can tell your body it’s safe to relax in the evening; there is no big bear or upsetting email or upsetting conversation with your partner coming for you. Your body can’t tell the difference. It’s still upsetting.

Dr. Eric:

Those are excellent points. I also agree on limiting screen time. I can’t say I always follow that.

Dr. Damiana:

That’s okay.

Dr. Eric:

But I have been trying more lately. You bring up a good point about not just being exposed to the blue light, but also if you come across something disturbing, like an email or an article, that raises cortisol, that is a good reason to turn off all electronics and read a physical book a couple hours before bed, like we did many years ago when we didn’t have all these other devices.

Dr. Damiana:

Kindles are not that bad these days. They’re more okay. It’s more like an iPad. It’s so tempting to flip over and go online. You can’t do that with Kindles, right? I haven’t owned a Kindle in a long time. I don’t know if you can go online and scroll the internet. Sometimes I read on my iPad. I can watch my mind wanting to check email and having to tell myself not to do it. Why? It can wait until the morning. There is an addiction. That novelty, it gives us dopamine, and we feel satisfied. It’s not helpful in the evening.

Dr. Eric:

I wanted to quickly get your thoughts on using things like sleep apps and devices like an Oura ring to measure sleep and sleep quality.

Dr. Damiana:

They can be helpful. I don’t think they’re 100% accurate. If you use them over a certain period of time, and then you make certain changes, then you can see the difference. That is where the amazing value in these apps is.

I always try to tell people not to obsess over these apps. The first thing people do in the morning is they don’t even feel how they feel; they just look at the app and decide how they feel based on what the app said, how many hours they slept. I always ask people how they feel, how their energy is. Give it some time, and then look at it, instead of letting the app decide how we feel based on their rating or how many hours it says we slept. It can go both ways. Sometimes, it says we got less sleep than we think, or it may say we got more than we think.

Dr. Eric:

When should someone consider working with a sleep specialist such as yourself?

Dr. Damiana:

If you have done a number of things you know can be helpful, such as winding down in the evening, and you notice you don’t get consistent sleep for 7.5 hours at least, or you wake up too early, or you can’t fall asleep within 10 minutes, or you wake up in the middle of the night and it takes a while to go back to sleep, or you wake up exhausted and don’t know why, those are all good reasons. Some people just want to optimize their health and sleep, even if it’s not a big problem. It can still be beneficial because sleep is so important for so many reasons.

The most common one I hear over and over is the fear of developing dementia. I know that firsthand. My dad had Alzheimer’s from 61-65, and he passed away. It was difficult to watch, and it was difficult for him. I can see why we would want to avoid that at all costs. Trying to get good quality sleep every night is quite helpful.

Dr. Eric:

Thank you. Are there any questions that I didn’t ask that I should have asked related to sleep? I’m sure there is more we can cover, but anything you would have wanted me to ask you?

Dr. Damiana:

Nothing comes to mind. When I do these interviews, I always think I could talk for hours and hours. That’s why I have written a book. It will hopefully come out by the end of this year. I wanted to have everything organized and educate people on why we don’t get good sleep and how we can get better sleep.

I do have a free gift for your listeners though. I cover the five main misconceptions around sleep, and I added another five not commonly known things about sleep. If you go to my website DamianaCorca.com/SleepMyths, you can download that guide for free. It will give more information about various things, like caffeine. It may sound silly, but some people are still wondering about milk. And eight other things. That is a good place to start working with sleep. It points out the main things we can do around sleep to make a change. If those are not enough, working with someone like me is truly advised.

Dr. Eric:

Thank you so much. We will be on the lookout for your book. Thanks for all the information you shared with us, Dr. Damiana.

Dr. Damiana:

You’re welcome. Thank you for having me.

Recently I interviewed Elizabeth Yarnell, as we chatted about how parasites can be a potential trigger of autoimmune conditions such as Graves’ disease and Hashimoto’s If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:

With me, I have Elizabeth Yarnell, and we will be discussing parasites. Elizabeth, since being diagnosed with multiple sclerosis in 1999, has been busy studying how to manage autoimmunity naturally as a traditional naturopath and certified LEAP therapist. She has worked withhundreds of people with MS as well as other autoimmune sufferers in her nationwide clinic using unique, personalized natural therapies to empower them to reclaim their health. She is a TEDX speaker and an award-winning author whose cookbook has sold more than 60,000 copies. She is a patented inventor and has been featured on CBS, NBC, ABC, PBS, Good Housekeeping, Health, Martha Stewart Living Radio, and many other outlets. Welcome, Elizabeth.

Elizabeth Yarnell:

Thank you, Eric. I’m so excited to be chatting with you today.

Dr. Eric:

Same here. Before we chat about parasites, I’d like for you to give a little bit of your background story and how you started helping people with MS as well as other autoimmune conditions.

Elizabeth:

My journey into the world of health started one night in 1999 when I went to sleep as usual, and I woke the next morning blind in my right eye. It turned out I had multiple sclerosis. At the time, all MS doctors would say is, “We don’t know why you got MS. What we do know is that it is a degenerative autoimmune disease that affects the nervous system and results in increasing levels of disability over time.” In fact, I learned that 80% of MS patients experience so significant disability within 10 years of diagnosis that most of them are in a wheelchair. That was a huge motivating factor for me to try to figure out what was going on in my body and what I could do to make my future better and keep myself out of a wheelchair.

That is when I started studying the connection between what we eat and how we feel. I went on to develop a whole theory about whole foods versus processed foods. Then I wrote a cookbook because I became an accidental inventor of a unique cooking method for preparing whole foods really quickly and easily to improve your diet any night of the week.

As I continue forward in my journey with multiple sclerosis and learning more about natural health and recognizing over time what the role of parasitic infection is in causing chronic conditions like autoimmunity, I have come to believe that hidden parasitic infection is often at the root of so many chronic and autoimmune conditions.

Dr. Eric:

I mentioned your cookbook, but I didn’t say the name. What is the name?

Elizabeth:

It’s called Glorious One-Pot Meals. It uses a cast-iron Dutch oven. It’s all whole foods. You just layer them into your cast-iron Dutch oven, and dinner is ready in about 45 minutes.

Dr. Eric:

Where can they find it?

Elizabeth:

Amazon. That’s a great place to get it.

Dr. Eric:

Wonderful. As you mentioned, you found that parasites are a big key when it comes to helping people with different types of autoimmune conditions. Elizabeth and I met recently at a conference, and we were chatting about this. When I help people with parasites and other types of gut infections, I do like to test. Admittedly, there are limitations to testing. I know based on our conversation that is a big reason why you don’t test people for parasites.

Elizabeth:

Unfortunately, testing for parasites is notorious for false negatives. That is well-known in the world of medicine. As much as medical doctors even think about parasites, which admittedly is not very much at all, and not enough, I think, as they should be thinking about them, because it is so easy to pick up parasites.

One reason parasite testing is so faulty is if we are relying on a stool test, maybe that particular stool sample might pick up a parasite if that parasite lives in your bowels. A lot of parasites don’t even live in your bowels. You could have liver flukes that live in your liver. You could have trichinosis that lives in your heart. You could have T. gondii that lives in your brain. You could have Chagas, a tropical South American parasite, which lives in the bloodstream and is only visible if you use a specific medium on the slide with the blood under a certain microscopic enhancement. Only two labs in the entire United States even look for something like Chagas. It is admittedly not that common in the U.S.

But that is just an example as to why parasite testing is so faulty and unreliable. I don’t like to use it because we go through all the trouble and expense and wait of testing to find out.If the test comes back positive, fantastic. We 100% know that person is infected with a parasite. But if the test comes back negative, there is still a 50/50 chance that person is infected with a parasite. The last thing I want someone to do is have a false sense of confidence they aren’t dealing with a parasite. There is only so much better you can ever get if you have parasites without addressing them directly.

Dr. Eric:

Makes sense. Do you have any concern about treating for parasites if the person weren’t to have any parasites?

Elizabeth:

The protocol I use is a 30-day herbal protocol. It’s super gentle. I have used it on hundreds of people, including toddlers when moms find worms in their diapers. My nine-year-old daughter did it when she weighed 45 pounds. I have done it myself as a person with an autoimmune disease four or five times. It’s so gentle. Most people tolerate it very well. The most commonly reported side effects are deeper sleep and more vivid dreams.

Dr. Eric:

Good to know. It sounds like you’re not just focusing on parasites in the gut. I was going to ask you, which you might not know the answer to, if you think the main relationship with autoimmunity to parasites is that autoimmunity has the leaky gut connection. If parasites affect the gut, they can potentially cause that increased intestinal permeability or leaky gut. But it sounds like you’re not just concerned about the gut parasites but parasites outside of the gut, which is one of the limitations of the stool testing.

Elizabeth:

That is one of the limitations, yes. A doctor who is basically considered the father of Celiac disease, he and his team have done thousands of bowel biopsies over the past 20-30 years. They have discovered that chronic inflammation damages the digestive tract in the gut. Wherever those parasites are, our T-cells, which are our body’s defense soldiers, notice there are foreign invaders. Typically, foreign invaders in a human body are viruses and bacteria. The T-cells can handle those pretty well. They can create antibodies against bacteria, and they have heat and inflammation they use against viruses. None of those work at all against parasites. The T-cells are going to see the parasites whether they are in your gut, heart, bloodstream, it doesn’t matter, and they are going to set off that inflammatory response over and over because they keep seeing them over and over, and they don’t go away. Any time you have chronic inflammation, it damages the gut and contributes to that intestinal permeability or leaky gut that you were mentioning.

Dr. Eric:

How about the impact of other gut infections? Do you just focus on the parasite?

Elizabeth:

I believe in the terrain theory more than the germ theory. Oftentimes, people say, “I have SIBO or H-pylori.” Then they want to take out antibiotics to wipe out those bacteria. The problem is now the whole reason those bacteria, which are always in our gut anyway—H-pylori is in everybody’s gut as part of our normal gut microbiome. Then we take antibiotics and wipe it out. Now we have a void, a vacuum. Nature abhors a vacuum. What is going to go in to fill that void? Other bacteria. How do the H-pylori get out of control in the first place? The whole terrain, the microbiome, was out of whack. That can often be from parasites. But there was an opening that the H-pylori moved into and expanded, more than they normally would in a healthy system.

I believe it’s better to address the entire body holistically rather than try to use a shotgun to kill one little mosquito and get all the collateral damage you will get.

Dr. Eric:

Makes sense. Even with the parasites, you want to get rid of the parasite, but it’s important to focus on the whole body. With the gut, make sure the person has sufficient hydrochloric acid, and maybe probiotics, digestive enzymes. I am not sure what specific approach you take. It’s not all about the parasite.

Elizabeth:

If you try to eradicate the parasites using pharmaceuticals, those pharmaceuticals are less discriminatory. They will wipe out all the flora and fauna in your microbiome while they are trying to go after the parasites. If you use an herbal approach, the herbs are more focused. They will only affect the parasites. They won’t wipe out the rest of your flora and fauna in your microbiome, so you don’t have to be that concerned about other things as you’re going through it because it will only affect the parasites.

Dr. Eric:

I know some of the medications they give for parasites could be harsh, like Flagyl,metronidazole, which affects the…

Elizabeth:

Ivermectin. We’ll bring that one up. Eric, can we pause just as second here and go back to talk a little bit more about how people might have picked up a parasite?

Dr. Eric:

Yes, go for it.

Elizabeth:

Oftentimes, people feel a little defensive. “I don’t have parasites. I have a clean home. I’m a hygienic person.” That has nothing to do with it. It is super easy to pick up parasites. You can pick them up from swimming in a lake or a river, or even a public pool or a water park. Chlorination does not necessarily eradicate all of them. Every summer, I see notices on the news that they discovered an infestation of giardia in a heavily chlorinated public pool. That doesn’t work.

You can get them from eating sushi, eating undercooked pork, traveling, playing with your pets, like your dog or cat from cleaning out the kitty litter box; that is how T. gandii spreads into the brain. The CDC believes there is a long-term infestation of Cyclospora that has been coming in through fresh cilantro. How frequently have you had fresh cilantro on your plate in restaurants? Remember in 2018, when there was an outbreak of Cyclospora in McDonald’s restaurants around 13 states in the Midwest. It was coming across in salads there. In the 1990s, the entire city of Milwaukee was infected with cryptosporidium through their municipal water supply. It can just be super easy to pick up parasites. It has almost nothing to do with you. You can get them walking barefoot. There has just been an outbreak in Texas of parasite strongyloides, which can come up when you walk barefoot across dirt, grass, and sandthrough the soles of your feet.

I have had parasites no fewer than six or seven times in my life. The first time, when I was about eight years old, and my family was in Israel, we were at this spring outside of the Dead Sea, the site of Masada. The spring is called Ein Gedi. It’s very prominent in Biblical times as a spring. We were swimming in the spring, and we all picked up a parasite. It’s just super easy.

One of the most recent times I picked up a parasite was when my fiancée and I were traveling in Asia. We did a two-week horseback trip across the eastern Tibetan plateau. We were on horseback for two weeks. We were camping. It was an amazing trip. When we came down off the plateau into Chengdu,China, in a big cosmopolitan city, we all gathered for a celebratory feast. There were 15 of us at a four-star restaurant. We met at 6pm. By midnight, 12 of the 15 of us were worshipping the porcelain gods. It can happen that fast.

Sometimes you may have been infected at a time when you think, “You know what? I had food poisoning or a 24-hour bug. I was traveling, and I got diarrhea, and it lingered on for a little bit.” If you think back on it, you may realize that you never totally regained yourself after that, even though you were able to move forward and live your life normally, but maybe not with the same vitality and energy you used to have. Maybe you had different bowel habits.

After I drank some water in Sofia, Bulgaria when I was 21 years old on a three-day train trip from Budapest, Hungary to Istanbul, Turkey, we stopped in Sofia and had run out of water, so we ran in and grabbed some. I had tremendous diarrhea for awhile. In fact, I had diarrhea for the next 10 years. Every morning, that is what I thought was my normal: either diarrhea or constipation. I didn’t really think that much of it. This is how my bowels are. It wasn’t until after we returned from Tibet when the diarrhea had continued, and I went to a GI doctor that time. He took a stool sample, and it made its way over to the Center for Disease Control, who actually picked up the phone and called my apartment and said, “Where have you been? We found five parasites in your poop. Is there an outbreak in Denver, Colorado where you live?” Yes, it can be very easy to pick up parasites.

The symptoms can be really random. It can be diarrhea or constipation. It could be fatigue and lack of energy. Could be headaches and migraines. One of my husband’s big symptoms was vomiting. He will randomly vomit when he is infected. Also, fainting. One night, we were watching TV in the living room, and he got up to get a drink out of the fridge. All of a sudden, I heard a thump. I walk into the kitchen. The refrigerator door was open, and he was flat on his back on the floor from fainting.

Dr. Eric:

When people think about parasites, they think about loose stools. They don’t think about other symptoms, such as constipation, let alone fatigue or fainting. I quite frankly haven’t heard of that associated with parasites, so that’s interesting. If someone isn’t experiencing diarrhea, that doesn’t mean they don’t have a parasite. Is it safe to say if someone has no digestive symptoms that they could also have parasites?

Elizabeth:

Not at all. It affects people in different ways. What I feel is that it doesn’t matter how things are manifesting in the body, but more that there is something there, and inflammation is at the root of it. It could be body aches. There are almost unlimited symptoms for parasitic infestation. If you are someone who has been to lots of doctors and haven’t been able to figure out what is causing your symptoms, or even if you have started to have new symptoms, like you never before were lactose-intolerant and now you are. You never before were gluten-intolerant, and now you are. You never before had blood sugar issues, and now you’re pre-diabetic without other symptoms. Even if you have chronic issues with weight management, either keeping on your weight or being able to remove excess weight, those could be signs of parasites, too.

Dr. Eric:

Good to know. I have a quick story to shareof a past patient with parasites. Keep in mind in the past years I have done testing not just for parasites, but for other things as well. I had a patient 7-8 years ago who symptom-wisewasn’t doing too bad. He was a Graves’ patient. No digestive symptoms, regular bowel movements. I didn’t suspect a parasite, so I didn’t do any testing. Long story short, he stopped seeing me. He went to another practitioner. The practitioner did do a test, and the test happened to find a parasite. The only reason I know was because I followed up with him a few months later. He got into remission by following a protocol for the parasite. His antibodies, his thyroid stimulating immunoglobulins normalized. It taught me a lesson that you can’t just rely on symptoms.

In your situation, of course, you wouldn’t have done the testing. You would have just put him on a protocol, which would have done the job. Either way, it’s something that at the time I overlooked. It did teach me a lesson. I knew the answers as I was asking you the questions: Do you have to have symptoms? I have had patients that didn’t have symptoms yet had parasites. I’m glad you brought up symptoms.

Elizabeth:

They did have symptoms, but they weren’t gut symptoms. He was coming to see you for thyroid issues, right? So he had some symptoms. They weren’t classically what you would consider parasitic infestation symptoms.

Dr. Eric:

Correct. No gut-related symptoms. I was thinking at the time no gut symptoms, probably no parasites or any gut infection. Lesson learned.

Elizabeth:

Sometimes skin issues can be parasitic. I have had clients where the parasites are coming out of their skin, and they make little bumps. If they break the top off the bump, they can sometimes see movement before the parasite dematerializes, kind of like Avengers Endgame when people disintegrate. Parasites are anaerobic. Sometimes they will literally disappear upon exposure to air, which is another reason that testing can be so unreliable. Sometimes the parasites aren’t even there by the time they reach the lab.

On top of that, my brother-in-law is a pathologist. He tells me that he is taught to look at a slide and identify all the structures that he recognizes on the slide. There might be 30 structures on the slide, out of which he probably recognizes 10-15 of them. The others, he is taught to ignore. Some of them might be parasites, but he can’t identify them because he has not been trained on them.

Dr. Eric:

One thing you mentioned about getting parasites is you can get parasites anywhere, not just internationally. You mentioned the salads. In the literature, one of the parasites, Blastocystis hominis, there is a new case study showing its association between Hashimoto’s thyroiditis. They can also be transmitted by eating a salad. You’re right. It’s not just drinking contaminated water or being overseas. You can get it having a salad somewhere.

Elizabeth:

Once I picked up parasites at a salad bar in Trinidad, Colorado at a Pizza Hut. Another time, my entire family picked up parasites after eating at a very upscale restaurant in Escondido, California.

Dr. Eric:

That’s scary. That’s a big reason why parasites are so widespread and why we are having this conversation.

Elizabeth:

And unrecognized. Let me give a little bit of story about that restaurant experience in California. We had gone out to a very lovely restaurant. When we came back that night, it started with my husband. I look at him as my canary in the coal mine. He started vomiting and explosive diarrhea about midnight that night. That continued for him through most of the night. The next morning, my son, who I think was around 12 at the time, had a migraine. That was part of his symptomology. That is how it manifested for him. About a week or two weeks later, my daughter, who must have been 10 at the time, said, “You know, Mom, I’ve had diarrhea since we were in California.” I looked at her and said, “You know what? Me, too. I think we all got infected.” We all went on the herbal protocol. It all cleared up.

Dr. Eric:

That’s a bummer, but it’s great that you knew what to do and cleared it up. In some situations, you might have gone to a conventional doctor, like if you didn’t know any better, you would have gone to a local doctor. Maybe they would have suspected parasites, but maybe not. They may have given you other medication to deal with the symptoms.

Elizabeth:

Probably not. We had only been in California. We hadn’t even been out of the country. We hadn’t been eating street food or something you would consider to be less hygienic. We hadn’t even gone swimming on that particular vacation because it was in the winter. It can be really easy and deceptive to pick these up.

I did have one client who while I was working with her had had a colonoscopy. Her GI doc, who was performing the colonoscopy, saw the parasites move while he was doing that, which doesn’t normally happen. He had a little freak-out, which I thought was very unprofessional.

Dr. Eric:

I haven’t heard that story about a colonoscopy.

Elizabeth:

Some parasites are visible to the naked eye, like many worms. Some are microscopic. Some are sub-microscopic.

Dr. Eric:

I do hear stories where some people follow parasite protocols…I don’t know if you commonly see where once they have their first bowel movement, or a few movements later, after the protocol, they will see parasites in the toilet. I never heard of it during a colonoscopy.

Elizabeth:

I ask of all my clients when you start the parasite protocol to watch your stool, watch your toilet bowl. If you see anything, snap a photo. That is the most reliable way to capture anything. I have had clients who get disposable chopsticks from Chinese restaurants that they can use to fish around in the toilet bowl. Sorry if I’m grossing anybody out here. This is my life, so it doesn’t gross me out at all. But they fish around and can find- I remember one client who said, “It looked like a piece of poop.” As soon as she poked at it, she could tell it was poop on the outside, but on the inside, it was a nest of worms.

Dr. Eric:

It’s okay for me. With my background, it takes a lot to gross me out. Again, if that was me having a bowel movement, who knows. Maybe I would have been grossed out. Fascinating. I find it very interesting.

When it comes to the herbs, you recommend an herbal protocol. I don’t know if you use some of the common herbs like wormwood or black walnut or clove and/or other ones.

Elizabeth:

I do. I use all three, and I also use neem. The important thing is that sometimes I see combination products where they might have 30 ingredients that are all kind of anti-parasitic. They aren’t in large enough quantities to make any kind of effect.

My protocol I work with starts slowly. Even one drop and one capsule. Then you go up to where you eventually are taking something like 30-40 capsules a day. You really need large quantities to saturate the tissues sometimes. Some parasites lay 2,000 eggs a day. If you only get the adults, you will have a repopulation, and you will be right back to where you were in just a couple months.

Dr. Eric:

I know some practitioners will take breaks. They will go 10 days on, 10 days off, 10 days on. Do you take that approach, too?

Elizabeth:

I don’t. I do a 30-day protocol because that covers all the phases of the lunar cycle. Parasites are lunar beings. They do become more active during the times of the full moon. Additionally, they have consciousness. They can actually affect the actions and behavior of their hosts. They can be an influence on you for acting to eradicate your protocol or not acting to help yourself.

Dr. Eric:

Do you find that some people need more than the 30 days? After 30 days, they’re a lot better, but they’re still not completely in the clear? Then you put them on another 30 days?

Elizabeth:

100%. Some people repeat. Immediately, they feel so much better afterwards, but they feel like they are not done. They continue and repeat the whole process for the next 30 days. A lot of people stay on a weekly maintenance dosage so that they continue to kill off anything new that is coming into their bodies. Still others need to progress on a second step parasite protocol that I will bring in if the first month hasn’t provided the results that I was looking for.

Dr. Eric:

That sounds good. Thanks for sharing. I warned you that I also wanted to talk to you about the MRT. We are going to get into that. Even though the focus is on parasites, I wanted you to take a few minutes to share that. Before we switch gears, any last words you want to say regarding parasites?

Elizabeth:

Let me give a segue. Part of the problem with parasites is that the job of a parasite is to find a host, take up residence, and multiply. That is the job of a parasite. A job is not something that is ever beneficial for the host. If it is a beneficial relationship, that is a symbiotic relationship, where both the host and the bugger benefit. That would be like a probiotic, where bacteria helps us, and they benefit because they have a place to live. But there are no benefits to parasites, or else it wouldn’t be called a parasite; it would be called a symbiote. Parasites are never helpful for the host.

When they are in your body, they are not super nice and well-behaved. I used to think of parasites as promenading very orderly through my intestines like a Bridgerton episode. The truth is they are much more like one of those ant farms or worm farms we had in kindergarten behind glass, where they just burrow through your tissues and make their own pathways and leave you perforated and pockmarked and scars all over. That contributes to that leaky gut and digestive issues and lack of complete digestion, which can manifest in all kinds of deficiencies and cause problems. That is why I prefer to follow up a parasite protocol with an anti-inflammatory diet. The best way I think to design an anti-inflammatory diet is using the MRT test. How is that for a segue?

Dr. Eric:

Sounds great. We had a conversation because I’m not a big fan of food sensitivity testing. Most practitioners use what is called IGG food sensitivity testing. I can’t say I never use it in my practice, but it’s one of those things I use as more of a last resort.

I start people off with an elimination diet. A big reason is because I haven’t found the IGG testing to be accurate. If I knew it was accurate, it would be much easier to have people do the testing and not have to go through an elimination diet.

We were chatting about your success with MRT.Can you explain how that differs from traditional food sensitivity testing? Some people might get confused. It is more of a food sensitivity test. There is allergy testing, which is IGE-mediated, more of an immediate response. There is food sensitivity, which is a delayed response. MRT uses more mediators. I will let you take over. You will do a much better job of explaining it than I.

Elizabeth:

Those are all good things to talk about. That’s what people hear about. Food sensitivity testing. Now, they are offering take-home food sensitivity tests you can do. They are super unreliable. I would not recommend wasting your money on those, specifically because they are looking for the IGs, the antibodies.

There are four types of hypersensitivity reactions. Type one hypersensitivity reactions cause anaphylaxis. Those are the people who will die if they eat a peanut or a shrimp or something like that. That is usually pretty quick afterwards. They definitely create antibodies, IGA antibodies, I think.

Dr. Eric:

IGE antibodies.

Elizabeth:

But type two and type three hypersensitivity reactions may or may not create antibodies and may or may not correlate with symptoms. I like to think of type three reactions as more like intolerances. They may be enzymatic deficiencies like lactase, not able to digest lactose in milk.

Type four hypersensitivities are mediator controlled or related. Mediators, the most famous mediator we all know is histamine. If we have a bee sting or poison ivy encounter, and we take some Benadryl or another antihistamine, we can get some relief from the pain that is being caused by the inflammation from that encounter. Histamine is only one of 80 or more mediators the bloodstream can release upon exposure to what it deems to be a threat.

The MRT, the Mediator Release Test, is quite unique. Most doctors don’t know about it, so you won’t usually find out about it in your doctor’s office. In fact, they might try to steer you away from it because they haven’t learned about it in medical school. It looks for how your blood reacts specifically to 150 foods and 20 or so chemicals in our food environment to see if your blood will release these mediators. It doesn’t look to see which mediator of the 80 or so because they all cause inflammation. They all become systemic. Because they are part of your bloodstream, they go everywhere your bloodstream goes. They may manifest differently in different people, but they are actually systemic. Because all mediators that are released cause inflammation, that is what we are focusing on it.

I don’t care how it manifests. I don’t care if it manifests that you have a headache or sinus issues or high blood pressure or asthma or heart issues or arthritis or fibromyalgia or gut issues or stomach pains or acid reflux. All of these are indications of inflammation.

The MRT gives us a really good road map on how to remove and reduce the inflammation in your body because what we get back is a bar chart of every single one of those 170 items that are tested, telling us exactly how reactive every single item is. Instead of saying, “You know what, A, B, and C turned up high on your test. Go back and eliminate them,” which is a classic elimination diet and not very helpful because people will say, “Wow, that is what I normally eat. What am I supposed to eat then?” They may go off and choose other foods that are also reactive, and thennot experience any improvement.

Instead of that, we look at the test very specifically. We cross-correlate botanical food families and identify X, Y, and Z, the foods you are least reactive to. Then we design a restricted, customized diet for you. “I only want you to eat these foods, and there are 40 or so that we know 100% are not inflammatory for you.” Usually within a week or two, people experience marked improvement. Within six weeks of dietary therapy, most of their symptoms are gone oftentimes. People literally deflate in front of my eyes as inflammation moves out of their body. Men lose jacket sizes. If you need to lose weight, it’s a great diet to do because you don’t have to limit your calories or food intake. We don’t look at macronutrients like proteins and carbs. In fact, we only look at which foods are inflammatory for you and make sure you are only eating foods that are not inflammatory for you based on the MRT. There is no guesswork. Sometimes those test results are really surprising. For me, when I eat lettuce, especially lettuce together with avocados, I get MS symptoms.

Dr. Eric:

Not only do you get symptoms, but those did show up positive on your MRT?

Elizabeth:

Yes, those were indicated as reactive for me. Who would have guessed lettuce and avocados? Avocados are so good for your brain and nervous system. For MS patients, they are very highly indicated. I agree with that for the general population. If you are ok with avocados, avocados are very healthy and helpful for maintaining your nervous system. For me, for some reason, my white blood cells have decided that avocados are a threat. So is lettuce. And other things, too.

For my son, when I tested him when he was six years old, three of his most reactive foods were some of the things we thought were most healthy for him: broccoli, garlic, and lemon. For him, they were making him constipated, vomit, giving him such terrible acid reflux that he couldn’t sleep through the night, keeping him as a bedwetter as six years old. As soon as we removed the foods, he stopped wetting the bed like literally the next day.

Dr. Eric:

Is this a test that you eventually retest? With food sensitivity testing, like IGG, the goal is to eliminate the foods. When your gut heals, you might be able to reintroduce those foods six months later. Is it similar with MRT, where you want to test again after a certain period of time?

Elizabeth:

It is unfortunately not inexpensive to do the MRT. Most people don’t need to retest for at least six or seven years. I teach every client that I work with how to challenge themselves on foods as they go forward and discover if they have recovered their tolerance thresholds enough to be able to tolerate them, or not.

Most importantly, what I teach them is how to recover when you are accidentally exposed. Regardless of how careful you are, there will be times where you accidentally eat something that causes you to flare up. A person who is suffering chronically to see you or me, they are probably walking around at 80-90% inflamed every day. When they eat something that causes them more inflammation, maybe shoots them up to 85-90%, they might not even notice it because they feel crappy all the time. It’s not that big of a difference. But when we bring you down to 10-20% inflamed, and then you eat something that shoots you up to 85%, wow, do you notice it.

Dr. Eric:

I bet. So many questions I have about this. I might have to interview you again. The main focus of this was to talk about parasites. The plan was to take a few minutes, but we could get into a lot greater detail when it comes to this test.

Let people know where they can find you if they are interested in MRT testing or getting help for MS or other autoimmune conditions. Is your website ElizabethYarnell.com?

Elizabeth:

Yes, that is correct. At the bottom of every page, there is a link to book a complimentary naturopathic health assessment, which I am happy to offer all our listeners today. It’s risk-free. We can talk about what’s going on with you and see if what I offer might help you. Specifically for parasites, I do have a little quiz. If you go to ParasitesAndAutoimmunity.com, there is a quiz you can take to see if maybe parasites might be at the root of your problems.

Dr. Eric:

That sounds wonderful. Visit Elizabeth’s website and the parasite quiz website. Thank you so much. It was great chatting with you about parasites and MRT testing. I appreciate you sharing this information. We will need to continue talking about MRT in a future interview.

Elizabeth:

Perfect, I look forward to it.

Recently I interviewed Dr. Anshul Gupta, as we chatted about some of the common triggers of Graves’ disease and Hashimoto’s, and he also discussed peptides, and how they can benefit people with these and other conditions (i.e. chronic Lyme disease). If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:

With me, I have Dr. Anshul Gupta. We are going to be talking about triggers of thyroid autoimmunity, meaning Graves’ and Hashimoto’s. We are also going to be talking about how to address those triggers. Dr. Gupta is going to get into peptides as well. This is the first time I’ll be covering peptides. Excited to learn a little bit more about those.

Dr. Gupta is a best-selling author, speaker, researcher, and a world expert in Hashimoto’s. He treats people worldwide in reversing Hashimoto’s. He is a board-certified family medicine physician with advance certification in functional medicine, peptide therapy, and fellowship training in integrative medicine. He has worked at the prestigious Cleveland Clinic Centerfor Functional Medicine alongside Dr. Mark Hyman. He has helped thousands of patients to reverse their health issues by using the concepts of functional medicine. Lot of credentials here.

Also, he is on a mission to help one million people reverse their health conditions. To achieve this mission, he has written a bestselling book called Reversing Hashimoto’s. He has also started a virtual functional medicine practice, a blog, and a YouTube channel so he can reach people all over the world. Through his innovative approach to Hashimoto’s, he has helped several patients to reverse their unresolved symptoms and live their life to the fullest.

He loves to spend time with his wife and two kids. In his free time, he enjoys traveling, hiking in the woods, and meditating in a quiet spot. Welcome. Thanks for joining us, Dr. Gupta.

Dr. Anshul Gupta:

Thank you so much for having me on the show. It is a privilege to be here.

Dr. Eric:

Definitely a privilege to have you. Look forward to talking about both Graves’ and Hashimoto’s. Your book is on reversing Hashimoto’s. Of course, a lot of information applies to both Graves’ and Hashimoto’s as well as other autoimmune conditions. Like I said, I am very excited also to learn more about peptides, which can apply to both conditions too.

Let’s start out with your backstory. Why did you decide to write your book?

Dr. Anshul:

This all started off with my own health journey. After doing my family medicine residency, I was working in a very small private family medicine primary care job. Just a couple of years into my work, I had my own health issues. I was having this horrible stomach pain that often caused me to double over because of the pain. Sometimes, the pain was so severe that I thought about going to the emergency room. Being a doctor myself, I knew that the emergency room doctors could not do anything except give me pain medications, so I bore through it.

Being a doctor, I started taking some medications to fix it. They were not working. I thought, Maybe I’m not smart enough. Let me see if a specialist who is smarter than me can fix my problem. I saw specialist after specialist, gastroenterologist, allergy specialist, you name it. We did tons of testing: lab testing, endoscopies, ultrasounds. Everything came back normal. There are no medications that would be helpful. They had no idea what was going on with me. I kept on taking more medications, but I was still miserable. I was having more symptoms. I was feeling so tired and fatigued that I had to take a nap during the day just to function during the day. After my day was done, I was so tired that I would literally not be able to function. I was gaining weight like crazy even though I had not changed my diet. At the time, I had no idea what to do. I was totally helpless and hopeless. Nobody could help me out.

Then somebody introduced me to functional medicine. These guys actually fix people who are not fixable by anybody. That is when I started training in functional medicine. The first thing I did was figure out my triggers. I figured that my trigger was some food sensitivities along with a lot of inflammation in my system. I addressed those things. Within one month, my pain was gone. Within six months, I was off all medications. I lost 40 pounds. I had more energy in my system than I ever had before. I even did a 5K like a maniac, which was totally unusual for me. After having phenomenal results with myself, I decided I wanted to help people with this functional medicine model of care. I worked at the Cleveland Clinic.

At the time, I was seeing these Hashimoto’s patients or thyroid disorder patients, and they were exactly like me. They were all going to doctors, taking medications, labs normal, but they were miserable. They all had brain fog issues, fatigue issues, weight gain problems, gut problems. Nobody knew how to fix them. They wanted answers because nobody was giving them answers. I needed to help these people.

I started a research journey into why these people were not feeling well. After a couple of years, I developed a three-step protocol that helped a lot of Hashimoto’s and thyroid disorder patients to get their life back. That is where I decided I now need to write a book because I wanted to share this message with the whole world. That is when I started writing the book, and finally the book came into being and is out now.

Dr. Eric:

As we chatted a little bit before starting the recording, I did go through your book. Excellent book. You talk about triggers, which play a big role when it comes to all different autoimmune conditions. Even though the triggers apply to Hashimoto’s, they can apply to people for Graves’ or other conditions, too. I’d like to dive into some of the different triggers. If you could talk about the main triggers that you discussed in your book that can affect people with Hashimoto’sand other conditions.

Dr. Anshul:

Through my research, I found there are five main categories of triggers that are responsible for the majority of chronic conditions, whether it’s thyroid or something else. The first one is food sensitivities. We all know that food is medicine, but food can also be an important reason for causing problems. What you’re seeing is more and more people are sensitive to certain foods, and those are the reason they are getting triggered for autoimmune conditions. These food sensitivity triggers could be gluten, dairy, soy, corn, processed meat, other processed foods, and sugars. That is the first category of triggers.

The second category of triggers is toxins. Our world is laden with toxins. Each and every day, we have more and more toxins poured into our environment. We now know that toxins are a big trigger for autoimmune conditions. They can be heavy metals like lead or mercury. There can be mold. There can be environmental toxins like pesticides.

The third category is nutritional deficiencies. Our body needs certain vitamins and minerals to function properly, especially the thyroid gland. If it doesn’t get those vitamins and minerals, it leads to the triggering of an autoimmune condition, be it deficiency of selenium or zinc or Vitamin D or Vitamin B12. They can all trigger a condition. It’s very important for us to know about that.

The next set of triggers is stress and trauma. In our world today, we are exposed to stress all the time, especially in the current scenario of the COVID pandemic. Everybody is so stressed out. Stress is a major reason, be it physical, emotional, mental, spiritual. Any kind of stress our body goes through can trigger an autoimmune reaction and lead to these conditions. A big stressor for women is post-delivery. Within a few months of delivering a child, a woman can often develop a condition like Hashimoto’s. That is a big trigger we see.

The last set of triggers is infections. Several infections have shown to lead to thyroid conditions, be they infections like Epstein-Barr, parasites in your gut, or chronic infections like Lyme or other co-infections. Candida, too. All of those infections can lead to autoimmune conditions.

These big five sets of triggers can lead to several autoimmune conditions. Every person who has an autoimmune condition should be assessed for all of them.

Dr. Eric:

Certain foods like gluten can potentially trigger autoimmunity directly. Would you also agree that the problem with some foods, too, is not that it is a direct trigger of autoimmunity, but it can also increase intestinal permeability, cause a leaky gut, which is a factor in autoimmune conditions?

Dr. Anshul:

Absolutely. Leaky gut, in the recent years of research, starts in the autoimmune process. Several foods that we are eating definitely causes that leaky gut. Not only the bigger ones like gluten and dairy, but if you are eating any processed meat or white flours or too much sugary foods or high glycemic index foods, those can all lead to leaky gut issues.

It also depends on how we are cooking our food. If you are charring your food or frying your food or overcooking, that can lead to increased intestinal permeability and cause leaky gut. It has an effect on the intestinal permeability, which can lead to leaky gut and autoimmunity.

Dr. Eric:

Do you test for food sensitivities? Do you put people through an elimination diet? How do you usually detect food sensitivities?

Dr. Anshul:

I do both. There is no foolproof way of knowing if a person is sensitive to food or not. We have several food sensitivity tests. All of them are great, but none of them are perfect. I have tried all of them, but they lack something. The foods that I know are not good for a person, I definitely do an elimination diet of five or six foods with them. At the same time, I order the food sensitivity panel, which gives us a better idea of whether they are certainly very sensitive to certain foods. We can eliminate those also in the later phases.

Dr. Eric:

Interesting. You have everybody avoid the common allergens, the foods that you mentioned, gluten, dairy, corn, soy, refined sugars, processed meats. Everybody has to avoid those when they are under your care. That’s what you recommend anyway. On top of that, you do food sensitivity testing. Correct?

Dr. Anshul:

Right. The timing works out pretty good. When the person sees me for the first time, by the time we order the food sensitivity panel and get the results, it’s three to four weeks. During this time, I take this opportunity to basically clean their whole system and wait for the test results. I do this elimination diet, which cleans up their system. It’s a brand-new function now. The food sensitivity panel gives us a better fine-tuned direction of which way we need to go. It’s a win-win situation for both sides.

Dr. Eric:

Is it IgG food sensitivity testing that you’re doing?

Dr. Anshul:

Yeah, mainly IgG testing. We have different versions of things now. We have this MRT test, which is good. We have the IgG testing also available. The MRT and newer tests are really expensive, so it also depends on affordability. If people can afford it, then I go with the more expensive ones, which not only look at IgG but also some of the other intermediate cytokines and histamine readers. It increases the sensitivity of the test. Now we are using not just a plain IgG.

Dr. Eric:

If you were given a choice, because you don’t have people who do both types, you would say #1 would be MRT testing if they can afford it. If not, then you would go toward the IgG test.

Dr. Anshul:

That’s correct.

Dr. Eric:

Both of theseare blood tests. Do you have them do the blood test first before giving up those foods? Or right away, do you have them give those foods up? At least with food sensitivity testing, you need to be eating the food for the test to be accurate. I’m wondering if you tell them to keep eating the same foods, and try to get the test as soon as possible. As soon as you get the blood draw, stop eating those allergens.

Dr. Anshul:

Exactly. I tell them, “If you want to do a food sensitivity test, this is the right time to do it. I don’t want you to eliminate the foods for four or six weeks and then order a panel.” As you rightly pointed out, then it would be useless. If you do decide to do the testing, get the bloodwork done, and within a few days, get the testing done. Then start the elimination diet. That is typically the work we do with them.

Dr. Eric:

Wonderful. Talk a little bit about toxins. There are so many toxins. I don’t know if you do testing for some toxins. Obviously, we can’t test for all of them. We could do some testing for heavy metals. There are other tests as well for certain environmental toxins. Tell me what you do in your practice.

Dr. Anshul:

I start with an in-depth questionnaire, asking about their potential risks for exposures. The big three categories of toxins are heavy metals, be it lead, mercury, arsenic, aluminum, etc.; mold; and environmental toxins. There are some clues that we can get by a patient’s history that point us toward where we might need to go. Once we get that, then I order tests.

What I’m seeing is more and more of my patients have more toxins. Previously, I was relying on heavy metals as the main reason. I think in the last couple of years, the shift has been more toward mold toxins. That is the triggering factor for a lot of my patients.

I have a 33-year-old female patient who came to see me for Hashimoto’s. She was diagnosed five years ago. She was having horrible symptoms. Feeling so tired that she has to take two naps during the day just to be functional. Along with that, she was having brain fog, gaining weight, and on the right medications. She kept on going to her doctor, and her doctor said, “You’re perfectly normal. Nothing else can be done for you.” She was definitely disappointed. She wanted to do something else. That’s when she came to see me.

The first evaluation, I am asking about different toxin exposures. I asked her to tell me more about her house. She said, “It’s a nice house. I have been living there for the past 10 years.” I asked her how old the house was. She said it was really old, from the 1960s. I asked her about mold. She said no. I asked, “But can you smell mold in your basement?” She said, “Yeah, my basement is moldy. But I don’t see any mold.” Bingo. Mold can be a trigger. “Since you moved into the house, did you notice in the couple of years after that is when you got diagnosed with Hashimoto’s?” She said yes. I said, “Let’s check you for mold.”

We ordered the test. The mold toxin was super high for her. She had no idea that mold was the trigger of her Hashimoto’s. Her house had mold toxins. She did the remediation for her house. We got her on a mold protocol. Within four to five months, she was phenomenal. Her fatigue was gone. She was able to function during the whole day. Her brain fog was gone. She lost 18 pounds during that time. Her life was totally back, and she had no idea because nobody had ever asked her about mold before.

These toxins are so important. A missing piece of the puzzle very often. We should have a very high index of suspicion. Again, as you pointed out, there is no perfect test for toxins. There are so many. Each and every day, we are producing new toxins in the market. Like with the careful history, a lot of the symptoms can point toward a person being toxic or not. Then I order a test to confirm things for us.

Dr. Eric:

I’m sure you have your patients incorporate the basics, like making sure they are eating organic foods to minimize pesticides and herbicide exposure. Drink purified water or some type of filtered water to avoid the tap water and water out of plastic bottles. Correct?

Dr. Anshul:

Absolutely. Before we go into a hard detox, we open up and help them out to clean up their environment as well as start working on the detox channels. As you said, cleaning up their water, cleaning up their foods, cleaning up their cosmetics because a lot of females are using a lot of cosmetic products which are heavy in a lot of chemicals. Working on that is important.

Working on air filters. A lot of us live in houses with poor air ventilation systems. That can lead to these problems. Working on proper air filters for that purpose. Working on basic things like dry brushing can be useful for detox. Working on saunas. Those are the basic things. Drinking lots of water.

Having bowel movements. That is the perfect way to detox your body. A lot of our patients are not having bowel movements. Incorporating those simple things. We start with those. Then we work on the hard detox.

The way people falter is without optimizing their detoxing, they just start with the hard detox. They get so many reactions. That is where people get worse. Let’s make sure that we are doing it step by step where we know how to do it gently and how to do it safely. That is the key about detox.

Dr. Eric:

Makes sense. I incorporate sauna. It’s not something everybody can do because they either need to have a sauna or go somewhere for a sauna. I don’t necessarily start out everybody where I recommend sauna therapy, but you brought up some great points.

When it comes to the next trigger, nutrient deficiencies. Can you also talk about some of the more common nutrient deficiencies? All nutrients are important. All vitamins and minerals are important. But the ones that relate more to autoimmunity, like selenium. If you could also jump into if you test for nutrient deficiencies, or do you just have everybody take a high potency multivitamin?

Dr. Anshul:

Yes, nutrient deficiency is a big one. Lots of patients who come to see me don’t think they are deficient in any nutrients because they eat a healthy diet. Research suggests that our food itself is deficient in minerals and vitamins. This research compared food from the 1990s to food in 2020. They saw that there was considerably lower amounts of vitamins and minerals in the food today. Even though you are eating the best quality food, we might not be getting the nutrients that our body needs. That is a very shocking revelation that I had when I looked at the research.

Several vitamins and minerals are associated with autoimmunity. Vitamin D is a common vitamin that almost everybody is deficient in. Very easy to check. That is one thing everybody should get checked.

The second one is selenium, especially for thyroid patients. Selenium is such an important mineral. We are very low. Unfortunately, there are not many good sources of food for selenium, so that’s why it’s important to make sure we are checking for selenium deficiency.

Vitamin B12 is very common. A lot of people are deficient in Vitamin B12, especially those who are vegan or vegetarian. We are checking those things for them. It’s very important. We need to check it out. Very common trigger of autoimmunity that we should be looking into.

Iron deficiency is another thing, especially in females. Very common. Often missed.

Those are the most common minerals that are associated with Hashimoto’s and Graves’. There are other things like Vitamin C, which a lot of people can be low in, zinc, and magnesium. But those are the foundation.

In terms of checking them or putting them on a multivitamin, I believe in being more specific with my supplements. I don’t put everyone on a multivitamin. I test for them first. Normal labs do not check for all the vitamins and minerals. We do use specialized lab testing, like Genova or SpectraCell. This gives us a better in-depth analysis of these vitamins and minerals. Then we curate a personalized plan, supplementing only what the body needs.

Dr. Eric:

You use either the NutrEval or micronutrient testing through SpectraCell. Is there one that you prefer over the other, just out of curiosity?

Dr. Anshul:

I like Genova. They have been in the market for forever. I believe in quality that way. I like Genova testing better than the SpectraCell.

Dr. Eric:

You also mentioned in your book when it comes to B12, you don’t want to rely on serum B12, which I’m glad you mentioned methylmalonic acid. The NutrEval is both blood and urine, right? That looks at the methylmalonic acid. From what I understand, urinary methylmalonic acid is supposed to be a little more accurate than the blood. I don’t know if you’ve heard the same thing.

Dr. Anshul:

I rely on these two or three different ways. You are looking at B12 levels, the MMA levels, and the homocysteine levels. That gives me a complete picture of where the B12 levels are, and what’s going on with the B12? Supplementing in the right form.

A lot of my Hashimoto’s clients have pernicious anemia. They are not absorbing B12 from their gut. They have this autoimmune condition. Then we have to rely on injections or sublingual B12 so they can absorb it and do better. B12 is such a complicated affair. It’s not simple. It’s much more complicated. Let’s make sure that you’re getting the right form of B12, and your body is converting and absorbing it.

Dr. Eric:

When it comes to selenium, if you determine through testing that someone has a selenium deficiency, do you usually try to correct that through supplementation, or do you have them eat foods? There are not a lot of foods high in selenium, but a lot of people bring up Brazil nuts. Can I just eat a few Brazil nuts instead of taking a supplement? What response do you have when someone brings that up to you?

Dr. Anshul:

Selenium is one of the minerals that has the most research studies backing for thyroid disorder. Whether that is Graves’ or Hashimoto’s or hypothyroidism, selenium is helpful for each of these things. There is not much toxicity of selenium unless you are taking huge doses. Whenever someone comes in with a thyroid disorder, I put them on selenium supplements to help them out. I don’t want to rely on food just to get the selenium. Supplementation, I know they are getting the required quantity so we can help them.

Dr. Eric:

I agree with everything you just said. When you eat Brazil nuts, you don’t know exactly how much selenium you’re getting. A Brazil nut might have 10-20mcg per nut, or sometimes it could have a lot higher, but you just don’t know. Even if it’s organic, it still might not have 70-80mcg per Brazil nut, so you might not be getting enough just by having a few. With the supplement, at least you know exactly how much you’re getting. Obviously, you want to try to do as much through food. Selenium is so important for overall health, but those with thyroid conditions, there is a lot of research there.

Let’s talk about stress. In your book, you did mention that you test cortisol in everybody, which I do, too. I recommend adrenal testing. Can you talk more about the effects of stress on the body as a trigger? I don’t remember if you do saliva testing or if you mentioned what type of testing. If you could get into that, too.

Dr. Anshul:

As you mentioned, stress is such an important trigger. Many of us discount stress as being nothing major. We know that research suggests every autoimmune disease can be triggered by stress. Stress can affect negatively our body in many ways. The major reason is about putting pressure on our adrenal glands. Cortisol is a great hormone. It is very protective of the body. When chronically the cortisol levels are high in our body, it starts burdening our body from the inside out.

There is a special connection between thyroid and adrenal glands. The thyroid gland actually helps with the adrenal functioning of the gland. The cortisol helps with the thyroid functioning. Chronically, cortisol causes negative feedback to the thyroid gland, to the point where it stops producing the thyroid hormone. It creates a scenario of hypothyroidism while in reality there is not.

The second thing cortisol does is play around with our immunity. Cortisol can actually change the inflammatory processes in our body and increase inflammatory markers. This can trigger an autoimmune process and cause a thyroid disorder. That is the reason adrenals are so important and limiting cortisol is important.

The easiest testing is the saliva cortisol testing. The problem is that the cortisol levels change during the day. If you just check cortisol levels one time a day, then it’s not accurate. You have to check it at least during four points throughout the day.

Dr. Eric:

I do use saliva testing in my practice, too. But in the last few years, for some patients, I started using the Dutch testing, dried urine testing.

Dr. Anshul:

That is awesome. If I am checking for all the hormones, that is great because it gives me a complete picture of their hormones: cortisol, progesterone, estrogen, metabolites, everything. Obviously, it’s an expensive test. If I am just looking at cortisol, and my patient cannot afford the Dutch test, we will go with the cheaper saliva testing. But if you ask me, the gold standard test right now to check for hormones, whether male or female, is the Dutch testing. It’s very accurate and gives us a very nice picture about the complete hormonal system. I love it.

Dr. Eric:

I think you’d also agree that you need healthy adrenals to have healthy sex hormones. Even if someone can’t afford a Dutch test, they could get a lot of value from doing the adrenal testing and supporting adrenals. Some people might decide to test the hormones in the blood. Maybe do total and free testosterone, progesterone, estrogen in the blood. It sounds like we’re on the same page when it comes to looking at adrenals and the sex hormones.

That leaves us with infections. That is the fifth and final category of triggers. You mentioned viruses, Lyme disease, parasites. Do you test for infections in your patients? Do you run blood testing for Epstein-Barr? Do you run a comprehensive stool panel? Does it depend on the person?

Dr. Anshul:

It depends on the person. It becomes overwhelming for our clients to do so many tests. Based on the questionnaire and the history, we decide where we need to go. Most of my clients end up doing the stool test because we know that leaky gut issues and SIBO, there are so many other things in the gut that can lead to an autoimmune condition. Stool testing is very common. That does cover the parasites.

The Lyme testing, I do not order the tests from the get-go because Lyme is so difficult to treat. It’s so way down the lane. Unless someone comes to me and they have already done everything, and the only thing left is Lyme, that is the last thing I will check for my patients. There is so much more we need to do beforehand.

Then comes Epstein-Barr virus. Depends on the person. If I get clear indications that they do have Epstein-Barr, if they have a history of it, we know that the virus is living in their body. Reactivation is very common. Most of our protocols is building their immunity back. That is where the peptides are useful. They do help immunity. We address Epstein-Barr by building their immunity and working on it through peptides anyway.

Dr. Eric:

How about H-pylori? Do you find that to be a problem with some people with thyroid autoimmunity?

Dr. Anshul:

Absolutely. That is a good test from a stool test. A lot of folks who have autoimmune conditions will be positive for H-pylori, too. Working on that is very important and improves a lot of my folks’ health.

Dr. Eric:

Let’s dive into peptides. You briefly mentioned peptides when talking about Epstein-Barr. Before you get into greater detail with peptides, can you explain for those who are unfamiliar with peptides what they are?

Dr. Anshul:

Peptides are basically a collection of small chain amino acids which are naturally produced by our body. We have proteins in our body, which are long chain amino acids. Similarly, we have these peptide molecules that are very small chain. The most common peptide that everyone knows about is insulin. We have been using insulin for a decade;that was the first peptide we were able to harvest and use as a medicine. With the recent advancement in technology, we were able to harvest more and more peptides and make them. The problem we are having with peptides is they were not being stable, so as soon as we would harvest them, and people used them, they would become inactive. Now we are able to combine them with different compounds and have better technology so we canuse them as medicines.

A couple of new peptides which are also approved for diabetes have come to the market. Several of them are in the pipeline of getting final FDA approval for various diseases.

The good part about peptides is they are natural. Your body is already producing them, so we are not using any external medications. We are using them in your body for specific therapeutic potentials. There is not much downside to peptides. Most of them have had research behind them that shows how safe they are.

Some of them are useful in this situation, especially for Graves’ and Hashimoto’s and other autoimmune conditions. We have at least 30 peptides in the market that we can get. Not all of them are good for autoimmune patients. Let’s talk about the fewof them that are useful for autoimmune patients.

The very first peptide which is useful is called BPC-157. It is naturally produced by our gut. It helps with healing and keeping our gut in good shape. When we were able to harvest BPC, there has been research to show its therapeutic potential. Leaky gut is a potential trigger of a lot of Hashimoto’s. BPC has shown improvement for leaky gut and gut permeability. That is one benefit of BPC. It definitely helps with leaky gut.

The second thing is H-pylori, which can be a trigger of Hashimoto’s or Graves’ patients. BPC can be helpful for removing or fighting the H-pylori. That is the second benefit of BPC.

The third benefit is healing. A lot of people come with a lot of issues with muscle injuries or joint pain or inflammation in their body with fibromyalgia-like symptoms. BPC has shown to improve those symptoms, especially for healing purposes for muscle injuries, ligament injuries, or joint issues. BPC is great for all of that.

It’s a wonderful peptide. It covers a bunch of things. It also supports a good gut microbiome. Most people have dysbiosis, an imbalance between the good and the bad bacteria. More bad bacteria than good. Because of the killing off of the bad bacteria that BPC does, it promotes good bacteria, which shifts the gut microbiome toward the healthier side. Helpful for a lot of autoimmune patients.

No downside to BPC. No side effects. Anybody can use it. That is one of the first peptides that a lot of my clients get started on to get the healing process going.

The second peptide is thymosin alpha 1. Thymosin is a peptide which is produced by our thymus glands. We have these thymus glands in our body when we are born. In the teenage years, these thymus glands produce all this good thymus stuff, which trains our immune system and helps us tackle all the infections when we get them. As our age advances, this thymus gland basically goes away, and we don’t have the thymosin compounds that our body produces.

This peptide has wonderful properties. Coming back to thyroid disorders, what is happening is that our immune system goes toward a more TH1 response. It’s a more inflammatory condition that is present in the majority of autoimmune conditions. We have different kind of immune cells like T cells and B cells. Those triggers retrain our immune system to cause inflammation. Thymosin retrains the system to do the opposite. From an inflammatory state, it reduces inflammation and retrains the T cells to start behaving and doing the right thing. Thymosin is good for a lot of infections, whether that’s Epstein-Barr or Lyme. It helps with the immunity purposes.

The second benefit of thymosin alpha 1 is it removes the reactive oxygen species. What happens with a lot of toxins, especially mold toxins, is they cause mitochondrial destruction, which leads to reactive oxygen species formation. These reactive oxygen species cause a lot of inflammation, destroying your body, producing more reactive oxygen species. You go in a loop. It breaks that loop. It removes a lot of reactive oxygen species, helps to reduce inflammation in the body.

That helps a lot of my clients with toxin issues. Some of my clients are so sensitive that they can eat like two foods and have random reactions all over their body. Those are the people we are using thymosin alpha 1 for. They can tolerate supplements and food and vitamins again. That is the beauty of thymosin alpha 1. It’s useful for immunity and fighting infections and mold toxins and reducing inflammation. Wonderful peptide.

No downside to thymosin alpha 1. It’s safe to use. Not many side effects we have seen.

The third peptide is thymosin beta. Thymosin beta is also an immunological peptide that helps with immunity. This one is important for repair. If people have chronic issues with leaky gut problems or problems with joints or muscle injuries, then thymosin beta is wonderful. It helps with immunity, meaning fighting chronic infections, especially Lyme. People who have been on antibiotics for Lyme for a long time and it doesn’t go away, thymosin beta can be useful. It goes inside the cells, which is where the Lyme hides. Lyme is not outside the cell; it’s inside the cell and causes reactivation. This goes inside the cells, too, and helps kill the Lyme. It’s potent for that.

The fourth peptide, a bit of a double-edged sword, is called LL-37. It’s an anti-microbial peptide. It helps to boost immunity as well as kill a lot of pathogens our body may be exposed to. It’s wonderful for Lyme. It’s wonderful for mold patients, for parasites. People in general who have very poor immunity, this is a good peptide to use for them.

The caution with LL-37 is that if somebody is having an acute flare-up of an autoimmune reaction, this is not the best peptide. It’s anti-microbial and can worsen the flare-up. We don’t want to use it during an acute flare-up. For chronic patients who have been without flare-ups but have been chronically infected and are not getting better, LL-37 can be useful.

Dr. Eric:

Why is that? Does it increase the TH1 response?

Dr. Anshul:

Not exactly. We don’t know that. But we have seen triggers. It’s improving the immunity of the body. It’s helping to fight off infection. Because a person is in a flare-up, it further feeds the fire into a flare-up and can sometimes lead to worsening things. We don’t see it very often. My first motto is do no harm. That’s the reason I’m always on the cautious side. If it can do harm, let’s not use it. That’s how I feel about it.

Dr. Eric:

As far as the administration, are they all administered the same way? How are they administered? Via injection? Can you take some of them orally?

Dr. Anshul:

The majority of them are through injections unfortunately. They are not very stable; once they go into the gut, they can get destroyed. That is a problem. The injections are very simple, like how people give insulin shots to themselves in their stomach every day. That’s the way we do it. Most of our patients are able to do it on their own. That’s how the majority of peptides are being used.

We have a couple of peptides, especially the BPC, that are capsules. People with leaky gut issues or people who are going through gastritis or GERD issues or H-pylori issues, we use the oral formof BPC because that works in the gut better and helps them more. BPC is the only one which is in the capsule form right now. All the others are in the injectable form unfortunately.

Dr. Eric:

Good to know. Very interesting. I’ve found all of this interesting, but especially with Lyme disease, you said that peptide could help in eradication of Lyme. It actually kills the Borrelia intracellularly?

Dr. Anshul:

Yeah. Obviously, there are no human trials, but the lab trials, animal trials they have done, very promising results. Again, it doesn’t work in the acute infection, but it works with more chronic Lyme. That is lying dormant, like in our cells, and making very subtle changes to our immune system. Then this actually goes intracellularly.

Not all these peptides actually work at the cellular level but in the nucleus of the cells. That is where a lot of these good organelles are present. These chronic infections like Lyme, they are working directly on our DNA and RNA and changing the messages from there, which changes our whole immune system. By changing the whole immune system, they are creating an inflammatory process. They are not active infections, as we know about them. These are subtle changes to the inside machinery of the body. The downstream effect of that is creating inflammation and autoimmunity. These peptides can directly enter the cell into the nucleus, which takes care of these Lyme and chronic infections.

Dr. Eric:

Wonderful. Thank you so much for sharing a lot of interesting information overall with the triggers and diving into the peptides. Before we wrap this up, are there any questions that I didn’t ask about triggers and peptides that I should have asked, or anything else that you want to say? Any last words?

Dr. Anshul:

No, I think we covered almost everything. There is so much more information that people can have, but I think what people should know is a high-level idea of what the triggers are that they should be looking for. What are the options of getting rid of those triggers? That is the most important thing people should know about.

There is hope for you to get better. Do not give up. Do not let anybody tell you that this is the life that you will be leading for the rest of your life. There is hope for you to get better. You just need to find the right person and the right trigger and work on it.

Dr. Eric:

Definitely agree with that, Dr. Gupta. Thanks again for sharing this information. Where can people find out more about you?

Dr. Anshul:

I have a virtual functional medicine practice. People can work with me from wherever they are in the country. My website is AnshulGuptaMD.com. I have tons of information over there. Right now, I am actually offering a limited number of free evaluation calls to my clients so they can get to know more about how I work with them and how my protocols can be helpful for them. They can go to my website and click on “Free Evaluation Calls.” I do have an active YouTube channel, so I share a lot of videos over there. I am on Instagram. I am also on Facebook. People can find me on social media channels to get more information about Hashimoto’s, thyroid, and all that stuff.

Dr. Eric:

Don’t forget your book. Amazon or ReversingHashimotosBook.com.

Dr. Anshul:

Correct. People can go to the website and buy the book. My book is also available on Amazon. My personal website also has information about the book.

Dr. Eric:

Thank you so much for agreeing to discuss triggers and peptides. Check out Dr. Gupta’s book as well as his website and YouTube channel. Appreciate the time and information you shared with everyone.

Dr. Anshul:

Thank you so much. It was really a pleasure talking with you. You’re doing so much great work. I keep listening to your podcast and learning new things.

Dr. Eric:

I’m sure everyone who listened found the information to be valuable. Take care.

Dr. Anshul:

You, too. Take care.