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.

Recently I interviewed Dr. Rani Banik, as she is a board-certified ophthalmologist and fellowship-trained neuro-ophthalmologist with additional training in functional medicine, and we chatted about thyroid eye disease. If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:With me, I have Dr. Rani Banik, who is a board-certified ophthalmologist and fellowship-trained neuro-ophthalmologist with additional training in functional medicine. Dr. Rani focuses on the root cause of eye diseases and uses integrative strategies for conditions such as thyroid eye disease, macular degeneration, cataracts, dry eyes,glaucoma, as well as other diseases of the visual system. Her treatments are based on nutrition, botanicals, lifestyle modifications, essential oils, and supplements. Dr. Rani runs a private practice based in New York City, in Manhattan. Thanks for joining us, Dr. Rani.

Dr. Rani Banik: Thanks so much, Dr. Osansky. So happy to be here.

Dr. Eric: Same here. It’s great to chat with you again. We’re of course going to cover thyroid eye disease. Why don’t you start out by briefly discussing what thyroid eye disease is?

Dr. Rani: Sure. Thyroid eye disease is an autoimmune disease. What happens is the body creates antibodies against tissues within the eye socket. We know that an autoimmune disease is the body attacking any tissues. Here specifically it’s attacking receptors found in the soft tissues of the eye socket, in the fat and the muscles of the eye socket. What ends up happening is there is an inflammatory response. There are certain signs and symptoms we can talk about that develop because the body is attacking itself.

The majority of people who have thyroid eye disease have Graves’ Disease. About 90% of people with thyroid eye disease have it. It can also occur with hypothyroidism. For example, Hashimoto’s. Sometimes people are even euthyroid, meaning their thyroid is functioning just fine, but they have autoimmune markers that are attacking the eye sockets. It can occur in the entire spectrum of thyroid disease in some form of autoimmune activation.

Dr. Eric: You said it can occur in Hashimoto’s. Percentage-wise, 80-90% of cases of thyroid eye disease is in those with Graves’.

Dr. Rani: The vast majority have hyperthyroidism from Graves’. The minority have Hashimoto’s or are euthyroid.

Dr. Eric: Why don’t we talk about the stages that one can expect to experience? There are different stages of thyroid eye disease.

Dr. Rani: It’s very easy. There are two main stages. One is the active stage of the disease, and then there is the inactive stage of the disease. The active stage is the acute inflammatory stage. It usually lasts anywhere from six months up to two years when there is a lot of congestion. The inflammatory cells, both B-cells and T cells, get activated. They cause swelling and redness and sometimes pain or discomfort. That is all the active stage of the disease.

In the inactive stage of the disease, which happens usually after two years of onset, people don’t have as much of the congestion, the redness, but they can certainly have puffiness, swelling, and continue to have some of the other symptoms of the active stage. For example, I didn’t mention this earlier, but double vision can persist into the inactive stage. Other things like dry eye can persist. That is the main way to categorize it. There is not a clear cut-off to the inactive stage. It’s not a sudden change; it’s a gradual change that happens.

Dr. Eric: I know it varies, but on average, how long does that active phase last?

Dr. Rani: In my patients, I would say the average is about a year, sometimes a little bit longer, that it persists. After two years, usually it does transition into the inactive stage. The first six months are usually the most dynamic. That is usually where the majority of the inflammation is apparent. That is when the patients are the most symptomatic, in the first six months.

Dr. Eric: Once someone is in the inactive stage, are they permanently in the inactive stage? Or can they revert back to the active stage?

Dr. Rani: Great question. A very small percentage of patients can get reactivated. Usually there is some kind of trigger. The trigger I have seen most often is stress. Or exposure to certain types of toxins. Perhaps they have been ill with something else, and that can trigger it. Many thyroid patients, because it is an autoimmune disease, other autoimmune diseases may coexist. Let’s say they have thyroid, but they also have something else like lupus. If their lupus flares up, it is much more likely that their thyroid eye disease is going to flare up as well. That is something to watch out for. These flares can sometimes happen together. But the vast majority of patients, and fortunately, once they go into that inactive stage, they remain inactive.

What I tell my patients is this is a long journey. It can be very frustrating. Having these symptoms can affect your function and your appearance. People are disturbed by all of these changes that are happening that they seem to have no control over. I tell them, “You have to hang in there. There is no quick fix for this. Eventually, things will get better, but it can take a couple of years before things start to get better.”

Dr. Eric: If someone does need surgery, they do need to wait until that inactive stage. Is that correct?

Dr. Rani:I base it off of their lab work. First, their thyroid has to be stable. If their thyroid values are still fluctuating, going up and down and up and down, that is not the opportune time for surgery. That means their eye changes could be fluctuating. Even if you think your eyes are stable, but your thyroid is still all over the place, you cannot have surgery. It is not a good idea.

Once the labs have stabilized, then I wait another six months to make sure that the eye findings are stable before recommending any type of intervention like surgery. In the meantime, there are so many things people can do, which we’ll talk about hopefully, to try to ameliorate some of those symptoms rather than going the surgical route.

Dr. Eric: Yes, we will discuss some of those things that they could do. You mentioned stress. Stress could be a factor in potentially reverting back to the active stage from the inactive stage. As far as triggers in general, you mentioned thyroid eye disease is autoimmune, so I imagine the same triggers that you see with Graves’ and Hashimoto’s and lupus and rheumatoid arthritis. Food, infections, chemicals, is that correct?

Dr. Rani: Absolutely. Infections, viruses in particular, I have seen people flare up after viruses. Not common, but it can happen. Stress, meaning lifestyle habits. When people don’t sleep well, when they are not rested, when they are not eating on a regular schedule, when they are eating inflammatory foods, all of those can be triggers.

Toxins. We know the biggest toxin exposure risk for thyroid eye disease is smoke. Smoking in particular. Any kind of air toxin, even cooking fumes. I have seen some patients who are professional chefs. They do know that if they are not wearing their eye protection when cooking, their eye symptoms tend to flare up. These are all things that are under your control. It’s important to be aware of all of these modifiable lifestyle factors.

Dr. Eric: Is it safe to say that if someone has Graves’ Disease with thyroid eye disease, since that is a common combination, that the triggers will be the same? Whatever is triggering Graves’ is triggering thyroid eye disease. Or do you find that it might be separate? I know it’s difficult to tell sometimes; you can’t always tell. In my opinion, I would say there is overlap. The same factors that trigger Graves’ can trigger thyroid eye disease. In your opinion, would you agree?

Dr. Rani:Absolutely. Even though they may have the same triggers, I want to point out one really interesting clinical pearl, I guess. A thyroid condition, whether it’s Graves’ or Hashimoto’s, and thyroid eye disease, even though they are caused by the same autoimmune process in the body, they don’t always go in parallel. For example, what I mean by that is someone could have a history of Graves’. It may have been a long time ago, like 20-30 years ago that it was treated. All of a sudden, they develop thyroid eye disease. I have seen that in a handful of patients. They are completely quiet from the thyroid side, and decades later, all of a sudden, they develop thyroid eye disease. In that situation, we have to think about these lifestyle triggers, exposures, etc. Why did they flare up?

Or the opposite can happen. Sometimes they can have no history of thyroid conditions and then all of a sudden start developing these unusual eye symptoms. They don’t know what’s going on. Ultimately, they get diagnosed with thyroid eye disease. Their thyroid seems to be fine. It’s functioning fine. They are euthyroid. Then years or even a decade later, they develop the clinical symptoms and signs of autoimmune thyroid disease. They don’t always go hand in hand in terms of the time frame.

The reason I say it’s a clinical pearl is because we are going to be talking about some of the symptoms and signs of thyroid eye disease. If you do experience any of these, be sure to talk to your eye doctor and primary doctor, and maybe get a referral to an endocrinologist. Or vice versa. If you are seeing an endocrinologist or are being managed by your primary care doctor, and you start to have some of these eye symptoms, be sure to ask for a referral to go see an eye doctor. It could be the onset of thyroid eye disease.

Dr. Eric: Why don’t we talk about some of the symptoms and signs? I also wanted to discuss what happens when someone sees you for the first time, like the procedure. Maybe start out by explaining why someone would see you. I imagine it’s more moderate to severe cases when they are seeing you because I know endocrinologists don’t refer every thyroid eye patient to an ophthalmologist. When would a patient usually see you or be referred to you? What is the routine when they initially see you for the first time?

Dr. Rani: The majority of patients who actually get referred to me as a neuro-ophthalmologist or an oculoplastic specialist who also deals with thyroid eye disease is when the condition is interfering with their function. Not just swelling of the lids or redness or dryness, but if there are other issues that come into play. For example, vision loss. That is a big one. If someone starts to have blurry vision, and they actually feel like their peripheral vision is somehow affected. Maybe they have some patchy vision, or their central vision is affected, or if they start to have double vision, that is usually when they get referred to a neuro-ophthalmologist.

Those are the more moderate to severe cases. I think that even the earlier cases should be referred. There are certain things that we can sometimes pick up on an exam that could help explain the patient’s symptoms that perhaps their endocrinologist won’t be able to pick up, or their regular ophthalmologist may not be able to pick up. These are very subtle things that either a neuro-ophthalmologist or an oculoplastic surgeon can pick up.

What happens during an eye exam? This is a great question. When patients come to see me, I tell them to block out half the day. They will be with me anywhere from two to four hours. This is not your regular eye visit. We are doing a lot of testing. We are getting a good feel for what is going on, what level are you at. What do we need to do to protect and preserve your vision?

First, I do a very thorough intake. I want to know not just their thyroid history but their entire medical history. I want to know what medications they’re on. I want to know their diet and lifestyle factors. It does get a bit of time to get all that information in the beginning. That can take me a half hour to 45 minutes to collect that preliminary information.

Then we start with the exam. Of course, we check vision, distance/near, color vision, depth perception (because that is important and can be affected in thyroid), and then we do a test called a visual field test. This is a challenging test to do. You sit in a machine, and the machine is like a white bowl. The machine is automated. It gives you little white dots. When you see the dot, you are pressing a button. The machine is testing your entire visual field, meaning your peripheral vision. This is very important for people with thyroid eye disease. If there is a lot of congestion in the eye socket, their optic nerve may be compressed, and they may have loss of peripheral vision. This will pick up even the earliest stages of optic nerve compression. That is important to do.

I check alignment. How do the eyes work together? Are they aligned? Are they misaligned? For example, is one eye higher than the other? Is one eye crossed in? Especially if someone has double vision, it’s important to do that alignment measurement.

I check their proptosis, meaning are their eyes bulging within their eye socket? There is a metal device that I use. I put it on their bones and can measure how prominent their eyes are. We do this at every visit.

Then we check their eye pressure, which is important because patients with thyroid eye disease can have elevated eye pressure. Some of them are at higher risk for glaucoma, which is associated with elevated eye pressure. It’s important to do that.

Then I check them under the microscope. I see their surface to see if their eyes are dry. I check their glands within their eyelids. I check the front of the eye, their iris, their lens. I am checking them for cataracts, etc. Then we dilate them.

Beyond the dilation, I check the nerve and the retina. We do photographs of the back of the eye. This is very important for monitoring patients. If there is any change, we can pick them up on serial photographs. We do regular photographs of the nerve and the retina. Then we do specialized, high resolution, ultrasound pictures. These ultrasound pictures tell us the health of the optic nerve, whether there has been any damage or not. We also do the retina.

All of that together takes a lengthy amount of time. It gives me the full profile of what is going on with a patient with thyroid eye disease. Of course, I look at their labs. I forgot to mention that. I ask my patients to bring in their labs. If they have had imaging, a CAT scan or an MRI, I ask them to bring me their CD-ROM so I can look at that. I can take a look at their eye socket. What is going on with their muscles? What is going on in the back of the eye socket? Is there any compression of the optic nerve? It’s pretty extensive.

Dr. Eric: I didn’t realize how detailed it was, that first visit. Do they have to come back for a second visit to get the findings explained to them? Or do they get the answers during the first visit?

Dr. Rani: I try to do everything at the first visit. I give them a road map of what to expect. Depending on where they are, if they have very mild symptoms, I may say, “Come back in six months or a year.” If they have more advanced disease, I may have to see them much sooner. In severe cases, I may be following up with them every week or two weeks. In moderate cases, I may be seeing them everythree to four months or so. It just depends on how they come in, where they are in the spectrum of the disease.

Dr. Eric: You also mentioned that you check things such as pressure to make sure that they don’t have glaucoma. Are people with thyroid eye disease more susceptible to developing other conditions such as cataracts, even macular degeneration, which is more age-related?

Dr. Rani: Glaucoma, definitely. If there is a lot of congestion in the eye socket, then the pressure in the eye can go up, just from the congestion. High eye pressure is a risk factor for glaucoma. Many people ask, “What’s a normal eye pressure?” This is in a Caucasian population of mainly men that the studies were done. Normal eye pressure is anywhere from 10-21. That being said, some people have pressures that are higher than 21, and it’s normal for them. Just having an eye pressure that is higher than 21 does not mean you automatically have glaucoma. We take the eye pressure in conjunction with the visual field test and the optic nerve appearance to determine if somebody has glaucoma.

That’s why all of those tests are important to determine is it just an elevated eye pressure, or is the elevated eye pressure putting someone at risk for damage to the optic nerve? It is really important that your eyedoctor should check it every visit. It’s kind of like a vital sign. When you go to the regular doctor, you get your blood pressure taken. When you go to the eye doctor, you get your eye pressure taken.

Dr. Eric: Makes sense. With cataracts and other eye conditions, are they more likely, too?

Dr. Rani: Fortunately, not that I have seen or heard about in the literature. As you mentioned, those are conditions that can happen to anyone as they get older. The one condition that is very common in thyroid eye disease patients is dry eye. It can occur independently of thyroid eye disease, but it can get exacerbated with thyroid eye disease. That is definitely something that your ophthalmologist will check. If you do have dry eye, it should be treated.

Dr. Eric: I was going to ask you about that. You mentioned how you feel that everyone with thyroid eye disease, even the mild cases, should see a specialist. Even if they are suspecting it might just be dry eye, you think it’s a good idea. Is it difficult to differentiate sometimes mild thyroid eye disease from a case of dry eyes?

Dr. Rani: Thyroid eye disease usually causes other congestion on the surface of the eye. We can see that under the microscope. Then there are also lid changes that can happen. Part of the exam as well is to look at the eyelids and see how the eyelids are resting on the eye. With thyroid eye disease, many of your listeners may know that the eyes start to open up. It becomes like a stare appearance. The eyes are wide open like a deer in the headlights. Because there are lid changes that happen where the muscles get pulled and tight and restricted, that alone can also contribute to dryness of thyroid eye disease.

It definitely needs to be treated much more aggressively. If the lids are wide open, let’s say when someone is sleeping, their cornea is not lubricated, they are at higher risk for not just dryness of the eyes but even a corneal ulcer. This is something that is so easy to prevent if it’s diagnosed early enough. Of course, we don’t want to let things go. That’s why I’m saying even patients with milder forms of disease should see an ophthalmologist at least for a baseline exam to see where they’re at, to see what they’re most at risk for, and to address it before it becomes a real problem, before it becomes an ulcer. The worst case scenario is an ulcer that is perforated. That is a medical emergency. We don’t want things like that to happen.

I don’t want to scare anyone. That is the other thing. We are talking about all of these potential things that can happen with thyroid eye disease. Some of these are really in the more advanced cases. We don’t see this commonly. Of course, you want to be aware of them so that you can be an advocate for your own health. If you do think that you have any of these things I’m talking about, definitely talk to your eye doctor about it. Get a referral to a neuro-ophthalmologist or oculoplastic specialist.

Dr. Eric: Thanks for sharing that, Dr. Rani. Before we talk about some of the natural options and things people can do in that active stage, can you talk about some of the conventional treatment options? I also want you to touch upon Tepezza as well.

Dr. Rani: Absolutely. We will talk about the traditional therapies that have been used for the past four to five decades. In terms of the order, the first thing we typically do is if someone is at risk for vision loss, we usually start with steroids. Steroids are not for the milder cases. They are reserved for the more advanced cases. We can give either IV steroids or oral steroids to help with the congestion in the eye socket. Steroids have lots of side effects. They are not ideal. It’s not something that we can use long-term.

In terms of long-term, there are other medications that can be used. Immunosuppressant medications to try to modulate the immune response. Even radiation therapy has been used.

The most exciting development in thyroid eye disease is Tepezza, which is teprotumumab-trbw. Tepezza is much easier to pronounce. This is the first FDA-approved treatment for thyroid eye disease. Steroids are used, but they are not officially FDA-approved. Tepezza is a biologic agent. What it does is targets a particular receptor that gets activated in thyroid eye disease. It targets the receptor for insulin-like growth factor. It prevents a lot of the release of some of the inflammatory modulators. It helps to improve congestion, puffiness, redness. It helps to reduce the size of the muscles in the back of the eye when they get inflamed. It can help reduce the proptosis/bulging of the eyes. It can also help with double vision.

Tepezza has changed the options for patients with thyroid eye disease. It is an infusion, just so you’re aware, that is given every three weeks for eight treatments, about six months of therapy. Usually within the first two to three months, patients notice a big improvement in their symptoms and signs in terms of the congestion and so forth. It may take a little bit longer to see some of the other benefits. For example, the double vision improvement, etc.

Tepezza is approved, but it is not easy for all people to get. The reason is because there are very specific criteria that patients need to meet for their insurances to pay for the drug. It is quite expensive. I don’t know the exact amount of the cost of therapy. I believe it’s well over $200,000 for six months of therapy. Sometimes patients need a second round six months or a year later. That’s why in order for patients to qualify, they have to meet certain clinical indicators for active thyroid eye disease.

Those are the typical standard treatment approaches. Surgery is an approach, which as I mentioned earlier, we usually reserve for the more advanced cases. There are a couple of different surgeries that can be used. Decompression surgery is one. Some of the bone is removed, either from the bottom of the eye socket or the medial wall of the eye socket. That lets the eye fall back into a more normal position. It helps with proptosis, congestion.

There can be a separate surgery for double vision if someone really has misaligned eyes. After some time, they are stable, and their thyroid is stable, but their double vision is not getting better. The surgery can realign the eyes so people can see single again.

There are cosmetic procedures that can be done to put the lids back into a more normal position. If the lids are wide open, there are surgeries to restore a normal lid positioning and improve cosmesis.

There are a lot of options out there. Not one combination of options is right for everyone. You should really talk to your doctor about what is the best option for you.

Dr. Eric: Getting back to the Tepezza. I know that it can have some dramatic effects when it comes to the eye bulging for example. I have had a few patients who had the Tepezza. With the double vision, you mentioned it takes longer. I have seen that, too, where if someone is going through the initial infusions, it doesn’t seem to be as effective. Very small sample size on my part. You probably have seen a lot more patients who have received it. As far as you have experienced, it can help with the double vision, but they might need another round?

Dr. Rani: Exactly. The patients I have seen who have had Tepezza, they had it mainly for their congestion issues. Let’s say they have double vision. If they have a big misalignment, let’s say one eye is up here and one eye is further down, it’s possible it could help to reduce it down. It may not exactly make it completely aligned. It definitely helps to reduce the congestion. We measure double vision in prism diopters. It improves that. Patients may still need to have a special type of glasses afterwards like prism glasses to help with any residual double. Ultimately, they may end up needing surgery. But the clinical studies have shown that it reduces the amount of double vision. It may not eliminate it inall patients, but it will reduce it. It is an indication for using Tepezza as well.

Dr. Eric: Okay. Any side effects people should be aware of with Tepezza?

Dr. Rani: Yes. There are side effects. They are considered mild, meaning not serious adverse effects, but they are adverse nonetheless. The most common ones I have seen are, after the infusion, nausea, fatigue, flu-like symptoms that can happen. Some of the more concerning side effects I have seen, I have had some patients who have had decreased hearing. That appears to be temporary fortunately. That is not something long-term, but it is something patients need to be aware of. Those are the main things.

I know that in the studies that were published on using Tepezza, the studies excluded patients with diabetes. I’m not sure exactly why they did that. I have seen some changes in blood sugar with Tepezza. It’s anecdotal experience. The patient should be under the care of an endocrinologist as well if they do have co-existing diabetes to monitor that.

Interestingly, there are also some reports of, and I don’t know whether this has been published yet, but I have talked to my colleagues about this. Patients who have thyroid eye disease sometimes have other changes in other parts of their body as well. For example, skin changes. I have heard that Tepezza has helped those changes as well. For example, people can get something called myxedema, which is a thickening of the skin in their lower extremities or a change in their skin texture. I have heard anecdotally that Tepezza may be able to help that as well. But that is not the real indication. The indication is eye disease.

Dr. Eric: There are alternatives if someone can’t get Tepezza, correct? As you mentioned, in other countries, it may not be available. There are other biologic agents?

Dr. Rani: Yes. The one that is most commonly used is called Rituxan or Rituximab. That particular biologic agent has been around for a long time. It’s a CD-20 inhibitor, so it’s a type of B cell inhibitor. It’s specific. It helps to modulate the immune system. Rituxan is used for many other conditions, such as other autoimmune conditions. It is more available in other countries. It is fairly safe. It is actually givennless frequently as an infusion. You have one dose, and you have a second dose within two weeks. After that, you have an infusion every six months. It is an indefinite treatment. Not like Tepezza where it’s six months and you’re done. It’s indefinite.

Dr. Eric: Let’s go ahead and discuss the natural, alternative options that people have with thyroid eye disease, especially in that active stage.

Dr. Rani: I am a strong believer that you can do a lot through your nutrition and lifestyle choices to help improve your autoimmune condition. This is very true for my patients with thyroid eye disease.

My first intervention is diet. First of all, I have them do a diet history and remove any pro-inflammatory foods that they have commonly. For example, initially, I do have them remove all gluten and dairy. You probably do the same, I’m guessing, because we are trained very similarly in functional medicine. Those are the two most common inflammatory foods that can trigger autoimmune disease. I usually tell them it’s difficult to do this, but I really want you to try to stick with this diet for three months. Some doctors will say three weeks, but I say three months because in three weeks it will hopefully decrease your IgG load. But the cells that create those IgGs, the T cells and the B cells, they live up to three months. If you really want to reset your immune system, do it consistently for three months.

Also, I use in my practice a specific diet that was designed by the Institute for Functional Medicine called the Renew Diet. It is an autoimmune diet that has certain other foods you are supposed to eliminate. The one class of foods I have found most important for these patients to eliminate are nightshades. I don’t know whether you have a similar experience as well in your practice. I do have quite a few patients that once they eliminate things like tomatoes, potatoes, eggplant, and peppers, they start to stabilize. If they accidentally have a little of it, they notice immediately that their disease is flaring up. They know their body is reacting to some compounds in those nightshades. I know it’s quite difficult to do because some of these vegetables and fruits are so pervasive in our foods that we eat. Most of us love these foods. But it is important to see if you are one of those people that reacts to nightshades. Do a trial. Eliminate it for, if you can, not just a couple of weeks but up to a couple of months and see how you respond to that. That is my first line of treatment.

I also use supplements and botanicals. In terms of supplements, the most important things are the anti-inflammatory supplements like Omega-3s, Vitamin D, and curcumin, which is turmeric. You can either have it as a spice with your food or take it as a supplement. Those are my top three for thyroid eye disease.

Of course, selenium. There is a European study that showed that selenium supplementation at 100mcg twice a day can be very useful. It can take some time to work. Don’t expect an immediate response. Some patients take it for a month or two and say, “it didn’t do anything, so I stopped taking it.” I tell them you have to take it for a good three to six months to see the benefits.

Dr. Eric: I do agree with the nightshades. I do have patients stop eating those as well. I also agree with Omega-3’s, Vitamin D, selenium, and turmeric/curcumin. They can all help with inflammation.

How about glutathione? Selenium is a co-factor for glutathione. Do you find taking NAC or liposomal glutathione to be beneficial at times?

Dr. Rani: It’s not my first line of therapy. But those agents, glutathione, NAC, and lipoic acid are all very potent antioxidants made by our bodies. We also can take them as supplements. In cases where patients are not responding, or if they continue to have worsening disease, I may add one or two of those into the regimen. They definitely are good for overall health. They are antioxidants, and they can help fight inflammation. It’s not my first line of therapy.

Dr. Eric: Being a functional medicine practitioner as well, I assume you also agree that it’s important to optimize the health of the gut because you need a healthy gut in order to have a healthy immune system.

Dr. Rani: Absolutely, yes. The gut is the cornerstone of functional medicine therapy. You want to promote gut health because in our gut resides a lot of our immune system. If you can decrease the activation of our immune system through the gut, promoting a good gut microbiome, you can decrease the immune system’s predisposition to getting ramped up and causing autoimmune disease.

I do recommend that patients have probiotics in their diet. Live probiotics, prebiotics, but also perhaps take a supplement as well. When I do recommend supplementation with a probiotic, I recommend cycling through it, not just to take the same probiotic all the time, but maybe every week or two weeks, cycle through two or three different brands, different strains of probiotics that you’re taking. Of course, make sure you are getting them in your diet as well. Lots of probiotic foods, fermented foods.

On the flipside, they can maybe trigger an autoimmune response in some patients. You have to see how your body is going to react to that in terms of live probiotic foods. I don’t know what your experience has been with patients with autoimmune thyroid condition and maybe even thyroid eye disease. You have to be a detective and find out if your body is going to react to something or not.

Dr. Eric: Definitely agree with that. How about the impact of stress, the role of stress management, as well as getting proper sleep?

Dr. Rani: So important. These are basic foundations of health. I have to keep emphasizing to my patients: How are you doing with your stress? What are you doing for stress relief? We all have stress in our lives. That is a normal part of our lives. We have to learn how to modulate that stress.

I will give you a perfect example of a patient of mine. This was a woman I started seeing over a year ago. She developed thyroid eye disease during the pandemic. She was completely fine, and all of a sudden, she had horrible swelling, double vision, dryness, etc. It turned out that during that time of lockdown, her daughter had come to live with her. They were living together. They had a lot of friction between the two of them. She was constantly fighting with her daughter. She believes this really triggered her stress. It’s unfortunate that this happened.

Then she made the decision to go visit her son, who lives out of state for six months. It was also a change in climate because she moved from New York to New Mexico for six months. In doing that, she was able to improve her stress level. She was exercising regularly in addition to that. She was eating the right foods. She was on the Renew Diet plan I mentioned earlier. She was taking the supplements. In doing that, she was able to put her body into a different state that was less inflammatory.

When she came back to New York, and she was back with her daughter, she was able to manage it better. She really attributes this sudden onset or development of thyroid eye disease to the stress in her life, both from COVID and from her home situation. She was able to modulate that. Just as an example of how stress can impact us. Little things that we can do to manage it are important.

Sleep is really important, too. I had another patient who I have been seeing for a very long time. She is actually a judge, so she has a very demanding schedule. A lot of stress in her life. She was barely sleeping, maybe four or five hours a night. That was impacting her health. Once she improved her sleep regimen, her habits, her sleep hygiene, she also started to meditate. That made all the difference for her in terms of being more at peace, more at ease in her stressful job. Her overall health improved as well. She had been on blood pressure medications. She was able to reduce her dosage. All of these lifestyle factors can improve not just your thyroid status, but perhaps many other aspects of your health as well.

Dr. Eric: Thank you so much for sharing those examples. I imagine anyone who has thyroid eye disease has found this to be really helpful. Before we wrap things up, a few things that I want to mention.

First of all, Dr. Rani and I had a masterclass earlier this year. If you want more information on how to improve your health when dealing with thyroid eye disease, that is something you might want to check out. Also, by listening, you could get 50% off. There is a code that you will need to enter.

Also, Dr. Rani is coming out with some books. We are recording this in December 2021, but in 2022, you’re coming out with not one but two books, correct?

Dr. Rani: Yes. I have been working on these books for the past three years. It’s taken a while to come to fruition, but I’m excited about them. One book is called Best Foods for Eye Health: A to Z. In this book, I go through all the nutrients we need for our eyes, for prevention of dry eye, cataracts, glaucoma, macular degeneration. I go through the nutrients we need and the foods that supply those nutrients. I have recipes in there as well.

The second book is a book on macular degeneration. It is very near and dear to my heart. I see a lot of patients with macular degeneration. I myself am at risk for macular degeneration because I have a gene for it. I am going to do everything I can to prevent vision loss. That is through nutrition and lifestyle. My book addresses functional, integrative approaches you can use, practical tips you can use, to decrease your risk for macular degeneration. Thank you for letting me share that.

Dr. Eric: You’re welcome. I assume they can visit Amazon to purchase them.

Dr. Rani: Yes, when they are out, they will be available on Amazon and Barnes & Noble, or you can visit my website, too. If any of you have taken on a project like writing a book, you know it is a long journey. This is something I poured my heart into, so I’m really excited about both of these projects.

Dr. Eric: As an author myself, I am excited for you as well and can’t wait to read them. Your website, what is it?

Dr. Rani: It’s my full name, www.RudraniBanikMD.com. I have a lot of blogs on my website. I talk about all kinds of eye health topics. As a neuro-ophthalmologist, I treat a lot of migraines, so you can find a lot of hopefully helpful information on migraines through my website.

Dr. Eric: Wonderful. Thanks again, Dr. Rani. As usual, it was great chatting with you. As I mentioned, I’m sure those with thyroid eye disease and even people without thyroid eye disease, because a lot of what we mention can also help people with other autoimmune conditions, too. Talking about some of the supplements and gut health. I’m sure everyone with thyroid eye disease found this to be valuable. Thank you again for joining me here.

Dr. Rani: It was my pleasure. Thank you so much.

Recently I interviewed Bridgit Danner, as she discussed toxic mold in detail, including some of the common symptoms, how to test for mold, the different treatment options, and how it relates to Graves’ disease and Hashimoto’s thyroiditis. If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:

With me, I have Bridgit Danner, and we are going to discuss toxic mold. Bridgit has been a licensed acupuncturist since 2004 and a certified functional diagnostic nutrition practitioner since 2015. After losing everything to toxic mold, Bridgit now educates about toxins and how to detoxify through a functional approach. You can find her at BridgitDanner.com and on Instagram @bridgit.danner. Welcome, Bridgit.

Bridgit:

Thanks, Eric. I am always happy to connect with you.

Dr. Eric:

Same here. Of course we have chatted many times in the past. For those who are not familiar with you, could you give a brief background?

Bridgit:

Sure. Unlike many health practitioners, I didn’t get into health because of my own health. I got into it because of my mission and my cause. I was a young environmentalist. I had this interest in natural medicine, and I thought it could be a great way to teach people to be more environmentally conscious. That is how I decided to go to Chinese medicine school. Then I opened a practice in Portland, Oregon, doing the normal things: treating back pain and stress, and all the things an acupuncturist does. I did a little bit of stuff around environmental awareness, but I lived in Portland, which is a very aware city, probably one of the most in this country for sure.

Then I developed my own environmental illness and didn’t know it. I was undiagnosed from toxic mold for 7-8 years. I was going through all the symptoms we will discuss later: fatigue, anxiety, hormonal issues, a lot of immune issues, chronic pain. I was learning about health trying to resolve my own health. I did really focus on some environmental threads, like toxins in my home and skin care. I completely revamped my diet. I was making my own bone broth. Super healthy. I was never quite getting better. I was always cycling in and out, worse in the winter. No surprise now.

When I eventually hit a health low, I was getting some IV therapy at a naturopathic clinic, and they asked me what changed in my home. We opened up the possibility that there could be mold in the home. Did testing. My family started on the journey of resolving mold in our bodies and our home. That influenced my practice, too. I was so passionate about detoxing and knew so much about it. I was focused on women’s hormones, but I slowly morphed it to talk more about detox. Now especially to talk about mold. As I was going through it, I didn’t have the energy to teach about mold or share, but now, on the other side of it, I have a lot of knowledge. I am trying to spread awareness that it’s not as uncommon as you think. If I can save someone four years in the journey or even one month on the journey of questioning if you have toxic mold illness, I am happy to be able to do it.

Dr. Eric:

It’s safe to say that mold is commonly overlooked. I have worked with a number of patients where mold wasn’t on their radar. Honestly, initially, especially years ago, it wasn’t on my radar either. When someone is not getting better, that’s an area you want to look at. With you, you probably now evaluate people right away when it comes to mold and looking at their health history.

When it comes to symptoms of toxic mold, can you talk not only about the symptoms you experienced, but some of the more common symptoms in general?

Bridgit:

Like thyroid illness, it’s a long list, and there are a lot of overlaps. That’s tricky. The two most common are brain fog and fatigue. Because it’s inflaming the entire body, we all have different weak and vulnerable systems. For one person, it could be a lot of respiratory stuff. For another, it could be mood. For kids, it could be attention or behavior issues. I never did have skin issues, but some people do. Digestive issues that won’t resolve, there is often a mold piece. What you said is true, Eric. If things aren’t responding, as you change your diet, take supplements, meditate, ding, ding, ding. There is probably some kind of toxic element going on. It’s a long list.

Some of my earlier symptoms probably aren’t the ones that a practitioner would think sounds like mold. The hormone ones are key. I was having spotting and off periods. I don’t even think there is so much association between that and mold, but there is a huge association. For a typical client, like I was, I was about 40ish when I was seeking help. You say, “I’m tired. I’m anxious.” They say, “You’re just a typical American woman.” Sometimes it gets overlooked because there is such a constellation of symptoms out there.

Dr. Eric:

Even the common symptoms you mentioned, like brain fog and fatigue, there could be overlap with other conditions as well. If someone is experiencing those symptoms, they initially wouldn’t think they have mold. Neither would practitioners. To be fair, most people will have symptoms other than brain fog and fatigue, too.

Bridgit:

I would say severity, inability to resolve them. If we open the conversation to environment, there is usually some suspected source. Not all the time. Sometimes we don’t know it. I was in my own house a long time with no suspicion. There has to be that awareness piece. We are trying to develop a mold quiz. It can’t be a symptom quiz. We can’t just say, “You’re tired. You’re having acne. You have mold.” It has to be the home or some source although it can be in your past plus the symptoms. In a way, it’s a bit easier. As you get in testing, we know what we’re looking for in the home and body to go with the symptoms.

Dr. Eric:

Why is mold toxic to some people and not others? At least it seems that way. There are four or five people in the household, and only one is sick due to the mold.

Bridgit:

This is a great question and why I think mold can get overlooked or downplayed, especially within a family unit. If the husband is fine, he may not want to rip apart the house. It’s health history, genetics, age, infections, chronic stress. I know you know about Lyme. Same with Lyme. We all get bit by different bugs, and we don’t all end up getting Lyme if we are potentially exposed. Some people get it really severely. Maybe it’s dormant and it comes out later when there is more stress. Lyme and mold have quite a bit of correlation as does thyroid conditions.

I don’t know if you know Jaban Moore, a functional chiropractor. He feels he was exposed to Lyme as a child. He lived an outdoors lifestyle. Later when he was in a moldy basement apartment, that is when his Lyme started to manifest. It can weaken your immune system, which is when you see other potentially latent infections. It’s a cocktail. It’s about how you detoxify genetically.

Are you pooping? If you are not pooping well, then you are recirculating toxins back in that you are meant to be pooping out. That could be a factor. How you eat, how you practice lifestyle. In my own case, and other cases I have seen, you can keep things somewhat at bay, just by having rockstar habits. It ultimately worked, just like it didn’t with me. I got some improvement by making all these changes, but I was still in a moldy home, so I was never really going to be able to kick it.

There are some genetic tests you can do about how well you make glutathione. They play in, but I still don’t think they are the only factor. I had a mother/daughter client. They were in the same home, the mother more so because the daughter was grown and had come in and out, but the mother had the dreaded gene for mold. The daughter didn’t. The mother’s levels were much higher than the daughter’s. But there are other factors, too. The mother is in her 70s. Sometimes genetics can show that you’re not clearing it very well. Even if you don’t have all the genetic predispositions, you can still be affected because chronically over time in a home, at first, you’re clearing it, but eventually you may lose the battle, and you’re not clearing it so well anymore.

Dr. Eric:

I agree. I’m glad you mentioned it’s not just the genetics. That does play a role. Even with my history of Lyme, there are biotoxins and mycotoxins with mold. Genes do play a role. With my history of Lyme, it wasn’t too severe. Did I do a better job of clearing some of the biotoxins? I was also diagnosed with Graves’ years ago and have been in remission and was taking care of my health, so maybe that’s why I wasn’t as symptomatic when it came to Lyme.

Same thing with mold. We will talk about addressing the cause of the mold. If you’re living in a moldy environment, the combination of the genetics and lifestyle factors will play a role, but you need to eventually get rid of the mold and remediate.

Let’s talk about some of the common ways we are exposed to mold first.

Bridgit:

The most common way that will make you really sick and symptomatic is being in a water-damaged building. There has been a roof leak, a plumbing issue, a ventilation issue. I interviewed one expert recently who said 100% of crawl spaces are moldy. Certainly not every house has a mold problem. It’s relative to your health. Pretty much every building will sustain some kind of water damage in its lifetime. How well you respond to that water damage is key. If you half-ass the job to remediate it, or whomever you hire does, that can linger. Maybe there is still some drip or humidity behind the wall. A lot of this is good home stewardship, which is not something I was aware of when this was going on for us.

We had our gutters not draining correctly. Some previous owner had done a lot of remodeling, putting in new additions that were not done correctly, so there was moisture in the walls. Nobody came to our house and thought it smelled or looked moldy. Potentially in humid climates, any time there is extra moisture, whether it’s from a leak or humidity, it can allow for mold to grow. It’s around.

Not all mold is dangerous. Not that much of it is super toxic. But in our indoor environment, it’s artificial. It’s not like the forest, so there is not correct competition or breakdown. It allows certain species that are dangerous to thrive. They are quietly thriving in the corner of your bathroom, getting picked out from the air circulation system. That’s the most common. Managing the humidity in your home. We had too high of humidity in our basement the entire time, and we had never run a dehumidifier. It was lack of awareness.

There is mold in food as well. It’s pretty common. It’s not usually the main factor as to why you get sick. The quantity usually isn’t enough. It can be something that can irritate you as you’re trying to heal from mold. It can irritate your digestive system. Some of the labs that do a lot of mold testing haven’t really found some widespread high levels of mold in your body based on food source.

Dr. Eric:

It’s mostly in the air. You brought up some good points about just because you can’t see the mold does not mean you don’t have a mold problem. You mentioned the crawl space. It could be under the floors or behind the walls. You can’t just go by whether or not you see mold. Some people will swear they don’t have a mold problem. But if you are not an expert in detecting mold, there is no way to know.

My next question is about testing. What do you recommend? Do you recommend having an indoor air specialist come by? There is micrometrics to order your own test kits. There is testing for microtoxins, which is completely different.

Bridgit:

It depends on your situation. Do you rent or own? You are not going to hire a mold inspector if you rent. It’s costly. If you own, I do think you should hire a reputable mold inspector. That’s a good first step. They will point out possible sources, like a moisture meter to notice moisture in the walls. They will notice the gutters aren’t draining correctly. They can do drywall and air samples. Not all of them are as good as others. Ours was good.

Be aware they are not health experts. They are passing off the first piece of information to you. It’s on you then to make next best decisions and get informed. We were not informed enough when we started taking our house apart, and we made it worse. Hopefully you will get some of my information before you do that, as it costs you a lot of money to make mistakes in the process.

You could also have mold in your workspace, your RV, a boat, anywhere you’re spending time. Sometimes starting with the mold plates, which are measuring more for mold growth rather than mold toxins that mold emits, that could be an affordable first step, and you could put them in various places. I interviewed someone about this recently as well. You don’t want to put it where you spend time, but you want also to put it in a basement and different places. Say it’s a workplace. You could do a couple plates there. They’re affordable. They will do a consultation with you. None of the ways are perfect though.

You mentioned the mycotoxin dust test. You can order it yourself. I like it because it’s testing for the part that is actually dangerous. As a practitioner, I like seeing that. It’s a little spendy, but it’s a pretty easy test to take. We did that in our own home.

The ERMI , or a cousin to that, I forget the name of it. This is a test that was developed for other purposes. Now it’s used a lot to see if there is toxic mold in the home. This also has some problems. If you ask me, not all of the types of mold are toxic. It’s measuring overall load. Some building inspectors do like it because they know how to interpret it. Sometimes the public buys it, and they don’t know how to interpret it. If you will self-test, there is not an easy answer. You might want to do a self-test, and some things are positive, which is when you know it’s time to get an expert opinion. Just like with a body, we can potentially miss things in testing. It’s good to know all your options so that you can test correctly. Sometimes it will take a couple tests in the same space. Really good mold inspectors will bore into the wall to get an air sample in there. Home testing can be really good and accurate, but know that you’re not done after an Ermi. It takes more than that.

Dr. Eric:

I agree they shouldn’t spend thousands of dollars on hiring someone and remediating because who knows how long they’ll be there. It’s worth asking the landlord. They may not do anything, but you never know. Sometimes they might. In that case, let’s say if the landlord isn’t willing to do anything, and someone is renting, would you recommend doing mycotoxin testing?

Bridgit:

Let’s say you’re renting, and you do see the floorboard is soft, and there is some visible mold by your bathtub. Bring that up to your landlord. “Hey, I know this could be dangerous to our health. If we get this resolved, I want it done correctly.” It’s often trying to get these things done cheaply when you are a landlord. You could potentially ask to test. Ask for the right kind of remediation. Be aware what that even is. Otherwise, if you don’t see anything visible, you may want to do a plate test or mycotoxin dust test. I wouldn’t say the landlord is going to pay for that right out of the gate. If you have that information, you could ask the landlord, “I suspected this. I did this testing myself. This is what I’d like to propose.”

Or maybe you want to break your lease. Over time, our rights will get stronger around this stuff as renters. It can be a big mess. Sometimes it’s better to move. Even our own home, and how much money we put into it, we didn’t stay there. It can be hard to thrive in the same space. Sometimes it’s better to move. But there is some home testing you can do as a renter. Or start the conversation with your landlord, and hopefully they have a good attitude about working with you.

Dr. Eric:

How about testing your body for mold?

Bridgit:

In the olden days, so to speak, not that long ago, they would run blood tests for different inflammatory markers and base that on they think you have mold. Now we do have a urine test for mycotoxins. It can potentially also get a false negative if you are not pushing out mycotoxins into the urine. I think it’s pretty rare. We see a lot of positives. It’s a pretty nice, easy at-home test. They are straightforward. They will tell you the type of mycotoxins, which will tell you the type of mold. It’s not necessarily a huge factor in your treatment, but it’s helpful to know. You could focus some binder treatment on different types of mycotoxins. We are lucky we have that now. It’s getting a little cheaper over time. That’s a great way to see the burden in your own body.

Dr. Eric:

I think you’re familiar with the visual contrast sensitivity test. Do you have any thoughts on that?

Bridgit:

That’s another early test. It’s not only for mold; it’s also testing for some other toxicity affecting your brain and visual abilities. You can do them at a clinic and sometimes online. My ex-husband and I both did it when we knew we were sick, and we both passed. It wasn’t accurate for us. That is my own experience. If you can do it for free online, it could be fun and helpful, but I wouldn’t personally rely on it. Maybe the ones in the clinic are more accurate. Maybe he and I were healing, so it wasn’t as bad. I was disappointed personally.

Dr. Eric:

I don’t know if this is true. I’ve heard different ones are more accurate than others. Surviving Mold, Ritchie Shoemaker’s test, is supposedly more accurate than others.

Bridgit:

That’s the one we did.

Dr. Eric:

That’s what I heard. I’m not sure how that differs from others. You did it, and it came back negative when mold was an obvious issue. It’s not specific for mold. Even if it’s positive, it doesn’t confirm that someone has a mold problem.

Bridgit:

He’s a real trailblazer in this space. We wouldn’t be having this conversation if not for him. There are some limits on what was available. He was a physician, so he did a lot of prescription-based stuff. This field is changing a lot quickly, and we are learning a lot of great stuff. A lot of people ask, “Do you do these blood tests?” There is no point anymore for the most part. Some practitioners still do them because they can take insurance, and it’s covered. Some of those markers are interesting to watch for inflammation and how it’s changing as you do your treatment. But they are not mold markers. There is only so much money we have for all this testing. You should put it in the most effective places.

Dr. Eric:

Agreed. Can you discuss how toxic mold can play a role in thyroid health and thyroid autoimmunity?

Bridgit:

When I ran my first mold event, there was some hurricane in Texas four years ago. I wanted to do a mold event, so people know if their houses are getting damaged. I couldn’t believe how many people wrote in saying, “I have Hashimoto’s and mold.” I found out I had Hashimoto’s markers at a low level probably two months before I found out I had mold. I am in remission now. It’s pretty common.

I don’t know about Graves’, but I see a lot of Hashimoto’s along with mold. It’s contributing to developing autoimmunity. It wrecks the gut. It’s hard on the liver. It makes the liver not function as well. It burdens the liver as a place of thyroid hormone conversion. If you don’t have autoimmunity, you could often still have poor conversion. Top down poor thyroid hormone production because it inflames your HPA axis. For me, for my female hormones, there was constant suppression of hormones being produced. There can be different hormonal patterns for everybody. Insulin can also be affected. Low thyroid, Hashimoto’s, pretty common with mold.

Dr. Eric:

I do see it with Graves’ patients, too. It definitely has an impact on the gut, as you said. We both know that not just Graves’ and Hashimoto’s, but all autoimmune conditions, most of the immune system cells are located in the gut. You need to have a healthy gut to have a healthy immune system. With any autoimmune condition, it could be a factor then. But I mainly focus on Graves’ and Hashimoto’s, I could say yes, with both. I see a good number of people where toxic mold is an issue.

Bridgit:

Food sensitivities can be another possible sign that you are dealing with toxic mold. What are they? What’s going on there? It’s some immune disruption, mucosal barriers damaged, leaky gut, inflamed gut. That has come up more lately when I talk to other experts. That’s another potential hidden sign of mold. You can barely eat anything without being irritated.

Dr. Eric:

Let’s get into treatment options for toxic mold. Which ones do you recommend?

Bridgit:

This is a happier part of this interview; there is a lot you can do. Definitely deal with your home. It’s not just your home anymore. Now the mycotoxins are in your clothing, your books. It depends to the extent of damage in your home. It’s hard for me to say without being involved in it, but for us, we lost everything inside the home. We couldn’t keep any of it. It was many years of being infected. I am going to go into body treatment, but just know that we moved to a temporary home and brought a normal amount of stuff: some clothes, etc. We ruined that temporary home in a matter of a couple months. Be careful that it’s not just your body; it’s being aware of what environment is following you as you move on. That’s important.

Sauna helped me a lot initially. Exercise, even when you are tired, you need to move your lymph. It’s important for your brain and detox to keep moving. Coffee enemas, I still do some of them for maintenance. I think they’re amazing. Dry brushing, I almost did every day when I was sick. It moves your lymph and energizes you and gets your circulation going. Epsom salt baths, easy thing you can do to support detox. Mini trampoline, something you can do throughout the day. Lymphatic massage, you can do.

A lot of this stuff is mobilization. It seems to work. If you are really sensitive and are not pooping, detoxing, some of these mobilizations could be giving you side effects. You have to measure how much mobilization you do versus how well you are detoxifying. Find that balance.

For supplements, binders are important. We can talk more about those. Glutathione, if tolerated, is helpful. Broccoli seed and sprout can be helpful. That pathway is important for detoxifying mycotoxins. Taking electrolytes is supportive. CoQ10, I like. Fish oil in high doses, especially if you are having trouble with your brain. Fiber supplements, I like. They can help heal your gut and brain barrier. Probiotics. Taking a multivitamin, getting those basics like Vitamin D and magnesium. Those are some of the core supplements.

From there, you may have to work on different body systems that need support. If you’re not pooping or not sleeping, working on different symptoms will still help those systems function correctly.

Dr. Eric:

Do you use binders such as zeolite, bentonite clay, activated charcoal?

Bridgit:

I use all of those. You can cycle different single ones. The citrus pectin can be a gentle one if you don’t tolerate charcoal. We mostly use ones that are a blend. I developed my own blend. Different mycotoxins respond to different binders. Sometimes having a blend is helpful for covering a lot of bases. There are different options for how you want to use them.

Dr. Eric:

How important do you think it is to have an air purification system in your home?

Bridgit:

I think that’s a good idea once you’re in a safe home. It’s a $1,000 mistake to buy one of those and put it in your moldy home. You won’t be able to bring it to your new home. We made that mistake, and I still hear other people make it. It will go in the machinery of that thing so you can’t bring it with you. Later, when you are in a safe place, change your home air filters often, the ones attached to your furnace system. Clean often. Keep dust under control. Make sure that your humidity is right, your drainage is right.

You don’t want to move into a permanent home right away because we are very sensitive, and we sometimes accidentally move into a place that has mold. You want to keep it a little loose for a year or two, especially if you are coming out of a major situation. I hear about it all the time.

Don’t invest super heavily into all the bells and whistles until you know you’re in a safe place. Open windows. Keep a clean home. Don’t buy toxic products to put in the home. That’s important. Up your game on building materials and rugs. Now you’re probably just sensitive to everything in the air. That’s how I became. You have to be on guard for air quality in general.

Dr. Eric:

When you were treating yourself for mold, I know not everybody has access to a sauna or would be willing to do coffee enemas, but how frequently did you do those two things?

Bridgit:

Sauna, you can do up to every day. You can now buy a pretty cheap home sauna thing. Don’t stick that in your moldy home and move it to your new home. We went to gyms; it’s different now. I was using saunas at a gym at least three times a week. But every day is even better if you can tolerate it. You can get a home unit or go to a gym.

Coffee enemas. I’m not a fan of doing them every single day because they can be rough on your tissue to do so often. But two or three times a week when you’re sick. I do one a week for maintenance. I find it to be a real quick win for me energy-wise. The coach who works for me, she does a binder enema if she goes into a moldy building, so that’s a cool option.

Dr. Eric:

Thanks for sharing. I’m glad you mentioned it because I didn’t think about getting a sauna in a moldy environment where you wouldn’t be able to bring it to your new place.

Bridgit:

You could put it on your porch or something. But that is one of the big mistakes people make. It’s logical. You think, “I’m here. I’m still here for some amount of time. Let me get this expensive air doctor.” But it’s ruined now. The way that mycotoxins work is they can adhere to plastic and fabric and get into motors and screens. That stuff is pretty much impossible to clean. Just be aware. It’s a sucky time in life when you are moving out and trying to move on, and you have all this stuff you can’t bring. It is not fun at all to be that careful and paranoid. But in the end, it’s usually what most people need. If you really have been quite exposed, as has your stuff, being loose with what you take with you will often come back on you. When you have to get rid of all it, you will be more depressed. If you’re listening, hopefully that just saved you some money.

Dr. Eric:

The last question I want to ask you is if you could give someone some action steps they would take if they are suspecting they might have mold. Relisten to this because you spoke about it. But if you could summarize and give a few action steps.

Bridgit:

Education is an important first step. If you are thinking maybe you do have mold, you can start perhaps with some kind of home testing. Getting some of those plates are quite affordable if you want to start with that as a renter or owner to experiment. We have an e-book on our site that links to different companies and helps you make a decision on home testing.

You could also do a home inspection for signs of moisture. I will refer people to our website to our free mold guide. You could visually inspect for possible intrusion. You could buy meters at Home Depot that can measure some things. Starting with some simple testing of the home. Then maybe some more advanced testing in the home. Body testing.

Unfortunately it’s a long process. It’s not simple. Some of the detox stuff I mentioned, anybody can do. If you’re not sure if you have mold, but you are feeling sluggish, can’t lose weight, I think everybody should be detoxing all the time. I haven’t stopped because I’m not in a moldy house. This is part of modern life. You need to detox all the time and make it part of your lifestyle. If you’re using red light therapy or jumping on your trampoline or getting out in nature with friends, this is critical. None of us are going to escape fatigue and early aging unless we get a sense of it.

Dr. Eric:

Thank you for sharing everything. The good news is you have some resources coming out. You have an upcoming summit focusing on toxic mold. You have a book coming out. They can visit your website BridgitDanner.com. Can you also talk about your upcoming book and summit?

Bridgit:

The summit starts on February 21, 2022. It’s free. It’s a week of different expert interviews. We had everybody do a slide presentation, so it’s detailed material. We talk about the home and the body and other ways to detox your home. That will be an evergreen free event.

Click Here to register for the Toxic Mold Masterclass

My book is coming out around April 1. You can buy it through the summit, too.

I’m excited to have more resources so more people find out sooner. The education is super important as you go through the process so that you can go through it as efficiently as possible. We are trying to make a lot of affordable info as people deal with it.

Dr. Eric:

Thank you for sharing your experience with toxic mold. I’m sure everyone listening has some knowledge themselves to go out and learn some more if they are suspecting toxic mold. They now have an idea of what to do next. Also, they will hopefully attend your upcoming summit and read your book.

Bridgit:

Step by step. You don’t have to do everything at once. Do a little bit. If it’s needed for your family, it will be important, and it will pay off. Thank you for having me. I found out about my own thyroid issues through learning about mold. It’s so important, the work you’re doing as well.

Dr. Eric:

Thanks again, Bridgit.