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.

Recently I interviewed Margie Bissinger, as we chatted about bone density and thyroid health, and below is the written transcript. If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky: With us, we have Margie Bissinger. We are going to be talking about healthy bones, how to improve bone health. As usual, I am going to dive into Margie’s bio. Margie Bissinger is a physical therapist, integrative health coach, and happiness trainer. Margie has over 25 years’ experience helping people with osteoporosis and osteopenia improve their bone health. Margie is the author of Osteoporosis: An Exercise Guide. She oversees all of the osteoporosis initiatives in the state of New Jersey as a representative to the New Jersey Interagency Council on Osteoporosis. Margie also teaches an online six-week program, “Happy Bones, Happy Life” to give people the tools to naturally achieve optimal bone health. Margie is the host of the Happy Bones, Happy Life podcast and the“Natural Approaches to Osteoporosis and Bone Health Summit.” Thank you so much for joining us, Margie.

Margie Bissinger: Thank you so much for inviting me. I’m so happy to be here.

Dr. Eric: Same here. Glad that you could join us. Why don’t we start out by giving your background? How did you start helping people to improve their bone health, to have happy bones and a happy life?

Margie: It was really interesting because I’m a physical therapist. My area of expertise is orthopedics, working with people with back pain, neck pain, head and neck TMJ. Then I moved from Chicago to New Jersey. I was working in my own private practice as a physical therapist, and a group of doctors asked me if I would see their patients with osteoporosis. This was way back. There wasn’t even a lot at that point in time. I said, “Sure.” I was absolutely mortified by what I saw. I was so upset because well-intentioned individuals, the doctors said they had to exercise, but they didn’t have guidance. They didn’t know where to go, or they didn’t get specifics. They had no idea. They found exercises through books or magazines or their trainer, and they were doing exercises that increased their risk of fractures.

At that point, I got really involved at the state level, the national level. That’s when I wrote my book. I need to get involved here because people need guidance. That is what got me started.

Fast forward, I had a son who had diabetes. I saw how food played such an important role in his condition. That is when I went back to school to study nutrition and became a health coach. I have always taught my patients happiness. There is a real correlation between happiness and chronic pain. The same thing with osteoporosis. That is how I got to do what I do.

Dr. Eric: Why don’t we jump into some of the common causes of osteopenia and osteoporosis?

Margie: For women especially, it’s menopause and the reduction in estrogen. As people age, they lose bone density. People think this is an older person’s issue. It’s really every age because the more bone we have—it’s like a bank as a kid—the more we can draw on later. There are lots of root causes. You’re big into this. All sorts of things. If there are certain medications, malabsorption, any problems with the gut, people aren’t getting their nutrients. They can have micronutrient deficiency. That’s a big one that I see.

Also, in terms of environmental toxins, stress, inflammation. When people have inflammation chronically, it’s going to affect their bones. This is something missed. There are so many underlying root causes. People are treated with a Band-Aid and not looking at these underlying causes that need to be dealt with in terms of a person getting better, really improving their bones and overall health. Also, people who are inactive. That is so common today, where people are sitting a lot. Certain medications. Thyroid, too. That’s your area.

Dr. Eric: We’ll definitely talk about the thyroid. How about medications? What are some of the common medications? PPIs are one of them.

Margie: That’s a big one. So many people are on PPIs, proton pump inhibitors. That’s the Nexium, Tums, anything blocking the acid. There are studies that show that people who are on these medications that block the acid actually have a significant increased risk of fractures and osteoporosis. There is a big correlation. We need that stomach acid. So many people are on that. It was never meant to be long-term. People need to know about this. If they are on these, don’t just get off them; work with your healthcare provider. But there are alternatives.

Even if you had to be on an acid-blocking medication, which some people do for ulcers, there are different ones such as the Tagamet and the Pepsid that don’t affect the bones. PPIs are a big reason. So many people are on them. People know about this.

The one that is so interesting, and people don’t know about, are anti-depressants. It’s not something the doctor will typically say, “I’m putting you on this anti-depressant. Just so you know, one of the side effects is reduced bone density and increased fracture risk.” It’s not usually talked about. The SSRIs, anything dealing with the serotonin, is going to affect bone density. They have done studies on that. That is really important to know. A lot of people are put on them, and they feel better, so they stay on them. That can significantly reduce their bone density and increase their risk of fractures and osteoporosis. That’s a big one.

Another category is any of the steroids, like corticosteroids that people are on, for asthma, inflammation, different things. Even a shorter-term dose of that can affect your bones. For cancer treatments, the aromatase inhibitors as well. There are more categories.

We can talk about thyroid. What happens in the bone is there are two things going on. It’s like build and repair. The bone we have doesn’t just stay there. What our body does to keep our bone nice and healthy is it gets rid of old bone and adds new bone. It throws away the old bone and builds new bone. What happens when there is too much thyroid hormone, or hyperthyroidism as you all know, is that it overdoes it. It gets rid of the osteoclasts; those are the breakdown cells. There are too many breakdown cells, so it offsets the balance. We’re breaking down most bone than we’re building up. That is a big one where if it’s not managed correctly, this can really affect bone health. Even if people have hypothyroidism, and they are taking too much of the medication as well, that can affect your bone, too.

Dr. Eric: Good points. With hyperthyroidism, that can affect bone density. What you’re also saying is if someone has hypothyroidism/Hashimoto’s, and they are taking thyroid hormone replacement, whether it’s levothyroxine or dessicated thyroid, that can also have a negative impact on bone density.

Margie: If your thyroid hormones aren’t balanced, if you have Hashimoto’s, first of all, the inflammation itself, the autoimmunity can be affecting your bones just like it can affect so many different things. Also, you need the right amount of thyroid hormone for building bone as well. Both areas can be affecting bone.

Dr. Eric: I have written some articles in the past where thyroid hormone is important when it comes to bone quality. If you don’t have a sufficient amount of thyroid hormone, that can decrease bone quality, and over time, can increase the susceptibility of fracture.

Margie: That’s a good point you brought up. A lot of people get the bone density test. It just has a number. That number has nothing. It just says how much bone is there. It’s quantity. It has nothing to do with quality. That’s so important because you can have two people with the exact same bone density, but one could fall and not fracture, and one is like chalk with them. That matters so much. That’s such a good point you brought up.

There is a test called the Trabecular Bone Scoring (TBS). It’s software added to the bone density that some places have now that can give you more information on your bone quality as well as the bone density.

Dr. Eric: What type of test is that?

Margie: TBS, Trabecular Bone Score. Not that many places have it unfortunately. A lot of doctors don’t order it, and it may not be covered by insurance. It’s just software that when you get your regular bone density, and it’s incredibly helpful information. Not only does it give you the density, but the quality, which is so important. It’s something that is often not thought about, but it will make the difference if you fracture or not. That’s huge in terms of your bone health.

Dr. Eric: It’s not an actual scan then, from what I understand.

Margie: It’s software that goes on the regular bone density. They can even take if the place has it. They can look at a bone density. You can’t mix places unfortunately. That’s an issue. The test is not that accurate. You can’t take the findings of one center and bring it to another. You have to stay at the same place. Sometimes you have to balance out what’s more important. Usually it’s staying at the same place. For anyone getting it for the first time, just check with your center. I’m a big believer in this test. It gives you additional information.

Dr. Eric: Good to know. How about stress? What impact does stress have on bone density?

Margie: I’m so glad you asked this question. People come to see me, and they are so worried if they are doing the right exercises. Are they eating the right foods? They don’t realize that the stress itself is such a problem. Stress is your body’s own steroid. Cortisol is your body’s steroid. It does the same thing as being on steroids. There have been studies done on both animals and humans that show that increased cortisol reduces bone density. It really makes a difference.

Every single person I work with, I really teach them life is stressful, so you can’t just say to get rid of stress. Doesn’t happen. But you can learn techniques so that you’re more resilient, and the stress isn’t going to topple you over. That’s my favorite thing I do. I teach people to reduce stress as well as increase happiness, which they have shown that people who are content with life and are happier have increased bone density. It all goes together.

I look at osteoporosis as an opportunity. People find out. It’s not something that you feel oftentimes. You’re 50, you get a bone density, and you’re like, “Oh no. I have osteoporosis.” You conjure up these images of your life is ruined. You can’t enjoy all the activities you did: playing with your grandchildren, etc. It’s very scary. I look at it as an opportunity to examine your life. What is missing? For example, stress. Am I a stressed-out person? Where can I improve upon it? Am I a couch potato? When you do all these things that help the bones, your whole life gets better. You’re in your 80s, and you’re lifting things. You have never felt better in your life. That’s how I look at it. Look at it as an opportunity to see where you may have issues that you need to deal with.

The bones aren’t in isolation. I know that’s something you practice as well. One part of the body,it all goes together. When something is wrong with the bones, usually there are other areas as well.

Stress is so important. I just think it’s something that every person needs to stop and see where they are at. I’ve always been a happy person, but physical therapy, you can get really busy. I remember working like crazy, shoving my lunch down. One day, I decided to take a meditation program for eight weeks. I did this Jon Kabat-Zinn program. The first class, we didn’t do much. The second class, I got a speeding ticket on the way to meditation. That was the best thing that happened. It hit me in the head that I was not practicing what I preached. Since that day, around 11 years ago, I made these practices such an important part of my life. It’s completely changed everything. I can’t say enough about how it’s helped me personally as well as everybody I work with. Very big thing.

Dr. Eric: Another reason why people should incorporate some type of mind body medicine or something else to manage stress. There is only so much we can do about the actual stressors. When it comes to stress management, there is definitely a lot we can do.

Margie: Absolutely. The benefits, I’m sure you’ve seen this as well in terms of health. I just can’t get over it actually, how big a role this plays. It also helps your digestion. The body thinks you are running from a tiger, and it shuts down digestion. If digestion is shut down, we are not absorbing our nutrients. We may be eating properly. All sorts of things with reducing our stress and learning the mind/body techniques are so helpful.

Dr. Eric: How about the gut microbiome, and how it impacts bone density?

Margie: Yes, they have done research on that. The composition of the gut microbiome, new research is coming out about how it can affect your bone density. As everybody knows, the gut can be the root of everything, especially when it comes to your bones. It’s one of the first things I have people work on. Oftentimes, people will just say, “I see your bone density. Let’s go on a medication,” not realizing this person has major issues. It’s good to have it evaluated, see what you can do to improve. Eat as best you can. Your prebiotics, your postbiotics. Do things to help the gut microbiome. Get it evaluated too. There are people who have issues, and that will definitely affect your bones.

In terms of the other thing with the gut that I find, the biggest thing that I see in my practice is food sensitivities. One that I see time and time again is gluten. It plays such a role. I can’t even tell you how many people have gotten off gluten and really improved their bone density and bones. Most doctors who deal with osteoporosis, the endocrinologist will test for Celiac Disease. They don’t go any further. That’s a real problem. Celiac Disease affects a small portion. Anyone who has non-Celiac gluten sensitivity or problems with gluten can also have significant inflammation and significant problems with their bones because they are not getting the nutrients. It’s not something that is routinely done. I think everybody should be tested for that personally as well. It’s very common, and it’ssomething that needs to be evaluated in the whole scheme of looking at why you might be losing bone.

Dr. Eric: That’s interesting, too. How about the dairy controversy? Like gluten, some people will say to avoid dairy because it’s inflammatory. There are others who say when it comes to bone health, you need to have dairy to have healthy bones. Can you talk about dairy and other foods that you would recommend that might be able to help with bone density?

Margie: That’s such a good question. It’s true. You will watch television. Years ago, they had the milk moustache. That’s what people are told. “Drink your milk. You will have strong bones.” That’s not what’s been found. The countries that have the most dairy do not have lower incidents of osteoporosis. There is not a correlation with increasing your dairy and osteoporosis at all. For so many people, dairy is inflammatory. That’s not what you want to do. You certainly don’t want to increase your inflammation. That is not what I tell people. A lot of people who can’t tolerate dairy, myself included. I eat very little dairy, if any. Some people can tolerate healthy dairy, like organic and pasteurized. Other people who can’t, there are lots of other ways to get your calcium.

I am a big believer in the leafy greens. Some of the ones that people don’t know about are collard greens. You can use that as a wrap. They have 250 mg of calcium per cup. Kale. Bok choy are some good ones. A lot of people think spinach is a good green. Spinach has oxalic acid, so you are not going to be getting the calcium from it. Not that you can’t have it, but don’t use that. Sardines are a great way to get calcium. Chia seeds. There are ways to get calcium outside of dairy. Don’t increase your dairy at all. I don’t believe in that. A lot of people need to appreciate how inflammatory dairy is. It’s one of the things I also often have people either eliminate or test for because it can be an issue as well. We certainly want to get rid of anything that causes inflammation.

Dr. Eric: Is broccoli also high in calcium?

Margie: Broccoli is good. It’s not huge, but it certainly is a very good thing to take, yeah.

Dr. Eric: You mentioned inflammation, which is huge because it’s not just the foods. We mentioned stress, which can lead to inflammation, a pro-inflammatory response. There are so many things that can cause inflammation. As a healthcare practitioner, a health coach, physical therapist, that is not just diet, not just stress management, but there are other things you look into to try to reduce inflammation.

Margie: Absolutely. There is a major workup when it comes to osteoporosis. I believe it’s so important. As I said before, it’s like putting a Band-Aid on it. I like to see in the bloodwork the homocysteine level and the C-reactive protein. That is just in the regular lab work. It can be ordered by any doctor. It’s not anything special when you get your bloodwork. It gives tremendous information.

A lot of people don’t know. Even just today, this morning, I spoke to someone who got diagnosed with very low bone density. Her numbers were awful in terms of her homocysteine and C-reactive protein. She didn’t realize; she doesn’t know. They are trying to figure out what could be causing it. That’s very important to see. Is there underlying inflammation? It can be for many reasons. It can be infection, food sensitivities. That’s why I’m such a big believer in working with a functional medicine or integrative or someone like you, working with someone who deals with this so you can delve in and see.

Osteoporosis, unlike some other things, let’s say you come in with eczema, or your stomach is hurting. You will know if you are getting better. With bones, you don’t know right away. It’s not as though the bone density test is that sensitive. Oftentimes, people do have other issues where we can see if they’re improving. That’s why it’s so important to initially figure out what could be the root cause because you don’t want to miss anything. Yes, inflammation. People who have rheumatoid arthritis, anything inflammatory because of autoimmune issues will affect the bones as well. It’s a big reason, and it’s something that needs to be taken into consideration and often isn’t.

Dr. Eric: Supplements. There are some people who might ask about taking calcium supplements. What are your thoughts?

Margie: It’s an interesting situation. Calcium is one of those situations where more is not better. What I see is people are getting calcium in their diet. In the United States, what’s recommended for anyone over 50 is 1,200mg of calcium. In terms of other places, it’s like 700. If they are put on 1,200, and they are getting some in their food, that’s more. I see people getting too much calcium because they think that’s the panacea. Let me take calcium supplements. They take the calcium plus what they are getting in their food. It’s too much.

There has been research, nothing 100% conclusive that we can say, “Oh yes, for sure,” but there has been some research on when there is increased calcium over the 1,200, people have had increased kidney stones, increased cardiovascular issues. It used to be called the National Osteoporosis Foundation, and now it’s called National Bone Health. They changed the name because bone health is in all ages, not just osteoporosis.

The recommendation is get as much as you can from food. Only supplement if necessary. That’s what I believe. See what you can get from your food. More is not better.

But the key thing here is that, and this is what’s missing. I work with all sorts of doctors. Most doctors will recommend calcium and Vitamin D, which is so essential; and make sure you have the 25-hydroxy Vitamin D so you see what your level is. Don’t guess this. It’s so important. We see now how it really has been helping with so many things. Our Vitamin D level is so critical. Yes, Vitamin D, calcium, and exercise. They will tell you this.

The other thing is there are some more things that are beyond critical. To absorb that calcium, yes, you need the Vitamin D. I believe in eating the rainbow. You need a whole symphony. It’s not just a few vitamins that will do the trick. You need to eat everything. However, the key ones for osteoporosis are magnesium. So many people are deficient in magnesium. Years ago, we had a 1:1 ratio. The amount of calcium we had to magnesium. Now, people are so deficient in magnesium. It’s so important for so many different activities in your body. At last half the calcium to magnesium, minimum.

The other thing that is so important is Vitamin K2. Vitamin K2 takes that calcium and makes sure it gets into the bones and not into the soft tissue. It’s so important. There is a food called natto that is a Japanese food that is very high in one type of K2 called MK7. They found in those areas of Japan there is a huge reduction in osteoporosis.

Those are the key ones. There is a lot more in terms of manganese, boron, zinc. There are a lot of other things in terms of supplements. Eating from the rainbow. Anti-inflammatory diet is so important. Not the calcium by itself. Try to get it from your food. If not, then you can supplement. The one supplement I don’t like is calcium carbonate. That reduces the acid, like Tums.

Dr. Eric: I’m glad you brought up the K2. Whenever I have someone take D3 supplement, I make sure they take the K2 as well for the reason you mentioned. You said you do recommend for people to test that 25-hydroxy. You have all of your clients go through that?

Margie: Typically, they have had it. Maybe it’s just who I work with here. All of the doctors order that. When people are referred to me, they already have osteoporosis or osteopenia, for the most part. Typically, that is part of the routine workup, the 25-hydroxy test. That is already done typically. I don’t think there is anyone that hasn’t had that that has been referred. That is part of the medical workup.

Dr. Eric: I agree. It is important.

Margie: The other thing is the parathyroid hormone. I’m doing this summit. I had a doctor who is a parathyroid surgeon come onthe summit. So often, she said this is missed. If someone has a tumor on their parathyroid, that can significantly affect your Vitamin D and calcium. A huge reason for osteoporosis is doctors are taught in medical school that if your calcium on your bloodwork is a little bit high, don’t worry about it. No big deal. She talks about that a lot. My point is that that is something that is important in the bloodwork for people to know about. That calcium level doesn’t affect the calcium you are getting in your body, but it can be very important for the parathyroid hormone. Make sure you have a look at the parathyroid hormone. The doctor should. But I wanted to mention that.

Dr. Eric: Good point. They don’t get as concerned if a nutrient like that is high. They are worried about something being low. If calcium is too high once, you want to retest. You can also do a test for parathyroid hormone pretty easily in the blood.

How about exercise? What impact can exercise have on improving bone health?

Margie: This is where I think we can all make such a difference. First of all, the research has shown certain types of exercise can really increase bone density. There was a study called the Lithmore Study done in Australia. They took people who had osteoporosis, low bone density, and put them through some serious weight training, not just minor. They showed improvement in bone density.

But the key thing here is safety. This was a supervised study. I really don’t believe to just go out, find a video, and start doing it. That’s dangerous. As a physical therapist, if you’re not in good posture, if you don’t know what you’re doing, you could really hurt yourself. What I always say is, if you can, and usually this is covered by insurance, get a referral to physical therapy, at least once, so you can figure out what’s best for you. They can look at if you have shoulder problems, hip problems, and give you a custom exercise program. That is my first thing.

Regardless, exercise is so important. The types of exercise that increase bone density are resistance. When the muscles contract against resistance, it’s like tugging on the bone and saying, “We need more bone here.” Strength training is really important. That is what they have shown makes a difference. I would not start it on my own unless you have been doing it for a while. I would work with someone who is knowledgeable in osteoporosis.

High-impact. This depends. If you already have osteoporosis, check what level you’re at with the people you’re working with. But for younger people, jump. Jumping, high impact forces increased bone density. Exercise at any stage can make such a big difference. That’s what I have seen. It’s so incredible. Whatever you can do.

You can always do balance exercises. Everybody should do those all day anyway. Not all day, but often, if you don’t use it, you lose it, both with exercise and balance. By improving your balance, you’re not going to fall. That is what is causing the fractures for the most part. Everybody can do balance exercises. That would be tai chi, standing on one foot, doing stabilizing. I love tai chi. That’s one of my favorites. Even just shifting your weight. The good thing is that when you do it, it’s amazing the difference.

Everybody, even if you’re at high risk, even if you’re on medications, can do the right exercises. That’s what I see. People think, “I will just walk 10 miles.” Yes, it’s good to walk. They did show in the Nurses’ Health study that they reduced your risk of hip fractures. That’s not what is actually increasing bone density. It’s the strength training. It’s lower reps. It’s 8-10 reps, not 50 reps.

The summit I’m doing, I have physical therapists who are fantastic, who are the people who teach the physical therapists demonstrating safe exercises, posture. That is critical. I’m very passionate about that. I’ve seen people, even twice a week when they are doing the right exercises, not only improve their bone density, but improve their strength and activity levels. You feel empowered. You feel really great when you exercise and improve your strength.

Dr. Eric: Especially the balance. I think about that. I do talk to patients at times about increasing weight-bearing exercises, especially with hyperthyroid patients. You also want to be cautious with that. You might need to work with someone for that as well. The balance makes a lot of sense to do what you can to prevent from falling in the future.

Margie: I work with the State of New Jersey on several state programs on exercise. People in their 70s, they’re older. By just doing these several balance exercises, it’s been amazing, and people have said how they felt they were gonna fall. When they are doing weight shifting, when you are going forward and back, which is part of tai chi, they said they didn’t. I can’t even tell you how many people have commented that they really feel these exercises have prevented them from falling. It’s not hard. You can throw these in during your day. That’s what’s so exciting.

Dr. Eric: The last question I have for you, Margie, is I have had a number of broken bones in the past. Early last year, my wife broke her big toe, and it was slow to heal. My question is if you have anything to speed up the healing process, whether it’s supplements or a cold laser (she thought that was beneficial). I wanted to pick your brain on that a bit.

Margie: I always make sure that people are getting the nutrients. I would really up your multivitamin. You’re getting the calcium, magnesium, boron, zinc, everything that builds bone. Make sure you’re getting enough protein. We didn’t talk about that. A lot of people think, “Too much protein isn’t good.” There is a Goldilocks, but you need enough. A lot of people as they get older aren’t getting that much protein for bone healing. Yes, make sure you are getting enough nutrients. If you need to supplement, this is when I would make sure if there is any question to make sure you are getting the bone-building nutrients.

#2 is there is some electrical stimulation. If people are not healing, that can speed up the process. They have done research on different electrical stimulation units. They have done those with non-union fractures. The orthopedists do have different things to help with fracture healing.

Dr. Eric: Thank you so much. You shared a lot of valuable information. Greatly appreciate it, Margie. If you could let people know where they can find you and where they can learn more about you?

Margie: Go to my website, MargieBissinger.com. The podcast is there, too.

Dr. Eric: What’s the name of your summit?

Margie: I’m so excited about this; you have no idea. I have wanted to do this for several years. It just worked out. It’s called the Natural Approaches to Osteoporosis and Bone Health Summit. I have 46 experts in different areas. What I wanted people to do is get tools. The physical therapists are actually showing the exercises. One person is a personal trainer who deals with osteoporosis, who actually worked with Jackie Onassis and Caroline Kennedy. She is showing amazing balance exercises. One physical therapist, Sherry Betz, really shows you how to do the exercises. I have physical therapists demonstrating and explaining the exercises in detail.

I have all sorts of people who deal with this; that is their area of expertise. Functional medicine doctors who work with osteoporosis. What works? What hasn’t worked? People talking about the foods. How to make foods. What do we need to eat? Stress. Not only do these people talk about stress reduction, but they have you go through processes. Even Chinese medicine, going through what we can do from that realm to help our bones. There is so much information. It’s a smorgasbord that you can pick from.

Even signing up. I wrote this exercise book, so that is a free gift when people sign up, just to get people started. It’s basic, what can you do easily. I don’t believe in overwhelm, so I want people to get things gradually. There are a lot of free gifts and lots of tools. That is what I wanted to do. Unfortunately, this information is not out there. Every person does not deal with osteoporosis from a functional medicine viewpoint. I wanted to show people what else is possible.

It’s not on medication at all because that wasn’t the point of it. Even if someone is on medication, absolutely come because you need all of this to build your bones. It goes into every aspect of bone health with all sorts of tools and things that people can put into their life. I’m excited about it getting all this information in one place and out to people. And it’s free. People can listen for free. They don’t have to pay for this.

Dr. Eric: They might as well take advantage of it. This is information that not just people with hyperthyroidism can benefit from, but pretty much everyone. A lot of people are faced with bone density problems as we get older. Whatever age you are, if you are younger, you want to prevent.

Margie: It’s such a good point. The next generation, if we start early, think of the kids. They are sitting like couch potatoes, not eating a good diet. It’s setting them up for poor bone health throughout life. I have a pediatrician who does a thing about milk, why that’s not what to get for the kids. She does a whole talk on what to feed your kids. I also have a whole program called Million Dollar Bones wheresomeone talks for teens about what to do. This is where we are going to make the impact. We are going to change the trajectory of osteoporosis if we start young. 80-90% of bones women have by 18 and men have by 20. It’s all ages. It’s not as if you wait until you’re older. Every age, there are things that can be done. That is what is so great. Putting bone health on the map. Why not enjoy your years later? Why have to worry about later? It’s not necessary when there is so much that can be done.

Dr. Eric: I couldn’t agree more. Thank you so much, Margie. Appreciate you taking the time to share this wonderful information.

Margie: Thank you so much. It’s been a pleasure.

Recently I interviewed Dr. Irene Cop, as we chatted about one of the biggest thyroid healing roadblocks, and below is the written transcript. If you would prefer to listen the interview you can access it by Clicking Here.

Dr. Eric Osansky:

With me, I have Dr. Irene Cop. How are you doing, Dr. Irene?

Dr. Irene Cop:

I’m awesome, thank you, Dr. Eric. How are you?

Dr. Eric:

Doing well.

Dr. Irene:

Thank you for having me here.

Dr. Eric:

You are very welcome. Thank you for joining me. We’re going to dive into Dr. Irene’s bio, as she is the founder of the Stress to Success Shift Institute. Dr. Irene helps purpose-driven high achievers shift from stress to success in all areas of life: their career and wealth, health and energy, relationships and personal life. Dr. Irene’s background and expertise extends to both Eastern and Western medicine, holding dual doctor degrees as a medical doctor as well as a Doctor of Chiropractic. She has extensive training in acupuncture, neuroplasticity, elite performance psychology, stress management. Dr. Irene is a globally sought-after speaker, neurophysiological meditation instructor, and host of the internationally acclaimed podcastThe Stress to Success Shift. Thanks so much for joining us.

Why don’t we start out by discussing a bit of your background, and how you ended up creating The Stress to SuccessShift Institute?

Dr. Irene:

I would love to. I was so happy that you asked me to be a guest on your podcast because of your specialized audience, as it is one that I have found really needs this message. How I started on this journey: I was already a doctor. I was a single mom of two young boys, four and six years old. I thought I had the world by the tail. I was doing it all. I was Superwoman. I was running my full-time practice. I was on the PTA board of directors. I was on the board of directors for the business association. I was running a whole local festival that drew hundreds of thousands of people. I was doing it all. I thought everything was great. That’s what thought did. As you know, Dr. Eric, there is a reason they say doctors make the worst patients.

What I didn’t know is that I was physically burned out and had developed a physical condition that caused me to lose consciousness while I was driving up in northern Canada. I live in Canada. I was driving to visit a friend and lost consciousness. The road curved, and I drove straight into a three-story rock face. It’s very common up there. My two sons were in the car with me. My youngest son had a catastrophic brain injury and had to be airlifted to the nearest sick children’s hospital in Toronto, three hours away. My six-year-old son had PTSD because there were adults throwing up at the scene because of what they witnessed. I ended up with 10 broken bones and a mild brain injury. It was during the first SARS quarantine. COVID is a SARS virus. Take COVID, except the first SARS was even more severe.

I was in hospital on quarantine with these 10 broken bones. Worse than the physical pain of the 10 broken bones was the emotional and mental pain that I was experiencing, suffering. I almost killed my young sons, the two people I cared about more than anything in the world. The guilt, the shame, the remorse was just- I was spiraling down. I was drowning in quicksand. My inner judge and jury had already convicted me. “What kind of mother are you? What kind of doctor are you for not knowing? What kind of monster are you for hurting these two beautiful souls?”

It took a couple weeks before they even decided my youngest son was going to live. After they decided he was, this top neurosurgeon in Canada said, “He’s never going to walk or talk. He’s not going to pass high school.” I am getting this news while lying all broken in my hospital bed. I was getting news on the other side that my six-year-old son was basically kicked out of school for the remainder of the year because he was threatening to hurt others and himself. The anger that was pouring out of him. It was truly the darkest point of my life. It literally was.

Then it got darker, surprisingly. Somehow, even though I couldn’t have visitors, I was served with legal papers. My ex-husband sued me for full custody of our children, saying I was a danger to them and an incompetent mother. I was lying in this dark hospital room, bawling my eyes out, tears streaming down my face. Why me? Why? That inner judge and jury agreed with my ex-husband. “I am an awful mother. I don’t deserve them. In fact, I am a danger to them. I almost killed them.” This dialogue was swirling around inside of me.

Finally, I realized I have a choice. I can either continue to spiral down and roll over and give up and say, “You’re right. I don’t deserve them. Here, take them. You’ll do a far better job.” We had joint custody before that. Or I realized I could give myself the grace of understanding that what I had experienced, the physical burnout, was something that was a silent pandemic that has killed far more people through the years than COVID. It’s hidden and accepted and encouraged and expected by our culture that we have to achieve to be worthy, that we have to give until we’re bled dry. It’s this gauntlet mentality of we don’t have what it takes if we’re weak, if we’re lazy because we’re tired. That shame, that stigma, associated with burnout. Obviously, we don’t have what it takes, and we should just give up and crawl away intoa corner. Better yet, man up. Suck it up. Take it like a man. Guys hear this. Women have our own version of it.

Irecognized that far from being alone, hundreds of millions of people, now we can say billions, are burned out. Over 90% of people are burned out in some areas of the workforce. It’s not just workplace related. COVID has shown us that. It’s our personal lives when life throws its curveballs like COVID. Guess what? We don’t just have to worry about us getting sick or our family getting sick; parents still get Alzheimer’s or cancer. Maybe we get diagnosed with breast cancer or prostate cancer. Our kids fall down and break legs. We go in and out of lockdowns, and we have to homeschool our children and juggle our own home/work life as well. It’s only gotten worse.

What I realized that day was that with my education and my personal experience, I was the perfect person to lead the charge on eradicating burnout. I call it flameout syndrome because burnout is only supposed to be workplace related. I have been on a mission ever since to help as many people in the world as possible avoid suffering what my family and I suffered. We should have died, and we didn’t. That is the background story.

Because I refused to accept that prognosis of my son being able to walk, talk, or pass high school, I went looking for the answers. I went back to school and got my medical degree at that point. I took six or seven certification courses. I got certified in brain injury so I could talk to all the experts in brain injury, so they would have to pay attention to me. I went looking for all of the answers. Spent years doing it.

I am happy to say both of my sons are doing great. My youngest son not only walks and talks, but he is also in his fourth year of engineering at one of the best schools in Canada. I cried tears of joy when he was accepted. It wasn’t easy, and it wasn’t just one simple decision. It’s been worth it every single step of the way.

What I realized was what helped my family and I heal were the very steps I’ve applied to other patients because I was still in physical practice and helped them get the so-called miraculous results that others weren’t getting. I became known as the go-to, last resort doctor. That’s not arrogance in saying it. I worked hard to find those answers and to become that person with those answers. It’s not rocket science. It’s energy efficiency. Really, truly, that’s what it comes down to.

When you remove all the energy efficiencies, we have this amazing innate genius in our body that allows us to heal and can heal ourselves. I don’t heal anybody else. I am no longer in physical practice. I now do it virtually with my programs and group coaching and some 1:1 coaching. The beautiful part is I am not doing it for anyone in my community. I am giving them the tools and showing them how to heal themselves. True success to me is in all areas of your life. You can’t have true success in your career and your wealth if your health and energy is down the toilet. Same with your relationships. That’s not true success. You have to have it everywhere in all parts of your life.

Dr. Eric:

That is so true.That is a traumatic story, but everything thankfully turned out okay with you and your sons. I’m glad they’re successful and healthy. You turned your life around as well. It’s one of those things where I dealt with Graves’, and now I help people with autoimmune thyroid conditions. You help so many people through your experience with burnout and helping them become successful.

Your case was an extreme stress situation. There are a lot of situations out there like that. But there are also everyday chronic stressors as well. In those situations, there is only so much we could do for the actual stressor. Getting into the perception, would you agree that a big part of handling stress, handling burnout is trying to change the environment and the perception of the stressor?

Dr. Irene:

Absolutely. I always say true success is an inside out job. Dealing with stress is as well. Dr. Hans Selye considered the father of stress—he coined the terms “stress” and “fight or flight”—he did all the research showing the physical effects of short-term, middle-term, and long-term stress. Even he said, and I will paraphrase him, “Stress is neither good nor bad, except thinking makes it so.” In other words, stress, when it’s used right, is our body’s high-octane energy. It is our superpower. They always talk about that stereotype of a 98-pound mother who lifts a car off her pinned child because the stress and the fear for her child gives her that strength in the moment. You couldn’t pay that woman millions of dollars to do it any other time. It’s in the moment, and it’s using her high-octane energy. That’s the beautiful part about it.

Our stress response is a beautiful part of what makes us amazing. It’s not just us. We share it with the animal kingdom. Stress response is our survival mode. We all have our different ways of being hardwired. Just as a gazelle runs when faced with a tiger, or a honey badger turns and fights, or a rabbit is paralyzed and shaking in fear, or a possum falls down and plays dead, we humans have the same hardwired responses. We either flee, fight, freeze, or faint, the four F’s. That part is a very necessary mechanism. It’s what has kept us alive for the most part and allowed us to survive so well through the millennia.

Where it becomes unhealthy is we are the only animals that we know of in the universe where we can continuously think about what happened in the past. Because part of that survival instinct is to think pessimistically, we don’t tend to focus on the glory days when we think about the past. We tend to focus on that fight I had with my spouse, or the thing my boss said to me, or the trauma we have suffered. When we dwell on the past, it’s all of the things that went wrong.

By the same token, we are the only animals who can focus on the future and future pacing. Again, part of what we instinctively, up until now, have been raised with is that negativity, that cautiousness. We don’t tend to think about how things are going to go well for us in the future. Our automatic default is to think about how things are going to go badly. Am I going to be able to pay the bills? Am I going to get sick? Am I going to be alone for the rest of my life? When we worry, that’s future pacing, and it’s negative. We are the only ones who can dwell on the past and worry about the future, which is both negative. Bothof those ramp up our stress response.

Then you add on a huge dollop of COVID. We literally are not getting a break. We are living in our stress responses. Unlike the gazelle that, hopefully if they make it clear of the lion or tiger, and they’re not meat for somebody, within about 20 minutes, after all of the stress neurotransmitters are used up and leave the system, they literally just shake it off and go back to grazing. They don’t stand there shaking with fear going, “What if there is another lion? I can’t believe what happened. I almost got eaten.” Gazelles don’t do that. We humans do.

A lot of what you’re talking about, we bring it on ourselves. I say that with all the love in my heart. We are continuously being chased by that lion, that tiger. We are constantly barely surviving in stress and survival mode. The challenge with that is that it’s really great for when you’re in the short-term. You have the adrenaline. That is the gazelle running away or the 98-pound mother lifting the car. It’s not meant to last for hours. The adrenaline is a short-term, high-octane juice.

Then your cortisol hormone ramps up. That is your marathon. It’s a hormone. It’s not a neurotransmitter. A neurotransmitter is a chemical messenger that happens in milliseconds. “I gotta do something now.” The cortisol takes more time to ramp up, but it’s that, “Okay, a den lion is not going to leave me alone. I gotta keep going.” It’s not as high-octane as the adrenaline, but it does the trick as far it’s meant to, which is keep you alive as much as possible.

The challenge again is that it’s only meant to be for a relatively short period of time, to allow you to get to safety so you can rest and relax and recuperate. The challenge is that if it keeps going, the long-term effects of having the cortisol hormone running through our body, it massively creates havoc. One way it gives our bodies enough juice to keep going is that it ramps up blood sugar. You pack on the pounds, which can lead to high blood sugar and diabetes, which can lead to heart disease and cardiovascular disease. It also ramps up blood pressure, which can lead into cardiovascular disease. It messes with other hormones of your body, like your hypothalamus and pituitary. Guess what? There is the thyroid hormone. Your thyroid is the metabolism. “I need more. I need more.” It can lead to problems like crappy sleep. It messes with your hormone balance. It causes inflammation in the body. Inflammation in the body is that derangement of the immune system where it goes all wonky. You get allergies that maybe you didn’t have before, or you haven’t had in years. Food sensitivities are another one. Of course, autoimmune conditions like Graves’.

In other words, I know you and I have talked about this in the past. I have talked with other experts of other autoimmune conditions. It’s wherever your weakest link is, whether it’s Graves’ or Hashimoto’s or multiple sclerosis or rheumatoid arthritis. I could keep naming them. It’s an autoimmune condition that happens because of this stress response. There is very typically trauma at the root of it, whether it’s massive trauma or cumulative micro-traumas. This is how chronic stress and our bodies’ way of trying to deal with it causes and greatly aggravates autoimmune conditions. I’m sure your community has found that if they were undercontrolled before, all of a sudden, things are out of wack, and they are coming to you with questions.

That is how the chronic stress directly leads to the development of Graves’. If it keeps going, you end up with adrenal exhaustion, where you have nothing. That is where it can get a whole lot worse from there physically, mentally, and emotionally.

Dr. Eric:

Thanks for making that connection. That is one thing I wanted to discuss with you, so you beat me to the punch. You dove into the connection between stress and autoimmunity. It’s not just Graves’, but pretty much any autoimmune condition. I can say from my own experience that stress was a big factor in the development of my condition. Emotional stressors played a role. Overtraining in my case put a lot of strain on the adrenals. I did adrenal testing.

I do a lot of adrenal testing with my patients. We confirm that cortisol levels are not looking good. A lot of people have the depressed DHEA levels. Not only will that dysregulation of the HPA access (hypopituitary adrenal axis) lead to that pro-inflammatory state. Another mechanism with autoimmunity is that you have that increased intestinal permeability. When you have the high cortisol levels, that can decrease secretory IGA, which lines the mucosal surfaces of the body, including the gastrointestinal tract, so that could be a factor in causing a leaky gut. It could maybe not directly cause autoimmunity but at least be a contributing factor. Thanks for making that connection.

When it comes to trauma, you mentioned there are different types of trauma. I’ve heard you in the past discussing them. Could you elaborate more on that?

Dr. Irene:

I’d love to because it’s such a huge factor. I loved how you tied it all together with the physiological side of how stress impacts Graves’ Disease. Trauma can be physical, mental, emotional. That may sound strange to say.

A physical trauma, I’ll give an example after I broke the 10 bones. Not only was I already burned out, but I was 35. I’ll be vain and say I didn’t look 35. Somebody had brought in a picture for me of my sons and myself. It had only been taken a few months earlier. It was sitting on my hospital table. An orderly came in. He looked at me, looked at the picture, and goes, “Is that you?” I said yes. He said, “You looked so young then.” Aside from the fact that obviously somebody didn’t teach him he wasn’t supposed to say that to a woman, he was right.

I had aged 10 years overnight. That is the physical impact of breaking 10 bones. My hair went darker. I have a picture afterward when I was able to sit in a wheelchair, and my back is to the camera. If I hadn’t known it was me, I wouldn’t have recognized me because my hair was a dark brown. It literally changed it. People will talk about that when they go through chemotherapy, and their hair will go curly or straight, or they will lose it, or it will go dark. It’s interesting how our body will respond to physical trauma.

Then there is the mental and emotional trauma. I’ve had people say to me, “I’ve never had trauma.” Oh, okay. Let’s talk through it and see. Often what they mean is that they don’t have trauma they recognize as being trauma. That can happen in a number of ways. In the extreme—and I have had this happen because I had an abusive childhood due to a father with PTSD—I didn’t remember anything before the age of eight. It was a survival mechanism, and it’s well-known in the literature that people have amnesia after trauma. They have selective memory. They don’t remember. Or it may be that it was considered acceptable, so it wasn’t considered to be trauma.

A good example of this is abuse. Physical abuse. Until not that long ago in relative terms, in the UK, there was a law—this is where the phrase “rule of thumb” comes from—that a man could not hit his wife, children, or animals with a stick bigger than this thumb. That was humane. It was in the law. In that time, women were considered chattels. Children were considered chattels. Property. It was not only accepted that a man might beat his family, but it was expected that he should keep them in line. Another phrase, “Spare the rod, spoil the child.” Even though at some point, women gained the right to vote and were no longer under the law considered “property,” old programming dies hard. There have been a lot of generations down since that time that grew up with, “Well, that’s just the way things were. You got whacked with a belt or a rod.” If a wife didn’t get dinner on table in time, she got whacked. There is a huge part of our programming that may still be telling us that’s not trauma.

Or it may be the micro-traumas. Instead of one big event, how about a bunch of little traumas wearing you down? It can be even the anticipation of trauma, shown in vets who were waiting to be deployed to Afghanistan. They didn’t even have to go. The future pacing, the worrying. They were already there in their minds. There was that fear, that negative anticipation of “Any time, I could get called up. That will be that phone call or email.” You’re constantly on tender hooks. That’s another way that personal trauma can happen.

Then there are two other types of trauma we are just starting to learn about. One is intergenerational trauma, which is where our parents, our grandparents, anyone who raised us, the trauma they went through, they teach unconsciously their fear responses and physical reactions to the trauma they had as children. That would be a case where a mother is afraid of spiders. “Eek!” The child learns to go, “Eek!” As they are being a sponge and downloading all of the programming as a child, there is no filter. They download the good, bad, and ugly. Bring it on. Load me up. Trauma that we didn’t personally experience ourselves.

Now they also realize there is something I call epigenetic trauma in PTSD. Your forbearers, your ancestors, went through trauma, and it modified the expression of the DNA, your genes. They have shown that fear responses can be transmitted down even without having direct contact with that person. Physical conditions can become part of it as well, where they show that offspring of people who have gone through trauma have a higher mortality rate and increased physical diseases than their siblings who were born before. Same family, same household. The only change was that one was born after, so the DNA was modified and then transmitted.

That is an area that is just on the cutting edge of what they’re learning about. They know it goes back at least three generations. The reality is they don’t know how far back it goes. When you look at just the past 100 years of what our ancestors have gone through, on a global scale, a couple world wars, at least one great depression, multiple other wars, slavery, Aboriginal mistreatment. That is not even including the personal traumas that have happened in lives. You can look at cultures, countries, your personal family, and go, “Wow, what trauma am I being impacted by that I don’t even know about that has set me up for failure physically, mentally, and emotionally?” That is why in my programs, I devote a huge part to releasing that trauma. It is a massive energy vampire that is sucking the energy right out of you so that you don’t have that opportunity to heal.

On top of that, without you even realizing it, it’s putting you into survival mode. You are unconsciously continuously living and reliving that trauma and the impacts of that trauma. You may be aware of it, or you may not be aware of it. All of that leads to that chronic stress, that adrenal exhaustion, which can then lead to Graves’.

Dr. Eric:

Pretty amazing, the connection. If someone is dealing with a current stressor, whether they are a caretaker, or they have a job that is stressful and they are not in a position to leave the job, compared to someone where the stressor was in the past. It’s a past trauma, but it’s still an issue. Whether it’s a trigger for Graves’ or a different autoimmune condition, or preventing them from recovering, is it a similar approach regardless of the nature of the stressor, or whether it was a past trauma?

Dr. Irene:

Yes and no. I am a firm believer that awakening awareness is 80% of the battle and the solution. It’s not to say that you can’t heal without it. Dr. Eric, I know you are a phenomenal doctor, but even you might have those clients where no matter how right the treatments are, they are just not getting better. There is an example of where you can be doing everything right, just as before I crashed and burned, I did everything right. I ate right, slept right, exercised. I was a meditation instructor, so I taught it and did it. I did all of that. I was still set up for failure by these energy vampires. You can do the right nutrition, take the right supplements, work on the hormone balances, do all of that right, and that’s important. Absolutely. If somebody still is not getting better, and this is why I still kept looking for those answers, if somebody is not getting better despite the best treatments out there, then there is something else at play, whether you recognize what it is or not.

There are two approaches. You can do a general elimination diet of trauma and stress, where you use the tools to work through how you’re feeling. “I’m feeling anxious. I’m feeling low. I’m feeling despair. I’m feeling hopeless. I’m angry.” You can work through that. In my experience, the more that you can drill down and get to the root cause, the more likely you are going to pull out the whole weed, the whole thorn that is sticking you in the side, where you can truly heal. Otherwise, it may take longer. For somebody who has had trauma in the past, and they know what it is, or we work together through it to figure out what it might be, then that is incredibly impactful.

For somebody who is going through current, or they are worried about the future, that actually canbe even more challenging. When you are feeling powerless, when you feel like life is being done to you—and let’s face it, most of the world is feeling that way right now—you are unwittingly the victim in your story. People don’t like to think of themselves as victims. It means simply that. You are not in control. You feel powerless. As long as you feel powerless anddon’t recognize that you have the ability to change your situation, and if you don’t believe that you can change, then you can’t. It comes down to choice and choosing to know that you have that ability first and foremost. Otherwise, you are in a cage of your own making. It’s that learned helplessness.

I love the analogy, not how it came to be, but how they train adult elephants to stay put. The biggest land mammal in the world. They start out as a baby, and they put this big, heavy, honking chain around their leg. They will bolt it into cement, and the baby elephant will try pulling and pulling, and they can’t get free. After a while, they stop trying. They get to be an adult elephant, the biggest, strongest in the world, and all they have to do is tie a little rope to it and maybe even attach it to a chair that is not bolted down. That elephant won’t even try to get free. That is learned helplessness.

Unfortunately, whether it’s because of our programming or our experienced trauma or the adversity that taught us we were powerless before so we don’t try now, or maybe a belief. I had a patient say to me once, “I’ve been diagnosed with prostate cancer.” I said, “How do you feel about that?” They said, “I was expecting it. All of the men in my family get prostate cancer. My father had it. My brother had it. I knew it was only a matter of time before I got it.” There is the biology of belief, as Bruce Lipton would say. It also adds to the victim. That learned helplessness, why even bother trying? I can’t do anything about it anyway.

It’s the awareness that makes the difference. The key for the victim is awakening awareness to go, “Wow, it doesn’t have to be that way.” This one tiny shift. Now what?

Dr. Eric:

You help people to overcome that learned helplessness. I do recommend for most of my patients mind body medicine techniques such as yoga, meditation, deep breathing. Some people are religious about doing it, and some people don’t do it. Some people might do it randomly. Either way, it sounds like it goes way beyond doing meditation. For a good number of people, that might be enough.

As you said, let’s say they are incorporating mind body medicine techniques, and they are doing everything, which happens with all practitioners, where people will reach a roadblock. This learned helplessness is something people should look into. I’m sure it comes to a relief to some people listening to this. I can imagine how frustrating it is for someone who is actually doing everything: following the diet, doing mind body medicine, and everything else that is recommended, and they still are not healing. Thank you for sharing that.

Dr. Irene:

Absolutely. I am a neurophysiological meditation instructor. I love it, and I love yoga, and I advocate for those mindset practices, like gratitude and appreciation. There is so much you can do to help yourself. And that is conscious-level.

The major roadblock that I talk about in my Five Steps to Shift from Stress to Success Blueprint is that when you are in stress, in survival mode, it literally wipes out your prefrontal cortex. That is the fancy word for the part of your brain behind your forehead. That is what I call your rockstar executive team. It’s what is responsible for being able to think straight, think logically, make good decisions, remember things, come up with creative solutions, be motivated to take action, just take the action, and very importantly, emotional inhibition, so you are not crying at the drop of a hat and flying off the handle at loved ones or coworkers. That is all the very important functions that are wiped out when you are in survival mode.

All we have to do is look around the world to see that most people are in survival mode right now. A lot of the anger and fear and polarity that we are seeing right now is that survival mode. People are either going to their hardwired, they want to fight, or they are afraid and shivering in fear. That is not a judgment in the slightest.

As long as your executive team is offline, then mind/body practices, you are not likely going to do them, and they are not going to work. It takes conscious thought to think, “I am going to be grateful right now. I am going to be mindful right now and actively appreciate what’s going on.” You are in survival mode. You want that to happen. You want the prefrontal cortex to be wiped out so you can go into your hardwired survival mode, whatever that happens to be. It’s not the time to sit there and go, “There is a lion approaching me. Should I run? Should I fight? Should I freeze and pretend he doesn’t see me?” No, you need to go into whatever survival mode you are suited for. That’s the good part about it.

That’s why I teach what I call lovingly SOS tools, to get to that unconscious level so they can then kickstart- It decreases down the stress response so that you have that reset, that relaxation, just like the gazelle, so your rockstar executive team can kick back in. Then you go, “It would be a good thing for me to meditate today.”

Everything I teach, and perhaps what is different about what many others do, is that I focus on the unconscious level first. That is where your survival mode is. It’s deep down in that primitive part of your brain that you share with all other animals. It’s like an iceberg. Yes, the part that is sticking out of the water looks majestic and beautiful. The reality is the massive bulk of the iceberg, which can be the most dangerous part, as the Titanic found out, is hidden underneath the water. That’s like your unconscious mind. Every tool I teach is about blasting away at the underside to release it so that it’s done in the fastest, easiest, most powerful way possible. I am an impatient person. I go looking for things that give you the results yesterday as much as possible.

That is the difference. Yes, I agree with you. If there is anyone listening who hasn’t been getting the results, maybe you’re frustrated. Maybe you’re impatient like me. Maybe you’re to the point of feeling despair, that there is no hope. “I am always going to be stuck with this.” The fear of it getting worse. “What is my life going to look like?” Just know there is hope. There are tools. Many clients have seen those so-called miraculous results that I look at and go, “It’s just energy efficiency. We have improved the energy efficiency.” That’s all it is.

Dr. Eric:

Thank you so much for sharing this information. You mentioned a blueprint. Can you let people know where to get that blueprint? Feel free to share your website. Remind them of your podcast. You also have an upcoming bootcamp as well. A lot of information, but if you could share where to find it.

Dr. Irene:

The Five-Step Stress to Success Shift Blueprint is the five steps that I realized that my family and I needed to go through to heal, which is part of success. Then I used them with so many other people as well. Each of those five steps allow you to shift, pun intended, from stress to success. If any one of those steps is out of line, and you haven’t taken care of it, then that will be a major roadblock. I have also recognized, because as I said, I did everything right, and I still developed catastrophic flameout syndrome. I realized that what set me up for failure were those energy inefficiencies: the faulty programming, the fears, trauma—I had a lot of trauma—the self-sabotage patterns that were at play.

I have a workbook that your audience can download. It’s awakening awareness around your success blocks. Remember, I said awareness is 80% of the battle and the solution. Because I realized that this was something that was so needed, I created a four-week bootcamp called Retrain Your Brain Bootcamp. It’s four weeks to shift from stress to success. It’s all about clearing the biggest, baddest of each of those four areas: the worst programming glitches I have seen in most people, the big fears, the sabotage patterns, and the personal, intergenerational, and epigenetic trauma. There is a group starting on January 17 as well. That will be led by another doctor who is one of my team members. I will be there as well. That is an opportunity to truly start digging down deep and finally once and for all releasing those energy vampires o you can heal and have the best, most successful life possible.

Dr. Eric:

If they are not ready yet to dive into that, there is the podcast, too.

Dr. Irene:

Yes, I have my own podcast. Dr. Eric, you will be on there soon. We will be flipping the tables on you. That is the beautiful part about it. We all bring value. My podcast is called The Stress to Success Shift. There is the Awakening Awareness workbook they can do around their success blocks. My website is DrIreneCop.com. You can find me on social media as well.

Dr. Eric:

Thanks again, Dr. Irene. Appreciate the time and all the information you provided.

Dr. Irene:

It’s been my pleasure. Thank you so much, Dr. Eric.