Although I chose not to take antithyroid medication when I was diagnosed with Graves’ disease back in 2008, over the years many of my patients have taken methimazole, PTU, carbimazole, etc.  Everything comes down to risks vs. benefits, and while many people want to avoid taking medication, sometimes this is the best option for managing the symptoms of hyperthyroidism.  One of the reasons why many prefer not taking antithyroid medication is because side effects are common.

While some people do perfectly fine taking antithyroid medication, others experience symptoms such as itching, nausea, skin rashes, joint and muscle pain, dizziness, and hair loss.  In addition, antithyroid medication can sometimes cause elevated liver enzymes and/or depressed white blood cells.  But how does antithyroid medication affect the gut microbiome?  I came across a very interesting journal article discussing this, and felt that it was important to write a post on this topic, which very well might deter even more people from taking the medication.

I do want to mention that in this blog post I’ll be using the term “dysbiosis” multiple times.  Dysbiosis is simply an imbalance of the gut flora.  So for example, taking antibiotics for a bacterial infection (i.e. H. pylori) will not only kill the harmful bacteria, but it will also have a negative effect on some of the beneficial bacteria, which in turn will result in “intestinal dysbiosis”.

Numerous Drugs Disrupt the Gut Microbiome

Most people know that antibiotics can disrupt the gut microbiome.  But there are other drugs that can also have a negative impact on the gut microbiota, and this includes proton-pump inhibitors, metformin, and antipsychotics (1) (2). There of course is a time and place for these and other drugs, and earlier I mentioned how everything comes down to risks vs. benefits.

For example, if you have a bad bacterial infection then you might need to take an antibiotic.  But you probably don’t need to take an antibiotic every time you have a mild infection.  I realize that sometimes it’s not easy to determine whether someone should take antibiotics, or a different medication, but my point is that sometimes taking medication is necessary…even if it disrupts the gut microbiome.  On a side note, before doing this research on antithyroid medication I didn’t realize the impact that metformin had on the gut microbiome.  And I’m sure there are many other drugs that have a similar impact that most practitioners don’t know about.

What is the Intestinal Endotoxemia Hypothesis?

During my research I came across something called the “intestinal endotoxemia hypothesis”, which states that a drug can cause gut microbiota dysbiosis, intestinal barrier injury and increased intestinal permeability (leaky gut).  This in turn can cause microbiota-derived products such as lipopolysaccharides (LPS) to get into the circulation and liver, which can either directly cause liver damage, or the disrupted gut microbiome can potentially cause liver damage.  In other words, taking antithyroid medication might not directly damage the liver, but it might cause the disruption of the gut microbiome, which in turn causes an increase in LPS, which causes liver damage, which on a blood test will show up as elevated liver enzymes (i.e. ALT and/or AST).

In 2014 I wrote a blog post on lipopolysaccharides, although at the time I didn’t realize the impact they had on the liver.  But numerous studies demonstrate that gut-derived bacterial lipopolysaccharides can cause liver injury (3) (4). LPS also might play a role in causing liver damage in nonalcoholic fatty liver disease (5).

intestinal endotoxemia hypothesis: a drug may give rise to gut microbiota dysbiosis, intestinal barrier injury and increased intestinal permeability, thus permitting gut microbiota or microbiota-derived product, such as lipopolysaccharide (LPS), translocation into the portal circulation and then transit to the liver. Then intestinal-derived LPS binds to toll-like receptor-4 (TLR-4) on hepatic sinusoidal endothelial cells and Kupffer cells, which can directly or indirectly lead to liver damage; and the gut microbiota transported to the liver can also activate a large number of hepatic inflammatory cells, which synthesize and release many proinflammatory factors in response to membrane antigens or toxic metabolites (such as LPS), causing further liver damage

How Does Methimazole and PTU Affect The Gut?

I’m not going to dive into the research too much here, but instead I’ll give the highlights of the research.  The first thing I learned is that both methimazole and PTU can cause dysbiosis.  However, they don’t have the same effects on the gut microbiome.  For example, even though PTU is associated with causing greater damage to the liver, methimazole was shown to cause greater dysbiosis.

Here are some of the other things I learned by doing my research:

• Intestinal barrier structure and function were destroyed.  In other words, both methimazole and PTU can cause a leaky gut.  According to the triad of autoimmunity, the three factors necessary for autoimmunity to develop includes 1) a genetic predisposition, 2) exposure to one or more environmental triggers, and 3) an increase in intestinal permeability (leaky gut).  Since a leaky gut is necessary for the development of autoimmune conditions such as Graves’ disease and Hashimoto’s, you of course would want to minimize your exposure to anything that can disrupt the intestinal barrier.  This also may mean that the gut won’t fully heal while taking antithyroid medication.
• The  fecal and serum LPS levels in both the clinical and animal antithyroid drug groups were higher than those in the control group, and the increase in LPS content was correlated with the change in blood indicators.  LPS stands for lipopolysaccharides, and earlier I mentioned how I discussed LPS in a past blog post entitled “What Are Lipopolysaccharides, And How Can They Affect Thyroid Health?”  LPS are large molecules found in gram-negative bacteria, and multiple studies show that they can cause a leaky gut (6) (7). This is one mechanism as to how people taking antithyroid medication develop a leaky gut.
• SCFAs-producing microbiota constituents, such as Faecalibacterium, Ruminococcaceae, Lactobacillus and Blautia, decreased after ATDs administration.  I briefly discussed short chain fatty acids (SCFA) in a past article I wrote entitled “What Thyroid Sufferers Need To Know About Fiber, Resistant Starch, and SCFA“.  SCFAs are a subset of fatty acids that are produced by the gut microbiota during the fermentation of partially and nondigestible polysaccharides, and they play a big role in the maintenance of gut and immune homeostasis (8).  Butyrate is the most important SCFA, and it has been shown to increase regulatory T cells (Tregs) while decreasing Th17 cells (9).  Tregs help to suppress autoimmunity, while Th17 cells promote autoimmunity.  As a result, you want to have an abundance of SCFAs.

Should Antithyroid Medication Be Avoided?

I already mentioned how “everything comes down to risks vs. benefits”, and how it’s important to safely manage the hyperthyroid symptoms, but the fact that antithyroid medication can disrupt the gut microbiome can’t be taken lightly. That being said, while taking natural agents such as bugleweed and L-carnitine are options to consider to address elevated thyroid hormone levels, these aren’t effective in everyone.  And so if someone is currently taking antithyroid medication and if they are tolerating it well, there is a risk if they stop taking the medication and switch to the bugleweed.

Will Lower Doses of Methimazole (or PTU) Cause a Leaky Gut?

For those who choose to take antithyroid medication, while the goal is to be on the medication temporarily, some people take a lower dose for a prolonged period of time.  For example, their endocrinologist might start them on 40mg of methimazole, eventually wean them down to 5mg, and perhaps even half a tablet per day.  But when the person stops taking the methimazole they eventually relapse, and so the endocrinologist agrees to allow the person to remain on a lower dose of methimazole.

Quite frankly, many endocrinologists aren’t open to this approach, and of course the reason why many people relapse is because the underlying cause of the condition was never addressed.  But to answer the question, I’m not sure if a low dose of antithyroid medication will cause a leaky gut, but you need to keep in mind that many people who choose to take the medication will need to be on a higher dose until they reach the point where they’re on a “maintenance” dose. It’s worth mentioning that lower doses of antibiotics don’t always cause dysbiosis.  For example, low dose erythromycin is used as a prokinetic for some cases of small intestinal bacterial overgrowth (SIBO).  And low dose erythromycin supposedly doesn’t have the same effect on the gut microbiome when compared to higher doses.

If I had to guess I would say that a lower dose of antithyroid medication wouldn’t cause as much gut disruption as a higher dose.  But the only way to know for certain would be to have another study that compared the impact of lower doses of antithyroid medication to those taking higher doses.

Can The Gut Be Healed After Stopping Antithyroid Medication?

If someone takes antibiotics and then stops taking them, it is possible to heal the gut.  And so the same should be true with any other medication that disrupts the gut microbiome and gut barrier.  So I think it’s safe to say that you can heal the gut once stopping antithyroid medication.

Is It Possible To Get Into Remission While Taking Antithyroid Medication?

Even though antithyroid medication can cause disruption of the gut, over the years I’ve had many patients take it while addressing the cause of the problem.  And many of these people eventually got into remission.  For those people who don’t get into remission, it is possible that taking the antithyroid medication was the reason for this.  It’s a bit of a catch-22, as those with hyperthyroidism want to be safe while addressing the cause of their condition, but it might be more challenging for some people to get into remission while still on antithyroid medication…especially when taking higher doses.

What Alternatives Are There To Taking Antithyroid Medication?

There are other symptom management options for hyperthyroidism that most medical doctors won’t bring up.  These include low dose naltrexone (LDN) and cholestyramine, and I have written articles on both of these.  LDN modulates the immune system, which can potentially help people with Graves’ disease.  Besides needing a prescription for LDN, it doesn’t work in everyone.  Cholestyramine can directly lower thyroid hormone levels, and also requires a prescription. I wasn’t able to find any research showing that LDN or cholestyramine has a negative effect on the gut microbiome. That being said, cholestyramine comes in powder form and needs to be taken on an empty stomach, and so patient compliance can be a challenge.

In summary, both methimazole and PTU can have a negative effect on the gut.  In addition, other side effects are common with antithyroid medication.  On the other hand, natural agents such as bugleweed aren’t always effective in managing the symptoms of hyperthyroidism.  As a result, it can be a challenge deciding whether or not to take antithyroid medication.  Just remember that everything comes down to risks vs. benefits, and you want to do what’s necessary to be safe while managing your symptoms.

**Click Here to access the main journal article related to the research in this blog post

COMING SOON: FREE 5-day Hyperthyroid Symptom Management Challenge: The week of August 16^th I’ll be conducting this free challenge, and so stay tuned for more details!

On Friday July 16th I interviewed Dr. Lisa Merritt, as we chatted about getting quality sleep and avoiding the anti-aging traps, and below is the written transcript. If you would prefer to watch the interview you can access it by clicking here:

Here is the transcript:

Dr. Eric:

Happy Friday everyone. Hope everyone is having an awesome day. And with me, I have my chiropractor, Dr. Lisa Merritt. So we’re not going to talk about  chiropractic… well, it’s up to Dr. Merritt, if she wants to talk about chiropractic she could. Maybe that’s part of anti aging traps to avoid, not see a chiropractor. We’ll talk about the anti aging traps, and we’re going to talk about getting quality sleep. But let me first give a brief intro of Dr. Merritt.

So Dr. Lisa Merritt, she is an educator, mentor and founder of the Merritt Wellness Method and Weddington Chiropractic Wellness Center, which is in Charlotte, North Carolina. Since 1980, Dr. Merritt’s diverse fields of disciplines as a functional medicine physician has offered numerous healing protocols using holistic, integrative healing methods. She has over 40 plus years of experience, has many impressive credentials as she is a licensed chiropractor, board certified naturopath and board certified in acupuncture. She’s a certified HeartMath Biofeedback practitioner, certified in physical therapeutic rehabilitation and has received other trainings as well. Welcome, Dr. Merritt, thank you so much for joining us.

Dr. Lisa:               

Well, thank you for inviting me, Eric. We always enjoy our time together and I’m happy to be here to share the things that you and I love to do.

Dr. Eric:                

Yeah, same here, Lisa. Great to chat with you. I figured we’d start out by talking about sleep, just showing those with hypothyroidism, hyperthyroidism, and anyone else joining us on how to get better quality sleep. And then we could talk about anti aging and I know sleep plays a big role also when it comes to anti aging. And also, is there anything else you’d like to share about your background, how you got into anti aging?

Dr. Lisa:               

Well, the first thing is, is that this has been my blood, sweat and tears my whole life. I will be 65 in November, but I was raised under holistic wellness and I was fortunate to have my dad as a role model, and my mother, but he was also a chiropractor, but we had a health food store and probably my calling was very early in life. My senior year was when I worked in a nursing home, they didn’t call them senior living centers. But it really motivated me and created my calling that I had passion for what made people age gracefully, what was the attitude, what were the things that would make me see how people can age, have longevity. And at a young age of 16, I just said there’s something about this that speaks to me and I really wanted to make a difference, and not only on my life. But I think that’s when I started to know I wanted to be a doctor.

The aging has been as I’m also gradually aging, hopefully gracefully, that as a chiropractor I saw people needing the structural health, but I knew there was more going on physically and physiologically, that they needed the psychological help, the inflammatory help, that people were not healing as well, and what were the problems with their repair and that’s what led me to be more in the naturopathy, do acupuncture, study mindset with biofeedback work from HeartMath.

And it just progresses that you have to look at what I call my triangle of health approach, there’s the structural, the chemical or nutritional, and the emotional wellbeing and you can’t leave any one of those sides out. And when we see people lost on one side and not looking and troubleshooting the other, you’re not going to have that total health. We know sleep is when your body repairs. If we don’t sleep well, we’re going to be in trouble for how we function in the day, so that’s why we’re going to go into it a little more with you and everyone here today.

Dr. Eric:

That sounds great.

Dr. Lisa:               

So I’ll go into it a little bit more, that we know … your rhythm of your day. We talk about adrenal health, we talk about what happens with the hormones in our body. This is a hyperthyroid group and hypothyroid. We know that the body is racing and there’s irritability and there’s heart rate that’s just out of control with a lot of hyperthyroid and the system that doesn’t know how to slow down can’t sleep and can’t digest and can’t let the rest of the functions go because the body’s revved up all day long.

And as you have taught them so much about dietary and those habits, we know that we have to think about what our minds are doing and how we can regulate our day, our sleep schedule, even like a baby. I’ve had six babies and knowing how to help a baby go to sleep is what we need to practice too, because you want to have the end of the day start to slow down and a lot of us don’t. We’re watching TV, we are on our computers, we may have stress that we haven’t resolved in the day, the concepts of what are we talking about at the end of the day. We do that even as a baby, slow down, get music going, get the environment to settle down, dim the lights, create a setting that slows us, get a nice bath at nighttime, practice your breathing, don’t do heavy exercises at night, gentle yoga, stretching, just settle your day.

That’s something a lot of people just … They go, “Yeah, I guess I need to do that,” but it is part of our practice to then stay away from caffeine, excess alcohol. You won’t sleep well and your body won’t repair well if you’re not thinking about what are you eating at night, eating too late at night, don’t have a heavy meal at night, but include your proteins. Those are all things that gradually get us to sleep, but most people will say, “But I can’t turn my mind off.” And there’s breathing exercises, there are meditations. Counting sheep help you sleep, but that doesn’t always work if our chemistry’s off too, right?

Dr. Eric:                

Yep. Being that you’re HeartMath certified, a certified HeartMath Biofeedback practitioner, can you talk a little bit about HeartMath and how that also might be beneficial when it comes to sleep?

Dr. Lisa:               

Yes. Well, I’m not sure if you’ve talked to your group about the vagal nerve. It is the tenth cranial nerve and it’s called the vagal nerve because it’s a vagrant, it’s the longest nerve from our brain going into our body. And the vagal nerve works with digestion, it works with our thought patterns, it works with our visceral, or hits the organs in our bodies and HeartMath works with the regulation of your heart rate. And our emotions change our heart rate and the demands of our body regulate our heart rate. So blood pressure, the fast and the slow of the body, like if you have that adrenaline rush, your heart rate picks up.

So what HeartMath actually does is it’s a breathing technique, but it’s also a visual connection of watching your heart rate in a baseline, and then also what happens when we have thoughts that get out of control. So say it could be trauma or post traumatic stress or we even say sometimes you can have road rage and you know what that does to you, but with HeartMath, it is a program of learning what is your base and do you have control of just the base of what your heart rate is doing. So you regulate it by your fingertip or it can go on your ear and it’s a software that shows how your heart rate is doing.

And the thing I love about it the most is it actually makes you connect with your emotions that you might not always want to talk about and then you learn to say, “Oh yeah, look at what my heart rate does when I talk about my mother-in-law or something like that, or something like how somebody can hate their job and then what does that do, “I hate my boss,” and then you see your heart rate do that. So you learn to say, “Okay, I know how to lower my heart rate by breathing. I know how to lower my heart rate by relaxing my body. I know how to lower my heart rate by these techniques of my mindset control.” And you realistically can say, “Okay, I get stressed about this,” so you don’t get in a panic attack, you learn to settle yourself.

Maybe some of the women out there went through natural child birth and one of the greatest things in natural childbirth is you learn to control that intense labor pain by breathing and settling your body. So it’s an incredible experience to learn. I’ve had all my children via natural childbirth and you’re learning to control your breath, you’re learning to control the physical pain, but then the fear and the overwhelming experience and that’s what we learn in life. COVID, I have seen so many patients just have incredible anxiety, incredible fear, and now they’re overwhelmed with obsessive thoughts, and learning to meditate and do this breathing with the regulation of heart rate monitoring is just an incredible tool.

Dr. Eric:                

Yeah. So not only can it help with sleep, but just overall health. And again, if someone’s anxious, again, which also could prevent someone from falling asleep…

Dr. Lisa:               

Absolutely.

Dr. Eric:                

Yeah, so again … I’m very familiar with HeartMath as well, so I’m also an advocate. I have the Inner Balance and the EmWave too. I use the Inner Balance more frequently.

Dr. Lisa:               

Yeah, the cool thing about it is we could practice yoga, or Tai chi, or our prayer time, people have prayer time, and these applications are all tools that we incorporate. When I even do acupuncture with my patients, I teach them a breathing technique. I teach them some physical breathing techniques that people breathe like this and you’re supposed to belly breathe and not over use these muscles. And an interesting point about that, especially with thyroid and going back to vagal nerve tone … I know I can talk in a lot of different directions and you know that’s the way I talk, but my mind has always got a lot of exciting things to share.

But when we breathe too much with our upper body, and when we have a lot of thyroid issues and we’re shutting down a flow, our lymph system gets blocked, our muscular system is viced, our vagal nerve connection is actually on the carotid arteries, it also is blocked. Chiropractically and even therapeutically, our necks may be tight, our vertebrae are also … range of motion is resisted and so all of that connects. And so if we just think about thyroid, thyroid, thyroid, without breathing, without the vagal nerve massage … And I’ll talk about that more if you would like me to share that.

Dr. Eric:                

Sure.

Dr. Lisa:               

Belly breathing, all these things are part of what we need to just look at that segment of our body. You know what I mean? And that’s where it always comes together with people who can’t swallow, that’s also part of this tension. So there’s that structural, chemical, emotional connection for just settling your body at night. A lot of people, they stay in the fetal position for sleep, learning to relax the neck muscles with a good pillow, practicing the breathing, you’ll start to sleep better. And then learning to just have the mindset with the thought patterns.

Dr. Eric:                

All right. Thank you for sharing that. You said you were going to possibly share some vagal exercises.

Dr. Lisa:               

Well, I know you know a lot about the vagal nerve tone and vagal nerve tone exercises are really fascinating. They said that even the monks had very good vagal nerve tone, it helps with cognitive functions and peace of mind, and it’s because they chant and sing and breathe and meditate, those are all vagal nerve tone exercises.

But the vagal nerve tone exercise that’s actually on your throat, you have to do it laying down because you can make yourself pass out, so remember this. And so while I show you, I am not going to really do it on myself because I don’t want to pass out. But we do want to think that each side of your throat, you want to find that deeper area where you will feel your pulse, which is your artery. And as you’re laying down, you want to keep your fingers like three, level, don’t have your finger nails go in too deep. So that’s why I keep my nails short.

But on each side, you will either … Some people like to massage, some people like to really apply just deep pressure for 10 seconds, about 30 seconds. I like to do maybe 10 seconds. Some people have a different thought. But you do it on each side, 10 seconds, three times, and you then will feel the massage, and then you go to the other side. And you’ll do that three times, but don’t do it together, okay? And that’ll start to … just sensory nerve pickup for that vagal nerve to wake up.

Dr. Eric:                

And is there a better time of day to do it if someone’s trying to kick in that parasympathetic nervous system and try to get better sleep? Should they do it right before they go to sleep, or should they do it multiple times throughout the day?

Dr. Lisa:               

Yes. Well, of course if you’re doing it laying down, it’s great to do it maybe twice a day, if not even three times a day. The twice a day would be when you’re going to sleep and then when you’re waking up in the morning. And I like people to even practice the breathing meditation techniques, or even HeartMath, say you’re going out at night or you’re going to have dinner and it could be three, four O’clock, it’ll give you that extra pickup to tone that vagal nerve by doing that exercise.

Another crazy one that I do every morning, and I don’t know how many people out there would raise their hand, is the cold shower, is to do that. I brace myself every morning. I get my hot shower, I’m doing it, and then I’m like, “Okay, got to turn off the hot.”

Dr. Eric:                

Yep, same here. I’ve been doing that too.

Dr. Lisa:               

And you let that cold water go all over you and I count it and then brace myself to turn around and get my back. When I wash my hair, I really get that cold water.

Dr. Eric:                

Yeah, it sounds like we have the same routine.

Dr. Lisa:               

But I know that’s why those … what do they call them? The Polar Bear Club people who jump in the ice water. I mean, there’s a lot of studies about that just brain function, energy function … I mean, it tones that vagal nerve and it’s a form of discipline that you just say, “Okay, it’s in my regimen.” So I do it and I go, “Okay, I’m ready for my day.” I’m certainly woken up by that.

Dr. Eric:                

Thanks for sharing that. How about supplements, because I know people tend to go to the supplements when it comes to sleeping, melatonin and GABA, so what are your thoughts? Is there a time and place for supplementation and even medication when it comes to getting better sleep?

Dr. Lisa:               

Well, that’s a really good question because a lot of people think melatonin is always the answer and it is not always the answer. In my opinion, we need to check that cortisol level, which has an inverse relationship with melatonin. There’s some people who do not respond well with melatonin, it actually does the opposite and a lot of the autoimmune people could have that opposite.

I am also not always a person who believes in an end product of a hormone, I like to get the body to create as much of it as it can before I say to take a melatonin or other kind of hormones. So to get that cortisol and inflammation down … We know with our thyroid patients, the inflammation is just always an issue for them and you won’t have the melatonin respond because at nighttime cortisol should go down and melatonin should go up and if you’re not in that regulation, then your body’s fighting, using melatonin. Do you agree with that?

Dr. Eric:                

Yeah, I would agree. And what you mentioned earlier about your environment, dimming the lights at night, just make sure your room’s completely dark when going to sleep, those things could help greatly with your body’s own production of melatonin.

Dr. Lisa:               

Yes. And we know at nighttime our body is in the major detoxification and repair time, so taking the wrong supplements or having the wrong diet and you’re not detoxifying at night. And if your blood sugar is not balanced, then you’re also not sleeping well at night. And we know our thyroid patients are not detoxifying and synthesizing their hormones the same, so doing the antiinflammatory and detoxification is going to actually help you sleep better at night and you won’t awaken so much.

The worst thing that I … It’s so hard to get people off of those sleep medications because Ambien is just so dependent and the body has gotten so used to it. And the more your body gets used to something on a chemical, synthetic level, it doesn’t know how to respond and work on its own, because you keep on switching and demand it to go to sleep and it doesn’t know how to reset. But the Ambien patients are never getting REM and REM sleep is when we are still and calm and our body is in deeper time to repair and our body is in deeper time to also help the brain heal and allows the memory and cognitive functions to occur.

So I like magnesium, I test magnesium. If your magnesium levels … and Dr. Osansky knows that when it goes below 2.0 of your blood chemistry for magnesium it’s been like that a while then. So we want that magnesium to be in the system. And I like valerian, I like chamomile teas if you’re not allergic to chamomile. I do think CBD has helped many people sleep better. And those calming teas are very helpful, and hydration.

Dr. Eric:                

How about essential oils?

Dr. Lisa:               

Yes, I love essential oils. The valerian oils, the calming oils-

Dr. Eric:                

Lavender?

Dr. Lisa:               

I use Young Living, I like the Stress Away. Frankincense has helped, which is also Boswellia. The proper B vitamins. Our adaptogenic process is very good to get the body to know how to help that, that time to get the adrenals to shut down and give you the cortisol for the nighttime balance.

Blood sugar is super important. People who can’t go to sleep and have hard time going to sleep, we know that that could be more on the hyperglycemic side, on insulin resistance. Having a little protein will help you keep those carbs lower, no sugar, no synthetic sugar. People say, “Well, it’s no sugar.” I’m like, “No, your brain thinks it got sugar, not a good idea.” People who wake up in the night, it can be a hypoadrenal response, you may need a little protein before bedtime to help you not wake up in the night, that brain needs fuel. So I don’t know if any of your people tried even the glass of water with a little grade B maple syrup sometimes helps them go back to sleep. Those are some things just to pick up the blood sugar a little bit in the middle of the night.

Dr. Eric:                

Okay, great tips. Thank you again for sharing. And I want to make sure we have time to dive into those anti aging traps that I told everybody that we’re going to have you discuss. So what are some of the anti aging traps that people could avoid, so when they turn 64 or 65 they can look just as great as you do?

Dr. Lisa:               

Thank you. My biggest thing, I have been writing my courses and building my vision of how I’m going to speak to people more and more about anti aging and I really … Like I said, that’s structural, chemical, emotional, but the fear of aging is the biggest thing I want people to battle. If you’re so afraid of aging, then you’re not living and you need to be smart. People start to freak out with aging when it starts to get to be too late. We need to think about how our body is at 30. I love teaching the young people, don’t wait till your body starts to shut down, learn the signs it’s giving you.

And so I also just really want people to embrace living and balance their living. Live and love and laugh and humor, and try not to stay so much that you can’t focus on the special things, don’t wait for bucket lists to be too late. My grandmother wrote once that we work so hard and we fail and save and we’re not thinking about what are we doing today to enjoy and embrace it. And you don’t want to be foolish and say, “Well, I’m living for today,” but you do want to savor each moment and think of your day on the good things, even 10 minutes of gratitude and little sharing in moments and laughter. I just think that we know laughter and peace of mind, it heals our immune system, it makes our bodies healthier, it helps our white blood cells just invigorate.

I love hearing older people talk about the things that they tell you is to resolve your issues, tell people you love them. Don’t wait so late in life with grudges, and let go of things and resolve it and share your thoughts today.

But aging is not just hiding and being an ostrich. What am I doing today? Do I have good instincts? We’re always trying to teach our patients about healthy diet and eating vegetables and getting exercise, but if we don’t keep that in check … You want good instincts. Am I moving my body? Am I sitting too long? Am I eating the colors of the rainbow? Am I eating healthy? Or do I have apathy that I don’t want to cook, I don’t have energy to cook? There’s so many people who don’t know how to cook. It’s not that hard, you don’t have to be that fancy. It’s just basically start getting it all … get your pantry full of good groceries.

And I think you learn from your ancestries. I have patients that … The American diet is sad, the standard American diet. What are people eating that their ancestries ate? Go back even to the Mediterranean diet or the Asian diet or the Middle-Eastern diet. What was it that they ate that kept them healthy? And there was a reason, it’s because it was fresh, there was a healthy oil, there was the healthier grains, it wasn’t processed. So those chemicals that are in it, the preservatives that are in it, we need to try to get back to those roots.

Dr. Eric:                

So it sounds like a lot of the basics need to be incorporated. So for those expecting you to talk about taking DHEA and resveratrol and other anti aging agents … I’m not saying there’s not a time and place for these, but I think there’s also a lot of hype with some of the natural agents to promote anti aging, but you could take all the resveratrol you want, all the DHEA… well, you don’t want to take a lot of DHEA since it’s a hormone. But point is you want to eat well, manage your stress, get proper sleep as we were talking about, or Dr. Lisa was talking about earlier. And you had some great tips, even the gratitude journal. Just the attitude someone has on life can play a big role when it comes to slowing down the aging process, just your outlook.

Dr. Lisa: 

Well, I take supplements, but that’s what we want to remember, they are called supplements. The nutraceuticals that are given to us now are not just vitamins, they’re not just minerals, they’re not just herbals. The research that I have seen over the last 40 years is now have so many wonderful co-factors of adding these herbs or putting this together, or adding hydrochloric acid so you absorb iron better, or adding something that works together so that you absorb it better is so much better than just one little thing at a time, so you don’t have to take a multitude list of tons of bottles.

I have a shake every morning, I add turmeric to it, I add vitamin D. We’re not going to get everything from the food we eat because our environment has ruined the quality. We know that broccoli doesn’t have the same amount of vitamin C as it used to 20 years ago unfortunately because of pollutants. If we all grew organic and we all had our own garden we probably … Of course, shop local, it’s better. We all know how great something freshly picked off your tree or picked off your own garden is just amazingly different, a tomato or a peach. My sister would bring mangoes. We know how delicious they are when they’re just so ripe, of course there’s so many more vitamins and minerals in them. But we do have to supplement.

It used to be the conventional doctors … Excuse me … they used to say, “Oh, you don’t need to take vitamins, just eat your diet.” But now we know, people get tested for vitamin D, people want extra B12. We need our probiotics, we’re not getting it like we used to. But we have to listen to the signs of our body, we have to look how the health of our skin is, looking at our nails, looking at our tongue, looking at how well are we digesting food, do we have heartburn, do we have bloating, do we have gas, do we move our bowels every day. Those are signs that hey, I’m not doing it.

If you’re not going to the bathroom every day, your body’s holding toxins. If you’re getting heartburn, you’re not absorbing nutrients. If you get sinus issues all the time, your body’s not flowing. If you get headaches every day, we know the body is telling you a message. So listening and not hiding it and masking it with medicines is so, so important.

Dr. Eric:

Great. So this all relates to that triangle that you mentioned. So for example you mentioned headaches and that could be chemical, that could be structural, it really could relate to any of the three aspects of the triangle. Correct?

Dr. Lisa:    

That’s right. As far as anti aging, I love when I have a patient who comes in and they could be 80 years old and they’re not on any medications, and I’m like, “Tell me.” And they’re not hiding their symptoms, it’s because you listen to their lifestyle, you listen to some of their habits and they have good instincts and they tell you what they eat. Even if they’re home alone, they cook and they eat fresh and they make sure that they are planning their meals. And they get out and they walk and they still stimulate their brains. The people that are aging gracefully are the ones who are still so proactive. And they’ve been proactive, it’s just natural in their … It’s not just genetics.

Our genetics will help us live longer, but our lifestyle is what keeps us living longer, so healthy lifestyle is that triangle approach. And the ones that are on so many medications, where they’re on one medication and then they’re on another because they may have a side effect, and then they’re on another because of the side effect, and then they’re on eight different medications. And then you can just tell, they don’t have energy, they don’t feel good, they don’t sleep good, they have body aches and pains and they’re not moving and they’re overweight, or they’re not sharp and they’re not happy either.

The ones that are aging gracefully … When I told you I was a young girl going to this nursing home, I had the job of going into … This is what they titled me was I was an assistant recreational director. So when they didn’t want to play bingo or go watch movies, I had to go talk to the people who didn’t want to leave their room, or they couldn’t leave their room, and I saw attitude, not just illness, the ones who were lonely, the ones who had no one come visit them.

And I saw the ones that everybody wanted to visit them, and maybe they were sicker but they wanted to visit them, they still told jokes. It was just amazing to just say, “I want to be like that,” and I hope I will. I want to be that cute little old lady who’s still dancing, right? And you want to be around those kind of people, you don’t want to be around negative people, you want to be around people … That’s why you and I like to get together, you want to be around people that are magnifying and who stimulate your brain, and who are positive and not toxic in your life.

Dr. Eric:

Yep. I definitely agree with that. Exercise, I wanted to talk a little bit about exercise. Does it make a difference what type of exercise? These days a lot of people are promoting high intensity interval training, then there’s just regular cardiovascular exercise such as general walking, weight-bearing exercises. Do you recommend a combination of everything?

Dr. Lisa:   

Well, that’s great a question too, but of course, it all depends on the person. The problem is, is things get to be a fad and we know the fad diets, there’s fad exercises, there’s fad activities that people just … The media and good advertising will just make you feel like you’ve got to be like this, the hottest thing that’s out there. We have to be careful, you have to listen to your body.

There are times that I’ll have patients who I can’t tell they’re the slower movers and I need to get them to move a little more. They tell me … This is a whole other topic, but there could be the person who’s the go, go, go and they would be my marathon, triathlon, they just get on that treadmill and they just don’t stop. And guess what I ask them? “So tell me, do you ever just stretch and would you ever consider yoga?” I could already see them go, “I knew you were going to ask me that.”

And then I talk to the people that do … They’ll say, “No, I hate yoga,” or, “I can’t stand people who do Tai chi, it’s too slow,” and I know they need that. And then there are those that go too slow and I’ll say, “Do you ever try to push that slow walk into a faster walk and move your body?” “Oh no, I never do that and that’s too much to me.” But then you know you’ve got to pump it a little bit more. So those are just different people that have to learn the balance and pacing.

And then we have muscular skeletal issues that maybe people will say, “I can’t do it because of my knees,” right? Well, that’s an excuse, because you could swim, you could do other things. So there’s no excuse for not getting movement. And then there are those that would tell me, “I don’t want to exercise because I work too much, I don’t have time.” So setting time for exercise is very important. And then if you have a lot of muscle aches…why are you getting muscle spasms? Could it be some of the thyroid problems? Could it be some of the issues of posture? So the dos and why’s of people’s lives are so important. Does that answer your question?

Dr. Eric: 

Yes, it does, thank you. What are your thoughts on fasting because again there has been research, more so on animal studies on caloric restriction. Intermittent fasting, a lot of people, including myself, I do intermittent fasting too. When you’re eating, you want to eat whole, healthy foods, try to eat organic whenever possible, but how about going longer periods of time, like 14, 16, 18 hours without eating?

Dr. Lisa:  

There’s times we instinctively may go through … We may not feel like we’re hungry and the body is telling you it doesn’t have to eat as much, so we do want to listen to that. And Eric, you and I probably haven’t talked about it enough, but there are debates about if the adrenal glands can handle intermittent fasting.

Dr. Eric:   

That is a good point, yeah.

Dr. Lisa: 

Some people just can’t do that. It’s too much.

Dr. Eric: 

Agreed.

Dr. Lisa: 

Their body’s not ready. It’s just like any other kind of fasting, you don’t just want to shut your body down if it doesn’t have the ability to have that resource to provide that repair time because it’s a shock. People do lose weight with intermittent fasting just because they knock out calories, they have to do it the right way.

I think not eating dinner too late and having a little bit of a breakfast, I think it’s still important, we do call it break fast. I like the Mediterranean diet of having the bigger lunch is healthier on our body and easier breakfast and easier dinner. But I don’t think everybody it’s always the greatest for intermittent fasting in my opinion.

Dr. Eric:  

Yeah, and I agree. Most of my patients I don’t recommend intermittent fasting for the reason you mentioned, because a lot of people have compromised adrenals. And of course, if someone has hypoglycemia or even for my hyperthyroid patients, when I dealt with Graves’ I lost 42 pounds, so definitely at that time I was not looking into intermittent fasting. But I always bring it up, because again, when it comes to anti aging, in the literature there is some evidence with caloric restriction, fasting and aging. But if you’re in a healthier state, maybe. If you’re still trying to restore the health of your adrenals, have blood sugar imbalances, probably not.

Dr. Lisa: 

Well, I think it’s just like any other kind of fasting. We talk about putting our patients on a cleanse or a detox, but I have found that it’s very important to educate about the pre fasting and the post fasting, because you don’t want to get your body to all of a sudden say, “Well, I’m fasting tomorrow, so let me have this giant spaghetti meal,” or, “Let’s go to the ice cream store tonight because I’m fasting tomorrow,” or vice versa, “I’m ending my fast and I can’t wait to do everything I hadn’t done all month.” It’s that prep before and that prep after that I think really just …

If you’re just always really balanced, you don’t have to do a lot of crazy stuff. You should know that you can enjoy a great thanksgiving dinner, you can enjoy a birthday party, but it’s that moderation and knowing when you should or shouldn’t and not get overwhelmed with it. A lot of patients who are trying to lose weight, they go through that time of like, “Well, I blew my diet, I might as well forget it,” and they just don’t forgive themselves and get back on track. And it goes through that mindset thing I was talking about again. We can’t do a detox properly if you don’t prep right and you can’t undetox if you don’t just really learn in the long run what you should be doing all the time.

I had a patient who told me, “I do your detox every year that you bring it up,” and then when we review what they’ve normally been eating he goes, “I’m always a little better than the year before.” And my encouragement is to try to say, “But why can’t you just keep it balanced all the time and 90%, 95% just be healthy? What is it that you want or what is it that makes you want the junk food so bad? What is it that makes you slide that you can’t …”

We want to have a balanced diet. I don’t get it because my instinct is I want to have a healthy meal, even if I’m quick grabbing something. My healthy meal would be I’m going to take a piece of turkey and carrot and celery, that’s what I’ll have, it won’t be chips, it won’t be a cookie. And my leftovers are a healthy meal, I’ll eat some leftover green beans and things like that. It’s just what are we reaching for? A handful of pecans, something like that holds me over instead of saying, “Oh, I haven’t eaten, let me grab a Coke, Coca-Cola.” It’s not my instinct.

Dr. Eric:  

Yeah, I get it. I agree. Before we answer some questions, because it looks like there’s a bunch of questions, is there anything else you’d like to mention when it comes to either sleep or anti aging, or both?

Dr. Lisa: 

I think that we know that sleep is something … I was doing a lot of sleep study and I was involved in a group for a while. Before I said my niche was about anti aging, I realized that sleep problems is very dark, it’s a very dismal world, and the people that suffer from sleep hide it and they don’t tell people all day. And so I saw the madness of it and I felt really … I had such compassion about that world of people not talking about why they’ll do anything to sleep better. It’s almost like the addiction of I’ve got to sleep because you know people who are a deficit of sleep, they do go crazy. You can’t think anymore, your moods won’t be balanced.

And I think it’s very important to keep a journal about your day and journaling is to think about the why’s of why you’re not sleeping, your troubleshooting, did I exercise? What happened in my thought process? What did I eat? And if you’re not going to sleep, you’re going to age. And if you don’t give your body the patterns of sleeping, a regular sleep schedule … I work my hours, but I basically wake up the same time every day. We want the same sleep schedule. Everybody, once in a while, stays up real late, but sleeping in and getting your clock off …

It’s just like I said, with a baby, if you want to teach a baby good sleep, you have to have a good schedule for them, because they’ll get off kilter and our bodies are the same way at no matter what age, if you’re 30, 50, 80, if you’re not sleeping like you would on a regular basis. So you want to try to have that same schedule. There are people who say, “I don’t even try to start thinking about going to sleep until 11 O’clock at night,” and you’re keeping that TV on for that favorite show or whatever routine you’re doing, I really advise you to try to shut down your life around that time and get your schedule regular as best you can.

Dr. Eric:  

All right, great advice. And again, thank you for sharing everything with everyone attending. Before we jump to the questions again, people could find you at … Is it weddingtonwellness.com as far as your practice website?

Dr. Lisa: 

Yes, weddingtonwellness.com.

Dr. Eric:   

Of course, I know the name of the practice, just not the website… I just drive there because I’m in Charlotte too, I don’t go to the website… But yeah, weddingtonwellness.com, and if you need an awesome chiropractor, again, see Dr. Lisa.

Dr. Lisa:

And we do acupuncture. Dr. Osansky does the chemical side of things, so let him work with you on your blood chemistry, on your testing, let him keep on teaching you because I totally … We meet up as colleagues and as friends and we have very like-minded thoughts and protocols. My brick and mortar setting is there for you if you want to come and see me in Charlotte.

Dr. Eric:

All right, wonderful. And then also your group is Fearless Aging, right? You have a Facebook group and the name is Fearless Aging?

Dr. Lisa:  

Yes. It is primarily a women’s group. I am letting women who are 30 in my group because I don’t want them to freak out with the first wrinkle or the first gray hair and I don’t want them to start thinking they need to do Botox and all this crazy expense on their skin. I wash my face with soap and I use a very mild soap that’s got olive oil and clay and natural things, I don’t use fancy lotions. I hydrate, I eat a lot of olive oil, I love my fish, I take fish oils. So your skin and your eyes and your hearing and your teeth … There’s times I think, “Oh, I need to get rid of the wrinkles,” but those things are … I want the smile wrinkles, right?

Dr. Eric:

All right, yes.

Dr. Lisa: 

People just need to get back to some of the basics again.

Dr. Eric:

Mm-hmm (affirmative). I definitely agree with that. All right. Well, thanks again and let’s see what questions we have … I think this first one relates to sleep. We have Darrell who has Graves’ disease. Blood tests are normal. Can’t sleep all night. I guess racing heart. What should we do? Also, my digestive system going, diarrhea every day. It doesn’t make any sense. I’d like to hear your thought. It sounds like digestion is … Maybe a comprehensive stool panel, there could be other things going on, even SIBO. Sometimes small intestinal bacteria overgrowth can present with diarrhea, but I’d love to hear your thoughts.

Dr. Lisa: 

Well, like we talked about, the diarrhea, it could definitely be a gut infection. It could be that Graves’ just making your sympathetic system on go. It could be that you may need to have those gut repairs to get the stool to see if you do have any dysbiosis, which is an imbalance of your good bacteria versus the bad bacteria. You might have a need for the probiotics and repair the gut. Diarrhea is a very … I don’t know if you are looking at your diet of what you’re eating, are you consuming caffeine, looking if you’re having any help with your Graves’ disease.

Talking to Dr. Osansky is very important for you to get some ideas of how your body … I don’t know if any of the pointers I gave you on what you’re doing at night and your breathing practices, but definitely get your digestive system checked, definitely see if your nervous system … acupuncture helps with that, the vagal nerve tone exercises, the meditations. I don’t know what else you’re doing. You certainly don’t want to keep on taking stuff that would be a … the brain health, your brain motility may just be overactive as well.

Dr. Eric:  

Yeah. I agree with Dr. Lisa. But I’ve only got one thing to mention because you say even though you have Graves’ your blood test is normal, so I assume your thyroid hormone levels are looking good, so that’s probably not what’s keeping you up at night. But also parasites, potentially. There’s a lot of things as Dr. Lisa said that could cause diarrhea, but when you mention the racing at night, sometimes infections also could cause problems with sleep, can cause heart racing. I dealt with chronic Lyme disease so I had some of those symptoms, not the diarrhea but some of the other symptoms. I’m not saying you have Lyme, Darrell, but again, parasites, or it could be another type of infection, possibly…just something to consider.

Dr. Lisa: 

And honestly, Darrell, a lot of people think their blood tests are normal. We talk about the functional ranges versus the conventional lab ranges. It’s amazing how many people say, “They said I’m normal,” and then when a functional medicine doctor, like Dr. Osansky and I, review the blood work, we look at so many more things that could be part of a pattern or a warning sign that is on those ranges that are not quite viewed as what we would say as normal. So you really do need a functional medicine doctor to look at the ranges that are normal and outside of even just the thyroid being normal. We want to look at these other lab tests that might give us more indications of what’s happening, like even your adrenal functions, because that, having Graves’ disease or auto-immunities, we could be seeing this as part of it for you.

Dr. Eric: 

Yep, I agree. Thanks for sharing that. And this is just a thank you for having Dr. Lisa here. And yes, I’m thrilled that we’re able to get her on as well. So Darrell asked another question, “Will this all go away or will we have this forever?”

Dr. Lisa:  

Darrell, I know, you feel very dismal about it and losing … Your diarrhea, you are not getting nutrients and you’re malabsorbing, so we have to look and see about that gut infection, because the whole thing with digestion is either are you absorbing nutrients or are you holding toxins. And if you are not absorbing nutrients, all your body is going to just fight you and degenerate. So getting the control of the diarrhea is very, very important.

Dr. Eric:  

Yeah, I agree, that’s definitely important.

Dr. Lisa:

So many things to check.

Dr. Eric:

All right. And then Ramin asks, “How do we learn more about all this?” With anti aging, again, well, I was going to say your website, but it’s for women, you said it’s mainly for women. Do you have anything on your website or any other resources if there are men who are looking for anti-aging tips

Dr. Lisa: 

Well, they can certainly work with you. I am building my website for my virtual course, but that still is building for that. But my weddingtonwellness.com is the avenue for those who want my nutritional and structural, chemical, emotional approach. So I do see people virtually and I’d be happy to do that. But as respect to my friend, Dr. Osansky, he does all these things that can give you even more insight about your chemical needs and nutritional needs.

Dr. Eric:  

All right, great. Thank you. What was the name of the vagal exercise around the neck?

Dr. Lisa: 

You could even just Google vagal nerve tone exercises and it will talk about the vagal nerve massage. It’s funny because in my vagal nerve tone courses that we’ve gone to, Eric, they will talk about different pressures. And then when I was taking it in other courses, because I do some primitive reflex work with the MNRI program, they talk about vagal nerve tone and everybody’s got a couple different nuance of how you do vagal nerve tone.

But like I said, do not do it standing up. The massage can either be a total pressure and you do it three times. It can also be a massage itself. And I found many times with my thyroid patients that they do have a blockage on one side more, definitely sensitivity on one side more, and that’s almost the side that needs more stimulus because that nerve itself is more deadened and needs stimulus. I had an article that I wrote about vagal nerve tone exercises. I could share that and Dr. Osansky can give that to the group, if you want, Eric.

Dr. Eric: 

Yeah, that would be wonderful. You could post it, you’re a member of the group too.

Dr. Lisa:

Okay.

Dr. Eric:

I’m probably going to be looking at it as well.

Dr. Lisa: 

I don’t know, have you ever done a blog on it, because maybe you can share that too?

Dr. Eric:

Yeah. Different types of vagal nerve exercises, not the one you described. But I do have an article that I wrote on the vagus nerve and yeah, I could definitely include that as well.

Dr. Lisa: 

I even like Stephen Porges’s work. He did the Polyvagal Theory, which is more than just vagal nerve tone. It was a very impressive book about how much learning disabilities and autism and cognitive and Alzheimer’s are tied together with this disconnect of brain to the rest of the body. So the Polyvagal Theory is a book by Stephen Porges that I would recommend.

Dr. Eric:

All right, great. Thank you for that as well. Anita asks, “I heard that humming can stimulate the vagus nerve?”

Dr. Lisa:

Yeah, humming’s another one. That’s why I was saying that about chanting and humming, and those are all fun and happy things to do. They say when you go driving down in your car, you should be singing really loud. There is vibrational music that also increases more vagal nerve tone. These are all things that connect to our brain, brain exercises. I could go in so many directions, color therapies, those are all frequencies in our body.

Dr. Eric:   

Yeah, and singing loud, not just humming, but singing loud stimulates the vagus nerve, vigorous gargling, coffee enemas, things like that.

Dr. Lisa:

So singing in the shower really loud and cold water, you could accomplish a lot at that whole time.

Dr. Eric: 

Yeah. All right, I think this is a response to Darrell, just another user mentioning with the diarrhea, could it be SIBO or SIFO, small intestinal fungal overgrowth, and it’s possible. Again, that’s where it gets challenging, with diarrhea, it could be a number of different factors.

Dr. Lisa:  

Yes. And Darrell, SIBO is a very difficult diet, it is. It does require sometimes a medication. It does not always remedy just with a herbal therapy. I don’t know if Dr. Osansky agrees with that, sometimes you’ve really got to get that. SIBO is the small intestine bacteria overgrowth. You want to get those patients back to a normal diet as much as possible because it eliminates so many healthy foods that SIBO, it’s a bear to work on, but you need to be tested for it. And one of the big SIBO signs is after you eat, your stomach blows up like a big beach ball. It’s not just a little bloating, it’s like a helium balloon blow up. Right, Eric, that’s what you would say as one of the given signs?

Dr. Eric:

Well, everybody’s different, not everybody will present with that. I do agree some people do need to take Rifaximin or Xifaxan, it really depends. With diarrhea, it’s usually more hydrogen dominant. There’s methane dominant SIBO, hydrogen dominant SIBO. So usually when it’s diarrhea, it’s more hydrogen dominant, which is easier to treat. It’s not easy to treat, but when compared to methane dominant. Methane dominant SIBO, if someone were to take an antibiotic approach, usually they’d need to take two antibiotics, usually they’d take Rifaximin and then maybe something like Neomycin, but it really depends.

I do like to start people with an herbal approach, and one reason also is because if they can’t get the Rifaximin covered by insurance it is very expensive. But besides that also, I guess with my background, I just try to go natural whenever possible. But sometimes, you’re right, sometimes the herbs don’t work, they’re not effective and then they’ll need to take a look at antibiotics.

Dr. Lisa:

The biggest thing is get tested. Get tested and do that breath test. It’s not just found so easy. Even H. pylori is not always just found by blood, you have to get a good stool test. I like the three day sample, I don’t know about you, Dr. Osansky, if you do stool testing and you get a three day sample. What do you like to do?

Dr. Eric:

I used to. When I was using Genova Diagnostics and Doctor’s Data, I used to have patients do the three day samples compared to the one day sample. More recently over the last few years, I’ve been using the GI-MAP from Diagnostic Solutions because it’s DNA-based.

Dr. Lisa:

I’ve done both.

Dr. Eric: 

But yeah, if there’s the option of doing one day versus three day I’d go with the three day… and I think with Genova and Doctor’s Data, I’m not sure, but I think it’s the same price if you do three samples compared to one. And even if you have to pay a little bit more, it probably is more worth it, because again, that’s the downside of stool testing is false negatives are common.

Dr. Lisa:

Right. And then even some blood testing can be false negatives. But the SIBO test, it is something that the breath is a good test to get that will define it.

Dr. Eric: 

Yeah. It’s not perfect either, but there’s no perfect test. So I agree, I do like the SIBO breath test as well, because again, otherwise you’re just guessing. If it’s negative and …someone mentioned SIFO and that can get challenging because that won’t present as being positive if someone’s doing a SIBO test, because with SIFO, there’s really no great diagnostic test. But I agree, if you’re suspecting SIBO, it’s a good idea to do a breath test, then, if it’s positive, then of course treat, if not, you might have to dig a little bit deeper.

And a few people (in the comments) mentioning Graves’ don’t need to fast, nobody with Graves’ needs to fast. So I agree, even though I will say the majority of people with Graves’ and hyperthyroidism Graves’ are losing weight, but some people do gain weight. Now, with that being said, I still wouldn’t say to fast, even if they’re gaining weight with Graves’. And even if someone has Hashimoto’s, as Dr. Lisa was saying, a lot of people have compromised adrenals and really if you’re going to consider intermittent fasting at all, you would want to restore the health of the adrenals. And if they have blood sugar issues, especially more so hypoglycemia than hyperglycemia, then that’s another reason why you wouldn’t consider intermittent fasting or any type of fasting really.

Dr. Lisa:   

Right.

Dr. Eric: 

Okay. Another question from Darrell, when I go to the bathroom and have a bowel movement, every morning my nose runs like a faucet. Any idea?

Dr. Lisa:   

In Chinese medicine, the large intestine and your mucous membranes are in their mind the same, and so you want to help large intestine, you help sinuses. And so this could be a little connection for you, but it is the body trying to … This mucous is trying to release from your body. I don’t want to get into too much detail with you about your diarrhea, but if there’s mucous and maybe the mucous here, and it could be that sympathetic response of the body trying to rid and letting the poisons out of your body. If you haven’t got a good functional medicine doctor helping you, Darrell, I highly recommend one … A lot our questions sounds like you need somebody to dive in a little deeper for you particularly.

Dr. Eric:

Yeah. We’re both going to be biased because we’re functional medicine practitioners, but yeah … I mean, there’s a lot you could do on your own with diet and stress management and some of the vagus nerve exercises and just keeping active, but there’s definitely a time and a place for working with someone one on one, so I agree it’s something to consider. Let’s make this the last question because we’ve been going well over an hour here. “I’m wondering about Graves’ and sports. My heart rates are very high when in activity. It takes time to go back to normal, so I stopped exercising since I’m not sure if it’s good. Any cure for that? We need more of this types of discussions.”

So yeah, that’s one thing with Graves’, I would be cautious when it comes to … I mean, really anybody. Like Dr. Lisa was also mentioning, there are people who go too slow, but then there’s definitely people who over train. But with Graves’, when you have an elevated heart rate, you want to be especially cautious when it comes to doing any type of cardiovascular exercise. I would say most people could do light walking, some light weight-bearing exercise, but a lot of people, even just jogging, that’s not high intensity interval training, but still, for some people it’s probably a good idea just to take a break if you do a run every morning and you have Graves’.

Dr. Lisa: 

And it’s the time of day. I mean, what time of day are you … This Facebook question is if you’re that person who’s exercising late at night, especially with Graves’, I wouldn’t have, the body can’t shut down that fast. And I know it’s hard to think about a better time of day for you to exercise, but maybe that might make a difference for you to feel like your body settles at night to heal and rest and get into a better rhythm for your sleep and for your body to heal. But the same thing goes with you’ve got to know maybe some of those vagal nerve tone things and learning heart rate might be an exercise that is part of the practice that you may need.

Dr. Eric:

Mm-hmm (affirmative). Yeah.

Dr. Lisa: 

There’s never one answer to everything and we all want to have one answer and we all wish there could be that miracle answer. And sometimes that one answer is the answer and one time … I know that and Dr. Osansky probably agrees. I had a patient with pancreatic cancer and had part of her pancreas removed and I was a young doctor and I thought, “Oh my gosh, this is going to be a really, really hard case for me.” This was 35 years ago or something and I thought, “Wow. Okay, I’m going to do my best.” And I was thinking I might not do very well, but I gave this patient a protocol and thought it was going to be one of my hardest, it turned out to be one of the best. I gave her some pancreatic enzymes. She didn’t need my help for many, many years later until she went into menopause. And I always thought to myself, “Wow, that was an easy one. She responded differently.”

And then sometimes we may have a migraine patient that is very detailed, very involved and a lot of things that you wish you could just snap it and help them and there’s more layers to unravel. We are doctors that have to find a protocol, sometimes we nip it and we find it and we’ve got the nail on the head for that patient and definitely have our priorities of what we decide is the first step, second step, what phase is best for that person. And just like any kind of thing, we have an educated trial and error. We know what we want to do, but there are different nuances that are involved that have to have us know what step to take. Like with the gentleman about the diarrhea, there’s a lot of little things that we were already thinking, but we don’t know this, we don’t that, we haven’t met you, we haven’t seen other things. You want a doctor who is passionate with their work, dedicated to their work, who is a curious doctor.

And I would definitely say Dr. Osansky and hopefully I would say that I’m a humble doctor. I am always looking at finding the answers. I want to say that I don’t always get to help everybody, but my integrity and my passion and my just finding the answers … and functional medicine definitely gives you a lot more avenues, so many more avenues. It’s not like well, we’re just going to do surgery, or well, we’re just going to do this medicine. There are so many little tangents that people are hungry for, people are wanting more answers.

We as doctors in our field of natural medicine, drugs and surgery are last and that’s just … You want to get to it before it gets so bad. And all of you out there, we want to inspire you to listen to your body. Get somebody who’s an extra brain. Obviously this patient or this person, Darrell, you have great knowledge, get an extra brain from somebody like Dr. Osansky and I. You need that extra brain. We all need that extra brain, all of us do. And get the answers for yourself.

Dr. Eric:

This is just a followup from that other person who’s saying they’re doing meditation, they’re actually doing acupuncture which is helping.

Dr. Lisa: 

Yes.

Dr. Eric: 

Which is great. You are very welcome, Darrell. We appreciate you. We appreciate everyone asking questions and showing up on this Friday. Thank you so much. Thanks for attending. And thank you Dr. Lisa for sharing-

Dr. Lisa: 

Thank you.

Dr. Eric: 

… and going over time. I appreciate you sticking around to answer questions, I know you have a busy schedule and we all appreciate it.

Dr. Lisa:

Well, I’ll be happy to come back on any time you want. You know you and I love to talk. Dr. Osansky and I will have lunch together and he keeps me on my watch, he goes, “What time do you have to get back?” because we’ve gone over before and I’m like, “Oh my gosh.” So we always eat close by and he gets me back to my office because I like to chit-chat quite a bit with him.

Dr. Eric:

Yeah, we have a good time when we talk. Yeah, all right. Well, I’m going to wrap this up and let everybody enjoy the rest of their Friday and I hope everyone has a great weekend ahead. And same with you, I hope you, Dr. Lisa, have a great Friday, a great Saturday and Sunday.

Dr. Lisa:

Thank you.

Dr. Eric: 

And yeah, look forward to doing lunch with you again.

Dr. Lisa: 

All right. Take care everyone. Bye-bye.

Dr. Eric: 

Bye. Take care everyone.

Note: I mentioned a blog post on the vagus nerve I previously wrote, and you can access it by Clicking Here

On Friday July 2nd I interviewed Dr. Deb Matthew, as we chatted about sex hormones, and below is the written transcript. If you would prefer to watch the interview you can access it by clicking here:

Here is the transcript:

Dr. Eric:

Well, hello everyone. Happy Friday!  I hope everyone is doing great today. With me, I have Dr. Deb Matthew. She just practices right down the road from me, so a lot of times we have practitioners from all over the world, all over the United States, so it’s nice every now and then to speak with someone who’s not too far away. Dr. Deb is known as the happy hormones doctor, and she’s a bestselling author, international speaker, educator, wife, and mom of four boys. After suffering for years with fatigue and irritability, her quest to resolve her personal health led her to change everything about her practice of medicine. And that’s the case with a lot of medical doctors, right?

Dr. Deb:

Yeah, of course.

Dr. Eric:

Yeah, practicing conventional and then something happens and then they open up to functional medicine. And so you’ve been featured on national podcasts, radio broadcast shows including NBC, ABC, CBS, and Fox, and thank you so much for joining us, Dr. Deb.

Dr. Deb:

Well, it’s great to be here.

Dr. Eric:

So we’re going to talk about sex hormones and thyroid health, talk also a little bit about adrenals … or maybe a lot about adrenals. It depends on you, how much you want to talk about adrenals. So the main sex hormones, testosterone, estrogen, progesterone … of course, there are different types of estrogens. Why don’t we start with testosterone, because first of all, I read your recent book, which focused on testosterone. But testosterone, just like all the sex hormones … When we think of testosterone, a lot of people just think men, but, of course, testosterone plays a big role in both men and women. And the same thing with progesterone and estrogen. Bpth men and women have all these hormones. But again, we’ll start with testosterone. As far as testosterone deficiency, what are some of the common symptoms of a testosterone deficiency?

Dr. Deb:

Well, testosterone is really important for muscles. It’s important for strength, stamina, and endurance. It’s important for muscle tone. It’s also really important to keep our bones strong, but you wouldn’t feel it if your bones are not strong. Testosterone is also really, really important for sexual health, so interest, caring about sex. It’s important for erectile function. For women, it’s important for vaginal lubrication. But what a lot of people don’t realize is testosterone is really important for how we feel on the inside. It’s important for how we relate to the world around us, how we react to other people. It’s kind of like our emotional shield or our inner strength, so it gives us competitive drive, motivation, confidence, assertiveness, self esteem, decisiveness.

When testosterone levels go down … and they can go down for men and for women … we just kind of tend to feel a little flat, kind of blah. For the most part, we put one foot in front of the other, we make our way through the day, if something has to happen today, we’ll make it happen. But if it doesn’t have to happen, a lot of times we kind of leave it by the wayside because we’re just not really feeling it, so we’re more prone to kind of procrastinating or having to kind of force things because we don’t feel like it, and it’s just not normal to feel that way. And because this is not something where people are thinking, “Gee, maybe it’s my testosterone,” usually what happens is if it gets bad enough, people will go to their doctor and they’ll say, “I have no motivation. I don’t feel like myself. I don’t really feel like doing the things I used to enjoy doing.”

What ends up happening is, the doctor whips out their prescription pad and the next thing you know, you got some kind of an antidepressant. The problem is, if the real underlying cause of why you’re not feeling great is low testosterone, then an antidepressant is really not going to do the trick. So it’s important that people know so that they can get the right diagnosis and then get the right treatment.

Dr. Eric:

All right. Thank you for mentioning that. So when it comes to diagnosing, what do you look at? I assume total testosterone, free testosterone, maybe sex hormone binding globulin?

Dr. Deb:

Yeah, exactly. We look at free and total testosterone. The total testosterone is obviously the total amount you’re making. The free testosterone is the tiny little fraction that is available to your cells to actually do the job. And there’s a whole bunch of things that can make it so that even if you were able to make enough testosterone, there’s not enough of that free fraction to feel. And one really important thing to mention for women is the use of birth control pills. Because when women are on birth control pills or on synthetic hormone replacement pills or really any kind of estrogen replacement pills, the body makes more of what’s called SHBG, sex hormone binding globulin, and this is a protein in our bloodstream that can grab hold of testosterone and inactivate it. So there’s less of that active free testosterone, and then you feel all those symptoms of low testosterone. And while we’re talking to people who may have hyperthyroidism, one of the things that can happen in hyperthyroidism is your body can make too much of the sex hormone binding globulin too, and so that can kind of make your testosterone levels or the free testosterone level go down so that you feel a little bit like you’re low testosterone, even if your body happens to be making enough testosterone.

Dr. Eric:

All right. That is very interesting. So they kind of go hand in hand where you see the high sex hormone binding globulin, SHBG, and then also the free testosterone. Are there times when you don’t see that pattern?

Dr. Deb:

Yeah. So very commonly, total testosterone, all the testosterone, kind of of goes down, and there’s a few scenarios for that. So for men, testosterone levels naturally decline with age, and it’s very gradual. So when women have hormone changes, it’s usually all up in our face. We get menstrual changes and we get hot flashes. Whereas for men, it’s very gradual. But it’s very common for men over the age of 40 for their testosterone levels to decline, and then they just don’t feel like they should. They lose that drive and energy. For women, testosterone levels commonly decline when we’re in the decade of our 40s, and then by the time we go through menopause, it’s very typical for testosterone levels to be low.

Another reason besides just age for testosterone levels to become low is adrenal stress. We talked a little bit about maybe mentioning adrenals, but when we are under a lot of stress, that affects cortisol, which is our main stress hormone that’s, of course, made in our adrenal glands. And cortisol and testosterone are kind of like opposites. When our body is under a lot of stress, it tries to put all the resources into making enough cortisol to help you cope with that stress. But another hormone that your adrenal glands are supposed to make is called DHEA, and when you’re under a lot of stress, often what happens is all the resources go to cortisol and then you don’t make as much DHEA anymore. The problem is, DHEA is the ingredient that our body can use to make more testosterone, and so that’s why stress can make testosterone levels lower.

So if you’re a man over 40 or a woman over 40, then your testosterone levels may be lower naturally. And maybe if you’re a younger woman on birth control pills, that’s interfering with testosterone. And then if we add the stress of top of all of that, that’s just enough to kind of push you over the edge, so you just really don’t feel good.

Dr. Eric:

So with men, the older you get, the lower the sex hormones get, but it could also be stress. But if it’s, let’s say, a 20-year-old male or a male in their 20s or 30s with a lower libido, if they have low testosterone, it’s probably not due to age.

Dr. Deb:

Exactly.

Dr. Eric:

You’re saying it’s a good chance it’s stress related, because obviously, they’re not going to be on birth control if it’s a male, so probably stress is the factor?

Dr. Deb:

Yeah. I think that’s a really, really important point, is it’s actually not as unusual as you might think for us to find young men with low testosterone these days. But it’s really important, in my opinion … we want to be asking why. So if some guy who’s 25 or 35 doesn’t feel good, lost libido, et cetera, they get their testosterone level tested and it’s kind of low, instead of just knee-jerk writing a prescription for testosterone replacement, we should be asking the question, “What is going on here?”

So maybe it’s stress, and there’s a way that we can sort of tell, because cortisol impacts our pituitary gland in the brain, and the pituitary gland makes a hormone called luteinizing hormone, or LH, which is something we can measure on a blood test. So when you’re under a lot of stress, that pituitary gland sometimes gets shut down a bit so that you don’t make enough LH, and so your body is just not getting the message to make testosterone. It’s not that it can’t, just the stress is turning the message off. And so in that case, if we deal with the stress, we can make things better.

On the other hand, if that LH, that hormone is high, that means your brain is already yelling, trying to get more testosterone made, which implies that the problem is in the testes, which is where testosterone is made for men, which means it’s a different kind of a medical problem that needs to be sorted out. So especially for young men, it’s really important to have that LH test done so that we can figure out, is it a brain problem or a testicular problem?

But one of the most common reasons that we see is the impact of environmental toxins. Because we live in this crazy world. We are all exposed to so many chemicals every day. They’re in pesticides in our food, they’re in plastics, they’re in our personal care products, the air we breathe. It’s just everywhere. And a lot of these chemicals are hormone disruptors. They mess up how our hormones work. And for men, they can suppress testosterone, they can make men create too much estrogen. It impairs fertility for men. It causes all kinds of problems that makes men not feel good. And so sometimes, looking at toxins in the environment, cleaning up your environment, doing things to help flush these toxins out of your system can actually go a long way towards restoring testosterone.

I think it’s important to note that a lot of times, men have all these things going on at the same time. So we might have a guy who’s 50 years old and he’s under a lot of stress and he’s had a lifetime exposure to all these toxins, maybe drinking too much alcohol, because alcohol is just toxic to the testes and not good for testosterone production. So it’s sort of the culmination of all of these things, and so we always want to be looking at somebody in a holistic way. So what I see happen in modern medicine … which I think is actually a good thing … is more and more doctors are aware of the importance of testosterone in men. They’re not doing such a good job for testosterone in women, unfortunately. But they’re more and more aware of how important testosterone is in men and they’re much more likely now than ever before to actually be willing to measure a testosterone level.

So it’s not that hard to get your doctor to measure a testosterone level. The problem is, they’ve only got one tool in their toolbox, which is testosterone replacement. And listen, sometimes that really helps and that’s really important. But if we’re not at least trying to understand why the testosterone is low, we don’t really get the best results. And if anybody is going to be on any kind of hormone replacement therapy, we want to be putting the hormone in a healthy body, so we want the healthiest version of you, whether you’re going to be on the testosterone replacement or not.

Dr. Eric:

Yeah. I’m glad you said that, because you are a medical doctor who does recommend at times bioidentical hormones, but what you’re saying here is that you want to address the cause of the problem even if someone does need to take testosterone replacement. That’s something I also tell patients as well, is that you want to improve adrenal health and correct other imbalances, and if someone still needs to be on testosterone or if a woman needs to be on estrogen, progesterone, then I completely understand. But you’re right, a lot of practitioners will just put people on the hormones without addressing the underlying imbalances.

Dr. Deb:

I learned this the hard way, because … I was a regular doctor and I didn’t know about any of this stuff. But I went through my own challenge. My personal story has to do with thyroid and adrenal problems, and my quest to figure out how to help myself is what had me change. Because there was nothing in my medical training to help me understand why I was so irritable and tired all the time and why my thyroid replacement medicine wasn’t making me feel better. And once I discovered there’s all these other things going on that affect our hormones and how we feel, I learned about hormone replacement therapy, about bioidentical hormone replacement.

But when I first started in my practice, that’s kind of all that I was doing, was I would measure hormones and then I would prescribe bioidentical hormones. And in the first few months of my practice, I recognized right away that some people felt a lot better right away, but there were some people that we just weren’t fixing the problem. We would try to adjust their dose, but we never could really get it right. That’s when I really realized we got to address adrenals and toxins and gut health and stress and lifestyle habits and nutrition. All of these things are so, so important in how our hormones work, and a prescription, even if it’s a more natural prescription, can never really be the whole solution all the time.

Dr. Eric:

Yeah. I of course agree with everything you said. Also, you mentioned endocrine disruptors. Of course, it’s not just with men, it’s with both men and women. Some examples like bisphenol A and phthalates, I mean, they’re widespread. And then, of course, people will say, “Well, I drink out of BPA-free bottles,” but then there are other chemicals in the BPA-free bottles.

Dr. Deb:

It can feel kind of overwhelming. How I talk to people about it … Because we could talk about all the chemicals. There’s even tests where we can measure different chemicals in people’s bodies. But the problem is, we’ve all got all kinds of chemicals in our body. Those test results are just really kind of depressing, and then it’s really hard to know, well, which of these chemicals is causing the problems? And it’s very hard to pinpoint all of that. But there are some really simple things that we can do in order to try to minimize exposure to toxins, and so I really try to help people focus on the simple things that we can be doing, like don’t microwave in plastic and buy skincare products that specifically say paraben free. Like you said, try not to use the plastic, because even if it’s BPA free, we don’t really know what’s in it.

So there are some fairly simple things that we can all do that are not really more expensive that really could go a long way. And focusing on the simple things, I think, is really important, instead of feeling overwhelmed and hopeless at escaping all of the toxins, because they really are pretty much everywhere these days, unfortunately.

Dr. Eric:

Yeah, exactly. Whatever you do, you’re not going to completely avoid them, but try to minimize your exposure and then maybe do things to improve detoxification. I mean, we’re always detoxifying, but just eating plenty of vegetables and sauna, things like sweating will help with the elimination of toxins. All right, well, so besides testosterone, there’s also, of course, estrogen and progesterone. And again, they do play a role in both men and women, but when we think about estrogen and progesterone, we do tend to think more about women. But I guess if you could talk more about that, and even maybe a little bit about estrogen dominance. I did have someone else a few months ago speak about that, but maybe talk a little bit about that.

Dr. Deb:

Yeah. Estrogen and progesterone are really important hormones for women. And if I could just say for two seconds about men and testosterone … Men can sometimes end up with too much testosterone because of inflammation, because of being overweight, because of toxins in the environment, and that doesn’t feel good for men. So we don’t want too much estrogen and we don’t want not enough testosterone. For women, when women are premenopausal, but especially in the perimenopausal time of our life which is sort of roughly age 35 until about 50, sometimes estrogen levels can really fluctuate a lot up and down. But progesterone levels tend to go downhill over this time, so what often happens is estrogen is still okay, but progesterone is too low.

So that’s what we call estrogen dominance, like you mentioned. And when women are estrogen dominant, we tend to start to have problems with menstrual cycles, so heavier periods, periods coming more often, lots of PMS symptoms, things like fibroids growing. And so a lot of women end up with a hysterectomy because that’s what their doctors have to offer, is birth control pills to make their periods better or a hysterectomy. But if we can replace natural progesterone in order to bring back balance, we can make periods lighter and more regular and minimize the growth of fibroids. But in addition to menstrual kind of things, progesterone is very calming. So it helps us to be relaxed and chilled out. It helps us to sleep soundly. So when our progesterone levels tend to drop, a lot of women notice anxiety, panic attacks, irritability. We sometimes feel just negative, impatient, critical, easily annoyed, not the best version of ourselves.

I lived this, and I can speak to this, but I hear it from my patients all the time. We’re shrieking at our kids and the poor kids didn’t really hardly do anything at all, but we can’t help it. Or one minute, we’re looking at our husband thinking, “What a great guy,” and then the next minute, we just want to stab him in the back because he’s so darn aggravating. We can’t help these crazy moods that we’re feeling and we don’t understand what the heck is going on with us, or the men in our lives don’t know what the heck to do with us. And once again, if you go to your doctor to complain, anxiety pills, sleeping pill. Progesterone helps us sleep soundly through the night so we wake up feeling refreshed in the morning, so we tend to wake up and have night sweats and things like that when progesterone goes down.

So after we go through all of that hot mess, then eventually we hit menopause. That’s when estrogen drops too, and estrogen is energizing, it’s a natural antidepressant, it’s good for our brain and our memory. And so when estrogen drops, sleep can get worse, we can feel just more tired and worn out, we can feel more moody, depressed, flat, irritable, and one of the most common things I hear women complain about is just our brain doesn’t work. There are just not enough sticky notes to keep track of everything because we keep forgetting stuff. We can’t get that word out that we want to say. We can’t remember why we walked in the room, where we left the car keys. Our brain is just not doing what it needs to do, and it’s scary. If you’re 16 and you forget something, you just laugh about it. But when you’re in your 50s or your 60s or your 70s, if your brain isn’t remembering things as well as it used to, you can’t help but worry that it’s the early signs of Alzheimer’s. That’s just where we all go. That’s what we think.

And most of the time it’s really not. It’s just that estrogen is what’s keeping those rich connections between your brain cells so that your brain can do its job and women can really notice a difference when that goes down. Another thing that often happens when estrogen goes down is vaginal dryness. Things can get dry and painful, and often, testosterone is going down at the same time so first we lose interest in sex, but then it hurts, so then who’s going to want to participate if it’s just uncomfortable? And when women are having a negative experience with sex, that impacts relationships, it impacts intimacy, it causes marital problems. So it really is kind of a big deal beyond just pleasure, and it’s something that is really very fixable. So it’s really just a shame for women to have to go through those kinds of experiences when there’s things that we can do to make it better.

Dr. Eric:

Yeah. Thank you for that. As you mentioned, when women hit menopause, the estrogen levels drop and all hormones as we age get lower. But again, in a scenario with a younger woman … again, in their 20s or 30s … when they have lower progesterone, is that once again more usually of an adrenal problem?

Dr. Deb:

You’re right. So when women are over 35 and especially getting into their 40s, so their ovaries are not working as well anymore, so progesterone can go down, and that’s mostly age. But on top of that, like you said, toxins and adrenals and all the rest just make it worse. But for younger women, they can also have estrogen dominance. They can have a lack of progesterone, but it’s not age, so that means we need to figure out what is the root cause. Sometimes it can be from too much stress in their lives. Sometimes it’s from something called PCOS, polycystic ovarian syndrome. And in this particular condition, there’s too much testosterone and problems with blood sugar metabolism, and so women aren’t ovulating regularly, and if you don’t ovulate, then you don’t make progesterone and you end up with this estrogen dominance and you gain weight and you struggle with things like acne and hair growth. It is super common. 1 in 10 women has PCOS. The vast majority are never diagnosed, and it’s an important thing for women to know about themselves so that they can get the proper help.

But there are other things as well that can interfere with ovulation and with progesterone. Another really common one that I see is a gluten sensitivity. So sometimes it’s super common for women who have hormone issues to also have digestive issues. They have IBS or just chronic digestive symptoms, and very commonly we find hidden food sensitivities, especially gluten, which is the protein in wheat. That’s the most common one. But there’s lots of other ones, and if we can get them to really clean up their diet, remove the foods that they’re sensitive to, often menstrual cycles get better, they ovulate again, the progesterone levels just are restored naturally, and that’s all that it took was just some lifestyle changes and eliminating a couple of foods that were causing big problems.

Dr. Eric:

So is it fair to say it’s not maybe just the gluten, but just anything that might cause gut inflammation in general?

Dr. Deb:

Anything that causes gut inflammation in general, and gluten just happens to be a really common cause of it.

Dr. Eric:

All right. And you mentioned PCOS. So PCOS is more of a blood sugar problem, more like an insulin-resistant problem than a hormone problem? Is that correct?

Dr. Deb:

Well, it’s two things. It’s the blood sugar problem and it’s a testosterone problem. When women have insulin resistance, one of the things that happens is the ovaries get triggered to make more testosterone and the extra testosterone causes the body to make more insulin, and so you get this kind of feed-forward cycle. Then the testosterone and the insulin interfere with ovulation, so it causes low progesterone, because if you don’t ovulate, you don’t make progesterone. So what may have started as a blood sugar issue ends up causing the hormone issues. And unfortunately, it’s how it’s generally treated … because a lot of times, women won’t have regular periods. They either have bleeding, long heavy periods that go on and on, or they don’t have any periods at all, or they get something in between.

So usually, how it’s treated is just by giving women birth control pills in order to try to regulate their period. And while often birth control pills can regulate the period, it’s kind of just artificially doing it. It’s not really fixing the underlying problem, it’s not addressing the blood sugar problem, and so then sadly, eventually women come off the birth control pills wanting to start a family, only to find out that they have fertility problems because that’s another part of PCOS. So we’re going off on a whole different ballpark here, but PCOS is a really common problem and most women who have it don’t even know that they do.

Dr. Eric:

Okay, yeah. We are straying a little bit, but covering a wide variety of different topics here. So let’s go back to testing. With testosterone, you mentioned free testosterone, total testosterone, sex hormone binding globulin, FSH, LH. So how about when it comes to estrogen and progesterone?

Dr. Deb:

Yeah. For estrogen and progesterone … and for the testosterone too … there’s different ways we can measure. We can do a regular blood test. For testosterone, I actually am perfectly fine with doing a regular blood test. For estrogen and progesterone, we have other ways besides that, in addition. So we have saliva testing, we also have urine testing, and we can get more information from these other tests than we can with just a blood test. The one that’s kind of becoming one of the most popular ones is called a DUTCH test, which stands for Dried Urine Test of Comprehensive Hormones. A DUTCH test can tell us how much estrogen you’re making. It tells us three different kinds of estrogen, and it tells us how you are metabolizing the estrogen. So you have to flush the estrogen out of your system in order to make way for tomorrow’s estrogen, and those estrogen byproducts are important, because some of them are breast protective and some of them could contribute to breast cancer. So we’ll know how your body is processing your estrogen, and if it’s the good way or the bad way.

For testosterone, we can also get how your body is metabolizing the testosterone, we can get more information. So a DUTCH test is something that’s really popular. It’s really important, no matter whether it’s going to be blood, saliva, or urine … it’s really important for premenopausal women, when they have their hormone testing done. So if you go into your gynecologist’s office to ask for your hormone levels to be done, usually you get one of three responses. One is just, “No, we don’t do that.” Another one is sometimes, “You’re too young to have hormone problems.” Or the third thing is, they’ll sometimes do an FSH, which kind of tells us if your ovaries are getting close to menopause or not, but oftentimes they don’t actually measure your estrogen, progesterone, and testosterone levels. They are certainly not going to offer you a DUTCH test. It is not covered by health insurance, but it’s just not something that the regular mainstream doctors even know about yet, and they don’t also typically do saliva testing.

But it’s really important when you get your tests done. So if you happen to have your gynecology appointment at 3:00 on some random Thursday, then part of why they don’t really want to measure your hormones is because it depends if you’re on your period, all those hormones are going to be low. If you ovulate, your estrogen’s going to be really high. The week before your period, estrogen and progesterone are going to be higher than the other times of the cycle, so it changes depending on where you are in your cycle. The best time for us to do the test is about a week before your next period is due, so about day 19, 20, or 21 of a 28-day menstrual cycle is the best time to have these tests done. And if you’re menopausal and you’re past menopause and not having any more periods, well, then it doesn’t matter. You can do it anytime.

Dr. Eric:

And it’s also important to mention that with the DUTCH test, for those who are cycling, they do have a cycle mapping test you could do … They have the DUTCH complete, but then the cycle mapping test, you’re collecting samples … I think it’s every few days of your cycle. I don’t think it’s every single day, right?

Dr. Deb:

Correct. And that’s great because then we can see when you ovulate and we can watch this whole dance that the hormones do, because through the cycle, our hormones are going up and down and that natural rhythm is really, really important.

Dr. Eric:

Yep. And some companies that do saliva testing also offer a cycling hormone panel as well.

Dr. Deb:

Yeah. They’ll also do that

Dr. Eric:

But thank you for that advice for those who are doing blood testing, because that’s the norm. Most people still will test the sex hormones in the blood and, as you said, timing is important. All right, so again, we covered testing, did we cover symptoms of … I guess some of the symptoms of testosterone. So estrogen, when someone’s low in estrogen, I think you mentioned the hot flashes, the night sweats.

Dr. Deb:

Yeah, vaginal dryness, dry skin, memory problems. Yep.

Dr. Eric:

Yep. And then progesterone, you mentioned sometimes they’ll be more anxious.

Dr. Deb:

Yeah, anxiety.

Dr. Eric:

Which is not … well, I was going to say it’s funny. It’s definitely not funny, but it’s coincidental with hyperthyroidism, Graves’ Disease, we see a lot of people with anxiety and problems with sleep. And the elevated thyroid hormone level definitely could be a factor with that, but also there could be other variables, such as low progesterone, so that’s also something to keep in mind. You were talking earlier about, essentially, the cortisol steal or pregnenolone steal where the body prioritizes cortisol at the expense of DHEA. But really, it’s sacrificing all the sex hormones, because DHEA is a precursor to testosterone, which is a precursor to estrogen, and progesterone is in the same pathway as cortisol. But essentially, it’s all about cortisol when you’re stressed out, so that in your practice, I imagine focusing on improving adrenal health is very important. So what are some of the things, whether it’s diet or stress management or supplements, that you do to help people with their adrenals?

Dr. Deb:

Yeah. The first thing is trying to find healthy balance. So if we can reduce stress, of course, that’s great, simplifying. Sometimes we do it to ourselves, like we were talking earlier. My superpower is over-scheduling myself, so I create my own stress. So if we have ways to reduce the stress in our lives, that’s always a wise idea. Sometimes there are stresses that we can’t get away from though, and so if we have ways of bringing balance, that’s really important. So things like breathing exercises, meditation, yoga, being outside in nature, prayer, laughter. All of these things elicit the relaxation response, which is kind of the opposite of our fight or flight response, and that can be really helpful for calming down adrenal function. So healthy ways of coping with stress can help to protect us from the harmful impacts of that excess cortisol can help right things.

Eating is also really important, so we want all the healthy nutrients that our body needs. And sugar is a toxin, first of all, but it stresses your cortisol. Because one of cortisol’s jobs is to help prevent your blood sugar from crashing too low, and so if you’re eating a lot of sugar, your blood sugar will spike up and then it crashes, and so that’s hard on your adrenals. Alcohol is hard on your adrenals too. Caffeine is hard on your adrenals, it kind of kicks them when they’re down. So in the moment, it makes you feel a little better, but in the long run, it’s not really helping. So cleaning up nutrition and having healthy lifestyle habits, whole foods, lots of fruits and vegetables, all the things that we know to do for a healthy diet, those things are really important.

And getting enough sleep is important too. Sleep is so restorative. For people who have adrenal problems, sometimes sleeping in just a little bit longer can be really kind of magical for making them feel better if that’s possible. But then there are some nutritional supplements that can be helpful too. And we can’t really make personal recommendations on a venue like this, but some of the herbs that can be really helpful are things like ashwagandha, which is something that’s been used for thousands of years all over the world to help people cope with stress. And of course, thousands of years ago, they may have not known all the chemistry inside our cells for how it works, but science has figured it out now and so there’s ashwagandha.

Holy basil is another herb that can be really helpful for people who have high cortisol at night, which is common … Cortisol is supposed to be higher in the morning so you have energy in the day. It’s supposed to be lower at night so that you can sleep. But a lot of people get flipped around backwards, so it’s too low in the morning and it’s too high at night. So phosphatidylserine is a nutrient that can actually help calm cortisol levels at night when it’s too high, and that can help you to go to sleep, fall asleep, stay asleep better so that maybe you wouldn’t need your Ambien or Lunesta or whatever kind of sleeping pill you’ve turned to in order to try to help you cope with sleep.

So there definitely are nutritional supplements that we can do, and if we can measure your cortisol to know what your personal pattern is, then we can kind of know, is it high? Is it low? Is it high one time of the day, low the other time of the day? That way we can target the right kind of treatment.

Dr. Eric:

So for high cortisol, the phosphatidylserine, ashwagandha … which is adaptogenic, and so really can be used even for low cortisol, but commonly also for high cortisol. So for lower cortisol, do you ever recommend things such as licorice root … which you do need to be cautious about because it could also affect blood pressure, so I just want to mention that before either one of us forgets to say that … but do you recommend licorice root or adrenal glandulars or anything else for lower cortisol?

Dr. Deb:

Yeah, I actually use a lot of adrenal glandulars, and that was one of the things that when I was first starting out as … I’d come from being a regular doctor and now I’m trying to do this functional medicine … I was really resistant about using adrenal glandulars because it just … I don’t know, it doesn’t sound very medicine-y, right? It doesn’t sound very science-y. But they work so well for so many people, and so it is one of the things that when I get people started on these, they sometimes feel so much better. And let’s say six months down the line, they’re doing better and I suggest, “Listen, maybe you don’t need these anymore. Why don’t we try to stop them?” A lot of people will tell me, “Oh no, please don’t take those away from me. I can really tell the difference. I really like those.” So this is one of the things that people keep coming back for more because they can really tell the difference. It’s really kind of helping give your adrenal glands what they need in order to do a good job, so I do use a lot of adrenal glandulars.

Dr. Eric:

All right. And then moving on to supplements for the sex hormones. So maca … which also could affect the HPA axis too … but Maca root, and there’s chaste tree, vitex … both are the same… to help with progesterone production, black cohosh. So  do you recommend any of these or other types of herbs?

Dr. Deb:

Yeah. So especially for younger women who aren’t making enough progesterone and they’re having a lot of PMS and menstrual problems, we really like the chaste tree because that can help you to make more progesterone, better progesterone production. Another supplement that we sometimes use to help women boost their testosterone, especially if they’ve got adrenal problems, is DHEA because that’s the other hormone from your adrenal gland that you can use to make testosterone. So typically, we would want to measure your DHEA level first, because if it’s already normal or high, then adding more can just cause side effects. But it can actually help to boost testosterone levels for women. Tribulus is an herb that we can use to help boost testosterone in men and in women. And then, as you mentioned, things like black cohosh can help kind of just calm down hot flashes and things like that.

So there are some women who … and I see lots of these women in my practice … they are eating a clean diet, they’ve minimize sugar, they’re eating their vegetables, they exercise regularly and do yoga and they’re taking their vitamins. They’re doing all the things. And nobody’s perfect, but they’re doing a pretty decent job and yet they still are exhausted, or sex is painful, or the night sweats are just preventing them from sleeping. They just have done all that they can, and those are the women where adding a little bit of bioidentical hormone replacement therapy can really make all the difference. There’s no herb that can really do the same thing as hormones for keeping your bones strong and keeping your brain healthy and your skin looking young. So it’s not that everybody needs bioidentical hormone replacement therapy, but for the women who do, it really, really can make a big difference.

Dr. Eric:

Well, a good comparison is thyroid hormone because I get patients asking me, “Is there an herb that I can take instead of thyroid hormone replacement?” But if you’re truly deficient in thyroid hormone, I mean, herbs such as ashwagandha, yes, it can in some cases stimulate, effect the HPT axis, the hypothalamic pituitary thyroid access, as well as adrenals, but in this case, maybe help with thyroid hormone production. But if someone has an autoimmune condition such as Hashimoto’s which is damaging the thyroid gland and just over time their levels are really deficient, taking ashwagandha probably is not really going to help, unfortunately. In this case, they may need to take thyroid hormone replacement… whether it’s Levothyroxine or desiccated thyroid.

But I agree. There is a time and place. And when it comes to hormones, if you’re truly deficient, of course you want to try to address the cause of the problem, as you said, so you always want to address the cause. But in some cases, hormone replacement is necessary. So of course, thyroid is what a lot of my patients deal with … either hyperthyroidism/Graves’, hypothyroidism/Hashimoto’s, and I know you work with thyroid patients as well. So you briefly mentioned that you had a thyroid problem and that’s kind of how you got into the functional medicine aspect with the thyroid?

Dr. Deb:

Yeah. When I was in medical school … Well, I used to be tired all the time. Napping was my favorite hobby. I needed more sleep than anybody else. I was always cold. I had dry hair. But those symptoms had been going on for so long, I just thought it was me. And when I was in medical school, on two different occasions, doctors would look at my neck and say, “Your thyroid is enlarged. You should go get it checked.” So I went and got it checked. I was told my labs were normal, and so I just accepted that and kept on being tired. I’d been on birth control pills all these years because I never had regular periods, so then I came off birth control pills in order to become pregnant and shockingly enough still didn’t have regular periods. I’m not sure why I would have thought it would be different. And in my infertility workup, I was diagnosed with Hashimoto’s.

I was given Synthroid and it worked. I’ve got four babies, so it worked for the fertility problem, but I didn’t feel any different. I still struggled with my weight, I was constipated, I had no libido, I was tired all the time, but my labs looked normal. And for 10 years, I was on that Synthroid, and it wasn’t until I read a book, actually, by Suzanne Somers, about natural hormones and this whole bioidentical thing and that there were natural ways of treating things. Totally blew my mind. I had no idea. They didn’t teach me any of that stuff in medical school. All I knew was if your TSH is not normal, we can give you a pill if it’s too high, we can give you a pill if it’s too low, but once your TSH is normal, then you’re normal and there’s so much more to the story than that.

So that’s when I got myself in better health. I addressed my adrenals, I addressed my low progesterone. I’d been having panic attacks in the middle of the night for no reason. And it just completely transformed my life. I got myself on desiccated thyroid. They will have to pry that out of my cold, dead hands because I will never go back to Synthroid again. It just does not work for me. But I couldn’t go back to just what I was doing before, which was just writing prescriptions for everybody all day long because that just didn’t make any sense to me anymore. And so I completely retired from my old job and I retrained in functional medicine. And so now for the last almost 15 years, I’ve been treating men and women to help them get their hormones back in balance so that they can actually get well, often get off a lot of their prescription medicines, and love the way they feel.

Dr. Eric:

All right. Have you had any issues with the recalls and everything going on? It seems like every year there’s something going on, whether it’s Nature-Throid or WP Thyroid, which have the same manufacturers, and then a number of years ago, Armour. I don’t know if there’s been anything recent with Armour, but I think even with NP Thyroid there’s been some issues.

Dr. Deb:

Yeah. It’s hard because thyroid hormone is in microgram doses. So most things are … like acetaminophen or Tylenol is like 500 milligrams, but when we’re talking about thyroid, we’re talking in micrograms. They’re tiny, tiny, little amounts and so it’s very difficult to be super perfect when we’re talking about such tiny little amounts. And the way the FDA works is you’re allowed to have 10% more … like if it’s supposed to be whatever the dose is, you’re allowed to be 10% above or 10% below, but you have to be that close. And so if it’s 12% below, then it gets recalled. And so even the regular Levothyroxine and things can have recalls sometimes, but it’s really sort of disheartening.

And one of the things that’s most disheartening about it is a lot of regular doctors don’t believe in desiccated thyroid. The only thing that they’re willing to talk about is Levothyroxine, which is fine for lots of people, but for some people like me, it just doesn’t really do it completely. And they’re so against the desiccated thyroid because they felt like it wasn’t properly regulated, and so when we have these recalls, it just reinforces that belief and so it makes it harder and harder for women to get the kind of medication that would actually really help them.

Dr. Eric:

Yeah. It is unfortunate that more don’t open their mind to desiccated thyroid, even though things are changing, I think. There are more doctors who are getting into functional medicine, so who knows. Hopefully in the upcoming years and decades ahead, more and more practitioners will recommend it.

Dr. Deb:

Hopefully.

Dr. Eric:

Yeah. So adrenal health, obviously, very important for optimal sex hormone health. And would you say then the same with thyroid? You need to have optimal thyroid health in order to have optimal sex hormone health?

Dr. Deb:

Yeah. Thyroid is so critical for so many parts of you, and in order for us to ovulate, we need enough thyroid. So in my case, the reason that I wasn’t having regular periods, the reason that I had fertility problems is because my thyroid was off. So I didn’t need birth control pills to regulate my periods. I needed thyroid to regulate my periods, but nobody was looking in the right place. So all of these different hormones that we’re talking about today, they all interact with each other, they all work together. And so if we’re really going to be looking at somebody hormonally, we need to look at the big picture. We need to look at all these different hormones together so that we can take into account how they all interplay, because what we’re really looking for is balance. Sometimes one hormone can be normal, but kind of high normal, and another hormone could be normal, but it’s kind of low normal, and so we’ve got this imbalance. So even though technically they’re both normal, you won’t feel your best. And so if we can bring it back into balance, symptoms melt away and you just feel so much better.

Dr. Eric:

Yeah. I’ve covered this with some other guests on this platform, but optimal ranges versus lab ranges … So that’s another thing. I mean, we won’t get into too much detail here, but you can’t just rely on the lab reference range.  So if someone has a TSH of, let’s say, 3.5, most labs will say that is fine and most doctors will go by those reference ranges, but unfortunately, that’s not optimal.

Dr. Deb:

That’s not optimal.

Dr. Eric:

Yeah, exactly. All right, well, thank you so much for sharing everything about sex hormones, Dr. Matthew. Where can people find out more about you?

Dr. Deb:

Yeah, well…

Dr. Eric:

And your books as well. I’ve seen your books on Amazon, but …

Dr. Deb:

Yeah. I wrote a book for women. It’s called This Is Not Normal: A Busy Woman’s Guide to Symptoms of Hormone Imbalance, and you can actually get a free copy at isityourhormones.com. So isityourhormones.com, you can download a free copy of the book for women. It’s got lots of quizzes about symptoms of low testosterone or symptoms of adrenal problems so that you can kind of figure out for yourself what sort of things are going on. I have a book for men. It’s called Why Can’t I Keep Up Anymore? A Guide to Regaining Energy Focus and Physical and Sexual Performance for Men Over 40. Both of those books are available on Amazon. There’s more information at my website, which is signaturewellness.org.

Dr. Eric:

All right. Wonderful. Well, thanks again for taking the time, and I’m sure everyone found this to be valuable. Let’s see if there are any questions. I think there are some questions. All right, so let’s see here. Okay. Just a thank you. You are very welcome. All right, then another thank you here. So again, if there are any questions about sex hormones, let us know. I think Victoria asked this. I think I saw this pop up with the adrenal desiccated. There’s a lot of different … well, I won’t say a lot, but there’s different companies that have adrenal desiccated. I know Standard Process has desiccated adrenal, and I think Seeking Health, there’s a few different companies. I don’t know if Dr. Deb has a favorite that she-

Dr. Deb:

Yeah. My favorite, actually, is Dr. Wilson’s. It’s called Adrenal Rebuilder. I use a lot of that.

Dr. Eric:

Okay. All right. Yeah, which is a awesome book as well, the Adrenal Fatigue book. All right, if there are any other questions, let us know. If not … Oh, here we go. All right, so, “My daughter is newly diagnosed with hyperthyroidism and is showing really high cortisol as well as high testosterone. Is that common with hyperthyroidism or is that a different issue maybe?”

Dr. Deb:

Hyperthyroidism doesn’t directly increase testosterone levels. But if she has high cortisol and if her adrenals are overacting, they also may be making a lot of DHEA, which is the one that can be made into testosterone. So the link that we would need to know is what is her DHEA level, and that might help explain why the testosterone level is high.

Dr. Eric:

All right. And I guess it could be something else as well, maybe a different issue. So yeah, as Dr. Deb said, it could be adrenals and looking at DHEA.

Dr. Deb:

Yeah. It could even be PCOS. That’s a common one.

Dr. Eric:

Yeah, that’s what I was thinking with the testosterone, even though that won’t necessarily cause high cortisol, but it can. People can present with PCOS, high cortisol, high testosterone.

Dr. Deb:

And that’s actually really, really common, is to have multiple things going on at the same time, because it’s almost like there’s … You know how you line up all those dominoes in a row and then you tip the first one and it tips the next one and it tips the next one? So once you have, let’s say, hyperthyroidism and you get all this inflammation going on in your system and your whole sympathetic nervous system gets revved up because of all that extra thyroid, that can rev up your adrenal glands, so now they can pump out more adrenal hormones and then the DHEA gets converted into testosterone. So then you may present to the doctor for a symptom over here, but if we really look at the big picture, we realize, “Okay, well, it really started from that one over there. That’s the root cause of the problem and we need to start over there.” So that’s why looking at all these different hormones actually really can help us, instead of if they just only looked at the thyroid, for example, without also looking at cortisol and testosterone, some of the other ones.

Dr. Eric:

Now, when you look at DHEA in the blood, do you look at both total DHEA and the sulfated version? Because on the DUTCH test, they look at both, but I know some practitioners will just test regular DHEA or sometimes it’ll just be DHEAS.

Dr. Deb:

Usually I just do DHEAS because that’s kind of the form that it circulates in the bloodstream. If we just look at DHEA, just kind of plain, that sort of comes and goes and so it’s not as stable in the bloodstream. So that’s why the DHEAS is kind of the standard one that we look at.

Dr. Eric:

Okay. All right. And this is just someone else here saying thank you. Then a followup here. “Pretty sure the DHEA was normal”. Okay, so the total testosterone that was high along with the cortisol with DHEA being normal.

Dr. Deb:

Okay. So probably something a little bit different. I mean, probably not the hyperthyroidism that caused the testosterone to be high. But it still could be something like PCOS, and some people just naturally have higher levels of testosterone. There are other precursor hormones besides just the DHEA, and in a DUTCH test, it looks at some of those other androgen hormones as well. But so we sort of need to know the whole rest of the history and the whole rest of the story to really be able to properly give input here.

Dr. Eric:

Yeah. And that’s an advantage of the DUTCH test, is that it does look at all the hormones and then it also looks at the hormone metabolites as well. But again, you could do…not the hormone metabolites in the blood, but you can get a good picture in the blood. One thing I wanted to ask you is … with PCOS… I know that typically will increase free testosterone. Will you also see the total testosterone and the free testosterone elevated?

Dr. Deb:

Usually. Usually we do. And sometimes the testosterone is normal, but the DHEA is high. So if we don’t measure both of them, then one might look okay. So in this case, the testosterone’s high, the DHEA is normal. Sometimes we see the other way around. But it’s not always both, so that’s why more information, more labs, the more that we can figure things out.

Dr. Eric:

Yep. All right. Makes sense. Are there any other questions? We’ll do last call for questions here. I think everybody’s ready for their July 4th barbecues, especially after last year, with all the craziness last year. There are a lot more people traveling. Let’s see, we did have this pop up… Okay, “See DHEA is on the …” Okay, so I think this is the same person. So DHEA is on the higher end of normal. All right. Well, if we’re done with questions, we’ll go ahead and call it a day and let Dr. Deb get back to whatever you need to do, whether it’s your practice or family, either way. But thank you again for joining us. Yeah, it was a pleasure talking about sex hormones and just again, testosterone, progesterone, and estrogen. We didn’t speak, of course … there’s estrone and estriol. Maybe we’ll do a followup in the future.

Dr. Deb:

That’s right. There’s so much to talk about, right?

Dr. Eric:

Yeah. Do a part two. And definitely check out her books. I did read the one on testosterone, which like she said, you can get both on Amazon. But then what was the website for the other one? You said the other one they could get for free? They can get it on Amazon, but also they could get a free version?

Dr. Deb:

Mm-hmm (affirmative). Yeah, it’s called isityourhormones.com.

Dr. Eric:

All right. That’s a good website. Isityourhormones.com. Okay. That’s the one for women, correct?

Dr. Deb:

That’s the women’s book, yeah.

Dr. Eric:

All right. Well, thank you. Thank you so much for talking about sex hormones and adrenals and, of course, thyroid health. Appreciate you taking the time, and yeah, maybe we’ll do a part two in the future.

Dr. Deb:

That sounds great.

Dr. Eric:

Yeah. And everyone, thanks for tuning in on this holiday… well, getting ready for the holiday weekend, and I hope I catch you next week. I’ll be on next Friday and yeah, everyone again have a wonderful day, a wonderful July 4th, and a wonderful week ahead. And you as well, Dr. Deb.

Dr. Deb:

Thank you so much. You too. Take care.

Dr. Eric:

All right, thanks. Take care, everyone.

Last week I put together a brief presentation entitled” bugleweed vs. antithyroid medication”, and because of its popularity I decided convert it into a blog post.  I’m also working on a research-based blog post on how antithyroid medication affects the gut microbiome…and so stay tuned!

If you would prefer to watch the video Click Here

Here is the edited version of the transcript:

Many know that I personally dealt with Graves’ disease. I was diagnosed in 2008 and I’ve been in remission since 2009. Since then, I’ve worked with a lot of people who have hyperthyroidism and Graves disease. Many of these people choose to take antithyroid medication, such as methimazole, sometimes PTU, and there’s also carbimazole. Some places in different countries use carbimazole, which converts into methimazole. So I’m definitely not opposed to my patients taking antithyroid medication. That being said, when I dealt with Graves’ disease I personally did not take antithyroid medication. I took the herb bugleweed and I also took motherwort. I started out with bugleweed.

And the bugleweed did help. I definitely noticed a difference in my resting heart rate and palpitations. But I was still experiencing some palpitations even while taking bugleweed, and so I added motherwort. There are a few different scenarios that I wanted to discuss to give you a better idea of whether you should take bugleweed or antithyroid medication…because I get asked all of the time, “Should I take Bugleweed? Should I take Methimazole or a different type of antithyroid medication?” So let’s talk about the different scenarios.

Scenario #1: Someone is already taking antithyroid medication and they’re doing fine and are okay with staying on the meds: In this case I’ll encourage them to stay on the medication because they’re doing fine with it and the medication is working. The one thing about antithyroid medication is that it is almost always effective. The problem with antithyroid medication is that side effects are common. So if the person’s feeling okay, if their liver enzymes are okay, if their white blood cell count is looking good, then I’m certainly not going to talk them out of taking the medication. In fact, I never tell someone to stop taking a medication because it’s prescribed by someone else. In addition, I’m not a medical doctor, so I won’t tell someone to stop taking medication. And in this scenario, I think it’s probably a good idea for them to continue taking the antithyroid medication.

Scenario #2: Someone is already taking antithyroid medication and they’re doing fine but they don’t want to stay on the medication. Of course nobody wants to stay on the medication. In most cases of hyperthyroidism, antithyroid medication should only be taken temporarily to manage the symptoms. But let’s look at a scenario where I have a patient that starts up care with me and they’re on, let’s say, methimazole, and everything’s going well, but they don’t want to stay on the medication.

Once again, I’m not going to tell them to stop taking the medication, but if they want to make the transition to bugleweed, then what I’ll usually do is I’ll have them take both the medication and herb at the same time.  Again, I’m not going to tell them to stop the medication, but I’ll have them add the bugleweed. And then over time they’ll need to do follow-up blood tests. And the goal is to not necessarily become hypothyroid because that’s not a good thing either, but to get their numbers towards the hypothyroid side. And then the prescribing doctor will typically reduce the dosage of the antithyroid medication based on the thyroid panel results. And then eventually the goal is to just be on the bugleweed and then the next goal is to not be on the bugleweed.

So again, like I mentioned, I was diagnosed with Graves’ disease in late 2008, and I took bugleweed and I took motherwort. I was on bugleweed a little bit longer because again, I started that before the motherwort. So I was on bugleweed for about nine months and I have not been on bugleweed since 2009. So I was on it for a while, but I’ve haven’t taken it since then. Nobody wants to stay on the medication. And again, you don’t want to stay on the bugleweed either. You want to get to the point where you don’t need either one of these, but there are some people that absolutely don’t want to be on the medication.

So once again, you could argue that nobody wants to be on the medication, which is true, but many people are actually okay with it because they know it comes down to risks vs. benefits. And the medication is helping to prevent them from getting an arrhythmia or going into thyroid storm. So some people are perfectly fine taking the medication, but then there are those who fit under scenario #2 who absolutely don’t want to take medication. And like I said, in that case, I can’t tell them to stop taking the medication, but we could put them on bugleweed and this can help them get off the antithyroid medication sooner under the guidance of the prescribing doctor.

Now of course, there are some people who will just take themselves off of the medication or reduce the dose on their own. And that’s up to them, as I can’t control what the person does, but all I’m saying is I’d never tell someone to stop taking antithyroid medication.

Scenario #3: Someone is already taking antithyroid medication and is experiencing side effects.  So for example, maybe they’re taking methimazole and are experiencing side effects. And so when this is the case, once again, I’m not going to tell the person, “You’re experiencing side effects so you should stop taking the antithyroid medication.” What I would do is tell them to go see the prescribing doctor.

Usually, it’s an endocrinologist. The downside of course, is that many endocrinologists will say, “if you can’t take the antithyroid medication, then you need to get radioactive iodine or thyroid surgery”, which isn’t always the case. There are other options. So another option is to take bugleweed, which is what this discussion is about, bugleweed vs. methimazole or bugleweed vs. antithyroid medication. But another option is to switch to a different type of antithyroid medication.

So if someone is on methimazole or carbimazole and they’re getting some type of side effect, so maybe they’re experiencing a rash or dizziness or some other type of symptom. Again, maybe it’s affecting their blood test, the liver enzymes, the white blood cell count, etc. So if this is the case, they could try switching to PTU. And some people absolutely don’t want to do that because they might have read that PTU can put more stress on the liver, which is true in some cases, but there are people who don’t do well on methimazole, but they do perfectly fine on PTU. So, taking a different type of antithyroid medication is at least an option to consider.

But of course, there are natural approaches such as bugleweed. And there’s also L-carnitine. I haven’t spoken about L-carnitine yet here, but L-carnitine when taken in higher doses (i.e. 2000 to 4,000 milligrams per day), also has antithyroid properties. I do find the bugleweed to be more effective, but I’ll add that it depends on the person, and it depends on the brand of bugleweed. Not all herbs are the same, as there are different qualities of herbs, different potencies. So if someone takes bugleweed and it doesn’t seem to work, then maybe it’s not a good quality herb, or it could be a lower potency.

So a lot of people will take Herb Pharm Bugleweed or Thyroid Calming Formula, which has a 1:5 extract ratio. Herb Pharm has good quality herbs, but they’re not high potency. So, that’s also something to consider. When I dealt with Graves’ disease, the bugleweed I took was a 1:2 extract. And therefore, I commonly recommended it to my patients, but I’ll have people who start working with me and they’re already taking Herb Pharm and they might be doing okay on it. So if someone’s taking Herb Pharm bugleweed and it’s doing a good job of managing their symptoms then that’s great. If not, then we might need to switch them to a different brand of bugleweed.

So, that’s another thing to consider. But if someone’s taking antithyroid medication and experiencing side effects, then it probably would be good idea to check with your prescribing doctor and either switch to a different type of antithyroid medication or take a natural approach. I’ll add that there are a few other options. I have written an article on cholestyramine, which is not specifically used for hyperthyroidism. It’s used for some cases for chronic diarrhea, also for toxic mold to bind to mycotoxins. But it can also bind to thyroid hormone. I’ve had a very small sample size in my practice take cholestyramine, and it does seem to be effective.

Again, it does require a prescription, but another option is to be on the cholestyramine. And then low dose naltrexone or LDN for those with Graves’ disease is another option. So if you have a condition such as toxic multinodular goiter, then LDN wouldn’t be a good option because it’s for the autoimmune component of not just Graves’ but other autoimmune conditions. The problem with LDN is it is hit or miss. So LDN doesn’t work on everybody, but again, it’s just something else to consider.

Scenario #4: Someone is hyperthyroid and they’re not doing anything to manage their symptoms.  So in this scenario they’re not taking antithyroid medication, they’re not taking herbs or other natural agents such as L-carnitine. So in this case, I will recommend for them to consider taking bugleweed. Now there are times when I might bring up the medication.  But if they’re not doing anything, many times the reason for this is because they don’t want to take the medication. This is assuming they are overtly hyperthyroid.  If someone has subclinical hyperthyroidism, where the TSH is depressed, but their  thyroid hormone levels look good, that’s a completely different scenario.

But if someone is overtly hyperthyroid and they’re not doing anything, it’s usually because they don’t want to take the medication. And they either are unfamiliar with natural symptom management methods, such as bugleweed and L-carnitine, or perhaps they’re familiar, but they are just cautious about self-treating themselves, which I think is wise. You want to be cautious about self-treating your condition. So in this case, I’ll bring up the different options, but many times they’ll want to take a natural approach. And in this situation, of course, I don’t have to worry about them stopping the antithyroid medication because they’re not taking antithyroid medication.

And so these are the four main scenarios I wanted to discuss. I will add that there are other scenarios besides these.  A fifth scenario is if someone is already taking bugleweed and let’s say the bugleweed is working, then of course I would say that everything’s great and they should continue taking the bugleweed. With all of these scenarios, we want to address the underlying cause. So these are just ways of keeping safe while you’re addressing the cause of the problem. It’s important for me to mention that.

And another scenario that I didn’t list here is if someone’s taking bugleweed, but it’s not working. I mentioned earlier, it might be because the quality of the herb isn’t great, or it could be the potency isn’t strong enough. But let’s say if they’re taking a good quality herb, the potency is high enough, they’ve been on it for, let’s say, a month or two, and it’s not working. Many times you’ll see changes before then.  I noticed an improvement in my hyperthyroid symptoms within a few weeks of taking the bugleweed. But again, let’s say someone has taken it longer, a month, two months, and they’re not feeling better. And then maybe on top of that they do another thyroid panel and it’s not improving, or it’s getting worse. Then in that situation, you probably would want to consider taking the medication or maybe cholestyramine or low dose naltrexone.

I’ll add that everything comes down to risks vs. benefits. So I realize that there are some people that absolutely do not want to take the medication, but if it will prevent you from receiving radioactive iodine or thyroid surgery, then it is something to consider.  Again, so I took bugleweed when I was dealing with Graves’ disease, but if I absolutely had to, I would have taken the medication. If let’s say a month or two went by and there was no change in my symptoms and the blood tests weren’t improving and especially if they were getting worse, I would’ve considered taking the medication. So I’m definitely not opposed to the medication, as there’s a time and place for it, and I would have resorted to taking the medication if I absolutely had to.

What’s Your Experience With Bugleweed?

If you have taken bugleweed I’d love to hear what your experience has been.  Did it successfully help to manage your hyperthyroid symptoms?  If so please let me know in the comments below! And if you tried taking bugleweed and it didn’t help also feel free to let me know! Thank you for sharing your experience with everyone.

On Friday June 11th I interviewed Dr. Kyrin Dunston on weight gain and thyroid health, and below is the written transcript. If you would prefer to watch the interview you can access it by clicking here:

Here is the transcript:

Dr. Eric:

Happy Friday, everyone! Hope everyone is having an awesome day, and with me I have Dr. Kyrin Dunston and we’re going to be talking about weight gain and thyroid health!

Dr. Kyrin:

Hi.

Dr. Eric:

Hey, Dr. Kyrin, how are you doing?

Dr. Kyrin:

Good, how are you, Eric?

Dr. Eric:

Doing good, doing good. Thanks for joining me here.

Dr. Kyrin:

Thank you for having me.

Dr. Eric:

Yeah. I look forward to talking about weight gain and thyroid health and sharing your experience and so, Dr. Kyrin’s bio here is a very impressive bio. She’s been a board certified OB/GYN for over 20 years and is fellowship trained in anti-aging, metabolic and functional medicine by the American Academy of Anti-Aging Medicine and then leading by example, she lost a life changing 100 pounds and healed herself from chronic disease by adjusting the root cause of her overweight and dysfunction. That’s a lot of weight and a lot of people are just looking to lose 20 pounds…

Dr. Kyrin:

I lost a person.

Dr. Eric:

Yeah, so we’ll definitely talk about that. Also, you have a book called Cracking the Bikini Code: Six Secrets to Permanent Weight Loss Success and I assume people could find that on Amazon?

Dr. Kyrin:

Mm-hmm (affirmative).

Dr. Eric:

Okay, great. And then she also is the host of her brilliant Health Revolution podcast where she offers interviews with inspiring and insightful experts in functional medicine for women, desiring to heal and achieve optimal health naturally and she also resides in Georgia with your two dogs, Otis and Carly, so not too far from North Carolina. So, I believe you’re also from up north too and you’re just like me, just escaped the cold and decided to go down south, and all right, well, thanks again for joining us, Dr. Kyrin.

Dr. Kyrin:

Thank you for having me, Eric. Super excited to be here.

Dr. Eric:

Yeah, so why don’t you start with your story, because again, a hundred pounds is, like you said, it’s a whole person. So why don’t you tell everybody a little bit about your journey?

Dr. Kyrin:

Sure. So, yeah, I was born and raised in New York City and I trained in Philadelphia and Delaware and ended up coming down to Savannah, Georgia because of a man and a job and I was a very successful OB/GYN. I delivered thousands of babies. I did pap smears and hysterectomies and worked with some wonderful women but my health suffered. I, at one point, weighed 243 pounds, so I was obese. I had chronic fatigue. I was tired all the time. I basically ended up only having energy to work and sleep. So when I wasn’t working, I was in my pajamas in my bed, even though I was a wife and a mom.

I didn’t have energy to show up as the wife and mom that I wanted to be. I had fibromyalgia, which is pain in the body on a consistent basis for over six months. I had anxiety and depression and was on multiple medications for those. I had gastric dysfunction, reflux. I had gastritis. I had irritable bowels, so I didn’t know if I was going to poo once every two weeks or if I was going to poo 15 times in one day.

And my health was really out of control, I was miserable and I used all the tools I learned in my medical training to figure out what was wrong and fix it. So, I would run tests. I’d say I’ve got to have a thyroid problem, right? I have cold hands, cold feet. I’m cold. I have weight gain. I am tired. I am constipated sometimes. So these are classic symptoms of low thyroid and I thought I’ve got to have a thyroid problem.

So I would do the test I was taught to use to diagnose a thyroid problem and they would come back normal or within normal limits or reference range. So, oh, I don’t have a thyroid problem and I think I checked it at least 10 times and it was normal and then I went to my doctor, my internal medicine doctor. I’d say, “Something’s got to be wrong, look at me. I’m miserable. I look and feel 20 years older than I am.” I was in my 40s at the time. And maybe some of you watching can relate to this.

And she’d say, “Okay, well, we’ll run tests. We’ll see what we find.” And she would run tests and she’d say, “All your tests are fine. They’re normal. You’re fine. You just need to eat less and exercise more. That’s your problem.” Basically, she told me it was my fault, which is what I told my patients because that’s what I was taught. So, she said, “It’s a math problem, too many calories in, not enough calories out.” I had no energy to exercise but sometimes I would muster the effort and energy to exercise and I tried diet programs, Weight Watchers, Jenny Craig, Nutrisystem. I tried them all, diet pills. And I might have a little bit of success but eventually, I’d gain it back and more. It wasn’t sustainable and I was just getting worse and worse and I call it circling the drain. My health was just spiraling.

They told me I needed a spinal fusion, which no good ever comes from a spinal fusion. It just destabilizes the rest of the spine and you end up having the entire spine surgerized and fixated and very little mobility, so I knew I didn’t want that and I was so depressed and I felt so hopeless. I’m thinking I’m supposed to know more about women’s health than anyone else. I’m a board certified OB/GYN, right? Women’s health specialist. I clearly am unhealthy and yet, all the tests I run are normal. My doctor runs them and they are normal and I remember the last time I left her office, it was a Thursday and it was raining outside and she yelled at me. She literally said, “Kyrin, there’s nothing wrong with you! You just need to stop eating so much and exercise more! Stop with this! There’s nothing wrong!”

And I went out into my car in the parking lot and I just closed the door, I didn’t even turn the motor on and I just started crying because I felt so hopeless and alone, like there are no answers and maybe other women or people, anyone watching will relate to this. You go, you trust your medical doctor to have the answers and I was a medical doctor and didn’t have the answers and she was a medical doctor and didn’t have the answers. So I felt like there is no hope, there is no answer.

This is my lot in life and I’m just going to have to deal with it. I knew that I was facing surgery or disability, probably because I couldn’t stand and do the surgeries and I didn’t have a choice because I was the breadwinner in my family, so I had to keep putting one foot in front of the other. Has anybody ever felt that hopeless with your health? You’re like, “I don’t even know which way to turn. There are no answers.” Well, that’s where I was.

And then not long after that, one of my patients who was a woman at midlife who was having all the same type of problems I had, I forgot to mention the period craziness and I had given her the usual prescriptions that we doctors give, birth control pill. She couldn’t sleep. I was too tired. I gave her a sleeping pill. Doctors give anti-depressants because that helps to mask some of the symptoms of these midlife problems, medication for her gut problems.

So she left with this fistful of prescriptions, maybe you can relate. Well, none of it helped her. So she went away and she came back about a year later and I saw her at the end of the hall. I’ll never forget it. And I said, “Oh my gosh, something’s different.” She was slender. She had lost that 30 pounds. Her eyes were bright. Her hair was full. She had this pep in her step and a smile on her face. Skin was bright and I knew something was different. So, I couldn’t wait to get her into the exam room and ask her what she did.

So, I did that. I got her in. I’m like, “Girl, what have you done because you look amazing?” And she said, “Well, I learned about this thing called functional medicine and they talked about resolving the cause of these symptoms that I’m having. So, I found this doctor in another town and I went and saw her and she did these tests that we never talked about, salivary hormone testing and she did this comprehensive thyroid profile and she did all these tests that we’ve never discussed, so I assume you don’t know about them and she found all these imbalances and she balanced my hormones and the weight just started coming off and my energy started coming back and my hair regrew and my mood improved and my periods are straight now and all the things,” and I was like, “Well, you are a walking billboard for this.”

So, I went home that night and I thought, how is this possible? Like I’ve paid a half a million dollars for my medical education, I have the best education in the world for women’s health and I don’t know any of what she’s talking about. Clearly, she’s been successful. So I set out to disprove what she was telling me because I’m like, this just can’t be true. It’s not possible that I didn’t learn the things that she’s talking about in med school. So, I set about doing the research and looking and scouring all the information I could find and instead of disproving what she was telling me, I ended up proving what she was telling me.

So, even though she was the N of one in my experience, the only person I knew, there was this whole world that I hadn’t ever been introduced to of root cause resolution, of testing that I had never been trained in, even though I’m supposed to know about women’s hormones, we were told, we don’t check women’s hormones. We don’t do that. We just treat by symptoms reflexively but there’s this whole world of you can test women’s hormones and you can adjust them to be at the right levels and in fact, when you do, guess what? Sleep problems, energy problems, weight problems, all the problems, health problems that I was having resolved and so I learned about this and when I read about it, I knew it was true because they talked about the way the body worked, which I learned all about in med school.

So, I said, ooh, I’m going to use this to address my own health concerns and if it works, I’m going to teach as many women as possible about this. Fast forward two years, I had lost a hundred pounds, hair regrown, sex drive back, gut healed, no anxiety and depression, off all prescription medications and my patients now are pulling me into the exam room, “Girl, what are you doing because we need that?” And so I started doing it with them and I actually, after about a year of doing it with them in my regular practice, walked away from mainstream medicine, a very lucrative successful practice because I knew that that was not the way to help people do anything but survive and I was all about helping people thrive and so this is my journey about why I do what I do now.

Dr. Eric:

All right, now that is awesome. So you had a lot going on. So you had low thyroid but not Hashimoto’s, correct?

Dr. Kyrin:

Correct.

Dr. Eric:

Okay. So you had low thyroid and IBS-like symptoms and just yeah, it sounded like you were a mess but a year later, just everything resolved, libido back, sleeping well, energy, just yeah, that’s great. So let’s talk a little bit about testing. So you said that, of course, most medical doctors, they just do the bare basics when it comes to testing. So, you mentioned more comprehensive thyroid panels. So, can you talk a little bit about that because I’m sure there’s a lot of people watching this who, again, their doctor, all they want to do is just a TSH. So, what do you consider to be more comprehensive testing when it comes to thyroid?

Dr. Kyrin:

Right. So yeah, the TSH is the standard screening test that we doctors do to screen you for thyroid hormone problems but the issue is that that’s actually a secondary factor and so in order to really know if you have a thyroid problem, you want to know is the thyroid making enough active hormone and is that active hormone being convert … That’s T4, is it being converted into T3, the inactive thyroid hormone, in your body and you want the free fraction. That’s the part that’s not bound to protein that actually has activity in your body. So the gold standards that you really want to know are your free T3 and your free T4.

The TSH is only a marker of the hormone the brain makes to tell the thyroid to function and so it’s a lagging indicator of thyroid function. You do want that but the truth is that in mainstream medicine the standard of care is they are concerned with what is the diagnosis and what drug do I need to give or what surgery do I need to do? Those are the questions that your mainstream doctor is asking because that’s what we’re taught to ask. What’s the diagnosis, what drug, what surgery? That’s their concern.

And in functional medicine and root cause resolution medicine, we’re concerned with a little bit of what but more why. So, to get to the why, you’ve got to look at all those thyroid parameters. So you need a TSH but you also need a free and total T4, free and total T3. You need something called a reverse T3, which looks at this abnormal form of T3, active thyroid hormone, that your body will make particularly when your cortisol is out of balance and you’re having stress. So, you need to look at the reverse T3 because everything may look great with the rest of your thyroid indexes but if you have high reverse T3, guess what? It’s sitting on your T3 receptors and healthy T3 then can’t get on it. So you’re going to essentially act like a low thyroid person.

So, if you don’t have that, you’re going to be confused and then the other indicators that you want are thyroid peroxidase antibody or TPO and antithyroglobulin antibody or what I call ATA because I catch so many people when I do my programs with women who, everything else looks pretty cool with their thyroid but they’ve got some symptoms but if you didn’t do the antibodies, you wouldn’t know that they had an autoimmune thyroiditis, the most common one being Hashimoto’s. So I pick up usually at least one in 10 women who have no thyroid diagnosis. They have symptoms. Their doctor told them they don’t have a thyroid problem. When they do that comprehensive profile, they come back positive for those antibodies and that is golden because the course of Hashimoto’s, for instance, is many years.

So, these women typically wouldn’t be diagnosed for another, I don’t know, three, five, 10 years till they’re really sick and their thyroid is very inflamed. They might even had a goiter or nodules and then it becomes a big issue but if you know you have antibodies, if you knew you had them five or 10 years ago, you can address the cause of those antibodies and get rid of them and then, guess what? You don’t have to have a horrible thyroid problem. So, that comprehensive test at least includes those parameters.

Dr. Eric:

All right, sounds good. And also, I’m sure there’s some people watching with Grave’s even though weight gain is more commonly associated with Hashimoto’s, some people with Grave’s actually do gain weight. So someone asked about TSI, thyroid stimulating immunoglobulin, so yes, that’s something with Grave’s that’s commonly tested as well but I want to talk more about reverse T3. So reverse T3, like you said, it’s an inactive form of T3 and we especially see it with increased stress levels, also see it a lot with hyperthyroidism too, with hyperthyroidism just very high levels but can you talk about more stress and weight gain, cortisol weight gain just because a lot of people are focusing on diet, just improving diet and exercising and of course, thyroid hormone balance is important too but how about other hormones such as cortisol?

Dr. Kyrin:

Right, so this is the thing, thyroid is important but I do see a lot of people get fixated on the thyroid and if you don’t address all the hormones, you’re never going to get your thyroid right and one of the main hormones you need to get right is your cortisol stress hormone made by your adrenal glands that sit back behind on top of your kidneys and they’re little walnut sized things that you can’t live without and your cortisol is … I call her queen cortisol, all hail the queen. If you don’t hail her, she will wreck everything for you, including your thyroid. So that reverse T3 that we’re talking about will go up when your cortisol is unbalanced and I have to be honest with you, there isn’t a person today alive on this planet that doesn’t have a jacked up cortisol, I’m just going to be honest with you.

If you’re not doing something to address your cortisol, it is jacked up and you can know this when you do a salivary cortisol profile and you collect saliva morning, noon, afternoon, midnight, so it’s not if your cortisol is messed up, it’s how much and in what direction so that you can address it but if that’s out of balance, it’s going to cause your reverse T3 to go up and then it blocks that healthy T3. So, your cortisol regulates your sleep/wake cycle along with your melatonin hormone that’s made in your brain. It regulates your weight. It regulates your immune system function. So whether you get autoimmune disease or not, whether you get cancer or not. So, I always say autoimmune disease, you have to have two things, you have to have your foot on the accelerator of inflammation and that’s from the gut and elsewhere toxicity in the body and you have to have no foot on the brake on inflammation. Your brake on inflammation is your cortisol stress hormone.

So, this is why you’ve got to deal with the queen and get her balanced out. If you have cortisol imbalance, which we’ve already established everyone has one, you will have typically weight gain in your midsection. This is the tire around the middle weight gain that you’re like, oh, I just have this roll in the middle. That was a big part of it for me whereas more often, sex hormone weight gain is going to be in your hips and thighs, cortisol is going to be in your stomach and in my experience, thyroid is more diffuse all over.

So, if you want to lose weight, it’s not a math problem, particularly for all of us starting at midlife, men and women, but particularly women, why is that difference between men and women, because men have 10 times the testosterone that we ladies have and guess what, testosterone is a secret weapon when it comes to weight. So men and also the testosterone decline in men or andropause as it’s called is way more gradual but we women, we start with this descent into perimenopause usually by 35, 40 or 45 and that’s when estrogen starts going up, progesterone starts going down and progesterone really is the weight loss hormone and then by 51, our ovaries cease production of these hormones, so the factories shut down and we need those to lose weight as well.  So, yes, thyroid issues are important and you’ve got to address all of these hormone imbalances.

Dr. Eric:

So, what recommendations do you give to your patients when it comes to trying to balance cortisol?  Probably the first thing is maybe testing, because I know you said you had saliva testing. I also had saliva testing done when I dealt with Grave’s disease, even though now I do saliva testing but sometimes I’ll do … You’re probably familiar with DUTCH testing, dried urine testing, so sometimes I’ll use that as well.  Both saliva and dried urine testing to look at circadian rhythm of cortisol.  So what steps would you recommend for someone who has done everything with diet, has done everything with exercise…or not everything but they exercise regularly, they eat well, maybe even follow like a ketogenic diet and again, thyroid seems to be in balance yet they’re gaining weight. So, at least from a stress perspective, what would you recommend?

Dr. Kyrin:

Right, I think that testing is invaluable versus guessing because when you see your cortisol numbers in black and white, ink on paper, it has a whole different meaning. When you’re just guessing at how stress is affecting your body and how your body’s handling stress, we often are very much in denial about what’s causing stress in our body and what’s happening. Our culture is very much what creates our cortisol problems. We are a go do culture and most of us overwork, we overdo, we over-participate and so it’s one thing, there’s stuff all over the internet on oh, do meditation, do relaxation exercises, change your mindset but the thing is, do we do it? No, we’re like I just want to know the strategies and things that I have to change so I can keep living my life exactly as I want to live it, which is how I’m doing it now.

So, I find that it’s a rare person who, without the black and white staring them in the face, is really willing to make the lifestyle changes they need to make to calm it down and this is even true for us healthcare practitioners. Eric, in one of the groups we belong to, someone posted recently that she knows she has adrenal fatigue and she’s about to crash and what expert can help her and I’m like, girl, I know you and I know you know as much as I do about this stuff and we all want what’s the pill we need to take, what’s the supplement, what’s the diet?

None of us wants to stop living our lives in overdrive because that’s our culture and we all are socialized to living this way and I basically said, you just got to stop doing what you’re doing and take a break before … Because if you don’t do it, your body will say no for you and the body says no by cancer diagnosis or a huge accident, that happened to me because I wouldn’t stop going and doing, you get a huge accident that your body then has … I had a foot fracture where I had to be with my foot up in the air for six months and they said we don’t know if you’re ever going to walk again. So there are some things you just have to dial it back but what I say is if you can get a cortisol test, get a cortisol test. Definitely tweak your diet.

But I find some people tweak their diet so far to the opposite extreme of popcorn and Twinkies, then Ho-Hos every day, they go to the opposite extreme and they have no carbohydrates and they’re intermittent fasting and they’re basically starving themselves and they work out like crazy, right? So I see these two extremes and neither extreme is better. You really have to come back to the center and start listening to your beloved body because she’s always talking to you about what she wants and what she needs but we’re so data driven, mind based and we are not in our bodies that we’re like I got my aura ring, I got my HRV checker, I got my continuous glucose monitor. I’m going to manage my body like I manage my bank account and I’m sorry, but your body is not a material thing, it’s a living, vital organism just like a plant.

So, we really need to step back and look at how we’re living our lives when it comes to stress. Are we overdoing it? Learning how to say no. Learning how to prioritize and do the things that really matter so we can manage our cortisol. So yes, it’s the diet but dialing that into what’s right for you and what’s right for someone else might not be right for you, dialing in our supplementation. Everyone needs to be on an adrenal supplement in this day and age, you just can’t avoid it but what are the right ones and how much and how frequently and when is what you’ve got to dial in and then dialing in your lifestyle and your blood sugar because that’s another big stressor for your cortisol and your gut health, which I know you teach about, Dr. Eric, and your toxicity. So, you’ve got to really do a comprehensive program.

Dr. Eric:

And of course, sleep. If you don’t sleep, you’re not going to heal … Also, you’re going to be inflamed and again, it’s a little bit of a catch-22 because sometimes, a lot of times, blood sugar imbalances and/or adrenal issues, they definitely have a lot in common, can affect sleep and then you’re not getting enough sleep and that also could be a factor with losing weight and yeah, you mentioned a healthy gut, problems with the gut microbiome could also make it a struggle to lose weight and liver increased toxic loads, so essentially what you’re saying, it’s a whole body picture…

Again, it’s not obviously, just diet, exercise, thyroid and then not even just adding stress management to the piece of the puzzle too. If you’re blocking out time doing mind/body medicine every day, which I do recommend,  I think it’s great to do that and it’s important, but if you have an increased toxic load, if you have problems with the gut microbiome, if you’re not getting enough sleep, all of these can be factors as well when it comes to gaining weight, correct?

Dr. Kyrin:

Absolutely. Everything above. Check, check, check, check, yes. You’ve got to consider all of that.

Dr. Eric:

Yeah. So, you said you had IBS-like symptoms and can you talk a little bit about that… Because, again, a lot of people have issues with digestion and again, you need a healthy gut to have a healthy immune system, healthy gut, to again, lose weight as well, so please talk about the gut microbiome and the gut. What are some of the things that you would recommend to optimize the health of the gut?

Dr. Kyrin:

Right, so the gut is really a complex organism. I think about it like it’s its own organism. It has a head and it has a tail and it’s got everything in between and if there’s a dysfunction in any part of it, it’s going to affect other parts and one of the main things that you can do to improve gut dysfunction, whether you know you have a gut problem or not because most all of us, like cortisol dysfunction, have some degree of gut dysfunction in this day and age, if you’ve taken even one course of antibiotics, the studies show that that can knock out the majority of your healthy gut microbiome for up to two years and most of us have had an antibiotic within the past few years, so most of us have that dysfunction.

But just even talking about the stress that’s so connected to your gut health because the frame of mind and the autonomic nervous system balance that you are in or not in when you start eating can speak volumes to improve your digestion. So are you eating standing at your desk shoveling like this while you’re on the phone in a Zoom meeting, right? You’re in a sympathetic, autonomic nervous system state which blood is not flowing to your digestive system and your digestive enzymes are going to be lower, your stomach acid is going to be lower and you need these to break your food down. So making sure even before you eat that you’re in a calm frame of mind, that you’re not multitasking, that you take time to appreciate the food and all the millions of people who participated in bringing this nourishing meal to you and that you take some deep breaths to invoke that parasympathetic nervous system before you start eating and you let the saliva start flowing by smelling it and just getting your body ready.

It’s not only sex we have to get ready for and have foreplay. We have to have food foreplay also. So having that with your food and then chewing it 30 times until it’s a liquid, how many of us do that? Nobody. And then swallowing it and if you need digestive enzymes or additional HCL to help with your digestion, which a lot of us need after 30 because our production goes down, taking that and then really not drinking liquids for about 30-45 minutes before you eat and for a couple hours after so you don’t dilute those gastric juices and then really managing your stress throughout the day so that your digestion can work in a coordinated manner because a lot of us don’t realize it if we jump up from a meal and then we’re on the Zoom meeting and doing 10 million things and running around and driving and stress and traffic, we’re taking blood from our digestive tract and taking it to our arms and legs so we can take action in the world and our digestion is faltering.

So, really looking at how we live our lives and our microbiome so we’ve got trillions of bacteria in our gut, more healthy bacteria in our gut than we have cells in our body. Scientists have wondered for decades how do humans have a fraction of the genetic material of an earthworm, a little earthworm is this big and it has almost twice as much genetic material as we have and the way we’re able to do that is that we upload a lot of our genetic information into the cloud. Well, where’s our cloud? We actually carry it around with us in our gut, right? It’s our microbiome. That is our cloud sourced genetic information.

So they’re vitally important, we can’t live without them and yet we do things every day that kill them, eating food that’s not organic, that has pesticides, consuming water that’s not filtered so that has toxins and contaminants in it too that kill our microbiome, taking antibiotics, living a stressful life because when we live a stressful life, blood flow to our gut decreases and can’t nourish these little bugs that keep us healthy.

So the care and feeding of your microbiome is something that we need to think about every day that almost nobody thinks about and I’m sorry, but I know a lot of people are like well, I eat yogurt every day. They get all up in arms. I eat yogurt, Dr. Kyrin. I’m doing my thing. Mmm, not so much, right? Because a couple things about the yogurt, one, it’s a cow’s milk dairy product, if you’re not eating nondairy and that’s very inflammatory for a lot of people. Also, if it’s a flavored yogurt, it tends to be sweetened with sugar or some sugar euphemism like my favorite one is concentrated fruit juice, that ain’t nothing but sugar, y’all. So, step away from that. Or evaporated cane juice is another one of my favorites because everyone bypasses that on the ingredient list. It ain’t nothing but sugar.

So, if it’s got some strawberry something in it, right, it’s sweetened with sugar and there really aren’t enough healthy bugs in there to bypass everything it needs to bypass and remain viable to get into your gut. So almost everyone needs to be taking some type of probiotic. Now, you need to watch your probiotic because if you take one that has very little numbers or we’re overburdened with the lactobacillus species, you can find that everywhere at Sam’s Club probiotic but you can actually cause more damage by that. So you want a high quality, what I call pharmaceutical grade, nutraceutical, so they’ve proven the purity and potency, they’re really researched very well by some of the better companies that you often need to get through a practitioner like Dr. Eric. You want that and you want to change up … I tell my people, change your brand and your formulation every month.

It’s like your social circle, right? How boring would it be if you only interacted with the same hundred people all the time, right? You’d get bored with that. Well, your body needs variety just like it needs variety of food. If you could only eat one meal every single day because I know we humans like habit and we’re like I take this probiotic, I’ve taken it every month for two years and we’re so proud of ourselves and your body’s like, no, stop. Give me some different people. Give me something different to eat. You need variety with your diet. You need variety with your microbiome and the probiotics that you take. So, start looking at your species. Make sure you’re getting various species in your probiotic and changing it up every month.

Dr. Eric:

All right, great advice. Thank you.  A lot of people, when they think about gut, they’re thinking about food and, we shouldn’t take antibiotics but you tied it back into stress and you mentioned autonomic nervous system. I mean some of it was very basic as you mentioned, as we don’t chew our food 30 times, making sure it’s liquified. I can’t say I do that all the time also, as I’m guilty as well and it’s something I’m aware of and sometimes I’m better than other times, and not eating on the run… Yeah, just great information.  Do you recommend things such as vagus nerve exercises to your patients…

Dr. Kyrin:

Oh, all the time.

Dr. Eric:

You mentioned HRV also, heart rate variability but regarding vagus nerve exercises, you said all the time you do recommend these?

Dr. Kyrin:

Oh absolutely. You’ve got to be priming that vagal tone, whether it’s toning or singing, so anything with laryngeal stimulation. You could do vagal massage, back here behind your ear, acupuncture points will stimulate the vagus nerve. Breathing and resonance breathing practices. Oh yeah, all my ladies in like my Hormone Balance Mastermind, I’m like twice a day, resonance breathing, twice a day checking your HRV because I do the one where you actually get your numbers that tell you the power in your parasympathetic nervous system, which is amazing because then you have it in hard … I think that data is very important to inform your choices. I don’t think it should become the holy grail of what you do.

You’ve got to learn to listen to your body but if you haven’t really been in your body and listening to your body for 20 years like most of us at midlife, you do need something to reacquaint you and data is very informative but now it’s to the point I know when my HRV is high, I know when it’s low and I always play a game with myself. I guess what it is before I check it so that I’m fine tuning my knowledge of how my body works, what it needs, what it wants, what it likes, what it doesn’t like and this is … We knew this when we were infants. When we were hungry, scream our freaking heads off.

Who hasn’t heard … I flew home the other day and there were a couple babies on the plane. When those babies aren’t happy, they let you know, right? They scream, mouth wide open. We’re so in tune when we were born with what was wrong and we needed it fixed but it’s socialized out of us, right? When we’re in kindergarten, we raise our hand, “Teacher, can I go to the bathroom?” Teachers says, “No, you have to wait until we are done with class,” right? So this starts the whole socialization away from being intimately familiar with our body and our biology and being in our bodies and being internally directed by what our health needs.

Kids who are allowed to go with their biologic urges like eat when they’re hungry, introduced to vegetables, really like them, we get this concept like that kids will only like a McNugget chicken that’s ground up and have all these additives added and breaded with a disgusting sauce with 50 ingredients that I wouldn’t even feed to my dog. Where did we get this idea? So, we train them to like to eat unhealthy foods, to not listen to their bodies when they have to go to the bathroom, when they want to go to sleep or not, right? If we just let kids decide when they’re tired and go to bed, they will learn pretty quickly that if I don’t want to be tired in the morning, I’m going to go to bed on time, right?

So, I know I get on my soapbox about this but part of my job to reacquaint women at midlife with their health, is to reacquaint them with their internal biologic urges. So you’ve got to start becoming cognizant of when is stress too much? What is stress? Most of the people I talk to, they have no idea and then they do the cortisol test and it’s a mess and they’re like wow but they’re teetering on this edge, this American edge of over-productivity and like we fuel it with caffeine and we dial it down with alcohol in the afternoon and evening, right? Up with caffeine and the alcohol in the evening. This is the American way and part of it is getting off that rollercoaster that’s just causing you to survive in overdrive and going I choose something different, I choose to thrive in peace. I choose to be in my body. I choose to really be present for this life and that gets back to HRV and stress management.

Dr. Eric:

All right, that was awesome. Thank you for sharing. So I want to also let everyone know that Dr. Kyrin will be answering some questions in a few minutes, so if you have questions, if there are questions, definitely type them into the comments but I wanted to ask you, Dr. Kyrin, as far as action steps then to … I know that it’s complex when it comes to weight gain but what would you recommend? What are some starting points you would recommend for those who have been struggling to lose weight?

Dr. Kyrin:

Well, let’s just get out of the way that the things that most everyone knows. So, you’ve got to eat … You literally are what you eat. So if you want to be healthy, you’ve got to eat healthy foods. So that means organic, non-processed and you’ve also got to cut the sugars out, not because of calories, that’s not the issue with sugar, but weight loss is all about hormone balance. Seven main metabolic hormones. So insulin is number one, thyroid, cortisol, DHEA, estrogen, progesterone, testosterone and it all starts with insulin.

So your food is important, not only that it’s clean but also that it doesn’t have a high sugar content because that leads into that first hormone, which is insulin. So it all starts with insulin balance. Why? Because insulin helps to balance your blood sugar and is unbalanced by unhealthy intake of sugars and it, in turn, affects your cortisol and your cortisol will be unbalanced if your insulin is unbalanced and it will unbalance your DHEA, your thyroid, your estrogen, progesterone, testosterone.

So, it just goes down the line. Your hormones are like a symphony playing music and if one violin is off and that’s insulin, then it makes all the other instruments go off or it’s like a mobile. I used to have this mobile over my office at my desk and it had all these different moving parts. You push one part, and that’s insulin, so the biggest input into our biology is what we eat and if you’re eating an insulin unbalancing diet, all the other hormones move just like on a mobile. So you have to start with that first input, which is insulin, so you’ve got to cut the sugars out.

And again, I’m a fan of testing, not guessing. Where are you starting with your insulin? How much support do you need? How radical do you need to be in terms of cutting out the sugars? We’re all on the internet looking for the one thing, what’s the one diet we all have to follow to have balanced hormones? It doesn’t work like that. We’re all so unique. You have to figure out what’s right for you. And so a certain degree of keto diet might not be healthy for you but it might be healthy for someone else. So I’m a big fan of testing, not guessing. So it starts with insulin.

And then you’ve got to look at all these other hormones but what can you do in your day-to-day life? Say you can’t get testing, you don’t have access to someone, you mentioned sleep earlier. I’m going to say, sleep. You have got to sleep by any means necessary. Now, I say that and a lot of women and men too, at midlife, use alcohol to sleep but that’s not a great option for many reasons. Alcohol often has a lot of sugar in it, so it unbalances your insulin. It also is toxic to the gastrointestinal lining and it taxes your liver, which hormone balances about liver function, and so you don’t want to do anything to your precious liver, which is your sanitation department.

But you want to take, whether it’s melatonin or I like a supplement that has phosphatidylserine and theanine in it with a little melatonin. You got to take something to get yourself to sleep because that gets directly to your cortisol that you want to balance and if you’ve got a thyroid problem, because I know, Dr. Eric, that’s your main thing but I see a lot of people that get such tunnel vision on it’s my thyroid, what supplement do I need? What do I need for my thyroid? Well, a lot of times what you need to do is fix your cortisol, fix your insulin, fix your sex hormones and when you do that, the thyroid goes, “Oh, thank you,” because it needs the support of these other hormones. They all support each other and they’re rising up or they’re all circling the drain.

It’s kind of like in our communities and just in humanity, either we’re helping each other to live better lives and do better or we’re pulling each other down and we’re all going to go down with the ship. So your hormones are no different. So with the weight loss, you’ve got to realize, after midlife, weight loss is not a math problem, it’s a communication problem. It is no longer about calories in minus calories out, it’s about hormone balance. So you need to do whatever you can to balance your hormones and for a lot of … Most women, by the time you’re 51 and you actually go through menopause, that means you actually would need natural hormone replacement to replace your sex hormones, estrogen, progesterone, testosterone, which is safe and if your doctor thinks it’s not, it’s because they’re confused about apples and orange type hormones.

This is something I teach people about. The natural hormones are safe. They’re the ones that 20-year-old women have and that’s why they look and feel so great and are so healthy. So you’ve got to get yours like a 20-year-old woman but it’s all about hormone balance, weight loss after 40 is not a math problem, it’s a communication problem. Hormones are communicators in your body that tell your cells what to do and you’ve got to get the communication right to get the weight to come off.

Dr. Eric:

All right. Would you agree though that … I know you’re familiar with the pregnenolone steal, so you need to optimize adrenal health … Would you say adrenals are still a priority or …

Dr. Kyrin:

Oh my gosh, that’s why I call it queen cortisol, which is made in the adrenal glands. You have got to hail the queen and address the queen in order to lose weight. If you don’t address her, you’re not going to lose weight and there’s so many factors that go into what she considers stress. So what you think is stress might be totally different from what she thinks is stress and if you don’t figure out what she considers stressful and is unhappy about and unbalanced about and address it, guess what? No weight loss for you. So you have to figure that out and for each person, the secret sauce balance is a little bit different.

Dr. Eric:

Yeah. All right, so where can people learn more about you, Dr. Kyrin? Where can they find out more about you?

Dr. Kyrin:

Sure, they can find my website, which is kyrindunstonmd.com, and I’m also @kyrindunstonmd on Facebook and Instagram.

Dr. Eric:

Okay and then also make sure you check out Dr. Kyrin’s podcast as well-

Dr. Kyrin:

Oh, the podcast. Yes, Dr. Eric was just … We did his interview which will air in July, you definitely want to check that out. It’s Her Brilliant Health Revolution podcast and it’s available on iTunes and Google Play and where most podcasts are made available and each week, we cover a topic important to women’s health, particularly at midlife.

Dr. Eric:

All right, great. Well, thank you. Thank you, again, for sharing how to lose weight for those who have problems losing weight and yeah, let’s go ahead and jump into some questions if that’s okay with you, because we have a few here now.

Dr. Kyrin:

Sure.

Dr. Eric:

Now, this one I kind of answered earlier because just TSI, so as I mentioned, with Grave’s, typically you’re going to test thyroid stimulating immunoglobulins and so I will also say that if someone with Grave’s is having problems with weight gain, one common issue is taking antithyroid medication like methimazole or PTU. That, many times, will cause weight gain but any of the other factors Dr. Kyrin mentioned also, so again, if someone’s having problems with cortisol, cortisol imbalances, insulin resistance, disrupted gut microbiome, increased toxic load, so all of these could also be factors. So when I dealt with hyperthyroidism as we discussed during the podcast interview, I lost 42 pounds, but again, there are some people with Grave’s who want that problem. They’re like oh, I would love to lose weight but they’re gaining weight so If it’s not due to the antithyroid medication, there’s usually another factor.

Dr. Eric:

And then so this person asks, “How can we measure HRV at home?” So, I’ll let you answer that.

Dr. Kyrin:

Sure, there are lots of free apps that you can download. My favorite is Elite HRV but there are many others. There’s also the oura ring that tracks HRV. It doesn’t get the detail that I like though. The Elite HRV is really like medical grade. It actually can almost completely replace my $6000 machine I used to have in my office. So that’s something that you can use at home.

Dr. Eric:

Well, that’s great. Okay. Yeah, because I use HeartMath, which you might be familiar with but you said Elite HRV, that’s an app that people could download on their smartphone? Okay, cool.

Dr. Kyrin:

Mm-hmm (affirmative).

Dr. Eric:

Thank you for sharing and then, let’s see, so Bonnie, I don’t know if you would mind mentioning, you mentioned a supplement with the phosphatidylserine and I think the theanine-

Dr. Kyrin:

Theanine and the melatonin. I think it’s Prothrivers Sleep Formula by Integrative Therapeutics. Hopefully, I’m remembering that correctly. I think that’s the one, mm-hmm (affirmative).

Dr. Eric:

Okay, very cool. Thank you. So Stephanie asks, “This has been great. Do you see pediatric patients with a family history of Hashimoto’s and obesity?”

Dr. Kyrin:

Oh, I used to but now I work exclusively with women at midlife in my Hormone Balance Mastermind, which we do virtually to help women at midlife because that’s really my sweet spot but there are lots of great practitioners out there who do exactly what you’re mentioning.

Dr. Eric:

All right and then Gabrielle, and again, if there’s any other questions, definitely type it in the comments. So, Gabrielle, “Can I lose weight while on methimazole? I’ve gained 20 pounds since being on it for my Grave’s disease and it won’t come off.”

Dr. Kyrin:

Yeah. Go ahead.

Dr. Eric:

No, no, that’s okay.

Dr. Kyrin:

I was going to say, absolutely, right? So it’s not only about thyroid, that’s what we’ve been talking about, it’s about all the hormones, right? And then if you’re on a medication like methimazole, that’s a lot of toxicity coming into your body. So detoxification is a big part of that and gut rehab but it starts with hormone balance. So yes, you’ve got to get your other hormones checked and get them balanced and yes, you can lose weight, mm-hmm (affirmative).

Dr. Eric:

Yup, okay. And I will say one thing though, like if you’re on a real high dose of methimazole and if it’s making you hypo, definitely check … Like you need to do regular labs as well, so it depends on if someone’s taking 40 mg of the methimazole and I mean usually they’ll start feeling hypo if they get pushed in that direction. So obviously, you might also need to have the medication modified too, so just keep that in mind and then let’s see, so “Hi, this has been great. I have both Hashimoto’s and Grave’s as well as other autoimmune disorders. Have you had other patients that have both?” And I will say, yeah, I do see a lot of people with the antibodies for Hashimoto’s and Grave’s but what’s your experience with that, Dr. Kyrin?

Dr. Kyrin:

Oh yeah, it’s not … I won’t say it’s common to see it but we see it not infrequently that people have both. The biggest risk for getting an autoimmune disease is having an autoimmune disease. So, where there’s one, there’s likely another and it may not have been diagnosed yet, but it’s very common and when you do a root cause resolution approach, you get back to that all autoimmune disease comes from inflammation, toxicity, gut disorder and cortisol problems, like the triad that when we were doing my podcast interview, Dr. Eric was talking about the triad, right? Genetic predisposition, maybe 5% to 10% in my opinion and then some inciting environmental exposure and gut dysfunction, right? Those are the three things you have to have and so it doesn’t matter if you have one auto-antibody or if you have five auto-antibodies, from a root cause resolution approach, the treatment is the same.

It’s only in mainstream medicine that we’re about what, what’s the diagnosis? What drug do I need to give you? What surgery do I need to do? But that’s just going around hitting every problem with a ginormous hammer instead of looking down at the roots of the tree and fixing the roots. So, to my root cause brain, it doesn’t matter to me if you have one auto-antibody or five, it’s still the same root causes, so you address the root causes and the auto-antibodies get better.

Dr. Eric:

All right, that makes sense and so Jennifer asks, “What should I get tested for a diagnosis?” And you spoke a little bit. You spoke about the thyroid testing. So the TSH, free T3, free T4, reverse T3, the antibodies if you’re looking to get diagnosed for Hashimoto’s, I mean either Hashimoto’s or Grave’s definitely do a full thyroid panel, look at the antibodies. Anything else that you commonly recommend to your patients? I mean I’m sure you recommend like the CBC with differential and comprehensive metabolic panel … But as far as diagnosis wise, what do you do? Just the thyroid panel antibodies?

Dr. Kyrin:

Like in my Hormone Balance Mastermind that I do with groups of women, they get blood chemistries, they get blood counts. Like we were talking about, I think on my podcast interview with you about I like to look for markers of inflammation. So, I have them do also an erythrocyte sedimentation rate. I have them do a high sensitivity C-reactive protein. I have them do a homocysteine and I do the full thyroid panel. I have them do a DUTCH Plus test that includes a salivary cortisol and then I teach them how to read this themselves and I got so frustrated with women not having access because then the next question would be well, where … Who in my state can prescribe natural thyroid or natural hormones for me, so I founded a telemedicine company to do that. But anyway, in terms of diagnosis, those are the things that I usually recommend.

Dr. Eric:

Okay. All right and Bonnie just says, “Great talk. Thank you. Love the talk on raising children to trust their intuition.” And yeah, thank you for sharing that.

Dr. Kyrin:

Yeah, if we did more teaching of our kids about these things when they were young, then we probably wouldn’t have the chronic health conditions that we have and then we wouldn’t have to unlearn all this stuff at midlife.

Dr. Eric:

Yup, very true. All right. Well, thanks, again, Dr. Kyrin. I appreciate you taking the time to share your story and a lot of valuable information about losing weight and I look forward to maybe having you again in the future and hope you have a great rest of your Friday and I hope everyone watching has a great rest of their Friday as well, and a great weekend ahead.

Dr. Kyrin:

Thank you so much for having me, Dr. Eric. Thanks to all of you who showed up and offered great questions. It was my pleasure to be here. Definitely check out Dr. Eric’s episode coming out in July on Her Brilliant Health Revolution podcast, which is on most major podcast outlets. Thanks so much for having me. All right, thank you. You take care. Again, thank you.

Dr. Eric:

Bye-bye.

Dr. Kyrin:

Okay, bye.