Recently, I interviewed Nicolas Pineault, and we talked about the sources of electromagnetic pollution, the effect of EMFs on sleep, fertility, and thyroid conditions, the need for reducing our exposure, whether you should be using shielding, the potential link between EMFs and thyroid cancer, the importance of proactive measures in the home, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with Nicolas Pineault, as we are going to be chatting about EMF hazards, of course tying them into thyroid health. It will be an awesome conversation here.

Let me dive into Nick’s impressive bio. Nick “The EMF Guy” Pineault is the #1 best-selling author of The Non-Tinfoil Guide to EMFs and an advocate for safe technologies. Through his unconventional approach blending humor, science, and common sense, he has become a leading voice on the topic of electromagnetic pollution and how it affects our health. For the last few years, Nick has been interviewing some of the best minds on health and technology and facilitating the curation of courses and educational materials to raise awareness on this very important issue. You can find more about Nick at TheEMFGuy.com. 

Thank you so much for joining us, Nick. 

Nicolas Pineault: 

Thanks for having me. It’s a pleasure. 

Dr. Eric: 

This is a fascinating topic, something that affects everyone. I want to start a little bit with your background. How did you start focusing on helping others become more aware of the problem with electronic pollution? 

Nicolas: 

My journey started in 2010 when I got into nutrition but quickly diverted into environmental toxins. Yes, I discovered that many people can argue online about what is the best diet, but we can all agree that if you add glyphosate or other pesticides/herbicides or heavy metals in your food, that’s not good. 

Also, some people realized by then that there is plenty of scientific research that shows we are impacted by these toxins at variable levels. It also showed me and made me a little bit blasé about the current state of regulatory agencies. I realized that these substances are not properly regulated in a sense that the public is not completely protected against these health hazards, especially when they are cumulative and act in synergy. 

Another toxin I came across later in my career as a citizen journalist is electropollution. That was new for me because I had heard a little bit about the dangers of putting a phone to your head and maybe the risks of a brain tumor, but I had no idea that hundreds of independent scientists, who had very prestigious careers in other types of pollution, were pretty much saying the same thing: We need more research. We are under-funded. Systematically defunded, in fact. The more you find negative health effects linking cell phones to poor health, the less you get funding, which it should be the opposite. Urgent funding, additional funding from the government or health agencies. 

I was very alarmed by the fact that we should be studying this technology more, but we are doing it less and less. At the same time, we are increasing our exposure. 

This led me to write my book in 2017, The Non-Tinfoil Guide to EMFs. I chose that title and that angle because I realized, my god, among many skeptics, even those in functional medicine who understand environmental toxins, a lot of them did not take EMFs seriously. 

Part of the reason is there is a lot of confusion online. Some of it is straight-up incorrect. A lot of it is fearmongering. Then you get the opposite side of the coin that there is no effect. This is non-ionizing radiation. It does nothing to the human body. It will not interfere with your sleep. It will not give you a brain tumor. There is nothing to see here. 

I think these two positions that are at the extremes are completely incorrect. I tried to make sense of what are these scientists actually saying? What can we safely say about these dangers? How can we communicate them? There is not a lot of certainty around EMFs. People are looking for certainty. “How dangerous are these, Nick? How long should I use my phone safely? What is the difference between cell phones, Wi-Fi, and Bluetooth?” The topic is very complicated to communicate on a scientific basis because most of these questions are left unanswered to this day, due to the lack of funding and the systematic defunding of the entire topic. 

Dr. Eric: 

I think more people, including practitioners, are becoming more open to EMFs. Still, we have a long way to go. 

Now, you mentioned brain tumors. I think it’s safe to say, and you would probably agree, that in most people, EMFs are not going to cause brain tumors. They could do that potentially, but it goes beyond that. Some people might hear “brain tumor” and dismiss it. I actually listened to some of your past interviews, talking about some of the effects, like sleep disruption. Even that alone could be a big reason to try to minimize your exposure. Or conditions like tinnitus. 

For those who are brand new to EMFs, can you first talk about what EMFs are? Then maybe we lead into the conversation of some of the concerns, like potentially cancer, sleep disruption, and others.

Nicolas: 

Sure. There are many different types of EMFs. Of course, the electromagnetic spectrum is very large. It encompasses everything from the Schumann resonance, which is the natural magnetism emitted by the planet Earth, which we actually need from a biological standpoint, up to microwave radiation, which is your cell phone. We also have visible light. Then we go at the extreme in nuclear radiation. All of these exposures have different dosages that are compatible with the body. 

One thing is generally true. Natural exposures tend to be more compatible with our biology. The sun, visible light, we do have a certain dose of sunlight that we can get safely. Then we can get risks or even skin burning or other things that aren’t pleasant if we get too much sun. It’s understood that these exposures are not only beneficial, but they are in fact needed for good health. 

With the Vitamin D research that is exploding in the last decade, it shows us that our health is intertwined with the sun cycle, not just on a Circadian rhythm level, but also Vitamin D production and overall immunity. Researchers think of Vitamin D as a hormone, not even as a vitamin per se. It’s even more profound than that. 

We are closely linked with natural EMFs. There are all the reasons to think that if you temper with the EMF environment by creating new EMFs in the form of cell phones, Wi-Fi, Bluetooth, cell phone towers, smart meters, everything that emits these signals that were essentially never seen in nature in these forms, intensities, and specific frequencies, then you might get into trouble. 

The entire topic of EMF needs to be understood by understanding first that we are bioelectrical beings. There are many components of our bodies that need electricity or produce electricity or have censors that read electricity around the cell or the mitochondria. If we understand that, and we recognize that we are bioelectrical beings, it makes it at least plausible that if you have a bunch of different random signals around you, that might create confusion on these bioelectrical censors of the human body.

We are really talking about electromagnetic biointerference, which is not a topic that is often discussed. Engineers are very well aware of electromagnetic interference. If your cell phone and neighbor’s cell phone talk to each other, and it causes disruption, and you both drop the call, or you hear each other when you shouldn’t, engineers are going to step in there and say, “There is something unacceptable going on. We have poor connectivity, or we have crosstalk. We will solve it.” In the case of biointerference, not so much. 

Our safety guidelines are simply based on the wrong assumptions. These engineers do not have the obligation to minimize the amount of radiation that your devices emit. To the contrary, at the moment, it’s almost anything goes. The threshold levels of EMFs that are accepted, especially in the U.S, Canada, Australia, and most of the Western nations, is so permissive that these engineers go for the maximum amount of emissions. Why would they choose that? It’s not to harm people; it’s just for better connectivity. They are not trying to minimize the potential harm or risks. 

This is really the situation here. We are talking about how to more safely use these devices, considering that our safety guidelines are anything but safe at the moment.  

Dr. Eric: 

Those are great points. There is research out there, but they are not paying attention to the research. Now we have 5G, which is even more powerful. I don’t know if 6G is coming in the near future. Is it? 

Nicolas: 

Yeah. It never stops. Part of the discussion we need to have is it’s not just what we’re exposed to right now; it’s what we have been exposed to before. Previous technologies were also unsafe. Many people focus on 5G. They hear 5G and read things. “Oh, 5G is dangerous.” They are reading these 5G articles on the web on their 4G phone and maybe are under the impression that they are doing well. 

I wrote my book in 2017. Way before that, you had scientists in the 1980s emitting concerns over the first Nokia phones, the big bricks. In reality, this topic has always been prone to controversy. We need to understand that all past technologies, and for the moment, all future versions of this technology, will be equally unsafe because we are not basing these safety standards on the right thing, which should be how much disruption are these causing? Instead, they are focused on how much heating are these devices generating on the body, which is the wrong thing to look at. 

Dr. Eric:

Let’s talk about how much disruption they cause, at least according to what you’ve read and the research that you’ve done. How harmful can they be? 

Nicolas: 

There is a vast amount of research on EMFs. The thing that is very concerning to me is a large traction of the public, including engineers and intellectuals, think there is no studies. I have even been told on Facebook- Of course, the Facebook comment section is not the most intelligent place for discussions. An electrical engineer told me, “This research that you are proposing is BS.” They weren’t so kind because they thought I was some sort of snake oil salesman or scam artist trying to create some elaborate scheme to extract money out of people by creating fearmongering around EMFs. They said, “Nick, there are zero studies showing that this radiation is harmful.” This is bizarre. If you just go on PubMed, you will find at least several thousand. 

We can say that some studies show no effect, and some do show effects. At least you can say to be fair that there is a mixed kind of literature.

Scientists are trying to pull together these studies on different topics such as, for example, cancer and cell phones. Is there a link between talking on a phone on the ear and different types of cancer of the head and neck, including thyroid cancer, which is increasingly being studied as we speak? It depends on which scientist you ask this question. 

You have groups of scientists, including top-educated etiologists who are recognized as great etiologists, such as Dr. Anthony Miller, who had great success in his scientific career around environmental pollutants. He said in 2018 that the data we have was sufficient to reclassify this agent called “radiofrequency radiation.” Radiofrequency is cell phones, Wi-Fi, and Bluetooth. He said it should be reclassified as a class 1 carcinogen. Six years ago, he said that it should be next to asbestos and cigarette smoking. 

If it were reclassified, I think the public perception around these risks would change. Of course, like you said very perfectly, it’s not like the entire population will die of a brain tumor. However, since we have nearly every single human being on the planet using a phone, if you change a small fraction of a percentage in brain tumors, you’re killing a bunch of people. 

The more the population is exposed to an agent, the greater the risks if we get it wrong. It’s part of the precautionary principle. If a technology is rolled out to the entire population, how much we assess the risk. The quality of our science needs to go way up compared to an agent that is used occasionally or in certain industries. Now we are talking about exposures to every single human being. Even more than that, we are talking about exposures to everything biological on the planet since we are rolling out these cell towers and global satellites around the planet, which is another rabbit hole.

As far as what kind of science we have besides cancer, there is good reason to think that our fertility is impaired by these things. Not only might it affect the thyroid hormones, but also, if you have a phone in your pocket, you might impact how much, for example, the tests will be producing testosterone. That plus maybe the quality of sperm can go down. It’s still being argued by different scientists. 

Some of them are quite convinced that there is a direct link between keeping a phone in your pocket and a reduction in fertility and testosterone. There are men out there who always laugh at this. “Perfect, I don’t want any more kids,” but they do want their testosterone and their longevity as well. Don’t disregard these risks.

As far as the thyroid goes, there are links between even just the presence of cell towers and thyroid dysfunction in certain studies. One of them found that you’re more likely to get hypothyroidism—which is very rampant these days, as I’m sure you’re talking about all the time—if you live within 300 feet (100m) of a cell phone station. The problem is these days, it’s becoming extremely likely that if you live in a city, you will be within this distance of a cell phone station because they’re everywhere. 

Now, with 5G, one of the big problems is the proximity of these antennas to the population. Even if you turn off your own phone, well, if you’re exposed to the cell towers, you might get these negative health effects as well. 

I was just looking at a review from 2019 called “The Possible Global Hazard of Cell Phone Radiation on Thyroid Cells and Hormones.” They said that more research is needed. It tends to be in every study you find on EMFs these days. More research is needed. It’s slow and tedious. Most of these lines of research will take a few decades to become strong enough. With enough studies of high quality and independent studies, we have a conclusion. 

However, the research has already said we think exposure by cell phones may negatively influence the iodine uptake in the thyroid gland or increases temperature effect on the thyroid gland. They also said that their reduction in diameter of thyroid follicles is potentially linked with cell phone radiation. 

Many of these researchers don’t talk about public policy. Does it mean cell phones are safe or unsafe? They just put the research out there and hope that WHO or a large governmental body will pick up these studies and do something with them. But many of them recommend against holding a phone to the head. 

It’s interesting because this is not what we hear from the governments at all. One of the only governments in the world that has been forced by its Supreme Court to communicate these dangers is the Italian government. A few years ago. That was after the Supreme Court found that a man was killed by a brain tumor, and they found causality between the tumor and his cell phone. They slapped the wrist of the government, saying you will be forced by your own justice to communicate these risks to the population. 

Let them know you can use your phone more safely by using speakerphone or headphones instead of putting it next to your thyroid and parathyroid gland and auditory nerves and all these delicate structures around your head and neck. If you don’t do that, then you’re avoiding most of the risks. 

Right there, you have many scientists who studied the topic argue: Why aren’t we erring on the side of safety while we’re waiting for these studies to become conclusive? What I see online and what I see from skeptics is, “No, I want definitive proof of harm. Then I’ll do something.” This is backwards thinking. It doesn’t work in public policy.

We have done that plenty with different agents. Agents are rolled out, and we say, “Oh, you know, we don’t see big dangers with lead.” 10 years later, we say, “Well, we think that we’re overexposed.” Every 10 years, the level of lead that is considered safe goes down. Eventually, I think most scientists agree that there is no level of lead that is acceptable in the body. Yet we do have occasional exposures.

The same with cell phone radiation. We are really far from that. Instead of preventatively lowering exposures from phones and maybe putting the cell phone towers a little bit further away from the population in case these effects exist, we are doing the opposite: bringing the cell phones to the population, making the phones stronger. It’s really where we’re doing it massively wrong with this entire story of health effects.

Dr. Eric: 

That was a great analogy with lead and other agents in the past. As you mentioned, why not just err on the side of caution and be safe rather than take the risks, even if it is controversial? Like you said, it’s backwards thinking. 

It could affect thyroid hormones, fertility, including testosterone, potentially also cause thyroid cancer. Is there any evidence that EMFs can play a role in autoimmunity, like compromised immune system and increased susceptibility? 

Nicolas: 

There are several papers showing different effects on immunity. It’s difficult because in many situations, certain exposures, especially when you are studying mice or rats or animal models or even just cell cultures, at certain exposure levels, you find effects like increasing immunity, but in certain other conditions, a decrease in immunity. 

It looks like in certain situations, we can adapt to the exposure. Maybe even the stress of this radiofrequency could make us stronger, act like a sort of hermetic stressor, like heat exposure or cold plunges or exercise. In other situations, when it’s chronic exposure, you see a depression, a downregulation of the immune system at many levels. 

As far as autoimmunity, there is not a lot of evidence, but we have certain researchers such as Dr. Trevor Marshall, who is a professor in California at the Autoimmunity Research Foundation, if I recall correctly. He basically ran a study with participants that had various conditions that are autoimmune, including lupus and other autoimmune conditions. I am not familiar with all of them. 

He basically shielded them against this electro smog at night. 90% of them said that they slept much better and started seeing their symptoms of different autoimmune conditions go down. He concluded himself that this is bizarre because if we believe the statistics, there should be around 3-5% of individuals who are electrosensitive that might be helped by these shielding strategies. He makes the case that people with autoimmunity are that much more likely to be electrosensitive and feel these effects.

Also, he said that in the future, an important component of autoimmune protocol to get better would be to shield against these external radiation stressors. That is something very radical to say, but he’s been studying the topic for over a decade now. He is considered an expert in autoimmunity. I don’t think many of his colleagues would necessarily agree because that is a fringe topic to study. I think it makes sense. 

Anecdotally, there are many functional medicine doctors who I connect with on a regular basis who see these patients come in, and they are affected by multiple things. Sometimes, they have autoimmune conditions. Some of them have multiple infections. They have low thyroid or hyperthyroid. Sometimes, they have 10 different things going on. 

One of them that holds true for all patients is that when they start reducing EMF exposure, everything seems to work better. Is it because you’re improving sleep and therefore overall healing? It might be one thing. It might be because you’re decreasing stress. There are different reasons. 

It looks like EMFs can worsen almost any condition out there, just like eating a diet of McDonald’s or Wendy’s will also do the same. In that sense, these man-made EMFs are almost the junk food of signals or frequencies if you will. 

Dr. Eric: 

Did I hear you correctly, that 3-5% of people are electrosensitive? 

Nicolas: 

It depends. Different scientists will have different assessments. I’d say 3% is very common among scientists. 3% are hypersensitive. That would be those who have a very hard time with EMFs. Normally, these people can pinpoint that certain exposures are causing them massive symptoms. Almost like a Celiac person knows they’re Celiac and eats bread; they can pinpoint that, “I ate my bread, and now I feel horrible for days on end.” 

Same thing can be said for 1-3%, some say 3-5%. Other scientists say there might be a third of the population who has mild to moderate symptoms, including a reduction in sleep. Maybe they feel more depressed, or they have different neuropsychiatric effects such as depression, anxiety, OCD-type behavior. That would be a third of all adults. 

Something I talked about in my 2024 summit on electrosensitivity, these two researchers on electrosensitivity had predicted that 50% of the population would be sensitive, based on the last studies, all the surveys they did in different countries. The curve was going up and up like in a hockey stick graphic. 

They asked the question in 2006, “Will we all become electrosensitive and be sickened by this technology?” I don’t know the answer to that. However, many doctors and even average laypeople who are fairly healthy changed their habits around technology and started feeling better. 

There is this difficulty to assess how much EMFs have contributed to my own health challenges, or even is preventing me from reaching my full potential. If I feel very well right now, do I feel 80%? In reality, I’m missing this extra 20% because of these exposures. If you cut down on EMFs, turn off Wi-Fi at night, turn off your phone, some of them realize, “I sleep much better. I thought I had reached the peak of my health, but it turns out that some of these gadgets around me were keeping me down. Now I have my full potential.” 

Same thing is seen in many professional athletes who know about the topic. I think increasingly, they will be interested in the topic although it’s tough because some of them are using censors and a lot of EMF things to perform better. It’s all a balance, especially not necessarily having these things with you at night. In the future, we’ll see EMFs being part of the discussion about the factors that we need to at least control in our environment. 

Dr. Eric: 

I’m glad you mentioned turning off devices before going to bed. If someone is having sleep issues, that’s something I definitely bring up. We are so quick to take supplements like melatonin and others to help with sleep. A lot of people overlook the impact of going on the computer an hour before going to bed or being on their cell phone and keeping their Wi-Fi plugged in at night. Those are simple changes. Unplugging the Wi-Fi every night, or having a switch, like a timer, to automatically turn it off and turn it back on in the morning. 

Would you say ideally a couple of hours before going to bed, people should stop being on devices? 

Nicolas: 

There are many aspects to this. Variations of radiation that connects your phone to a cell tower, not only is this impacting your melatonin possibly and shifting your brain waves in a way that is not conductive to great sleep. In fact, it will cause sleep onset delay. You are trying to go to sleep, but you toss and turn. Your brain is not going in the right type of brain waves that it needs to go in order to fall into your first sleep cycle and go into deep sleep and REM and cycle through these different cycles throughout the night.

I would say not only is radiofrequency a problem, but also the visible EMFs that are emitted by devices. Two hours before bed is good. I personally advocate for the use of blue-blocking glasses that help mitigate some of the problems with light.

In the scope of my work, especially during sleep is when you want to absolutely make sure that your cell phone is not emitting 4G/LTE/Wi-Fi/Bluetooth, all these signals under your pillow. The reality is you have 75% of the population in some studies that have a cell phone near their pillow. 

Those that use airplane mode, in one study I saw from a few years ago, was 20%. It’s still not that popular. 2/10 people made me a little bit happy, I must say. I thought it might have been 3%, something very depressing, to be honest. But 20% is not enough. 

We know that it can impact sleep. We also know that for some people, it’s not just a small impact on sleep. It might be a huge impact. There are genetic differences, and there are also health status differences in different people. 

It looks like the stability of your bioelectrical system also will change with your overall health. That’s just an overall systems-thinking perspective here. If you’re in better health, you’re better able to handle occasional things that make you weak, such as alcohol, junk food. Maybe you drink one night, and the next day, you’re fine to go jogging, whereas someone in extremely poor health or chronic fatigue might do one workout or have one glass of wine and feel very fatigued from that same exposure. 

The same looks like it’s true for EMFs. Your ability to handle radiation might be way better if your overall health is better. That’s another reason if you already have autoimmune issues or thyroid issues, you should be more motivated to turn off the EMFs under your pillow. 

One thing you can do is charge your phone in the next room. I know a lot of parents use their phone as their emergency line for their kids. Maybe they are getting older. They are going out at night for the first time. They don’t feel good about turning off their phone at night. They never listen to me. That’s fair. Put it in the bathroom or on the kitchen table, somewhere you’ll still hear it, but make sure it’s not right next to your pillow. You shouldn’t be able to reach out to your phone. It’s just a distraction. Also, the radiation it emits will negatively impact your sleep. 

Dr. Eric: 

You mentioned airplane mode. If it is in airplane mode but still nearby within arm’s reach, is there still concern of some radiation? 

Nicolas: 

It’s more complicated than that unfortunately. You can be on airplane mode and still have Wi-Fi on. You need not only to be on airplane mode, which turns off the cellular antenna, which is what connects to the towers. Also, make sure to turn off Wi-Fi and Bluetooth. You need to be aware of these things, especially if you have the phone by your bedstand. 

Some people use basic EMF meters, which can help. Double check your work. If you don’t know if your phone is emitting or under which conditions it is emitting radiation, if you have a meter that screens, it shows you that your phone is still emitting a signal. If you have Wi-Fi, it will sound almost like a rifle sound. If you have Bluetooth, you’ll hear a clicking. If you have these sound indications, or even visuals in certain meters that your phone is still emitting, it gives you an indication that you’re doing it wrong. You should go in the menu and turn everything off.

Something I can mention that is not for sleep. A lot of people work nowadays in front of a computer, including myself. I am in a new environment today, and I do have to use Wi-Fi. In many situations, I’m back home and use an internet cable to connect my computer to the router. 

Regardless, if you have a Wi-Fi router or non-Wi-Fi router, which most people don’t have these days, the reality is that your computer is often much closer to your body and your thyroid for that matter compared to your router. Your router may be in a corner of your home or in the living room next to the TV, which is often the case. Your computer will emit a fair amount of radiation with Wi-Fi and Bluetooth all day every day for hours on end as you’re working on it. 

Something that can be extremely positive if you want to reduce your cumulative dose of EMFs is to use these wires to connect your computer. Some people perceive it as a retrograde or old-school idea, but it’s still feasible. In reality, if you go in businesses, a lot of commercial buildings still use ethernet cables. It’s still a great technology to use for rapid data transfer and also cybersecurity. Much safer on many levels than Wi-Fi. 

If you have a home office, and you don’t like your Wi-Fi and complain about it, hit two birds with one stone. Wire up your internet to your computer, and you can cut down on radiation and have a steady signal that never drops. 

Dr. Eric: 

I’m using ethernet. It’s not just to minimize Wi-Fi, but it’s a better signal. It’s more reliable. 

Shielding, you mentioned blue blockers. Earlier, briefly, you spoke about shielding. If you can’t get your smart meter removed, it does sound like you’re a supporter of shielding for EMFs. 

Nicolas: 

Yes. Cutting down on emissions is way more effective than shielding. Partial shielding might dampen the signals. An example is something that’s sold that you can put over your Wi-Fi router, which will dampen the signal 90%. The problem with that is we currently don’t even know what is a safe dose of EMFs. When you have 90% reduction, is it a 90% reduction in biological effects? Is it a 90% reduction in risk? Not necessarily. Is it better than nothing? Likely, yes.

Even with that, I would turn off Wi-Fi at night. When it’s turned off, you know you’re doing good. When you’re starting to go into reduction of EMFs such as lower EMF technologies, some of it I perceive as EMF washing, just like brainwashing is the perception that your product is healthier for the environment when in reality, you’re playing with words. 

It’s a bit tricky here to talk about how much these are contributing to lowering your exposure. There are shielding strategies that are more advanced that you can successfully use at home although they require a larger investment of time and money, such as shielding the bedroom. Increasingly so, certain environmental medicine doctors are recommending these strategies to their patients. 

You can completely shield a room either with a bed canopy over the bed that is made oftentimes of cotton and copper or stainless steel or silver mesh. It doesn’t look like metal. It really looks like fabric that you put over your bed. It will cut down all the exposures that would have come from the outside. 

This is especially important in patients who have this level of sickness, such as autoimmune conditions, or have these levels of exposures that are tremendously high because they live too close to cell phone towers for example. They don’t feel well in their home. Some people really swear by these different strategies that are applied and verified by biologists or EMF mitigation specialists.

One of these specialists is my colleague Brian Hoyer from Shielded Healing. There are plenty of specialists who can come to your home and do a survey. I recommend it for almost anyone who can afford it to be honest. 

Many people tend to fear the towers so much and say, “I see this tower. It’s ugly. It’s very dangerous.” But they don’t recognize that all of the other things that they have installed inside their home sometimes can be worse than what the tower emits toward their home. It’s sometimes very difficult to assess what exposure is a priority for you if you don’t have the EMF meters and then the expertise to survey the home for these sources. 

Dr. Eric: 

What are your thoughts about pendants? There are some pendants that supposedly protect you from EMFs, which I’ve been skeptical of. It would be great to put on a pendant. I’m sure even they wouldn’t say it’s completely going to shield you. Do they have any benefit at all in your opinion? 

Nicolas: 

Some electrosensitivity sufferers seem to do very well on certain technologies. There is a question: Does it play on a reduction of symptoms, or is it protective? This is where you don’t really see scientists endorsing these as a magic bullet. I think many people are looking for a magic bullet that says, “This is tedious, turning off the Wi-Fi at night. Thinking about the cell phone towers and how much I’m exposed. Instead, I’ll wear something on my person and be completely invincible.” This is a nice thought. This is something that is very appealing to our psyche. It does sound too good to be true. It is too good to be true, in my opinion. 

So far, I have seen different technologies seem to lower some of the biological effects of EMFs, such as, for example, certain technologies you can use in your bedroom to sleep better, even in a high EMF environment. Would that be beneficial? Yes. Are you also supposed to turn off the EMF sources in the first place? Yes. If you do both, you’re doing yourself a favor. If you rely solely on these different stickers on the phone and pyramids and solar energy devices, I think you’re under the illusion of protection. It’s a dangerous game to play. 

Why I’m still taking this position is since we have indications that some people could be killed by this technology, that’s a big word to use. If you get a brain tumor and a glioblastoma and you die from your cell phone exposure, that’s extremely sad. In many cases, this has already happened throughout the world. 

If you are under the illusion that you have a sticker on your phone, and you will never get brain cancer from these exposures, and yet in 10 years, you come back to me and say, “Nick, I think I’m going to die. I have a brain tumor,” I wouldn’t feel good about myself because we don’t know for sure if it removes any potentially carcinogenic potential of these emissions. We don’t know that. 

Yes, these gizmos and EMF harmonization devices should be explored, especially for people who are electro-hypersensitive. But I have seen none of them offer the magic bullet that many people are looking for. 

Dr. Eric: 

Thank you for sharing that. Before we wrap things up, I definitely want you to talk about your upcoming EMF Hazard summit. 

I also want to ask you about Oura rings or other devices like that. A lot of people use those at night to help them monitor their sleep and see their sleep quality. With Oura rings, you can turn off Bluetooth. I wanted to get your opinion, if you think there is also risk with those. 

Nicolas: 

What we know on shifting brain waves is concerning to me when you use wearables to track your sleep. The Bluetooth technology might be impairing your sleep. It’s a bit ironic in how these things are designed. 

However, the Oura is one of the brands that I appreciate because you can keep it on airplane mode while you sleep. It will store the data locally inside the ring. I don’t know how, but the technology is becoming so small it’s almost ridiculous. It’s just a little bit of data about your HRV and body temperature that are picked up by the censors. Then in the morning, you can put it out of airplane mode and sync the data to your phone to visualize it and say, “How am I feeling right now? How does it corroborate with the data I have?” Then put it back on airplane mode.

My amount of exposure I am getting from the Oura is next to nothing. However, a lot of other types of wearables emit Bluetooth sometimes multiple times per second. I have a problem with that. I don’t think it’s well-designed. I think that if the technology can be designed in a way that it stores the data locally, and it just will sync the data once per day, or on demand, why aren’t all types of wearables built this way? 

It’s just poor engineering. I would recommend against it. Maybe there are occasions where you want to track your sleep with certain sleep tracking devices that emit Bluetooth. You do it for a month. Then you discontinue the use. I wouldn’t be completely against it. Chronic, prolonged exposure would be a problem. I don’t think it’s going to serve you well. 

Dr. Eric: 

Thank you so much for sharing this information, Nick. Before we wrap things up, is there anything else I should have asked you that I didn’t ask you? Anything else you wanted to summarize? 

Nicolas: 

If you want to summarize how to reduce exposure quickly, focus on the bedroom first. That is something I remind people. 

There are two things we can talk about when it comes to exposures. If you start playing around with a meter, everything emits EMFs. It’s hard to think about your priority here. Living in the woods? Hiding in a cave? It doesn’t work for most people.

In reality, look at what is inside your bedroom that could be contributing to these exposures at night. Where are you spending most of your time during the day? Some people have a home office. My dad, for example, he’s a realtor, so it would be his car. He is in the car three hours per day minimum, sometimes more. For him, it may be turning off the Bluetooth function in his car and pre-downloading songs or podcasts on his cell phone. I don’t think he’s going to do it, but still, I have to keep trying to educate him.

Think about where you’re spending most of your time. Focus there. If you start to think about all EMF exposures, it’s like being concerned over all toxins. It doesn’t work. You have to prioritize. In that case, make sure you tackle the bedroom and then where you’re spending a lot of time. I think you’re going to be 90% of the way there.

Dr. Eric: 

Wonderful advice. Thank you so much for sharing. Where can people find out more about you? Feel free to share your website. Also, if you could talk about your upcoming EMF Hazard summit. 

Nicolas: 

Sure. TheEMFGuy.com is my website. There is my book, courses, and whatnot. 

The EMF Hazard Summit 2024 will be live from April 11-14. It is focused this year on what I call the hidden academic of electrosensitivity. We give people 20 different talks that are focused on electrosensitivity. We have presidential candidate Robert F. Kennedy, Jr. as one of the headliners. We also have environmental medicine doctors who are specialized in treating EMF-sensitive patients. That is very rare that we can find these doctors who have the medical expertise to diagnose electrosensitivity and who have figured out how to get these people to a place where they feel better. 

Of course, regardless of if you feel better or not, you should still lower EMFs. For some people, the level of EMF reduction that they require to feel well is completely unattainable in a city. They can’t actually live in society anymore. Their life choices are that much more reduced by their circumstances. How can they go back to good health and a good level of sensitivity, where they can still travel? They can take a car and go see a friend. Or maybe they can spend a few days in a city that they want to visit. 

It’s for people who feel electrosensitive or don’t know if they are electrosensitive or not. April 11-14. I think it’s the best yet. I can’t wait to get your feedback. 

Dr. Eric: 

I am very excited as well. Thank you again so much, not only for this interview, but for the research you’ve done, the upcoming summit, the past summits you’ve done, spreading awareness. I think it’s such an important topic. Appreciate everything you do. 

Nicolas: 

Thank you so much. Thanks for having me and helping spread the word the way you’re doing it.

Recently, I interviewed Bronte May, and we talked about how she overcame thyroid autoimmunity, the complexities of thyroid healing, the need for a holistic approach, the importance of self-advocacy, the controversial role of iodine, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am pleased to have Bronte May on today’s episode, talking about common oversights when healing, including talking about emotional healing. It’s going to be a great conversation.

Let me go ahead and give Bronte’s impressive bio here: Bronte May is a naturopath with a passion for thyroid health. She knows firsthand the multi-layered journey to heal from a thyroid autoimmune condition, having personally dealt with and healed from Graves’. She understands how healing the emotional aspects of the disease can unlock deeper healing, and how mindset coaching can support this often challenging journey. 

Interweaving a variety of modalities from her toolkit, Bronte facilitates healing on a cellular and soul level to create space for self-healing. Bronte also offers an individualized 12-week one-on-one thyroid healing program and a 10-week group program, where she guides you through steps and tools that worked for herself and her numerous thyroid clients. Her programs are life-changing. Thank you so much for joining us, Bronte. 

Bronte May: 

Thank you so much for having me here.  

Dr. Eric: 

This is going to be great. Very excited to chat with you. Before we get into the common oversights, definitely want to dive into your background. I gave it away a little bit in the bio, but we’ll have you expand on your journey a little bit. How are you doing what you do right now? 

Bronte: 

Sure. Quite a few years ago now, I was diagnosed with hyperthyroidism. Knowing what I know now as a thyroid naturopath, I was misdiagnosed. I had high antibodies, and they were not really spoken about. I even pointed them out to my GP, and she said, “Don’t worry about those.”

Fast forward to three years after that original diagnosis. I had a relapse, and I was very sick, not knowing it was my thyroid again until I did further testing. They sent me to an endocrinologist, and I was diagnosed with Graves’.

From that point, they gave me some treatment options, which sounded very scary to me and nothing that I wanted to choose: having my thyroid taken out or radioactive iodine. They spoke about the risks of staying on carbimazole long-term. That felt very scary for me. No one explained to me what the thyroid was, where it was, what it did, how important it was. I was sent off and told I had six weeks to make a decision.

In that six weeks, I reached out to a friend who was in the medical industry. We spoke about changing my diet. When I went back to the endocrinologist six weeks later, they asked what I decided. I said, “Well, I’ve decided to create my own fourth option” because I didn’t like the three options they presented. They asked what I meant. I said, “I’m going to heal myself with food.” They told me I was crazy.

Fast forward, that really helped. I got my antibodies down by changing up my diet. With a thyroid autoimmune journey, it’s not just about your diet. That’s so much more. That’s what I discovered.

Through that journey, I became very passionate about health. That’s what led me to become a naturopath and teach other women what I have done myself. 

I see it as negligence, that the medical industry is not looking at the whole person. No one said to me, and I hear this from countless patients as well, “What is your lifestyle like? How are you feeling? How are you sleeping? What are your stress levels like?” They are not asking about your toxins or any digestive issues or anything like that. They are not unpacking what’s going on in your emotional body. They’re not asking anything about your mindset. All of these things matter. 

That’s what I’m passionate about in guiding my clients and teaching them about the different aspects and the self-empowerment piece as well, how to advocate for yourself. 

Dr. Eric: 

Same here. In the United States, I wish I could say endocrinologists were more open-minded, but it sounds like they’re the same way. They’re dismissive of diet and lifestyle playing a role in the development of conditions such as Graves’ and Hashimoto’s. Pretty much when it comes to hyperthyroidism, they give the three options: antithyroid medication, radioactive iodine, or thyroid surgery. Sounds like pretty similar in Australia. Not too many natural endocrinologists. 

Bronte: 

We hear it so much here. “Don’t worry about changing diet; it won’t do anything for your thyroid.” Your options are medication or removal essentially. Shutting down your thyroid with radioactive iodine. Even when I went back and my antibodies went down, they weren’t curious to ask what I did. “Ah, it’s just luck.” I was like, okay. 

I hear that from my patients as well. People who are inquiring to work with me, my endocrinologist or GP said that changing my diet won’t change anything. “How can I get off medication? How can I heal my thyroid? Is it actually possible?” I get that question all the time: Is it possible? Yeah, it’s so possible. So many people do it. You’re helping countless people do the same thing as well. 

Dr. Eric: 

Obviously, we both agree. We both have experienced it ourselves and have helped many people. I would say with endocrinologists, I could understand that’s just how they’re trained. I would like to think if I was an endocrinologist, even if I was a little bit closed-minded, I would think I’d say, “I’m not sure if diet would help, but you can always give it a try. It’s never going to hurt. If anything, it will help to clean up your diet.” They don’t even say that. They’re very dismissive, saying, “No, diet won’t help at all. These are the only three options.” It’s very discouraging. I don’t see it changing anytime soon. 

Bronte: 

The majority of them aren’t even curious about it. There are some good ones out there. I have had some of my patients who have seen good endocrinologists, but they are few and far between unfortunately. I hope that begins to change. There is a lot of information out there. There is a lot of people waking up to understanding that there are more ways to heal than just the mainstream. 

Dr. Eric:

Let’s dive into those common oversights when it comes to thyroid healing. I’d like to start with iodine. There is a lot of controversy with iodine and thyroid health. Some people say to take really high amounts of iodine. Other people say you don’t want to take any iodine when you’re dealing with hyperthyroidism or Hashimoto’s. What is your perspective on iodine in both hyperthyroidism and Hashimoto’s? 

Bronte: 

It’s very important in both of them. There is a time and way to introduce it. Obviously, there is more caution when the person is hyperactive or has Graves’. 

In both cases, I’m always looking at the antibodies, making sure we can get the antibodies down to a more reasonable amount before we start to introduce iodine. Introducing it slowly, particularly for those Graves’ patients. Introducing it alongside selenium as well. There is a delicate balance in the dosage and making sure that you do have enough selenium supplementation alongside the iodine. 

It’s definitely important for both. I think the other misconception around iodine is it is only for your thyroid health. This is not true. It’s really important for immune function. It’s important for breast health. It’s important for detoxifying estrogen as well. It’s not just thyroid health. For some people who have had a thyroidectomy, they don’t think they need iodine, but you still do. 

There is a lot of misconception around iodine. That is definitely one thing to be working with someone who knows what they’re doing and knows how to introduce it into your supplementation and when to do it. 

Keeping an eye on it. Even though some people are really depleted in iodine, they may have Graves’, and it’s not the right time for them to introduce it. They can get a flare. Same with Hashimoto’s as well. Sometimes, it can elevate antibodies temporarily. People start to freak out about that. I think the best advice is to be working with someone who knows what they’re doing around how and when to introduce iodine.

Dr. Eric: 

Do you recommend iodine testing? 

Bronte: 

Yeah, the urine testing. Is that what you do as well? 

Dr. Eric: 

When I do iodine testing, yeah, I find urine testing to be more accurate than blood testing. There is the patch test, which when most people do, it will disappear relatively quickly. I was guilty of recommending that years ago. If I recommend iodine testing, urine is the way to go. 

Bronte: 

Yeah. There is also testing for bromine. There is a lab out here. I’m sure you probably have labs over there that test it as well. Because it’s a halide, we want to make sure we are also looking at the bromine levels. Our halides, like fluoride and bromine, can affect the body’s ability to uptake the iodine. Even though some people may, on a urinary iodine test, be presenting with enough iodine, they are not actually getting it because of the halides they are exposed to through bromine or fluoride, if they are drinking fluorinated water. 

Dr. Eric: 

I imagine you’re recommending to avoid water with fluorine, toothpaste with fluoride, and minimize other halides, like bromine or chlorine. Install a shower filter? 

Bronte: 

Yeah, we can’t do everything at once. Detoxing your lifestyle is a rabbit hole in itself. Same as trying to navigate your thyroid autoimmune journey can be a rabbit hole. This is why it’s really helpful to work with someone who can help you take it step by step. That is very important. 

If you are going to invest money into your health, I would highly recommend at least starting with a water filter and getting rid of your fluoride toothpaste. Very important for thyroid health. 

Dr. Eric: 

What are some other common oversights when it comes to thyroid healing? 

Bronte: 

Other common things that I often hear is people saying, “I tried the AIP diet or the paleo diet or another diet,” but often people are not trying it for long enough. You really need to be giving something a go for three months or three menstrual cycles to really understand if it’s going to be helping you or not. 

Yes, if you have major adverse reactions to something, like straight up, that may not be right for you. Just because you are following an elimination diet, it also doesn’t mean that all of the yes foods on the list are going to be right for you as an individual. It’s important to listen to your body, but it’s important to give it that time and the consistency. I feel that people probably only gave it 70% commitment. It’s really important there is a high level of commitment, being really consistent and giving it the time frame. 

Dr. Eric: 

I agree. Following a healthy diet, like you said, AIP or paleo for 30 days is obviously better than not following it at all. Still, I agree. It’s best to try to do it for at least three months. Sometimes it is a mental game, where you have to tell yourself you will start out with 30 days. Inside, knowing that after that, you hopefully will continue with that. Definitely agree with that.

Do you recommend for most of your clients an elimination diet? Do you recommend food sensitivity testing? A combination of both? 

Bronte: 

It depends on the patient who is sitting in front of me as to their personality type. It would depend on what sort of elimination diet. The AIP diet is extremely restrictive. For some people, it’s very stressful to do that. That is counterproductive in itself because it’s causing too much stress for them. I am a bit more flexible for some patients, so I am doing a more paleo-style diet.

I also do testing. I have a hair test I do. It’s a biocompatibility test. It tests for over 600 items. It gives you an exact list of yes and no foods for you as an individual. Some patients choose that option, so they have an exact list to go by.

It’s coaching them around how to effectively create healthy meals. How to eat to optimize your digestion and get your nutrients from your food. 

Dr. Eric: 

We both agree three months sometimes longer. Let’s say three months go by, and someone is following a paleo diet, and they are not really experiencing any improvement in the symptoms. Maybe even the blood tests haven’t improved. What would be the next step for that person? 

Bronte: 

For that person, I’d be looking at other things, like underlying infections, toxin exposure, looking at their stress levels, looking at their sleep. Also, really going deeper into how they are as a person. How are they managing stress? How do they think? How is their relationship with themselves? Going even deeper than that. Looking into trauma history as well. 

I believe that the root cause of any disharmony—is what I call instead of illness or disease. Any form of disharmony really is in the emotional body. How we have responded to things that we have encountered in life. There is a bit of a list there.

I have a story of a patient who was doing all of the things. She was so consistent, so compliant, so committed. She still had symptoms that weren’t correcting with her digestion. I needed to investigate further, and we did a gut test for her. She came up with four infections in her digestive tract. 

It does pay to do further testing as well. If you find that your symptoms aren’t correcting, there are so many other aspects we need to be looking at. Gut health is a big part of it. Like I said, looking at mindset and the emotional components as well. We’re a whole person. We’re not just this physical body; we do need to look at all the physical aspects. I do believe we need to go beyond the physical aspects as well. 

Dr. Eric: 

You would agree that diet is important, but it’s usually just a piece of the puzzle. Changing your diet alone usually is not going to completely help someone with hyperthyroidism or Hashimoto’s reverse their condition. 

Bronte: 

No. Some people might be really lucky, but it just won’t be what you ate that caused your thyroid imbalance or thyroid autoimmunity. It’s an accumulation of many components over time. Our health is accumulative. 

While you may very likely reduce your symptoms by just changing your diet, as that was my story. That’s all I did, and I didn’t have anyone guiding me through the other aspects, the initial stages of my own healing journey. Yes, I got my antibodies down, and they also went back up when I got stressed. I realized stress is a big part of it. 

Through my journey, I realized there is so much more to this that I needed to dive deeper into: looking at my gut health further, looking at underlying infections, going deeper again. I found out early on about the mindset stuff. 

I had a breakdown in the supermarket because I was- You know when you have Graves’, you are always hungry. You constantly eat 24/7, but you are never satiated. That was me. I was wanting to eat, eat, eat, losing weight. I was at work and hadn’t taken enough food to work. I went over to the supermarket to try to get some food. There is nothing there I wanted to eat. This was so frustrating. This was so hard. 

When I went home that night, I was like, “Okay, I can’t have this perspective on my healing journey. I can’t keep telling myself this is hard. I need to be focused on what it is of the direction I am moving in, and what is my goal? What am I moving away from? What don’t I want? What do I want?” I needed to get clear on that. I started working more on mindset. 

Fast forward again, I realized that I needed to look into traumas and life events that have happened that have caused imbalance in my system, in my energetic system and emotional system. That was contributing to an imbalance in my physical system. There is a lot of different components to look past. 

My advice is to take a step. You don’t need to do all the things at once. In fact, I wouldn’t even recommend all the things at once. It’s overwhelming. The physical body is a good place to start. You will start to get symptom relief and feel better. You feel like you have more space and capacity to start to look at other areas. Maybe your next step is looking at detoxifying your lifestyle, living a more low-tox lifestyle. Then you might move into mindset, which you should do near the beginning. That’s what I do with my patients. If you don’t have someone guiding you, you decide what you introduce when because you’re the pilot of your own flight. But I would look at mindset. 

Then when you have more understanding of how you operate, then you have more confidence and hopefully tools to be able to unpack what is in the emotional body.

Dr. Eric: 

Start with the physical changes: diet, mindset. Then maybe later on, incorporate more emotional healing? 

Bronte: 

Yeah. I think that’s the best way. If you start to unpack some emotional healing in the beginning when you are feeling really crappy because you have an overactive or underactive thyroid, so you could be anxious or depressed, it’s not the right time to be looking at all the emotional stuff. I feel like it’s better to get your thyroid in balance first. Start to reduce your symptoms. You will start to feel a bit more like yourself, so you have more capacity and energy to be able to start to look at the emotional components. 

For some people, there is a lot there. A lot of my patients have very big stories, and there is quite a bit to unpack. There is quite a bit of trauma. 

Dr. Eric: 

You mentioned the example where you did a stool test, you found the four gut infections. Is that dependent on the person, like the person’s case history? When should they consider doing a stool test to look at gut infections, for example? 

Bronte: 

It’s dependent on the symptoms that you’re presenting with as well. Some people may have really extensive digestive issues, so you might want to be testing much earlier on. For a lot of my patients, I don’t need to do stool testing because the process that I take them through to heal their gut works. 

For this particular patient, it wasn’t correcting. It’s not that she wasn’t compliant in what we were doing; she was extremely compliant, very committed, and that’s why I was baffled. Why is this one not correcting? We need to look further. 

If you are doing all of the things, and the symptoms are not correcting, then look further. Or if you’re feeling really horrible, like you have a lot of digestive issues, like bloating, food intolerances, chronic constipation, or loose bowels multiple times a day (3+ times), which is consistent every day, you might want to be looking into doing a gut test to see what’s happening there. That is certainly not normal to have so many digestive issues. 

For some people, if they’ve had digestive issues for such a long time, that becomes their normal. But it’s not normal. I’ve worked with people who have had a bowel movement 3-4 times a week their whole life, so they figured that was normal. Same with people who experience PMS. They think that’s normal, and it’s not. It’s common, but it’s not normal. We want to have a bowel movement every day, 1-2 times a day. You don’t want to be having PMS symptoms either. When your body is in balance, you will be having regular bowel movements, and you won’t know when your period is coming, as you generally won’t have too many symptoms. 

Dr. Eric: 

Any other common oversights that you didn’t cover? 

Bronte: 

I think we covered it all. We talked about giving it enough time, being consistent, being compliant, the iodine piece, further investigation, getting further testing. We talked about the mental and emotional aspects as well.

Dr. Eric: 

When it comes to patient compliance, as far as the timetable for people to heal, as it does take a commitment. Some people have unrealistic expectations and might think that within two months, especially if they have Graves’ or Hashimoto’s, probably takes quite a bit longer, maybe not to start feeling better, but to reach the point of remission. 

What do you find in your practice with your clients as far as on average? Everybody is different. How long does it usually take for someone with Graves’ or Hashimoto’s to get to the point where they are fully healed? 

Bronte: 

Like you said, the timeline is very case by case. I do a 12-week program. Some people may think they are going to do that program, and then they’re good. That’s not the case. That’s why we say you need three months. That’s where you have to give commitment to heal the gut and reduce inflammation. But that is only the beginning.

What you do after that is so important as well. Your lifestyle needs to change. What you did before you started on your healing journey, all of the different things that you were doing that contributed to you having this imbalance in your body, having a thyroid condition. You can’t go back to those habits. It’s about learning to change your lifestyle and habits and identity around who you are and how you view your health.

The time frame, I would say for most people, is at least a year. For many people, it’s a couple of years. I’ve had the odd patient who got into remission in three months, but I rarely see that happen. She was lucky. I shouldn’t use the word “lucky” because I was upset when my endo said that to me. She was very committed, but she also didn’t have a lot of other things to be dealing with. She had already low-toxed her life. Her body just corrected quickly.

You need to give it at least 12 months of reasonably high commitment. I feel like the first three months needs to be the highest commitment you can give yourself. Then you can start to be a little more flexible and start to introduce some foods back in. Consistency is key.

Even now, me, years later, over Christmas, it’s not like I am going weeks and weeks of drinking alcohol every day and having sugar every day or eating gluten or dairy. It’s not part of how I am. I have completely changed the way that I view health. My identity doesn’t identify with that.

We were talking about this with a client yesterday. When you drive past McDonald’s or KFC or any sort of fast-food joint, I do not even associate that with food. Not even one percent of me would consider going in there, or eating a pizza with gluten and cheese. To me, that’s not food. You guys don’t’ have Tim-Tams over there. I wouldn’t eat packaged biscuits. If you go to your aunt or granny’s house, and they have biscuits there, I have no desire to eat it. I completely changed my identity around how I view food and how I view what I do with my body. I see my body as my temple. A bit of a tangent there with that answer. 

It’s an ongoing thing to heal. For you to reach remission, I can’t give a time frame. I would say for the average person, it would be at least 12 months. Then to stay in remission is that consistency and commitment and devotion to your temple, to your body. It really is a personality and a lifestyle shift to be healthy. It’s not just I do it for a snapshot in time. 

Dr. Eric: 

I agree. I’d say the average is 12 months. Everybody is different, so some people might take longer than that, or a little bit less than that. Three months, that’s rare, unusual, like you said. It sounds like maintaining a state of wellness overall, still eating a pretty healthy diet, living a healthy lifestyle, which I do as well although I admit I can’t deny that I sometimes have cauliflower crust pizza. I can’t say I’m completely pizza-free. 

Bronte: 

No, I do have different types of pizza. I wouldn’t sit down to a regular pizza with heaps of cheese and a normal gluten base. 

Dr. Eric: 

You do indulge every now and then with different foods. 

Bronte: 

Yeah. It was my birthday just last Friday, and I had sparkling red. I drink alcohol, but I don’t do it every week. I don’t even do it every month. 

You get to decide what is your level of commitment, so you can still have balance in your life. If you come from a European background, say, family and food is a big part of who you are. So much of that culture is around food and getting together with family. You might choose how you’re going to navigate that. You don’t want to completely not have those foods. 

You decide what is the right balance for you. What is your level of commitment? Is 70/30 where your balance sits for you once you have passed the main part of your healing, once you get past 6-12 months? You get to decide what your level of commitment is. 

I’m about a 90/10. That doesn’t stress me out. My devotion to my wellness is my joy. I get a lot of joy out of being really healthy and looking after myself. For some people, it’s not like that.

What I would say to those people is have a look at your identity. What is underneath all of that? Why do you think that way? It’s not that it’s right or wrong. It’s interesting to look at how we identify with health, how we identify with food. 

There is a big emotional component to it. So many people have an emotional attachment to food. That’s ingrained in us from childhood. You go to a birthday party, and you’re celebrating the birth of this person. Look at the food on the table. None of it is food. When we celebrate, we are putting poisons into our body. If you do really well at school, your folks are like, “Let’s go celebrate. We’ll go to Pizza Hut.” Those are toxins, right? 

When you’re an adult and have had a tough week at work, “I deserve to have a pizza or ice cream and a bottle of wine because it was a shit week.” You’re just punishing yourself even more by doing that. We all have these patterns until we become aware of them. It’s like becoming aware of what is driving that? If I have had a really crappy week, my default might be, “I am going to crack a beer open or pour a glass of wine. Really, what do I need?” 

So many people are afraid of connecting with their feelings. Can I actually sit with the feelings that are present? Can I actually make space for them to be felt, to be witnessed, instead of being pushed down and ignored? What do I actually need? Do I just need to have a good cry? Do I need to move my body? Do I need to ask someone for a hug? Do I need to reach out to a friend because I need someone to hold space for me and have a chat? 

Understanding what it is that I need, and meeting those needs with something that is not food. There is a lot to unpack when it comes to changing your lifestyle and resetting your identity of yourself, especially when it comes to wellness. How we respond to life really does have an influence over our physical body. 

Dr. Eric: 

I agree with all of that. I want to go in a different direction now. Maybe I should have brought this up in the beginning because this is more about staying safe while restoring your health. I think it’s important to chat about this because obviously, your background, you help people get into remission, restore their health. 

But when you dealt with Graves’, you did take carbimazole. A lot of my patients take antithyroid medication; it all comes down to risk versus benefit. Some people don’t want anything to do with medication. Same thing with Hashimoto’s. Some people should be on thyroid hormone replacement but don’t want to be on it. 

When I dealt with Graves’, I was able to avoid antithyroid medication, but not everybody can do that. I do work with people in the US who are on methimazole. Carbimazole converts to methimazole. 

Was there any hesitation at first when you took the carbimazole? Did you weigh those risks and benefits? “I don’t want to take the medication, but I know that it’s risky not to manage the symptoms.” Knowing that you are also going to try to address the cause of the problem, which you successfully did at the same time. 

Bronte: 

This is a part of my story I haven’t openly shared too much about. I do with my patients, but I don’t think I have on a podcast.

When I was initially diagnosed with hyperthyroidism, I was pretty unwell. When I had that relapse three years later and was diagnosed with Graves’, I was actually suicidal. I thought because before my initial diagnosis of hyperthyroidism, I had depression and anxiety, and I was on antidepressants, which I didn’t want to do, but I had quite a lot of stories and trauma to unpack from my childhood. I went and saw a naturopath, and we did a six-month detox before I went on antidepressants. It helped, but it wasn’t enough. I needed the antidepressants.

When I was coming off those is when I got diagnosed with hyperthyroidism. I was a bit scared that it was me going off antidepressants. I will get to the answer of your question.

I did go on the carbimazole because I had a lot of symptoms. My eyesight was weird. I had heart palpitations. When I had the relapse, I was very mentally unstable. I thought my depression had come back because I was off antidepressants at that point. I was seriously thinking to end my life. I planned how I was going to do it. I went to see the doctor. 

I couldn’t walk up a couple of stairs without losing my breath. I would go to the gym, and my heart rate would go up to 190 within 60 seconds. “This is not normal. Maybe I have a heart condition.” 

When they diagnosed me, the doctor said, “All of what you’re experiencing, you don’t have depression or anxiety. This is a thyroid condition, so it’s physiological and not psychological. Don’t worry, you will start to feel better quite quickly.” The antithyroid medication worked pretty quickly. I started to feel so much better within less than a week of being on the medication. 

If you don’t want to go on the medication, that’s your choice. It’s your body, and it is your choice. Listen to what it is that your body actually needs. If you’re like me and very mentally and emotionally unstable, it might be a really good idea that you do go on the medication, even it is for a short term, because you can get off it. If you get your thyroid removed, you will need to have medication. If you have really bad heart palpitations, that can be a risk. 

It is important to go on the medication to be able to support your body to come back into balance while you are also working on all of the other root causes, helping to support your body to heal holistically. That will support you to get off the medication, but the medication in the meantime will help you feel some kind of balance. 

That is my advice to any patients who come to me. How are you feeling? I’ve had a patient who came to me with T4 so high. I think she was 80-something. How are you sitting here normal, not losing your mind? Mine wasn’t that high, and I really wasn’t coping. I was crying every day. My coordination was off. I did a chef apprenticeship. I remember before I was diagnosed at my relapse point, I couldn’t coordinate in the kitchen. I was cutting myself all the time. I was off. I had a rash all up my stomach and my chest. I wasn’t sleeping. I was sweating in the middle of the night in the middle of winter. 

This lady who had T4 over 80, she seemed so normal. I didn’t get it. She was someone who didn’t want to go on thyroid medication. I supported her with that decision, and we got her thyroid back into range. 

If it’s something that you don’t want to do, then do seek to work with someone that is going to help your body heal holistically. Also, consider that maybe it is something you just go on short-term. You can get off it with the right support and putting the right steps in place. 

Listen to your own intuition. Your body doesn’t lie. If you have such a strong aversion to doing something or not doing something, you have to listen to your own internal guidance system. The practitioners you work with will discuss the risks with you. Ultimately, at the end of the day, it is your decision. 

Dr. Eric: 

That is true. The truth is that not everybody can manage your symptoms naturally. Even when I dealt with Graves’, I was open to taking the medication. I just made that decision initially not to do it, but it’s not like I completely ruled it out. 

If people are already taking antithyroid medication, whether it’s carbimazole for those who are in Australia or the UK, or methimazole for those in the US, there is a risk to switch to the natural agents because they don’t always work. Things like bugleweed or high doses of L-carnitine can be effective, but the medication is more potent. 

The challenge with antithyroid medication is it can cause side effects. Obviously, if someone is taking antithyroid meds, and their liver enzymes are really elevated, or their white blood cell count is depressed, or they are having other symptoms, and then the medical doctor/endocrinologist is pressuring the person to do radioactive iodine or thyroid surgery, in that case, you want to look at alternatives. 

If someone is listening to this, and they are already taking medication and tolerating it well, as long as you are doing things to address the cause of the problem, I agree. You don’t want to get discouraged about taking meds because you are keeping safe while you are addressing the cause of the problem. 

Most people don’t do that. They just take meds and pray they will go into remission after a year and a half or two years. Obviously, since they are not doing anything to improve their health, a lot of times, they will relapse. 

Bronte: 

That is such an important point to speak to. Many people are doing the medication route without doing anything else and wondering why they are not getting better. They go back to their endo or GP and up their medication, but it still doesn’t work.

I am particularly speaking to the Hashimoto’s people. They are taking thyroid hormone. A lot of times, they are on thyroxine, which is the T4 form, and it’s not working. Then their dose gets increased, but it is still not working. The underlying drivers are not being addressed. 

For a lot of these people, they are not able to convert T4 to T3, which is why they’re still feeling crappy. Upping their medication is not going to change that. If your body is not able to convert it properly, why? It’s not effectively getting into the cells. Why? We need to look at that. That is not what is being addressed in the mainstream. People are being let down in that regard.

It does really pay to be working with someone who is going to support you to understand how to approach your health from a holistic standpoint. Even if you only just want to do the physical aspects. “I am not looking at the mindset or the emotional.” Some people don’t want to or are not ready to do so. 

I would encourage you to look at the physical aspects and support the body holistically, so all of the systems within your body are working as best as they can be, that you are supporting those processes, so you can be converting your medication effectively, and you can get the energy you deserve to be having and reduce those symptoms. 

The hair loss aspect. You just taking thyroxine is not going to help your hair grow back. I’m sorry. It’s not going to fix that. Even if you are converting it properly, you’re probably still not going to get your hair to grow back effectively because you need other aspects. That is a common symptom with a lot of our thyroid patients, is the hair loss. It’s upsetting for women because we place so much emphasis on our presentation. We don’t want to be balding. I think the holistic approach is so important. 

Dr. Eric: 

Definitely agree. Is there anything else that you want to cover? Anything I should have asked you that I didn’t ask you? For those who want to know where to get started, you mentioned the physical aspects before getting into emotional healing. 

Bronte: 

Another important piece is to learn to advocate for yourself. I find a lot of patients, when they are going to see their endocrinologist or GP, and they get shut down, they are not feeling heard or seen or understood, or they’re told things like, “Oh no, we don’t need to test your antibodies because once they’re high, they’re always going to be high.” “I don’t test for iodine because I don’t know how to interpret the lab results.” I hear that a lot from patients’ doctors. Being shut down in their experience.

It’s learning to advocate for yourself. How you feel matters. What’s happening with you matters. Your voice matters when it comes to your health. If you’re not getting the support that you know that you want and need, and you actually deserve to get, I encourage you to find somebody else. Find another doctor to work with. Learn to advocate for yourself. That is even with your holistic practitioners. There are holistic practitioners out there who aren’t fully supportive either, who do shut down patients’ experiences. 

Listening to your own internal guidance. No matter what. Doesn’t matter who you are working with. You need to listen to what a yes or a no or a not yet for you is when it comes to your healing journey. Really listen to your internal guidance as to where to next and who to work with next. 

Just because you are working with one practitioner doesn’t mean that they need to be your practitioner forever. They might get you through this door or that door, but they might not have the key for the next door, so you might go need to work with someone else. Listen to that as well.

Dr. Eric: 

Well said. Bronte, where can people find out more about you? 

Bronte: 

I hang out mostly on Instagram, @BronteMay.Naturopath. Same for Facebook. My website is Bronte-May.com. 

Dr. Eric: 

Wonderful. Thank you so much. You shared a lot of great information. It was amazing having this conversation. Keep up the good work, helping others with thyroid and autoimmune thyroid conditions. 

Bronte: 

Thank you so much for the opportunity to be here and share this info with your audience as well.

Recently, I interviewed Dr. Jill Carnahan, and we talked about about her experiences overcoming numerous complex health issues, which is what her excellent book, Unexpected, is all about. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with Dr. Jill Carnahan, who recently released an amazing book. I listened to the audiobook. It’s called Unexpected. Dr. Jill goes into detail about her health journey. Let me go ahead and dive into Dr. Jill’s impressive bio here.

Dr. Jill Carnahan is a board-certified, integrative, holistic medicine specialist, known as your functional medicine expert, often referred to as the Sherlock Holmes of medicine for solving the cases of the most well-known medical mysteries. 

Using state-of-the-art lab testing and biochemical analysis, she helps each patient identify the root cause of their illness by identifying nutritional or metabolic imbalances that may be contributing to their symptoms. Dr. Jill uses nutritional protocols and supplements, lifestyle changes, and medication to improve patient levels of function and always seeks to enlist the least invasive way to restore health and optimize healing. 

She has also sustained a 5+-year waiting list as the medical director of Flatiron Functional Medicine, a widely sought-after practice. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness, Dr. Jill provides a unique perspective to treating a variety of complex illnesses and has traveled the world sharing her knowledge of hope, health, and healing live on stage as well as through newsletters, articles, books, podcasts, social media. Her memoir Unexpected is out now. That’s what we’ll be chatting about. Thanks so much for joining us, Dr. Jill.  

Dr. Jill Carnahan: 

I am delighted to be here. Thank you so much for having me.  

Dr. Eric: 

I enjoyed listening to your book. It was great listening to your health journey, even beyond your health journey because you discuss your divorce. I saw this summer, you actually interviewed your ex-husband on your podcast. 

Dr. Jill:

Yes, we have a lot to say about how you have a healthy relationship. He is in another relationship and engaged. I am so happy for him. It’s been a transition. We always say we didn’t do marriage so well, but we do business so well, and we have gone on to be great friends. That is so needed in our world, forgiveness and how we reconnect with other relationships that have changed over time. 

Dr. Eric: 

That is awesome. You have been through a lot: breast cancer, Crohn’s, toxic mold, getting a divorce. This really all started when you were young. According to your book, you were brought up on a farm, exposed to pesticides, took antibiotics, had your tonsils removed. A lot of people don’t tend to think about these things. As practitioners, we do, and we try to go back. I ask people commonly about antibiotic use and other things in childhood. You’re pretty confident that played a big role in your breast cancer diagnosis, maybe even your Crohn’s later on. 

Dr. Jill: 

This is part of the beauty and curse of medicine and being a medical detective. Ever since I had breast cancer at 25, I was like, why? Why did that happen? My last 20 years have been spent doing a deep dive into what factors contributed to my illness. What it’s allowed me to do, and you’ve had the same kind of journey, is really look at root cause medicine and what things contribute. I have no doubt that there were probably in utero exposures to chemicals, pesticides, and other things from the farm when I was young. A lot of these things are endocrine disruptors.

I don’t know if I mentioned this in the book or not. My sister had thyroid cancer. I had breast cancer at 25, and she had thyroid cancer at 28. Two girls, same farm, both endocrine-related cancers. To me, that’s even more evidence. Yes, genetics probably played some role. In my mind, genetics played the role in poor detox mechanisms. 

The environment on the farm. This is just anywhere because nowadays, rivers and streams and pesticides are all over the place. Of course, in the farm environment, there is lots of those. Because they are endocrine disruptors, they act as hormones in the body. They can disrupt thyroid, breast, and prostate for men. At 25, I was diagnosed with cancer. Looking back, hindsight is 20/20. We can start to see the patterns. 

What it’s allowed me to do is to look at patterns in my patients. “What of your lifestyle right now could be contributing to your chronic illness or potential future diseases? How do we reverse that?”  

Dr. Eric: 

Also, diet. You were also a vegetarian for quite some time as a teenager. It wasn’t a healthy vegetarian diet as you explain in the book. You were eating pasta and bread.  

Dr. Jill: 

Carbs. 

Dr. Eric:

I’m sure that also didn’t help. 

Dr. Jill: 

I want to speak to that. In hindsight, I grew up on a farm. It was steak and potatoes. It was a heavy meat diet. I realized right away very young that I didn’t feel very well. Looking back, it was low stomach acid, so hypochloridria, which leads to difficulty breaking down meat, so it doesn’t feel good in your stomach.

I was also zinc-deficient and B12-deficient, two things that are pretty critical. What we know about zinc deficiency is it can cause a lack of desire for taste in meat, or you don’t like the taste of it. Those things contributed to me deciding maybe I don’t need meat.

Of course, I wasn’t really schooled on what a healthy vegetarian diet is. I was 14 years old when I stopped eating meat. I gravitated toward carbs and processed foods. All I could get was processed soy, fake meat products. I joke because I say it almost killed me. 

Up until I was 25 and diagnosed with cancer, I was not eating a great diet. Unbeknownst to me, I had Celiac. I was eating a lot of gluten and didn’t know that was contributing to inflammation. Lots of bread and pasta. Not a great way to be a vegetarian. Nowadays, people can do well with that, but you have to be very deliberate about how you get your B vitamins and protein. From 14-25, I was not deliberate. 

Dr. Eric: 

You were a vegetarian until the breast cancer diagnosis? 

Dr. Jill:

Yes, for over 10 years. 14-25. 

Dr. Eric: 

Wow. After your diagnosis, was it a pretty quick change? Did it still take some time, like years later, when you started making dietary changes? 

Dr. Jill: 

What I also didn’t know is I was severely B12-deficient. I have some genetic mutations in my ability to absorb B12. When you take out the main source, which is meat, vegetarians/vegans are at risk for low B12. Most of them supplement because it’s hard to get enough B12 in a vegetarian diet. That is one thing we think about. I didn’t know this. 

I was zinc-deficient, low stomach acid. On top of that, I was silent or undiagnosed Celiac, which means I was already having atrophy of the absorptive surface of the gut. I was going into this malnourished. That particular diet, for me, did not help at all. 

Then I get diagnosed with breast cancer. I started looking at diet again. Didn’t make a huge change then. What happened was I got through three drug chemotherapy, which destroyed my gut. I already had a gut that wasn’t super stable, so it went to a really bad state after the chemo. Within six months, I started having gas, bloating, abdominal pain, bleeding, weight loss, all kinds of symptoms. 

I remember one day I am in the ER helping a patient get their blood pressure, and I literally passed out. I was taken into emergency surgery for an abscess for early sepsis. I woke up the next morning with a surgeon saying, “Jill, you have Crohn’s.” 

For anyone who doesn’t know what Crohn’s is, it’s an autoimmune disorder where your body attacks the gut lining. How weird that you had breast cancer and then Crohn’s. 

Let me tell you a story. I had this undiagnosed Celiac, so already a damaged gut lining. The chemotherapy that I took, especially cyclophosphamide, Cytoxan, is known to damage the permeability, the membrane that lines the gut. It basically induced a much more severe form of leaky gut, on top of my already undiagnosed Celiac. 

Then I had this gene I didn’t know about called NOD2, which makes me higher risk of developing Crohn’s. In this case, all it was was a hyper-responsive action to the microbial contents of my gut, spilling through the leaky gut into my bloodstream. That literally contributed to the Crohn’s. 

In my mind, it’s the perfect storm: undiagnosed Celiac, poor nutrition, B12 malabsorption, probable dysbiosis, meaning abnormal microbes in the gut. You take a drug like chemotherapy that causes more permeability, dumping the bacterial coating in someone who is very susceptible to this immune/autoimmune reaction. Bingo, you have Crohn’s. It makes sense, doesn’t it?

The Crohn’s was my opening of the door into diet changes. I sat with a gastroenterologist after I found my diagnosis. I needed to know what it meant. He said, “Lifelong medication. Probably immune-modulating drugs. You may need surgery to remove part of your colon.” He was very depressive with his prognosis. 

The last thing I said as I walked out the door was, “Doc, you know, I want to do whatever I can. Can I change my diet? Is there anything I can do?” He said, “Jill, diet has nothing to do with this.” I knew in my intuition that something didn’t sound right about that, even though I had no knowledge of a nutritional background then. So I started to go on a search to find answers.

That’s when I came across how a diet could potentially have something to do with it. I changed my diet. I got rid of gluten, processed foods. I completely revamped my diet. Within about two weeks, my symptoms of bleeding and pain were gone.  

Dr. Eric: 

Awesome. It’s sad. Even today, I get countless patients telling me that the endocrinologist told them that diet doesn’t play a role. Most of the people I see have Graves’ or Hashimoto’s or a non-autoimmune thyroid condition. Even if they don’t believe diet will play a role, why can’t they say, “It’s not going to hurt to eat a healthy diet, so you might as well give it a try?” Just to dismiss it, “No, diet definitely won’t help.” I am glad you made those dietary changes.

You mentioned silent Celiac. A lot of people think of Celiac as “I eat gluten all the time. I feel okay, so I probably don’t have Celiac or non-Celiac gluten sensitivity.” You weren’t experiencing symptoms for a number of years. 

Dr. Jill: 

In hindsight, of course. I had severe eczema and skin issues, which usually relate to leaky gut. I had some intestinal permeability. The zinc and B12 malabsorption are both common with intestinal inflammation, which I didn’t know until later. I was very tired. I pushed myself hard, so I didn’t realize how fatigued I was. Probably from that B12 deficiency, too. There were lots of signs and symptoms leading up to this.

I like to tell my patients this. If we check the genetics, there is a DQ2 and DQ8. These are the high-risk genes for Celiac. You can ask this of your doctor, and it’s very relevant to thyroid disorders as you well know. If you have those genes, even a half copy, even if you never in your lifetime get Celiac, the lifetime risk. The average age of diagnosis of true Celiac is 55 years old. 

As we know with autoimmune, you need a genetic predisposition, which is the genetics, like I had as well. You need an environmental trigger, like gluten over time. You need a permeable gut. When those three things are present, that is the triad of autoimmune disease. Celiac is a great example.

Say I have a patient with a DQ2 gene, a high-risk gene. You could go your whole life and never develop Celiac even though you are at 13-20% more risk. However, I think of it as a wagon wheel. In the center of that wagon wheel is that gene. One spoke is Celiac. The other spokes are Graves’, Hashimoto’s, rheumatoid arthritis, Crohn’s, lupus, and multiple sclerosis. 

I could name any autoimmune disease and link it to that predisposition because we know that autoimmunity can come from that permeable gut and that constant barrage of microbial contents on the blood, on the immune system, creating inflammation that eventually ends in the body attacking itself. It can attack nerves in MS. It can attack the blood system in lupus. It can attack joints in RA. Any one of those things could be the outcome, even if you never get Celiac.

I say that all the time because people go, “Oh. If I avoid gluten right now, I could potentially prevent myself from getting an autoimmune disorder.” I say, “Yes. There is no guarantee, but you will definitely decrease that risk.”

If I could go back to my younger self and know all of this, I would have done my diet differently at 14 years old. 

Dr. Eric: 

You test genetics for Celiac for everyone. Do you also do a Celiac panel if they are eating gluten? 

Dr. Jill: 

The genetics are the predisposition you came into this life with. Like I said, the relevance is so important. I was shocked by the statistic that the average age of diagnosis of Celiac is not childhood, but 55 years old. That is a lot of decades of a barrage of the immune system before you actually become full-blown Celiac. 

If you think of the lining of the gut like the shag carpet in your ‘70s bedroom, that shag carpet starts to get ruined. You don’t have true Celiac until it’s almost down to a hardwood floor. A lot of damage has to happen for Celiac. You could have anywhere in between where there is lack of absorption of B12 or zinc or other minerals. You could have manifestations of fatigue. 

There could have been a connection to the cancer. I don’t think it was casual, but that whole immune inflammation, immune dysfunction certainly didn’t help me fight the cancer cells in my body.

In hindsight, all these things are relevant to tell the patient, “This is your risk. You have a choice today at 25 or 35 or 45 to change the trajectory of your illness.” If you know that, you can shift. 

What you ask about is the Celiac panel. In addition, which I also do, you can test for anti-gliadin, or deamidated gliadin antibodies. IgA and IgG. IgA is the mucosal lining, so that’s an early responder. IgG is systemic immune system. I do that as well. 

If you see that happening, that can either equal a non-Celiac gluten sensitivity, where they don’t truly have damage to the gut, but they are starting to have this very significant immune reaction to gluten. Or it could mean that they have full-blown ruining of that shag carpet that is leading to malabsorption and symptoms. It’s so core because I really believe that so many autoimmune diseases begin with part of this inflammation with our diet. 

Dr. Eric: 

My guess is if you do testing, let’s say the genetics are negative. Celiac panel is negative. It’s an autoimmune patient. Do you still have them avoid gluten? I’m thinking you do because it can affect the permeability of the gut and lead to other problems. 

Dr. Jill: 

What you are saying is you can have someone who comes in with no Celiac genes and no antibodies, so there is no known documented inflammation going on in the body. But, just like you alluded to, what happens is every single human post-prandial, meaning around four hours after we eat, with the consumption of gluten, it increases all of our permeability. 

Now, if you are perfectly healthy, with no sign of autoimmunity, no joint pain or brain fog, you feel amazing. Probably not a big deal. I don’t know about you, but for me, the patients who come to see me are not that class. They have multiple autoimmune diseases, sometimes chronic complex disease, sometimes unexplained brain fog, migraine headaches, joint pain, etc. Thyroid disease is rampant. Probably 8/10 of my patients have hypothyroid, Graves’, or Hashimoto’s, or some form of thyroid disorder. Because at least for me, that’s not the population I see. I really ask almost all of my patients to be gluten-free, most of the time dairy-free, and sugar-free. That is a core. I’m sure you’re similar. 

Dr. Eric: 

Yeah. I was going to ask you about dairy. You do have to avoid gluten, dairy, and sugar. Do you currently still avoid dairy? I know you avoid gluten. But dairy permanently, or do you sometimes have it? 

Dr. Jill: 

No, it’s been 20+ years now. I’m very stringent on my diet. I just feel so good when I’m eating clean. I am 99% grain-free. Maybe twice a month, I will have a little quinoa. That is the only exception. I’m completely dairy-free. All cow’s milk dairy of some types. Free of all sugar. I don’t do a lot of nightshades. There are a few other odds and ends. I don’t do soy or corn. 

This is another story. I definitely had significant bacterial and fungal overgrowth in my gut. Part of my healing completely from Crohn’s was dealing with that. Specific carbohydrate diet or candida diet, these are two separate diets. They are some of the ways we decrease those microbial overgrowths in the gut. I found years and years ago that those diets worked. A low glycemic, low grain type of diet. Soy and corn aren’t horrible, but in the U.S., they are so often sprayed with glyphosate and often triggers for immune issues. They are in everything, so we get so much immune exposure to them. 

The broader elimination diet would be gluten, dairy, egg, corn, soy, sugar, alcohol. That is a lot more, but that is also a little bit more expanded to include the most common allergens we have in the U.S. 

Dr. Eric: 

You had candida overgrowth and SIBO. 

Dr. Jill: 

Yes. Just in case someone who is listening who has Crohn’s or colitis, we do a conventional lab on a conventional panel with a conventional doctor called IBD Risk Score. What it does is checks among other things Saccharomyces antibodies. This is brewer’s yeast. If it’s positive, it contributes to a prognosis that is worse with Crohn’s. When I started to understand this, I found out that 80-90% of Crohn’s patients have an underlying fungal component. It’s tested with the antibodies. That is conventionally indicated with severity scores.

This is part of my healing, but even in my Crohn’s or colitis patients, if they have any evidence on organic acids or bloodwork of antibodies to candida or signs in the urine of metabolites of yeast or Saccharomyces, that antifungal regime, whether it’s a low sugar diet, caprylic acid, and gallic acid, oregano, I use all of those things in order to treat and heal patients from inflammatory bowel disease. 

Dr. Eric: 

That works with both Crohn’s and ulcerative colitis? 

Dr. Jill:

Yes. The main difference there is Crohn’s is systemic. You could have ulcerations all the way from the gut/stomach to the end of the bowel. There is more systemic manifestations. Ulcerative colitis is more localized. Localized ulcerative colitis often needs some sort of topical or enema treatment that is anti-inflammatory in that local area. Typically, they both can be driven by SIBO and SIFO. If you find the root cause, you can often reverse. 

I don’t think I mentioned this, but 20+ years ago, I was diagnosed with Crohn’s. I was told it was incurable. I don’t have Crohn’s any longer. There is no evidence of it. That is something the medical system doesn’t really understand. 

Dr. Eric: 

If you went back to the doctor and got diagnosed, which you probably didn’t do, they would blow it off. 

Dr. Jill: 

Right. 

Dr. Eric: 

You also had a toxic mold exposure. If you could talk a little bit about that, as well as how common it is. In your practice, I’m guessing it’s a lot more common. I don’t know if you have any data on averages. I know there is genetics. 25% of people have the genetics that make them more susceptible, having difficulty clearing the mycotoxins from their body. What do you see in your practice when it comes to mold? 

Dr. Jill: 

Mold is super insidious. Let’s do a 30,000-foot view for a second. You and I deal with complex chronic disease. I think Mark Hyman, our colleague, said I am the doctor of last resort. He’s the one who people come to. I tend to see a lot of people like that, too, who have been to a lot of places. The conventional system has failed them, and they still don’t feel well.

The biggest framework is complex chronic illness is usually a combination of toxic load and infectious burden. These old infections like EBV or tick-borne infections or mycoplasma, these underlying infections inside of a weakened immune system that is not keeping them under control. 

And then the toxic load. Of course, phthalates, parabens, pesticides, endocrine disruptors, glyphosate, Roundup. All these things. Also in that bucket of toxic load is mold and mycotoxins. Mycotoxins are the chemicals produced by molds to protect themselves. These are smaller than particulate matter 1.0 or even 2.5, which is the size of a virus. We can inhale them into our lungs. They don’t need transport. They can go directly into our bloodstream through the villi. 

That is significant because we could be for 5-10 seconds in a moldy building and start to have symptoms because it goes so quickly from the airborne sensation into the villi into the bloodstream. It’s very quick. People can tell right away if they are exposed if they are sensitive.

Back to my analogy of complex chronic illness. Mold is a big deal because it’s often hidden. People often don’t know. They just know they haven’t felt well since moving into a house. It’s often location-based, environmentally-based.

About one in four people have the genetics where they have innate immune inflammation related to mold that can cause all kinds of damage and symptoms and diagnoses. But usually, in a household, some of the people are infected more than others. It can be very confusing. You can have one or two who are fine, no problems at all. Then you have a father and daughter who are incredibly sick. It could be respiratory symptoms, like chronic sinusitis, sinus issues, pain in the eyes, sore throat, trouble breathing, asthma, allergies. It could also be systemic. Probably the most common thing we see is fatigue, brain fog, and cognitive issues. 

This is relevant when you ask about statistics. Dale Bredesen, who does a ton of work with Alzheimer’s and reversing Alzheimer’s, he’s one of our colleagues. He talks about percentages. He has been saying for years that one in three cases of early onset dementia is related to mold. That is staggering. That is 33% of people with early onset dementia. Early, meaning 40s and 50s and maybe early 60s, not the classical Alzheimer’s. it’s very significant.

I was just with him a couple weekends ago. He for the first time said 80%. His percentage is going up. I have been used to him saying 30%. This is younger people who are presenting with dementia and cognitive decline.

I say that because typically people come to their doctor and might have a new diagnosis of Hashimoto’s or Graves’ or another autoimmune condition, or their cognition isn’t sharp, or they are waking up with a lot of pain, or they are having exhaustion with no cause. Granted, there is other things we look at. If everything else is coming back negative, over and over again, the environment can play a role. Mold, I see all the time. 

One of the questions I hear is, “My grandmother had mildew in her shower. Is mold really that big a deal? Why is it worse now than it was 20, 30, 40 years ago?” There are a couple things. First of all, in the ‘70s, we knew that mold could grow in houses, and we started putting fungicides or antifungal, anti-mold substances in standard paint. When you paint the inside of your house, it probably contains an anti-mold and fungicide. That all sounds well and good. 

What happened is just like what we have seen happen with antibiotic resistance, as we give it more to livestock and humans. We have these superbacteria that we can’t treat. Mold is the same way. It’s really smart, and it has outsmarted some of those fungicides. When we have indoor microbial growth related to mold or water damage, very frequently, it’s aggressive, puts out more mycotoxins than we used to see. 

If you think about construction nowadays, it’s often more porous materials. Things are put up much more quickly. Maybe less quality in some cases. The surprising thing is a lot of people are having trouble with mold in new construction. It’s not always an old home. 

Dr. Eric: 

If someone just moved into their home six months or a year or two ago, obviously, if they have any type of noticeable water damage, it could be a problem. It could still be hidden even if it’s new construction? 

Dr. Jill: 

Yes. I keep hearing stories. This is my world, so I hear all the stories. Things like they installed brand new cabinets. When they drilled into a wall, they drilled into a pipe. No one knew about it. That pipe leaked into the wall for months or years until they realized that mold was growing behind the wall in their kitchen.

Anyone who has ever had a leak under the sink, a leak from their fridge, water leaching into the wall or near the fridge. A washing machine that leaks. A bathtub that overflows. A shower that wasn’t properly installed. 

We think about grout as being protective. But grout is porous. If you don’t water seal and properly install a shower with grout in the sealant, it’s porous. It will go straight into the drywall and create a mold issue. 

One thing I learned is a year and a half ago, one of my neighbors’ fridge lines leaked into my wall, down into my condo. We had a major mold issue. Ever since then, I disconnected the water line from my fridge. It’s not worth it. I make regular old ice cubes in the freezer the old-fashioned way. For me, it’s not worth having that water source that could leak in my wall ever again. I, probably no matter where I live, won’t ever hook up my water line to my fridge in the future just because of that risk. 

Dr. Eric: 

That’s interesting. We don’t have that on our current fridge, so we don’t have to worry about disconnecting it. At least I don’t think so. We don’t have water from the front. 

Dr. Jill: 

Then you’re good. I ask about air filters, water filters because clean air, clean water, clean food is one thing I say all the time. 

“I have a fridge filter.” Fridge filters are not cutting it. They are pretty minimal in terms of the quality of filtration you want anyway. I would never rely on that as your sole filter for water in your house. 

Dr. Eric: 

I use reverse osmosis. What do you like? 

Dr. Jill: 

I am going to mention this because this is so significant. I am in the state of Colorado. They recently tested our water supply a year and a half ago. Every single water body tested tested above the legal limits of PFAs, polyfluorinated compounds like Teflon. These are forever chemicals. That means the half-life, we can’t even calculate. I think 50 years is underestimating it. Probably hundreds of thousands of years, we will still have these chemicals in our environment.

If you’re not filtering your water in some form, you are behind the game. You’re getting chemicals in your body guaranteed. Tap water is no longer safe. Then what do you do? 

Reverse osmosis. You could put whole house filters or under the sink filters. Those are amazing. They are kind of costly. They take a little bit to install. As they are pulling out those chemicals, they also deplete minerals, so you get a more acidic product. But it’s a great way to do it. You just to need to make sure you are replacing those minerals in your diet or as a supplement.

You can now get some really good fridge or standalone countertop filters that do a great job and are less expensive for someone who is in an apartment or smaller space. Nowadays, there are even good filters that come in water bottles, so you travel and take that with you. I always travel with a regular stainless water bottle with a filter inside if I am going places to save on clean water. 

Dr. Eric: 

How about spring water out of a glass bottle, like Mountain Valley Springs? 

Dr. Jill: 

As long as you know your source, and they test for toxins, I think you’re in good hands. The downside is water supply here in Colorado, from good mountain sources, has been contaminated with PFAs. 

To your point, reverse osmosis is the best. Carbon filtration, which can be as simple as a handheld thing in your water bottle, is pretty darn good even for PFAs and other toxic chemicals. 

Dr. Eric:

Getting back to mold. Do you test your patients with urinary mycotoxin testing? Do you have them test their house for mold, doing ERMI testing or using plates? How do you determine if mold is a problem? You probably know by looking at them, you have seen so many patients, so you have a good idea. I imagine you still do some testing. 

Dr. Jill: 

This is the million-dollar question: What is the one test for mold? Unfortunately, there is no one. There is a little bit of a scenario I can say. History is important. Even if you’re just listening, and you think, “Ever since I moved into this house, changed workplaces,” If there is a story that you can tell that your change of environment caused you to become ill. Maybe six months later, there is a little delay. Or a year later. 

My example is there was a flood in 2013 that flooded massive parts of Boulder. My office building was damaged. Didn’t know it. About 6-9 months later, I started having symptoms because there was mold growing in my office building. That time frame fits really well with this kind of damage.

History, stories are important. You can online for free do a visual contrast test. This tests your visual acuity and the small retinal vessels in your eyes. These little vessels can be damaged by biotoxins. If you’re having trouble with that test, you could be exposed to mold. That’s one more thing. 

Test-wise, I still do the markers like TGF-beta, MMP-9, EGF, MSH, and osmolality. ADH, antidiuretic hormone. Those are trickier to interpret. They are innate immune markers, and they don’t diagnose mold. You need to see a pattern, but if you see all of those abnormal plus a history of mold plus an abnormal visual contrast, there is a likelihood that mold is in the mix.

Urinary mycotoxins, this is not a perfect science. People are like, they should test that. It doesn’t always indicate exposure. There are some caveats. 

There are three main labs that do testing: Real Time Labs, Vibrant Labs, and Mosaic Labs. They are all very different technologies, so you cannot compare one to another. They all have different thresholds. Because this is such a new science, even the labs will tell you they don’t know what’s toxic or not. 

Now, do I use those in patients? Yes, I do. I use it as part of the bigger picture. I wanted to say that because that is the easiest thing to go out and get done. You could very well have mold. Just because you have positive urinary mycotoxins, it could be that you were excreting from years ago when you had an exposure. There are other answers. It’s a better idea to look at the whole picture and use that as part of your diagnostics, but don’t leave your home because you have a positive urine mycotoxin test.

Dr. Eric: 

It’s interesting what you said. I heard Dr. Neil Nathan say he uses two tests. He has a practice where he sees mold patients, and he uses Real Time Labs and Great Plains, which is now Mosaic Diagnostics. Just because one isn’t necessarily reliable. 

Dr. Jill: 

I agree 100% with Neil Nathan on that. It’s so easy to go out there and be like, I just tested positive. There are so many factors to take into consideration. 

For example, someone I know has mold. We will talk about environment as well. When a positive urinary mycotoxin test came back positive, we started detoxing. Six months later, we tested, and their levels are higher. They started to panic. I say, “Wait a second. We are measuring excretion. We want you to be excreting. I would expect in the first 3-6 months for it to go high.” 

Sometimes, it goes down. But sometimes, you are getting your body to get rid of a toxin that was stored in the tissues. For the first six months or so—this is one reason I don’t retest right away—you will get these values that sometimes go up. It’s not always a bad thing if they are really excreting that toxic load. 

You mentioned environment. I want to mention this quickly. Once again, it is by far the best to get an inspector who knows what they’re doing. So many areas in the U.S. or outside of here don’t have great quality inspectors who know what they’re doing. 

If that’s the case, I will still often recommend patients do a dust sample. It used to be called ERMI, But the data for ERMI, the way they do the diagnostics on that test is not very well validated. The technical name of ERMI is called Q PCR, quantitative PCR, meaning they check in the dust that you send in for DNA of mold in that dust. That is a very valid technology. What you’re doing is a historical snapshot of your home. 

I still do a QPCR in my condo once a year just to check in. I do it for my workplace. I think it’s a great place to start for patients who want to know if there is an issue. 

Say you have one that has loads of Chaetomium or a very high Aspergillus score. You need to find where that’s coming from. It’s not the end-all be-all. It’s an affordable way for the average consumer who maybe is trying to figure out if they should hire an inspector to start the process. Because I have seen hundreds of them, I often have my patients do that to look at that with them. Sometimes, we can look at the types of mold in the dust of their home, look at their results, and if it matches—it doesn’t always—you have a pretty good case for their exposure and where it might have come from. 

Dr. Eric: 

One more question with mold. You mentioned in your book supermolds. What is a supermold? 

Dr. Jill: 

Classical molds, Aspergillus, Penicillin, it’s where we get our antibiotics. These are not good. They cause more allergies, sensitivities, inflammation. There are some molds out there, like Stachybotrys that are just really nasty. They secrete a type of mycotoxin that has literally been studied as a chemical warfare agent. It’s been known to cause nephrotoxicity, damage to your kidneys; lung pulmonary toxicity; neurotoxicity to the brain and nervous system; and I could go on and on. Almost every system can be severely damaged. 

Some of these mycotoxins have literally been used to develop drugs that are immunosuppressants for organ transplant. For example, mycophenolic acid is a mycotoxin produced by some of these toxic molds that is used to make a drug called Cellcept, which is used in organ transplants to cause no rejection. They basically shut down their immune system. 

This is important because the molds are bad enough. They are spores, growing, throwing out these things. Say you remediate a place and have dead debris. I always think of it as a dried flower arrangement. If you flicked it with your fingers or blew on it, and you shattered it into these pieces because it’s dried and dead, you could have dead, dried mold debris particulate that could still stimulate immune inflammation. This is why it’s so important to clean up after you remediate. 

You could also have the production of the mycotoxins that get stuck in paper and other porous materials in your home or clothing. Even though that’s not the mold itself, and you might have removed the mold, if you still have those really toxic trichothecenes hanging around in your home after you remediate or whatever state of the process you’re in, they can cause some very severe immune and other issues in your body. 

Dr. Eric: 

That’s why some people have to throw out all their books when they have a mold issue. 

Dr. Jill: 

Yes. I’m so careful because we have seen patients who go into panic. There is another side of this that’s post-traumatic stress. It’s so stressful to have mold. The chemical reaction of mold, inhaling it through your nose, can trigger amygdala, the fight or flight system. Almost anyone who has had a significant mold health issue has a little bit of PTSD. Even if it’s the chemical. 

The reason that’s important is because you really want to downregulate the trauma related to mold. Because there is a lot of online groups that say, “Walk out of the house. Leave everything. Sell everything you own. Get rid of it. Go to the desert, and avoid mold.” Some really sick patients have gotten well that way. Mold avoidance is a real thing. It is a part of my protocol. You’re not going to get well with any number of supplements, IVs, or protocols if you have a massive mold exposure.

But the bottom line here is it doesn’t mean you have to throw everything out. That’s really important. The worst types of things are porous materials, like paper or books. What I always recommend is if you have scrapbooks or photo albums. I have a library behind me. What I recommend is if you consider those to be potentially contaminated, buy some plastic bins from Walmart, put all of those porous materials in them, seal them, put them in your garage or somewhere out of your house. Keep them sealed away as you’re getting well. 

Then in six months or a year, you can open that up, see if you react. You will know. You will feel fine or have an immediate headache or sneezing or some issue. That’s a great way not to throw everything out. If you feel like you need to separate them out, you can put them in a contained area in plastic bins for a while until you’re ready to take a look at them. 

Dr. Eric: 

That’s great advice. People don’t have to panic and throw everything out. Just put it in bins. Get reexposed in about six months, and see how you react then. 

Any additional tips? You already gave a lot when it comes to reducing toxic burden with clean water, related to the mold. There are air filters. I imagine you recommend infrared sauna therapy. 

Dr. Jill: 

This can be overwhelming. Even listening to me, “Dr. Jill, I can’t do all of this stuff.” Start with simple things. Clean air, clean water, clean food. 

Clean air, 80% of our toxic load comes from the air we breathe. You should have an air filter in your bedroom. Ideally, you want to have a classical filtration system that filters the larger particulate. Within that filter, make sure there is a VOC, a volatile organic compound filter, or particulate matter 2.5 or 1.0. Those are the really tiny particles. Usually, that means the core of that filter has charcoal, clay, or some absorptive material. There is a ton of brands out there, but get a good one that has that technology. That’s clean air. At the very least, in the bedroom.

Clean water. We talked about reverse osmosis and other ways to filter your water. You should be filtering your drinking water at the very least if you don’t do a whole house filter.

Clean food. Choosing organic whenever possible. Non-GMO, locally sourced, as close to home as possible. Grow some of your own things, even if it’s just herbs on your balcony. That is all super important. Eating things that don’t have a lot of unpronounceable ingredients. Very basic, whole foods is where it starts.

Other things you can add on: Infrared sauna is a powerful way to detox. You can either go to a gym or get your own sauna. You can get a sleeping bag sauna or a little envelope sauna tent that you sit in. These are less expensive ways to use a sauna.

Epsom salts baths, I’m a huge fan of those. I do them almost every night myself. That magnesium sulfate is a powerful detoxifier.

Castor oil packs on the liver and gallbladder can be incredibly helpful. All you need is organic castor oil and organic flannel. Put that on your liver, maybe with a little bit of heat from a hot water bottle or something similar. That’s wonderful for the detox system. 

Lymphatic drainage, you can do rebounding. You can do vibrational plate exercises or technology. You can do dry brushing before you shower. This is one of the reasons why the cold plunge is so popular because it’s wonderful for lymphatics. Even if you don’t have a cold plunge pool, you can just end your shoer with 30 seconds of cool water from your neck down, and that gives you the same effect.

Dr. Eric: 

One thing I should add, which I’m sure you agree with and don’t think you mentioned, even if you have to do it gradually, as far as cleaners and cosmetics. If you don’t want to switch to all-natural right away, I know it can be overwhelming, especially when you are already focusing on food, air, and water. But I would recommend the products you’re using on a regular basis, if you have a spray that you use every day, if you are using 409 to spray the household, use a natural cleaner. On your own, you can make a concoction that doesn’t cost a lot, too. I agree with everything you said.

I remember when I was young, my mom would spray these air fresheners all over. 

Dr. Jill: 

You have those plugins or things like that? Not good. I won’t tell you where, but a common area in some place where I frequent had these plugins, and I literally snuck around and pulled them out. This is toxic! People don’t realize it. They just think they’re freshening the air, but they’re putting in VOCs, which are not good. Those are hormone disruptors, too. 

Dr. Eric: 

I know we could go on for easily another hour chatting about this. Is there anything else that I should have asked you that I didn’t ask you? Anything burning before we wrap it up that you wanted to say? Any last words of advice for those dealing with any type of chronic health issue or trauma? 

Dr. Jill: 

No, I am just delighted to be here. I love the work you are putting out in this world. It’s so great to be with you.

If you’re out there suffering in some way, be it autoimmune or a cancer diagnosis, or even a loved one with early onset dementia, you name the issue, there is always hope. You’re already here, so you’re actively learning about your health. Continue to dive in. There are so many resources now for you. 

Sadly, we can’t expect our doctors to do the prevention anymore. Our system is designed for calamity and stroke and heart attack and car accidents. It’s not well designed to heal and help us optimally thrive. That’s up to you. But we’re here to help you. Go out there and do the next best thing. 

Dr. Eric: 

Where can people find out more about you? If you could give your website. Where can they get your latest book Unexpected? Anything else you want to lead them to?  

Dr. Jill: 

My website is JillCarnahan.com. You can find the podcast, the book, online resources, products we love. Everything is there. I have written a blog every week for the last 10 years. Any topic you want, you can search there and find it. 

If you want the book, go to ReadUnexpected.com. 

Dr. Eric: 

Wonderful, thank you. This was awesome. Appreciate you taking the time to chat about your health journey. As usual, I always learn things, and I’m sure the listeners did. Thank you so much, Dr. Jill. 

Dr. Jill: 

You’re welcome, Dr. Eric. Thank you for having me.

Recently, I interviewed Dr. Angela Mazza, and we talked about her book, Thyroid Talk: An Integrative Guide to Optimal Thyroid Health, what to include in comprehensive thyroid testing, the effects of thyroid disruptors, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I have a return guest today who I am very excited to chat with, Dr. Angela Mazza. Very excited to talk about her new book Thyroid Talk. For those who didn’t listen to her first interview, which I highly recommend, I will give a brief bio here.

Dr. Angela Mazza is the founder of Metabolic Center for Wellness in Oviedo, Florida, where she spends a great majority of her time caring for persons with autoimmune thyroid disease, thyroid nodules, and thyroid cancer. Metabolic Center for Wellness is the only center in central Florida providing the thyroid-saving procedure radiofrequency ablation (RFA) for thyroid nodules. Highly regarded for her individualized approach for thyroid care, Dr. Mazza empowers each person to achieve their unique goals by providing education, lifestyle management, and support. Thanks for joining us again, Dr. Mazza.

Dr. Angela Mazza: 

Thanks so much for having me, Dr. Eric. 

Dr. Eric: 

Really excited to talk about your book. Last time, you focused on a lot of things in your practice, including radiofrequency ablation, which is a very interesting procedure and something that can actually save people’s thyroid glands. We can chat about that here as well. What motivated you to write the book Thyroid Talk? 

Dr. Angela: 

There is probably a few things. We have been in practice for about nine years as well. As an integrative endocrinologist, I really feel like we are treating patients with thyroid issues the best they could possibly be treated. Traditional medicine falls short on a number of levels.

I got to a point a few years ago where I couldn’t take on any new patients. I was only taking on patients for procedures, like radiofrequency ablation and thyroid biopsies. We had people calling all the time, looking for new patient appointments. I felt so bad because I felt like these people were looking for help, and I’m not able to do that on a one-on-one basis.

Then I had people say, “You have to train other people.” We do some training. I lecture for A4M and societies like that. But I found there was a real need for solid information, like you give really good information to your listeners. It’s reliable, true information. There is a lot of false information out there. I’ll get questions all the time, like “Where did you even hear that from?” 

That’s around the time we started the podcast to help give reliable, good information regarding thyroid health out there. Organically, I started writing a book. I would sit down and write one chapter at a time. Let’s start with the basics. How is thyroid hormone made? How is it controlled? What does it do? I went through, and the book came together by itself. I was addressing questions that patients were having concerns about, or even other practitioners had questions about. It was really a labor of trying to help more people that I couldn’t one-on-one help myself.

Dr. Eric: 

What I love about the book is first of all, if someone has recently been diagnosed, it’s great because it does cover the basics. But if someone has been diagnosed for a number of years with Hashimoto’s or Graves’ or a non-autoimmune thyroid condition, they can still benefit from the book. There is some advanced stuff. You don’t have to go in order. 

If someone was recently diagnosed, it might be a good idea for them to start at the beginning and go through the whole book. But they certainly don’t have to. If someone wants to skip around and just learn about the thyroid-gut connection or other things we will talk about, they can do that. Like I said, I think it fits anyone with any thyroid or autoimmune thyroid condition. 

Dr. Angela: 

I wrote it for patients who are motivated to put the work in, even providers who want to learn more. They don’t know everything because we don’t stop learning when we finish med school. We want to help our patients live their best lives.

Integrative endocrinology, especially when it comes to thyroid, there is really no magic pill. Wish there was. There are so many things we can use to achieve better thyroid health. 

Dr. Eric: 

Definitely agree. Most people listening to this probably know the basics, as far as hypo versus hyperthyroidism, thyroid glands. For those who don’t, check out Dr. Angela’s book.

We will hit a number of different topics. The first thing I want to talk about is testing. As far as blood testing, what do you recommend for those with hyperthyroidism or Hashimoto’s? I guess we should backtrack a little bit. When people come see me, they have already been diagnosed with hyperthyroidism, etc. I’m guessing with you, that might not be the case. You’re an endocrinologist, so going to you with an undiagnosed condition, and then they get diagnosed. What type of patients do you see? Then the testing you typically recommend. 

Dr. Angela: 

You’re right on. A lot of patients who have been referred to me already have a preceding diagnosis of hypo/Hashimoto’s. Some are hypo after surgery or a procedure. Some are hyper, not specifically diagnosed as Graves’. When patients get sent to me for hyper often, there is not a clear diagnosis. That’s where a little more digging in comes along.

I do take care of patients with diabetes where we uncover thyroid issues all the time that were not uncovered before. We do catch some new cases or find ones that were probably there all along or were undiagnosed. 

As far as testing, I would have to say my go-to panel is TSH. I do want to say, and you and I are like-minded, TSH is not the be-all end-all. It’s an okay screening test, but it doesn’t tell us the full picture. 

Free T4, free T3. I do only test free levels because thyroid hormones do circulate bound by protein. What’s bound by protein is really not usable. That’s why I tend to look at the free levels because the total levels can be misleading, especially in women when they are premenopausal. 

I do check thyroid antibodies in pretty much everyone with any sort of thyroid issue. Thyroid globulin antibodies, thyroid peroxidase antibodies (TPO). I only check thyroid stimulating immunoglobulins (TSI) in someone I suspect is hypo. 

But I will tell you anyone who has positive antibodies for Graves’, almost all of them are positive for TPO. I never used to check that if I knew someone had Graves’ already. But if we can adequately bring someone back into a euthyroid state from Graves’, having those antibodies, you can tell if they are going to develop hypo down the line. 

Reverse T3, I do check quite a lot. It gives me a lot of information. Reverse T3 gets a bad rap, like it’s bad. But it tells us what’s going on in the body. It’s really a survival mechanism. If the body needs to conserve energy, mainly the mitochondria don’t have energy, we’re going to convert more T4 to T3. That gives me an idea of the mitochondrial reserve.

It also tells me if someone is on thyroid hormone replacement. If they are getting too much T4, we are going to use up our pathways to convert to T3 and start making too much reverse T3. That’s counterproductive.

The last part of my panel is I always check a random urine for iodine and creatinine. That way, I can extrapolate a 24-hour urine collection, which tells me if someone is getting too much or too little iodine. I am finding issues with iodine a lot. Not only not enough for some people, because we don’t eat as much iodized food, but having a lot of people who are taking thyroid hormone supplements, and they have a ton of iodine in them. That also can cause an issue. 

Dr. Eric: 

I want to talk more about iodine. With the panel, I agree. I test the free hormones. TPO, it’s interesting. Some of the research shows that anywhere from 60-80% of people with Graves’ have TPO antibodies. I didn’t when I dealt with Graves’; mine were negative. But I agree that the majority of people I see have elevated TPO antibodies. I’m sure you see some people with all three antibodies at times. Sometimes, TSI with TPO and thyroid globulins. 

Reverse T3, I stopped testing it in my hyper patients because almost everybody has elevated reverse T3 if they have hyperthyroidism. 

Dr. Angela: 

It’s going to be high. 

Dr. Eric: 

It does make a lot of sense if someone has hypo. I agree that reverse T3 can be helpful. 

A urinary test for iodine. Is that a 24-hour loading test? You said 24-hour iodine test? 

Dr. Angela: 

I’ll get a random because it’s a pain to do a 24-hour urine collection for everyone. It’s labor-intensive. I’ll get a random. It gives me a shout as to what the 24-hour urine collection is. You can extrapolate it out to a 24-hour, and it gives you a general idea. 

Dr. Eric: 

Like a spot test? 

Dr. Angela: 

Exactly. Super easy, inexpensive. It gives you a good idea of what’s going on with iodine stores. 

Dr. Eric: 

Do you see a lot of people with low levels of that urinary iodine?  

Dr. Angela: 

I do. A lot of people used to use iodized salt. Now everybody is using pink Himalayan salt and sea salt, which don’t have iodine in them. A lot of people used to eat iodized bread, but it’s not a regular staple in our diet as much as it used to be. A lot of places used to have iodinated water, but that’s not so much the case anymore.

Dr. Eric: 

If you see someone who is low in urinary iodine, do you recommend supplementation? Do you encourage them to eat more foods that are rich in iodine? 

Dr. Angela: 

I do try to do the dietary route. Even if you do a quarter of a teaspoon twice a week of iodized salt, that’s going to be enough for the week. Our body is pretty efficient at using iodine. We only need 100-200mcg a day. It’s a very small amount.

Dr. Eric: 

It sounds like you’re not advocating high dose iodine supplements. Just if someone is low, make sure you’re getting enough through food. 

Dr. Angela: 

I’ll once in a while do an iodine potassium supplement. It’s only going to be people who can’t have salt. Again, it’s only a couple times a week. It’s not a daily thing. 

Dr. Eric: 

When you see someone that is high in iodine on the test, is it typically because they’re supplementing? Or are they eating a lot of seafood or sea vegetables? I’m sure it varies. What do you typically see? 

Dr. Angela: 

It varies. It tends to be people who are doing extra supplementation mostly. I’ll get some really weird ones that are super high. It’s usually after they’ve had some sort of contrast study. I ask if they had that done. 

Dr. Eric: 

That’s a good point. If someone is doing an iodine test, that is a good question to ask, just to make sure they didn’t have any type of iodine contrast. Thanks for bringing that up.

I was going to ask you about serum iodine. What are your thoughts on testing for iodine in the blood compared to the urine? 

Dr. Angela: 

It’s just not as accurate. We have studies that support that. It’s not a really good plasma measurement. 

Dr. Eric: 

I agree. I figured that’s why you did urine because you’re not a fan of blood testing. 

Next question that you are probably not expecting me to ask. I know you mentioned thyroid globulin antibodies, and you mentioned thyroid globulin when going over some of the basics. As far as testing for thyroid globulin, I’m bringing this up because I don’t know if you know this- But you do deal with cancer. When thyroid globulin is really high, it can be an indication of cancer, but it won’t confirm it. Some studies show that it can be related to an iodine deficiency. Some also show that it can be related to thyroid globulin antibodies. 

I don’t test routinely thyroid globulin on my patients. I’m just curious if you test for it. What are your thoughts on that marker? 

Dr. Angela: 

Great question. Actually, I had that question come up today with a patient. Thyroid globulin is a substance of the thyroid itself. Thyroid globulin acts as a template for thyroid hormone assembly.

You’re right. In someone who has had total thyroidectomy followed by radioactive iodine for thyroid cancer, it will be a clue as to if there is a return to the thyroid cancer. If there is an elevation of thyroid globulin, it means that there are tissues. 

The question my patient had for me was I was following up with her after an RFA. Her primary care doctor had ordered a thyroid globulin level for her, and it was elevated. She said, “He said I have cancer.” No. This just means you have a thyroid. It may be a little bit higher, maybe normal range. I find that patients who have larger thyroids tend to have higher thyroid globulin, whatever that means. There is no point in ordering a thyroid globulin if someone has a thyroid. 

Dr. Eric: 

Like I said, I typically don’t, but some endocrinologists or other doctors do. Sometimes, they might mistakenly order that instead of the antibodies. Maybe it’s a lab error. Either way, if it’s on the panel and it’s elevated- 

Dr. Angela: 

It’s scary. 

Dr. Eric: 

To the patient. 

Dr. Angela: 

It’s on a number of panels. If you go on Lab Corps and order a thyroid panel, it sneaks in there for a lot of these panels. 

Dr. Eric: 

I didn’t know that. I see it sometimes. Maybe it is paired up with thyroid globulin antibodies on one of the panels. It’s reassuring to hear that if it’s elevated, the person probably shouldn’t stress out. 

Dr. Angela: 

Exactly. Great question. 

Dr. Eric: 

Unless they had a history of surgery and radioactive iodine and then monitoring it. Then you don’t want it to be elevated. Especially if they had a complete thyroidectomy, it should be 0 then? Or less than one? Undetectable? 

Dr. Angela: 

It’s usually undetectable or less than .1. It depends on the lab itself. Some assays will be less than one. We shoot for undetectable. 

One caveat with thyroid cancer patients is we are doing more conservative treatments for thyroid cancer now. Only half of the gland may be taken out. We leave the remaining gland in place. That would be a case of thyroid cancer where you don’t want to do a thyroid globulin check because it’s still going to be positive. That can be alarming to patients. 

Dr. Eric: 

Good to know. Just thinking on the topic for one other question. Last time we spoke, I think I asked you about RFA for thyroid cancer. At that time, it wasn’t approved. It hasn’t been that long since we chatted, so I’m guessing if someone has a cancerous thyroid nodule, is that something where you would not- 

Dr. Angela: 

It actually has been approved. 

Dr. Eric: 

Oh, it has? 

Dr. Angela: 

Yes. Pretty exciting. It’s very small, microcapillary, thyroid cancer. These are the cancers that our option before was either partial or total thyroidectomy, or observation. Just observation can be kind of alarming to a patient. They know they have cancer, even though it’s small. It’s 1.5cm or less usually. 

RFA was approved for the treatment of capillary thyroid cancers that are less than 1.5cm. They can be adequately ablated. It’s pretty cool. I think that’s a big advancement for RFA. 

Dr. Eric: 

That’s awesome. I’m glad I asked that. 

Dr. Angela: 

I’m glad you did, too. 

Dr. Eric: 

In chapter six, you spoke about thyroid disruptors. I was very interested. Before we started recording, I mentioned cadmium. Most practitioners don’t talk about cadmium in general. I know you also mentioned fluoride and flame retardants. Let’s talk about some of the different ones. 

Let’s start with heavy metals. Why did you focus on cadmium in that chapter? 

Dr. Angela: 

I don’t think we talk enough about cadmium. It’s present around us. I think cadmium doesn’t get enough credit in terms of bad things in smoking and cigarettes. 

Cadmium is really important because it affects our selenium levels. That’s the key thing about it. Selenium is really our protector of our thyroid. It contributes to antioxidants that help protect the thyroid. Thyroid hormone production is an oxidative process. It’s inflammatory. Selenium helps protect our thyroid from that inflammatory state. If we don’t have selenium, our thyroid is left unprotected.

If we have a lot of cadmium, it will prevent selenium absorption, so we are not going to have our selenium that we need. It’s kind of a vicious cycle. If we have too much cadmium, we won’t have enough selenium. Selenium is needed to get rid of cadmium. It’s a self-perpetrating cycle. Nonetheless, cadmium has been linked to growths on the thyroid, like thyroid nodules and even thyroid cancer. It all comes back to selenium for me. 

Dr. Eric: 

It makes sense. 

Dr. Angela: 

Any of the disruptors of thyroid hormone production and thyroid activation, even thyroid receptor activation, at any step of the way. They are really destructive.

Dr. Eric: 

You did mention other metals. Cadmium was the first one. You focused on it a little bit, but you did mention mercury, aluminum, lead. I forgot which other ones. You’re concerned with not just cadmium but the other ones, too. 

Dr. Angela: 

They’re all bad. It’s not to be scary. We’re exposed to things all the time. We can’t get away from them. We try to limit what we can. If you want to live in a bubble, you can’t get away from all the toxins we’re exposed to. If we can give our body what it needs to help detox and protect it as much as we can, then it gives us a fighting chance at offsetting the potential harm that these toxins can cause. 

Dr. Eric: 

How about fluoride? I had an interview about a year and a half ago with a medical doctor who briefly admitted that fluoride was a problem but didn’t want to talk about it. They were nervous about talking about it. You put it in your book, so I assume you won’t be nervous about chatting about it, how people should avoid it or minimize their exposure to it. 

Dr. Angela: 

I grew up in Delaware with fluorinated water. That was supposed to be good for us. It was good for teeth, bones. That’s what they said. Perhaps it does have some benefit there.

When it comes to thyroid, too much fluoride can actually decrease our thyroid hormone production. I mention in the book that if you put it in context to this, fluoride used to be used to treat hyperthyroidism. It used to be used to shut down thyroid hormone production. Too much fluoride does affect our thyroid hormone production, T4 as well as T3. That essentially leads to, whether it’s permanent or temporary, inadequate thyroid hormone production.

Dr. Eric: 

Do you recommend not only avoiding drinking water with fluoride but using a fluoride-free toothpaste? Do you use toothpaste without fluoride? 

Dr. Angela: 

Yes, I do. If we are exposed to so many chemicals, how much do we want to try to work on detoxing? We can expose ourselves knowingly to these extra toxins. I would go the fluoride-free route. 

Dr. Eric: 

I agree. I use fluoride-free toothpaste. How do you filter your water? What type of water do you drink?  

Dr. Angela: 

We have a water filtration system. There will be times where you can’t get filtered water, or you have to drink out of plastic bottles. Again, you try to minimize what you can. There is controllables, and there is non-controllables. If you try to keep your health as optimal as you can, your body is able to handle some of these toxins. It can get overwhelming and scary, and I think you can fixate. The last thing I want to do is cause people to get too scared of things. Just provide knowledge like you’re doing, and you can be aware of it. 

Dr. Eric: 

I agree. I can’t say I never drink tap water. If I’m out and about, I don’t buy plastic water bottles by the case to keep in my home, but if I’m somewhere, like a plane, where you can’t bring your own stainless steel water bottle. I can bring it, but it can’t have water from outside. 

Dr. Angela: 

You have to find a place to get it. 

Dr. Eric: 

I think we’re on the same page with that. Any other thyroid disruptors/endocrine disrupting chemicals you want to chat about? 

Dr. Angela: 

Those are the biggies. These chemicals can really just disrupt thyroid on every level. Be aware. That’s all. 

Dr. Eric: 

Let’s talk a little bit about thyroid/gut connection. I like that you talked about concerns with PPIs, acid blockers. You also brought up the betaine HCL challenge, talking about supplementing with betaine HCL. Do you see a lot of people with lower stomach acid in your practice? 

Dr. Angela: 

Oh yes. The tough thing is you have every other patient already on a proton pump inhibitor. It’s tough to work backwards because there are over 110 million prescriptions for PPIs. They are available over the counter. Everyone who thinks they have a little bit of stomach upset or bloating thinks it’s GERD-related. GERD does exist. 

But in our patients with Hashimoto’s especially, low hydrochloric acid tends to be the problem. If we put them on a PPI, it makes the problem worse. It’s better if I have someone who is not on a PPI to make the diagnosis. 

That’s where the betaine challenge comes into play. Just to mention, it’s more of a progressive challenge, to see- It’s not only a challenge, but it’s a diagnostic test. If you try it out, if you take 1 betaine HCL and feel a burn right away, that’s probably not the problem. It’s a progressive increase with the betaine to figure out what is the dose that is needed. I’ll go a couple months and then retest things out. If we don’t have HCL, we can’t break down food, which leads to nutrient deficiencies like B12 and iron. Iron is important for our thyroid again. We need iron for thyroid peroxidase.  

Dr. Eric: 

Also, it has antimicrobial effects, so you need stomach acid to keep not just bacteria, but potentially pathogenic microbes in check. 

Dr. Angela: 

Exactly. The tough thing is when we have this HCL acid, people who are on hormone replacement don’t absorb thyroid hormone very well. That in turn leads to poor absorption, which leads to hypothyroidism, which decreases gut motility, which is another self-perpetuating cycle. 

Dr. Eric: 

In the same chapter, you also spoke about the gallbladder and how especially people with hypothyroidism are more susceptible to having gallbladder issues.  

Dr. Angela: 

Yes. I think you will probably agree. I’ve had a lot of patients who have gallbladder surgeries in the past. “You don’t even need a gallbladder, so just take it out.” It serves a purpose. 

People with hypothyroidism have decreased cholesterol metabolism in the liver. That leads to super thick bile, which is stored in the gallbladder. The gallbladder can’t contract, which leads to gallbladder sludge. In worst cases, gallstones. That storage really serves a purpose. If we don’t have bile to go along with the enzymes for our pancreas, it’s tough to break down fats and proteins. It does serve a purpose. If we can catch that before the gallstones become a problem. Otherwise, it leads to unnecessary surgeries. 

Dr. Eric: 

Agreed. About half a million people get their gallbladder removed. I’m sure some of them are necessary, but who knows how many could have been saved if they addressed the cause of the problem. 

Dr. Angela: 

Sometimes, the threshold is very low for doing the surgery. If someone is uncomfortable, they take it out. I have seen more often recently patients who tend to have that same discomfort even when the gallbladder is out. It didn’t solve the problem. 

Dr. Eric: 

Again, that’s not addressing the underlying bile metabolism issue. 

We’re just going through all these different topics. You covered a lot in the book. Obviously, we can’t cover everything, which is why people need to read your book. I want to touch upon some different topics, so we can take a different approach than in the first interview, when we just focused on RFA.

Brain fog. What are some potential causes and solutions for brain fog? 

Dr. Angela: 

Brain fog is a super frustrating thing. I’m sure your patients complain of brain fog sometimes. “Man, I can’t complete a task. I feel like I’m not getting things done or not remembering things. My brain is not as sharp as it used to be.” 

Brain fog can be related to thyroid. It can be related to a lot of other things, so that’s the tricky thing about brain fog. You name it. Stress, dehydration, micronutrient deficiencies. We need all those neurons snapping, so they can work. They need the raw material to be fed. Anemia can cause brain fog. Infections. Medicines. Toxins. Biotoxins, like mold. Dementia. There are so many things that can cause brain fog, I don’t want to ignore them. But it is pretty common in folks with hypothyroidism.

Lots of times, if we get thyroid levels back on track, work on addressing root causes, decreasing inflammation. That’s what brain fog is, neuroinflammation, inflammation in the brain. That brain fog does improve. That’s when we’re healed with brain fog and even high antibodies. That’s where things like LDN are a good tool to use. 

Dr. Eric: 

Do you use it not only on your Hashimoto’s patients but also Graves’ patients? 

Dr. Angela: 

Yeah. I feel like it’s such a great immune modulator. It’s not an overnight fix, but it does really help bring down the inflammation from the immune standpoint. 

Dr. Eric: 

How long do you usually expect someone to be on LDN before they notice benefits? You said it’s not a quick fix. Is it something where they have to be on it for a few months to give it a chance to work? 

Dr. Angela:

I usually say give it at least three months before you notice a big change. Just hang in there. As long as you’re not having any problems, keep with it. It’s almost like the clouds part, and the antibodies start coming down. Once it starts working, it starts working. 

Dr. Eric: 

Next topic is cortisol. Did you mention saliva testing as far as cortisol? 

Dr. Angela: 

Yeah. 

Dr. Eric: 

That’s your main way of testing for cortisol in your practice? 

Dr. Angela: 

Yeah, that’s the main way. Cortisol is a tough one. Cortisol in general, it’s like stress. There is good stress and bad stress. Good stress doesn’t last long. Bad stress hangs in. That is what pushes you over the edge when it comes to disease.

The cortisol/thyroid relationship is a complex one for sure. We have too much cortisol; it affects TSH production, conversion of T4 to T3, not to mention cortisol is catabolic to the gut lining. It impairs intestinal permeability. 

I do cortisol testing pretty frequently and repeatedly in patients who I feel aren’t responding so well to thyroid hormone replacement as I think they should, or balancing thyroid hormone levels. Yes, I will do the four-point cortisol test to touch base and see where we’re at. If the cortisol curve is low, those symptoms can overlap with hypothyroidism: fatigue, not feeling well, lethargic. It’s tough to tell the two apart. If you bump up the medicine, you’re essentially making the cortisol lower because you’re metabolizing out the cortisol. You’re making that situation worse and not getting any better.

Dr. Eric: 

When I dealt with Graves’, I did a salivary cortisol test, and it’s something I commonly recommend as well. Do you use any Dutch testing in your practice? Sometimes I will do Dutch testing, which also looks at cortisol. If I’m just focusing on adrenals, I will typically recommend saliva. If I am looking more comprehensively at the hormones, then I will do the Dutch test. 

Dr. Angela: 

I agree. 

Dr. Eric: 

Epstein-Barr (EBV). Also dedicated an entire chapter to EBV. Why did you do that? In my book, Natural Treatment Solutions to Hyperthyroidism and Graves’, I have a chapter focused on infections. But you go beyond that and have a chapter on EBV. 

Dr. Angela: 

I find EBV reactivation to be such a hidden thing. I almost think of EBV as a nuisance. It’s a real pain because just when you think you have everything taken care of, someone starts feeling like the cyclical fatigue. Oh my gosh, this is EBV reactivation. 

I do screen for it a lot on patients who I feel like aren’t digging in deep enough, aren’t getting to the root cause, or aren’t getting the results we want. EBV is a tough thing because it has so many different phases. It will hang out in our system and reactivate when our bodies are less able to handle it, like in times of stress. If cortisol is up, that’s a time when EBV will reactivate. 

Plus I feel like it’s something that we can treat well naturally. It follows the same principles as trying to keep stress low, sleep, taking care of our bodies as far as nutrition. We have great natural supplements that really do help. Whenever there is something that doesn’t seem right, it’s gotta be EBV. 

Dr. Eric: 

For both Graves’ and Hashimoto’s, it could be problematic. Other types of viruses, too. EBV is the most well-known. That might have changed over the last few years since 2020, but still, EBV is a pretty prominent virus. 

I agree. You want to do things to manage your stress. Make sure you’re getting sufficient sleep. If necessary, there are some great natural approaches. You mentioned some of those in your book as well, like monolaurin and olive leaf and other antivirals. 

The final thing I want to cover with you is radioactive iodine. When we had our first conversation, I don’t know if we spoke about radioactive iodine. 

Dr. Angela: 

I think we did. 

Dr. Eric: 

I know I asked you about the radioactive iodine uptake test, which you weren’t a big fan of. I was happy to hear that because I am not a big fan of that either. 

Dr. Angela: 

I really hate that test.

Dr. Eric: 

It was good coming from an endocrinologist. Maybe our perspectives will differ on this, but I’m sure you prefer someone not to get radioactive iodine or surgery and save their thyroid. There is a time and place without question for conventional medical treatment. 

If I was in this situation, if I had to choose between one or the other, I can’t picture myself getting radioactive iodine. I would probably go with the surgery because I know some people get radioactive iodine and have no regrets, but in our Facebook groups, I hear some nightmare stories. Same with surgery, too. There is no perfect method. There are risks with surgery as well. 

What are your thoughts on that? If you had to recommend one or the other, do you have a preference? 

Dr. Angela: 

In my experience with radioactive iodine for Graves’, the thyroid cancer space is probably a different conversation. For Graves’- 

Dr. Eric: 

For Graves’, yeah. 

Dr. Angela: 

Specifically for Graves’. It’s almost a 50/50 shot. I find with radioactive iodine and Graves’, half the time, I will say it’s 40/40/20, or maybe 45/45/10. 10% of the time, maybe it’s in the sweet spot, and they end up normal. It’s like heaven. Perfect.

The other part, they become hypothyroid. They need to be on thyroid hormone replacement anyway.

Or that other part, it’s not enough, and they have to go through it again. You have to wait six months to a year to go through it again. You’re back on antithyroid medicine. That’s a problem. There is probably a reason why they couldn’t take antithyroid medicine, and they want the radioactive iodine. 

At least with surgery, you know you fixed the problem, and you’re done. Then you have to be on thyroid hormone replacement. If you became hypo from radioactive iodine, you will need to be on thyroid hormone replacement, too. 

It’s very patient-individualized. If we have to treat it, let’s just take it out and go from there if it’s that severe. It’s all patient-individualized. I wish there was a clear cut. 

Dr. Eric:

What do you see less complications with? Is it about even? 

Dr. Angela: 

I think it’s about even. I think with a really good thyroid surgeon, you will have low complications. With radioactive iodine, I find the biggest complications can be more short-lived. Then again, you don’t know years down the line what problems may occur with radioactive iodine. It’s tough. Do you think the surgery would be better? 

Dr. Eric: 

Well, it comes with its own set of risks. 

Dr. Angela: 

Right. 

Dr. Eric: 

You could get damage to the parathyroid glands, the laryngeal nerve. Like you said, a lot of it comes down to choosing a surgeon who has a lot of experience. To me, the thought, like all the precautions to take with radioactive iodine, in some countries, they even quarantine. In the United States- 

Dr. Angela: 

That’s what they used to do here. 

Dr. Eric: 

I know they don’t quarantine. Still, you can’t share the same bathroom. I don’t know. It sounds very easy. Just swallow this pill, and that’s it, compared to going through surgery, which is more extensive. 

I guess, hearing the stories from people who received radioactive iodine compared to people who received surgery, I don’t see a lot of those people personally. Usually, I see people who have the opposite; they are trying to save their thyroid and prevent those two. 

In the Facebook group, we have thousands of members, people who received radioactive iodine or surgery and will share their stories there. It sounds like there is more negativity when it comes to radioactive iodine. I have also received emails over the years from people saying, “I got radioactive iodine and never felt the same. I wish I didn’t get it.” I know there are people who get it and feel fine afterwards. We could say the same thing with surgery. 

In my personal experience, I hope I’m not faced with that decision. If I was, if I absolutely had to choose, I’m thinking I probably would try to find a surgeon who has a lot of experience and take my chances with the surgeon rather than receive radioactive iodine. Again, that’s just my opinion. 

Dr. Angela: 

It’s tough. You’re trying to foresee years into the future, too. 

Dr. Eric: 

Exactly. 

Dr. Angela: 

It’s not easy. If push comes to shove, and I have to present these options, I lay it out at the table and let the patient decide. Luckily, I don’t have to do that very often. 

Dr. Eric: 

At least you give them the option if someone needs to do it, where some endocrinologists will say one or the other and not even bring up the other option. That makes sense.  

Dr. Angela: 

I take care of patients not when they were under treatment for Graves’, but afterwards. I always hate to hear, “I wish I never did this. I wish someone would have told me.” Wow. I’m sorry. Let’s try to do the best we can now.  

Dr. Eric: 

That’s all we can do. 

We covered a lot. There is a lot that we didn’t cover that is in your book. For those who are interested, definitely check out Dr. Angela’s book. Anything else that you really wanted to cover? Did we cover everything you wanted to? Any last words? 

Dr. Angela: 

I want to thank you for the opportunity to review my book. I really appreciate it. I so respect you.

I want to encourage people who have thyroid issues or think they might have thyroid issues to pursue your own health. My goal with the podcast and the book and even the master class is to empower patients to know that they’re not alone in this. There are things that are in their control that they can work toward their health now and years down the line. That’s really what it is. We want to feel good now, but we also want our health to be good 10, 20, 30 years down the line. 

To encourage them to work with their doctor. If you feel like your doctor is not listening to you, it’s time to be proactive. I know it’s hard getting a second opinion, but go get one. This is information that you can use. I always love spreading good information. Just like you, Dr. Eric, it’s important to spread good information. There is a lot of scary things out there that aren’t quite right. 

If people want to check out my podcast, Thyroid Talk with Dr. Angela Mazza. Also, the book. We have an upcoming online master class called Thrive Through Thyroid. We have different modules that dig into diagnosis, symptoms, treatment for both hypo and hyper. We really talk about gut health. You’ll be sick about gut health, but you’ll be an expert on gut health. Stress, putting it all together. We even have some bonus modules like hair loss, weight loss, specifically Hashimoto’s, Graves’, some recipes.

I think the cool thing we put together with this master class is once a month, a live coaching session. I meet with everyone, kind of like this. We answer questions, field concerns. It’s like a thyroid community, so people know they are not alone in some of their struggles, because you’re not. 

Dr. Eric: 

Wonderful. Where is it best to buy your book?  

Dr. Angela: 

It’s on Amazon, so that’s probably the best way. 

Dr. Eric: 

Definitely check out Dr. Angela’s book, Thyroid Talk. Her podcast is amazing, so check that out, too. Also called Thyroid Talk. That thyroid master class, too. Thank you so much. This has been great. Really enjoyed reading your book. I think I enjoyed even more chatting with you about it. 

Dr. Angela: 

Thank you so much. I appreciate it. I want to applaud you for all the good work that you do.  

Dr. Eric: 

Thank you. Same with you. You’re doing a great job, too. Keep up the good work.

 

Recently, I interviewed Dr. Deva Boone, and we talked about how the parathyroid glands regulate calcium levels in your bloodstream, the role of calcium in the body, and more. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am very excited to chat with Dr. Deva Boone, who is one of the most experienced parathyroid surgeons in the United States. Obviously, we are going to be chatting about the parathyroid glands, and we will talk about Vitamin D. 

Dr. Deva was the medical director and senior surgeon at the Norman Parathyroid Center until 2020 when she left to open the Southwest Parathyroid Center, located in Phoenix, Arizona. Thank you so much for joining us, Dr. Deva. 

Dr. Deva Boone: 

Hi! Yes, thank you for having me. 

Dr. Eric: 

Really excited to talk with you about the parathyroid glands. Can you give a brief background? How did you decide that you were going to focus on the parathyroid glands? Was it something that you knew when you were in medical school or upon graduating? Did you have a personal experience? 

Dr. Deva: 

It wasn’t really that. I went to medical school not even knowing I was going to be a surgeon. I thought I was going to be a neurologist. During my rotations in my third year of medical school, I really enjoyed surgery and decided to do general surgery. I didn’t really decide on parathyroids until the end of that residency. 

I really liked endocrine surgeons. I did a fellowship in endocrine surgery. Then I went down to Tampa to work with the Norman Parathyroid Center because they do just parathyroid surgery. I was really impressed with the set-up they had and the way they did the operation. I decided to focus on that forever. 

It is a really nice operation because you can really help a lot of people. A lot of people feel pretty bad beforehand, and they feel much better afterwards on average. It’s pretty satisfying to be able to help people with this operation. 

Dr. Eric: 

For those who are not familiar with the parathyroid glands, can you explain the function of them? 

Dr. Deva: 

Sure. The parathyroid glands are the forgotten cousin of the endocrine glands. A lot of people don’t know about them. They are right next to the thyroid. Your thyroid is this butterfly-shaped gland at the base of the neck. The parathyroid glands sound like thyroid because they have thyroid in the name, but that comes from the fact that they are right next to the thyroid. When they were discovered, we didn’t know what they were, so they were called “para,” next to, the thyroid.

There are four parathyroid glands. They are typically right around the thyroid, two on each side. They exist solely to regulate your calcium. If you think about it, there aren’t any minerals in your body that have a whole organ dedicated to them. They just regulate calcium. 

It’s also the only thing that you have four of. They are pretty cool. They are tiny. They are about the size of a grain of rice, each one of them. But they are really important because they regulate your calcium.  

Dr. Eric: 

Why do you need a separate gland to regulate calcium? 

Dr. Deva: 

When most people think about calcium, they think about bones. The Got Mlk? billboards. Calcium is really important for your bones. That is the main storage location of calcium in your body. Calcium is what makes your bones hard.

But the reason the parathyroid glands exist is really not to regulate your bone calcium, but the blood calcium. That actually is really important in itself. Your brain, your muscles, all your nerves depend on having a set level of calcium in order to function properly. For your muscles to contract properly, for your brain to have correct signaling, you actually use calcium during all of those processes. Calcium is necessary for that reason.

It’s necessary even in other areas where the electrical signaling is important, like your heart. When your heart beats, there is an electric signal going through it. Calcium is necessary for that. It’s necessary for blood clotting.

For all of these reasons, your calcium in your blood is kept in a very tight range. Sometimes, other things can vary, but your calcium typically doesn’t vary that much because your parathyroids are keeping it in a tight range, so your brain and nervous system can all function properly. 

Dr. Eric: 

You don’t want calcium to be too low or too high. That goes with any nutrient. When people focus on any mineral or nutrient, they are probably more concerned about deficiencies. They’re concerned about low calcium, which could be a factor in osteoporosis. What you see a lot in your practice is the opposite, elevated calcium levels. 

Dr. Deva: 

Yes. It’s interesting because low calcium is a problem, but what I see a lot more of is high calcium because I treat primary hyperparathyroidism. When the parathyroids have a problem, typically it’s not a deficiency of PTH, it’s that they have too much parathyroid hormone. The parathyroid glands are pretty simple. They make one hormone called PTH, parathyroid hormone. PTH is just regulating calcium, and phosphorous, but that’s a separate issue. You can think of it as doing one thing with one hormone.

When you have a really low calcium level, and this is important to understand, this thermostat concept. Your parathyroid glands’ job in life is to get that calcium up. They sense that. If you set your thermostat to 68 degrees, and it’s starting to go below that, your thermostat will sense that, and the heat comes on. It brings the temperature back up to 68, and the heating can turn back off. 

When that happens in your body, when the calcium level drops too low, the parathyroids turn on, make more hormone. The hormone then raises the calcium by doing a few things, like taking calcium out of your bones to put it in the blood. As the calcium rises and goes back up to the normal range, the parathyroids can turn off and make less hormone. 

If the calcium level goes too high for any reason, the parathyroids turn off. Just like if your temperature went up to 90, your heating should turn off. Your parathyroids are regulating things throughout the day. 

I do sometimes see people with low calcium because for whatever reason, they have a problem getting calcium. If they have issues with chronic diarrhea or any problem with absorption from a gastric bypass, that kind of thing, they can have problems keeping their calcium up.

When you have a problem with the parathyroids, typically you see a high calcium level. That is because when you have a parathyroid problem, most of the time, it’s due to a small, benign tumor in the gland. That tumor is acting inappropriately, meaning it’s making hormone even though it shouldn’t. That means that PTH continues to dump out and raise the calcium level. You end up with these high calcium levels.

Most people, when they see that, they actually think it’s a good thing. They look at their labs and are looking for deficiencies. If they see their potassium is low, they clue into that. If they see their Vitamin D is low, they clue into that. If they see their calcium is low, they might worry about that. If they see it’s a little high, they think that’s probably good for their bones to have more calcium because they have been taught that they should take calcium for their bones. If their calcium is on the high side, that must be a great thing. They don’t realize that’s as much a problem as having low calcium, possibly more. 

You really want to pay attention to keeping that calcium in range, not letting it get too low or too high. Your brain, nerves, muscles all want that calcium to be in a certain range. Anywhere outside of that range will cause problems. 

Dr. Eric: 

It’s a negative feedback mechanism, similar to thyroid. If you have low thyroid hormone, you have TSH, thyroid stimulating hormone, signaling to the thyroid to produce more thyroid hormone. Under normal circumstances, if serum calcium was low, you’d want to see the PTH high, signaling for the parathyroids to increase the calcium levels, correct? 

Dr. Deva: 

Right. The parathyroids do that through a couple of ways. One of the ways they get the calcium up is PTH actually stimulates the bones to release calcium. That is how patients with these parathyroid tumors get osteoporosis. You see that your calcium is high, but actually, your bones don’t have enough calcium. You see your bone density dropping. That is connected. The reason your calcium in your blood is high because it’s coming out of your bones. It wants to go back in. That is part of primary hyperparathyroidism, or having too much PTH. 

Dr. Eric: 

How common is primary hyperparathyroidism? 

Dr. Deva: 

Unfortunately, it’s more common than most people realize. A lot of people don’t even know what the parathyroids are. They don’t know what they do. 

Just to get to exactly how many, it’s hard to say. It does increase as you get older. It is more common in women. Probably even up to 1% of women over the age of 50 will get this. It’s most common in post-menopausal women. Having said that, I have had teenage boys with this, so it doesn’t mean that you can’t get it if you’re younger. There are a lot of people who get it younger and as men. About 75% of the patients are women, and the average age is probably about 60.

I think that gets into why the disease is underdiagnosed. If you think about it, it tends to happen in women who are around the age of menopause. A lot of the symptoms tend to get blamed on that. If you’ve gone through menopause in the last 10 years, and you start to tell your doctor that you’re tired and can’t sleep at night, the immediate thing is not to check your calcium, but to respond with, “This is probably menopause.” That is partly why the disease gets overlooked a little bit.

Another reason is that our labs give a very broad range for calcium. If you get your labs, and I encourage everybody to get their own labs, get the results, keep them for yourself in a file, so you have them and can review them. If you look at your labs, a lot of times, what you’re doing and what your doctor is doing is scanning down for anything that’s abnormal. They put an abnormal note or make it red. Often, you get so many labs that you’re just looking for that.

With calcium unfortunately, a lot of the labs give a range that is both too far on the low end and on the high end. It will say 8.5-10.5 is normal. Really, it’s more like 9.2-9.9 is the normal range. 10.0 can be normal. Once you get further in age, your calcium level shouldn’t be in the 10s. The labs don’t adjust for that. You end up sometimes with people who have had high calcium for years, but it didn’t register until the calcium went to 11. That’s part of the reason why.

I also think a big part is that a lot of patients are having these symptoms that are non-specific, and they go to their doctor, and it’s blamed on age or menopause. 

Dr. Eric: 

Can you talk more about the ranges? You mentioned that as we get older, you shouldn’t have a calcium level that’s higher. The serum calcium should decrease as you get older? 

Dr. Deva: 

Yeah. Children actually can have pretty high calcium levels. Their calcium levels, and this is in U.S. ranges, mg/dl. Their calcium levels are often in the 10s, even up to 11. Then it drops as you get older. In your 20s, a lot of people will have calcium levels in their 9s or 10s. In your 30s, maybe you can have some calcium levels in the low 10s, but it drops with time. By the time you get to age 40, most of your calcium levels should be in that 9s range. As I said, mid- to high 9s. 9.2/9.3-10.0. If you’re outside that range, usually it indicates a problem. 

Dr. Eric: 

If it’s above 10, especially above age 40- 

Dr. Deva: 

Or 10.0. It does get tighter as you get older. If I see a 40-year-old with a 10.1, I want to check things out. That’s not definitive yet. If I see an 80-year-old with a 10.1, and they have a PTH that is either normal or high, that is primary hyperparathyroidism. 

There is no clear cutoff with the age thing. It’s not like you wake up at 40 with a different calcium level. It slowly happens over time, and everybody is a little different. In general, if you’re 60 years old, all your calcium levels should be 10.0 or under. You don’t want it too low, but you don’t want it to go above 10.0. 

Dr. Eric: 

If you see it above 10.0, as you mentioned, then you order a PTH test to see if that is elevated. If that’s elevated, then that’s typically indicating hyperparathyroidism. 

Dr. Deva: 

That’s the most common scenario, high calcium and high PTH. Interestingly, you don’t need the high PTH. That is why I went over the thermostat analogy. Think for a second: If your house is 90 degrees, and your heating is on low, but it’s still on, that’s a problem. Your thermostat clearly is not sensing that it’s 90 degrees. It should have kicked in, and the heating should be off. 

It’s like that with parathyroid glands. If you have a calcium of 11, and your PTH is in the normal range, that’s an inappropriate response. Your parathyroid glands should turn off. All of your normal parathyroid glands are turning off. You’ll have a very low PTH level if something else is causing the high calcium. If you have a PTH that is normal range with a high calcium, that is usually primary hyperparathyroidism.  

Dr. Eric: 

We were chatting a little bit before. A lot of people who are listening to this have hyperthyroidism, be it Graves’ or toxic multinodular goiter. Some people with hyperthyroidism will have an elevated serum calcium as well. The way to know if it’s related to the thyroid or if it’s hyperparathyroidism is what you just said. If someone has hyperthyroidism, their serum calcium is 10.2, so you look at PTH and see if it’s elevated or normal. It should be on the lower side normally. 

Dr. Deva: 

Exactly. You look at the overall picture. There aren’t that many things that can cause high calcium first of all. Most of the time, if you’re going to place a bet on someone with high calcium, you will bet they have primary hyperparathyroidism. That by far is the most common thing.

There are these scenarios with hyperthyroidism where you do get high calcium levels. With all of these issues, I want to see the history. Some of these patients had high calcium before they developed hyperthyroidism. Doesn’t seem like that was probably it. When some people’s thyroid disease is particularly active, their calcium can rise. That can be true of something like sarcoidosis, too. If they have very active sarcoidosis, they will see the calcium rise. Once it’s treated, the calcium goes back to normal. 

That is true of the thyroid as well. If you are under in control, if you haven’t had many issues, your labs will typically go back to normal. Tracking those over time—the calcium, PTH, and Vitamin D levels all together—is the best way to figure it out.  

Dr. Eric: 

You mentioned Vitamin D. Vitamin D also in some cases can cause elevated serum calcium, correct? 

Dr. Deva: 

Yes. Vitamin D is one of my favorite topics because it is intimately related to calcium and parathyroid hormone. A lot of people really like Vitamin D. A lot of people take Vitamin D. I take Vitamin D. But there are things you need to know about Vitamin D.

First, it’s not really a vitamin. Your body does produce it. Second, it’s a hormone. You have to treat it like any other hormone. We know when we’re talking about sex hormones or steroids which are hormones, we know you have to treat those carefully because they can have these systemic effects. But Vitamin D doesn’t always have that reputation because it’s a supplement people can buy over the counter. It’s sometimes not treated with the same respect.

Vitamin D is essential. It is really essential for calcium metabolism. One of the main things that active Vitamin D does is help your intestines absorb calcium. If you have a severe Vitamin D deficiency, you won’t be able to absorb calcium appropriately. This can lead to things like Ricketts. This is how low Vitamin D causes issues. You’re not absorbing the calcium or properly handling the calcium. 

The way that it’s involved with the parathyroid is part of the way they get your calcium level up. Remember I said they sense that low calcium and turn on. They make more hormone. Part of what that hormone does is stimulate the activation of Vitamin D that happens in your kidneys. 

Your Vitamin D exists in multiple forms in your body. This is really confusing, too, but we’ll keep it simple and just talk about the inactive form and active form of Vitamin D. To activate that form, you need PTH and an enzyme, which is just directly stimulated by PTH. PTH ramps up the conversion of inactive Vitamin D to the active Vitamin D, which then goes to the intestines and helps your intestines absorb calcium. That is one way it will raise your calcium level. 

The way this gets confusing, even for doctors as well. I have to explain this to doctors all the time. When you have a parathyroid tumor, you will end up with a low Vitamin D level and a high calcium level. You should not treat that. That Vitamin D is not real exactly. What they’re measuring is the inactive form. That is the form that we measure on people. If I say, “I want you to get Vitamin D checked,” and I check off Vitamin D at the lab, they will draw the inactive form, Vitamin D 25 hydroxy. That is the form that is really accurate for most people. It indicates your overall Vitamin D status better than the other forms. The other forms tend to break down more easily, and they are not as easy to measure.

Now we can measure the active form. We do sometimes. But in most cases, we don’t because it tends to break down quickly. It’s not a good assessment of your overall Vitamin D status.

Inactive Vitamin D is accurate for almost everyone. But it is not accurate for people with primary hyperparathyroidism. Go back to what I said about PTH. It activates the Vitamin D. Your inactive form drops because it’s getting converted to the active form. If I measure the active form in primary hyperparathyroidism, you will see it’s actually high. Your inactive form is low. 

We only measure the inactive form. Because of that, most patients with parathyroid disease will get diagnosed with Vitamin D deficiency, and they will automatically be prescribed Vitamin D. 

Why is that a problem? If your calcium is already high, and you start taking more Vitamin D, you can raise your calcium into a dangerous level by taking more Vitamin D. It is a little bit complicated. 

Basically, if you see a low Vitamin D, don’t immediately treat it. You want to know your calcium level as well. If your calcium level is high, you don’t want to take it.

The thing that is really confusing—stop me if I am talking too much because I love talking about Vitamin D—is that when you’re deficient in Vitamin D, that causes your calcium level to be low. That low calcium will then stimulate your parathyroids and raise your PTH. This is as separate condition called secondary hyperparathyroidism. Your parathyroids are active but only because they have to be because you’re not getting enough calcium. They get activated and make more PTH to try to get the calcium up if you have a severe Vitamin D deficiency. In that case, you want to treat that with Vitamin D. That will help get your calcium up and bring your PTH down.

The place where doctors get confused is they see the high PTH and low Vitamin D. They ignore the calcium and give you more Vitamin D. That’s not going to solve the underlying problem. The underlying problem is a parathyroid tumor. 

Dr. Eric: 

Just to clarify, with someone who does not have primary hyperparathyroidism, you do recommend the 25 hydroxy Vitamin D test, like the inactive form, as far as testing.

Dr. Deva: 

I do. For most people, that form is the most accurate and the easiest to get. If you just order it from the lab, if you just check off Vitamin D, that’s the one you’re going to get. I do recommend that.

There are two populations where it’s not accurate: primary hyperparathyroidism and sarcoidosis. They also have an abnormal conversion to the active form. There are those two scenarios where it’s not going to be as accurate. But for almost everybody else, I would track the inactive form. 

Also, all of our recommendations and studies are done on the inactive form. We don’t have a lot of data on how to interpret or what to do with the active form and where to adjust it. When we are talking about guidelines, we are talking about the inactive form. 

Dr. Eric: 

I agree. I test the inactive form, 25 OH Vitamin D. 

Taking too much Vitamin D can increase serum calcium. What do you like to see Vitamin D levels at? Some will say at least 50 ng/ml. Some will say between 60-80. Every now and then, someone will say greater than 80.

Dr. Deva: 

Yeah, this is really controversial. I do love this topic. First, remember that I have a selected patient base. The people who come to me are people generally who are worried about their parathyroids and typically have high calcium levels. 

I will just say that when I see the high calcium level, I always check the PTH and Vitamin D levels. If the Vitamin D level is very high, there is a pretty good chance that is causing the high calcium, as long as the PTH is in the normal to low range. 

What I have them do first is stop the Vitamin D. Now you’re wondering what level of Vitamin D do I see it? I see it happen over 50 ng/ml. Now, lots of people can tolerate a Vitamin D of 60 and not get high calcium. Those aren’t the patients I tend to see. I tend to see patients where when it’s over 50, they end up with calcium levels pushing into the 10s. It’s not always recognized by their doctors as high calcium, but I know that’s a high calcium, and it will cause symptoms of high calcium. 

I typically recommend people keep it in the 30-50 range, unless they’re using Vitamin D to treat something else. I always encourage people to treat any supplements as a medication. Have a reason why you’re taking it. There are people who are taking higher doses of certain vitamins in order to treat a condition or try to mitigate a condition or alleviate a condition. That is okay. As long as you know what you’re taking and what the risks are. 

With Vitamin D, the thing you have to know is there is a risk that your calcium will go too high. If you’re on high doses of Vitamin D, if your Vitamin D level is 70, there is not a lot of evidence that it really is beneficial to be 70 versus 50. But if you wanted to do that and keep it there, all I would say is watch your calcium level and make sure it’s not going into the high range. 

There are people who can tolerate Vitamin D levels of 80, and their calcium level is normal. Then there are people who have a Vitamin D level of 60, and their calcium level is 10.5 as a result of it. They’re going to get the symptoms of high calcium. You have to tailor it. There isn’t one amount for everybody. 

In general, I encourage people to keep it in the 30-50 range because we have a lot of evidence that Vitamin D deficiency, meaning true deficiency, like under 15, does cause problems. We likely have problems with under 30. That’s not as clear; the evidence is not as good. I think it’s reasonable enough to say there may be issues with under 30. 

Keeping it in the 30-50 range is a nice medium for me. I don’t see it causing high calcium. I think you’re probably getting most of the benefits from Vitamin D in that range. That’s where I stand on it. I know I’m going against a lot of other people. That’s because I see these effects. I see a lot of patients come to me with high calcium, and I do have to caution them to keep it in the range. If you don’t want to keep an eye on your calcium all the time, 30-50 for Vitamin D is a good range. 

Dr. Eric: 

30-50 is where you like to see it. 

Dr. Deva: 

That’s my opinion. 

Dr. Eric: 

If someone insists on having it where the level is 50 or greater, you would say to monitor the serum calcium to make sure that it’s not elevated. If it’s elevated, it very well might be due to Vitamin D. There is a chance someone could have hyperparathyroidism if someone is taking too much Vitamin D. It could be a combination of both. The first thing is to look at serum calcium. 

Dr. Deva: 

Exactly. Sometimes, it is. Sometimes, Vitamin D will uncover parathyroid disease. Maybe the tumor was growing. As you take more Vitamin D, it easily slips into the 10s. That can be early parathyroid disease. I do see it where it starts going into the 10s.

I also see it happen over time. Remember Vitamin D is a fat-soluble vitamin. The longer you take these high doses, the more it’s collecting up in your body. It can take a while for it to drop even if you stopped entirely taking any. 

I see these people who will be on these very high doses. What I consider a high dose is 5,000 units a day, which is what a lot of people are on. If you take that for a short period of time, it is unlikely you will see bad effects from it. if someone is on it for 10 years, and then they didn’t get a high calcium level for the first few years, and it took a few years for the calcium level to start rising. They are thinking they have been on this for so long that this can’t be the problem. But it could be. You see those effects add up over the years. 

Dr. Eric: 

Based on what you just said: Let’s say someone is taking Vitamin D, and their Vitamin D levels are 60 or 70. Then their serum calcium is over 10. Would you recommend for them just to go ahead and test PTH just to make sure it’s not high? You would say probably stop the Vitamin D anyway. Is another option to stop the Vitamin D and wait a few months because it could take quite a while for that to drop significantly to impact the serum calcium, if that is indeed the cause of the elevated serum calcium? 

Dr. Deva: 

I don’t want to miss a parathyroid tumor. I will have them recheck labs with calcium, PTH, and Vitamin D. Typically, when the Vitamin D is causing it, the PTH will be on that low end of normal. I do have patients where their calcium is 10.5, their Vitamin D is 70, but their PTH is 100. That’s primary hyperparathyroidism. The PTH level is not responding appropriately to that calcium. I know that’s a parathyroid problem.

If on the other hand, the PTH level is 25, on that lower end of normal, that is more consistent with Vitamin D. I do have them stop Vitamin D regardless, whether it’s primary hyperparathyroidism or not because your calcium is high. The high calcium is what is causing most of the symptoms with parathyroid disease. You want to stop the Vitamin D. You want to stop it and repeat labs. 

Three months is the earliest I will recheck. If it’s that high because you have been on high doses for many years, it may take six months for it to drop below 50. That’s what I’m looking for. Once it gets below 50, that’s when I see the calcium drop back to normal. That’s what I have people do. Sometimes, it takes six months, but it will happen. 

Dr. Eric: 

Talking about primary hyperparathyroidism, if someone has a benign adenoma, is there any natural options out there? When it comes to hyperthyroidism and hypothyroidism, I’m all about trying to improve the health of the immune system, address the cause of the problem, as are many other functional medicine and natural health care practitioners. Any other options besides surgery when it comes to benign adenomas? 

Dr. Deva: 

Sure. I will first say I am a huge proponent of lifestyle medicine and modifying your lifestyle, your diet, in order to treat and prevent disease. For the thyroid, that makes a lot of sense. As I mentioned earlier, I am not a huge fan of surgery for Graves’. I think that should be the last resort option after you’ve tried other things to control your thyroid. 

Having said that, there are some things where surgery is just necessary. For parathyroid tumors, there really isn’t any lifestyle modification that you can make that will affect it. It is a small tumor. It’s benign; it’s not a cancer. It’s a small tumor growing inside the parathyroid gland. There is nothing that will get rid of it or cause it to go away without taking it out, at least anything we have right now. The only treatment is removing this. 

In that case, it makes sense to have the operation because it does have such a huge effect. You can cure it. For most people, once you take the parathyroid gland disease out, your other glands react normally. Then you prevent all of the potential medications you might need to take later on down the road if you had left it in place. A lot of people with parathyroid disease get high blood pressure, cardiac arrythmias, fatigue, constipation, reflux. They end up on all of these other medications to try to treat the symptoms of this when really a simple operation can cure it and prevent these complications. 

Dr. Eric: 

Prior to going live, as you mentioned, we were talking about Graves’ and how you recommend not having surgery as a last resort. There is a time and place. One thing you mentioned with surgery of the thyroid is complications are common. With parathyroid surgery, it all comes down to choosing the right surgeon, too. 

Same thing with thyroid. You wouldn’t want to get thyroid surgery from someone who just did 10 thyroid surgeries. At least I wouldn’t want to go to someone who was not experienced. Obviously, you focus on that. Can you talk more about potential complications, like the risk factors of this surgery? 

Dr. Deva: 

Especially with something like Graves’, that is my main reason for not wanting to push for surgery because the complication rate is high. Actually, one of the big complications with surgery for Graves’ is hypoparathyroidism, meaning all the parathyroid glands can be injured during the operation. That is a serious, can be lifelong complication that can be very hard to manage if you don’t have any parathyroids.

The reason it’s more of an issue than with other thyroid operations, because not all thyroid operations are equal. Surgery for Graves’ is one of the riskier ones because of all that inflammation around the thyroid. It makes it very difficult. I have operated on Graves’ thyroids. They are hard to deal with. They are very temperamental, they bleed easily, and they’re stiff. It’s hard to get around them.

For all those reasons, when you do a Graves’ thyroid and take it out, it is very easy to injure the parathyroid glands around it and not even realize it. And also injure the nerve that controls your voice. For all those reasons, I say try to treat it medically or with lifestyle medicine, even radioactive iodine, before I would recommend surgery. 

There are patients who need surgery for Graves’, and they should get it. If you do that, go to a surgeon who just does thyroid operations. There are people who really specialize in this and are mostly doing thyroid operations or solely doing thyroid operations. That’s who I would want doing my operation.

Parathyroid surgery tends to be a very safe operation. It has some of the same risks as with thyroid surgery and with any other operation. Any time someone takes a knife to any part of your body, there is a risk of bleeding. That is true for parathyroid disease, like any other operation. But it’s pretty low. There is always a risk to those nerves that control your voice. Again, pretty low risk. Finally, there is a risk that you would injure or remove all the parathyroid glands. Typically, you’re trying not to do that. In general, it is a very safe operation. It lasts under an hour. It’s usually about half an hour to see all the glands.

With this as with other operations, you do want to get someone who is experienced in this. A lot of general surgeons are credentialed to perform thyroid surgery and parathyroid surgery. It doesn’t mean that you would want them doing your parathyroid or thyroid operation. 

Parathyroid surgery can be pretty hard if you’re not experienced in it. Those glands are a grain of rice. It could be a grain of rice that is stuck to the nerve that controls your voice. You really don’t want someone inexperienced digging around in there. You want someone who is going to be able to evaluate it and remove the tumor safely and quickly in order to reduce those complications, get you out of the hospital. It’s a same-day procedure. It’s a very safe operation in general, as long as you have someone experienced doing it. 

Dr. Eric: 

If you had to take a guess, how many surgeries have you done? 

Dr. Deva: 

I’ve done at least 4,000, which makes me the most experienced person in the western U.S., I think. I’ve only done parathyroid operations for the last 10 years. That’s all I focus on. 

To me, I wouldn’t want a surgeon who just did this operation once a week to do my operation. A lot of the guidelines will say that you’re an expert if you do 50 a year, which is about one a week. That is not very many. To get good at this, you have to do a lot of operations. That means specializing in the area, which a lot of surgeons aren’t doing. 

I will say the thing I do differently is I look at all four parathyroid glands in the operating room. It’s the most accurate and reliable way to actually assess the parathyroid glands. Scans and imaging studies are so often wrong with the parathyroids because they are so tiny to begin with. You can’t see normal glands. You can’t even see small tumors. 

I have a lot of patients who have completely negative scans. This is weird to think about because when I say you have a small tumor, most people are thinking, “Okay, you know that because either you see a lump or feel a lump or see it on the scan.” If I say you have a tumor, you are thinking about a scan or a lump you have on your arm.

With parathyroid disease, it’s not like that. I can’t feel it on your neck. We can’t see it on imaging studies, even with the most advanced imaging studies we have. They may not show up. You have to base it on the labs. I know from your labs, you have a parathyroid tumor. It’s a little weird. “I don’t see anything on the scans, but I know you have a parathyroid tumor. If I look at your parathyroid glands, I will be able to figure it out.” That means going in there and being able to find all four safely and quickly. 

For most surgeons, they often won’t do that. They will rely solely on imaging, so they will only operate if they have a positive scan. They will only go after that gland. That does lead to a lot of patients needing further surgery in the future. I avoid that by looking at all four parathyroid glands during that one operation, so it’s a one and done procedure. 

Dr. Eric: 

Thanks for bringing that up. That’s really important to know. If a surgeon relies on finding it on a scan, and it’s there, but it just doesn’t show up on the scan, then that person will be continuing to have the symptoms associated with elevated calcium levels, hypercalcemia. Eventually, they will probably get the surgery when they get a second or third opinion. 

Dr. Deva: 

They find another surgeon, yeah. 

Dr. Eric: 

Exactly. You shared a lot of information, Dr. Deva. Is there anything else I should have asked you that I didn’t ask you? Any last words that you have for those who might be suspecting that they might have an issue with the parathyroid glands? 

Dr. Deva: 

I think that’s covering a lot of it. It’s a lot of information in a short period of time. If your fans don’t know much about the parathyroids, it’s overwhelming.

My advice to all people is to get your own medical records. Get your lab results. Look at them yourself. If you’re having symptoms, get a second opinion. Read through your results yourself. Do your research. 

Some doctors don’t like patients looking up their illnesses on Google. I’m fine with it. I think that’s great. You can learn a lot online and through reading. A lot of my patients figure this out themselves because they’re really tired and have headaches every day and can’t figure out why. They finally get their lab reports themselves and see that their calcium is high, and it has been high, but nobody has mentioned it. Then they finally find me online and get treated for it and feel better. 

It’s one of those things where your doctors may miss it. This is one where they often don’t take it as seriously, or they will give a “wait and see” attitude, to just watch it over time. You really need to take control of your health. Remember that nobody is going to care about your health as much as you do. You need to advocate for yourself. 

That is definitely true with Graves’ as well. There are some things we learn for Graves’ that I have learned are not true and disagree with and have changed my practice based on that. 

Take control of your own health. 

Dr. Eric: 

Thank you so much. Where can people find out more about you? 

Dr. Deva: 

My center is Southwest Parathyroid Center. Go to SouthwestParathyroid.com to find me. 

Also, I have my own Facebook page and answer a bunch of questions there. 

You can go to ParathyroidQAndA.com, where I answer a lot of questions, too. Any question about parathyroid disease. 

Dr. Eric: 

Wonderful. Thank you so much, Dr. Deva. Really appreciate you taking the time to talk about the parathyroid glands, hyperparathyroidism, and Vitamin D. 

Dr. Deva: 

Sure. Thank you for having me. If people have questions, they can always reach out to me through my website.

 

Recently, I interviewed Dr. Christine Smith, and we talked about exploring the biochemistry of injury and how this relates to thyroid health. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with Dr. Christine Smith, as we are going to be discussing three types of injuries that can play a role in the autoimmune thyroid experience, be it you have Graves’ or Hashimoto’s or probably even a non-autoimmune thyroid condition. 

Let me go ahead and dive into Dr. Christine’s bio: Dr. Christine Smith is a functional medicine practitioner and doctor of chiropractic with a background in cognitive neuroscience. She specializes in holistic injury recovery and optimization to help active people come back stronger, recover hidden injuries, and prevent reinjury. She does this by teaching clients how to use recovery time as a gift to restructure lifestyle priorities and become their own health authority through education rather than medication. Thank you for joining us, Dr. Christine. 

Dr. Christine Smith: 

Absolutely, thank you for having me. I’m excited to be here. 

Dr. Eric: 

I’m excited to chat with you about these injuries. When talking about injuries, I think a lot of people will think of just physical injuries, but I think this is going beyond that, and that’s why we’re talking about three different types of injuries.

Before we talk about this, can you get more into your background? How did you decide to focus on helping people with different types of injuries? 

Dr. Christine: 

Yeah, absolutely. I feel like that’s a deeper question than average. It came through a journey of my own experience and of understanding the power of the mind and healing, and the power of energy and understanding the frequency that your body is putting out. 

In chiropractic, we talk a lot about the tone of the nervous system. I consider it like an instrument, and that’s how I talk to clients when I do body work. It’s like tuning an instrument, making sure there are no sharp points or flat points, bringing everything back to harmony, and understanding the mind/body connection. 

That’s how I got the specialization in cognitive neuroscience. I had my own experience with a lot of stress and anxiety, and my chemistry was off. No one had talked to me about diet and lifestyle. I was really confused, following the conventional methods, and it was getting worse. I saw this body worker who did some touch therapy and reset my nervous system. After that, I had this shift in my perception of the world. For the first time in 20 years, my system had exited fight or flight.

It was this whole new way of being. You can almost feel it in your cells when something like that happens. It’s like you have been at a loud concert, and you walk out, and it’s silent. You have this shift. Understanding those things made me realize there are different kinds of injuries. 

Also, in chiropractic philosophy, we talk about thoughts, traumas, and toxins. These are the things that stress your body. Thoughts are general stressful thoughts. Now, it’s really different than when we were being chased by tigers. Now that tiger is a bill or an exam or a work project or an upset partner or friend. Those things are ongoing and chronic and go over time. 

We have this big stressor over time that is coming from our own mind. It literally changes the chemistry of the body. A divorce or losing your home, that is a mental injury. It creates a really similar cascade biochemically as breaking your leg or tweaking your shoulder or hurting your lower back at the gym. 

There is also a chemical component. All the toxins that we deal with in our environment and all the things we can be exposed to, all of these add up to what’s called allostatic load, which is the overall capacity for your body. If you have a bunch of mental stress going on, you won’t have as much capacity to get injured or heal quickly or deal with a chemical exposure. If you just had a big chemical exposure, you will have no emotional resiliency to deal with the stressors in your life.

That is how I explain things to people and why I got into understanding things through injury. If I can help people understand the cascade that happens in your body with a cellular injury, this is how we prevent disease. If we can catch it early and allow the cell time to heal and recover, just like if you tweak your back at the gym, you won’t deadlift the next day. It’s the concept of giving the body to recover. Each of these injuries requires different kinds of recovery. Depending on what’s going on with your life and which one is most prevalent for you, that tends to change my approach to care. 

That is how all of this came into being: understanding how physiology works and then going through my own experiences in my life, where trying to approach things from a single point of view just wasn’t working. We have to take into consideration all of these other modalities that exist and understand that all of our chemistry on a personal, custom level is different, and what’s going on in our life is different. You can have two people who just went through the same intense mental stress experience at work, but one of them is also dealing with a mold exposure at home. A different one also just hurt their shoulder. They are going to have different responses and different capacities for dealing with it. 

That’s a good summary of an answer to that question. Let me know if I can expand. 

Dr. Eric: 

I think you did great. Obviously, the shoulder injury would be an example of a physical injury. The exposure to mold would be more of that cellular injury. 

Dr. Christine: 

A chemical injury. 

Dr. Eric: 

Same thing with stress and other types of trauma as well. 

Dr. Christine: 

Stress and trauma, I consider them mental injuries. It’s happening on a biochemical level. All of these are happening on a biochemical level. 

If we really break it down and get a little nerdy for a second. When I was studying biology, I realized that in order to understand biology, I had to understand chemistry. In order to understand chemistry, I had to understand physics. To understand physics, you have to understand quantum physics, which leads you back to energy and frequency. Really everything is frequency. All of it comes down to that. 

If you understand chemistry in the way molecules and atoms work, they work with electrons in certain fields that are called valence shells. Depending on the organization of those energetic particles, that’s how you get matter or sound waves or the visual light spectrum or anything tangible versus not tangible. 

Energy and frequency are what make up matter and the state of that matter. If we have thoughts, that is frequency and energy coming for our neurological system that is being turned into chemistry. If we have a physical injury, that is two pieces of matter interacting to change matter because of the force of the frequency they interacted with. If we are dealing with chemistry, that is a certain chemical organized into a certain pattern that emits energy that affects other molecules.

This is why frequency medicine or things like meditation can affect a physical injury. When you start diving into this world, you understand that our modalities of care are so far beyond a pill. I think that’s really important for people to understand. If you’re just looking for a pill to fix your ill, it usually doesn’t always work out the best. 

I will find when I am working with people in care, if they have been through some kind of mental injury and are coming in with physical ailments like gut, because gut is tied to everything, if I start giving them a bunch of nutrition and supplements and capsules, and they are still in a mentally injured state, their cells are in a cellular danger response. They’re almost stiffer. The membranes change when our cells are in that energetic frequency state of a cellular danger protective response. We can’t absorb nutrition correctly because our nervous system isn’t in the right state to send the correct signals to the cells to absorb and utilize it. 

For that client, I start with physical body work to get their nervous system tuned and toned, so it’s sending the right frequency signals to their cells, so they can absorb nutrition in order to heal. If I just give that patient nutrition, they might get better, but we usually hit a plateau. 

If I can get my clients working with their mental game, and their mental stress, which I find is a huge component of pretty much any autoimmune condition, and it’s very well dived into the book When the Body Says No by Gabor Maté. It’s this concept of a mental injury that is creating a chemical cascade can actually contribute to your autoimmune reaction because if your mental state is that you are in a state of defense against your environment or the universe, your immune system responds and goes, “I should be on defense, too.” 

If we can help people understand you have to address your mental state and bring you back into a state of feeling safe in your environment, and then we have to address your nutrition or toxin component, what’s floating around in your system, then we can address the physical component of how all of those affect that. That is the key to healing. 

Dr. Eric: 

Awesome. Just to summarize those three different types of injury: There is physical injury, mental injury, and biochemical injury, which is not exactly the same as mental injury. 

Dr. Christine: 

Yeah, that’s how I think of it and how I explain it to clients, so we can understand we are always addressing the chemistry, the mental output that is affecting the chemistry, and the physical impact from the environment. 

Dr. Eric: 

How does this relate to inflammation? With inflammation, if you have physical trauma, you can get inflammation. If you want to talk about the difference between acute and chronic inflammation. With biochemical injury, you can also get inflammation. I’m also thinking that with mental injury, you could also get inflammation. If I’m wrong, correct me. If you could elaborate on that. 

Dr. Christine: 

You are so right. Step two of everything we were just talking about. Everything we were just discussing is the insult, the activity that instigates a response in your body. Inflammation is the response. It’s a healthy response. We’re supposed to have it. It’s how our cells repair themselves and rebuild. 

Chronic inflammation is a dysfunctional response. We can absolutely get this from a mental injury. 

Let’s use a real-life example. Let’s say that your dog passed away. Then you went through a breakup or a divorce. It’s all adding up. You’re mentally stressed. Then you get into a fender bender. You get that nasty whiplash. “Ugh, I’m fine, whatever.” You’re dealing with the car, with insurance, with the divorce. All of a sudden, you get hit with some virus. Now you’re sick and dealing with it. Or even a mold exposure in your home. You get some kind of environmental insult. We’ve had emotional, physical, and now chemical. 

All of a sudden, your health just tanks. You don’t understand what’s going on. You’re feeling bloated and have brain fog and can’t sleep and have headaches and are feeling sluggish. “What is wrong with me?” This is happening over the course of time. 

Before that, you probably had some other stressors. Maybe you were in school or had a huge project at work that was on your system. Or you go through societal stresses that have been happening over the last few years. Those accumulate into this as well. 

This is how we hit that wall of our injuries. All of this comes back to inflammation because that’s how our body responds. We have that original stressor of- Grief really is what those situations are. Grief is an emotional injury, and that can come in many forms.

When we have this emotional stressor, we put out an inflammation response. In that inflammation response, part of what happens is just our normal immune response: our tissues become more permeable. This is how our immune cells move through the tissues to repair the site that needs it or respond with healthy, acute inflammation. When this happens, we can also get some gut permeability. Let’s say we are really stressed out. Now we’re eating things that maybe aren’t totally great for us because they’re comfort foods. Our gut’s permeable, and it’s leaking through while also feeding our bad gut bacteria.

The other part of an emotional injury that people often don’t realize is there are dysbiotic Gram-negative—meaning they put out nasty chemicals—bacteria in our gut that feed and grow when your stress hormones are present. They actually have receptors for things like cortisol. That is Yersinia, E. coli, and stuff like that. When you’re stressed out, you grow bad bacteria in your gut. And your gut’s leaky. And now you’re maybe eating a bunch of gluten, which acts like a rake on the soft tissue of our gut and creates holes and irritates the gut lining. Then this stuff starts leaking through. Then it starts going into our blood stream. Now we have what’s called a subclinical level of endotoxemia, meaning we are accidentally poisoning ourselves in small amounts from the inside out.

Our immune system freaks out appropriately because all this stuff is in the bloodstream that’s not supposed to be there. Now we have a hyperinflammation response. In this, our body is trying to take care of these things, but we get a secondary injury from the immune response. When you have bad guys on the battlefield, you go take care of them, but the battle damages the battlefield. Now our immune system responds by trying to clean up the battlefield. It sends a whole bunch of neutrophils and acute responders, and that’s part of the Th17 pathway. 

All of these responders come, and they are trying to heal the area. In doing so, and still fighting off the bad guys, they’re releasing this chemistry to protect us that is accidentally creating more damage to the area. We get another immune response of more acute responders coming to the area to repair it while also accidentally damaging it at the same time. We get stuck in this cycle of chronic inflammation. Our immune system is trying to repair us, but it is accidentally damaging us in an effort to protect us from our environmental exposures. That is how we get stuck in a state of chronic inflammation.

If we can’t move out of inflammation and into the stage of what’s called proliferation, where I call it assimilation, meaning building stuff and repairing it. Then we move into remodeling, which is like testing it out and stressing it in a good way and making sure the tissues are strong. If we can’t enter into that stage, we stay in that inflammatory stage, which is essentially a breakdown stage. Whatever area this is happening in, that organ is going to start to break down.

This is why different people can have completely different responses to a very similar exposure. What is your Achilles heel? What are your genetics? I don’t consider genetics fate. I consider them blueprints that we have tendencies towards. We have an environmental exposure activate them, including stress. Stress will activate dormant genetics. With these, this is how we get the outcome of whatever is happening to our body, which might be a thyroid condition or gut condition or anxiety. 

When I had my stresses, I had no idea it was coming from my gut. I had no gut symptoms. My gut symptoms showed up in my brain. Your gut symptoms might show up in your thyroid. Someone else’s gut symptoms might show up in their liver, and they have problems detoxing. If you have genetics where you have problems detoxing, and you get this environmental exposure, it will be a much bigger burden on you than this person who has different detox genetics. That is why some people are super affected by mold, and others aren’t. 

That is how inflammation plays into this whole game. It’s a piece of everything. It depends on if our body can make it through a healthy injury cycle with that cell, or if that cell gets stuck in a state of inflammation and breakdown. 

Dr. Eric: 

You gave a lot of good information there. I like what you said about the absence of gut symptoms doesn’t rule out a gut problem. I’ve come across many people over the years with no gas, bloating, pain, and regular bowel movements, and still, it is possible to have a leaky gut in that situation. It’s still possible to have dysbiosis in that situation. 

You also mentioned the Th17, which is associated with autoimmunity. If someone is stuck in that chronic inflammatory cycle, that can set the stage for different autoimmune conditions, not just Graves’ and Hashimoto’s, but MS or RA. 

The example you gave, a lot of practitioners might just focus on the gut if they realize that the person has a leaky gut, but if they’re not addressing that mental injury, let alone the physical injury, because you gave an example where someone had all three, a lot of times, as functional medicine practitioners, we’re just focusing on that cellular component, that biochemical injury component. As you mentioned, you really need to take a whole-body approach. 

Dr. Christine: 

Absolutely. Just in a short way of saying it: If your mind is in a state of feeling like it’s under attack, or another way of saying it is a victim mindset, your cells are going to be in a danger response, which means they are not going to be in a healing response. They have to be in one or the other. They can’t do both at the same time. That is why getting your mental game corrected I think is just as important as any medication. Your brain is the most powerful drug you will ever have. 

Dr. Eric: 

When it comes to addressing that, especially the mental injury, is it more than just blocking out time for mind/body medicine, assuming there is at least a component of that? In preparation for this episode, I listened to some of your other interviews, and you’ve spoken about meditation. I’m guilty of using it broadly, too. I heard you talk about different types of meditation. I also wanted you to talk about that. It’s a two-part question: What do you do in general, maybe besides meditation? Also, if you could elaborate on your definition of what meditation is. 

Dr. Christine: 

That’s a great question. One of the easiest ways to define meditation that also identifies the purpose behind it, which I think people talk about these different ways to do it and what it looks like. It’s time for your body to feel safe and enter a creative state, and a building state, and a repair state. We have to make that time to feel safe. 

That can come in a variety of different forms. It can be a walking meditation. It can be a sport you like doing. It can be sitting on a cushion. It can be doing it in a group. It can come in a variety of forms. All of them have different benefits. 

If you’re an antsy person who cannot sit there for 15 minutes. “This is a waste of my life.” We should work on that perspective because it’s self-care. You’re going to the gym for your brain. When you sit down, and you have that anxiety, that is the point of meditation, is facing it and sitting with it and realizing that it’s not you; it is separate from you. It is usually the energy of society putting these burdens on you that make you think that self-care is a waste of your time. 

If you can start to sit there and be curious about it, then you start to see these mental patterns you get caught in. No wonder you’re stressed out all the time. “I think self-care for 15 minutes is a waste of my life. Okay, how can I shift my perspective on this?” 

When you start to become conscious about your own thinking patterns, you can shift your perspective. That perspective is what has to shift for you to feel safe. You can really do this in any environment. That is the whole idea of Victor Frankel’s book Man’s Search for Meaning. He wrote that from a concentration camp. It’s this book about the experience of your perception in whatever you’re in. There is a lot of different approaches to it.

I really love Joe Dispenza’s work. He is leading the forefront on research in meditation and how you can literally change your entire gut microbiome in seven days as a novice meditator with no other changes in your life. Just from meditation. Pretty darn cool. They’re even showing that in the blood of advanced meditators, they produce proteins that prevent viruses to enter cells. All of this research is being peer-reviewed and going through all the things to get published. It’s pretty phenomenal research. 

The idea is when you go into meditation, and enter this state of safety, you completely change the chemistry you’re putting out. Maybe you’re doing that on a walk. Walking meditation can be really powerful because you are practicing this state with your eyes open in your active waking life. You can go meditate for 20 minutes and feel really great in the morning. “Ah, this is so nice.” You open your eyes and go back to your old patterns immediately. Then the rest of the day, you’re in that stressed state. 

Your meditation is not totally gonna matter. It’s nice. It’s a Band-Aid. You have to practice it in your life. That’s the idea. It’s just like you go get fit at the gym, so you can do activities in your life. You don’t get super fit to sit on the couch. We get fit in our mind, so we can apply it to our life. When you realize you are slipping back into your old patterns, that is when you mentally snap the rubber band on your wrist. “This is what I told myself I wanted to feel today this morning.” You choose your emotions throughout the day.

That is another component of meditation: setting time aside to practice how you want to feel, so it’s familiar to you, so you can activate those neural pathways through the rest of your day. It’s this choice of how you want to feel in your life.

I had gotten into that work for many years. I slipped out of it. This happens to everybody. It’s a lifelong practice of coming back to yourself. That’s another way I describe it to people. it’s simply coming back to you and who you choose that to be. Shaking off the energy of everything else and everyone else. Figuring out your own true core center. Sometimes, when you really dive deep into it, you realize that you doesn’t exist. We’re all just part of this energetic field. Essentially, little pieces of the universe experiencing itself. That’s when you dive into the more existential component of that meaning for life. 

The way I really got into this is I was that person in my own form that we were talking about earlier: huge emotional stressor, huge societal stressor, then a toxin exposure, and then someone going too hard on my gut with supplements and my gut getting messed up. All of a sudden, my health just shut down. 

I didn’t know about the mold exposure until later. I found it and realized it was the gasoline on the fire, which is usually what an environmental exposure is. Whatever fire is going on in your body, it pours gas on that fire and explodes it all. 

I became allergic to food and supplements. I was a functional medicine practitioner who couldn’t use supplements. That was a very frustrating time. In that, what can I do? My brain also wasn’t working at that time. 

I think the mental component of illness is something that isn’t always discussed, along with the concept of an identity crisis. When you’re a very active person, all of a sudden, something shifts dramatically in your life, and you can’t do the things that make you feel like yourself. That in itself is a mental injury and needs to be talked more about in health care, as well as the identity crisis of illness.

In that, I was like, “Okay, what can I do? I can’t exercise. I can’t eat healthy foods. I have been to all the other routes.” I turned to meditation. I went really deep into it. I realized that because of the accumulated effect of things that happened, I was in a state of not trusting the universe. I was in a state of defense on a mental game level, even though it was subconscious. When I took time with my subconscious and see my thought patterns that were coming up, I was able to realize the mental state I was in and work on it.

There is meditation where you are very focused on a certain thing, and you’re going inward and paying it really close attention. There is mindfulness. You take a raisin and feel every single indent of the raisin. It’s taking time to be in peaceful presence with whatever you’re doing.

There is meditation like Dr. Joe Dispenza’s work. I find it’s very much an expansion, going outward. It’s going so far outward with your energy that you forget that you as an individual exist. You connect with this greater field of energy in this place of complete peace. When you enter that state of peace, and they’re still coming to understand how all of this works. I don’t know if we’ll ever fully understand it. This is energy far beyond us that is really complex, and what created us in the first place. It’s going back to that state of oneness and sitting there and almost charging yourself with this healthy frequency from the universe and letting that imbue all the cells in your body, so they resonate at a healthier frequency. 

That might have been a bit of a long-winded and complex answer. This is why I love it so much. When I finally realized that and did this work, my immune system calmed down. I was able to eat food again and use supplements again. It took me a couple months. Nothing else had worked. I was at the point where I’d lost a bunch of weight, and my hair was falling out. It was not great. That is what turned everything around for me and got me back to the point where I could use functional medicine to do the rest of the cleanup I needed to do.

I still go in and out of my practice. I try really hard to have a super good practice. It’s amazing because I know how good it is for me, but I still find days where I resist it. That resistance is my old patterns. It’s like we can almost get addicted to our emotions of anxiety because they’re familiar. The unknown is scary. 

That is the idea of meditation. It’s like sitting in this unknown place and becoming comfortable with the unknown and not trying to predict anything in the future, so in your own life, you can be comfortable without being in anxiety. If you fall out of your practice, you’re probably being affected by your old patterns. 

The #1 thing you need to do is go back and sit with yourself, so you can figure out what’s pulling you out and what you’re trying to protect. That’s really where they all come from. Your patterns are just trying to protect you. It’s time to go inward and feel safe and understand your own mind and patterns without the influence of anybody else. 

Dr. Eric: 

That’s really interesting. Usually when someone has food sensitivities to supplements, it’s usually coming from the gut. In your case, you didn’t focus on the gut, but you focused on the mental injury, which in turn helped with the gut, if I’m understanding correctly. 

Dr. Christine: 

That is correct. I didn’t have the option to focus on the gut. I couldn’t. That is where I gained a whole other level of respect for it. Understanding the capacity of the mental state to heal the body. Your body is amazing, and there are so many stories of people doing absolutely unreal things. 

There is a woman in one of the Joe Dispenza workshops who through meditation—and this is a single case, but this happened—regrew her ablated thyroid. Proven by imaging. 

Your body is capable of amazing stuff if you give It incredibly clear instructions. But you have to be very clear on what you want. You have to give instructions in energy, not words. Your body doesn’t understand words. If you just sit there and affirm all day, that’s not going to work. You have to work with the subconscious. 

There are different tools for that. Sometimes, you need help. I do a modality with clients called PSYCH-K. it’s a way to use neurological postures to imprint a subconscious belief in a way that your subconscious mind understands, and your body can respond. Your subconscious mind is 95% of the mind; it’s what runs the body. If your 5% up here is saying you’re healthy, but you’re not feeling it energetically, your body won’t respond to that. Energy and the feeling of it is the most important piece, which is hard and takes practice.

Dr. Eric: 

You said that it was called PSYCH-K? 

Dr. Christine: 

That’s one of many modalities. Bruce Lipton really likes it. He is another person who is mildly similar to Joe Dispenza; he has a book called The Biology of Belief. And Dr. Joe has a book called Becoming Supernatural. Both books are great places to explore these concepts. 

Dr. Eric: 

He has a number of different books. I went on Audible and saw that he has at least four or five. 

Dr. Christine: 

Yeah, Dr. Joe has four. I think he’s working on another one. Dr. Lipton also has a couple.  

Dr. Eric: 

Do you do any testing in your practice? Before I pressed the record, I think I heard you say that you either did AK (applied kinesiologies). I don’t know if you still do a lot of muscle testing in your practice, or if you do more functional medicine testing, or a combination of both.  

Dr. Christine: 

All of the above. Why would I not use a tool that’s present to me? I love lab testing. I think it’s incredibly important. I think it can miss things. I think understanding your tools is probably the hardest part of being a functional medicine practitioner. There are a lot of trainings where people can go through and understand functional medicine concepts, which is just lifestyle concepts. If you don’t understand physiology, the labs, and the supplements, you’re at a loss.

There are a ton of labs I use. It depends on the case. Ideally, I’d love to see all the labs all the time. You have to do what’s realistic for people. Depending on what comes up in a case, I will prioritize labs in a different order. 

I also like actionable labs. There are a lot of labs you can do that tell you what’s wrong, but they don’t tell you how to fix it. I really like labs that show me what’s going on with you nutritionally. I also really like things that show me inflammation levels. You can see those on a classic blood lab with CRP and ESR. I consider things like cholesterol and homocysteine as inflammatory markers, which I think is a little non-traditional. It tells me that the system is off. I consider homocysteine a much more important cardiovascular/inflammation marker than cholesterol. If you have high cholesterol, it’s telling me your body is trying to repair something. What is your body trying to repair? I need to find that thing.

I prefer functional tests. I’ll run food sensitivity tests. Even though they change, and there are arguments about them, I want to know the #1 immediate thing I can do that is free for you to get your inflammation down. Rather than me putting more supplements into your mouth, it is me helping you take poison out of your mouth. Things your body is reacting to poorly, which is not always something you’d expect. 

Sometimes, it’s foods you don’t expect, like eggs. I love eggs. Eggs are great. They have great nutritional quality. I find a lot of the time in inflammatory responses in autoimmune people, they have a sensitivity to eggs along with classic ones like gluten, dairy, and sugar. I’ll see what the immediate thing we can change in your life is to start getting inflammation down while making up the rest of your plan.

I also love to run gut tests. There are labs that are run, like classic gut tests that look at infections that might kill you. I’ll make sure you’re not having some horrible infection. I like to look at the subtle things. Do you have any parasites that are lingering that we need to take care of? Those can get missed on those labs. I’ll come back to why I like muscle testing here.

I also like looking at the gut biome and understanding the distribution of your gut bacteria, getting really specific on what probiotics are right for you. Or if your gut is even ready for a probiotic. That’s a mistake people make. They think probiotics are the answer, and they will take a bunch of them. They’ll wonder why they’re bloated. 

If you take probiotics too early before your gut lining is ready, you can actually cause more inflammation. People forget that they have inflammatory effects. They are a killing agent that knock out bad bacteria and take their place. Understanding the order of operations of things is where the labs can come in. How inflamed are you? Do I need to work on your gut lining first? Are you ready for a probiotic? 

I’ll run other labs like autoimmune or hormones. Sometimes I will look at neurotransmitters, but I often find that’s tied back to gut. 

It depends on what’s going on with the client. I think functional lab testing is valuable. I had a client the other day who is struggling with some cognitive decline. Their neurologist was like, “Let’s put you on this Alzheimer’s medication.” I asked if I could run some functional tests first. I ran a toxin screen and a gut panel. He had an amoeba and high levels of lead and mycotoxins. Okay, let’s work on getting these out of the system first and see if the cognition improves. Then you can decide what to do with the conventional route. He might not even need the medication. He might have brain fog because he has a bunch of infections and lead he is dealing with. We are going to address those first. That’s an example.

Muscle testing is highly undervalued. I know it’s argued in different communities, which I understand because it is more of a subjective method. It’s working with the electrical neurological system of the body. It’s a way to essentially ask the body questions simply by learning how to speak its language. Lab testing is like translating the body’s language into something we can read. Muscle testing is translating our language into something the body can read.

It’s using a strong muscle as an indicator because your muscles should be able to be strong. Now, if you are holding your arm out, and someone is pushing down on it, and then you step on a tack, you’re not going to be focused on your arm. You will be focused on the tack. The arm will go weak. That is the concept of muscle testing in a simplified way. Stress a piece of the body, see if the strength of the body changes. 

This can be done in a number of different ways. You can do direct wiring testing. If I have you put your shoulders out, and I push down on your elbow while you turn your head to one side, and that arm goes weak, it lets me know that your C5 nerve is disrupted, and I should probably address that segment of your neck. That’s a direct way to look at it.

If we are doing it with nutrition, if I have you put your arm out, and it’s strong, and then I push upward on your stomach, and it goes weak, that tells me that your stomach has slid above your diaphragm a little bit, and we might need to pull it down. That is the idea of a hiatal hernia. I can’t tell you how many hiatal hernias that are non-surgical. People have had reflux and GERD for 10 years, and I pulled their stomach down, and it’s gone. Nobody does this work anymore. I don’t understand why. 

Touching your organ, if you are trying to heal an organ, touch that organ. Massage it. Love it. It’s the concept of where attention goes, energy flows, and blood follows. Give that organ love and attention with physical touch. Physical touch has also been lost from care. When you are working with someone, you are also close to them. You are physically present. That kind of energy, that kind of space-holding also has its own healing component. 

Then you can get more complex and subtle with muscle testing. You can use it to address energetic fields. If you can use that indicator muscle and bring a supplement into someone’s field, or you can have them put it in their mouth, you can see if that supplement weakens a body or strengthens it before they even have to swallow it. That’s cool. With sensitive clients, I love this. It’s a way to get very specific on what supplements their body responds to versus not, instead of a guessing game of trying something and seeing how it goes. We can get specific that these things will be okay for their system.

You can even do it with mental thoughts, which is how PSYCH-K works. If you bring up that stressor mental thought to your system, your body will respond in a way that’s weaker because it’s a stressor to your system. Then you can go through thinking patterns and subconscious thoughts and figure out which ones the body is strong to and which ones the body is weak to. Then you can figure out what the actual thing is that’s stressing out your system. 

I was just working with a client the other day who is working on fertility. We are helping her brain get on board with this. We went through a couple statements of, “My body is healthy enough to become pregnant.” It was strong to that. We finally got to, “I’m not too old to become pregnant. I’m young enough to become pregnant.” That’s what her mind was weak to. That’s what we worked on.

If you can help the subconscious mind get over these little hiccups that it has, then that’s a component of healing for the body. That’s how you can heal a physical ailment, chemical ailment, or mental ailment. I won’t even say “ailment,” but a thing you’re working on, a stress point. 

That’s where muscle testing is quite beautiful. Labs, we check every couple months because they’re expensive. Muscle testing, we can check all the time throughout our appointment. Different practitioners have different approaches. But I have a kit with vials that have been energetically imprinted with the resonance of certain enzymes in the body. We can literally sit there, and I can muscle test through an entire blood panel through the energetic vial kit in our office, which is great for when people are financially restricted.

Again, it’s a subjective measure, which is when I love to back it up with labs. It’s pretty cool when you do muscle testing and go through everything subjectively. Then you run the lab, and it’s all the same stuff.

For the skeptics out there, I understand. I come from a research background. I worked in many research labs. I’m all about data and numbers. When I was learning this, I remember saying to a friend, “I don’t feel ethical using something that I can’t always fully explain to my client.” They say, “If you have something that works, and you’re not using it because you can’t explain it, that’s unethical. You’re depriving your client.” Ooh, touché. Okay. With that, I became more open-minded. Now I have seen it work over and over again. 

That is ultimately what made me go to chiropractic school instead of going to school to become a neurologist. I worked in this integrative practice where he was essentially using muscle testing components for functional medicine. I watched people who had been sick for years get better in three months. I needed to understand what he was doing. That led me to chiropractic school, as he was a chiropractor. 

Chiropractic school doesn’t always cover this stuff. That was stuff I learned outside of it. The concept in chiropractic school is the mental component that goes with all of this, which is constant vitalism instead of pathology. Our conventional model works in pathology, which Is let me find what’s wrong and shut it down. Chiropractic and muscle testing and these kinds of concepts work more in the realm of vitalism, which is let me figure out what’s right with your body and how to support it. 

Dr. Eric: 

I don’t practice AK, but a number of years ago, I went to a conference where they were pretty much teaching that. An instructor said that when it comes to muscle testing supplements, it’s a lot more accurate if you do put it in the mouth. I wanted to get your opinion. A lot of practitioners will just have their patients hold the bottle and then do the muscle testing, probably because it’s a lot more convenient. You’re not using up supplements that way. What are your thoughts on that? 

Dr. Christine: 

In the very traditional AK training, you should put the supplement in your mouth, or have it touching the skin in some way. I have small vials that have supplements in them, so I will have that person hold that vial. Sometimes, we’ll take the supplements out if I am not getting a clear read. 

I have seen enough practitioners who are incredibly successful at helping people in what they do that don’t put it in the mouth where it still works. To me, that all comes back to the concept of the energetics and frequency, and everything in the world has its own bio field, including that supplement in your hand. You’re testing the bio field. As long as it’s not being blocked by some kind of material, I think you’re usually in the realm of it working. 

It’s always best and most accurate to put it in the mouth. I have seen both of them work though. 

Dr. Eric: 

Very cool. You covered a lot of information here. Is there anything else you’d like to chat about? Anything I should have asked you that I didn’t ask you? 

Dr. Christine: 

I love your audience. I love thyroid. I think it’s a really cool organ. I know when you’re going through a health issue, it’s really easy to be angry at your body. If there is one thing that I really want people to work on, it’s this concept of seeing your body as your best friend that just got injured. 

If your best friend just twisted their ankle during a marathon, you wouldn’t be mad at them for running slower. You’d be encouraging them and helping them and giving them water. It’s this idea of seeing your body as this friend that’s going through a hard time. 

All of a sudden, your energy shifts from being mad at your body from not working to, “Oh my gosh, I’m so sorry you’re going through this. How can I support you?” That energetic shift is how we start to create the biochemical shift. 

I find the thyroid intriguing because I consider it the sentinel of the body. It’s this very sensitive organ that is essentially your fuel manager. If something is off with your energy and your fuel, it’s a check engine light. It’s an indicator of go look at the rest of the body and see what might be irritating this very sensitive organ. Versus throwing pills at the organ and thinking it’s working now. 

We have to remove the irritant and the instigator, which is where it all comes back to gut and infection and environmental and mental stress. You could have done all the things and the detoxes. “My house is completely free of any environmental toxin. I do everything cleanly.” You still live in this mental state of being judgmental and feeling under attack by everybody and resentful toward other people in your life. That’s just as toxic as any cleaner or hormone-disrupting BPA chemical. It’s working with that component and understanding your thyroid is this indicator. 

That’s where the deeper work can really start. I’m a huge fan of retreats and making time for yourself to go and do a deep dive with yourself. It’s really hard to do those deep dives into your day-to-day lives. Taking some time for yourself, even if it’s two days, to go on a yoga retreat or health and wellness retreat or an energetic deepening spiritual awareness retreat. There are tons of these. Take some time to explore that side of yourself if you never have. The thyroid is very telling.

Also, if you’re working on your thyroid and doing all the medications, and it’s doing okay, but you’re still exhausted and can’t figure out why, check out your mitochondria. It’s what the thyroid works on. The signal from the thyroid goes to the mitochondria to produce energy. If the signal is going out, but the factory can’t receive it and produce the outcome, that’s the thing that needs to be checked out. 

Understanding that your body is this beautiful, dynamic system. All of these little symptoms or things you might be dealing with are just indicators. That’s how your body speaks to you. Starting to have this relationship with your body, “If you’re talking to me, something’s wrong. How can I love you?” Shifting into that relationship instead of being mad at your body for its illness. I think that’s the last thing I make sure people get from this. 

Dr. Eric: 

Wonderful, thank you. How can people find out more about you, Dr. Christine? 

Dr. Christine: 

I provide a ton of free education online. They can go to my social media, @DrChristineSmith. I have a YouTube as well, where there is a bunch of free education. Depth Wellness is my channel. That’s also my practice. 

If you want to learn more about services, or explore other things, because I try to provide things at every level for people. If you want education, go check out those resources. If you want a deeper dive, I have some online courses and guided meditations I created for my clients. I use those as packages for people. Sometimes people just want the meditative component. 

There are online courses I do. I will run another group course in February. It’s five weeks where I guide people through not just how to cleanse your body, but how to cleanse your mind and environment at the same time. Understand the physiology behind how this works. Create a new relationship with your body. I call that one Reclaim Vitality. There are other options. That website is DepthWellness.com. That will have links to everything else that you can check out. Reach out any time. 

Dr. Eric: 

Appreciate you taking the time to discuss the different injuries. I learned a lot. I’m sure the listeners did as well. Thank you. 

Dr. Christine: 

Thank you. Thanks for having your podcast. I think it’s important for people to have resources to learn about themselves.

 

Recently, I interviewed Dr. Wendy Myers, and we talked about the impact of environmental toxins, especially heavy metals like mercury, on thyroid healt. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am very excited to chat with Dr. Wendy Myers, as we will be discussing the impact of environmental toxins on your thyroid health. 

Let me go ahead and dive into Dr. Wendy’s bio: She is a naturopathic doctor and founder of MyersDetox.com. She is an anti-aging, heavy metal detox, and bioenergetics expert as well as the #1 best-selling author of Limitless Energy: How to Detox Toxic Metals to End Exhaustion and Chronic Fatigue. Dr. Wendy is the host of a top 100-rated podcast The Myers Detox Podcast, about protecting your health with detoxification. Thank you so much for joining us, Dr. Wendy. 

Dr. Wendy Myers: 

Thank you so much for having me. 

Dr. Eric: 

Very excited to chat with you about toxins and the way they impact the thyroid. You could start out with your own thyroid-related story. If you could give your background and how you started helping others focusing on helping people with environmental toxins. 

Dr. Wendy: 

Right after I had a baby, I noticed I was having a lot of different issues going on. I made the mistake of going vegan for about six months, and I had a lot of stress prior to getting pregnant. All of these stressors caused me to eventually develop some thyroid issues. A lot of people who are vegan inevitably have thyroid issues. 

Heavy metals and toxins play a huge role, especially mercury, in promoting thyroid issues. I’ll get into that. I was very mercury-toxic because I had a lot of fillings removed when I was 21 improperly. I think that knocked my thyroid out and caused depression and gut issues and many other things that I dealt with in my 20s. 

I was living this healthy lifestyle after having a baby. Then my health took a huge nosedive. I went to the doctor and found out for the first time I had low thyroid function; I was hypothyroid. All my other hormones were low as well. Toxins interfere with our sex and stress hormones as well. 

One of the big reasons so many people have thyroid issues, which we’ll talk about, is because of pesticides and heavy metals and mercury. I’ll go into detail about the exact mechanisms by which heavy metals cause thyroid issues. 

I was very dismayed to learn I was having all these different issues, that my body was going awry. It’s so easy for people to mark these things up as getting older. Your thyroid or other hormones become imbalanced. It’s not just because of aging. That can certainly play a role in it. But it’s more the toxins we’re exposed to, and our diet and lifestyle as well. 

Dr. Eric: 

It’s safe to say that’s why we have a greater incidence of people with thyroid /autoimmune thyroid conditions. The environment is not getting any better when it comes to these heavy metals, pesticides, and other toxins.

Dr. Wendy: 

No, it’s only going to get worse. We have 140,000 chemicals that have been developed right now. There are about 40,000 in use. That’s a lot. There are dozens of metals being drudged up around the planet for various uses. They get into our air, food, and water. They are being removed from the earth’s crust. 

Look around you. There is metal in everything you’re touching. More importantly, we’re breathing all this stuff in. The #1 way we become toxic is actually breathing. There is also chemicals in our food, toxins in our shower water. Even if you’re filtering drinking filtered water or spring water, you’re getting exposures in the shower. It sounds really depressing. We are getting exposed in a lot of different ways. 

There are different things people can do to remove these toxins from their body that are creating roadblocks to function in all the different organ systems, including the thyroid. 

Dr. Eric: 

Let’s go into some of the mechanisms as far as how heavy metals and other environmental toxins impact the thyroid. Even if you want to expand on that in the immune system, not just thyroid autoimmunity, but there are a lot of different autoimmune conditions like MS or RA. Environmental toxins have an impact on these as well.

Dr. Wendy: 

Most chronic health conditions will have a heavy metal or chemical as an underlying root cause, if not outright causing it. We can say that about diabetes or heart disease or high blood pressure or any kind of chronic health condition. There is a toxin that we have seen in the research that is contributing to it. 

As far as thyroid functioning, there are a lot of different metals like mercury, lead, cadmium, and nickel that reduce thyroid function in a few different ways. What they do is cause enzyme inhibition. The enzymes are involved in the production of thyroid globulin, which is the storage form of thyroid hormone. 

They interfere in amino acid absorption, so toxic metals like arsenic, aluminum, tin, thallium negatively impact the absorption of tyrosine in the gut. Tyrosine is required for the manufacture of thyroid globulin. If you have low tyrosine, you will have low thyroid globulin. If you take proton pump inhibitors, you will have the same problem with tyrosine absorption. 

We also have issues with energy production that is required for iodine uptake. Our thyroid hormones are made of iodine. If you have any toxins, which are all of them that interfere in mitochondrial energy production, you will have a problem taking in that iodine, if you even have enough. 

Most people are deficient in iodine. I take 15mg per day of iodine. Most people are not getting any iodine in their food. A lot of people are avoiding fish or not eating that much. They certainly are not eating seaweed. Where are you getting your iodine? People typically need to supplement with it. 

When we are talking about specific heavy metals, mercury is a huge culprit. It’s one of the #1 culprits in interfering with thyroid function. It has an affinity for the thyroid gland. Mercury gets stored in the thyroid gland. It can also take the place of iodine, which is a crucial component, the main ingredient in creating thyroid hormones. The T3 hormone, which is three molecules of iodine, and T4 molecule, which is four molecules of iodine. 

When the mercury gets into the thyroid gland, you could have a sensitivity to mercury. Your immune system could launch an attack on mercury, and your thyroid gets taken out as a side effect. We can see people losing thyroid tissue because their body is trying to attack the mercury. You can develop a sensitivity to anything in your body: any food, heavy metals, etc. You will have more increased symptoms as a result of that mercury versus the next person, who has the same amount of mercury but doesn’t have an immune response to it.

When we are talking about our pituitary gland, it’s like the master gland. It’s signaling to the hypothalamus to make more TSH, which tells our body to make more thyroid hormone. Mercury interferes in this feedback loop, telling the body to make T4 and then communicating that to make more TSH. 

In the hypothalamus, mercury can deposit in there. When this happens, the TSH manufacture can be inhibited. 

Additionally, in the blood, mercury can inhibit the conversion of free T4 to free T3. Mercury poisons enzymes like deiodinase, which convert free T4 to T3 in blood circulation.

That is a very small glimpse of one heavy metal and what it’s doing to the thyroid. This is not accounting for the dozens of metals and the thousands of chemicals. If anyone wants to do a deep dive on how chemicals affect the thyroid, I have 180 different research citations on how pesticides and other toxins affect the thyroid. It’s no wonder today that so many people are on thyroid hormones or have undiagnosed thyroid issues that are resulting in resistant weight loss, depression, and other issues related to low thyroid hormone production. 

All of this can apply to people who have hyperthyroidism as well. Different toxins can cause general malfunction of the thyroid, either high thyroid hormones or low thyroid production. 

Dr. Eric: 

Or they can impact the immune system, which most cases of both hyper and hypo are autoimmune. Most hypothyroid conditions are Hashimoto’s, and most hyper conditions are Graves’. The heavy metals, including mercury, can impact the immune system. That’s another mechanism. 

When you talk about mercury, are you concerned about both methyl mercury that is in fish as well as inorganic mercury, which is in silver fillings? Is there one that you’re more concerned about over another? 

Dr. Wendy: 

They’re all problematic. We don’t need mercury of any type in our body. The inorganic and organic are both problematic. 

What’s really more problematic is testing. A lot of testing doesn’t distinguish between the different types, so you don’t know which one to go after. Quicksilver Scientific has a great test called the Mercury Tri-Test, which will tell you about the different types of mercury you have. But that’s just one toxin. 

Testing is great. I recommend heavy metals testing. Sometimes, people have weird metals that require specific nutrients to remove them. Any kind of detox program is going to go a long way, like sweating or ionic foot baths or coffee enemas or liver supports. Minerals go a long way to removing a lot of the toxins that people have, regardless of what type of metal it is. There are different types of arsenic and mercury. We can all get them removed with a good detox program. 

Dr. Eric: 

I listened to a few of your podcast interviews and heard you talk about ionic foot baths. I do sauna regularly. Supplementation is something that I do and recommend. I can’t say I have much experience with ionic foot baths. Is that specific for heavy metals, or is that good for all different types of environmental toxins? 

Dr. Wendy: 

I like them because they are good for all different types of toxins. Plus they get rid of radiation in your body. Infrared saunas also kill cells affected by radiation, which is a big problem in our environment right now. 

I love ionic foot baths because they are easy to use, and anyone can use them. They don’t take up a lot of space. You don’t get sweaty and gross. I love infrared saunas, believe me. I love sweating. I love doing them. But the ionic foot baths are really easy to do, and I think people can be more compliant with them. You can do them while at your computer or watching TV. Little kids or sick people or old people can do them. Not everyone can do saunas or has the space for them. 

Dr. Eric: 

That’s a good point. I work with a lot of people who have hyperthyroidism. Some of them have an elevated resting heart rate, which is common with hyperthyroidism. They might not be a good candidate for sauna since that raises heart rate. They may want to wait until things are more stable before going into the sauna. 

I use the sauna now three times a week. When I was dealing with Graves’ and active hyperthyroidism, I wouldn’t have wanted to go into a sauna because my resting heart rate would sometimes get in triple digits. Definitely a believer in sauna. Thank you for that explanation with the ionic foot baths. 

Dr. Wendy: 

On that note, there is a lot of garbage out there. I really like the HEALTHandMED IonizeMe Maxx 5. You can do a code Wendy6, for a 6% discount. 

There is a lot of expensive foot baths and a lot of cheap ones on Amazon that are not worth even bothering with. You have to have a really strong one. Most people have to do 400 hours of foot baths on average. That’s a lot of time invested. If you get a really cheap one, you might have to do 2,000 hours. You will be doing it and not improving how you’re feeling or your symptoms and think it doesn’t work when it’s just the foot bath you bought. So you have to be careful with that. 

Dr. Eric: 

For someone who is a new patient or client, do you have them do the ionic foot baths every day? 

Dr. Wendy: 

It depends. Some people might not be able to handle every day. I would start with a few a week. I used to do two hours a day, but I have been detoxing for a long time. I have been doing stuff for 15 years. I wanted to get to my 400 hours as fast as I could. 

You also have to replete minerals. They do pull minerals out of you. Everywhere there is heavy metals, there is also minerals you could be detoxing, so you have to replete those for every foot bath you do. Take a bunch of sea salt and water or coconut water or something like that. 

Do it a few times a week. You can eventually work up to every day or a couple times a day, two in a row.  

Dr. Eric: 

It’s similar to a sauna. When I do sauna, I definitely replete minerals. I didn’t realize that with ionic foot baths, it’s the same thing.  

Dr. Wendy: 

Yeah, same deal. 

Dr. Eric: 

Thank you for that code. 

We focused on heavy metals. How about other environmental chemicals? How concerned are you about pesticides or herbicides? There’s glyphosate, flame retardants, and so many other chemicals. A lot of them do affect thyroid, at least indirectly. Glyphosate could affect the gut microbiome, which could in turn set the stage for Graves’ or Hashimoto’s. 

Dr. Wendy: 

If people really want to go in depth and look at the research, I have that article on my site, “The Pesticides and Chemicals That Impact the Thyroid.” That goes in deep. 

These chemicals in general poison enzymes, things like hydroxylase enzymes. That will negatively impact the ability of the body to produce all different types of hormones in the body. The glyphosate is essentially an antibiotic, killing gut bacteria. Different pesticides are very estrogenic and interfere in the production and balance and conversion of our sex hormones. All of it creates this domino effect in the body to weaken the body, our immunity, our hormone production; stress the body, the adrenals, the thyroid, our blood sugar balance. Every organ system in the body is affected, our neurotransmitter production, our brain function. It’s pretty devastating what all these pesticides, herbicides, insecticides, and other chemicals are doing. 

It’s not only what we’re breathing in the air; we’re getting it in our food. Even in organic food, 7% of that is contaminated with chemicals. We’re getting it in our beauty products. We have a lot of exposure. 

I think there is so many loved ones we know that are on five or more medications or are chronically ill and are not getting better. This is a huge underlying root cause that is not being looked at by the conventional medical community. It’s my passion and mission to educate the public, educate the medical community. 

The research I have done over the last 15 years, these chemicals and toxins are huge roadblocks to our organ systems functioning, huge contributors to so many health issues. It’s shown in the research that lead alone is responsible for 17% of all-cause mortality. This is a quote from Dr. Joe Pizzorno, who is on my Heavy docuseries that is coming out soon. 

I don’t think people understand the huge impact that heavy metals and chemicals are having on their health, their loved ones’ symptoms and outcomes. There are very simple, holistic, natural ways that don’t have side effects that people can do to dramatically improve their symptoms and outcomes for them and their loved ones and their family.

Just another example, diabetes, the #1 cause of diabetes is heavy metals and chemicals. Namely, arsenic. It dramatically interferes in our pancreas’ ability to control our blood sugar. There are a thousand other examples I can cite. It’s not just our thyroid that is being affected, though I can cite dozens of examples of mechanisms of how it’s being affected. 

When you look at the obesity epidemic, 2/3 of people in the U.S. alone are obese. There is so many mechanisms by which heavy metals and chemicals are interfering in liver function, blood sugar control, sleep, appetite, and gut bacteria that contribute to obesity and resistant weight loss. All the chemicals and additives in the food as well. 

With people who are dealing with weight issues, another passion of mine is communicating to people that it’s not necessarily your fault. It’s not just calories or carbohydrates consumed. There are a lot of toxins that are throwing a wrench into people’s weight loss efforts. It can be resolved and remedied, doing detoxification strategies. Not only for weight loss, but for so many other chronic health conditions as well. 

Dr. Eric: 

I don’t know if you have read the book Clean, Green, and Lean, focusing on the impact of environmental toxins on weight gain. I wrote an article a number of years ago on the term “obesogen.” Without question, for those who are struggling to lose weight, that is an excellent point. A lot of people focus on diet and exercise and won’t consider at all the impact of these environmental toxins. 

Dr. Wendy: 

One clue that toxins might be a problem is if, say, after I had a baby and was trying to lose weight, the amount of effort that I put in, going to bed hungry, working out 68 hours a week, injuring myself because I was pushing so hard, low carb, all the stuff I was doing. I should be an Olympic athlete if I was doing this in my 20s. I realized then something innately was wrong in my body. It wasn’t working how it used to work, and I was only 37 at the time. That is what propelled me to do all this testing, which is when I found out I had low thyroid function.

If you are struggling with your weight, and you are doing everything right, and you seem like you are killing yourself, you want to be looking at getting some heavy metal or chemical testing and doing some detox. I assure you, no one’s exempt. It’s impossible living on the planet we are on right now and not be breathing in or eating or showering in toxins every single day. 

Dr. Eric: 

I think your favorite test is hair testing? 

Dr. Wendy: 

Yeah, I love the hair mineral analysis. It’s really easy and cheap to do. Anyone can do it. I like to start with that. I usually will recommend the full picture, looking at hair, urine, and stool. Just a hair mineral analysis is enough to design a good detox program for someone that will work perfectly adequate for them. 

Dr. Eric: 

What are your thoughts on chelation therapy? I kind of know your thoughts, but I want for others to hear them. I have heard you talk about chelation on other podcasts. 

Dr. Wendy: 

Heavy metal chelation, like what a lot of functional medical doctors would offer for detox support, has its place for sure. If you go to your functional doctor, that’s what they will recommend typically. It’s almost like dropping a nuclear bomb on an anthill to get rid of it. It’s not the place that you start. 

It certainly has its use case if someone has a life-threatening heavy metal toxicity. If they have life-threatening mercury or lead toxicity, yes. We have to get it out of the body right away.

The problem with chelation is it doesn’t go deep enough. Realistically, you will only be able to do so many of those in a row. Maybe 10 sessions in a row. It will be very expensive. The body is not going to release heavy metals that it’s using. It’s not going to release heavy metals that it’s using for various things, like cadmium being used in the arteries to repair them, or in deeper places in the body, like the brain or the liver or in the bones. The chelation is not going to get to these deep, buried toxins.

What you have to do is facilitate the body’s natural ability to detox. It needs minerals. It needs magnesium. Any time you take a ton of calcium, you will displace and push lead out of the bones. That is just one example. If you take a ton of zinc, you will displace and push out cadmium from the body. That takes months, if not years. 

Chelation is not going to do that, though it does have its place. It’s not something I ever actually recommend to any of my patients, and I never have.

Dr. Eric: 

Balancing the minerals, correcting mineral deficiencies is very important when it comes to detoxification. You mentioned sauna, the ionic foot baths. How about diet? How important is eating a healthy diet? I don’t know if you recommend a plant-based diet, not vegan, but cruciferous vegetables. Is that not sufficient to support detoxification? 

Dr. Wendy: 

No, you can’t detox just with diet alone, definitely not. You can’t just detox with juicing. I try to drink one juice a day because it’s very mineral-rich. That’s another way to get a lot of minerals.

I recommend a paleo diet for the majority of people. There is a bell curve. Everyone is different, what diet they should eat. 

If you think about it, over millions of years, we evolved eating meat. There isn’t any denying that, no matter what ideation or saving the planet or other arguments for various plant-based diets. If we’re talking strictly along the lines of health, then it’s a diet including animal proteins, for not just the sulfur-containing amino acids in our liver, but also for the different types of fats that comprise the membranes of our brain. 25% of our brain is cholesterol. 

You are not going to fare very well over a period of time completely eliminating animal foods out of your diet. I know. I have been there. I was vegetarian for a while and then vegan, and definitely paid the price in my health and brain function, which all disappeared as soon as I started eating animal protein again. 

I do know some people who seem to do okay on vegan. That’s very few people. Very few people. But I just don’t think most people can long-term deal with the severe nutrient deficiencies in that diet. Certainly, their detoxification ability will be compromised. 

A lot of people can fare on a very well-designed vegetarian diet. But the majority of people are going to do best on a paleo or paleo-based diet that includes animal protein. 

Dr. Eric: 

I agree. I follow more of a paleo diet. As far as patients with Graves’ or Hashimoto’s, many times, I’ll have them follow a paleo or AIP diet. Some people will be vegetarian or vegan, but if someone asks me what I recommend, it’s more of what you said. 

Dr. Wendy: 

I generally find people fare better and feel better with more energy, and symptoms magically disappear once they start incorporating some animal protein, if they haven’t eaten that in a long time. 

If you want to know the top five detox foods, I would say #1 is broccoli sprouts. They are amazing. Then onions, garlic, ginger, and some cruciferous vegetables, and egg yolk. It has lots of choline in it. Very good for detoxification. 

Dr. Eric: 

Awesome. I want to talk about your documentary. Anything else you want to cover first? Obviously, there is a lot to cover. You and other experts will be talking a lot during the documentary. Any last words before you dive into the documentary? 

Dr. Wendy: 

A lot of people out there are going down different rabbit holes trying to figure out how to improve their symptoms or how to address their thyroid or how to address another issue. I think people need to pull back. Usually, any health issue they have, it’s really a systemic issue. Everyone also has heavy metals and chemicals. There are some people out there who are unbelievable detoxers genetically. Grandma who smoked until she was 100, she probably has pretty good detox genes. That might not be you. It might be. 

A lot of people are exposed to a lot of toxins, so this needs to be on your radar. It needs to be part of your health protocol, things you do on a daily basis, doing daily detox. I assure you, it’s an underlying root cause of your symptoms: fatigue, brain fog, weight loss, a diagnosis, whatever it is that’s annoying you. Toxins are exacerbating it. When you remove them, you are removing all the roadblocks to your body functioning better. 

I urge people to start taking the power back in their hands because they are not going to get this information at your conventional medical doctor’s. They won’t do heavy metal testing. They won’t know anything about it. Even if they do, they don’t know how to detox you. 

You need to educate yourself about this because there are very simple things you can do that are incredibly effective, and the research stands behind them. Infrared sauna, 40% reduction of mortality from all causes, using it five days a week. You can’t argue with that. Very simple and pleasurable things you can do on a daily basis to get rid of these toxins causing your health issues. 

Dr. Eric: 

I am only using the sauna three days a week, and I thought I was doing good. I need to add an extra two days per week to get to that 40%. 

Dr. Wendy: 

With three times per week, there is a 25% reduction. You’re not short changing yourself; there are still benefits. 

Dr. Eric: 

Cool. Let’s talk more about the upcoming documentary, which is free. What can people expect when they attend the docuseries? 

Dr. Wendy: 

My documentary is called Heavy. I interviewed 100 different experts on the topic of how heavy metals and chemicals cause various health issues. We are focusing on a few. 

We are focusing on how toxins cause brain health issues, like brain fog and dementia. Dementia is a huge problem, and it’s totally reversible. Not every type. Alzheimer’s and other ones have amazing researchers talking about how these are induced by toxins, and they are reversible if caught early enough.

We talk about weight, obesity, and how toxins are contributing in so many ways, throwing a wrench in so many organ systems and other body systems to produce the result: 2/3 of people in the U.S. are obese, and it’s a growing problem around the world. It’s not just diet; it isn’t. In China, they are eating thousands of billions of pounds of rice every year. India, same thing. Everyone in the world is eating tons of carbohydrates, and they are not all obese. It’s something more than that. It’s the chemicals in our environment that have grown exponentially since the ‘80s and ‘90s. 

We also talk about hormones—sex, stress, and thyroid—and how chemicals are negatively impacting those.

We talk about energy. We talk about how toxins are interfering in mitochondrial functioning. 

We have videos about how toxins affect digestion. 40% of people have digestive issues. It’s amazing how much toxins can destroy our gut microbiome, our gut’s ability to absorb nutrients. 

We have one on anti-aging, how toxins are causing aging, which is a big passion of mine, to educate on that.

We have other videos as well. There will be seven videos that are available for free during the free viewing period, which begins on February 15. I’d love for you guys to join me. There are experts like Dr. David Perlmutter, Dave Asprey, Chris Kresser, Dr. Chris Shade, Dr. Jill Carnahan. There are 100 experts, like Dr. Joe Pizzorno, founder of Bastyr University. Dr. Jeffrey Bland. So many others who are coming together to help educate you about how toxins are causing so many different health epidemics and what you can do about it. 

Dr. Eric: 

Wonderful. I look forward to tuning in. Your website is MyersDetox.com. Your podcast is The Myers Detox Podcast. Anywhere else where people can find you? 

Dr. Wendy: 

My website is great. I’m on all the social media, @MyersDetox. 

Dr. Eric: 

Thank you so much, Dr. Wendy. You shared some great information. I’m sure that many listening to this will want to learn more. Definitely sign up for Dr. Wendy’s documentary. You said Heavy is the name? 

Dr. Wendy: 

Yes, the documentary is called Heavy. 

Dr. Eric: 

Again, thank you so much for your time. 

 

Recently, I interviewed Dr. Tabatha Barber, and we talked about how fasting and faith can help shift your body into a parasympathetic state. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with Dr. Tabatha Barber. We are going to be talking about her new book Fast to Faith. We are going to be talking about hormones. Thank you so much for joining us, Dr. Barber. Appreciate you being here. Really excited about your book. We are going to be talking about fasting, how fasting impacts hormones, and your experience with Hashimoto’s. Thank you so much for joining us. 

Dr. Tabatha Barker: 

Thank you for having me. This is such an important conversation. I think so many women are going to benefit from this. 

Dr. Eric: 

I definitely agree. Let’s talk a little bit more about your background. You are a functional OB-GYN/gynecologist. What prompted you first of all to write this book? Also, most gynecologists don’t practice functional medicine. How did that journey begin? 

Dr. Tabatha: 

It’s a long, convoluted story. I’ll shorten it up. Essentially, I got pregnant in high school, and I had a very traumatic delivery. Out of that experience, I had a come to Jesus moment, where I realized that God wanted me to help other women not go through what I went through. 

I was a high school dropout; I went back to school and got my GED. I became a doctor. The idea was I was going to help women have a voice and a choice in their care, and not have to suffer and go through what I went through. Unfortunately, the medical system is not set up for health or wellness, either for the patient or the doctor. 

About 10 years into my practice, I found myself miserable. Here I thought I was living into God’s purpose for me. I had done everything I was supposed to do. Yet I was barely surviving. I had chronic back pain. I had Hashimoto’s that was uncontrolled. I had depression and heart reflux and IBS. All these drugs I was on. All these diagnoses. I reached my breaking point and realized this isn’t sustainable. I’m not actually helping women long-term. I can’t continue on this. 

I started down the path of figuring out how do I heal myself? That’s how I found functional medicine. I realized what I was doing was a lot of band-aid medicine. I was helping people relieve their symptoms, but I wasn’t really figuring out what was causing it. I was giving birth control pills for heavy periods and mood swings and acne. That was the end-all, be-all treatment. Or I would do surgery. 

A lot of women are surprised to hear that OB-GYNs are actually surgeons. I spent four years learning how to do a hysterectomy four different ways, how to do C-sections and deliveries and procedures. I didn’t study hormone imbalances and all the intricacies of the endocrine system and how our gut health impacts our overall health. We look to OB-GYNs as hormone experts, but they’re really not. They’re surgeons. 

I found myself in this dilemma of how to really care for women. It wasn’t until I healed myself with functional medicine that I realized what I needed to be doing. About a year and a half ago, I got a download from God. I can’t explain it any other way. He made it clear, “You have a new purpose. You fulfilled that. You’re supposed to be doing what you’re doing. Now we have a new plan. You have to write this book. You have to create this program. You have to teach women how to love themselves again, how to love their bodies back into healing.” 

All day, every day, I was seeing women complaining about their bodies, hating their bodies, feeling frustrated. At war with their bodies because of pain, because it wouldn’t do what they wanted it to do, because they couldn’t release extra weight. They didn’t look the way they wanted to look. All the things.

That Is really what I’ve been focused on the past 15 months: bringing women the truth. The functional medicine, everything I learned, I poured it into this book, so women can really start to understand what the heck is going on in their body. Why don’t I recognize myself anymore? Why do I have Hashimoto’s or some autoimmune disease? Why are my hormones out of whack? Why are my adrenals tanked? I explain all of that.

The cool thing is I just lay out a plan that is free and easy, because fasting is free, on how to really get back in tune with your body and listen to it again. That is where the magic happens.

Dr. Eric: 

Very eye-opening. OB-GYNs, not a surprise that they don’t focus on the gut, that they don’t have a lot of knowledge about leaky gut, healing the gut. When you said that they’re not hormone experts, because a lot of people have the perception that they will go to their OB-GYN and ask them for a hormone panel, not that some of them won’t order it, but for you to say that they are more surgeons than hormone experts I think will surprise a lot of people. 

Dr. Tabatha: 

I had very minimal training in how to handle a menopausal woman. I was definitely trained on what preventative tests to order, like a colonoscopy, a mammogram, a lipid panel to test your cholesterol. 

I was explaining this on a podcast earlier today: The medical system was created out of an acute care problem. We were trying to treat infections and save people’s lives and do lifesaving surgeries and things like that. The whole world of medicine comes from the idea of pathology and disease. It doesn’t come from a standpoint of health and wellness. 

We’re just looking to the wrong people for answers about how to get well, how to reverse disease. That’s not what doctors are trained to do. They honestly don’t know that. I didn’t know that. I was really well trained. That’s not what you learn. 

It wasn’t until I went on and got a ton more training that I actually started to understand and comprehend the idea that I was practicing Band-Aid medicine. If you came to me with typical symptoms of thyroid disease, my only solution was Synthroid. That’s honestly all I knew. Or you need to go have your thyroid removed, if it’s acting up and overgrowing. 

As a surgeon, we are taught to remove the offending organ. The uterus is bleeding too much; just remove it. The gallbladder is creating stones; just remove it. The appendix is inflamed; just remove it. That’s the mentality. It breaks my heart that I used to think that way and practice that way.

I wasn’t until I had failed my back surgery, and I was laying in bed for seven days. The third or fourth day, I realized I hadn’t eaten at all. Why am I not hungry? Why don’t I even care about eating? Then I remembered when I was doing my surgery rotations, one of the first things we learned as a student was how to write NPO orders. We would tell the nurses, don’t feed this patient who just had surgery. You cannot feed them until we give you an order, and then you can feed them. As surgeons, we know that fasting is part of the healing process. My body was doing that innately. It was not wanting to eat because I was trying to recover from this back injury.

I’m laying in bed. I can’t do anything else except talk to God. I got so much clarity that week. Wow, when I stop giving into all my bodily cravings and desires, and just let my physical desires drive everything, my mind can open up. I can actually reestablish that connection with my creator and get so much clarity, and I can heal. 

You know this. When we eat, we need resources. It requires energy and supplies to break down the food, digest the food, absorb the vitamins and minerals from the food. It’s a very active energy-heavy process. If you’re eating all the time, you can’t heal and take care of other things throughout the body. If you fast, you can divert those resources to where they need to go. It’s a pretty incredible process. 

God said, “Teach people how to do this.” That is the innate intelligence of your body to heal. 

Dr. Eric: 

I agree. When it comes to fasting, there are different types of fasting, like 16/8 fasts, 24-hour fasts, three-day water fasts. What do you practice yourself? What do you typically recommend to patients? 

Dr. Tabatha: 

Great question. My program is 40 days long. I developed it after listening to my patients over and over and watching them work with the nutritionist and seeing where they were struggling. Time and time again, women would tell me, “I can’t fast. It’s too hard. That’s too long.” They would have symptoms. 

What I realized was they were stuck in sugar burning mode. They were eating a lot of carbohydrates and using that immediate blood sugar to get through their day, for their energy. Whatever was left over, they would store it as fat. That’s what we do. 

Women aren’t eating enough healthy fats and protein, one because we were told fat makes you fat for decades, which is absolutely not true. Women are afraid to eat healthy fats. When you use fats to burn fuel, you are satiated longer, so you’re not as hungry as quickly. You don’t ride the hangry rollercoaster of the blood sugar issues. You can go into ketosis, which sets you up for success with fasting. 

The process of fasting, we have to retrain our bodies how to do the innate intelligence it was designed to do because honestly, when we were created forever ago, we didn’t have grocery stores on every corner. We didn’t have access to unlimited foods 24/7. We didn’t have DoorDash and all this crazy stuff. Our bodies know how to go quite long time periods without food. How to feast, how to famine again. 

All you have to do is break up with snacking, break up with sugar, get back down to your normal three meals a day, and then you can start to shrink your eating window. Then you can start to drop off a meal and go only a dinner and maybe a lunch, or do a 24-hour fast. 

It’s like learning how to run. People don’t just get up and run a 5K very often. The ones that do, that’s pretty awesome. Most people do a couch to 5K. They get the training manual and every day, they slowly increase what they’re doing and add onto it. 

That’s fasting. You have to retrain your body on how to burn fat for fuel instead of sugar for fuel. We use all of it. We begin by getting into ketosis and burning fat for fuel. We play around with that eating window. 16/8 is the most common. That’s where most people feel good long-term and have long-term benefits. 

I don’t think our bodies were created to eat 24/7. They just weren’t. You should not. It’s too hard on the pancreas; it’s too hard on the body. You should be eating in a 6-8-hour window on a regular basis. Then we can add in longer fasts, depending on your goals. Are you trying to lose weight? Are you trying to get mental clarity? Are you trying to heal from an injury or reverse a disease process? What is your motivation behind it? I teach all of that in the online version of my program. 

It’s been such a game-changer for women. Nobody is talking about this! People are like, “Well, we can all fast the same. You should be able to do it.” People feel like a failure if they just can’t get on board with the trend and do it. It’s not a trend. It’s actually how God created your body to function. You just have to remind it what to do. 

Dr. Eric: 

It’s more about losing weight. Obviously, fasting can definitely help people to lose weight. You mentioned healing overall. It could benefit people with all different conditions. Most people listening to this have autoimmune thyroid conditions. You dealt with Hashimoto’s, so I imagine fasting is a big part of patients you see with Hashimoto’s. 

I would say that most people who fast, at least initially, a lot of people are doing it to lose weight, but it goes way beyond just losing weight, if I understand you correctly. 

Dr. Tabatha: 

If you do it right. Weight loss is a side effect. It’s a benefit of getting healthy. I’m hearing a new trend where people are poo-pooing fasting if there is any kind of thyroid disease. “Oh, you shouldn’t fast. You have an autoimmune condition. Or you have hypothyroidism.” That’s really not true. That is not how our physiology is designed. It’s actually beneficial for people with thyroid conditions and autoimmune conditions.

The key is to do it in a way that your body doesn’t think you’re starving. We know that thyroid, being the master gland it is, is trying to regulate all of our resources. It’s taking in information from our adrenal glands, our gut, our immune system, our sex hormones. It’s trying to keep everything in balance. It affects your thermostat, your metabolism, how quickly your bowels move, how quickly your hair grows. It affects everything. It responds to all the stimuli coming in, the environmental stimuli, the internal stimuli. It decides who gets the resources. 

This is what I love explaining to women: Your thyroid doesn’t just become sluggish and fail you. Your thyroid is actually protecting you. It’s doing its job a lot of the times. When it’s shifting resources, or “downregulating,” I call it, where you kind of look like you’re going into a hypothyroid picture, and nobody is checking your full lab panel. 

Your reverse T3 is really high, and your free T3 is really getting on the lower end. It’s because your thyroid is responding to something that’s happening, either a gut imbalance, an infection, heavy metal exposure, a virus you just got, an autoimmune attack on your thyroid. If you can just remember that your body is working for you, and it’s doing its best to actually keep you in balance and protect you, and stop being mad at it, then you will be able to know what it needs and pull it out of that situation. 

When I see women coming to me with hypothyroidism, and they have gained weight, they immediately focus on losing the weight. We have to figure out why is your thyroid downregulating and sending out resources elsewhere? It’s because you have gut dysbiosis that we need to treat. When you treat those root causes, a lot of times, I see the thyroid shift and go back into balance because it’s no longer worried or trying to treat this infection or deal with something else. 

You have to start listening to your body. We do this as children. We are strong with our intuition. We hear what our body has to say, but we get trained by grownups to ignore it and cover it up with medications and over the counter stuff. Just think of it as a nuisance. 

When your body is giving you little signs in the beginning—your skin is a little dry, you’re getting a little constipated, your brain isn’t functioning very well—we just keep ignoring all the symptoms instead of going, “Hmm, I wonder what’s got the thyroid angry. Maybe we should evaluate why is the thyroid shifting how it’s functioning.” When we do that, we can figure out the root cause and treat it. Oftentimes, we can finally release the weight.

Part of it is that fasting stops all of the stuff happening in the gut. The gut is the end-all be-all. It’s where all disease and health begin. If you’re constantly feeding your gut, and you have leaky gut and autoimmune conditions, it’s like fuel on the fire. It’s taking lighter fluid and shooting it at the tiny little embers, and it starts to flare back up again. You get the food sensitivities all angry again. You get the leaky gut going again. You get the immune response flared up. You’re driving more thyroid dysfunction instead of actually giving it all a rest. 

Fasting is one of the quickest ways to heal your gut. If you really want to calm things down with an autoimmune condition or thyroid condition, you want to incorporate fasting. That gives your body the ability to divert resources over and start healing. 

It can start doing the process of autophagy, meaning we have cells that we send out through our body that eat and kill other bad cells that need to leave. They need to be done and gone. If that process doesn’t happen, those cells sit there, and they go rogue and turn into cancer and disease. We have to give that autophagy a chance. We are just continuing to spiral down with more conditions and more conditions. 

Dr. Eric: 

Fasting is important for overall health, especially for gut healing. Like you said, we might need to go beyond that. If you have gut dysbiosis due to some type of infection or other imbalances/other triggers, we need to address that. Fasting helps with the gut. 

You’re known as the Gutsy Gynecologist. What is that connection between the gut and the hormones? 

Dr. Tabatha: 

I first started noticing this as a surgeon. I did a lot of stage IV robotic endometriosis surgery. Endometriosis is where the cells inside the uterus that grow every month in response to estrogen grow and then bleed, which is what’s called a menstrual period. These cells get outside of the uterus into the abdominal cavity, and they can start to grow on top of the uterus, the ovaries, the tubes, the side walls of your abdomen and pelvis, on your bowels and bladder. It was my job to go in as a surgeon and try to separate all the adhesions and the scarring that was taking place. The bowels and bladder and ovaries were growing together essentially from this disease process. 

It was never taught to me that the gut was involved at all, but it was obvious looking through the robotic lens that how is the gut not involved? The gut is literally scarred to these pelvic organs, and I’m sitting here peeling bowel off and taking down adhesions for two hours at a time. The gut has to be involved. 

When I started studying functional medicine, I really began to understand that all of the things happening inside the intestines, the lumen, the tube where the food is being digested and broken down and turned into stool, those processes, chemical reactions are happening. They don’t just stay in the lumen. They cross through that one cell layer into our bloodstream and through the serosa out into the abdominal cavity. 

If you have inflammation in your gut, you’re producing cytokines and interleukins and all the bad stuff that we heard about through the pandemic in your gut. They’re seeping into the pelvis the same way that the pelvic stuff is seeping into the gut. It’s impossible to heal endometriosis without healing the gut. It’s impossible to stop fibroids from growing and fertility scarring and issues like that without healing the gut. As long as you have inflammation processes and chemical reactions happening from all the bad bacteria and the overactive immune response, you just can’t stop it. 

When I made that connection, it was lifechanging for my patients. As soon as I started with the gut first, so many of their GYN problems just went away. We weren’t dealing with them directly. All the painful periods; the crazy, heavy, irregular periods; the disease processes, they start going away once you heal the gut. 

It’s way more in depth than that. There are certain bacteria that live in our intestines that will make an enzyme called beta-glucuronidase. This enzyme cuts the garbage tag off of the estrogen that we are trying to remove from our body. If I’m done using my estrogen that I just made, I want to get rid of it. I put a methylation group on it, send it through the liver, send it to the urine and stool for removal. This enzyme from the bacteria will cut it off and help you reabsorb it through your intestines. 

Again, I believe it’s our body’s innate intelligence because almost every single day, I see menopausal women with really high beta-glucuronidase levels. I think their body is trying to reabsorb as much estrogen as possible because they are so low in estrogen, and estrogen is protective.

We also see that with fat cells. Women get so angry that they gain five or 10 pounds at menopause. Every woman almost. That is your body’s way of protecting you because you no longer have enough estrogen to protect your heart, bones, and brain. Fat cells make estrogen, so we add some more fat cells to bump up your estrogen, just enough to give you that protection. 

We look at this like our body’s failing us. Our body hates us. Why is it doing this? That’s not what’s happening. That’s what’s supposed to happen, unless you go on hormone replacement therapy, and then that little belly fat you gained goes away because your body doesn’t need to make estrogen. You’re taking it. 

You have to understand and believe that your body is always working for you. It’s not working against you. It doesn’t hate you. We just don’t understand it. 

Dr. Eric: 

You mentioned beta-glucuronidase. It sounds like you do comprehensive stool tests to look at not only to see if they have dysbiosis but see if they have an elevated beta-glucuronidase. Do you also use dried urine testing to look at the estrogen metabolites? 

Dr. Tabatha: 

Every day, yep. I love when women do my Healthy Her program. You have to take a comprehensive approach. You have to see what’s going on in the gut. You have to see how your hormones are being metabolized. You need to see what your adrenals are doing. You need to look at that 24-hour cortisol pattern and see how are your adrenals handling your daily stress in your life? 

It isn’t until you see all of these pieces of the puzzle to see the picture clearly. Then you can start to understand, “Oh, that’s why my thyroid’s behaving that way. This is what’s going on.” “This is why I went into premature menopause.” “This is why I’m infertile.” Absolutely. 

I try to get most women to do my program, which is stool testing, food sensitivity testing, Dutch, hormone, and adrenal testing, all upfront. 

Dr. Eric: 

I’m glad you brought up adrenals because one question I have for you related to fasting: Any concerns with the adrenals and fasting? If you look at a Dutch test, and someone has cortisol levels that are sky high or depressed, along with, say, depressed total DHEA, should that person fast, or should they avoid fasting? 

Dr. Tabatha: 

That’s a great question. This is one of the biggest things that I address in the program because it comes up time and time again. Either women have no idea they have an adrenal issue. They have never heard of this. Or they have a Dutch test, they know what their 24-hour cortisol panel looks like. 

I would say the only real concern is when you are in stage III adrenal dysfunction. We used to call it “adrenal fatigue.” You look at your pattern, and it’s flatlined. You don’t have a nice cortisol awakening response the first 30 minutes of waking up in the morning. That means your body is losing resiliency. It’s losing its ability to respond to and give you the cortisol production that it needs to function. 

Fasting is a little bit of a stressor. It’s a good stressor. The same way exercise is a stressor. Moderate exercise is good. Triathlon training, that’s probably excessive and bad. You have to think about it that way. 

Fasting is a good stressor, but not in someone who doesn’t have the resiliency to be able to respond appropriately. If your cortisol is flatlined, you want to start with getting a more ketogenic diet and really shrinking up your eating window. Then staying there and making sure you’re having high feast days, where you’re reminding your body that you’re not starving because your thyroid will respond. 

If you eat low calorie day after day after day, it will say, “She’s starving us to death. Let’s turn down this production here. We can’t lose any more weight. She’s going to starve us.” You have to make sure you’re eating enough when you are eating. That’s where a lot of women are falling short. They’re trying to calorie-restrict while also fasting. That’s not the most beneficial way to do it. 

I would say if you haven’t had Dutch testing, you don’t know what your adrenals are doing. Ask yourself some basic questions: Can you get out of bed in the morning? Can you get going without coffee? Are you requiring naps during the day? Are you pretty much sleeping at night? If those things are really messed up, you probably want to get your adrenals tested. 

Dr. Eric: 

Just to clarify, if someone does have that low cortisol pattern, it sounds like it’s a good idea to fast, but you want to make sure that you’re getting enough nutrients, calories, and protein during that eating window. 

Dr. Tabatha: 

Right. And you really need to start loving your body and giving it rest time and helping it restore and repair. It’s in a state of severe stress. What we are trained to do is push through, keep going, drink more caffeine, get more sugar, do whatever it takes, take stimulants. That is not the answer. 

I go through this in the book. We have two parts of our autonomic nervous system. We have this sympathetic, fight or flight. If you’re afraid, you’re going to run. If you’re stressed out, you’re going to fight. There is the parasympathetic, rest and digest. You can’t be in both stages at the same time. 

Adrenal fatigue is you were in sympathetic/fight or flight for so long that you can’t even function anymore. Now you have to be in parasympathetic to heal. I don’t want anybody to get to that point. The more you pull yourself over to the parasympathetic nervous system and really nurture that side of you, the quicker you’re going to heal. 

To me, fasting with faith is one of the quickest ways to get into parasympathetic mode because you’re meditating on scripture, you’re trying to listen to what God has to say for you. You’re slowing down and understanding that you don’t have to figure it all out. You don’t have to carry all the burdens. God’s got you. He already has a great future lined up for you. You need to trust in him. 

When you start reading that truth, the words of the Bible, you really can shift into that parasympathetic nervous system and start to heal. It’s beautiful and incredible. Women’s DHEA levels will increase. DHEA is like our anti-aging, keep us young and healthy hormone. We need that. So often, we start to get it really depleted in that stressed out, over-adrenaled state.

I was just thinking about this this morning. Everybody used to say, “How are you?” You would say, “Good. Fine.” Now the answer is, “I’m really busy.” Like it’s a badge of honor, something to be proud of. God does not want us to be busy and overly productive. We don’t have to earn our salvation or our place. We have to take a step back and just relax a little bit. Realize that we are worthy just because we are. We don’t have to produce and perform and do all the things to earn our place. 

I think we get stuck in this busy mindset. I hear this every day from women, “But I can handle it. Everybody’s doing it. That’s just life.” Okay. Your mind can handle that stressed out life, that overactive life, that busy life. But your physiology can’t. Your thyroid can’t. Your adrenals can’t. Your gut can’t handle it. Your physiology still responds with a chemical reaction every time you are in a stressful, sympathetic state. 

That’s just the truth of it. You study rats and pigs and people. That’s just the response that happens. You get a stimulant. We release cortisol. We release epinephrine. We release cytokines. All these inflammatory processes happen. Then our mind is like, “Oh, that’s fine. Don’t worry about that. We got it.” The physiology already happened. The inflammation already happened. We just killed all the good bacteria. We just caused our leaky gut. It just happened. It doesn’t matter now. 

We need to be more mindful about how we’re living and take some authority and responsibility over the fact that what we are doing all throughout the day is completely impacting our health. We have way more control over it than we want to admit. We want to think doctors are the answers. Doctors are going to help us and save us. Really, your body is totally created to heal. 

I tell people as a surgeon, I will cut your skin open and fascia and muscle and pull the baby out and sew everything back up with sutures. I know it’s kind of graphic. I didn’t actually heal you shut. I literally put some suture in there to approximate those tissues, so that the muscle of the uterus laid next to each other. 

If those stitches broke, you weren’t healed shut. Your tissues have innate intelligence that they grow back together. The cells regrow together. That is what we are not believing in anymore. We are not believing that our body has any ability to heal or do what it’s supposed to do. I really want women to understand that there is so much more of it in their control than they realize. 

Dr. Eric: 

We’re essentially assisting with the healing. Like you said, it’s innate intelligence. 

Today, I had two patient consultations. We were talking about why the endocrinologist can’t be more open-minded. They bring up a diet for cases of Graves’ or Hashimoto’s, “No, diet won’t do anything.” You need the thyroid hormone replacement, or in the case of Graves’, antithyroid medication or radioactive iodine. So negative when it comes to diet. 

There is an underlying cause behind everything. Like you said, our job isn’t really to fix the person; it’s to give them the guidance and have their body take over, that innate intelligence. I’m glad you spoke about that.

Parasympathetic, I want to talk a little bit about that. When it comes to spirituality, religion, and the overlap between that and mind/body medicine. For example, when I have a conversation with a patient, I ask them what they’re doing from a stress management perspective. If their response is praying every day, which is important, do they need to go beyond that? Your book talks about that probably, and you’re talking about that now. How much do they have to incorporate mindfulness? How much overlap is there between religion and meditation and yoga? Anywhere you want to go.   

Dr. Tabatha: 

If your listeners are anything like me, I was raised Catholic. I had a lot of confusing messages being in religion and in the church. I really pulled away from it for a long time. I always knew that I believed Jesus Christ did walk the Earth, and he was my savior. I had that belief in the back of my head. I treated God like he was a genie in a bottle. I would just wish and pray and wish and pray. Why won’t it happen? I’m waiting for things to magically happen within the same day of me asking for it. That’s a really scarce mindset and a weak and fearful way to live. 

I don’t believe that’s strong faith. I had to learn to actually trust God and believe him before I see it. We always want to see and then believe. You actually have to believe and then see it. When I shifted how I was praying, and I shifted to a state of gratitude, like thank God first, and then come to him with my issues and requests, that was a gamechanger. 

That changed everything because what I realized was you can’t be anxious and worrying and in a state of gratitude at the same time. Just like you can’t be in fight or flight and rest or digest at the same time. If you are staying, “Thank you, God, for this incredible body that got up and went to Pilates this morning. Thank you for my sweet dog giving me attention when I get home. Thank you for the warm cup of coffee that I’m drinking right now,” you can’t actually be worrying about stuff at the same time. 

You start to shift the chemicals that are created in your body and how you feel. When we are in a state of gratitude, we produce oxytocin, which is our love hormone. It actually helps us feel good. We produce more serotonin and melatonin and all of the good chemicals. 

When we are in a state of anxiety and worry, we tend to remember past events. As soon as we remember something, our brain is hardwired to feel those feelings and create those chemicals again. 

Say you got in a really big fight with somebody. Somebody did you wrong. You could probably relive that in your head right now and feel all those feelings and get the heart racing and get sweaty and get jittery and pumped up, like you gotta talk about it. You’re making chemicals from that thought response, those feelings. 

What I teach women is in order to change your body, you have to change your mind. It all comes back to Romans 12:2, “You have to renew your mind in order to be above any of this physical reality that you’re suffering through.” Your brain is a computer. Your mind is a computer program. It’s just doing what you’ve trained it to do. Unfortunately, most of the programming was done when we were young, or it’s done subconsciously without much of our thoughts. Paying attention is just happening to us. People say things, and we record them, and we play them over and over and over. We create these new nerve pathways that just get ingrained and driven deeper. 

It’s not until you start to make new pathways and think new thoughts and break those old thought patterns that you can create new chemicals to send a new signal to your cells that are healing and health-restoring.

It all does begin in your mind. Anything that happens in the world, somebody wanted to create an airplane and get us to fly. That had to first happen in his mind before he developed the airplane physically. If you want a healthy body that isn’t overweight, that isn’t in pain, that isn’t exhausted, you have to first envision it in your mind. 

I do this whole thing called Future Gazing with God. I walk women through the process of figuring out: What are they struggling with? What don’t they like? How do they see themselves? Then I help them envision, “Imagine seeing yourself through God’s eyes, through your creator, who has plans for you. Imagine what he sees you as. How can you get to that woman of your dreams that you envision yourself becoming?” 

Then we work backwards. What is that woman doing every day? How is she waking up in the morning? How is she moving her body? What choices is she making about food? How does she manage her stressors? When you get that kind of clarity, you can start creating new thought patterns and reprogramming your mind. That will change your behaviors, and that will change your body. 

It’s a lot. I get it. But it’s life changing. It’s transformational. Watching women go through this has just been the most rewarding thing I’ve ever done. It lights me up.  

Dr. Eric: 

I asked you that question because it happens a lot. I’ll talk about stress management, and a woman will typically say, “I’m praying, and that’s my form of stress management.” I always give a positive response because I think that’s great and is helping, but it sounds like many times, they do need to go beyond that, to go deeper to get into that parasympathetic state. 

Dr. Tabatha: 

Unfortunately, a lot of prayer is actually bad repetitive thoughts. It’s a negative feedback loop of worrying and praying and asking God to fix something that he doesn’t necessarily want to fix. He might want to be teaching you a lesson. He might be showing you all kinds of doors you’re supposed to be going through. You are so stuck in that symptom that you can’t see it. Sometimes, we have to get a fresh, new perspective. 

When I was so overworked as an OB-GYN, I worked in a small town. I was on call every other night. I was exhausted. I couldn’t remember my patients’ names from the delivery the night before. I literally could not remember stuff. I had to rely on my assistant. 

That was really eye-opening for me to understand that none of that was ever going to change until I decided that it was no longer something I was going to tolerate. I was going to put some boundaries in place. I was going to shift my mindset about things. I believed I was supposed to be exhausted and overworked. I was trained to think that you hold your bladder and don’t eat and just struggle through and keep on going, and you always put the patient first. That was my mindset. That was my belief. 

It wasn’t until I realized God gave me this body, and I am not honoring him by treating it like a garbage can. I need to shift and change how I’m treating myself because that’s going to be sustainable. You cannot continue to pour from an empty cup. You just can’t. 

It wasn’t until I shifted my internal mindset to believe that I can have boundaries. I can work less. I can sleep more. My patients will survive if someone else takes care of them. I had to shift so many beliefs. Once I started to do that, and started focusing on me and my health and my body, that’s when everything changed. A lot of people need a new perspective unfortunately. 

Dr. Eric: 

I definitely agree. Dr. Tabatha, you shared a lot of great information. I know people are probably really excited to read your book. Before you talk more about where they can get it, is there anything else that I should have asked you that I didn’t ask you? Anything else that you want to talk about? 

Dr. Tabatha: 

I just want people to know that you’re never too far gone. I had a 70-year-old woman do the online program for Lent last year. She had uncontrolled diabetes at 70 years old. She had a wound that wouldn’t heal because her blood sugar was so elevated. Her hemoglobin A1C was 8.5 going into the program; that is really uncontrolled. She decided she was going to give it a try. 

She didn’t believe that she could do the whole thing, but she started believing she could at least do the day. We took it day by day. By the time we got to an extended fast, she was like, “I think I can do this.” She completely did it. She felt so empowered. It absolutely shifted everything. 

This is a woman with fibromyalgia and chronic pain and non-healing wounds, everything you can imagine. A list of drugs she was on. By the end of it, her hemoglobin A1C was down in the 6s. She was out moving her body like she hadn’t in years. 

She was the greatest example to me because she thought she was too far gone. She was believing the lies, “It’s too late. I can’t heal. My body can’t change at this point.” I was a little skeptical. She was 70. That is a lot of comorbidities, right? I know it works in 40- and 50-year-olds. Man, did she make me a believer. 

I love that story. The fact that I had Hashimoto’s at 17, and my antibodies were sky high. Now, they’re down in single digits. You can reverse stuff. Your body wants to be in homeostasis. 

It wants to heal. It is always trying to heal. It’s in a constant state of healing. It’s only us interfering that it gets into a state of not healing. If you just shift and choose to believe, and know with all your being- Just as the sun rises every morning, you know the sun is going to rise. Just know your body is going to heal. Your mind will start to find those solutions and those opportunities for healing. 

Like listening to the podcast today. “Oh my gosh, I’ve never thought of fasting. Let me try this. Let me see.” God gave you a new possibility. That’s what I would say: You cannot give up hope. 

Dr. Eric: 

Wonderful. Where is the best place people can get your book?  

Dr. Tabatha: 

Go straight to FastToFaith.com. Right now, if you get the book, we’re giving awesome bonuses with it. We’re giving $20 to the supplement store. We’re doing extra scripture bonuses. I am doing a really awesome master class where I am doing a deep dive called Ultimate Transformation. It’s only for the people buying the book right now. I’m really excited about that conversation. You get to interact with me one-on-one and ask questions. All that good stuff.

Dr. Eric:

Once they buy the book, they get access to that master class you mentioned? 

Dr. Tabatha: 

Exactly. They just put their order number in, and we’ll send it to you. 

Dr. Eric: 

Check out Dr. Tabatha’s amazing podcast, The Gutsy Gynecologist Show. Also, there is a free guide, The Gutsy Gynecologist’s Guide to Balancing Your Hormones. This was a wonderful conversation, Dr. Tabatha. Thank you so much for your time. Appreciate it. Best of luck with your book. I’m very excited about it and think it’s going to do amazing. 

Dr. Tabatha: 

Thank you. I’m so honored that everybody just took the time to listen today, and they stayed with us. Thank you so much.

 

Recently, I interviewed Dr. Kristi Tompkins, and we talked about the significance of managing stress, the importance of individualized dietary plans, the interplay between hormones and thyroid health. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with Dr. Kristi Tompkins, as we are going to have a comprehensive chat on hormones, including hormone stressors. I am going to dive into Dr. Kristi’s bio: 

Dr. Kristi Tompkins is a naturopathic doctor, functional medicine practitioner, and transformational coach. Having treated a variety of clients over the last 15 years, her specialty is helping women to become more aware, adapt, and thrive during the perimenopausal and early menopausal years. Integrating a blend of personalized lifestyle medicine, brain-based coaching, and mind/body healing, Dr. Kristi enjoys encouraging and empowering her clients to make better choices in their health and their lives. Thank you so much for joining us, Dr. Kristi.

Dr. Kristi Tompkins: 

Thank you, Dr. Eric. So happy to be here with you.

Dr. Eric: 

Before we talk about hormones, can you give a little bit more of your background? How did you start focusing on helping women with hormones? 

Dr. Kristi: 

I trained as a naturopathic doctor, so I have a doctorate degree in naturopathic medicine up in the Pacific Northwest at Bastyr. In medical school, you learn about treating everybody: men, women, children, all the different health conditions. 

After I graduated, I started working with an integrative medical doctor. He would now be considered a functional medicine doctor, but very much integrative. Trained as an MD but integrated a lot of botanical medicine and nutrient therapy. He also had a specialty in hormone replacement therapy, bioidentical hormones, hormone testing for men and women. 

Early on in my practice, working as a naturopathic medical doctor, I learned about how to diagnose, how to test, how to read the functional labs, how to prescribe bioidentical hormones for women going through perimenopause, which is anywhere from 4-5 years up to 10 years before menopause, leading up to when their period stops, on how to help them holistically but also with bioidentical hormones.

Same thing with men. Prescribing hormones, not just bioidentical hormones, but also thyroid hormone as well. 

It also happened to interest me. I’ve had an interest in women’s health for quite a number of years, just based on my own female hormonal symptoms that I had many years ago when I was in my teens and 20s. I naturally gravitated toward women’s health. 

At some point, I moved from the Pacific Northwest back down to California, where I’m from, and I started a practice there. It was back to general medicine again, treating a variety of people. It’s been probably within the last 4-5 years that I have really narrowed my niche on women’s health, specifically perimenopause. I still treat a variety of people with different conditions. That seems to be something that really calls to me. 

It’s that time in a woman’s life where there is a lot of changes that are happening with her body. Of course, life changes as well around her. There is a lot of things that happen that women don’t necessarily direct or pinpoint it to, “This might be related to my hormones changing or menstrual cycle changing in preparation for menopause.” It tends to take a lot of women by surprise, the weight gain, the hormone changes, the sleep, the mood, vision changes, and thyroid changes. 

I want to help take out the mystery and the confusion and the stress of these symptoms and help women feel more empowered as their body is inevitably going through these changes, so they feel a lot more confident and in control, as much as they can during that time. 

Dr. Eric: 

You mentioned a number of different symptoms. Would you say these symptoms associated with perimenopause are normal, or would you say they are common but not necessarily normal? 

Dr. Kristi: 

Great question. I would say it’s both. It depends. If you throw in unhealthy foods or pro-inflammatory foods, and you add in chronic stress and environmental exposures, and the list is infinite, that will affect not only the entire body, but it will also affect the ovaries, uterus, communication between the brain, the pituitary gland, and the ovaries. It will affect the cycle indirectly or directly. 

Things like changes in their menstrual cycle, like heavier bleeding or a shorter cycle, where it’s a shorter time in between. Women are starting to notice more headaches right before their period maybe, mood changes, sleep changes. Some of those things can be mild, but they can also be exacerbated and worsened through some of those other stressors in our lives. 

That’s where personalized lifestyle medicine, stress management, exercise, meditation, mindfulness, treating the whole person can help everybody, but it can really help women as their body is having the dip in hormones. Having this dip throws them off balance. They don’t feel like they can adapt to life changes as well, just with the hormones dropping anyway, but then you add in all these other factors that makes it worse.

Some of the symptoms can be normal, like skipping periods. Maybe you skip a few months in a row, or maybe it ends up being 21 days in between your cycle. That’s pretty common as you’re approaching that time when the period stops. That can actually be worsened by things that you are doing in your life that you’re not aware of, or maybe you are aware of. What you’re eating or what beverages you’re consuming or how much sleep you’re getting. That can throw that over the edge. It can be a fine line between “natural” symptoms and exacerbated symptoms. 

Dr. Eric: 

Makes sense. You’re going to get some symptoms regardless of how healthy of a lifestyle you live. The problem is that many people don’t live a healthy lifestyle. If you’re eating a lot of refined sugars and gluten, and you’re stressed out all the time, that almost definitely will lead to an exacerbation of symptoms.

Let’s talk about some of these stressors. Starting with stress itself, let’s say if everything else was perfect. Overall eating a very healthy diet, doing things to minimize exposure to environmental toxins, which we can get into more of. If everything else was in alignment, but the person was in a state of chronic stress, how dramatic of an impact can that have on one’s health? 

Dr. Kristi: 

As you and I both know, a little bit of stress sometimes can be to your advantage. That acute stress, the stress of writing a book or starting a business. There can be “good stressors” in our lives. Sometimes, that pushes us to grow and change and evolve in our life. Usually, that is considered maybe more of a positive excitement, something new. 

Then there is the chronic stress of financial stress, maybe the stress of relationships or divorce or something happening with your children. There are a million different types of stressors. Sometimes, there is a lot of internal stress. Probably more than sometimes. There is a lot of perception of things that may or may not happen, or maybe recounting stories from however many days, weeks, months, years ago that we’re still reliving. 

A lot of times, our emotional/psychological distress comes from within. That can be the same type of stressor as anything outside of us. That puts our body into a higher focus on the sympathetic nervous system. If there are more of those stress hormones, there is not a lot of time or opportunity for growth, repair, relaxation, restfulness, absorbing your nutrients, creating new hormones, and creating new proteins. There is a static interference between the stress hormones and our other nutrients, neurotransmitters, and hormones in our body. The body can’t thrive. It can’t expand if it becomes too constricted, too inflamed. 

The body is pretty fantastically wise and resilient. It can usually help you. Your body really does have your back. Over time, if you’re constantly in that fight or flight, feeling threatened or feeling like you might be attacked from an ancestral perspective, like if you are going to die, it puts you in that state of chronic stress hormones. Your body can’t really grow in the way that it’s supposed to. 

That is when a lot of cells start to change. They become different, and the organs change. The body is trying to adapt, but it’s maladaptive over time. That is when you start to see illnesses and diseases set in. There is a whole assortment of those. The body is trying to adapt with you, with the stress, but that is not a normal state. Blood sugar, blood pressure, weight changes, changes in the brain, changes in your skin, changes with your hormone levels, changes with your thyroid. 

That is when people wake up. They have all these symptoms, “Wow, I feel terrible.” Maybe it’s been gradual over a period of time. “I’m just tired all the time. I’m achy. I’m not sleeping well.” “I’m chronically congested and have this mild achiness throughout my body. I don’t know what’s going on.” Then it gets to be really bad. That is the body’s way of saying, “We need to get your attention. Something has been off for a period of time.” That is usually when people seek out care.

Fortunately or unfortunately, a lot of people go to their regular, conventional doctor for a prescription, for help. Sometimes, that can be helpful, lifesaving in emergency cases. Sometimes, that can be incredibly therapeutic. It’s a very limited amount of tools in the toolbox. Whether it’s medication or somebody running a lab test that comes back “normal,” a lot of people are sent away going, “Okay, the problem is still here.” In some cases, “I feel worse.” The root cause wasn’t addressed. 

For a lot of people, they don’t understand that they might be part of the root cause. Their own internal overreaction to stress or life, they might be part of the problem. Not to point fingers and blame them, but to show people what you’re doing in your life might be contributing to how you’re feeling. There is a lot of personal accountability and empowerment that you can share with your patients or clients, that you can make these changes in your life in so many different ways, so your body can get back into that balance again. It’s not constantly in the fight or flight stress, so it can actually heal. 

Dr. Eric: 

One of the strategies you recommend is doing mind/body medicine, meditation, yoga, and other techniques? 

Dr. Kristi: 

A lot of people feel, “I can’t meditate. I have too much going on in my life and brain.” That’s a lot of people. That’s why they call it meditation practice. You don’t exercise one time. You don’t have one healthy salad, and you’re good. You really do keep going. 

It’s the whole person perspective, healthy eating, moving your body, strengthening your muscles. It’s taking whatever supplements, nutrients that you need. Cultivating healthy relationships. It’s that mind/body connection, whether it’s meditation, breathwork, yoga. There are other ways to meditate. Listening to music and focusing on your breathing can work wonders at calming the nervous system.

The whole point is not only to calm your nervous system or regulate it, because we don’t always want to be in the parasympathetic or always in the sympathetic. It’s more about the balance and regulation. 

Oftentimes, meditation can also help you make changes in your life. It can help you shift your thinking and shift the beliefs you’ve had about yourself and your life. It can help you shift your emotions in a way. 

A lot of times, you can make positive changes in your life, in your habits, or get rid of self-sabotaging habits and beliefs, and actually create new things in your life. You’re continually growing. You’re letting go of the old ways of living and doing and thinking and being, but you’re moving toward more of a positive, expansive way of living. 

That also naturally resets the body back to homeostasis, where it’s actually functioning normally. It’s got many different benefits to it. 

Dr. Eric: 

If you could talk about some of the other stressors, the other factors that can cause imbalances in your hormones? 

Dr. Kristi: 

I would say a big one is the food that you put into your body. Whether it’s alcohol or too much caffeine or sugary beverages, pro-inflammatory foods. My undergrad is in nutrition, and I know you have a heavy nutrition background as well. 

Putting these foods into your body once a while is okay, but when you put these foods into your body over time, chronically, and your body reacts in a way that actually causes the immune system to be overactive, so foods that your body is like, “What is this? I don’t totally recognize this. Yes, this is food, but I don’t know what to do with this. I don’t know how to break it down. I’m perceiving this as something foreign or potentially a threat.” 

It creates this cascade of inflammatory cells that react to the foods or beverages. That can cause a dysregulated immune system, but it can also cause a lot of symptoms like pain, congestion, inflammation, hormone imbalances, and things to become more swollen. Sometimes, we get these benign tumors throughout our body because of things that have gone awry over a period of time. 

That in itself is a stressor. It can affect the gut, the digestive function in the body, the liver, your skin, your joints, your muscles. That over time can cause problems in each organ system. Ultimately, it affects the entire body. 

I think that is not so much the biggest surprise to people because people know if they eat the wrong foods, they’ll gain weight or have heartburn, or they’ll get IBS. A lot of people don’t make the connection between their autoimmune disorders or female hormone or male hormone symptoms or conditions or their skin or chronic headaches or chronic respiratory symptoms. They don’t make the connection between the foods you’re putting into your body, even if you might think they’re healthy. 

A lot of people eat foods as part of their family ancestry, part of what they know. If they’re eating those foods that maybe were relevant to a different generation, but now they are eating this food today, which may or may not be processed, and you add in their own biochemistry and life stressors, things are different. It’s really showing people not only through testing but through spending time with your clients and asking questions. I want to understand not only what their current symptoms are but what their past medical history is. What has led them up to this point? 

If you get rid of those “stressors,” the diet, certain foods and beverages, again, the body has a chance to calm down. That nervous system can regulate. The immune system, the gastrointestinal system can now regulate. 

It’s a pleasant surprise for a lot of people if they are not already doing that. Getting rid of those foods. Often, it’s not just, “I think this is healthy for me.” It’s an addiction. There is a lot of comfort foods out there that people choose because they’re stressed, or it’s “Why change now? I’m this age, so I will keep eating these foods because that’s what I’ve always done. These are my staples.” That can affect the body. 

Showing people that the stress in their foods might be contributing to their own symptoms. They can make those changes to help the body heal. 

Dr. Eric: 

What dietary approaches do you have in your practice? Do you tell someone to eat whole, healthy foods, like following a paleo diet? Or do you have them follow some type of elimination diet? Do you do food sensitivity testing to see what foods people are reacting to? 

Dr. Kristi: 

It comes back to the individual person. Not to say that if they love ice cream, yes, keep eating a bunch of ice cream every day. 

I personally and professionally love the paleo diet. It really does have this beautiful assortment of different macro- and micronutrients. Proteins, healthy carbohydrates with fruits and vegetables, healthy fats. Not as much emphasis on grains, starchy vegetables. 

There are different variations of a paleo diet. I know some people are following the ketogenic diet or a vegan diet. Maybe they have a little bit of grains every day. It’s case by case. There are some people who can eat grains or sweet potatoes. They can have red meat or pork. Their body might process that really well. 

There are other people who can follow a paleo diet, for example, but it might need to be modified based on their inflammation, weight, digestive system, age. There is a big difference between a younger male who is in his 20s versus a 50-year-old, menopausal woman. The metabolic rate is different. The caloric demands are different. It depends on your activity level, your body mass index (BMI), and other factors. I love the paleo diet as a general guide. 

To answer your question, I do food allergy testing. I do gut testing. I do hormone testing. I do nutrient devaluation testing. I do DNA testing. There are a lot of different tests. I have been in practice for a really long time. I have run pretty much every single functional lab out there, it seems like. I have tailored that to a certain array of labs that I really feel accurately capture what’s happening in the body. 

I love doing a whole custom panel, like a comprehensive metabolic panel for men or women, which really looks at the thyroid, the liver enzymes, the advanced cardio-lipid panel. Looking at all that data in relation or in addition to their symptoms, in addition to their preferences. If somebody is not into kale, that’s okay. You don’t have to eat kale. If they’re not into eating quinoa, you don’t have to eat quinoa. I try to meet them where they’re at. 

I give them the guidance and data and recommendations and insight as much as I can. “If you continue eating this, you will probably have these same symptoms.” I try to work with them as best I can. I realize it’s a process. I had major food allergies when I was younger. I didn’t realize it. I didn’t even know what the term “food allergy” meant. Looking back, I had a lot of that. I didn’t understand that was affecting my body, and I was doing that to myself. That was affecting my hormones. 

It took me a period of time to really make those changes to my diet. Now, I notice, because I have done so much work on myself physically and emotionally, that when I eat those foods, I know when it feels off. I know I have those symptoms right away. A lot of people don’t realize that they feel so bad or miserable all the time because they are eating it day in and day out. They don’t realize the connection there.

It is mostly paleo. If they’re vegan, that’s okay; I work with them. If they prefer to have a higher caloric intake, based on their individual preferences, I do try to work with them. It’s not a cookie cutter approach to any person. Again, I do try to give them my best recommendations to help them heal. 

Dr. Eric: 

Sounds good. I like paleo as well. If someone is a vegan/vegetarian, it sounds like you will make modifications if necessary.

Dr. Kristi: 

Yeah, I want to add to that though. You brought up a good point. If someone is vegan or vegetarian, and they are specifically not having any animal protein. I know there is a lot of vegetarians who will eat dairy or gluten. We know there is protein in dairy and gluten grains. 

If I feel that somebody’s health is adversely affected because they’re vegan, like thyroid. That’s a big one I see a lot. I have seen this many times over the years with men and women. If they are vegan or vegetarian because they chose it, or their partner is eating that way, so they will do that, too, because it’s easier. Or their partner is giving them a hard time for eating chicken or steak. If I see it affecting the person’s thyroid level or energy or testosterone, or their ability to repair and heal and thrive, I will point that out. I don’t do that a lot, but I’ll point it out from time to time. 

Your body might actually function better with this type of protein from turkey or chicken or seafood. You might have this assortment of amino acids that you’re now absorbing, so you can produce these basic building blocks. Using food as your medicine, food can be your therapy. Reminding people that we’re eating for a reason. Yes, we’re eating to live, and we’re eating for enjoyment. We’re also feeding our body with the things that it needs to rebuild and repair. I have mentioned that to a few people over the years, and it’s amazing that when they start introducing maybe in small amounts, their body is able to heal. 

Dr. Eric: 

You mentioned protein. Is there a specific amount of protein that you recommend for people to consume? 

Dr. Kristi: 

I don’t do that. I don’t do a lot of macronutrient numbers. I really think it’s based on the person’s metabolic rate, how much you’re exercising. There are so many factors involved.

I tend not to overrecommend a lot of protein because sometimes, people get too much. I know that’s a very common topic these days: making sure you are having enough animal protein. I get it. We do need those amino acids for certain reasons in our body. 

I have seen some women in my practice who are doing more of the ketogenic, higher protein and higher fat, and limited carbs. Maybe it’s 20-30g or less of carbs per day. I see that change their lipid levels, and I see it change their mood. It changes the gut. Sometimes, there can be adverse effects. Again, it might be mild. 

I usually don’t give people a gram of protein per day to eat. I put it back to them. If you love chicken, seafood, turkey, that’s great. If you love to have steak a few times a week, your body seems to be taking that in and absorbing it well, then keep doing that. 

I tend to think that people overdo it quite honestly with the amount of protein. They overestimate the amount. If your body is getting too much, it’s going to excrete it or store it, or it can cause other problems. 

I give general recommendations to people. I give them a guide.

Dr. Eric: 

I’d like to talk about testing. You said you do a good amount of testing. I don’t know if you do all the tests on everybody. You mentioned gut testing and DNA testing. Can you talk about what tests you recommend on most people? If there are other tests that you recommend, depending on the person? I don’t know if you recommend genetic testing for everybody or just a subset of your patients. Same thing with gut testing. If you test for not only sex hormones but adrenal hormones, do a saliva test or dried urine test? 

Dr. Kristi: 

As I mentioned, I’ve run almost every test on clients over the last 15 years in practice. There is so many. There are almost too many possibilities out there on what can be evaluated with the body. 

There are certain programs I have in my practice that I have built in the last few years. I have a six-month program called Elite that contains a lot of cool features. It includes all the testing in the program. 

I do food allergy testing. I have been doing it for so many years. Sometimes, I think about getting rid of that test. I personally love it. Professionally, I love it because it’s a blood test, and it’s showing an IgG and IgE antibody or immune globulin reaction to those foods. It seems to be very sensitive. I have looked at other food sensitivity panels over the years, but I keep coming back to this one. There are certain favorites I have. We tend to think of gluten and dairy and the common foods that are talked about so often today, but there are other foods like green beans. 

You asked me earlier about food elimination. If I see certain foods that might be elevated, maybe in the moderate to high category, or simply based on what they shared with me. I do know certain tests are very accurate, or there can be a false negative, where it doesn’t show much, but I am suspecting they might still be sensitive to a food. I will have them get rid of it for at least a month if not longer. Some people are okay with that; other people have a really hard time. 

If it’s the holidays, I don’t usually have people get rid of eight foods right before Thanksgiving and Christmas. If you really want to start cutting back, maybe start at the beginning of the year. Really clear this out of your body, so you will feel much better. Usually, they’re on board with that.

The food allergy test, anywhere from 100-200 foods. People love it. They love that kind of data. That’s the one test they are super fascinated by. It shows them what’s happening when they put these foods into their body.

I also do that custom comprehensive metabolic panel. All the different systems, the livers, the kidneys, the reproductive hormones. I love to look at the sex hormones on a serum level, but I also do the Dutch test, which is part urine and part saliva. I love to compare those two because there are sometimes certain test markers, certain hormones that are more sensitively picked up on a blood test compared to urine or saliva. Pros and cons to every test.

It also looks at all the different thyroid markers, the antibodies, the advanced cardio-lipid markers, Vitamin D, iron, FSH, LH. It’s something I’ve put together myself as a custom panel. Based on my years of experience. It’s so simple. It’s just a simple blood test that I order through Quest, but it shows so much. 

I love to do the Dutch test, as I just mentioned. Looking at reproductive hormones, sex steroid hormones, corticosteroid hormones. It’s part urine, part saliva. It shows that cortisol awakening response and that Circadian rhythm tendency or influence and how the corticosteroid hormones will affect the reproductive hormones. 

That’s usually done at a certain time of a woman’s cycle. If she is not bleeding anymore because she is menopausal or had a partial hysterectomy or a Mirena IUD, which is pretty common for a lot of women, to have an IUD and not get their period anymore. That’s another topic. The Dutch test can be done. If you’re not using a period, it may not be as sensitive.

I love to do stool testing. This is in the Elite program I have. I do the Genovva GI Effects. There is a one-day or three-day. I have a mid-tier six-month program that will still incorporate many of those labs, but it might be quite the expanded, detailed nature of some of these other labs. They have other modifications, other smaller versions of these labs, too. 

The GI Effects, I love because it looks at the healthy gut bacteria, potentially disease-causing bacteria, candida, yeast, protozoa, parasites, inflammatory markers, digestive markers, absorption markers. It’s what your body is excreting. Nobody really likes to do that test. It’s not the most favorite one to collect for. It does show quite a bit of data.

The last two would be a nutrient devaluation, which looks at how well your body is absorbing your proteins, amino acids, antioxidants, vitamins, minerals. And the organic acids, which is what we excrete in the urine as a way to show a deeper level of what’s happening biochemically, metabolically within the body.

The DNA test, I have recently started doing that one. I know it’s been around for quite a while. That one is in the Elite program I have. I love it because it shows these detailed reports that accompany- It’s a very simple salivary collection that shows genetic potential or susceptibility that is not a diagnosis by any stretch, as you and I both know. 

Epigenetics plays a big role here. You can influence not only what happens to your body, but you can also make changes now, so you may not be at a higher risk for certain things developing. You may need to make some modifications along the way. I like the detailed nature of the reports that accommodate the different body systems.

Those are the types of tests I love to order. Based on my history of having been in practice for so many years. I’ve run SIBO testing and heavy metal testing and all sorts of different valuations to see what’s happening. I think it’s easy to go down that rabbit hole. 

For some people, that more one-on-one care, where it’s somebody coming in for a variety of different health conditions. My practice or business has now focused more on women’s health and hormones. I have chosen certain labs that I feel best reflect or best show what’s happening in the body. 

The patients love it. They love the data. They like the one-on-one connection as well. I do spend a lot of time with my clients. But they love the data. They are always curious about what each test will show. “That’s why I’m feeling so tired. That’s why my body feels so inflamed. That’s why my eczema flares up when I eat these foods, and I’m under a lot of stress.” People find it really interesting. 

Dr. Eric: 

Can I ask what company you use for genetic testing? 

Dr. Kristi: 

I use the DNA Company. 

Dr. Eric: 

Since you use Genovva for the GI Effects, where you talk about Nutreval, is that what you use for nutrient testing and organic acids testing? 

Dr. Kristi: 

Yeah. There is a lot to this. That’s why I have a six-month program. People meet with me consecutively for six months. My practice is completely virtual, so I do a screen share. We go over all the testing. The testing procedure itself can be complex for some people. I can always go over that with them directly. 

Fortunately, each lab has collection instructions on their website. Genovva has completely revamped everything, but they have a beautiful description and summary and tutorial of how to go about collecting. Same thing with the Dutch test and some other tests. This can be overwhelming. 

I usually tell all my clients, “You don’t have to do all this testing right at the beginning.” I have a three-month program, where they meet with me for three consecutive months. That doesn’t include any testing. That way, they get to pick and choose which labs they want. It’s less involved, and it might just be one or two tests, especially for younger clients under the age of 30. They don’t have a lot of serious health problems, so they often choose the three-month program.

The lab testing shows a lot of data, but it can be overwhelming. I usually tell people, “Let’s have you do one or two tests per month” to break it up. I am giving them a specific, personalized treatment protocol to go with each appointment. They are following the treatment, making changes to their diet, getting the supplements. Now they are doing testing. The six months is a good start. It seems like a long time, but that’s just the beginning of them making substantial changes in their life and body.

From that point on, they can continue to work with me on a monthly membership basis. If they feel like their body has healed, and they feel like they have a really good handle on the resources and information and guidance that they have received, they can now go on their own. That happens a lot. “I had no idea my body was reacting in this way. Now that I know what to do, I can take this with me and move forward.” 

Some people need more help. I have clients who have been working with me for 10-15 years. I have some five-years. I have some who go through the program, feel great, and move on. 

It can seem like a lot. I am there to guide them the whole way. The communication, the interaction is really key here. That’s what I love about functional medicine, naturopathic medicine. There is so much more care and attention involved in somebody’s healing versus “Here’s your medication, here’s your pill, send you on your way, come back in a few months.” I don’t think that delivers the best resolution for people with regard to their health.

Dr. Eric: 

I agree. I want to talk to you quickly about bioidentical hormones. Obviously, you do this testing to try to find out the imbalances they have and make recommendations to correct those. For hormones, especially the sex hormones, like progesterone, estrogen, testosterone, when do you recommend bioidentical hormones? Are there times when you don’t recommend bioidentical hormones? When you try to correct the hormones through diet and lifestyle.

Dr. Kristi: 

Another great question. Coming back to an individualized approach to each person, that’s why I love the lab tests to show what’s happening in the body. I have been doing this for a while. I can often assess what’s happening in the body based on their symptoms. “Oh, I bet they are not producing enough progesterone in the second half of the luteal phase of their cycle if they are still menstruating.” “I’m suspecting their testosterone is too high or low. Maybe their estrogen is too high.” Based on their symptoms. Having spoken to thousands of patients by now. 

I like to use the lab test data, the blood tests, the comprehensive panel that looks at the sex steroid hormones, plus the Dutch test. Sometimes, they don’t need to do both. Sometimes, doing one or the other is sufficient for me or them. 

For some clients, I will prescribe all three: estrogen, progesterone, testosterone, especially if they are post-menopausal. If they are post-menopausal and having hot flashes and night sweats and trouble sleeping and low libido and all sorts of other estrogen deficiency symptoms, I will prescribe all three. 

I love prescribing to compounding pharmacies. I have been working with compounding pharmacies for over 15 years now. I love them. They really do work with the doctor and the patient to get the right dose. 

I learned from this doctor up in the northwest, Dr. Jonathan Wright. I learned about how to really lower the dose, so it’s not so high. I see a lot of other doctors and practitioners that are prescribing a cookie cutter recipe of hormones for every client: Here is the estrogen patch or pill. I think that often gives the female too much, and now she is gaining weight or having adverse symptoms. I think it should be tailored. 

I don’t prescribe high doses of hormones usually. The application site matters. The amount of cream, the concentration of the hormones. Sometimes, I use bioidentical oral hormones. Sometimes, I use progesterone, based on her symptoms. Sometimes, I will just use one hormone, and I won’t use the other two. Sometimes, it’s just twice a week instead of consecutive days in a row. Maybe it’s only two weeks out of the month. 

That’s where that personalized care for each person comes into play. “This is what I have always done. Here is your recipe. Here you go. Pick it up at the pharmacy. I’ll see you in two months.” I want it to work for her. 

That is the benefit of working with somebody like me, where there is a program. If you’re having a reaction to something, you can send me a message and say, “Hey, my body isn’t responding well to this.” “I don’t think this is enough. I think we need a higher dose because it’s not fully addressing.” That’s where that adaptability of “Let’s use this hormone. Let’s take this hormone out. It sounds like your body may not need that quite yet. It’s causing a reaction.” I typically use a variety of bioidentical hormones if I feel it’s a good fit for her. If not, we tried it. Maybe we reduce the dose. 

I use botanical medicine. I love botanical medicine, herbal supplements, nutrient therapy, diet/lifestyle. It’s going back to the whole person. It’s not just take this pill for your night sweats, and take this pill for your sleep. It really is looking at the whole person and giving them a recipe. It’s a personalized treatment protocol for that person, men or women. I don’t see a lot of men in my practice like I used to. It really is a personalized approach to giving her what she needs and knowing that that can change over the course of several months or years. 

Dr. Eric: 

It sounds like you do like bioidentical hormones, but you don’t give the same dosage or hormones necessarily to everyone. I like that you said that you’ll tend to give lower doses. If someone needs a higher dose, I’m sure you’ll give it. It sounds like there are practitioners out there who give the same dose to everybody. It doesn’t make a difference to the person. Probably also giving all three hormones to everybody as well. More cookie cutter. If someone needs a higher dose, you will give it. You won’t give every single person a high dose of all three hormones. Some people might just get one hormone. It really does depend on the person. 

Dr. Kristi: 

If a woman is getting acne breakouts because I gave her testosterone to help support her libido, or getting chin hair or having hair loss, that is not going to make her a very happy woman. She doesn’t want those reactions. That’s where you cut back. 

There is a dance between what is the right amount to help you with your symptoms, and what is the amount that is going to cause adverse side effects? Same thing with progesterone and estrogen. It’s really tuning in to each woman to ask the right questions, so it can be changed. It should be. 

Going back to compounding pharmacies, I love that I get to modify the dose, send it over, and it’s usually a better fit. It is more personalized for the client as well. 

Dr. Eric: 

Dr. Kristi, you have covered a lot. Is there anything that I should have asked you that I didn’t ask you? Anything else you’d like to talk about? Any final thoughts or advice to give to the listeners? 

Dr. Kristi: 

We did cover quite a bit. I know your specialty is thyroid. I would say that with women’s health, I’m sure you’ve encountered this over the years, having thyroid health be your specialty. That tends to be more common in women. 

A lot of times, with the hormone changes that a woman will experience, that will sometimes affect her thyroid in a way that will either lower the thyroid hormone or sometimes raise it. It can change the thyroid markers and levels in her body, so her metabolic rate is different with the hormone changes, which can change metabolic rate. Of course, thyroid tends to change for a lot of women in their 40s as well. As we know, it does change in the second half of everybody’s life.

That’s where focusing on diet and exercise- Muscle strengthening raises your overall metabolic rate and mitochondria. That helps with everything. Why is my thyroid off right now when I am going through perimenopausal changes? Why is my thyroid off when I am going through this stressful time in my life? Bringing that piece in, too, and making sure that gets normalized. 

You have probably found this before. When you work with somebody to treat the whole person on every level, as much as you can, the thyroid can correct itself over time. it can often regulate. 

In working with me over a period of time, a lot of times, they are able to come off their thyroid hormone completely. It surprises me to this day still. It surprises them. They feel too revved up on it because their body is functioning at an optimal rate and working more efficiently, so they don’t need it anymore. If you don’t need it, you don’t need it. That’s with anything. If you don’t need a medication or extra supplement or a higher dose of bioidentical hormone creams, and you can come off of it, I think that’s a win. That’s one last piece I wanted to add in.

Dr. Eric: 

I agree. Quick question: Do you recommend desiccated thyroid, or is it more levothyroxine for thyroid hormone replacement? 

Dr. Kristi: 

It depends. There are some people who do really well with the desiccated. I know there have been some changes with the desiccated thyroid availability in the last few years. I have a lot of clients who have been on desiccated over the years, and they do well.

I have some who don’t. It just makes their body feel worse. We do either the standardized prescription levothyroxine Synthroid. Sometimes, I will do a compounded version of synthetic T3/T4. I do that for some of my Hashimoto’s patients, working with everything else in their health. That goes back to the case by case. I want to make sure I am giving them the right medication, so it works well for their body. As much as I love the natural T3/T4, some people overreact to that. It varies from person to person.

Dr. Eric: 

Where can people find out more about you? You mentioned your programs. If someone is interested in joining one of your programs, can you mention your website? I also know you have a podcast. If you want to bring up social media, feel free to do that as well.

Dr. Kristi: 

My website is DoctorKristi.com. I am on Instagram, @DoctorKristiTompkins. I have a Facebook group called Perimenopause/Menopause Like a Goddess that you can join, all about hormones. We talk about a variety of different women’s health issues.

I have a new podcast that I just launched called Fire, Soul, & Grace. It’s going to be a lot of different episodes on women’s health, hormones, functional medicine, mind/body medicine, meditation, ways of healing the body, and ways to optimize your health and life, and uplevel your health, too. Really excited about that. If you go to FireSoulAndGracePodcast.com, that will reroute you back to my website. Lots of great guests I have on my podcast coming up. 

I have been so excited to be here with you, Eric. 

Dr. Eric: 

Same here. Thank you so much. I’m sure the listeners learned a lot. As usual, I learned some things as well. Appreciate you taking the time to share your thoughts on hormones.

Dr. Kristi: 

Thanks, Eric.

 

Recently, I interviewed Dr. Florence Comite, and we talked about healthy longevity and hormone optimization. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am very excited to chat with Dr. Florence Comite. We are going to be talking about precision medication, optimizing hormones. It’s going to be a really fascinating call here. 

Let me go ahead and give Dr. Florence’s bio here, as Dr. Florence Comite is a clinician, scientist, and innovator in the field of precision medicine. She is world-renowned for her expertise in predicting, preventing, and reversing chronic disease and the disorders associated with aging. 

In 2005, Dr. Comite founded the Comite Center for Precision Medicine and Health, where she practices a clinically proven, academic approach to personalized health care, structured as a clinical trial in Groq Health, a mobile app with science-backed AI and ML-backed systems to identify treatment and lifestyle changes to reverse and prevent the diseases of aging.

Groq Health, a revolutionary new app that delivers personalized precision medicine to reverse biological aging. It’s currently in beta testing. The application offers Dr. Comite’s patients highly personalized health care that interprets their genomic, metabolic, phenotypic, and digital health data into individualized action plans. The AI-powered app is being developed with the intent to expand the impact of precision medicine and empower people to take control of their health. Check out that app. 

I think I listened on a previous podcast that it won’t be out until sometime in 2024, which we are pretty close to as of recording it.

Very excited. Thank you so much for being here, Dr. Comite. 

Dr. Florence Comite: 

Appreciate being here. Florence is fine. Can I call you Eric? 

Dr. Eric: 

Without question. 

Dr. Florence: 

Great. Since we’re both from Brooklyn and Queens, I think we’re related probably. 

Dr. Eric: 

Florence, can you dive a little bit into your background? When you graduated from medical school, were you a more conventional doctor? Did you always want to be more integrative, functional medicine? Give more of your background. 

Dr. Florence: 

I’d love to. I actually did start when I graduated. Maybe not quite in the way we’re thinking. My father asked me when I graduated medical school, “Can you now help me be healthy?” I looked at him a little confused and said, “Medicine is about treating disease.” He said, “That doesn’t make sense. Shouldn’t you try to keep people healthy?” I said, “That’s a great idea.”

I think I went through training subsequently after graduating from Yale. I stayed at Yale doing residency in internal medicine and hit several fields: a deep dive into adult specialty, pediatrics, and women’s health, which also incorporated men’s health but more from the fertility point of view.

Then I was at NIH, where I became a clinical scientist and worked hard to look at research and how you bring a research, scientific mindset. I did a lot of research. I published a fair amount. I went back to Yale and stayed on the faculty for 20 years.

I began to realize about 20 years ago that we all start aging in our 30s. Why don’t we pick up on that and stop disease from happening before you get symptoms? That started me on this path of proactively wanting to stop people aging, which is a big risk factor for all diseases. I felt like if I could stop aging, it would also stop chronic diseases of aging. 

If you think about it, diabetes for example is one great disease that happens more often than not as people get older, like in their 40s, 50s, and 60s. It’s really beginning way before that.

I felt that if people could stay physiologically younger and healthier the way my dad described it and wanted for himself, that would be a gift. Why get sick if you don’t have to? That’s how my work began in this field, from scientific and clinical applications. 

Dr. Eric: 

You still to this day then do quite a bit of research? 

Dr. Florence: 

I do. In fact, the center that I started in New York in 2005 was an outcome of that. What I designed was something we now call at this Comite Center for Precision Medicine and Healthy Longevity as an individualized study of each human being. We think of it as n of 1. 

Most of medicine is population research, where you are looking at thousands if not millions of people. Then you are applying it almost as a one size fits all, not individually to each human being. 

That came at the same time I had this epiphany. I was giving a dinner club at Yale. Why do we begin to fall apart in our 30s? We’re fine up until then. In our 30s, fertility. Men begin to get heart attacks in their late 30s if they have a proclivity to that. Women start more easily than men putting some weight around the middle, slowing down. In some ways, energy becomes a factor. Osteoporosis. That just begins to accumulate as you hit each subsequent decade of life.

I knew at the time being an identical twin that my twin and I were not exactly alike. I was always interested in genomics. It was around that time that the whole genome was described, looking at DNA. I felt that it wasn’t ready for prime time because you couldn’t really peer into function at a dynamic way. 

I began to study metabolism and endocrinological, hormonal optimization to see how we stop people from getting older at the cellular level. How do we keep them in the best shape they can be in, which generally happens, not everyone but most people in our 20s? That is prime time.

I felt like if we could keep people physiologically in their 20s, or no more than 30, we wouldn’t be doing the Abby Hoffman thing, where we’re getting old in our 30s. Effectively, we are. Many of us blame it on having children, a family, being really busy, trying to make it in our career. Even if we did exactly the same thing as we did in our 20s- Marathoners or triathletes are great examples of it, but they still have heart attacks. Why? Those questions occurred to me. 

Along with the fact that each one of us is unique. My identical twin and I are not even alike. For example, I could live on sushi and sashimi, and she doesn’t like fish at all, except for mackerel, which I always forget to say. We grew up eating herring, which is mackerel. It’s a very strong fish, so it’s unlike tuna and salmon and all the rest of that delicious stuff. 

She is an amazing gardener. I can’t garden. Our teeth and eyes are different. Our guts are different. It didn’t make sense to me. If we’re identical twins, what’s changing? 

What occurred to me at the time is it’s expression of genes. That’s what my research has been about for the last 15 years. How we define n of 1. What’s right for you, Eric, might not be right for your brothers, if you have brothers. I don’t know if you have siblings. Or your cousins. Even if the genes look alike, they don’t always act alike. That’s identical twins.

Dr. Eric: 

That is tying into precision medicine. Everybody is different from what you’re saying. Not everybody requires the same diet. Not everybody requires the same stress management skills. We could go beyond and beyond. Supplementation. Maybe you could give a better definition of precision medicine. 

Dr. Florence: 

Exactly. You got it right. I can delve a little deeper. The word “precision” for me comes from data. To me, without data about a human being and how they act at the cellular level, metabolically, hormonally, what their thyroid is doing, what their brain is doing, what their ovaries or testes are doing, you can’t tell people apart necessarily. 

The data is what I think of as the personal health story. Instead of what we typically do in conventional medicine is very reactive. You have to get sick, and then we’re good at it. We jump all over you. That is reactive medicine. To me, it’s about being proactive. 

I’m actually, unlike you, not trained in functional medicine although a lot of my functional medicine colleagues and friends think I know functional medicine. To me, the root cause of disease, which is the core of functional medicine, has to do with the etiology and how genes are expressed. 

Precision to me is data married to somebody living life: how they sleep or don’t sleep, what their exercise is like, what they are willing to do to put effort into eating maybe a little differently. I don’t believe in suffering. If we get this right, we’ll live even longer, maybe to 120 or 150, in great shape and enjoying life. It’s not about suffering to do everything perfectly. It’s not about fasting all the time or living on paleo or keto. It’s about what’s right for that singular human being. 

The Comite Center has been called a living n of 1 lab, meaning that it is really about a collection of people and data and people who want to invest in their health and own their own health trajectory. How do we stay healthy for the rest of our lives and never get diabetes or have a heart attack or Alzheimer’s or a stroke or cancer or osteoporosis? That’s really what precision is about to me. The data to put into play actionable interventions that are fit for that specific human being, if that makes sense. I hope it does.

Dr. Eric: 

It does. I guess you are going with the Groq app that’s coming out. Getting even deeper into genomics. I assume now, these days, you do genomic testing on patients? 

Dr. Florence: 

Yes, we do. I felt about a couple of years ago that we were beginning to reach a time where we could use genetic variance, meaning if your genes aren’t exactly functioning right, what are those variants telling us? 

Can you detox mercury? I found out that I’m not a great detoxifier. That puts me at higher risk for certain kinds of cancer and accumulating bad toxins like mercury, which is at 38 for me when you want it less than 10. My twin sister is undetectable because she doesn’t live on fish the way I used to. 

In one year, I was able to bring it down after identifying it. I didn’t learn until a couple of years ago when I looked at gene variance that we now have operational at the living n of 1 lab, which is the Center, that I knew that I don’t detox well. I need to be able to be careful what I do.

Another example which I’m not too good at, so I hope your audience can appreciate, as they may feel the same way. I don’t have Celiac, which would make it hard to digest gluten. It’s ubiquitous out there in every slice of pizza and great bread, which I could live on, too. Yet it’s hard for me to be gluten-free. I go through periods where I try to be my best at it. That inability to detoxify also affects me. There are lots of examples of that. Yes, we’re in genomics. 

What Groq is, because you have connected the dots, is really taking a component of what we do at the center and delivering it to everybody on a virtual medical platform, using an app for people to be able to upload their own data to get a continuous glucose monitor to measure sugar, for example; to look at their bio markers and their five key ones, which I’m happy to jump into, that have come out of my research and make a difference in every single one of us. 

We are all born as men and women with genes that may not be perfect. When they come together, it creates a unique human being. By figuring out how we live life and what we do, we can change your future state of health by stopping chronic disease and reversing aging, which people stop me when I say that. We have the data to prove it. I don’t know how much you’re into that, but I’m happy to point you in the right direction to hear more about it.

Dr. Eric: 

I’m definitely interested. I would love to talk more about the biomarkers. 

Before you dive into those, quick question: When it comes to reversing aging, I assume the earlier you make these changes, the better. For someone like me, who is 53, and someone else who might be in their 60s or 70s, is it ever too late to reverse the aging process? 

Dr. Florence: 

Great question. No, it’s not. If you look up RejuvenationOlympics.com, which is a site that was started by someone who has gotten out there because he is spending millions on his own health to try to reverse aging in every cell in his body. He is in his 40s, Bryan Johnson. Have you seen or heard about his work? 

Dr. Eric: 

I don’t think so.

Dr. Florence: 

He created a website. I’m not sure if it’s a business, Blueprint.com. He also set up this site called RejuvenationOlympics.com. You’ll see that people are listed there who have reversed aging. As such, we are 25% of the leaderboard. Peter Diamandis and some of the other folks who believe in extending health and longevity are also part of it. 

The Comite Center is 25% of the change. The top 20 of a couple of thousand people who have found it and uploaded their data. I am very proud of that because it’s independent validation, looking at biological aging. That is the point I want to make.

It’s far easier if you’re younger. Your system has more to it. You can burn the candles at both ends as a teenager and 20-something. It gets harder as a 30-something. It gets even harder every decade. Then I have seen 70-year-young people twice as healthy as 35-year-young people. It’s completely up to that n of 1 individual and what’s going on below the surface, in their health story, how they live life, their family history, the choices they’ve made. All of that is reversible and changeable.

With the exception of some genes that are known to be autosomal dominant, meaning they will express no matter what. A good example might be BRCA. 88% of people have a certain kind of BRCA gene that causes breast cancer, prostate cancer, and a few others. They are more likely to express it. It depends on how they live life and what they are doing to treat it.

There are other conditions that are supposed to be autosomal dominant that are not. Lewy body Parkinson’s, which Robin Williams had. Nobody diagnosed it. One of my cousins had it and sadly died at 70. You start with dementia and then get signs of Parkinson’s. Sometimes, it’s not diagnosed. It wasn’t in my cousin for about 20 years. It wasn’t in Robin Williams either. He was able to cover it up as an actor really well. 

Most things though, believe it or not, are reversible. If you catch it at an early age, and even later, if you’re willing to put in some effort in juggling your life. Everybody has to make those decisions. 

I told you about me and gluten. On the other hand, I’m at high risk for macular degeneration, which is an eye condition where you don’t have central vision. My father had it. I inherited the gene, as did my twin sister. It turns out that by limiting Vitamin A and not overdosing on Vitamin A in certain fruits and vegetables that I love, it will help me avoid macular degeneration because it helps to precipitate macular degeneration. By using sufficient amounts of Vitamin D and making sure I absorb it.

That’s kind of interesting, isn’t it? Vitamin A is great for the eyes. Tomatoes, anything red, red peppers, carrots. All three of them, I can live on. I munch on tomatoes all summer. I mentioned my sister is a gardener, and so was my mother. We grew up eating tomatoes like they were apples. They are a fruit, but we think of them as a vegetable. 

I avoid a lot of Vitamin A now. I try to do it more in moderation. Instead of three packages of two pounds of carrots in the chicken soup I make, I try to limit it to one package of carrots. It’s sweet. I like sweets. That’s an example.

When you look at the Rejuvenation Olympics website, to go back to your question about being too early or too late, where the right time is, it’s never too late or too early. The age range for our clients (we don’t call them patients because we want them healthy, and in Groq, they’re members), is 15-73. You can see the span is great. We want it to be for everybody. 

I think if people own their own health—that’s what Groq is about—then they won’t get sick in the same way. They will be able to protect aging and their health and their money. Being sick costs a lot of money, not only compromising life. That’s what should be stopped. I believe it can be in this century. 

Dr. Eric: 

That’s awesome to hear. It’s very interesting about Vitamin A. I would have thought the opposite, like you mentioned Vitamin A is known for eye health. If you have the gene that predisposes you to macular degeneration, you’d want more Vitamin A, not only through food but maybe supplements. It sounds like it’s the exact opposite, where you want to limit it. Beta carotene sources, not just active Vitamin A. Very interesting. 

Dr. Florence: 

You’re exactly right. There was even a study years ago in the New England Journal, where if you take Vitamin E, but only one type, it increases cancer. I like to keep people aware of what their nutrient makeup is. For example, you know as well as I do that fat soluble vitamins can be dangerous. Too much Vitamin A causes hair loss as well. You could overdose on Vitamin A. 

It’s confusing out there. You go into any pharmacy, and how do you choose what supplements are good for you? 

We believe in looking at the specifics that make up you as a human being to figure out if you actually need D to pull in more calcium and strengthen your bones, but D is also a hormone that is fat soluble. You can’t overdose on D almost. Most of us have too low D. I haven’t met a person with D that is greater than 50. A lot of people are in the 20s or even in the teens. We want Vitamin D levels to be 60-80 as a sweet spot. 

It’s really good not just for calcium and bones, which we all know. But it’s actually a hormone that affects every cell in the body and protects the immune system, brain, heart, thyroid. You want to be able to know these facts to be able to apply them for yourself. 

Dr. Eric: 

Same here. I see a lot of people deficient in Vitamin D. Most people are lower. I’m guessing Vitamin D is one of those top biomarkers that you mentioned earlier that you are going to discuss? 

Dr. Florence: 

It actually isn’t. Here’s the thinking around it. Vitamin D is really important. The one group of people you want to be careful of is people who are stone formers and make calcium. That can be genetic. It can also be from dehydration and not drinking enough water. If you have it in your family, it makes the odds higher.

Vitamin D presumably is low in everyone. You can’t get enough from the sun. We have lost that ability. Darker-skinned people even more so. The data I have read and interpreted over the years has shown that if you want to absorb Vitamin D from the sun, you have to be nude for an hour near the equator, and you can probably get some Vitamin D. I follow people who live in NYC and go to Florida during the winter. I have only seen one person increase their Vitamin D level from sun alone. 

You really need to take a supplement. That would be something that everybody should take, but not a lot of it. Maybe 1,000-2,000 a day of D3. We believe it should be taken with K2 because otherwise, you don’t channel the D or the calcium into bone. You need the K2, which acts in a coagulation sequence. 

There are some complexities around that because if someone is on a blood thinner, you have to be careful when you take it. Vitamin D with K2 at a certain level and a certain kind of K2 is important to have enough calcium in bone, not to get the calcium in breasts or the heart or precipitating in the prostate or anywhere else in the body. That’s a good combination.

It’s not one of our top biomarkers because it is ubiquitous. I’m sure your followers who have had their Vitamin D measured have seen how low it is. Sometimes, the doctors don’t know that a Vitamin D of 30, just because it says it’s okay on a Quest or LabCorps range is fine. It’s not usually adequate. There are many people who have osteopenia and are at risk for osteoporosis who should have more calcium in their body as well.

We don’t actually prescribe calcium ever. I haven’t done that for 20 years. There is no need. If you have adequate D, you will mobilize calcium from your gut. Make sure you have calcium in your diet. Does that answer your question with a little bit more frills? 

Dr. Eric: 

It definitely does. Just to confirm, do you like to see in most people, if not everyone, the 25 hydroxy Vitamin D levels to be at least 50? 

Dr. Florence: 

At least 60 actually. 60-80. If they go up to 100, no problem. In people who are at risk of forming calcium stones, sometimes people know they have kidney stones, but they don’t know what kind. If they have had an immediate family member—a father, a mother, a sibling, even a child—just be aware that they need to undertake Vitamin D. Don’t take too much; take less. 

People who don’t have stones can take 5,000 international units a day. People who have stones in their family or they themselves have produced a stone, I’d be careful and make sure to take 1,000-2,000 daily, no more. Make sure that they drink a lot of water to the extent that their urine is clear, that it looks like water. Forget counting. If you know that you’re peeing, and it looks clear, that’s a good sign. You’re staying hydrated, which helps to stop precipitation of stones.

Dr. Eric: 

That sounds good. I could talk more about Vitamin D for a while. Definitely want to hit some of the other points, including those top biomarkers. Why don’t you talk about those five? 

Dr. Florence: 

There are five that we found are most critical in everybody. This is the part we based on research in that there is no one person I’ve seen, and I’ve seen thousands over the years who actually metabolize sugar effectively who aren’t on a trajectory to become diabetic at some point in their life. It could happen in their 30s or their 90s. That’s because it’s survival.

The five key biomarkers speak to hormonal optimization, cholesterol, and all the carbohydrate markers that can tell a person what’s happening today, and where they are headed for the future. No one wants to become a diabetic. It’s not a fun thing. If you can stop diabetes in your tracks, you’re stopping the risk of heart attack, stroke, even Alzheimer’s. You’re stopping the risk of kidney disease or eye disease, skin disease, things like neurological disease, like paresthesias of the hands and feet, which I have seen precede diabetes in people who don’t even know they are prediabetic or diabetic. 

The millions and millions of people around the globe with prediabetes or diabetes is to me an understatement. It’s actually everyone. It’s a survival gene. If we couldn’t put on weight when we fasted or when there was a famine or when there was the Holocaust, we wouldn’t be able to pass on those genes because the folks who lived through being cavemen/cavewomen, which all of us must come from that era, had a survival winter that may not have fed them. Those genes are ubiquitous. There are at least 1,500 variants of sugar, metabolism, types of genes. We all have combinations of them. 

We measure fasting sugar, fasting insulin, and hemoglobin A1C. I can talk more to the complexities and combination thereof if you’d like. 

But the other two biomarkers that relate but also have other impact is free testosterone and what we call cholesterol risk ratio. That looks at a ratio of total cholesterol and HGL, or what a lot of people think of as “good cholesterol.” The lower that ratio is, if it’s less than 2, the safer you are. These are values that we consider critical biomarkers. In other terms, we call them lab tests. But biomarkers to me are data that help us define the state of your health today and where you’re headed tomorrow. 

Dr. Eric: 

Cholesterol risk ratio, less than 2. How about those other markers? The fasting insulin, hemoglobin A1C, etc. 

Dr. Florence: 

Fasting sugar or glucose, after an overnight fast, sugar should be between 70-80. That is a pretty tight range, but that’s optimal. That means your body has no insulin on board. Insulin should be undetectable, or less than 2 as well, which is the dimension of detectability in the lab studies. 

Both of them speak to how well you manage and metabolize glucose in the system. We don’t need any insulin if we haven’t eaten for 8-10-12 hours. Actually, we don’t need insulin if we haven’t eaten for three hours. If we have too much insulin on board, even greater than 2, 2-5 is sort of target range but not optimal. Anything over 5 speaks to insulin resistance, which means the insulin has been overused in a way, and it’s not working as effectively as it should. 

You really want fasting sugar to be between 70-80. Insulin should be undetectable at less than 2. Then when you eat, insulin does go up. It should mirror glucose. There are ways of eating to do that. Glucose should stay below 120. 

Now, there are reasons glucose might shoot out higher to 150 or 180. They include some good reasons, like exercise. There are patterns that have to be interpreted. But if you eat a banana, and your sugar goes to over 200, that’s a risk factor. The fructose in a banana is not compatible with your system. It doesn’t mean you never eat bananas, but maybe there is a way you eat bananas that keep your sugar below 120. Between 70-120. 

I didn’t mention this, but you don’t want your sugar to go below 70 either. That is a risk for diabetes. Sugar needs to be maintained in this tight zone to keep you optimal and to prevent chronic disease from appearing and sticking with you for the rest of your life. Sugar damages every cell of the body.

We have another trick to it that your followers may be interested in. That is we use continuous glucose monitors (CGMs), so people can really see, like I mentioned with a banana, and test it themselves. They can see singular foods, like what they might eat, what that does to sugar, whether it’s a carb or protein or fat or fiber. Then they can start mixing foods. 

One of the ways we know that we can keep insulin and sugar in parallel together and protective of your health is by starting with a protein before you eat a carb, any carb. Protein, high fiber, or healthy fats, like avocado, olive oil, those in balance will keep your body’s absorbing and metabolizing sugar in a way that’s the healthiest and optimal. 

Dr. Eric: 

If you have an undetectable insulin, and your fasting glucose is between 70-80, is it safe to say that your hemoglobin A1C is most likely looking good? This should also be on the lower side. 

Dr. Florence: 

That’s a great question. It is, with one exception. If your sugar and insulin shoot up in patterns that are not healthy, like after a meal. Let’s say you sit down and have steak and potatoes and green beans with a nice salad on the side. You have your steak that fits in the palm of your hand, so it’s the right amount of protein. You want to have at least 20-30g of protein at each meal. It should add up to at least a gram of protein per kg per day. A kg for those who may not know is 2.2 pounds. If you weigh 60 kilos, which is about 130 pounds or something of that nature, for the women out there, you want to take in at least 60g of protein a day. That would be 20 at each meal if you’re a three meal per day kind of person. If not, keep track of it. 

You absolutely want to see what your sugar does after that. That’s where the CGM can come in handy. I’m sure you’ve heard of all those companies that prescribe CGMs and follow your food. It’s not as simple as food alone, as you’re probably getting the idea from all the information I’m pouring out there. 

If I’m doing too much too fast, tell me, Eric. I’m a New Yorker. We speak very fast here. You can relate. You’re more measured, so I’m impressed. 

If you eat food, and your sugar jumps up to 250 having mashed potatoes, that’s a problem. You could look perfect fasting, but not necessarily what we call post-paranal, which means after food. 

Here’s another tip: I don’t actually call diabetes “diabetes” anymore. I almost try never to call it “type 1” or “type 2.” Type 1 is an immunological disorder, and that is very different than what we think of as type 2. 

I actually call this a disorder of carbohydrate metabolism because it is. All of us have one in one way or the other. As I mentioned, it is Darwinian. It’s about survival. If we couldn’t put weight on our bones and fat on our bones when times are lean, we don’t live through those times. Those genes don’t get passed down. 

We owe it to our ancestors for why food is plentiful. There are golden arches on every street corner right? We can have those delicious French fries although they used to be more delicious; I have tried them recently, and they are not so good anymore. I think they made them healthier. I’m not sure, but I’ve heard they’re different.

It’s easier to put on weight. It’s easier to put on weight in our mid-30s and beyond because our hormones are shifting. You have to be careful. In order to be careful, you have to know what your body is actually doing. The more data you have about how you personally function, the better off a person is going to be. They will be able to judge accordingly. 

Does that mean you avoid all food all the time that causes your sugar to go up to 180, 200, 250? Whether it’s a banana or a bowl of ice cream or a cookie or cake? Absolutely not. There are some people who can eat a banana, and their sugar stays at 80 or 100. There are some people who eat a bowl of ice cream, and their sugar stays at 110. Remember, ice cream has some protein in it. 

There is a study out of Israel from the Weizmann Institute that showed very clearly, they compared two people out of the thousands they studied. I think they studied 1,600 or so. One person, sugar went sky high on a banana but didn’t do anything with a cookie. The other person had a cookie, and it went sky high, but the banana didn’t do a thing. It’s about learning about you individually as a human being, that whole n of 1 concept.  

Dr. Eric: 

That makes a lot of sense. Do you currently use a CGM on yourself? 

Dr. Florence: 

All the time. It’s right here. I have to feel for it because they’re so tiny. I can show it. I don’t know if people want to see it. Don’t look at my triceps though. They’re not the best. I work on it, but I’m convinced I was born without triceps. I am only kidding, but it’s so hard. See it right there? 

Dr. Eric: 

I do.

Dr. Florence: 

My sister has amazing triceps because she did more swimming than I did years ago. I don’t swim because it gets your hair wet, and it’s hard to dry it when your hair is long. That’s one excuse anyway.

I love rollerblading, and she doesn’t rollerblade. She has great triceps, so she is able to wear sleeveless clothes and look much better than I do. I guess as an identical twin, I probably can get great triceps. So far, I’m working on it. It’s a work in progress.  

Dr. Eric: 

I’m sure you’ll get there. Tying into muscle mass, free testosterone. Testosterone is important for muscle mass. Protein also, which you mentioned. Free testosterone, another one of those biomarkers. What’s an optimal range for that? I guess it probably differs with men and women. 

Dr. Florence: 

It does, but we do have optimals. There is a spectrum, and we judge according to somebody’s health, how they feel, what they’re presenting with. In men, it’s a little easier than women. We women, as you men probably know, are very complex. Each woman is really her own thing. 

In men, it’s still the n of 1, but you can look at change in men as they age over time. It’s more linear. In men, beginning in their 30s, just like women, testosterone falls by 1-3% a year. We women have far less testosterone than men. That’s why we’re at higher risk earlier in life for osteoporosis and fracturing our wrist or shrinking or curvature of the spine or hip fracture later in life. You’ve seen plenty of men walking around hunched over a walker because they have severe osteoporosis, and their spine has collapsed. 25% of all men and women will be osteoporotic. Men, it starts about 10 years later than women.

Women’s testosterone should be between 6-30. I’m talking about free testosterone. Why we women also put more weight around the waist, women who do everything pretty much perfectly and maintain their weight, frequently, they’re 35-45, and they come to see me because they have put on 2, 3, 4, 5, 6 pounds, which is almost nothing for some other women. In these women, they look great, they have done everything, they work out, they eat as well as possible, or they are just gifted genetically, which is a thing. That’s because their testosterone is low. 

I think of a woman I just saw and spoke to a couple weeks ago, Sarah, who was in fabulous shape. She was turning 43, and she wasn’t happy because she had put on five pounds, and her clothes didn’t fit her right. We put her on testosterone. We also found out at the time that she was osteoporotic, and that was only by doing a bone density test, which I recommend strongly for everybody at least starting in their 20s but definitely in their 30s, when you can make a real dent in growing bone. Within weeks, her weight had dropped. It was definitely related to the fall in testosterone because everything else was pretty much in the sweet spot. 

You really want to raise testosterone. Most women come in at less than 2, sometimes less than 1, which is tiny. We have 5-10% of what men have. In men, you want it over 180. I am talking about free testosterone, not total. I’ll tell you why in a second. 

In her case, she went from 1-12 over a period of weeks to months. Her weight dropped almost immediately. She was doing other things she should be doing. When I say that, it’s not just eating protein, which I mentioned at least 1g per kg. For the 60kg women, let’s say it’s 60g. It could be more if you’re heavily into resistance training, which is a good thing because that’s how we grow muscle. 

Those are the three elements that can really make a difference for aging. Without enough muscle, you can become sarcopenic. That allows disease to creep in, either from the outside in, like with COVID for people who have comorbidities and diabetes, or had heart disease. When they were sick, they didn’t have enough muscle and more fat and more visceral fat, so they got sicker, and they died more often than people without it. 

If you were prediabetic, it was 8x as likely for you to die from COVID because of the comorbidity than if you didn’t have diabetes or prediabetes. 

Testosterone, 6-30, free. Other labs may have other levels. Depends on the units that get measured. We happen to use Quest. LabCorps might measure it a little bit differently. Everybody could be a little different. You have to look at where that is in terms of optimal. 

Make sure you’re taking adequate protein in your meal daily and doing resistance training at least 2-3x a week.

Dr. Eric: 

Sticking to the topic of hormones, can you discuss the difference between hormone replacement versus hormone optimization? Does everybody with low testosterone or estrogen or progesterone need hormone replacement in your opinion? 

Dr. Florence: 

Let me start with what is hormone replacement, and what is hormone optimization? First, I started feeling uncomfortable with hormone replacement right from the beginning as an endocrinologist and a reproductive endocrinologist. Hormones was a very deep field of mine along with peptides. I did a lot of research in my earlier years at NIH and Yale in children who had early puberty, using peptides, and in adults, women with endometriosis and fibroids. 

With respect to that, we are not Mother Nature. We can’t do what Mother Nature does and cause a woman- Week-to-week, women’s cycles change. Women’s symptoms change. In men, it’s more every hundred days, every three months, their system evolves. Sperm takes that long to be made. Testosterone goes up and down with response to what we call a negative feedback loop in the body. There is more consistency in it for men. That shifts as men hit their 30s and 40s when they don’t release as much testosterone. Their brain doesn’t recognize it. They are not making enough. In women, it shifts as well based on their ovulatory cycle, or if they are on birth control pills.

To me, optimizing hormones means we can start addressing what Father Time starts taking away from us. In our 30s, testosterone begins to fall. Even before menopause in women and andropause in men starts hitting us, where ovaries stop performing. You can’t make eggs. Men start drifting downward with their testosterone, but they are not recognizing it. Their brain hormones are low. They can make testosterone, but their testes are not being told, “This is how you make testosterone. This is the hormone.” Hormones start falling, particularly LH and FSH.

The optimization is how do we limit risk and improve health? The risk/benefit ratio to me is how I apply doing clinical research with dealing with a singular human being. When we do research, we look at risk/benefit for a whole group of people. How can we get them healthier by any intervention we’re doing or testing? How do we prevent side effects? 

Hormonal optimization is limiting side effects but increasing response. What is the best benefit? As I mentioned with Vitamin D or the hormone D, that is what we do when we look at people at risk of stones. We don’t want them to have stones, but we want to maximize their health. We compromise on the dose of D. That’s the same way I approach any hormone, including testosterone, estrogen, progesterone, prednisone, DHEA, DHT, etc. That is how we look at hormonal optimization. Does that make sense? We want to get the best out of it with the least risk. If that’s what we need for that person. 

Dr. Eric: 

Yeah, that makes sense. One thing I heard with men and testosterone, because you said it starts declining in their 30s. Would you be cautious about giving a male in their 30s or 40s testosterone? I heard if they are still thinking about having children, you would not want to give testosterone. 

Dr. Florence: 

Actually, the opposite. Would you think twice about testosterone if a man wants children? The most common way of giving hormones in this country for now, maybe in the world, is testosterone itself. I have a unique approach to it. I actually use a hormone which is a peptide hormone, not a steroid hormone, called HCG. Have you heard of it? 

Dr. Eric: 

Yeah. 

Dr. Florence: 

HCG, Human Chorionic Gonadotropin. It acts like the hormone that comes from the brain, LH, which I mentioned earlier. It tells male testes to make testosterone. It triggers the lytic cells in the testicle and says, “Hey, wake up. It’s time to make more testosterone. You’re drifting to sleep.” The brain is not paying attention to low circulating testosterone. 

That hormone actually increases fertility. We use it to help men become fertile. Testosterone can suppress the testes itself because you’re giving the hormone. You’re giving the hormone, the testes looks around, and says, “Hey, you might not need any testosterone because it’s on board already.” 

It’s not perfect that way. Actually, men still make sperm. If it was perfectly shutting off the testes, then you’d be able to use it as a birth control. We have never been able to use testosterone as a birth control because it doesn’t really shut down. 

For safety reasons, I would not give men testosterone if they were trying to conceive children. But a lot of men in their 30s are not. If they are at risk, which is less common than your 40s or 50s or 60s, we judge it accordingly based on those biomarkers. 

If your T is low, whether you’re 35 or 45 or 55, we are going to look at starting with HCG if the rest of the numbers fill that pattern. I can give you examples. There is a whole group of men that we treat who has Ashkenazi Jewish background, or they’re Indian and Asian, that have very early heart attack and stroke in the family. A lot of times, relatives, men and women, died early, like by 60, of heart attack or stroke. They were sick beginning in their 40s. We have a whole group of people we treat gingerly, looking at risk/benefit to make sure that we don’t let them go down the path of having a heart attack at 40 or 45 and die in their 60s. 

in fact, the very first person who tried Groq in February 2021 was somebody who had that history whose father was Ashkenazi and mother was Puerto Rican. His numbers looked like a 50-something-year-young man. Maybe this time, year-old man. He was already expressing symptoms of low testosterone, which we hear about, or hypogonadism, meaning his testes weren’t producing enough. His numbers were tested three times. They were quite low. His free T ranged from 50-70 instead of over 180. He was putting weight around the middle. He had less energy, less libido. It was completely reversed within a few months. 

Dr. Eric: 

Wow. Before we start wrapping things up, can you talk a little bit about thyroid? What do you test for in your practice with your clients? 

Dr. Florence: 

Yep. I do. I can. Thyroid is an important hormone as well. Our thyroid gland sits around our neck. It’s kind of like a bow tie, I guess. A little knot in the middle, but with two wings. 

80% of people have abnormal thyroid function. As we age, it’s clear-cut. You can’t just measure TSH. You have to measure free T3 and free T4. Again, that system is interactive. We create TSH from our brain, the pituitary. The hypothalamus at a higher level makes TRF, thyroid releasing hormone, which tells the pituitary to make TSH, thyroid stimulating hormone. That in turn tells the thyroid to make T4. Interestingly enough, T4 is converted to T3, and T3 is the active thyroid hormone. 

If you don’t measure TSH, free T3, and free T4 together, you don’t know the relationship. The range for TSH is 0.4-4 or 4.5. It’s a humongous range. Insurance companies sometimes only want that number, but you can have a high TSH or a low TSH, and your thyroid, your free T3 and free T4 can be abnormal, not the range we want. We look for a free T3 of 3-4ish. We look for a free T4 of about 1-1.5. The balance has to be there. 

I have seen lots of variations on that theme. I think we’ve come too far in a way. Sometimes using lab tests. I have seen many women and men who complain of classical thyroid symptoms like hair loss, weight gain or loss, constipation, ends of the eyebrows losing hair, slowing down in their thinking, or speeding up heart rates. Those are variations on the theme of high thyroid/low thyroid. 

In women, it’s actually interesting. It’s the opposite. If your menstrual cycle is too heavy, it’s usually related to low T3. If it’s high, you have higher thyroid hormones, you can stop your menstrual cycle, or you have a very light cycle. 

You know better than me, I’m sure, that thyroid affects every cell in the body as well. It affects the brain for cognition and memory. It affects the heart for rhythm, muscle, and conduction. It affects muscle and bone. 

Being in that optimal range for all three. I pay attention more to free T3 and free T4 than TSH because that could be anywhere. 

The final thing is if we do see a disruption, particularly where we suspect something called Hashimoto’s thyroiditis, or an inflammatory process that is immunological, we will look at antibodies as well. That is an autoimmune form of thyroid disease. Does that help? 

Dr. Eric: 

It does. It’s important not to look at just TSH. I’m glad you test for the thyroid hormones, free T3 and free T4. If you’re suspecting autoimmunity, you will also look at antibodies. 

I’m sure there is so much you could cover. Anything that I didn’t ask you that you wanted me to ask you? 

Dr. Florence: 

I’ll add one more thing for thyroid. I know we have to wrap up because it’s been fun, and we might be even over the hour. 

With thyroid, be aware that you need to know what your free T3 is. A lot of folks do reverse T3. I don’t find it as helpful, except maybe when people are ill. 20% of people can’t convert T4 to T3. That is why if they are already taking thyroid hormone, but it isn’t doing as much as they hope, like Synthroid is the most common, which is a T4 or generic type, then they need T3. 20% of people cannot convert genetically T4 to T3. That is the active hormone. 

Last words on this interview: I think everybody could take care of their health, so they become knowledgeable with not that much data. If they can follow along and really invest in their health, it will pay off in spades. Getting sick is very costly and not much fun. By understanding more about your personal history, your family history, your exercise and sleep, even your restorative stuff like yoga or meditation, which turns off cortisol, one can really preserve their health and actually get younger biologically as they age longitudinally and chronologically. 

I just hope we can deliver this to everybody by scaling the Comite Center through the virtual app Groq Health. 

Dr. Eric: 

Speaking of which, can you let people know where they can find you? Also, how can they get on the waitlist for that app since it’s not officially out yet? 

Dr. Florence: 

They can find me on Instagram, Twitter/X, and LinkedIn, @DrFlorenceComite. We are posting there. We also post on Comite Center on Instagram, Facebook, and Twitter. 

Groq Health, as far as signing up on the waitlist, it would be going to GroqHealth.com. The link may not be working right now, but we are trying to fix it. We have close to 20,000 people already signed up. 

A little tidbit: Groq Health is out there on Android. We are collecting anybody who signs up, so when we are ready to open it up to direct to consumer, which will happen sometime in 2024, anybody who signs up on an Android will be at the top of the list. With the iPhone, you need an invite. With an Android, you don’t. You can go to Google Play and download the app. 

Dr. Eric: 

Good to know. Whether you have an Android or iPhone, Android, you’re on the top of the list if you sign up. iPhone, you need an invite. Either way, they will visit GroqHealth.com, correct? 

Dr. Florence: 

Yes.  

Dr. Eric: 

Wonderful. Thank you so much, Florence. This was an amazing interview. I really appreciate you taking the time to discuss how to reverse aging and optimize hormones. 

Dr. Florence: 

I appreciate it. You clearly know your stuff. It was great talking to someone who is an educated, informed physician who can help sort out these thorny questions for people. I think it’s really hard to understand medicine. We are so complex, all of us. Thanks for having me. 

Dr. Eric: 

Thank you.