Dr. Shook’s Presentation on Hashimoto’s Thyroid Support and Low Thyroid Conditions
Hashimoto's Thyroid Support and Low Thyroid Conditions
Hashimoto’s Thyroid Support and Low Thyroid Conditions – Dr. Brad Shook
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Hi, I’m Dr. Brad Shook. I’d like to welcome you to this presentation on the new science of natural Hashimoto’s thyroid support and thyroid disorders.
In this presentation, I’m going to go into some science that I’m positive that 99 percent of you have never heard of because a lot of the information that I’m going to be covering is based on new literature and new science, that is, some of it is as sold as 20 or 30 years. But most of the science and the new understanding of these relationships with other systems of our body and how they influence our thyroid function or lack of thyroid function had been within the last 5 years.
Some of the science I’m going to discuss has been published within the last year and it’s cutting edge and it relates directly to thyroid dysfunction. I’m going to talk about some of the ways that the thyroid hormone becomes less active in the body. There is something a lot of people don’t realize. There are about 24 to 30 – we know of 24, but there are new patterns being identified everyday of ways that you can have adequate thyroid hormones, so your labs look normal, but you actually feel bad. You have all the symptoms of hypothyroidism or low thyroid condition.
Of those patterns, there is only one of those 24 to 30 patterns where thyroid hormone replacement therapy is the answer. In the other patterns, there are actually a lot – we call them functional disorders or breakdown in your biochemistry where on system maybe stressing your endocrine system and causing a breakdown in the way that your body can utilize a thyroid hormone, causing you to have these symptoms of low thyroid.
Without explaining too much here, we’ll get into that in future slides, but I just want to introduce you to the overall concept. We’re going to talk about the drivers and causes of a lot of these processes. We’re going to talk about how we identify them with testing, then we’re also going to talk about some of the ways that we will approach treatment.
Why I Work with Thyroid Patients
Before we get started, I want to talk a little bit about myself and why I work with patients that have thyroid disorders. It all starts with my own autoimmune condition. I have psoriasis, and then about year ago, I learned that I have Hashimoto’s euthyroid. Hashimoto’s is an autoimmune condition where my immune system is actually attacking my thyroid gland. I learned that because through this process of investigating how to help myself, I did antibody testing, and antibodies came back positive for my thyroid-binding globulin, which is a protein that is associated with Hashimoto’s. I live this everyday and a lot of the stuff that I’m going to cover, I’ve done with myself and I do today.
My story, it all began when I was a teenager and I started developing issues with digestion. I have problems with digestion, which today it would be diagnosed as irritable bowel syndrome, and I’ve had those issues over a period of about 20 years before I developed my first symptom of true autoimmunity. At that time, I developed psoriasis on my elbows and my knees.
They reason I bring up the digestion in regards to autoimmunity is because we’re going to talk about a lot of the drivers or triggers for autoimmune conditions. One of the things that we know in the literature, they found that you have to have a condition called intestinal hyperpermeability or intestinal permeability, which we call in lay terms leaky gut to develop an autoimmune condition. I’ll explain that in future slides, but that was this process that happened over a period of 20 years broke down my intestinal lining and set me up for an immune system problem. I developed psoriasis when I was in my doctoral program under a lot of stress, not eating the best, not taking care of myself.
Then about a year ago because I’m ongoing over the past 8 years, I learned as much as I could about how to identify the drivers or causes of autoimmune conditions and figure out what I could do to help decrease the tissue destruction because that’s what autoimmunity is. It’s where your body attacks itself and whatever tissue is being targeted in the body, it’s getting destroyed every time there is a flare-up of the autoimmune attack or there is an autoimmune attack.
I want to figure out what I can do to stop this progression because quite frankly, autoimmunity sets you up for tissue destruction, poor quality of life, and it’s considered precancerous because every time you have an autoimmune attack against your tissues, it destroys tissue and it can cause DNA damage. It could potentially set you up for cancer. I take it very seriously, and everyone who has an autoimmune condition, they should take it very seriously.
About a year ago, I learned that I have Hashimoto’s euthyroid. What that means is I have an autoimmune attack against my thyroid gland that causes destruction and causes inflammation and can cause a lot of problems. I have euthyroid because euthyroid means that my lab test looked normal. My markers for my TSH and all of my other thyroid markers, which we do about 10 to 12 marker panel, they looked normal except for the autoimmune antibodies against my thyroid.
People that are in my situation that have euthyroid don’t have hypothyroidism, which is low. If you have Hashimoto’s, there is literature that shows that you still have suffering, that the increased inflammation still causes problems with your body’s ability to use the thyroid hormone. This is my story. This is why I work with autoimmunity. This is why my practice is focused on helping people with metabolic problems of the inflammatory type, primarily autoimmune and with neurological dysfunction.
When I mean neurological dysfunction, I mean we also do functional neurology because you will find that a lot of these problems that are related to your endocrine system or the hormonal system, your immune system. All of these things, what they do is they converge. Where they all meet and are all coordinated is in the brain at an area called the hypothalamus.
Your endocrine system, your immune system, and your nervous system all meet at this center in the brain called the hypothalamus, and it’s the final common pathway where they all meet and all the systems are coordinated. A lot of these problems we’re going t to talk about how the thyroid works, it all begins in the brain.
You can have problems with the normal firing of the brain and the neurons in the brain. It’s a functional problem. It’s not something that you see pathologically. That’s a very advanced case if you see something pathologically that we address. You can do that through functional neurology to actually help improve brain function and that helps to improve autonomic nervous system function.
I don’t want to get too far ahead of myself, but I want to talk a little bit about the concepts because these are all things that help you to get healthy.
My Professional Background
I want to talk about myself and my training because my training goes far beyond my doctoral program. I am a board certified chiropractic physician. I love to talk to my patients about that because they’re always curious about as a chiropractor what you do [unintelligible [0:07:24] work with spine, you work with the back. A lot of chiropractors do work with the spine, and I do have training in spine. But my postgraduate training and the doctoral program first of all, the chiropractic doctoral program is very similar to a medical curriculum.
I had to have a 4-year pre-medicine program that included organic chemistries and college-level physics. It’s a pre-medicine program and my chiropractic doctoral program was 4 years. It included the same classes that medical doctors get except medical doctors focus on pharmacology while we focus more on neuroanatomy and the biomechanics of the spine. That’s where our training diverge, but really very similar in that we had a lot of biochemistry. We had all the physiology classes. We have endocrinology. We have fluids and we have laboratory analysis. We have almost the same curriculum, a similar amount of hours in the doctoral program. But the medical doctors focus more on pharmacology and using medications whereas chiropractic, we focus more on nutritional classes and using nutrition and natural means to help the body heal.
The philosophy of chiropractic as a whole is a natural healing profession that’s focused on the body healing from the inside out. It’s a non-drug profession. It’s not that we don’t advocate or we’re not supportive of drugs. I think there’s always a time and a place for that but what we want to do is look at the foundational health of the person.
With my doctoral program, I get a lot of these foundational classes and training that you don’t use in a typical musculoskeletal clinic. With my personal experiences and my personal journey seeking health, I learned a lot of things that I’ve come to find patients come into the clinic and I end up talking to them about all of these other metabolic issues. I said, “You know what, this is what I need to be helping people with because this is where I can make the greatest impact.” There are a lot of people that can work with musculoskeletal conditions, and there are very few that do this.
What I did was over the past several years trying to help myself, I’ve done a lot of additional training and I continue to train very, very aggressively because I like to learn. I want to live a long, healthy life. I want to be there for my children. I want to help my patients. What I did was I got certified in integrative medicine, which is looking at people as a whole. Then I went through and I’m currently going through a lot of additional training towards a diplomate of the American Board of Nutrition, and that is a doctoral-level nutritional program that focuses on helping people basically with nutrition at a totally different level than what you would consider is like dietary considerations or concerns. It’s really looking at customized nutrition for the person depending on what’s happening to their body using specialized testing.
I’ve also been trained by Dr. Datis Kharrazian, and through Dr. Kharrazian, I studied functional blood chemistry, functional endocrinology, functional neurotransmitters, and also brain health. Dr. Kharrazian, a lot of his work is the foundation for a lot of the things that I’m going to talk to you about, and he really is a leader in functional medicine, which seeks to look at what causes disease processes and how do you identify those drivers or causes and help the person to identify them and then work to heal their body naturally.
I’ve studied extensively functional neurology, an ongoing program through the Carrick Institute and then also through the American Functional Neurology Institute, so two different organizations learning and training in functional neurology. Then more recently something that I think is the future of healthcare is actually this idea of genetics and something called genetic SNPs or single nucleotide polymorphisms. That’s basically where we know after sequencing the human genome that you can have basically genetic deletions or additions to your DNA that will cause you problems with the way that your biochemistry works to keep it as simple as possible.
We can identify those and then we can look at your individual biochemistry through specialized testing and determine if there’s a problem with your biochemistry. This is where we get to a completely different level of looking at a person as an individual. This is one of the things that I’ve been training in more recently and that we use in the clinic that is really changing I think the world of medicine, but functional medicine allowing us to give the truly, most customized treatment that you can possibly get. It’s something that I’m really excited about because it’s changing the way that we approach people’s health.
Three Goals for this Presentation
I have three goals for this presentation.
(1) I really want to give you a new perspective on thyroid dysfunction.
(2) I want to make a positive impact on your life so that you can take this information and really change things because this is information that has the capacity to really change your life for the long term. A lot of people are looking for help and they’re getting the same answers from their primary care physicians because those doctors don’t know about the new science of working with these disorders. I really want this to be empowering.
(3) I want to give you information to really help you improve your health, and I think when we go through this, you’re going to see that there are a lot of ways that you could have these problems and they’re not being identified. If you can fix some of these fundamental issues, which we help people do that every day, then you can really change your quality of life for the long term. I mean really these conditions are degenerative. They are long-term conditions. You don’t cure yourself of an autoimmune condition.
Some of these conditions are autoimmune. A lot of them aren’t autoimmune mechanisms, but they are absolutely things that you have to address through diet, lifestyle, and a lot of times making some other changes and using temporary nutraceuticals.
Why are you Watching this Presentation
I have a question, and this is a question that you need to ask yourself, why are you here? Why are you watching this presentation?
I can tell you the reason I asked this question is because most of the people that I see as patients, they’re being treated or they have been treated and checked for thyroid problems by other providers. All of my patients, every single person that we see despite treatment and being checked by a doctor and having a few of their labs ran and ordered, they’re still having thyroid symptoms.
What this really comes down to is there’s something that you need to ask yourself. Why do I still have this problem? I’m having this testing. I’m the taking replacement hormone. I’m on antidepressant or whatever else you’ve been prescribed, and I don’t feel better. I mean I just had a patient two days ago come in and she’s been on thyroid hormone replacement for 5 years. She told me, “When I started taking it, I really didn’t feel any better, and I still have brain fog and I still have all these issues with my energy levels and weight gain and all of the classic low thyroid symptoms.”
I was like, “Why are you still going to your doctor because they’re not fixing your problem? I mean you need to go see someone else and get another opinion on this.” That’s one thing I can tell you is why do you still have the problems that you’re having. Because what it comes down to is, I look at look at someone has had this problem and if it’s most people tell me for years, I know that they’re problem has not been properly worked up because it hasn’t been diagnosed.
You have to understand that in the primary care world today with primary care medical physicians, and even endocrinologists, who are the specialists, the endocrine hormone specialists, they mean very well and all these people do care about you. But they don’t know how to identify these problems because consider this: they’re in a world it’s based completely on insurance reimbursement. They have 5 to 10 minutes typically to see you. They have time for you to report what’s going on, to read over your history, report your symptoms, either order a test, which they don’t order ‑ I’m telling you the standard workup is inadequate, and I’m going to explain why that is. They don’t order enough tests. They don’t understand the relationship that other systems in the body can have on your thyroid that can cause you to have low thyroid symptoms, and they don’t know how to work it up because they don’t get this continuing education. They don’t have time to do anything other than prescribe your medication, order a lab test. They don’t have time to tell you anything else. Many times, their training is just inadequate.
Consider it for a second. They’re stressed for time. Where do they get their continuing education? Their continuing education comes from the pharmaceutical rep that comes in to educate them on what? On the newest drug that’s on the market for the conditions that they see.
When they go to their continuing education seminars, who sponsors their seminars? A pharmaceutical company that brings in representatives to talk about the drugs and the disease processes and the newest and greatest things that are there. The entire perspective is based on a pharmaceutical or an intervention that is not natural.
Do you understand the entire perspective is the problem? I mean that perspective, medications and these drugs are necessary for some of these cases, but when you completely neglect the fact that something is causing the person to be sick, and you’re just looking at a symptom, and how can I match it with a medication, that is a broken system.
I have people that come in and say, “But I go to an endocrinologist. I go to the best endocrinologist in my town. Why don’t they know about this?” It’s what I just said. There’s no time in the insurance mandated-world to read journals, to study anything outside of how they have to practice to keep their business running. They have to practice in a model that everything is covered by insurance. If there’s a test that’s not covered by the insurance, are they going to order it? It’s not going to happen. You won’t see that happen. Are they going to give you a recommendation for some dietary changes and some temporary nutritional supplementation? It’s not going to happen because that’s not a way for one to be reimbursed but they don’t have training in those areas. Because their training is on matching a problem that you have with the medication that you have to offer you. That’s it. unless they have specialized training and they’re working on understanding the drivers of this disease process and how these systems interact with your particular group of symptoms, for example a thyroid, they’re not going to know this information.
They rely on what they learned in school. What they’re being taught by these pharmaceutical reps or these continuing education classes, which are all based on the idea of pharmacology. There’s no appreciation for what’s driving the process. To me, I am completely feed up with this entire system because it fails to identify what’s driving the disease process. It’s just outdated information.
That’s why this is so important because with my own journey through this, I couldn’t understand, no one could tell me why do I have an autoimmune condition, what’s pushing my autoimmune condition along, what can I do for my autoimmune condition. There is nothing except steroids, antiinflammatories, and immunesuppressing drugs. I refused to accept that because the body is self-healing. If I cut my hand and do nothing to it, it will clot and it will heal overtime. The body is self-healing. Why isn’t my body healing itself? Why is my body attacking itself? There are answers to those questions and there are good reasons that we’re going to identify that I’m going to share with you.
A Holistic Approach to Support the Body
The approach that I use supports the whole body. It is a holistic approach. If your doctor doesn’t look at health this way, if they’re not looking at you as a whole person, they don’t believe or they don’t understand drivers of disease processes and in particular autoimmunity, and they don’t understand how thyroid hormones can be affected by different systems of the body and other things like chronic inflammation, chronic stress, and they don’t understand the mechanisms behind that, then you’re not going to get help or anything other than symptom management. You will never get anything other than symptom management.
Why are you still seeing your Doctor
Ask yourself another question. If you don’t feel better, why are you seeing your doctor? It’s because most patients come in like, “I don’t know what else to do.” They find me through either a referral from a friend, they find me online, or they find some of the information that I’ve written. That’s how they get to me, but people don’t know what else to do. The thing is people aren’t getting results, and every time I talk to people about thyroid dysfunction, I mean it is staggering at how many people are still having symptoms with their thyroid and they’re told they don’t have any problems because their labs are normal. They’re put on a thyroid replacement and they might feel good for a little bit and they might feel bad again, or they don’t have any effect from the thyroid replacement. They continue to feel bad but their doctor just says, “Well, there’s nothing wrong with you. I don’t know what to tell you.” They give you an antidepressant as if it’s in your head.
Listen, these are all things that I’m going to explain to you that have real physiological mechanisms behind them. Many people see their doctors because they have nowhere else to turn. They don’t know what else to do, and it’s not because they’re getting results and that’s really all that matters. You need to seek out and you need to look for other alternatives, and I hope that’s why I’m giving you some information on where to start.
The Fundamental Problem
Here is the fundamental problem with the issue. Consider this scenario. How we look at your health from an allopathic medical or traditional medical approach is failing us in this country. If you need crisis care, you need a heart transplant or a bypass surgery, or you’re in a terrible accident you need to be put back together, this is where you want to be. It’s the best place in the world, and I completely agree with that. I have good friends that are medical doctors, that are surgeons. I have family members that are medical doctors, but when it comes to chronic care to people that are chronically sick, we are failing miserably.
Some of the statistics is that in the US in healthcare has one of the lowest as far as outcomes amongst industrialized nations. How can that be? When you look at this, you start thinking about it, we spend the most money on healthcare yet we have poor results. I mean if spending money equaled quality of healthcare, we should be number 1 by far, but we’re not.
Here’s the fundamental problem. You go to your doctor and you become unhealthy. You get unhealthy a number of different ways basically through either chemical, physical, or emotional stresses. This can range from anything through traumas to biochemical imbalances in your body, which we’re going to talk a lot about, from hidden infections to food sensitivities and allergies that go untreated to infections and overgrowth of bad bacteria in the gut, and yeast infections to parasites, to heavy metal toxicities, a lot of things that cause you to become unhealthy.
You go to your doctor because you became unhealthy through a number of different things. You go to him and you say, “Doc, I’m having headaches. They bother me. My head is killing me.
“No problem. We’ve got Botox, Imitrex. We’ve got five different medications for that. Here let me give you a prescription.” So he gives you a prescription, and your symptoms are gone, but what are you left with? You’re still healthy, so you’ve treated the symptom and you didn’t address why you’re having the problem.
Six months pass by and you develop another symptom because you’re still unhealthy. Now this time, you do in and you say, “Doc, I’m having terrible heartburn. I’m having this reflux every time I eat, I got this terrible indigestion.”
He says, “No problem. We’ve got Prilosec. We’ve got every single heartburn medication. We’ve got 10 to choose from. I’ve got something for that. No problem at all. Let me just write you a prescription.” He writes you a prescription. You go get it filled, you start taking it. Your symptom goes away, but what are you left with? Now you’re taking two drugs and you’re still unhealthy.
Another year goes by. Now you’re 1 year and 6 months into this thing. Now every time you stand up, you’re getting dizzy and you go to your doctors. You say, “Doc, every time I stand up, I thought I’m going to faint. I’m going to pass out.”
Doc is like, “No problem. No problem. We’ve got something for that. We’ve got five different medications I can help you with, lightheadedness and blood pressure when you stand up.” He writes you another prescription. It takes away your symptom. What are you left with? You are still unhealthy. Now you’re on three medications to manage three different systems and you’ve done nothing else to help with the actual reason that your body is running down and declining in health.
Now 6 months later, you develop a side effect from the first medication that you started taking because now it’s depleting your body of nutrients and it’s causing you to have another symptom. You go to your doctor. This time, maybe you have high blood pressure because that happens to be one side effect of a lot of different medications. You say, “Doc, my blood pressure is killing me. I have all these problems. I’m angry. I’m irritable.”
He says, “No problem! We’ve got 20 different blood pressure medications.” He prescribes you a drug. But what are you left with? What are you left with? At this point, you’re still unhealthy and he’s done nothing to address the fundamental problems that brought you to his office in the first place except to continually address your symptoms with a medication that there is no strategy to take you off of, that you are taking, depleting your body, running down your systems. You don’t know what you’re being treated for as you go further down the road. I think people come into my office on 14 or 16 medications. That is absolutely crazy. This system does nothing to address why you’re sick in the first place. You’ve got to ask yourself is that what you want? Is that what you want for yourself and your health because that’s not what we do here. We look for the drivers of the disease process to help you regain your health.
A Web of Physiological Dysfunction
This is obviously a spider web, and this is a great representation of how your body works. In medicine today, we have a different specialist for every different system of the body. You’ve got a gastroenterologist, an endocrinologist, an endocrinologist, a neurologist. Everyone does different systems and no one talks to one another. The fact is that everyone of these systems are related, and so if you have a problem with one area of your body, your digestive system for example and you pull just like if you touch a spider web at one point and you try to move it, everything moves with it because influencing one system influences the others. That’s exactly what happens to your body.
This is what I know: every person with low thyroid symptoms or an autoimmune thyroid, they’re suffering from something I call a web of physiological dysfunction. This web of physiological dysfunction is what contributes to these 24 to 30 patterns of low thyroid symptoms when your labs are still normal into thyroid problems that don’t respond to medications.
This picture is a graphic representation of that, and I don’t expect you to understand it but what I do want to show you is if we talk about let’s say you have a thyroid disorder and that’s right here in the center, all of these systems, all of these systems of the body will influence your thyroid function. You can see they’re all connected because one system affects the other, and we know this endocrinology, but these doctors, your primary care physicians they don’t have time to read their own journals and to change the way that they’re practicing because they’re stuck in a model that does not address the cause of a lot of these problems, talking about a disease process and disease processes, yes.
Here’s the thing: if you have for example a liver problem, that can affect your thyroid, and I’m going to show you how 60 percent of the thyroid hormones that are made by your gland is actually converted in your liver. If your liver isn’t working properly, you may have a problem converting your thyroid hormone into the active form. That’s not going to show up on your lab tests unless you know how to look for that and unless you order an expanded panel.
Your adrenal glands, which are your stress hormones, I’m going to show you several patterns that are related to adrenal glands and blood sugar imbalances that directly affect the thyroid. These are all things that are part of this web of dysfunction, and every single person with a thyroid problem has multiple issues going on.
Is there a pill for any of that? Can you take something to fix those five different things? Does it really fix it because what’s causing the problem to occur in the first place? That’s what we seek to do. That’s what my goal is. That’s how you get healthy. That’s how you have long-term vibrancy and how when you age and you get older, you can still move. You can enjoy your grandkids. You can travel. You can do the things that you want to do. The golden years can actually be golden.
Thyroid Dysfunction – Hypothyroidism
At this point, what we’re going is just shift gears a little bit. We’re going to start talking about how the thyroid works so you can understand how it breaks down, and I’m going to show you a few patterns that are specific to low thyroid symptoms or what we call as hypothyroid symptoms but will not show up on your lab tests. I’m going to cover the six most common patterns that I see, and we’re going to talk about how the body breaks down and how those can occur, how we identify and test, and then we’ll go from there.
With thyroid dysfunction, typically the most common thing we see is hypothyroidism or low thyroid symptoms. People do have hyperthyroidism but we’re not going to specifically talk about that in this section. Ninety percent of people that have hypothyroidism are due to an autoimmune condition called Hashimoto’s thyroiditis and that was published in a journal in 1998.
I have Hashimoto’s. I am euthyroid and my labs look normal but I do have Hashimoto’s, the autoimmune process. It’s the most common autoimmune disease in women. If you think about this, that means if 90 percent of hypothyroidism is due to Hashimoto’s or an autoimmune condition, that means that 9 out of 10 people that have low thyroid or diagnosis of hypothyroidism have Hashimoto’s. I mean it is at an epidemic level and it is a major, major problem that is completely ignored. The autoimmunity is ignored and not even tested for, and we know and I’m going to show you how that’s a big mistake.
The thyroid itself, thyroid hormone every single cell in your body, every single cell from your brain to your heart to your digestive tract to your eyes, they all have receptors for thyroid hormone. It means that the thyroid hormone is like the gas in the car. If you don’t have thyroid hormone stimulating the cells and the cells don’t regenerate, they don’t work properly. That’s a major problem. Just imagine your brain. If your neurons, the nerve cells in your brain don’t get proper stimulation, they will not heal. They will not work properly and you can have brain degeneration.
The issues with the brain are that the cells in the brain don’t go through mitosis where they divide and you have cell division where they renew themselves. You’re born with the ones that you have and when they’re gone, they’re gone.
Symptoms of Hypothyroidism
Some of the symptoms of hypothyroidism are fatigue, weight gain even on a low-calorie diet, waking up with morning headaches, depression, anxiety, and brain fog.
Constipation and diarrhea, those can alternate depending on what’s happening. Stomach aching, gas bloating. Acid reflux is one of the most common things that we see with hypothyroidism , so I typically see someone that’s on thyroid replacement and also on a medication for acid reflux.
Cold weather sensitivity is also another classic hallmark. Cold hands and feet and the tip of the nose being cold.
Very much problems with mood and not being happy or just having issues or you’re grumpy or you’re just in a bad state of mind.
Being itchy. Having dry brittle hair or hair loss where it thins and where it falls out and something else you can look for is to see if you have thinning of the eyebrows in the lateral one-third of the outside of the eyebrows. That’s also another classic sign of hypothyroidism.
Like I was saying earlier, every single cell in the body has receptors for thyroid hormone. That means that you won’t have normal cellular function or healing or regeneration or even normal metabolism within the cells if you don’t have adequate thyroid hormones. It’s absolutely a critical thyroid that you have to have adequate quantities of and those quantities have to be able to work within the body.
I’m going to show you several ways in which you can have normal thyroid hormone levels, but because of other problems, the thyroid hormone isn’t being active or affecting the tissues or the cells the way it should.
Thyroid Metabolism
Let’s look at how the thyroid works because you need to know how thyroid hormone is stimulated and made, so you can understand how this process breaks down. Just follow me here. This is going to be in a diagram format.
It all starts in the brain at a structure called the hypothalamus. The hypothalamus is the end or final common pathway of the immune system, the nervous system, and the endocrine system. This is where they all come together and it’s all coordinated. It is a brain process that initiates this.
The hypothalamus releases TRH or thyroid releasing hormone. What that hormone does is it stimulates another brain structure called the pituitary gland to release thyroid stimulating hormone or TSH. Now TSH is the one hormone that’s typically measured for signs of a low or high functioning thyroid but it’s the one that’s typically ordered, and it’s a brain hormone made by the pituitary gland. It’s not even a thyroid marker.
What TSH does is it stimulates the thyroid gland to increase its activity of an enzyme called TPO. TPO just happens to be one of the targets of the immune system in Hashimoto’s whenever you have an autoimmune attack. What TPO does is it helps to create T4 and T3, which are your thyroid hormones.
Now of the hormone that’s made by the thyroid gland, most of that is T4, which is an inactive or a much less active form of thyroid hormone. About 7 percent is T3, so that T4 has to be converted into T3 within the body. Sixty percent of the T4 that’s made is converted into T3, the more active form in the liver; 20 percent is converted into something called T3S and T3AC. Those are primarily inactive, but what happens is they go to the gastrointestinal tract or the GI tract, and they’re converted into T3 only in the presence of good gut bacteria.
I want to point out two things: if you have poor gut function and you have inflammation of your gut, digestive issues, you could have a problem converting T4 to T3. Could you see how that if you just don’t have adequate T3, you won’t have normal physiological function? That’s something that your doctor is not going to pick up on because they’re not ordering these tests. I can tell you that. Even if they do, unless they’re trained in functional medicine, they’re not going to find these patterns.
The liver, that’s a major area where the majority of the T4 that’s made gets converted into T3. If you have a problem with liver function, you have slightly elevated liver enzymes, there’s some other things that we can look at, then you may not be converting your T4 to T3. It’s a major issue that we have to look. The liver is a big player here.
Another 20 percent goes into something reverse T3 and that’s primarily inactive. It’s not something that we’re looking for to stimulate the physiological function that we’re after. Then the remaining portion, which is a very small percentage, is converted to T3 in the peripheral tissues like the heart, muscles, and nerves.
This is the story of the thyroid hormone, how it’s made from the brain, how the pituitary signals the gland, how the gland makes T4 and T3 and then how the T4 is converted into what your body needs to use. This is the story that we’re going to go through and I’m going to show you how these different processes break down due to things that are completely unrelated to the thyroid hormone levels itself and why you cannot just take a thyroid replacement for symptoms of low thyroid.
I really want you to remember this is all initiated with the brain because the brain is something that is neglected. In my clinic, some of the patients that we see will actually do brain-based rehabilitation to stimulate the brain and to make sure that the brain is firing properly, that you’re getting normal autonomic nervous system functioning, which is what drives all of the involuntary processes and the synchronization and production of hormones.
The Six Most Common Patterns of Thyroid Dysfunction
The six most common patterns that I see with thyroid dysfunction are what I want to go through.
(1) Primary hypothyroidism. Let’s start with the first one and this is the only one that will respond to hormone replacement therapy, and this is primary hypothyroidism. It’s where the gland won’t enough of the hormone. Basically, the gland just cannot produce enough T4 and T3. If you have Hashimoto’s where your gland is being destroyed over and over by an autoimmune process, you may have to be on a replacement hormone at some point because your gland is so small, it no longer has capacity to produce enough. There are other reasons for the gland not being able to produce enough hormones, but primary hypothyroidism is the only one that responds to replacement therapy.
(2) Hypothyroidism secondary to pituitary gland hypofunction. The second most common pattern that we see is called hypothyroidism ‑ so it’s low thyroid – secondary to pituitary gland hypofunction. Remember that gland in the brain I was telling you about that makes TSH? That’s the marker that your doctor primarily checks. He’s looking to see how much TSH is the pituitary is producing because if that level is real high, then his thought process is that the thyroid must not be making enough hormones so he wants to give you a replacement.
He’s looking at this indirect measure. TSH was really low and he would think that your thyroid is really high, maybe you have hyperthyroidism. We’re primarily talking about hypo here. What happens here is when that gland and its production of TSH is suppressed, we can pick this up. We order a lot of the markers that we look at. How this happens is that pattern where the TSH is produced in adequate levels becomes suppressed and the number 1 cause are stressors that cause you to basically produce cortisol or stress hormone. There are four ways that this primarily happens.
First of all, there is an active stress response. Your adrenal glands sit on top of your kidneys. Adrenal glands are your stress hormone producing glands. They produce stress hormones. They produce cortisol and epinephrine, norepinephrine, and adrenaline. Whenever you’re under an active stress response and your stress is really high, high levels of cortisol will actually suppress the pituitary gland from making TSH and stimulating the thyroid.
You can also have through postpartum depression ‑ basically stress, fatigue the adrenal, and it overwhelms the pituitary. It’s a very similar mechanism but it’s a different time of life. It’s a different trigger for the stress.
Then inappropriate use of thyroid medications. Here’s a very interesting one. If you have some of these patterns I’m going to go through which aren’t related to the thyroid hormone levels. But you take more thyroid hormone thinking it’s going to help, which is what happens a lot, you can actually have so much thyroid hormone in your body that it floods the cells in your body and it floods the pituitary with thyroid hormone. The pituitary says, “Whoa, whoa, whoa! There’s too much here and I’m going to shut down production, so I’m not going to make any TSH.”
What it will actually do is it will break the feedback loop to the pituitary gland, and it will permanently suppress the pituitary gland’s production of TSH. Because your levels are so high, the gland says, “Hey, I don’t need to make anymore. The levels are high.” What ends up happening is it just stops producing TSH altogether, and that’s actually the fourth pattern is we have an overabundance of thyroid hormone that shuts down this pituitary gland.
Here’s the thing: you don’t need to understand this. You just need to know that there are different mechanisms at work here that will cause you to not have normal function and normal thyroid hormone activity, even if you have normal levels.
(3) Thyroid under conversion. The third reason and the third most common pattern I see is thyroid under-conversion. Remember we talked about how T4 gets made into T3? Here’s the story: the thyroid hormone makes T4 and T3. Remember T4 is 93 percent that has to be converted. What happens here is that you know this T4 gets converted in the liver, the GI tract, and the rest of it goes to reverse T3 in the peripheral tissues.
What will happen here is if you have excessive cortisol, which is the stress hormone, it prevents – remember these are your stress hormones and the glands on top of the kidneys here are the adrenal glands – what they do is they prevent that conversion. This is something that happens due to excessive stress, prolonged stress. Chronic inflammation will also prevent the conversion. This is something we know that are research-based mechanisms. If you don’t realize that inflammation and that chronic stress can do this and you don’t check for it on labs, and you have no idea why the person is feeling the way they do and you give them an antidepressant or you refer them to someone else that is going to do that.
This results in basically this type of pattern, you will see normal TSH levels but you have low thyroid symptoms because it’s cortisol. This is why we look and we order a lot of other testing in some cases. Sometimes I just pick it up in on the history. It just really depends on the individual, but thyroid under-conversion, so you’re not converting T4 to T3.
(4) Thyroid over-conversion and decreased thyroid binding globulin. The fourth pattern that I see that’s very common is thyroid over-conversion where you actually convert more of that T4 than you want to T3 and what will go hand-in-hand with that is decreased thyroid binding globulin. On this slide, bear with me here. What you can have if you have elevated testosterone, you have this thing in your body. Here’s our story. Thyroid makes T4 and T3. T4 needs to be converted in the liver, the GI tract, and it goes into peripheral tissues into reverse T3.
If you have elevated testosterone, this can happen for a number of different reasons. I’ve seen this with women that their husbands use testosterone cream. Because they’re in contact, that testosterone gets passed on to the woman and now she has elevated testosterone. What that does is a few things. It drops the level of these things called binding globulins. Basically here’s what you need to know. This thyroid hormone that’s made and converted in your body, the T3, it has to hitch a ride on a binding globulin.
It’s like people take a taxicab. Your thyroid hormone has to get in the taxicab and be taken to the tissues in body where it can be used and that’s where the taxicab drops off the hormone. What happens when you have increased testosterone is that you don’t have enough taxicabs, and you have all these circulating thyroid hormone but it can’t get to where it needs to go and what it tends to do is it overwhelms the tissues of the body or the cells and it causes resistance.
There are so much thyroid hormone that’s circulating the cells stop the activity of the hormone because your body is intelligent, so that you don’t have a heart attack. Because if all was circulating hormone was available and your body didn’t stop the production or stop its activity, then what would end up happening is that your heart would race and you could have a heart attack and you have all these symptoms of hyperthyroidism.
Increased testosterone that occurs through insulin resistance, so spikes and dips in blood sugar would do that, through PCOS or polycystic ovarian syndrome. That also contributes to this. It’s a very common thing, so elevated testosterone levels. That’s why a lot of times I order a dried urine to do a comprehensive hormone panel. In that way, we can look at all these sex hormones and cortisol and we can figure out these other things that are playing into the bigger picture. You just have overproduction here.
(5) Thyroid binding globulin elevation. We’re getting to the end of this because I want to get to six, the six most common patterns. This is where basically the thyroid makes all of its hormones. It makes T4. It gets converted in the liver, the GI tract, and the peripheral tissues to T3. Remember I said that the thyroid hormone that’s made gets in the taxicab and the taxicab takes the T3 to the tissues of the body where it’s used. In this scenario, what you tend to find happen is there is increased estrogen. I see this with birth control and hormone replacement for women on anti-aging protocols that are taking estrogen.
What will end up happening here is that you have too many taxicabs. What happens is you have so many taxicabs or binding globulins, you have an over elevation of binding globulins that the thyroid hormone it can’t break free or it can’t get out of the taxicab. There are so many taxicabs that all of the thyroid hormones in there and the cab drivers won’t open the doors. The thyroid hormone stays bound, and it cannot be used by the tissue, so you have symptoms of low thyroid or hypothyroidism so that it can’t be used and that causes all the symptoms of hypothyroidism. You have to clear the body of excess estrogen, identify why, and then help the body clear the excess estrogen and the symptoms can improve.
(6) Thyroid resistance. This is the last pattern that I’m going to discuss with you. Basically, it’s another one that’s related to cortisol or stress hormone. Basically, you get normal production by the pituitary gland of thyroid stimulating hormone. The thyroid produces enough thyroid hormone and what happens here is that this cortisol, which is your stress hormone, can act a lot of ways and influence thyroid hormone physiology and the way your thyroid hormone works or fails to work.
What it does is excessive cortisol blocks the thyroid hormone from being able to have its effect on the body and that ends up with the symptoms of low hypothyroidism. Some of the things that we look for with this are we want to look at your adrenal glands. We want to look at your cortisol production, and we want to look at homocysteine levels, which are really the key at understanding what’s happening and gives us an idea of how we can approach it naturally.
Can you see those are the six common patterns and there are 24 to 30 patterns total. Can you see how thyroid problem is not just the thyroid gland? I mean there’s the adrenal glands. There’s blood sugar. There’s the digestive tract. There’s the liver. There are hormone problems. There are brain-based issues were the brain may not be stimulating the autonomic nervous system to stimulate the gland to produce the hormone, where you can have immune system issues with inflammation that can block the thyroid hormone.
I mean there are these mechanisms, and you got to look at this and say the approach is kind of like taking the light bulb out of your car when you check engine light. Check engine light comes on and it’s just like taking the bulb out and not addressing anything, not even looking at really what’s happening. That’s what my problem was when I was first diagnosed with psoriasis. I just knew that I wasn’t satisfied with not addressing “why,” and that’s what I seek to do in practice.
Dr. Datis Kharrazian
A lot of the information that I got that I use are modeled after the teachings of Datis Kharrazian. He is a functional medicine doctor. He teaches for the Institute of Functional Medicine. He does a lot of work. He’s a researcher and most of my patients I have them read his book before they start care with me.
What Causes the Body and Immune System to Lose Normal Regulation or Become Autoimmune?
Now we’ve talked about how the thyroid works. Some of the common patterns that we see, let’s talk about how these problems actually occur. How does it actually lose normal regulation and become potentially autoimmune because most people I see actually have Hashimoto’s even if they don’t know it. We can check and see if we can find that to be positive on labs, but how does this occur.
Really, the loss of normal regulation of the hormonal system, your endocrine system, and then your immune system comes down to dysregulators, things that cause dysregulation or loss of regulation, and some things called active antigens or things that cause your immune system to [unintelligible [0:48:45] that your immune system tries to kill.
Dysregulators
(1) Inflammation from poor diet. One of the most common things that we find is inflammation from poor diet. Basically we have too many bad fats, too many omega-6s, and you eat trans fats, and you don’t have enough omega-3s. This creates a proinflammatory environment in your body. Trans fats, the fats make up all of your cell membranes or the walls of your cells. It’s a major, major problem that’s involved in hormone function. Everything in your body needs good fat levels, so you need to be eating a good diet with good fats. It’s one of the first things we address.
(2) Bad blood sugar and stress. The second thing is blood sugar and stress. We’ve talked a lot about stress and cortisol and how that breaks down thyroid function, and this is something that we look at. This is foundational to health. We look to see if you have inflammation. We look to see if you have anemia, low red blood cell count because everything needs oxygen to work and that’s what the red blood cells’ one of the main functions is to carry oxygen. You need good blood sugar.
Blood sugar and stress are hand-in-hand because cortisol affects your blood sugar and blood sugar will affect your cortisol. These are things that will cause loss of regulation of normal hormone production and can be a trigger for autoimmunity.
(3) Hormone imbalances. We’ve talked about this in great detail with cortisol being elevated, how that can block and influence a lot of thyroid physiology to where the thyroid gland just doesn’t work. But there are a lot of things that we look for with hormone imbalances from the male and female sex hormones. If the estrogen was elevated, I told you your thyroid hormone wouldn’t have an effect because you have too many of those binding globulins. If your testosterone is high, you don’t have enough of those binding globulins and you have too much thyroid hormone free, which can cause a lot of problems with cell thyroid hormone resistance. There’s a lot of things you got to look at these problems to see where the breakdown is.
(4) Neurological imbalances. I talked about this because the entire process starts in the brain. It starts with the hypothalamus that signals the pituitary, so you can lose these feedback loops and specially some of the things I was telling you if you take thyroid hormone and it’s not necessary. See the thing is you can’t measure some of this levels because the labs only check for bioidentical levels of thyroid hormone. If you’re taking synthetic T4, it won’t show on labs. You can’t measure it. You’ve got to look at the sympathetic nervous system because a lot of times, the brain can actually be playing into this. You’re not getting good signaling from the brain to coordinate and synchronize the thyroid hormone production.
(5) Poor absorption of fat. Poor absorption of fat and digestive function. Remember how I talked about the GI tract and how important that is with good healthy bacteria that’s required to convert 20 percent of the T4 that’s made into T3 and that could be one of the reasons right there? Your GI tract is also a very common source of infections from parasites to yeast overgrowth to dysbiosis or overgrowth of bad bacteria, and it can be a really common source of inflammation. Remember how I talked to you about how inflammation can cause problems with conversion of T4 and T3? This is how you have to look at the body because a whole person because when you start looking and realizing that there are actually physiological mechanisms, there are things that occur that will mess up your thyroid hormone and its function, then it makes sense. But when you are never exposed to this, you don’t know what you don’t know.
(6) Methylation problems and genetic SNP. The last thing that we look at from dysregulators are methylation problems and genetic SNPs. We can actually do genetic testing and look at something called your organic acids, which organic acids to look at primarily vitamins, minerals, and several things that could be deficient in your body, and then we can look at the methylation panel and put those together and see a picture of where is your biochemistry breaking down. We don’t always need all those tests, but this is a great place to get very good information. When I see people that have been everywhere, this is the first place I’ll start.
Active Antigens. Now we’re getting into the other category, so we had dysregulators. Now these are active antigens. These are things that cause your immune system to be hypervigilant or work overtime and it can cause it to be chronically stressed and on alert, and this can be a trigger for autoimmunity. It can cause chronic inflammation.
(1) Food sensitivities. Number 1 thing is food sensitivities. A lot of us eat foods that don’t cause like allergy or anaphylactic response, but what it does do is it causes a low-grade inflammatory response and an immune system response that we’re not perceiving and not aware of. This is one of the first places that we have to start because it’s a common trigger.
(2) Hidden chronic infections. The next thing that we’re going to look at and these are things that your body is trying to kill are hidden chronic infections. I can’t tell you how many times we see dysbiosis or an overgrowth of bad bacteria in the gut and that’s not good because quite frankly, this is how I can put it: bad bacteria eat all the good stuff in your gut and put bad stuff. Good bacteria in your gut eat bad stuff and put good stuff, so they make vitamins and minerals. They do all kinds of good stuff. The bad bacteria create gas and methane and all these other issues and things that will cause constipation, diarrhea, and cause inflammation in your gut.
- pylori is a very common infection of the upper and lower GI tract that can cause suppressed hydrochloric acid or stomach acid production, which is a major problem. A lot of people have parasites, and if you ever had sushi, you could have a parasite. There’s a lot of things that can cause parasites and a lot of people have them and are not aware of it. Candida or yeast overgrowth in the gut is also a major problem. These are all things that we need to address because it causes chronic inflammation, chronic immune system basically hypervigilance or activity.
(3) Environmental toxins. Environmental toxins are something that is on the radar for people that work with autoimmune thyroiditis, Hashimoto’s, and take a natural approach because a lot of these environmental toxins have been shown to mimic or look similar to your thyroid tissue. If you get exposed to them and your immune system launches an attack against one of these compounds, what can happen is sometimes it can mistake your thyroid gland for that compound and you can actually have something called cross-reactivity where your immune system starts attacking your gland. These are major concerns and there are some of these in particular that we need to look with someone that has Hashimoto’s. But the environmental toxins have to be something that you look at and you consider.
(4) Leaky gut (intestinal permeability). Leaky gut and intestinal permeability can be a trigger for an autoimmune condition. I mean the literature actually says that you have to have a leaky gut now before you develop an autoimmune condition. That’s because the gut leaks and it lets food that’s digesting and bacteria and other things into the bloodstream, which should stay in the digestive tract but comes into the bloodstream. What ends up happening is it stimulates an immune response and it can be a trigger for autoimmunity.
What the Scientific Literature Says Now
Now the scientific literature what it says now is that just like this colander is letting water pour through, if you think of your intestinal wall, the two and the colander being the wall, if things are just leaking through into the bloodstream, then it will trigger leaky gut and the literature is saying it’s a prerequisite now for that.
Foundational Body Chemistry
This causes you to develop basically problems with foundational body chemistry. When I look at someone that comes into my office and they’re sick, the first thing I do is I look at the foundational body chemistry. If you are going to build a house, you’re going to grade the land. You’re going to clear the land. Grade the land. You’re going to prepare the land to pour the foundation. You’re going to pour the foundation, and you’re going to build the house on top of that.
This body chemistry is that process of clearing the land and getting the foundation ready so that anything you do will be stable. Anything that you do is dependent upon that foundation. This is the foundation of your health.
(1) Systemic inflammation. The first thing that I look for is systemic inflammation. We’ve already talked about how that can play a role and wreak havoc on your health.
(2) Anemia. The next thing I look for is anemia. I look for anemia. Anemia means you have low red blood cells, and it can be that they have change in their size due to B vitamins. It can be change in their size due to iron deficiency. It can be an anemia of chronic disease. There can be a lot of different types of anemia, but anemia is where you don’t have enough red blood cells of the wrong size or shape, and you can’t carry oxygen to the cells and tissues of the body. Every cell needs oxygen to function and produce energy. We cannot be anemic. We got to look to see if there’s anemia.
(3) Lose optimal blood sugar regulation. Next we look to see if you have optimal blood sugar regulation because if you’re losing normal regulation of your blood sugar, either high or low, the same problem occurs. If you have low blood sugar, you don’t have enough sugar getting into the cells. If you have high blood sugar, you develop something called insulin resistance, and you can’t get sugar into the cells, and you don’t have normal cellular function. Blood sugar is a major, major problem.
(4) Intestinal inflammation. Intestinal inflammation, we look for that.
(5) Poor liver function. We’ve talked about how you need that for good conversion.
(6) Cannot Absorb Dietary Fats. We look to see if you absorb dietary fats in your GI tract because the fats are critically important for absorbing fat-soluble vitamins A, D, E, and K and also for making your hormones. They are the foundation for all of the cells in your body. These are foundational to your health.
Ask the Right Questions and Do the Right Testing
You have to ask the right questions and do the right testing to figure out what to do. Sometimes I have to get a lot of testing. It is what it is. There are other times when I can look at the history and I can say, “You know what, this is what I think is happening. Let’s try this first.” But you don’t know in a lot of cases unless we do the right testing.
Where to Start
A lot of people are looking at me. They’re like, “Whoa! There’s a lot of stuff going on with me. How do you know where to start?” Well you just start at the beginning.
(1) Get a comprehensive metabolic panel. Basically what I do is I get a comprehensive metabolic panel, which is the most expanded blood panel that you ever have. I’ve never had anyone that’s had a blood panel that’s this expansive because it looks at your complete blood count. It looks at 10 to 12 thyroid markers. It looks at your lipids. It looks at inflammatory markers like homocysteine, C-reactive protein. It looks at your blood sugar, but it also looks at hemoglobin A1c, which is a three-month measure. It looks at your vitamin D. I mean there are a number of different markers, and this is invaluable to determining where to start.
(2) Get genetic testing for SNPs. The next thing I’ll do is get genetic testing for single nucleotide polymorphisms, and that’s the genetic changes that will cause problems with methylation and mineral deficiencies.
(3) Determine nutrient and mineral deficiencies. To look at mineral deficiencies, we’re primarily looking at organic acid testing.
(4) Determine problems with methylation. Then I can look at methylation panels to determine more about methylation and if you have specific problems with your biochemistry.
This is typically where I’ll go first. Depending on what I see, I may have to do these tests, or I may have to considerably more testing. It all depends and that’s customized to you.
(5) Balance the immune system. The goal is to balance the immune system. Regulate the immune system, normal immune system functioning.
(6) Heal barrier systems (gut, lung, and brain). Heal your barrier systems – the gut lining, the lung barrier, and the blood brain barrier.
(7) Kill bad bacteria, parasites, and fungi. Kill bacteria, parasites, and fungus.
(8) Remove environmental chemicals and triggers. Remove environmental chemicals and triggers that can cause autoimmunity and cause it to become exacerbated.
(9) Improve lifestyle and remove dietary triggers. Focus on improving lifestyle and stressors and removing dietary triggers as well. I mean this is an overall approach. This is where we start. These are some of our goals.
Important Advance in Testing: Identifying Genetic SNPs
The important thing with genetic testing is that now we have the ability to look at your genes and know if you have some genetic defects that can cause you to have problems with biochemical processes and that can really contribute to thyroid disorders and to just general problems with health decline.
I want to make something really clear though: we don’t treat genetic tests. We treat the person. You may have an issue with your test that looks like it’s a problem and you’re thinking you need to do something about it and you don’t. We treat the person. We use that information to help us if you don’t respond to treatment the way that you should.
Again, I mentioned this a little bit. We look at genetic testing, organic acids, and methylation panels. This is the future of customized medicine, but you don’t treat the panels. I have to say that because people ask me a lot about genetic testing, and you don’t treat the gene test. You treat the person and you use that test as a supplement if the person is not responding.
Lab Tests that are all “Normal”
A lot of people tell me, “I’ve had lab tests but they’re normal.” Here’s what I got to tell you. This is going to be really important for you to know. Lab ranges are misleading because these ranges are really broad and the thing is that they’re based on the averages of people that go to get their lab work done and blood drawn at that particular lab.
Think about this: who goes to a lab and gets blood drawn? Primarily it’s not everybody that’s in great shape and is healthy. It’s primarily people that are having health problems that are looking for answers. You’ll go in there and you’ll see like a lot of people that are sick and you’re being compared to those people and that’s what normal is. That’s what they’re considering normal, and you’re comparing yourself and your doctors are comparing you to that population of people. It’s based on unhealthy people.
What we do is we use if this entire range that you see here, the top and bottom of the labs are these red areas that would be the high and low of a lab range. We use more narrow ranges, which are called the functional lab ranges, which are more sensitive for declines in health or a system that’s declining and this is much more sensitive. We look at more sensitive ranges to detect problems before they can be diagnosed with more disease.
These are just some of the examples. I mean so for example, let’s talk about TSH, which is a common thing that my patients and people that are watching this are going to be able to relate to. Standard lab ranges and they all differ depending on what lab you go to – that’s the other thing. They’re all slightly different, but average TSH so if you go to like a lab locally might be the low end would be 0.3 U/L and the high end would be 5.7 U/L, so it’s a really broad range for TSH. We use 1.8 U/L to 3 U/L.
These are all literature-based references ranges that I’m using. They are from consensus statements. That’s what we use which are more ideal ranges. It’s a more narrow range. If you have 4.2 U/L and you came to see me, I would say there’s a problem here that’s a functionally high TSH whereas if you go to your medical doctor, they might say, “Well, you’re within the lab range, so there’s nothing wrong.” But that’s suggestive of other problems. That’s how we investigate differently by using these more narrow ranges and getting more sensitive testing.
You think about this: if you want to see normal, just go to Wal-Mart and walk around. Just look at the general health of people that are around you. I mean everyone is sick, and overweight, and obese. I don’t want people to be normal because that’s what the labs are seeing. The labs are seeing people that come in that are the new American normal, and that’s not good enough. I mean you want health; we are trying to find healthier, trying to find out what’s causing problems and get you healthy. That’s what I want for every patient that comes in here is to be healthy, not normal.
Tests Based on your History to Look at Functional Values
I might run a lot of tests. It just depends on what you come in with, and I look at those functional values so there are more narrow ranges typically with lab testing, with some of the other testing we use like genetic SNPs and organic acid methylation panels. Those have ranges as well, and we will look at those. But there are a lot of different tests that we’ll run. The metabolic panel, which is a very expandable panel, genetic testing, organic acids, and methylation.
We can do urine and hormone testing, which is something I do quite a bit because I can measure cortisol over an entire 24-hour period, which is you do it four times during the day and that gives us a good what we call circadian rhythm of hormone production throughout the day.
We can look at your sex hormones to see if the testosterone or estrogen is elevated or decreased.
We can look at stool ecology profile. We can look at your stool and actually see if you have an overgrowth of bacteria, parasites, or other problems.
Cyrex Lab Testing
Then I want to talk specifically about some immune system testing. There’s a lab that I use in Arizona called Cyrex Labs, and they are by far the most advanced laboratory at measuring and looking at the immune system. What we can do is we can really kind of focus in on dietary changes or even determine if you’re having multiple tissues. Let’s say we diagnose you with Hashimoto’s. If you have Hashimoto’s, then you probably have other tissues that are being attacked as well because other autoimmune conditions expand. They don’t just stay with one tissue.
We continue to Cyrex Labs. We can get a number of different tests that include food sensitivity testing for gluten and other foods. We can look for leaky gut syndrome through there.
We can look at these 24 different tissues in your body that can be attacked through one of the other tests, and today we can look at almost 200 different foods that you may be having a reaction to, an immune response to, and we can use that to make sure we’ll get those out of your diet.
A lot of these foods are even on like a Paleo diet, which a lot of people try and some people have success with autoimmunity and other people, they don’t do well at all and that’s because it’s not any particular diet. It’s what’s best for you.
What Makes us Different from Every Other Doctor you have Seen
What makes us different is that we look at you several different ways.
We look at you neurologically because I want to know about your brain health. We’re doing an examination that’s a functional neurological exam. We’re looking for brain function. We also do a very thorough metabolic assessment. I look at your history. I go through metabolic testing with you, so we’re going to need to get some testing done. Then we consider genetics.
Taking all these things into consideration really help me get a much better picture of what’s going on with you and what can we do if anything to help.
Hashimoto’s Disease (hyperthyroid) and Grave’s disease (hypothyroid)
These are not thyroid problems when we talk about Hashimoto’s. It’s an immune system problem. A lot of people, they’re told that they’ve got Hashimoto’s disease and of course it’s associated with their thyroid. The thing is a thyroid disorder, but it’s really not a thyroid problem. It’s an immune system problem where it’s attacking your thyroid gland.
Graves’ disease is the same way but Graves’ disease has a different target. It targets your TSH, which is what’s produced by the pituitary gland, and that will cause hyperthyroid symptoms whereas Hashimoto’s targets thyroid-binding globulin and TPO enzymes.
The only way that you can know really what’s going on is to have proper testing done, and that’s one of the things that we have to do some testing.
My Approach
My approach is I look at the whole person. Basically, I want to heal you naturally and help you get better naturally. Now there’s no cure for autoimmune conditions. There is none, but you can take an autoimmune condition. You can put it into dormancy by doing some of the things that I’m talking about here. Just keep it dormant, so you’re not expressive and if you do testing, it shows negative that you don’t even have an autoimmune condition, but that takes work and that takes time.
This traditional approach that we see is based on just tissue destruction. We just wait until the tissue is destroyed enough and until the problem is bad enough, and then we can do something for you. That typical approach is putting on medications and immunosuppressants, steroids, and antiinflammatories. It doesn’t address why. It doesn’t address why you’re having a problem. This is the best system. I mean our healthcare system – don’t get me wrong. I have a lot of family members and doctors that are a friend of mine. It’s a great system for crisis care. When you have this chronic disease processes or autoimmune conditions, it is purely symptom based. It doesn’t do anything to address the drivers of the process.
The Medical Approach to Thyroid Dysfunction
The medical approach to thyroid dysfunction now is basically you replace or remove it, so you either give a supplement or you take it out. That just doesn’t address anything. Antidepressants and these acid reflux medications I see people do nothing to address why you’re having a problem in the first place.
I have people come in and they have all these issues and they have brain fog and say “I can’t think.” A lot of times, it’s because they have chronic inflammation and they’re having brain inflammation due to the inflammation circulating through their entire body and it causes brain fog. It causes issues with their neurons and their brain and ultimately it’s going to lead to brain degeneration.
All these different medications for the SSRIs, the tricyclic antidepressants, the MOA inhibitors, all these stuff, these are not addressing cause. I’m not saying that you don’t need any medications because there are a lot of cases where you do, but there are so many things that drive these processes. If those are not being addressed, then you’re just treating a symptom and the problem is still raging on. It’s still going to cause problems and cause you more problems in the future.
Functional Medicine Approach
The approach that we take is a functional medicine approach. It looks at the whole person. We’re going to look at food sensitivities, address nutrient deficiencies; yeast infections; blood sugar and adrenal glands. We look at hormone dysfunction. We look at liver problems.
I’m even going to look at the supplements that most people will have a bag of supplements. Basically a lot of those things can be making you worse because they have things in them that can actually exacerbate and trigger an immune response or they’re full of fillers and these excipients and other things that you don’t want in there.
Functional Medicine and Functional Neurology Approach
This is focused on balancing and regulating the immune system. Everything that I do is focused on decreasing the immune response, decreasing the inflammation, getting an appropriate immune response. This all requires dietary modification, lifestyle changes, and sometimes we use temporary nutraceuticals to help your body heal and improve nutrient deficiencies, help your immune system become more regulated, help heal the gut, and that’s part of human process because we know we can do it better with a little bit of assistance.
We also address those brain problems, the issues if you have any kind of we call it misfiring or there’s not proper neurological firing within your brain because that is what stimulates and initiates all of your functions, all of the hormonal functions through the autonomic nervous system.
Whole Person Care not just Condition Based
This is really a whole-person approach, and that’s what I really wanted to get across is there are ways that we can look at this, but it’s not as simple as just taking your medication.
I always talk to my patients. Just to let you know look I started this journey for myself because I want to live a long life and I want to be as healthy as possible and I want to be able to enjoy my life and be here for people that I care about – my family, my friends, my kids. I want to see grandkids. I want to be there and I don’t want this kind of stuff, these autoimmune problems, my Hashimoto’s and my psoriasis. I don’t want that to rob me of my quality of life in the future or to shorten my lifespan.
What I tell people is these problems lead to a lot of degeneration in the future. If you don’t address why and you just cover up these symptoms with medications, you’re not addressing the problem. That’s not going to help you longer term. How do you want to live your life? How do you want to be later in life? Where are you going to be in 3, 5, 10 years? For me I want to be vibrant, and I want to be there for my children.
If you have any questions or if there is anything we can do for you, let us know. I’m here to help you out if I can help. I’m going to continue putting more information on there so that you can help yourself, but all you have to do is ask. We’re here for you if we can help you. I appreciate you taking this time because I know this is a lot of information to go over, but this is so valuable because I know if I don’t tell people, you’re not going to get it anywhere else.
I really appreciate you taking time to learn about this approach and to listen to what I have to say because I think it can really change your life. If you have any questions or you need anything, just let us know. I hope you have a wonderful day.
Thanks!
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