Thyroid Mystery Solved: Hashimoto's and Hypothyroidism Revealed

The Case:  Linda was having trouble with anxiety and sleep Routine blood work revealed a very high TSH (thyroid stimulating hormone) and she was given a medication to treat hypothyroidism. Linda wondered why she didn’t have many of the typical symptoms for hypothyroidism and worried that going on medication might be the wrong move.   Even though Linda was happy to have an answer, something didn’t add up. She was told to get on the medication, regardless of whether she showed typical symptoms or not. Linda wasn’t convinced. That’s when she came to see me.    The Investigation Linda was right to question her results and her treatment even though her numbers were very high. I knew I needed to figure out the root cause of her elevated TSH and determine if there might be a way to get her back into optimal range.    Normal Range for Thyroid Stimulating Hormone (TSH)  The regular lab range for TSH is between .5 and 4.5, but the more functional range that we want to aim for is really between 1.8 and 3 if not medicated. Linda’s TSH was at 19, which was why her doctor was immediately alarmed.    Evaluating Thyroid Markers or Why You Need To Test All Thyroid Markers In order to truly evaluate the thyroid, it is very important to test all of the thyroid markers (as I explained in Episodes 27 & 28). We ran a second blood test with TSH and all the thyroid hormones as well as all 3 antibodies: TPO, thyroglobulin, and TSI antibodies. When the results came back with high TSH (even higher than before!), the interesting thing was that the other actual thyroid hormone markers were completely normal. Linda’s T3 and T4 were at optimal levels. Typically, when those thyroid hormones drop, the body’s signal to correct that would be raising the TSH. We were able to see here that the other hormones had not dropped in the first place, so that was not the reason the TSH was up.    High TSH with High Thyroid Antibodies  In Linda’s case, she didn’t have typical hypothyroid or slow thyroid symptoms and her thyroid hormones were normal. Her TPO antibodies however were 529, which is quite high. Her thyroglobulin antibodies were also slightly elevated at 42 and her TSI antibodies were negative. TSI antibodies are representatives of Graves disease, so she didn’t have that, but TPO and Thyroglobulin antibodies are representative of Hashimoto’s. Linda’s results were positive for TPO and Thyroglobulin, which showed us that she had Hashimoto’s.    Hashimoto’s and Thyroid Inflammation When there is Hashimoto’s there can also be thyroid inflammation. I have found that when the thyroid is inflamed, the TSH can go up without it triggering any low thyroid hormones. This is not what the textbooks say in typical cases, but as we know here at Health Mysteries Solved, many of us are not textbook cases, and issues can be complex!   Misdiagnosed Hypothyroidism  Our bodies have tons of feedback loops and when all the loops work like they are supposed to, then we can follow a textbook pathway to healing. But, in many cases, there are other issues at play from stress to autoimmunity to toxicity, to the foods that we eat. It’s not uncommon that the feedback loops may not work the way we think they should. In this case, High TSH is showing inflammation of the thyroid rather than an actually slow thyroid. This not only explains why she didn’t have hypothyroidism symptoms, but also that the inflammation could have actually been triggering the anxiety and sleep issues.    Medication when Necessary I was so happy that I met Linda so that we could work on the inflammation. In her case, medication was actually not necessary because her thyroid hormones were normal.  Even though I am always trying to find natural solutions, I am not anti-medication when truly necessary. Especially when it comes to thyroid medication. As some of you may know, I take a small dose of compounded thyroid medication because I have hypothyroidism. My perspective is that when the thyroid truly is slow, medication is replacing something that the body can’t make but absolutely needs. This is a very important medication for me to have. However using it when you don't need it is a different story.   The Link Between Hashimoto’s and Hypothyroidism? While many people with Hashimoto’s do in fact have hypothyroidism (because of damage to the thyroid), other times, we can catch the Hashimoto’s and the inflammation it may cause early before the thyroid gets damaged. In this case, if we address the inflammation and underlying immune triggers driving the autoimmune response, it is possible to save the thyroid from being destroyed.  By the time I found out I had Hashimoto's, my thyroid was already affected but even if that is the case for you, there is still a lot you can do to stop the progression of the attack by addressing the triggers.   Next Steps For Linda, we caught the Hashimoto’s early before it actually damaged her thyroid. We worked on lowering inflammation and calming her adrenal glands (the glands that deal with stress), which was one of her triggers. We did a genetic test for gluten, the D2 DQ8 which showed that she was positive for both the DQ8 and D2 (meaning her body was not genetically predisposed to process gluten). There is a big connection between gluten and Hashimoto’s due to molecular mimicry (where there are similar molecules at play so the body attacks all of them by mistake). We took gluten out of her diet and used PS 150 and liquid GABA to help lower her cortisol and support her adrenals and sleep. Stress can be both physical as well as emotional and so for Linda, we reduced the physical stress caused by her body trying to process gluten. She also added mindfulness exercises to further lower her cortisol. This  helped her calm down, relax and feel less anxious which, along with the GABA, improved her sleep.  The better she slept, the more her adrenals were able to heal. We retested her full thyroid panel of markers in 6 weeks and her TSH had returned to normal! We were both thrilled. Eliminating Health Mysteries Can you see how this could have become quite a health mystery had she not explored this further? I am so glad she did reach out for support, and hope you can keep her story in mind in case you ever get similar results. For Linda, we were able to find that missing piece of the health puzzle so she could regain her health. Could this be the missing clue for you or someone in your life?    Links: Suggested Products Liquid GABA PS 150 Related Podcast Episodes: EPISODE #028 Navigating the Thyroid Treatment Mystery with Inna Topiler EPISODE #027 Solving the Thyroid Mystery w/ Inna Topiler EPISODE #080 The Link Betw...

4 Feb 202112min

The Case:  Paulina is dealing with tension and constant pain in her upper back and neck.  She’s also experiencing frequent sleep interruptions, headaches and her body is in a constant state of inflammation. Paulina tried adjusting her work set up, saw doctors and a chiropractor, following their advice to take NSAIDs and anti-inflammatory medications but they left her with a sore stomach and still in pain. Natural anti-inflammatories (like fish oil and curcumin) only dulled the pain without decreasing inflammation. When it comes to inflammation and pain, many things are at play and like most things in health, things are interconnected. We often talk about inflammatory cytokines but my instinct was that there really was more going on and we had to dig to find the root cause.   The Investigation My instinct was to focus on the endocannabinoid system, which I suspected might assist in understanding and solving Paulina’s case.  When I went over the history and looked at all the things that she tried for inflammation, my sense was that she may not be able to process the inflammation properly because another system was dysregulated. Pat Gawrysiak is a formulation scientist and the Founder and CEO of RSPrecision Pharma, a pharmaceutical manufacturing and compounding company and President of 7 Leaf Compounds, (a company that grows and manufactures CBD products). I knew he’d be the ideal person to speak with about this. Endocannabinoid System and Clinical Endocannabinoid Deficiency Endocannabinoids are a system of cell receptors. This molecular system balances many body processes, such as immune response, cell communication, appetite, mood, metabolism, memory, and sleep. Phytocannabinoids are plant molecules, such as Tetrahydrocannabinol (THC), CBD-A, CBD-G, and CBD-N. The phytocannabinoids are from plants, and endocannabinoids are from mammals.  High quality CBD products are known to activate the CB-1 and CB-2 receptors.  Clinical endocannabinoid deficiency is a medical theory which suggests that a deficiency of endocannabinoids is the underlying cause of migraines, fibromyalgia, and irritable bowel syndrome.   Not all CBD Products are the Same Many people are familiar with CBD but may not really know how or why it works.  And, while many may have tried CBD, they may not have gotten the results they were looking for because they were  not taking ones that are fully broad spectrum. Or, they may have gotten their dosages wrong for their weight. Anyone taking CBD for inflammation should ensure the product has proper testing (cannabinoid content, metals, pesticides) and is grown organically to get the best results. There can also be different results depending on the person. Treatments can be designed for balancing or acute treatment with doses varying for the desired effectivement.  This is why it’s important to consult an expert. The recommended dosage is 50-100 mg for an average adult.    Proper Absorption and Bioavailability Proper bioavailability is important and the method of consumption and dosage will impact this. You always want to work with an expert to ensure you are getting the right dosage for your body. CBD is similar to a water soluble vitamin in that there’s only so much that the body can absorb. The rest of the cannabinoid will be rejected by the body if it is not needed. Despite there being little to no risk of overdosing on clean CBD, it’s vital to get the right dosage to avoid feeling unwell.    Mystery Solved Because Paulina was so sensitive to anti-inflammatory medications, I knew that we had to look at her gut. However, while we were waiting for those results to come back, I recommended we start with a potent CBD both orally and topically to get the inflammation under control.  Paulina had never tried CBD before because she didn’t really know how it worked, but after I explained the pathway, she was excited to try it. She took 50 mg of the Physicians Only CBD twice a day and she applied a little topical cream to her neck 3 times a day.  By the 3rd day, she noticed a considerable reduction in her pain -- she reported that it was almost cut in half! She continued on the same dose and the pain stayed at that level for the next 2 weeks. I knew there was more inflammation in her body and so we continued on the same dose.  2 weeks after that, she felt another drop and now the pain was about 75% gone. She was really excited! By then, we had the results of her stool test and saw a few bugs and evidence of leaky gut.  We did a GI cleanse with GI Microb-x and FC Cidal, worked on her digestion and her intestinal lining with L-glutamine and zinc carnosine. After the gut protocol, she noticed less bloating, something she didn't even realize she had until it was completely gone!    Next Steps  Paulina is continuing with the CBD, along with multivitamins and omegas for maintenance, and to keep everything at bay.   Happy Ending The CBD helped to reduce the pain she was experiencing by 75%, by also balancing and healing the gut, she is now at a place where her symptoms are almost completely gone. I’m so thrilled this was the solution for Paulina!   Eliminating Health Mysteries For Paulina, we were able to find that missing piece of the health puzzle and help her regain her health. Could this be the missing clue for you or someone in your life?    Links: Resources Mentioned:  Physicians CBD - Use INNA10 to get 10% off your order   Thanks to my guest Pat Gawrysiak. You can learn more about him through his websites for 7 Leaf Compounds and RS Precision Pharma.    Suggested Products: GI Microb-x  FC Cidal  L Glutamine  Cannab-FS 350  Nano Emulsified Colorado Hemp Oil  Zinc Carnosine

21 Jan 202136min

The Investigation Where I live, the pandemic is still very much in full swing with cases continuing to rise. This may not be what we want to hear or think about after the year we’ve just had but I want you to know that all of this can’t take away your power. You still have the power to protect your body  and your immune system so that you can best deal with whatever comes at you in the coming months.  As we learn more about the virus and as the situation shifts, my immune recommendations have also shifted. There is a lot of information floating around and not all of it is good or relevant to people with certain immune conditions.  In this episode of Health Mysteries Solved, I want to share my latest updates on immunity. I’m including the best information on how food, nutrients, contraptions and health-hacks can help you stay healthy this winter.     Protecting Your Autoimmune Self When you have an autoimmune disease, the immune system is already overactive against your own organs. Many immune formulas (supplements) boost the immune system which, when your immune system is already overactive, is not good. This is why it’s so important that people with autoimmune issues don’t take general immunity advice. Otherwise, you might end up making your immune system even more overactive resulting in your immune system attacking your organs even more. We sure don’t want that!   Immune Recommendations to Avoid (for those with Autoimmune Diseases) If you know that you have an autoimmune disease or may suspect one, please be very mindful about immune boosting herbs. Specifically, these ones that are often recommended by health practitioners:    Echinacea Astragalus Reishi and other immune supporting mushrooms Green Tea and Elderberry   Make sure you read the labels of all supplements being touted as immune boosting because these ingredients may be included.    Immune-Boosting Dangers with COVID-19 We’ve learned that when covid goes to the later stages, it can produce something called a cytokine-storm. This is basically an inflammatory cascade that can then affect many other areas of the body. This happens because the immune system is in overdrive trying to fight the virus and not succeeding. Taking immune boosting herbs (like the ones listed above)  can make that worse because the immune system is already in a state of disarray.    Autoimmune Safe Immune Support Not to worry, there are other nutrients that are not only super-effective but also very safe when it comes to both autoimmunity and preventing immune dysregulation. In this episode, I got into greater detail with each of these but I wanted to provide you with a list of my go-to recommendations for my clients and myself. Here are my top recommendations for autoimmune safe immune-boosting supplements:    1. Vitamin C  This is my first go-to, my power tool, and the one that I think many people overlook. My recommendation for general immune support for a typical 150 pound adult  is 1000-2000 mg of vitamin C per day. I personally use the C+Bio Fizz from Designs for Health (makes a yummy, fizzy drink) but capsules like Stellar C are great. For some, vitamin C can cause loose bowels. If that happens for you, Liposomal Vitamin C is a wonderful solution to this problem as it absorbs through the mucous membranes in your mouth first and is easier to absorb - just remember to refrigerate.  Please note that if you are already sick (with COVID or any other virus, respiratory illness, or cold), you will want to shift your Vitamin C protocol. I, along with  many of my integrative colleagues, recommend increasing vitamin C significantly for the course of a week or so while not well. Do this in divided doses and more frequently. So, it would look something like taking 500 to 1000 mg of C (it can be powder, liposomal or capsules) every 30-60 min to bowel tolerance (until you get diarrhea which is when your body says it's saturated and had enough). You would then restart it later in the day or next day. Do this for a few days when you are sick. There is a ton of research about high dose vitamin C in helping fight infections.    2. Vitamin D  It’s imperative that our vitamin D levels are optimal as we head into winter. The dosage of D is going to vary based on your actual vitamin D status (if you know it). I like to have people somewhere between the 50-80 range on a blood test (lab range is only 30-100). If you don't know your levels but you have not supplemented with vitamin D recently, and especially if you live in the northern hemisphere, 5000 IU of vitamin D would typically be recommended.  Vitamin D is huge for balancing the immune system which is why it is so wonderful for illness prevention but also to keep the immune system in a place of homeostasis to help prevent upregulations on your own tissues if, or when an infection strikes. Vitamin D should ideally come with Vitamin K so that we prevent calcification of tissues and organs. I use a Liquid D for those who may have issues with fat soluble vitamins and the Vitamin D Supreme capsules for all others.    3. Zinc  This is not a new recommendation. Zinc has been widely talked about online and in the media. However, while it is very beneficial, many people have been taking extra zinc since the start of the pandemic (about 9 month). The issue is that zinc is a mineral and like other minerals, it works synergistically with other minerals. In particular, taking a very high dose of Zinc over an extended period can deplete your copper. That is why I don’t recommend more than 30 mg of zinc generally for prevention (unless you are taking extra copper) and while its safe to double the zinc if you are feeling sick, you are doing this for a short period of time, a week or 2 so that it doesn’t cause an issue with copper.  Note that copper deficiency can potentially lead to more bacterial infections and problems with the blood and even things like aneurysms. A hair test is a great way to measure levels of both zinc and copper. When you get the results, look at not just the individual zinc and copper levels but at the ratio of the 2. Ideally the zinc to copper ratio should be at around 8. If you are lower than 8 you can use more zinc however if you are above 8 you would take extra copper along with the zinc. Even a multivitamin with copper would help.   4. Oregano & Garlic  I love them because they work well and they work quickly. Plus, I typically don’t see many side effects with them. They both have not only anti-viral properties but they are also anti-microbial in general (meaning they can work on bacteria, yeasts and other bugs). The thing to note here is that I don’t recommend these to be taken long term and for general immune support (unless of course you are working on a specific protocol with your p...

7 Jan 202118min

The Investigation Resolutions don’t work. In this episode of Health Mysteries Solved, we’re going to explore why and what you should be doing instead.    New Year’s Resolutions Don’t Work We all make them, and most of us fail at them. Or, we have small successes that don’t last. Why? I think there are a few reasons:  Tied to New Years. Most of us only think about resolutions as the calendar rolls over. So, we think about this goal once. And then, we forget it so there’s not much consistency.  Obligation. For many of us, we make these resolutions about things we feel like we should be doing. We don’t think about why we want these things, or if we truly want them.  Wrong focus. We think about the resolution but don’t always put ourselves in a place where we can really feel it happening. We focus on fixing specific health issues and getting to the root of our ailments but not on what we really want and how we want to feel. We focus on what we don’t want instead of what we do want.  The New Year’s Resolutions Replacement I want to share an exercise with you that is much more powerful than the typical New Year’s Resolution practice. This is something I do (and I have my clients do) consistently throughout the year - not just at New Year’s! Do this when you have about 10 minutes in a quiet, comfortable spot where you can focus on your desired future.  Make sure nobody will interrupt you. Don’t do this while driving - this is not something you want to be multitasking! Health Visualization Exercise I’ll explain the process but I highly recommend you listen to the podcast so I can walk you through it.  Have a seat and close your eyes. Take a breath. Take one more. Think about a few things you are grateful for. Even if you’re struggling, find something to be grateful for.  Say ‘thank you’ outloud for each thing you are grateful for. Take your time and allow things to come to the surface.  Think of one health goal.  Think about WHY you want this goal. Consider the potential hardships you will endure if this doesn’t happen.  Visualize your goal as if it's happening right now. Try to really see yourself living in this new state of health. Evoke all the senses in this visualization. Take your time with this - you want to be able to feel this new reality. If negative thoughts arise and you feel like you are questioning this reality, acknowledge them, take a breath, try and feel where in your body you are feeling the resistance and observe it, this will allow the thought to subside so you can return to your full visualization immersion.  Write it down.  Write down what you said, how you felt, and what you were doing. The key is to write it as you see it, as if it's happening right now, not what you would like someday. Be mindful to not write down what you don’t want, you want it in the present and in the positive.  Get motivated. You very likely know exactly what action you need to take, now use the WHY to get motivated to take action. If you’re not sure where to start taking action, write down as many things as you can about all the possible actions and choose one to do.   Year-Round Keep visualizing. Remember this isn’t a once a year empty exercise. To help make your visualization a reality as quickly as possible is consistency. Envisioning your dream is something  you can do as often as you like, ideally each day. Download and save this episode so you can listen to it and revisit your visualization or do it on your own. Really seeing and feeling what you want will help to bring it closer to you.  You my friend, deserve all of the things that you wrote down and I want your dream to become a reality in the coming year. Connect! I would love to hear how this exercise went for you, what you noticed, what happened a few days later and what opportunities come your way. Drop me a line on Instagram or use the contact form on the Health Mysteries Solved website.  I love hearing from you!   Related Podcast Episodes: Beyond Mysteries: Create Your Best Year of Health Investigating Emotional Resiliency with Anat Peri 6 Ways to Improve Your Life When Self-Isolating   Thanks for Listening If you like what you heard, please rate and review this podcast. Every piece of feedback not only helps me create better shows, it helps more people find this important information.   Never miss an episode -  Subscribe NOW to Health Mysteries Solved with host, Inna Topiler on Apple Podcasts, Spotify, Stitcher or Google Podcasts and remember to rate and review the show! Find out more at http://healthmysteriessolved.com   PLEASE NOTE All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Some of the links provided are affiliate links. This means we may make a very small amount of money should you choose to buy after clicking on them. This will in no way affect the price of the product but it helps us a tiny bit in covering our

22 Des 202017min

The Case:  Rachel is dealing with digestion problems, sleep issues, headaches, psoriasis, and rashes.  She’s seen a ton of specialists, including a dermatologist, gastroenterologist, neurologist, and an endocrinologist She tried steroids, acid lowering medications, and a Selective Serotonin Reuptake Inhibitor (SSRI) with little improvement.   The Investigation This battery of symptoms may seem unrelated but I suspected that they were all connected.  My first clue was in her diet - which was not unhealthy but did have one common element that raised my suspicions. It’s found naturally in many foods and many traditional doctors don’t know to look for it - despite the fact that it’s estimated that as much as 17% of the population may have a reaction to it.  Dr. Beth O’Hara is a Functional Naturopath and the owner of Mast Cell 360, a Functional practice specializing in root cause approach to Mast Cell Activation Syndrome, Histamine Intolerance, and related conditions such as oxalates, mold toxicity, and chemical sensitivities.  You may recall that Beth appeared on episode 67 when we discussed a case involving oxalates.  This time we’re focusing on mast cell activation syndrome and histamine intolerance, which I suspected in Rachel’s case.    What is Histamine Intolerance? Most people think of allergies when they think about histamines because antihistamines are taken to deal with the symptoms. However, histamine has a much bigger role in the body than reacting to allergens. Histamine helps regulate estrogen levels, the sleep-wake cycle, acts as neurotransmitter, activates stomach acid and plays a role in digestion. The body can build up high levels of histamines to a point where the enzymes that break down histamine can’t keep up. At this point, it exceeds the threshold causing a histamine intolerance that leads to many different symptoms.    Symptoms of Histamine Intolerance There are a wide range of symptoms and they vary from person to person. Here are the big ones:   Skin irritation Rashes or hives Headaches (even migraines)  Gastro-intestinal issues Inflammation   Causes of Histamine Intolerance There are many things that can push histamine levels over the top including environmental toxins and certain foods. Some of the most common foods that are high in histamines include:  Spinach Strawberries Pineapple Fish (especially tinned) Packaged/processed foods   Click here for a comprehensive list of high and low histamine foods.  In addition to diet and environmental triggers, there are also genetic factors to consider. Specifically the genes that are coded for histamine degrading enzymes like ABP1 and AOC1 that produce diamine oxidase (DAO). Also, Histamine N-Methyltransferase (HNMT) which is another gene with the function of breaking down histamines.  Alternatively, a gut issue where the microbiome is impeding the natural creation of DAO can also cause a histamine overload.    What is Mast Cell Activation Syndrome Sometimes a histamine intolerance is caused by mast cell activation. Mast cells are the frontline defenders of the immune system and they produce histamine. These cells are activated when there is a threat like a virus, bacteria, parasites, mold or toxins. When they find this issue, they surround it with inflammation producing molecules and call to other immune cells to come in and do the rest of the clean-up process. This activation can result in an over-production of histamine. If the body is under constant attack (from toxins or stress), then mast cell activation can turn into mast cell activation syndrome. This can manifest in many ways with a variety of symptoms and can be difficult to diagnose.    Testing for Histamine Intolerance and Mast Cell Activation Syndrome Diagnosing mast cell activation syndrome is to see if there are symptoms involving two or more systems of the body. For example, GI issues, headaches, hives or others listed here. One of the first diagnostic tests is to have the patient take an antihistamine to see if the symptoms are related to histamine. However, you have to make sure that the antihistamine does not have mast cell triggers like dyes or titanium dioxide. The final piece of identifying mast cell activation syndrome is a genetic test showing a positive result for one of the mast cell mediators like tryptase, N-methylhistamine, prostaglandins, or cytokines.   Treating Histamine Overload or Mast Cell Activation Syndrome The most important step is to reduce histamine intake. This is most commonly managed through a low-histamine diet. It’s important to note that foods that are seen as health-promoting, like fermented foods or spinach smoothies, can in fact be quite high in histamines. Eating organic is also important (to reduce pesticide exposure) as is making sure your protein is clean and fresh. In particular, you want wild caught fish that is frozen at sea. Histamines can be elevated in food over time which is why it’s also important not to eat old leftovers (best to freeze them right away instead of leaving them in the fridge).  And, avoid processed foods especially canned foods (including fish and meat).  The next step is to make sure there aren’t any other triggers like mold, parasites, bacteria (including in the gut microbiome), or viruses.  And the final step is to support the body in breaking down histamines. For some this may mean supporting the gut with supplements like DAO  and if needed Betaine HCL, . Dr. O’Hara will also recommend herbal treatments (to patients who aren’t too sensitive) such as Baicalin (Chinese Skullcap) and Perimine (perilla extract) to support the mast cells. Every treatment has to be specific to the individual since the presentation of symptoms and the triggers are often unique to the individual.    Mystery Solved As you can see, histamines can play a role in a multitude of symptoms and this was in fact the case for Rachel.  The first step was to remove high histamine foods from her diet and add a DAO enzyme to break down the histamines.  Just doing this resulted in a significant reduction in her skin irritations and headaches. But, I suspected that the histamine issue was secondary to other imbalances.  We ran an organic acid test and a stool test and saw she had a lot of Candida. She was already eating well and didn’t over consume starches or sugars so we worked on it through supplements. I used GI Microb-X, FC Cidal and

10 Des 202050min

The Case:  Jane has been experiencing dry, irritated eyes for the past 2 years She’s treated them with steroid drops and antihistamines but the problem persists After consulting many doctors and taking tests, there seem to be no answers.    Eye irritations can range from dry, itchy eyes to puffiness. Most people reach for over-the-counter eye drops or antihistamines for temporary relief. If it’s caused by the environment or allergies, this might solve the issue but when it persists - there may be a bigger issue at play.    The Investigation My sense was that another organ was driving her eye issues. I suspected that it actually wasn’t  an eye issue, so to solve this health mystery, we had to look outside the box. And, I knew just who to contact, Dr. Rudrani Banik (Dr. Rani). She’s a board-certified and fellowship-trained Neuro-Ophthalmologist with a functional medicine approach. You may remember her, she was on episode 50.  Dr. Rani confirmed that eye issues aren’t always just about the eyes.    The Eye Thyroid Connection The thyroid is related to the health of your eyes. The receptors on the thyroid look very similar to the receptors that are found on the connective tissue in the eye socket. When there are issues with the thyroid, specifically autoimmune issues, there is the possibility that the eyes can be affected. There are a lot of different eye issues that are related to either Graves Disease or Hashimoto’s (autoimmune issues related to the thyroid).  However, sometimes the eye issues present before the autoimmune issue is detected or diagnosed making the connection difficult to make.    Symptoms of Thyroid Eye Disease The symptoms of thyroid eye issues can start out like many eye issues. For example, you might have dryness, irritation, redness, puffiness or swollen lids. The usual course of action for these symptoms might be to use drops (including over the counter and steroid gel drops), antihistamines or both but if these don’t work, these may be symptoms of thyroid eye disease.  Additional characteristics of thyroid eye disease may include the swelling or puffiness of the upper eyelids especially in the morning with the swelling decreasing through the day. Other symptoms may include chronic redness or a shift in the width of the eye socket. The latter may result in the eyes appearing bigger or wider. There may even be some inflammation causing the eyes to protrude or bulge (proptosis).  If left undiagnosed and untreated, the muscles behind the eye socket can get involved and cause double vision and even vision loss. Note that this does not happen overnight - it’s a severe advancement of the condition but it’s worth noting what can happen if the situation is not dealt with.    Diagnosing Thyroid Eye Disease The most important part of tying an eye issue to the thyroid is to get blood tests.  But, it’s not enough to just test the TSH or T3 as many doctors will do as a thyroid test. Dr. Rani says she likes to get the full antibody panel including TPO (thyroid peroxidase), Tg (thyroglobulin  antibodies), and TSH (thyroid-stimulating hormone) receptor (which tends to be elevated in thyroid eye disease patients).    Dr. Rani also says an eye exam is very important. She measures the lids very carefully to see if they are more open. She also tracks this over time to watch for changes. She’s also looking for congestion in the eye socket, asks about double vision, and checks the ocular motility.  Finally she uses an exophthalmometer to determine how the eye rests within the socket. Sometimes a CAT scan or MRI are required.    Treatment of Thyroid Eye Disease Once the issue has been properly diagnosed, there are several things that can be done to help treat thyroid eye disease including:     Eye Lubrication    Treating eye redness, dryness, and irritation can be done with topical medications (typically drops or ointments). Sometimes patients require medications (antihistamines or topical steroids but Dr. Rani only uses steroids in extreme cases (when vision is at risk) because there is a risk of side effects like developing glaucoma or herpetic infections.      Diet Changes    Certain foods may be triggering thyroid issues (for example, gluten, dairy, and goitrogens like cruciferous vegetables). Avoiding these foods may help.      Avoid Smoke    Dr. Rani says it's really really important to avoid any kind of smoke or fumes. Studies show that people who smoke have a much worse prognosis when it comes to thyroid eye disease, so it’s suggested that they quit smoking and even avoid secondhand smoke. Cooking fumes can even create a problem.     Reduce Stress    When it comes to managing the thyroid, stress is a major factor. Stressful periods can trigger thyroid issues so ongoing stress-management is important.      Selenium    A European study found that selenium (a mineral) can reduce the symptoms of thyroid eye disease. In that study, they used a supplement (100 mcg twice per day) but selenium can also be found in Brazil nuts, eggs, beef, chicken, and pork. Selenium can also be helpful for the conversion of T4 to T3.    Zinc    Zinc is really important for healthy thyroid function and producing hormones. You can take a zinc supplement, eat foods rich in zinc or do zinc lozenges.  Treatment Cautions There are a lot of eye drops for reducing dryness, redness and irritation but Dr. Rani encourages people to read the label. Look specifically for polyvinyl alcohol. It is a lubricant but the pH is not balanced to the eye so it can be very toxic to the surface of the eye and make dry eyes worse. Some brands that Dr. Rani says are free of alcohol are Refresh, Systane, and Genteel.    Who to See - Optometrist vs. Opthamologist Many people aren’t sure about the difference between an optometrist and an ophthalmologist - and who to see if they think they may have thyroid eye disease. Both are doctors but the optometrist is a doctor of optometry (OD) and must go to college for four years and then optometry school for four years. Ophthalmologists are MDs (medical doctors) with four years in school, four years in medical school and then an additional internship and residence (another four years). It’s training in both medical and surgical aspects of the eye. For thyroid eye disease, Dr. Rani says you would want to see an ophthalmologist because you may need to get special treatment which may include surgery.     Mystery Solved  Jane didn’t specifically present with many classic thyroid symptoms, but knowing the connection, I knew I needed to evaluate this further. Comprehensive lab tests revealed that Jane’s TSH, T4 and T3 were completely normal however her thyroid peroxidase antibodies (associated with Hashimoto’s) were 325. Ideally they should be below 35. We didn’t know how long her antibodies had been elevated but the good news was that (unlike many others with Hashimoto’s) her actual thyroid function had not been affected. The eye issues were the first symptom. .With the mystery solved, we knew we needed to address the immune system which was confused and attacking the thyroid and the eyes due to molecular mimicry.    Next Steps  If you heard

26 Nov 202039min

The Case:  Lori is 42 and has an autoimmune disease She works in the media and is concerned about her aging skin and wrinkles She’s worked hard to improve her health naturally and doesn’t want to do anything that will trigger her autoimmunity. Lori and I had been working together for months to get her health back on track due to her autoimmune condition. She asked me about how her condition might be affected by potential anti-aging therapies. I’m glad she asked because many doctors or aestheticians who provide anti-aging therapies don’t even think to ask a patient about other health issues. Dr. Raheleh Sarbaziha (aka Dr. Rahi) is not one of those doctors. In her practice, she makes sure to take a full health history before she will recommend potential therapies for skin rejuvenation and wrinkle reduction.  Aging is a natural process and part of that is the degradation of collagen which shows up most visibly as wrinkled or sagging skin.    Better Skin Through Diet Dr. Rahi believes that great skins starts within. You have to take care of the inside before you can expect great results from any external treatment. Dr. Rahi recommends a mostly plant-based diet. She says it’s important to understand how to read a label and to eat whole food.     Supplements for Better Skin Here are the top supplements Dr. Rahi recommends for healthy looking skin: 1. Collagen Since collagen is such an important part of healthy, young looking skin, collagen supplements can help.  2. Magnesium This is one of her top recommendations because it improves the quality of skin but it’s also so important on a cellular level. Most of us are deficient in magnesium so supplementing is valuable inside and out. Magnesium Citrate is a good option. 3. Turmeric This supplement helps decrease inflammation in the body and many skin disorders are a result of inflammation.  4. Fish Oil or Omega-3 A good, clean fish oil can help with healthy looking skin. For anyone who is vega, a good Omega 3 is an option.  5. Prenatal DHA This is something Dr. Rahi takes even though she is not pregnant. Look for brands like Designs for Health or Vibrant Beginning that have 90% triglycerides.   6. Vitamin C Vitamin C is super important in collagen production and it also helps keep your immune balanced. You can take it as a supplement or get it through diet (but likely both).    Micro-needling Micro-needling is a process of making many micro-punctures in the skin using a special tool. This brings the blood to the surface which stimulates your immune system and regenerates collagen production. It’s considered a minimally invasive, very safe treatment that generates amazing results.  It can be uncomfortable or even painful depending on your pain tolerance and the quality of the numbing cream used. Dr. Rahi also says that patients may be more sensitive during menstruation or if you are tired or stressed.  There are a variety of options for increasing the efficacy of the treatment including coating the skin with hyaluronic acid (so that it is injected with each micro-puncture). Other options include adding vitamin C, B Complex or glutathione.  Another popular option is the PRP or Platelet-rich Plasma. This is extracted from your own blood using a centrifuge. Using PRP during microneedling increases collagen regeneration and gives the practitioner the option to localize treatment (for example on deep lines or scars).    PDO Threads PDO threads are small sutures that are injected under the skin to pull the skin back and make the skin appear tighter. The threads themselves degrade over time and are absorbed by the body. There are many different types of threads (smooth, twisted, and barbed) that serve different ‘lifting’ purposes. As a foreign object under the skin, they also trigger an immune response and stimulate collagen production. This treatment is generally not recommended for those above the age of 65 if they have thinner skin.  Dr. Rahi says that it could trigger a response for anyone with an autoimmune disease but she’s never seen a negative reaction.    Radio Frequency Radio frequency treatments trigger an immune response when the frequency is emitted through the skin and causes the dermal layer to heat up resulting in a burn, almost.  There are two options using radio frequency - a sort of probe onto the skin (kind of like getting an ultrasound) and in combination with microneedling (Morpheus8) .  This kind of treatment should be safe for those with autoimmunity because it is simply stimulating collagen production.   Fillers There is the potential for immune reactivity with fillers so be sure to select an informed technician or doctor.  Dr. Rahi also cautions against irreversible fillers, favoring dissolvable fillers instead. This option allows you to dissolve it if you don’t like it for any reason.  Common fillers contain Hyaluronic Acid and BDDE (butanediol diglycidyl ether) as a cross linking agent which can cause an immune reaction.  For anyone with autoimmunity, Dr. Rahi cautions against Volbella, Vollure, and Voluma. The safer options (according to Dr. Rahi) are Juvederm  Ultra, Ultra XC and Restylanes.    Neurotoxins Dr. Rahi says she hasn’t personally seen any autoimmune sort of reaction to Botox, Dysport or any other neurotoxin injectables. She has heard reports of people developing a resistance to specific neurotoxins like Botox after extended use (6-10 years).   Next Steps  In this episode, we outline many options for anti aging treatments but depending on your body and your immune system, some are more natural than others and therefore can be safer than others, especially for those who have autoimmunity and are more sensitive.    Happy Ending Lori and I discussed everything in detail and opted for microneedling with vitamins as well as doing the PRP injections with her own platelets. The great thing about these treatments is that there are no added toxins or chemicals but they do actually work! Lori found her skin to look much better and smoother after 6 months of treatments.    Eliminating Health Mysteries For Lori we were able to find a way to help her age gracefully without triggering an autoimmune response. Could one of these options be what you or someone in your life is looking for?    Links: Resources mentioned Thanks to my guest Dr. Rahi. You can connect with her here through her website https://doctorrahi.com/ or on Instagram.   Suggested Products: Vegan ‘fish’ oil  ...

12 Nov 202044min

I recently opened the door to questions about thyroid conditions and Hashimoto’s on my Instagram page. And, wow, was I flooded with really great questions. In this episode, I answer as many as I can.    The Question - How do you Shrink Your Thyroid Nodules? This was the question I got the most from my Instagram followers. Before I answer, I want to clarify a few things. There are many different types of growths on the thyroid. Many people confuse enlargement of the thyroid with nodules or inflammation. If the thyroid is enlarged in one spot, that is a nodule. However, if the whole thyroid is enlarged it’s either a goiter or thyroiditis. A goiter is caused by iodine deficiency (uncommon in the US), consumption of too many goitrogenic foods, or thyroiditis. This swelling is often painless (pain may indicate that inflammation is from a virus).  Goiter growth is fed by a high TSH (Thyroid Stimulating Hormone) and also by high hCG (human chorionic gonadotropin) which is present during and after pregnancy. Eventually the hCG will go back down but if the TSH level is not treated, it can continue to feed the goiter and it will continue to grow.  The first step in reducing a swollen thyroid is to get TSH levels in balance and to reduce goitrogenic foods.  As for nodules on the thyroid, these could be solid or cysts filled with fluid. About 50% of people have these and many are benign. Someone with Hashimoto’s may experience nodules during a flare up. However, it’s important to have them checked because they could lead to thyroid cancer. The good news is if the nodules are due to Hashimoto’s, addressing the root cause of Hashimoto’s can help shrink the nodules as well. For more on this, refer to past episodes 32 - Solving the Autoimmunity Mystery, and 68 - Ask Inna: Hashimoto’s Questions.   The Question - Do people with Hashimoto’s have a compromised immune system? This is a question that has popped up a lot more since the start of the pandemic. People want to know if having Hashimoto’s means your immune system is weakened.  Inna’s Response  This might seem logical but it’s actually the opposite.  Hashimoto’s makes the immune system hyper-vigilant. The problem is that the immune system is confused so it’s extra-active. But this extra activity means that it attacks your own tissue - in this case, your thyroid. So, it’s not weak in that sense but because it’s so hyper-vigilant and attacking your tissue, it can actually weaken its response to bacteria and viruses.    The Question - My antibodies are still high. Is there something else I should look at? This question came with quite a bit of backstory. She explained that she had switched from taking just Synthroid (a prescription synthetic thyroid hormone replacement) to adding Cytomel. However her hashimoto antibodies continue to be high despite adhering to the autoimmune protocol (AIP) diet (with the exception of eggs). She wondered if the eggs could really cause that much of an issue. An ultrasound also revealed that she has two nodules on her thyroid. So, the real question is, what’s the root cause and what else can she do? Inna’s Response  Finding the underlying cause can be tricky. It seems like she’s already looked at the food angle by doing a mostly AIP diet. It is possible that the eggs are a trigger because every person is different but it’s hard to say. A really good food sensitivity test (like the comprehensive panel test done at Vibrant America), and find out conclusively if eggs are an issue for you.  After that, you want to make sure you look for other underlying causes like stress, infections, and toxins. Keep in mind that you want to give new medication combinations a couple of months to shift your antibody response.    The Question - My TSH levels are very erratic as is my weight gain. What are the best diet plans, supplements and essential tests? Inna’s Response  In this case it sounds like it may be Hashimoto’s and the swings are caused by flare ups. TSH can go up and down erratically with Hashimoto’s.  For tests, you want to make sure to get a TSH a total T for the total T3 free, a T4, free T3, reverse T3 and (very importantly) both thyroid antibodies for Hashimoto’s - thyroglobulin and thyroid peroxidase.  As for the diet plan, the best one to start with is the AIP plan where you take out grains, dairy, nuts, eggs and processed foods. If this feels too restrictive at first, you can start with removing gluten and dairy. You should also look at underlying causes like infections, toxins and stress.   The Question - I’ve been diagnosed with Hashimoto’s but my tests are now normal and I don’t have any symptoms. Do I still have Hashi’s? This Instagram follower has seen her test results move into normal range lately with TSH at 1.5 and antibodies consistently below the threshold of 35 (from 17 to 34). And, without any mood or energy symptoms it has her feeling like she’s in a gray zone.  Inna’s Response  The answer here depends on when and how the diagnosis was made. Look back at your blood work and see that original test that led to a diagnosis. Were your antibodies actually high at the time? Or, did your diagnosis come from an ultrasound? Some practitioners assume Hashimoto’s when they see nodules which is not always an indication of Hashimoto’s. This can lead to a misdiagnosis.  If the diagnosis was correct, antibodies in the normal range does not mean that your Hashimoto’s is cured per say because technically once the autoimmune is there, it will be there, but it would mean that it’s in remission and what you are doing is working so keep up the good work.   The Question - What could cause T4 to convert to reverse T3?  This question is a bit complicated for anyone not familiar with how the thyroid works, but essentially T4 normally converts to T3 but in this case, it’s converting to reverse T3.  Inna’s Response  The biggest thing here is stress and inflammation. Stress can come from emotional stress (our thoughts). It can also be physical, for example if you have any type of underlying infection (like Epstein-Barr Virus, Candida, or a parasite). Another possible cause might be food or toxins.  You want to find that root cause but while you’re investigating, I do find taking Phosphatidylserine is helpful. I use PS 150 from Designs for Health which is a soy-free formula. It helps bring down cortisol and lowers reverse T3. I usually suggest people take two capsules around bedtime.    The Question - How can I lower my TPO (Thyroid peroxidase)? There was a lot more to this question, so I wanted to share exactly what she wrote, “I have Hashi's. My naturopath has patiently and skillfully supported my thyroid, and other hormones, over the past two years to the point where I haven't needed any T4 or T3 for months (steady labs)! Yet, my system is so reactive, daily. I feel like I'm on the edge of hypo/hyper symptoms. And my TPO is still 75-100...? Is there anything I can do to help lower it? I'm on a dialed-in, wholefoods diet (lots of intolerances). Inna’s Response Looking at diet is definitely key here. You mentioned that your naturopath supported your thyroid and your hormones but have you supported the rest of your system? Dealing with food intolerances isn’t just about removing those foods from your diet. It’s good that you are but have you looked into the underl...

28 Okt 202017min