The Dr. Hedberg Show

What is Hepatitis C?

The Hepatitis C Virus infects the liver and it can spread to other body tissues such as the thyroid gland. Once inside the thyroid gland, it multiplies and may cause Hashimoto’s disease. Hepatitis C has also been found to trigger arthritis, diabetes, autoimmunity to the liver, Sjogren’s syndrome, and autoimmunity to the kidney. Chronic infection of the liver causes liver cirrhosis and even liver cancer.

What are the symptoms of Hepatitis C?

This can be the tricky part because some people don’t have any symptoms. The virus could be silent for many years before you get symptoms. You could have Hepatitis C along with Hashimoto’s disease and not know it. The main symptoms include:

Abdominal pain

Yellowing of your skin and eyes (jaundice)

Fatigue

Fever

Loss of appetite

Swollen blood vessels that look like a web

Nausea

Rectal bleeding

Bloating

Fluid in your abdomen

Confusion

Drowsiness

Slurred speech

Weight loss

Swelling in your legs

Itchy skin

Bruising and bleeding easily

Dark-colored urine

Muscle aches

How do you get Hepatitis C and how is it tested?

This virus is transmitted by sexual intercourse, blood transfusion, or sharing drug needles with someone who is infected. Antibody tests to Hepatitis C are readily available through most commercial labs such as Labcorp.

One of the things I will see on blood testing is elevated liver enzymes including AST and ALT in Hepatitis C infection. I’ll also look at a CBC (complete blood count) which usually reveals elevated lymphocytes indicating viral infection. Inflammatory markers such as c-reactive protein and erythrocyte sedimentation rate may also be elevated. The ANA (anti-nuclear antibody test) has been shown to be positive in up to 33% of cases.

How does Hepatitis C trigger Hashimoto’s disease?

At the time of this writing, the exact cause is unknown but there are a few different theories. These include triggering the immune system to attack thyroid cells when the Hepatitis C virus is actively infecting the thyroid gland. The immune system may be tricked into attacking thyroid cells instead of the virus.

We do know that the Hepatitis C Virus can leave the liver via the bloodstream and infect the thyroid gland. It can remain there in a chronic state resulting in autoimmunity and inflammation in the thyroid gland.

How is Hepatitis C treated?

Interferon is the standard treatment but using interferon can actually trigger Hashimoto’s disease. It is recommended that patients with Hepatitis C be tested for thyroid antibodies prior to interferon treatment. Elevations in thyroid antibodies prior to interferon treatment are a big risk factor for developing Hashimoto’s disease.

There are a number of natural agents that may work well for the Hepatitis C Virus.  These include:

Elderberry

Isatis

Shisandra berry

Licorice root

Garlic

Silver

St. John's Wort

Lactoferrin

Zinc

Another important factor is to focus on improving glutathione levels in the liver with the following:

Whey protein

NAC

Milk thistle

Selenomethionine

Glycine

Glutathione itself can be taken as a supplement in the liposomal or reduced form, but make sure it is a quality brand with good absorption.

The other important factor is to help with “liver congestion” due to all the inflammation and damage the Hepatitis C virus does to the liver. These compounds can help:

Dandelion

Methionine

Choline

Inositol

Artichoke

Taurine

Ox Bile

Curcumin

Beet root powder

Black radish

B-vitamins

Magnesium

In addition to fighting the Hepatitis C virus and supporting the liver, we must also use our normal protocols for viral infections inside the thyroid gland in patients who have Hashimoto’s disease as well. The focus is reducing inflammation inside the thyroid gland, reducing viral activity, and balancing the immune system. These protocols are unique to each patient so I won’t get into them here. Your functional medicine practitioner will identify the best treatment approaches for your Hashimoto’s disease as well as the Hepatitis C virus.

This can result in improvement in thyroid antibody levels and thyroid function. If you have had Hepatitis C virus then I would definitely recommend getting tested for Hashimoto’s disease. Or if you have Hashimoto’s disease and potentially have some of the risk factors for Hepatitis C, then you may want to get a hepatitis panel blood test to rule this out.

In this exciting interview on The Dr. Hedberg Show, I interviewed Dr. Izabella Wentz about everything Hashimoto's disease.  We had a great conversation and covered some very practical information that everyone can use right away.

 

Here are the topics we covered in the interview:

How did you become interested in the thyroid?

What are some of the common root causes of Hashimoto’s?

You’ve now worked with over a thousand people with Hashimoto’s and figured out that you can accelerate healing and symptom reduction within one to two weeks, even for people who have been suffering for years. How do you do that?

Is there a particular diet that you recommend that is better for people with Hashimoto’s?

How big of an effect do you feel that food sensitivities play in not only developing Hashimoto’s, but also in hindering remission?

Stress can negatively affect your adrenals. What are some coping mechanisms that people can use so that stress doesn’t compromise their health?

Can you talk about the gut and thyroid connection?

Are there supplements that would benefit most people with Hashimoto’s?

What role does trauma and stress play in Hashimoto’s?

Is it possible to get Hashimoto’s into remission?

Can thyroid tissue regenerate after it’s been damaged by the immune system?

Where can people get more information on your work?

For those of you new to Dr. Izabella Wentz, here is her story:

Izabella Wentz, PharmD, FASCP is an internationally acclaimed thyroid specialist and licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s thyroiditis in 2009.

Dr. Wentz is the author of the New York Times best-selling patient guide Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause and the recently released protocol-based book Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back.

As a patient advocate, researcher, clinician, and educator, Dr. Wentz is committed to raising awareness on how to overcome autoimmune thyroid disease through The Thyroid Secret Documentary Series, the Hashimoto’s Institute Practitioner Training, and her international consulting and speaking services offered to both patients and healthcare professionals.

You can visit her website for more information:

www.thyroidpharmacist.com

Download a free 2-week recipe plan to begin healing your Hashimoto's here:

===> 2-Week Recipe Plan

Epstein-Barr Virus or EBV is a herpes virus (Herpes 4) that is significantly connected to Hashimoto’s disease and many other autoimmune diseases.  It is the most common infection I see in my patients with Hashimoto’s thyroiditis.  Testing for Epstein-barr virus is fairly straightforward but treatment can take a long time.

How do you get infected?

Epstein-Barr Virus is transmitted by saliva resulting in mononucleosis (“mono”) also known as “the kissing disease.”  EBV can also be transmitted via semen during sexual intercourse, by blood or blood transfusion. Most people get infected when they are young after their first kiss or if they exposed to another infected person’s saliva on a shared drinking glass.

What are the symptoms of mono due to acute Epstein-Barr Virus infection?

FatigueSwollen lymph nodes in the neckSore throatFeverRashEnlarged liver and spleen

The above symptoms are the usual result of the initial infection which lasts about 2-4 weeks but sometimes they can go on for months.  Once your immune system fights off the virus, it becomes inactive for life.  Epstein-Barr Virus however can reactivate later in life resulting in autoimmune disease such as Hashimoto’s thyroiditis, fatigue and many more illnesses.  This is similar to the Chicken Pox virus that stays in your body for life but it can reactivate resulting in painful shingles.

Key point: Just because you never had mono, this doesn’t mean you can’t have the virus.  Some people get infected with EBV and never develop symptoms.

You can infect another person no matter how old you are if the virus is reactivated in your body.

***Some people will have a “mono-like” illness and EBV antibodies are negative. This is due to another active infection including cytomegalovirus, toxoplasmosis, herpes 6, herpes 7, HIV or hepatitis B.

What health problems can Epstein-Barr Virus cause?

Many autoimmune diseases such as Hashimoto’s disease, Lupus, Rheumatoid arthritis etc.Weakened immune system making it more difficult to fight other infectionsFacial nerve palsy (Bell’s palsy)Guillan-Barre SyndromeSleep problemsChronic fatigue syndromeViral meningitisTransverse myelitisOptic neuritisEncephalitisCerebellar ataxiaParalysis on one side of the bodyPneumoniaPancreatitis (swelling of the pancreas)Myocarditis (swelling of the heart)

Epstein-Barr Virus is also associated with a number of cancers including Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma, nasopharyngeal carcinoma, and Burkitt’s lymphoma.

What is the best test for Epstein-Barr Virus?

Blood testing through all commercial labs such as Labcorp are readily available for testing.

Let’s break down each test component:

EBV Viral Capsid Antigen (VCA) IgM: Indicates an active infection and stays positive for 4-6 weeks.***VCA IgM antibodies can cross-react with cytomegalovirus, toxoplasmosis, herpes simplex or rheumatoid factors. This must be taken into account due the potential of a false positive.***VCA IgM antibodies have been shown to rise in those over 60 years of age.

EBV Viral Capsid Antigen (VCA) IgG: Positive in the early stages of infection peaking at 2-4 weeks, then it begins to drop and stays positive for life.

EBV Nuclear Antigen (EBNA) IgG: Not positive in the acute phase but starts to elevate 2-4 months after infection.  IgG stays positive for life.

EBV Early Antigen (EA) IgG: Positive in the acute phase of infection and then begins to drop for 3-6 months after infection.  A positive test indicates active infection.

The early antigen is usually left out of many EBV tests I review which unfortunately means we can’t make an accurate diagnosis of reactivation without it.  Since the VCA and EBNA IgG tests are positive for life, it is best to use the Early Antigen IgG to monitor successful treatment of the infection.  The VCA IgM is beneficial to have only if you want to see if it is an acute infection or a recent reactivation. The panel I order through Labcorp contains all of the above markers and then I will just use the Early Antigen IgG in most cases to monitor progress.

The Monospot test is not a very accurate test because it is negative many times in children with mono. It also has shown to have too many false positive and false negative tests.

It is important to note that in very rare cases, you can have active EBV infection but none of the antibodies are present on your blood tests.

If you are hypersensitive to mosquito bites then you may have an active infection.

How does Epstein-Barr Virus cause Hashimoto’s Disease?

Dr. Michael Pender does an excellent job in this paper explaining how EBV can cause autoimmune diseases including Hashimoto’s thyroiditis.  I will try and simplify the paper for you below.

Due to specific genetic reasons, people with autoimmune disease tend to have fewer immune cells that can fight the Epstein-Barr Virus so it can more easily reactivate and stay active.  Biopsies of the thyroid glands of patients with Hashimoto’s disease and Epstein-Barr Virus show massive amounts of the virus inside the thyroid gland.  This results in an immune attack on the virus and the thyroid gland.

A number of things can prevent your ability to fight off EBV including:

Too much estrogen in your bodyVitamin D deficiencyLow Ferritin levelsAnemiaHypothyroidismZinc deficiencyChronic stress (adrenal and autonomic nervous system imbalances)Insulin resistanceChronic inflammationGut dysbiosis and/or gut infectionInsufficient protein intake known as “Protein Energy Malnutrition”Chronic insomniaOther stealth infections that are stressing your immune system

What are the best treatment options for Epstein-Barr Virus?

There are a number of compounds that are effective for EBV including:

MonolaurinCordycepsReishiCurcuminOlive leaf extractArtemisininBerberineVitamin C (Intravenous is very effective)EGCG

I want to make it very clear that simply taking any of these will most likely not result in successful treatment.  Why is that?  Simply attacking the virus does nothing to solve the underlying reasons why your immune system can’t control this virus.  A successful treatment plan is a comprehensive approach including all the things we do in functional medicine such as gut health, stress physiology, macro/micronutrient balance, hormone balancing, reducing inflammation etc.

Many people make the mistake of taking compounds for EBV which suppresses the viruses activity, but then it just reactivates when they stop supplementing.  This is because the reasons why it reactivated have not been addressed.

There are cases where I don’t even target the virus and it deactivates because we work on the underlying causes of the infection.  It is however extremely beneficial in many cases to target the virus as well as everything else that needs fixing for a quicker and more successful outcome.

Epstein-Barr Virus and Hashimoto’s Disease Summary

The first thing to do is work with a functional medicine practitioner who will properly test you for EBV reactivation.  The second thing to do is work with your functional medicine practitioner to balance all of your body systems and address all the potential causes of EBV reactivation noted above. This way you can have lasting control of the virus so it doesn’t reactivate again.

As long as the Epstein-Barr Virus is active, your immune system will continue to be under stress and out of balance.  Since Hashimoto’s disease is an autoimmune disease, all potential stressors on the immune system must be eliminated in order to be successful and heal properly.

I get great results with patients who have Hashimoto’s disease with associated Epstein-Barr Virus reactivation.  This is one infection you don’t want to overlook so get tested soon and you’ll be on your way to eliminating one more piece of the Hashimoto’s puzzle.

Discovered in 1982 in those with gastritis and ulcers, Helicobacter pylori or “H. pylori” is one of the most common infections connected to Hashimoto’s disease and also Graves’ disease for that matter. Like Yersinia enterocolitica and Epstein-Barr Virus infections, Hashimoto’s thyroiditis can be triggered by H. pylori through a process called molecular mimicry which basically means that the infection looks similar to your thyroid tissue so the immune system attacks the infection and the thyroid gland.

What is Helicobacter pylori?

H. pylori is a bacteria (gram-negative) usually found in the stomach of 50% of the world’s population. It tends to found in those with gastritis, GERD(heartburn), gastric ulcers and stomach cancer. It burrows into the stomach lining resulting in inflammation and damage.

H. pylori is capable of forming biofilms which protect it from the immune system and antibiotics.

H. pylori doesn’t like the acid in your stomach so it will infect areas of low acid production. Low stomach acid also known as hypochlorhydria, can set you up for H. pylori infection.

Hypothyroidism leads to low stomach acid production which makes you more susceptible to H. pylori infection. Also, if you are taking antacids for a long time then you are more prone to infection.

Stress (cortisol and adrenaline), Zinc deficiency, adrenal imbalances, intestinal dysbiosis and b-vitamin deficiencies also contribute to low stomach acid production.

Is it contagious?

We actually don’t really know for sure how it is transmitted but it can be contagious. It is most likely transferred from mouth to mouth or oral to fecal routes. We do know that H. pylori is found in contaminated food and water as well as dental plaque, saliva, vomit and feces of those who are infected. This would indicate a simple kiss may result in infection or sharing of a drink.

What are the symptoms of H. pylori infection?

Up to 85% of those with H. pylori are asymptomatic! Symptoms can include:

Stomach pain, burning or ache (worse when your stomach is empty)HeartburnNauseaBlack stoolBelchingBloatingVomitingLoss of appetiteWeight loss

Is H. pylori actually beneficial?

Some strains of H. pylori can actually help with the following:

Normalizing stomach acid productionGERD(heartburn)DermatitisAsthmaRhinitisInflammatory bowelEsophageal cancer preventionBarrett’s esophagusAppetite normalization

Your stomach makes a hormone called ghrelin which makes you hungry. H. pylori can potentially suppress ghrelin levels so you aren’t hungry all the time. Sometimes after H. pylori is treated, people will say that they always feel hungry, even after they eat. This is because ghrelin levels are no longer suppressed by the H. pylori.

We also know that people gain weight after being treated for H. pylori so we must use caution in someone who is obese or has type 2 diabetes.

What are the best tests for H. pylori?

There are five ways to test for H. pylori:

Urea breath testBlood testStool testStomach biopsyUrine test

The urea breath test and the stool test are the most accurate for active infection. The blood test can show past infection and active infection, however, it can remain positive for years after the infection is gone. The blood test is adequate if you have never been treated for H. pylori before. The blood test has advantages because it can show an infection that has gone systemic meaning it has left the stomach and is now present in arterial plaques for example.

After a review of many research publications on testing, they all report different results as to what the best test is for H. pylori. A biopsy is very invasive but highly accurate so we have to choose between stool, blood and urea breath test. Blood testing is 76-85% sensitive, the urea breath test is >93% sensitive and specific, and the stool test is 93-98% sensitive and 88-96% specific.

I recommend the urea breath test or the stool test as a first-line test for H. pylori in people with Hashimoto’s thyroiditis. If someone is on proton pump inhibitors then the blood test is fine as long as they have never been treated before for H. pylori.

How is H. pylori treated?

Conventional treatment consists of what is called the “triple therapy” which includes a proton pump inhibitor to reduce stomach acid and the two antibiotics amoxicillin and clarithromycin. This is usually only given to those with ulcers however, since doctors aren’t usually looking for H. pylori for other reasons like Hashimoto’s disease.

This is a strange therapy because it reduces stomach acid that helps H. pylori and the antibiotics don’t always work creating “antibiotic resistant H. pylori.”

Alternative treatments work extremely well and don’t create resistant strains of H. pylori.

There are a number of effective natural compounds shown to eradicate H. pylori including:

Mastic gumN-acetyl cysteine(works on H. pylori biofilm)BerberineOil of oreganoProbioticsOmega-3 fatty acidsBuffered vitamin CSaccharomyces boulardiiSulforophaneDGL (deglycrrhizinated licorice)Aloe veraBismuth citrate

You should be retested after 4 weeks of treatment to be sure the infection is gone.

Hashimoto’s disease and Helicobacter pylori summary

If you have Hashimoto’s disease you should definitely get tested for H. pylori infection due to the strong connection. There are a number of studies on the connection including this one if you would like to read research on this topic.

If your tests come back positive, your functional medicine doctor can put together a strong treatment plan that will not create drug-resistant H. pylori or disrupt your entire gut flora which can happen with antibiotics. After you are treated for 4 weeks, get checked to see if the plan was successful.

You may see a drop in your thyroid antibodies and improvement in your symptoms when this infection is treated successfully.

I get great results with my patients who have Hashimoto’s disease and H. pylori infection so make sure you get tested soon.

Yersinia enterocolitica is one of the most common infections I see in my patients who have Hashimoto’s disease.  Let us explore some basic information about Yersinia so you can understand it better and how it relates to Hashimoto’s thyroiditis.

What is Yersinia enterocolitica?

Yersinia enterocolitica is a gram-negative bacteria that causes yersiniosis usually caused by drinking contaminated milk or water or eating raw or undercooked meat, usually pork (chitlins).  Human-to-human infection is possible if the carrier doesn’t thoroughly wash his or her hands before preparing food. You can also get yersiniosis from a blood transfusion.

Approximately 117,000 people every year in the US get yersiniosis and it mostly affects children in the winter.  Additional carriers of Yersinia enterocolitica include cats, dogs, birds, deer, rodents, rabbits, sheep, cattle and horses.

What are the symptoms of Yersinia enterocolitica infection?

This bacteria infects the intestines causing diarrhea (usually watery or bloody), vomiting, abdominal pain, and fever which lasts about 4-7 days but can last up to three weeks.  Many people think they just have some food poisoning which eventually goes away unless medical attention is required.

Yersinia can cause right-sided abdominal pain which may be confused for appendicitis.  A skin rash called erythema nodosum (red or purple lesions) is sometimes present 2-20 days after infection mainly on the legs and torso in women but it usually goes away within one month.

Joint pain can develop called reactive arthritis which can last for 1 to 6 months.  Yersiniosis can become life-threatening when it spreads into the liver, spleen and bloodstream due to a compromised immune system.

Yersinia enterocolitica loves iron so infection could be problematic in someone with low ferritin levels when we are trying to improve iron stores in a patient’s body.

What is the best test for Yersinia enterocolitica?

This infection can be detected in a stool analysis or blood test.  Stool testing is best for an acute infection but it can miss many infections when the infection is chronic.  It can take up to two weeks for the stool test to be positive after infection.

Blood testing checks for IgG, IgA and IgM antibodies.  A positive IgG test indicates a past infection.  If IgG and IgM are positive then we know the infection has been present for 1-3 months.  If IgG and IgA are positive but IgM is negative, then we know the infection has been ongoing for greater than three months in the intestinal barrier.  IgM is not entirely necessary if you aren’t concerned about knowing if it is recent or not, so IgG and IgA will usually suffice.  If IgG, IgA and IgM are all present then you know it is an active infection in the last 3 months.

Always check for Yersinia in stool and blood for the best chance of identifying the infection.

It is possible that the Yersinia enterocolitica blood test may cross-react with a virus or the bacteria Borrelia burgdorferi which causes Lyme disease.  If you use an effective treatment for Yersinia and then retest the blood and it is still showing active infection, this may mean that the positive test was actually for a virus or Lyme disease.

How is Yersinia enterocolitica treated?

Yersinia usually goes away on its own but if not, then it is treated with antibiotics.  If Yersinia comes back positive in a stool analysis, then the lab will run a sensitivity to identify herbal medicines that will eradicate the bacteria.  Berberine, black walnut, caprylic acid, oil of oregano, uva ursi, grapefruit seed extract and silver can all eradicate this bacteria.  The sensitivity will tell you which one of these will work best.

If we only have a positive in blood, then I’ll use a combination of these herbal medicines for about 4 weeks with excellent results.  It is important to get retested after treatment to be sure the infection is gone.

How is Yersinia enterocolitica connected to Hashimoto’s disease?

Certain infections can be associated with autoimmune disease by something called molecular mimicry. This basically means that your immune system targets the infection which also looks like a certain part of your own body tissue such as the thyroid gland.  As long as the infection is present, the immune system will attack the microbe and the thyroid for example.Yersinia is also connected to Graves’ disease which is another form of autoimmune thyroid disease.

There are a number of studies that support the connection between Yersinia enterocolitica and Hashimoto’s disease including this one.

I get great results with Hashimoto’s disease when we find this infection and eradicate it from the body. This reduces the antibody attack on the thyroid gland thus reducing inflammation in the gland so it can function better and stay healthy longer.

If you have Hashimoto’s disease, be sure to be tested for Yersinia enterocolitica because it could be the missing link for you getting better.

In this episode of The Dr. Hedberg Show I interview Stacey Robbins!  This was a very unique interview because we didn’t focus on biochemistry, but rather how Hashimoto’s can affect your life and your relationships.

Stacey Robbins (Certified Health Coach and Certified Yoga Instructor RYT200)

is an award-winning Author, Speaker, and Integrated Wellness Coach.

She is honored to work with senior executives in global organizations and is a trusted advisor to influential thought leaders, film producers, authors and creators who make a major impact in the world through their work.

Stacey took a diagnosis with an autoimmune condition, Hashimoto’s – where the body attacks the thyroid -- and turned it into an opportunity to look behind the scenes at where she was at war with herself.  Traveling around the country for years to study and attend conferences, Stacey learned more about the mind, body, spirit connection, which allowed her to dive into the thoughts, patterns, and beliefs that were undermining her health.

Her book, ‘You’re Not Crazy and You’re Not Alone: Losing the Victim, Finding Your Sense of Humor and Learning to Love Yourself through Hashimoto’s’(with a foreword by Dr. Izabella Wentz) is Stacey’s funny, honest, and soulful journey, to not only heal from the physical part of Hashimoto’s, but to address the inner work and healing that is available to every woman with Hashimoto’s.

Giving back to the community is a core value as Stacey serves on the Board of Directors for Hashimoto’s Awareness, an organization that educates and empowers the Hashimoto’s community in the areas of testing, self-care, and healing.  At Hashimoto’s Awareness, she works alongside esteemed experts in the field of Thyroid health:  Dr. Izabella Wentz, Mickey Trescott, and Dana Trentini (a.k.a. Hypothyroid Mom).

Stacey inspires women to live their happiest, healthiest life with Hashimoto’s and to use it as a teacher and guide to discovery as they learn to love themselves. As she says, “Hashimoto’s isn’t the end of your health, it’s the beginning of your healing.”

We discussed the following topics in detail during the interview:

-How Stacey got connected to Hashimoto's.

-The top three messages women should know from reading Stacey’s book.

-How relationships are affected with your spouse or partner, when you have an autoimmune condition.

-Helpful tips for both of you to have when dealing with Hashimoto’s.

-How Hashimoto’s affects being a parent.

-How Stacey’s life and lifestyle changed by having Hashimoto's.

I urge everyone to connect with Stacey at the following resources:

You can find her at ⇒  http://www.staceyrobbins.com

Her Facebook group the “Girlfriends’ Guide to Hashimoto’s” ⇒ https://www.facebook.com/groups/girlfriendsguidetohashimotos/

Stacey’s book on Amazon ⇒ You’re Not Crazy and You’re Not Alone

In this podcast episode I interview Dana Trentini, the founder of the well-known Hypothyroid Mom blog.  I really enjoyed our talk, in particular discussing thyroid issues with someone who is so passionate about thyroid health.

Dana Trentini created the thyroid advocacy blog Hypothyroid Mom. Dana launched her blog on October 1st, 2012, in memory of the unborn baby she lost due to hypothyroidism. She set out on a mission to learn all she could about hypothyroidism and to share her discoveries with people around the globe. Dana has since been featured in The Wall Street Journal and The Atlantic.

In our new podcast interview, we covered the following topics in order:

What motivated you to become a thyroid patient advocate and create your blog?

What are the signs and symptoms of hypothyroidism?

What is the prevalence of thyroid disease?

Why do you think there are so many undiagnosed thyroid sufferers in the world?

Which lab tests do you recommend for hypothyroidism?

The number one prescribed medication for hypothyroidism is Synthroid. Why are so many hypothyroid patients still struggling despite taking levothyroxine medications like Synthroid?

You write at Hypothyroid Mom that treating thyroid disease is really like putting together a big puzzle. What are the main pieces of the puzzle that should be considered?

What resources are available to help patients find open-minded thyroid doctors?

You wrote a book with Mary Shomon, Your Healthy Pregnancy with Thyroid Disease: A Guide to Fertility, Pregnancy, and Postpartum Wellness. Tell us about it.

Dana has a true passion for Hashimoto's and Hypothyroidism advocacy so I urge everyone to connect with her online to learn more.  Her blog is filled with many excellent articles and resources to help you wade through all the thyroid information that is available on the internet.

Connect with Dana online:

Visit the Hypothyroid Mom blog here ⇒  Hypothyroid Mom

Facebook Page ⇒ https://www.facebook.com/HypothyroidMom/

Twitter ⇒ https://twitter.com/HypothyroidMom

Pinterest ⇒ https://www.pinterest.com/hypothyroidmom/

Google+ ⇒ https://plus.google.com/+Hypothyroidmomblog

Instagram ⇒ https://www.instagram.com/hypothyroidmom/

Dana’s favorite thyroid books ⇒ http://hypothyroidmom.com/hypothyroid-moms-favorite-books/

Dana’s top thyroid resources ⇒ http://hypothyroidmom.com/hypothyroid-mom-top-resources/

The thyroid gland, like any gland in your body, requires a number of basic nutrients to function properly. Every day your thyroid gland produces a certain amount of thyroid hormone that requires specific building blocks. If any of those building blocks are missing, your thyroid may not make enough thyroid hormone and you may suffer from common symptoms of hypothyroidism such as:

=> Fatigue

=> Weight Gain

=> Depression

=> Constipation

=> Hair Loss

=> Cold hands and feet

=> Brain fog

=> Dry brittle nails and hair

Let's talk about each nutrient that your thyroid needs and how to find out if you are deficient. It may be that you would benefit from some simple supplements for hypothyroidism.

Zinc

Zinc is required for the production of T4 and the conversion to the active form of thyroid hormone known as T3 (triiodothyronine). T4 (thyroxine) is the inactive form of thyroid hormone and does not become active until it converted into T3. T3 enters your cells and fires up the energy-producing parts of your cell known as mitochondria.  Zinc is required for healthy T3 receptors in your cells so even if you have enough T3, it won't work optimally if you are deficient in Zinc.

A Zinc taste test is the easiest way to determine if you are Zinc deficient. Simply purchase a liquid Zinc solution such as Zinc Challenge from Designs for Health and follow these instructions:

Put about 2 tablespoons of the Zinc Challenge in your mouth and swish it around for 30 seconds noting any specific tastes. Spit out the solution and do not swallow because Zinc can cause nausea on an empty stomach.

=> If you don't taste anything then you are probably Zinc deficient.

=> If you notice a “dry”, “furry”, “sweet” or “mineral” taste then you are probably Zinc deficient.

=> If you notice a strong unpleasant taste that gets worse over time then you probably have just a mild Zinc deficiency.

=> If you immediately notice a strong unpleasant or “metallic” taste then you probably have sufficient Zinc levels.

If you are Zinc deficient I recommend taking 30-60mg of Zinc a day with food for 30 days and then retesting. It may take up to 60 days to replenish your Zinc levels. Make sure your Zinc supplement has a small amount of copper in it because taking Zinc will deplete your body of this important mineral.

Vitamin A

Vitamin A is the most common vitamin deficiency in the world. Vitamin A is important for thyroid hormone receptors and it activates the gene that regulates Thyroid Stimulating Hormone (TSH). You should be getting plenty of vitamin A if you are eating lots of fruits and vegetables. Be careful when supplementing with vitamin A because it can cause deficiencies in other fat-soluble vitamins such as D, K and E. Vitamin A can also cause liver toxicity and bone loss. Your vitamin A supplement should say “natural carotenoids” or “mixed carotenoids” so you know they are close to what Mother Nature intended. Taking a single synthetic carotenoid such as beta carotene can potentially cause health problems.

B-Vitamins

A deficiency in B-vitamins, more specifically B2, B3, B6, B12 and B9 (folate) can lead to hypothyroidism. Folate is also important as it ties in closely with TSH levels. B-vitamins are usually depleted due to high levels of stress. B6 deficiencies can lead to low serotonin levels and sleep problems. B12 deficiency is common in those with gluten-intolerance and Celiac disease. This is true for folate as well but make sure you are taking the “methylated” form of folate if you have the MTHFR defect. MTHFR is a blood test to see if you have a genetic problem with folate metabolism.

Asparagine

Asparagine is an amino acid that makes up thyroid stimulating hor...

What is the Best Thyroid Diet?

If you have a thyroid problem, the way you should eat is very similar to that of an individual who does not have a thyroid issue. Organic foods contain fewer amounts of chemicals and pesticides which, as you know from the thyroid-disrupting chemical chapter article, can have a negative effect on the thyroid gland. The main goals of a thyroid diet are those which remove any stress from the thyroid gland itself and any systems that may be affecting the thyroid gland.

The first major priority in eating to have a healthy thyroid is to make sure you do not have blood sugar swings. This requires consistent eating throughout the day of high-quality protein at every meal without eating too many carbohydrates.  Remember that blood sugar swings not only affect the thyroid gland itself but also indirectly affect adrenal gland function which, as previously discussed, is highly connected to thyroid physiology.

The ideal protein/carbohydrate intake for someone with thyroid gland dysfunction is to eat a moderate- to low-carbohydrate diet to keep blood sugar levels in check.

The next important step in optimizing thyroid function is to alkalize your body. Your body contains approximately sixty trillion cells which are involved in six trillion chemical reactions every second. Your cells work best to carry out these chemical processes in an alkaline environment versus an acidic environment. The machinery in your cells that produce energy and burn fat can most easily do their job when the pH is alkaline.

Eating foods that drive you into an acidic environment will put undue stress on your cells leading to sub-optimal energy production and function. The best way to find out if you are in an acid or alkaline state is to do a first morning pH test with Hydrion pH strip paper.  You should be aiming for a pH of 6.4-7.4. A pH below 6.4 indicates an acidic cellular environment that could be contributing to a decrease in your metabolism.  At the same time, you should not be too alkaline which would be a pH above 7.4. This would indicate a catabolic state meaning your body is breaking down its tissues rapidly due to some kind of metabolic or chemical stress. Start by taking your first morning urine pH for five days consecutively. Eliminate the highest and the lowest of the five readings and then average the middle three to attain your pH.

So how do you become more alkaline? The first thing you must do is eat a vegetable or fruit or both at every meal.  Produce contains alkaline-forming substances including calcium, magnesium, potassium and zinc.  These are “buffering” agents meaning they help to reduce acid by-products of metabolism.  The way foods are designated as acid or alkaline is based on the “ash” that is left over when they are burned:  the more buffering minerals in the ash, the more alkaline the food.  In addition, the protein content of a food will also determine its acid/alkaline status.  The presence of more amino acids (protein) in a food leads to more acidity in the body due to amino acid metabolism in the liver resulting in acidic by-products.

Adding sweet potatoes and yams as well as lentils will also enhance your alkalinity.  In addition, try to eat at least two cups of alkalinizing greens such as kale, mustard greens, turnip greens, or collard greens each day.  Lean towards the three most alkalinizing grains:  oats (gluten-free if you have Hashimoto's or Graves’), quinoa and wild rice.

There are many other strategies you can use to become more alkaline.  Taking an alkalizing bath of one cup Epsom salts and a half-cup of baking soda will aid in alkalizing your body.  The Epsom salts contain magnesium which is a buffering mineral that will assist in the elimination of acid residues that result from metabolism and detoxification.  The baking soda is also extremely alkaline and will aid in neutrali...

The thyroid is a small gland that lies in the neck about the level of the Adam’s apple and weighs approximately one ounce.  It produces thyroid hormone and calcitonin.  The parathyroid glands are very small and lie on the outside portion of the thyroid gland and secrete parathyroid hormone.  Thyroid hormone ignites your metabolism so you can burn fat and produce energy.  We will be focusing on thyroid hormone.

The thyroid gland is stimulated to make thyroid hormone by thyroid-stimulating hormone (TSH) which is produced in the pituitary gland located in the brain.  The pituitary is controlled by the hypothalamus in the brain which monitors the amount of circulating thyroid hormone.  Iodine must enter the thyroid gland through a transport system that is repaired with the intake of vitamin C.  There is usually about 20-30 mg of iodine in the body and 75 percent of it is stored in the thyroid.  In addition to iodine, iron, tyrosine, selenium, vitamin E, vitamin C, vitamin D, magnesium, zinc, copper, and vitamins B2, B3, and B6 are required for thyroid hormone production.

The thyroid gland produces two thyroid hormones: T4 (thyroxine) and T3 (triiodothyronine).  Eighty percent of thyroid hormone produced is T4 and twenty percent is T3.  T3 is ten times more biologically active than T4 and it is produced as a result of one iodine being cleaved from T4.  T4 is inactive so the majority of thyroid hormone produced is actually inactive.  The numbers “3” and “4” indicate the number of iodines.  This is key in understanding optimal thyroid function.  Both T4 and T3 are bound to proteins in the blood until they reach your cells and become unbound to work their magic on metabolism.

Most of the T4 is converted into T3 in the liver.  Approximately sixty percent of the T4 is converted into T3, twenty percent is converted into an inactive form of thyroid hormone known as reverse T3 (irreversible), and the remaining twenty percent is converted into T3S (T3 sulfate) and T3AC (triiodothyroacetic acid).

Reverse T3 can be problematic; even though it is inactive, it will still bind to T3 receptors and block T3 from binding and working its magic on metabolism.  Too much or too little cortisol that is produced by the adrenal glands will increase circulating levels of reverse T3.  This mechanism is due to suppressed liver detoxification and clearance of reverse T3 from excess cortisol production.  Stress can not only cause signs of hypothyroidism but it will also impair the liver’s ability to detoxify.  Cortisol will also suppress TSH production resulting in low thyroid function.  Immune system activation, high adrenaline, excess free radicals, aging, fasting, stress, prolonged illness, and diabetes will also drive the inactivation of T3 to reverse T3.

T3 and reverse T3 can also be inactivated by conversion into a hormone known as T2.  Elevated insulin levels due to a diet high in refined carbohydrates will also increase reverse T3 levels.  Toxic metals including mercury, cadmium and lead will also increase reverse T3 production.  T3S and T3AC are inactive until they are catalyzed by an enzyme in the GI tract known as sulfatase.  This enzyme is dependent on healthy gut bacteria.

Thyroid hormone’s main role is to control metabolism (energy production) inside the cell.  Our cells contain tiny factories called mitochondria that produce energy from fat, sugar and protein.  Thyroid hormone controls the function of the mitochondria which determines how much energy is produced.  Symptoms of low thyroid function are related to a decrease in energy production including:

Fatigue

Weight gain/inability to lose weight

Constipation

Dry/itchy skin

Dry brittle hair and nails

Depression

Headaches

Overly sensitive to cold

Cold/numb hands and feet

Muscle cramps

Depressed immune system–can’t recover from infections

Slow wound healing

Unrefreshing sleep

Digestive problems due to low stomach acid

Hair loss

Water retention

Lateral third of eyebrow thinning

Muscle and joint pain

Thyroid-Stimulating Hormone (TSH)

Traditional medicine relies mainly on the TSH or thyroid-stimulating hormone blood  test to measure thyroid function.  TSH is not a thyroid hormone.  TSH is produced by the pituitary based on how much thyroid hormone is circulating in the bloodstream.  As thyroid hormone levels drop, TSH production will increase to stimulate the thyroid to make more hormone.  If thyroid hormone increases, then TSH production will decrease because the thyroid is making plenty of hormone.

The TSH alone is not adequate to assess thyroid function because it doesn’t take into consideration the conversion of thyroid hormone into its active form which occurs in the liver, kidneys and lungs.  The TSH test also does not take into account thyroid hormone receptor resistance.  Thyroid hormone receptors can become resistant to thyroid hormone due to thyroid-disrupting chemical exposure and 1,25-hydroxy vitamin D leading to normal blood tests but development of low thyroid symptoms.

Cortisol produced during stress by the adrenal gland can also inhibit TSH production further throwing off the accuracy of the test.  If the TSH is elevated, the traditional physician will prescribe synthetic T4 and this will usually reduce TSH into the “normal” range.  This approach does not take into account peripheral thyroid hormone conversion or receptor binding.

If the body is compromised in its ability to activate thyroid hormone into T3, then taking T4 may result in a failure of treatment.  If the adrenal glands are out of balance, then most likely thyroid hormone function will also be out of balance.  In addition, if thyroid hormone receptors are desensitized, this approach may fail as well.

An excellent study was published by Obal and Krueger (2001) on sleep deprivation and thyroid hormone production.  The researchers concluded:  “When sleep deprivation is maintained for weeks, the plasma concentrations of T4 and particularly T3 decline but TSH remains normal.”  Perhaps this could be the reason for the abnormal TSH.

I have seen many patients who also suffer from insomnia and sleep problems and present with low thyroid symptoms and abnormal TSH levels.  I always take into account every patient’s sleep pattern and correct it as part of our treatment plan.  Many times, sleep patterns are abnormal due to blood sugar and adrenal gland imbalances.  Remember, you are not a lab test but a beautiful, complex being where everything is connected as one.

Testing & Diagnosis

Blood tests alone cannot always adequately diagnose thyroid hormone imbalance.  It is estimated that about forty percent of the U.S. population suffers from some kind of thyroid imbalance as opposed to the current traditional figure of ten percent.  This is due to the inadequacies of the TSH test.

In addition to blood testing, I review a thorough case history and a number of detailed health questionnaires and also perform a comprehensive physical examination for clues to thyroid hormone imbalance.  Basal body temperature testing is used by many practitioners to evaluate thyroid function but this does not solely indicate a thyroid imbalance.  There are many other factors that can cause a low basal body temperature such as adrenal fatigue, leaky gut, impaired liver detoxification and malnutrition.  I use the basal body temperature simply as one more diagnostic tool to evaluate the overall picture of a patient.  Another sign that may indicate low thyroid function is thinning of the lateral one-third of the eyebrow.

The following thyroid tests can provide more information about your thyroid.  Use this as a guide when you get the results of your blood tests:

TSH (Thyrotropin) – Thyroid-stimulating hormone is produced by the pituitary to stimulate the thyroid to make hormone.  The ideal range is debatable.  Traditional medicine uses a much broader range of about 0.5-4.5.  This range misses many hypothyroid patients such as those with a TSH between 1.0-4.5.

Total Thyroxine (T4) – This test measures the amount of T4 (thyroxine) that is both bound to protein and unbound.

Free Thyroxine Index – This is calculated by multiplying the TT4 by the T3 uptake.  The result gives you the amount of unbound T4 or Free T4.

Free Thyroxine (Free T4) – This measures the amount of unbound or free T4 which is the most active form.  Free T4 is not affected by medications or other factors that affect protein bound thyroxine (TT4).

T3 Uptake – A measurement of the amount of available binding sites for free T3 on thyroxine-binding proteins.  Elevated testosterone will reduce the number of binding sites and cause a low T4 and high T3 uptake.  Excess estrogen from hormone replacement or birth control pills will increase binding sites and can cause high T4 and low T3 uptake.

Free Triiodothyronine (Free T3) – This is a measure of free T3 levels or unbound T3.  This is the best test if your natural physician wants to see the amount of available active thyroid hormone in the bloodstream.

Reverse T3 (rT3) – This is a measurement of the amount of T3 that has been inactivated.

Thyroid Antibodies – Thyroid peroxidase, thyroid-stimulating immunoglobulin and antithyroglobulin elevations indicate autoimmune thyroid disease such as Hashimoto’s or Graves’ disease.  Thyroglobulin and calcitonin are mainly used in the diagnosis of more serious thyroid diseases such as cancer.

Prescription Medications

Prescription medications do not take into account underlying physiological imbalances and may lead to dependence on the medication.  The following drugs are prescribed by physicians to treat the thyroid:

Tirosint - Synthetic thyroxine (T4) in a liquid gel.  This is my new favorite T4 medication because studies show that it can be taken with breakfast and be fully absorbed....