The Dr. Hedberg Show

We all have favorites and my favorite mineral may very well be the mighty Zinc. Sometimes I go back and forth between magnesium and zinc but I always tend to lean towards “Heavy-Z”.

It is estimated that zinc is involved in 300 enzymatic reactions in the body most of which involve the immune system and repair of body tissues. In order to simply burn fat, carbohydrates and metabolize protein you need healthy zinc levels. Zinc is important for chemical detoxification, growth, development, immune function and sexual function. Healing cannot take place without adequate zinc. Having problems with brain function such as memory and learning? Well zinc is involved in every enzymatic reaction in the brain. Zinc is found in it’s highest concentrations in the ear and the eye so any problems with vision or hearing can be a zinc deficiency.

What causes zinc deficiencies?

Due to our high-stress lifestyles, poor diets, smoking, vegetarianism, alcohol, and food processing, zinc deficiency is rampant. In addition, we only consume on average as low as 47% of the recommended daily intake of zinc. Toxic metals such as cadmium from cigarettes and copper from copper-lined water pipes deplete zinc from the body. Stress is a killer and one of the reasons is because it wipes out your zinc levels pretty quickly.

Zinc and your skin

Zinc has been shown to be more effective than the antibiotic tetracycline for acne in teenagers. Zinc deficiency can be a contributing factor in other skin conditions as well including psoriasis, eczema, burns and wounds that heal slowly.

Every man should check his zinc levels

Zinc is a vital nutrient for sexual health. It works in virtually every aspect of male reproduction including sperm production, sperm motility and hormone metabolism. Men with low testosterone and low sperm counts are usually zinc deficient. Men who supplement with zinc can reduce the size of the prostate and symptoms of benign prostatic hyperplasia. Frequent urination and urge to urinate diminishes with zinc supplementation. Zinc has been shown to return testosterone levels back to normal if they are low. Zinc will not increase your testosterone levels above normal however.

Should you take zinc if you are pregnant?

Zinc deficiency in women can lead to premature births, low birth weight, delivery problems, growth retardation, spontaneous abortion and toxemia.

Zinc and your immune system

Zinc is directly involved in the production of white blood cells and it supports natural killer cells which fight infections such as viruses, bacteria and yeasts. Zinc is also required for producing the hormone thymulin which is produced by the thymus. The lower the thymulin levels the more susceptible you are to infections. Supplementing with zinc has been shown to reduce how long you stay sick from the common cold by about 3 days. In order to truly defeat chronic infections you must have healthy zinc levels. Too much zinc however can actually suppress your immune function so as usual with supplementation, it's all about balance.

Having trouble seeing at night?

Night blindness is a common sign of zinc deficiency. Zinc is important for the health of your vision, taste and smell. The elderly tend to have poor zinc status resulting in loss of taste and smell as well as falling in the dark because their vision is compromised.

What about zinc and copper balance?

Birth control pills, hormone replacement and drinking water from copper-lined pipes can lead to copper toxicity which results in zinc deficiency. Copper toxicity can lead to migraines, eye damage, macular degeneration, breast cancer, preeclampsia, lymphoma, anxiety, depression, leukemia and schizophrenia. Zinc supplementation will help to rid the body of excess copper. However, you don't want your copper levels to get too low so I always recommend taking a zinc supplement that has a small amount of copper, about 1mg of copper for every 30mg of zinc.

Zinc and eating disorders

Zinc is important in eating disorders such anorexia and bulimia. In one study, anorexic women taking zinc supplements gained double the amount of body weight compared to those in the study who didn’t supplement. Zinc also improved their desire to eat.

Zinc and your blood sugar

Zinc is very important for balancing blood sugar. Low zinc levels have been found in those with diabetes and coronary artery disease. Zinc helps the pancreas make insulin and it protects insulin receptors resulting in better blood sugar metabolism. Whenever I diagnose a patient with insulin resistance I always make sure to carefully evaluate their zinc status and supplement appropriately.

Can zinc help Alzheimer’s disease?

When Alzheimer’s patients were given zinc supplements they showed improvement in memory, communication, understanding and social contact. Zinc deficiency can result in the destruction of nerve cells leading to the formation of plaque tangles found in Alzheimer’s Disease.

Zinc and your thyroid

A zinc deficiency has been shown to result in hypothyroidism because it is required for the production of thyroid hormone. A zinc deficiency has been shown to lower free T4 and T3 levels about 30%. Thyroid hormone is also required for healthy zinc absorption and utilization so most patients with hypothyroidism will have a zinc deficiency resulting in a vicious cycle. Hair loss is a common symptom of hypothyroidism but it has been shown that correcting hypothyroidism without correcting zinc deficiency at the same time will not restore hair growth. Supplementing with zinc in addition to taking thyroid hormone is required to regrow hair.

Zinc is also extremely important for the T3 receptor to work properly. T3 is the most active form of thyroid hormone but if it can't bind properly to it's receptor due to a zinc deficiency then thyroid hormone replacement may fail and the patient's blood tests still look normal. Zinc is also required for the conversion of T4 into T3 so a zinc deficiency can result in low T3 levels.

Low zinc levels can result in subclinical hypothyroidism and high TSH levels which are corrected by zinc supplementation.

What about Hashimoto's thyroiditis?

Patients with Hashimoto's disease have been shown to have higher antibody levels if they are deficient in zinc and antibody levels may come down when zinc deficiency is corrected. Additionally, many patients with Hashimoto's have Epstein-Barr Virus reactivation and zinc is beneficial as an antiviral so it can target the autoimmunity in this way as well.

How do you know if you need zinc?

I can tell from a few markers on a patient's blood tests such as a low alkaline phosphatase if they are deficient. We also do a test called a zinc challenge test which is done with liquid containing zinc. You swish a small amount of liquid zinc in your mouth for about 30 seconds and if you experience a metallic taste then you probably don’t need to supplement with zinc. If you can’t taste anything or taste something strange like hydrogen peroxide, sweetness, fuzziness etc. then you are most likely deficient in zinc. We do this on all our patients because zinc is so important for so many aspects of health.

Another sign of zinc deficiency is white marks on your fingernails. Also, if you notice your appetite is low or if you are having difficulty tasting or smelling then you may be deficient.

If you find yourself deficient in zinc then I recommend taking 60mg a day of zinc with food for 30 days and then recheck your zinc levels through the taste test. Zinc can cause nausea in some people so be sure not to take it on an empty stomach.

What are the best zinc supplements?

As with all mineral supplements it should be in the chelated form with a ratio of about 30mg of zinc to 1mg of copper per capsule. Additionally, some added ginger and gentian root will help reduce the chance of nausea and betaine HCL will help to lower your stomach pH to enhance digestion and absorption of the zinc.  I recommend Zinc Select by Moss Nutrition.

What are the best dietary sources of zinc?

Oysters, shellfish, red meat, eggs and poultry are the best animal sources. Nuts, grains and legumes are good sources however they contain phytates which inhibit absorption of zinc so if you are a vegetarian you may be deficient. Dairy products also inhibit zinc absorption so supplements should be taken away from dairy.

In summary, if you have any of the following symptoms or diseases, you should definitely have your zinc levels checked and restored to normal if you are deficient:

Poor immune system function/difficulty fighting infections

Tinnitus

Night blindness

Loss of taste or smell

Diarrhea

White spots on your fingernails

Brittle nails

Hair loss

Hypothyroidism symptoms (fatigue, weight gain, depression etc.)

Hashimoto's thyroiditis

Graves' disease

Sleep problems

Insulin resistance

Delayed wound healing

Skin problems such as psoriasis, acne, eczema and rashes

Infertility

Prostate problems

Low sex drive

Problems with your menstrual cycle

Gut inflammation

Cataracts

Food allergies

Hearing impairment

Ulcers

Osteoporosis

Coronary artery disease

Diabetes

ADHD

Macular degeneration

What may seem like such a simple mineral could actually be the key to unlocking your healing potential.

I was recently interviewed by Diana Bowman on Thyroid Nation in a discussion about Hashimoto's disease and hypothyroidism

Diana : Hi everybody! Welcome to the third week, episode three, of Thyroid Nation Radio Talk Show Live and Podcast. I'm Diana Bowman, founder of thyroidnation.com.

Tiffany: And I'm Tiffany Mladinich [SP] of gratefulgarden.biz.

Diana: Also known as Diana and Tiffany, bringing you the voices of thyroid advocates, clinicians, bloggers and thyroid thrivers everywhere. In just a few minutes, we'll be talking live with Dr. Nikolas Hedberg [SP]. I know that, I for one, am really excited. We've had kind of a working relationship, Dr. Hedberg and I, over the last, I don't know, seven or eight months. I have lots of articles of his on my site, which are fabulous. Tiffany, I'm excited. Are you excited?

Tiffany: Yes, I am. I, for one, appreciate Dr. Hedberg's thorough and very easy to understand approach in his articles, and love the fact that he was drawn to functional medicine model because it leaves no stone upturned. Which so many of us need because there's so many different reasons, problems, and approaches, that no one should be treated as a lab test or in a cookie cutter kind of way. So really, really just so excited to talk to him. I love the fact that he offers his free Thyroid Ear course through his website, drhedberg.com. So it's amazing and I'm just so excited to talk to him. I truly enjoy reading his articles. They're very easy to understand and it doesn't surprise me at all that he's a regular speaker at integrative medicine conferences, and is also a consultant for other practitioners on very difficult cases. I'm excited to hear from him today.

Diana: Yeah, me too. I'm really excited.

Tiffany: I know you've got some exciting news, Diana, that you want to share with everyone first.

Diana: Yeah. Yeah, absolutely. If you guys tuned in last week, which I hope you did, you know we were talking to the fabulous Isabella Wentz [SP]. If you missed it, though, you can always go back to Blog Talk Radio or the Thyroid Nation Radio page, and scroll down and you can find it there and listen to it, because it was wonderful and she was fabulous. Also, she talked about an anti-inflammatory green smoothie on the show, and I went and I put it back in the notes on the Blog Talk Radio page. So if you feel like it and want to see that, you can log into Blog Talk Radio, find Thyroid Nation, follow us, and in the notes, you'll see the wonderful recipe that I put on there from Isabella.

Also, we celebrated our one year anniversary on the 22nd of February, which we never mentioned on the first show, which is why we chose that day, and we gave away great prizes. We had like $1,700 worth of prizes and we drew the names, 42 lucky winners. We're right in the process of collecting their email addresses and their mailing addresses and things. So they should be getting those and hopefully they'll take pictures and send them in. I think that'd be kind of cool to share, don't you?

Tiffany: I do.

Diana: Yeah?

Tiffany: Yeah, I do. I think that's very cool. We also want to thank our amazing Thyroid Nation Radio team of advisors, without whom this show would not be possible. They do so many amazing things behind the scenes that most people don't know, so very, very special thank you to Raina Kranz, Laura Scheunemann, Melissa Phipps, Blythe Clifford, Penny Jensen, Sarah Downing and Marissa Ravelo. You can read about all these amazing women and their thyroid survivor stories on the Thyroid Nation Radio website. Very cool, and thank you so much to all you ladies.

Diana: Amen. You really don't realize what goes on behind the scenes and even to put on a show like this, so we're really thankful to have them. Plus, they're there for support. As a thyroid patient, you, me, everybody out there listening, that's what all this is about, and the support they offer. They're so positive. They share and they're trying to spread the message.

Kind of like my husband mentioned, you know, posting the links and the pictures and things, it's how we find you guys. It's not like we're doing a TV commercial, so it's how we find you guys. They help post in all the different groups, Facebook and things. The support is just wonderful. So we couldn't do it without them. What's really cool is there's so many of them that if one's busy, or three or four of them are busy, and they can't help us one weekend, then the other ones can. So it's really grand and we thank them all for what they do behind the scenes. Surely, you'll hear from some of them coming up as co-hosts, so that would be cool. Okay. Let's get this Thyroid Nation thriving. Today, our guest, hopefully he's on the phone.

Tiffany: Yes, he is.

Diana: He's a board certified naturopathic physician. His name is Dr. Nikolas Hedberg. Among many of his credentials, he is a board certified nutritionist and chiropractic internist. He is the founder of the Immune Restoration Center in Asheville, Carolina - where some of my great friends live - where he helps people from all around the world suffering with a variety of chronic illness, including autoimmune and thyroid disorders. Welcome!

Tiffany: Hi, Dr. Hedberg. Thank you so much for joining us. Can you hear us all right?

Dr. Hedberg: Hi, Diana. Hi, Tiffany. Thanks for having me.

Tiffany: Hi, how are ya!

Diana: Welcome!

Dr. Hedberg: Great, great. It's a beautiful day in the mountains, mid 60s. It's been pretty cold here lately, so everybody's out and about today.

Diana: I bet they are. Because I have some friends - I think I mentioned to you in an email - that we met here in Costa Rica. We didn't know them before that and they wanted to move back to be closer to family. They chose Asheville for some of the schools that are there. They sent us a little video yesterday, or the day before, of them snowboarding in their backyard! So if it's 60 and sunny, a couple days ago they were snowboarding in their backyard, so I bet everybody is out and enjoying the day. Right?

Dr. Hedberg: Exactly. Yeah, it's really beautiful here in the spring, in the mountains. My wife and I, we're not really big fans of the winter.

Diana: Well, you're not snowboarding.

Dr. Hedberg: Yeah. No, not snowboarding. And you guys [inaudible 00:07:37].

Tiffany: What do you do for fun, Dr. Hedberg? We wanna know. We wanna know the real you. Tell us something.

Dr. Hedberg: I like camping, hiking around here. I'm actually a pretty big computer geek, so I teach myself computer programming. I taught myself how to build computers. So I do a lot of that stuff on the side, a lot of tinkering, a lot of programming and stuff like that. Obviously, I spend a lot of time reading health books, research, and stuff like that.

Diana: Yeah, your articles are really wonderful, and I really appreciate you sharing them and letting me share them with the world on Thyroid Nation.

Tiffany: They're so thorough! Totally!

Diana: Totally thorough articles.

Dr. Hedberg: Yeah, I mean there's so much information out there on the internet. It's kind of hard to wade through it all.

Tiffany: And so much of it is not true, or doesn't apply, or has special circumstances per person, right?

Dr. Hedberg: Right. The other thing that you'll find on the internet is these black-and-white type statements. You know, like, Synthroid is bad. It's bad for everybody, which is clearly not true. So you'll have a lot of [inaudible 00:09:02] out there.

Tiffany: I love this man already!

Diana: Yeah, really, we love you already. That's what Thyroid Nation is about. I know you know, Dr. Hedberg, but really, it is. It's about there's not just one answer. There isn't.

Tiffany: Not one answer.

Diana: No, because everybody's different. We're all made different, right? So you were interested in medicine from a young age. Tell us a little bit about how you got started and just a little bit about you, before we get into all these wonderful questions we have here.

Tiffany: And about your book coming up, so we wanna hear about that too.

Dr. Hedberg: I was about five or six when I really wanted to become a doctor. I was watching Little House On The Prairie. I don't know if you remember that show.

Tiffany: Of course, we do.

Diana: I do, yeah.

Dr. Hedberg: So you guys probably remember Dr. Baker, who was the small town physician who took care of everyone. I remember being five, watching that, and I just thought, "That's really what I want to do," and it just stuck from there. I even started reading health books when I was in elementary school, and did book reports on vitamin books and things like that when I was in middle school and high school. It's a real interest in health and helping people since I was a little kid. I got my undergraduate in exercise science. I was a bodybuilder for years when I was in college. So I studied a lot of nutrition, exercise, and then went down the road that I did, into functional medicine, naturopathic medicine.

Getting involved in thyroid is really just a result of seeing so many people who were on it, had thyroid problems. They were taking thyroid medication and it just wasn't working. I would do these health lectures around Asheville, and whenever I would give one on thyroid disorders, it was always packed. You know, standing room only. Whereas if I did one on, say, allergies or gluten or you name it, the crowds were always somewhat moderate. But thyroid, it was just a packed house because so many people with thyroid problems and they're just not getting the answers they need from conventional medicine.

Diana: It's crazy, isn't it? You know, it's funny that you mention bodybuilding because some of the best, most intricate articles that I've read on the thyroid have actually been on bodybuilding sites. It's where you're like, "that is so intensive....

I was recently interviewed by The Natural Nurse - Dr. Ellen Kamhi discussing Hashimoto's disease and hypothyroidism on the Progressive Radio Network.  This was one of my favorite interviews and I really enjoyed talking to Dr. Kamhi.

Here is a list of the topics we discussed during the interview:

What got you started in working with patients who have thyroid disorders?

Why do so many people suffer from a thyroid problem?

What are the most common causes of thyroid disorders?

What tests should patients ask for from their doctors to uncover the underlying causes of their thyroid problem?

There are many types of thyroid medication, what are the best choices available today?

Is iodine a safe and effective supplement for those with Hashimoto’s or hypothyroidism?

When is a gluten-free diet the best option for someone with a thyroid problem?

Can you tell us why vitamin D may not be the best option?

If you have an underlying infection that is driving your Hashimoto’s disease, what are the best treatment options?

What is the best diet for someone with a thyroid disorder?

Do people need to worry about goitrogens in foods?

Please tell us more about leaky gut syndrome and some strategies to heal the digestive system.

How does hormone replacement affect thyroid function?

How does stress and the adrenal glands affect thyroid function?

What are some of the most effective supplements for someone with Hashimoto’s disease?

Dr. Kamhi: And welcome. Thank you so much for joining us right here on the Natural Nurse and Dr. Z. We're so happy to be with you. And one of the things that's very exciting to me is to take a look at the podcast archives that we have here on Progressive Radio Network. And we have, just for the Natural Nurse and Dr. Z, well over 100,000 of you that are downloading and listening to the archives. We're really excited to be able to share this information with you.

Dr. Zampieron and I have been operating in terms of natural medicine, myself since 1964 and Dr. Zampieron is a little whippersnapper from around 1980. Not that he's little. We don't call him Eugene for nothing. Dr. Z is a big, big guy. And you can see photos of us by visiting our various websites. You can always go to naturalnurse.com and Dr. Z's website, drznaturally.com. And of course find us on Facebook at facebook/thenaturalnurse.

Today we're very happy to have as our guest Dr. Nikolas Hedberg. Dr. Hedberg is a board certified naturopathic physician, chiropractic physician, and is board certified in nutrition by the American Clinical Board of Nutrition. He is the founder of the Immune Restoration Center in beautiful Asheville, North Carolina, just an absolutely lovely place, I love it there, where he helps patients worldwide, not only in his local area, with thyroid disorders, immune disease, and chronic illness. His focus is a telemedicine practice, and he's able to help patients regardless of their location.

Dr. Hedberg is a regular speaker at integrated medical conferences, author, and practitioner of all types. And other practitioners also consult with him on their most difficult cases.

Dr. Hedberg has several books. One is The Thyroid Alternative and a brand-new book that is going to be coming out this year, called The Complete Thyroid Health and Diet Guide. So thank you so much for being our guest today, Dr. Hedberg.

Dr. Hedberg: Thank you for having me, Dr. Kamhi.

Dr. Kamhi: Now during our show may I call you Nick or Dr. Nick?

Dr. Hedberg: Yeah, Nick is fine.

Dr. Kamhi: That's great. So I'm going to go back in time a little bit. Let's take you back many years to yourself as a child. And when did you start to sort of get an inkling that you felt drawn to natural medicine?

Dr. Hedberg: Well, actually I was watching Little House on the Prairie when I was about five years old. And for those of you who have seen the show, there's sort of a town physician, Dr. Baker, on that show, and Dr. Baker took care of everybody in the town. He was the only doctor there. And when I was kid I thought this is something that I really want to do. I want to help people to the best of my ability who are sick and help them from when they're a child, and when they grow up, and as they get older. And just even when I was a kid I was reading books about vitamins, and minerals, and nutrition.

Dr. Kamhi: When you were a kid? Wait. Let's stop there. When you were a child you were actually reading books about those things? I was too, but it's not the normal thing that children do.

Dr. Hedberg: The first book report that I ever had to do when I was a little kid, I read a book called The Vitamin Book.

Dr. Kamhi: Was that by Earl Mindell?

Dr. Hedberg: You know, I don't even remember. I mean, it was so long ago.

Dr. Kamhi: Um-hum.

Dr. Hedberg: But yeah, so even as a young child I was interested in these things from the beginning. And then I started bodybuilding as a kid too, lifting weights, and reading books about nutrition and exercise, and also experimenting with some natural medicines, even when I was a kid.

Dr. Kamhi: Well, isn't that really a fantastic story? And the fact that we have to wonder where is that coming through? It's almost like a cosmic consciousness that's coming into you. And then there is a word called dharmic path, which is an Eastern philosophical concept, which talks about the fact that people do have their place in terms of what their life's work is. And to be able to actually manifest that as you have, and having that interest so early on, I imagine is very fulfilling.

Dr. Hedberg: Very fulfilling because you sort of know your direction from the time you're a child. And then you know exactly what path you need to take. And then it was just a matter of focusing on that path, buckling down, and working as hard as possible.

Dr. Kamhi: And that's where the work comes in. I was speaking to Dr. Michael Murray recently, who I'm sure you're familiar with. And I'm a real fan of his for many years. And Dr. Murray calls that, "Well, you have the vision and then you need the grit." I mean, no one says that you're going to get very far in life regardless of what your ambitions are without really putting the work in. Getting the number of degrees you have, being a naturopathic physician, and a chiropractic physician, and a nutritionist, that doesn't just happen. That happens through focus and work.

So then, well, let's continue on your path. So then you went and got all these educational, which I'm sure has never ended. I'm sure you continue to do education as well.

Dr. Hedberg: Yes, yes. Always continuing to read and stay up on the latest research. Reading books, reading peer-reviewed medical journals, attending conferences. You're right. The process just never ends.

Dr. Kamhi: Are you originally from Asheville or is that a place that you more recently relocated to?

Dr. Hedberg: I'm originally from Western New York, a place called Chautauqua, which is close to Lake Erie. And then I moved to Asheville to start my practice many years ago.

Dr. Kamhi: They almost have a similar vibe though, to me. That Upstate New York area is not like New York City. It's quite rural in its energy.

Dr. Hedberg: Yes, yes. Exactly.

Dr. Kamhi: So when you moved to Asheville then you started this practice, which really has an integrated focus right from the beginning.

Dr. Hedberg: Yes. Right from the beginning. Started some advanced training, as soon as I graduated, in functional medicine. Did a lot of things at first. Did nutrition and acupuncture, functional medicine, some chiropractic. I was doing a lot of things. And then over the years it's just become very, very focused on functional medicine and nutrition, and mainly focusing on that, thyroid disorders, autoimmune disease. A lot of people with chronic immune system imbalances that just really haven't found answers by not only conventional medicine but also alternative medicine as well.

Dr. Kamhi: That's true. And although the name of Dr. Zampieron and our organization is called Natural Alternative Health Education and Multimedia Services, we made up that name years ago and I guess I am less happy with the word alternative these days. The reason for that is I think the kind of interventions you are focusing on in your center and in your books, such as The Thyroid Alternative, really shouldn't actually be the alternative. It should be the first intervention considered because that is actually good medicine according to the latest research.

Dr. Hedberg: That's exactly right. And I've always been a big believer in combining the best of conventional medicine and so-called alternative medicine. And there are a lot of alternative practitioners and followers of alternative medicine who are very, very critical, very, very hard on conventional medicine and I'm really not that way at all. I think that they've made great strides in science. And a lot of what we draw from in so-called alternative medicine, especially these days, comes from the conventional medical literature. So I think the best really comes in combining the two and it's just a matter of educating both sides, and I think that creates the best outcomes for the patients.

Dr. Kamhi: Exactly. And that is patient-centered care. Rather than feeling like you have to follow one particular strain, if you do like you do, your homework and your research, there's no reason why these things can't be used together, and yourself as a practitioner will prioritize that. But unfortunately it seems in conventional medicine there is even more bias against natural therapies.

Dr. Hedberg: Yes. Definitely a lot of bias. And a lot of that just comes from a lack of education. Your average physician has gone through a significant amount of training. And then residency is obviously going to be heavily focused on the conventional model....

In this interview I discuss the connection between Epstein-Barr Virus and Autoimmune Disease

You can listen to the interview above or read the transcript below:

Dr. Brady:  Dr. Hedberg lectures all over the place, a lot of integrative medicine conferences. He's published in many journals. He teaches advanced functional medicine courses with Functional Medicine Town, professional co-op and as adjunct faculty with Hawthorn University. Dr. Hedberg has found that many chronic diseases are a result of stealth infections and that's what we're going to focus on tonight. Basically, he's also formed a website and a community known as "The Infection Connection" and I'll have him tell you a little bit more about that later in the call. You can learn more at infectionconnection.net.

Nick's a good friend of mine. I've known him for probably, I don't know, over 10 years I would say. He has the perfect radio DJ voice, as I always say, and you'll hear in a minute. When you hear that voice, I didn't know this at first, I learned this only in few years ago, but it did not surprise me when I found out that he's quite an accomplished opera singer. Nick, do you want to do a little tune for us to lead off or not?

Dr. Hedberg: No singing tonight Dave, LOL.

Dr. Brady: Okay. All right.

Dr. Hedberg: Yeah. Yeah.

Dr. Brady: All right. Well, thanks for being on, Nick, I appreciate it.

Dr. Hedberg: Yeah. It's great to be on again.

Dr. Brady: Great. Well, let's dive right into the topic. We're going to talk a lot about thyroid issues and stealth infections. We're going to look specifically tonight at the connections between Epstein-Barr virus and autoimmune diseases. I know that Epstein-Barr virus is certainly not the only virus out there implicated as an autoimmune potential trigger. Let's explore EBV first, so just give us an idea how you first started making the connection between EBV and autoimmune diseases, and just lay the groundwork for us, if you don't mind.

Dr. Hedberg: Right. So the first connection in the literature between EBV and autoimmune disease was actually in 1971. So a little over 40 years ago when they found that patients with Systemic lupus erythematosus had elevated antibody levels to EBV. It was actually about 10 years ago, David, you were talking about the connection between Yersinia and thyroiditis and that just kind of got me into looking at this molecular mimicry. So I just started noticing patterns on blood chemistry in patients with autoimmune diseases like low white blood cell counts, and then the class that has got elevated lymphocytes and low neutrophils which is the classic picture for a chronic viral activity. So I was seeing that a lot in the patients with autoimmune disease.

The other thing that shows up a lot in these patients were chronic low-grade fevers, getting fevers of unknown origin. A fever is basically an infection until proven otherwise. Then one of the other major red flag was, of course, cancer, but in these patients, cancer was not suspected. There was something going on there causing these chronic low-grade fevers. And then just started doing more and more Epstein-Barr virus panels on the autoimmune patients and seeing them coming back positive, reactivation of the Epstein-Barr virus. And then when I started focusing on that, the viral activity, that's when we started seeing excellent results in a lot of these patients.

Dr. Brady: I see. Did you happen to hear my interview earlier this year, in January sometime, with Derek Enlander, by any chance, from Columbia?

Dr. Hedberg: No. I didn't hear that.

Dr. Brady: Well, many of you on the call may have heard that. We talked about Myalgic Encephalomyelitis which is basically Fibromyalgia Chronic Fatigue Syndrome of viral origin. Of course, a lot of different viral agents are being studied and have been studied in relation to that, even though you wouldn't consider that necessarily an autoimmune disease classically. I think it's living in the same kind of sphere or camp and actually Enlander was first brought to the US by Stanford to study the relationship between Epstein-Barr virus and Cancer. So I thought it's kind of interesting. These calls kind of dovetail a little bit.

If you want to know more about his work, you can just look up Derek Enlander, you can go on our library and listen, download and listen to that Clinical Rounds call and some of the research he's doing at Columbia on Fibromyalgia Chronic Fatigue patients related to viral ideology and immune dysfunction from virus. But certainly this is in play in classic autoimmune conditions as well. So tell us just a little bit more about Epstein-Barr virus, some of the characteristics of the virus, the epidemiology of it out there, mechanisms, and can you share anything, anything meaty like that on EBV?

Dr. Hedberg: Right. So a lot of people forget that Epstein-Barr virus is a herpes virus. It's in that family. It's a gamma virus and it's very different from the other herpes virus in that it's the only one to infect B cells. It's these naive B cells that get infected. The other thing to know about it is that unlike, for example, say the flu virus where when the flu multiples and it expands, the cell is destroyed. There's almost instantaneous cellisis [SP] and viruses are spread into the system. The herpes viruses are very slow. What they do, it's called budding. The budding is just basically the virus is using the DNA to replicate itself, but the cell is actually not destroyed, and that's one of the main...

Dr. Brady: So that's why there's not such a virulent course or a [inaudible 00:13:57] obvious acute illness like there is with something like the flu, I would imagine.

Dr. Hedberg: Exactly. So it's slow like that and the host cell is spared by the virus. The other herpes viruses are of course, the cytomegalovirus virus and then we have herpes 1, 2, 6, 7 and 8. We're learning a lot more about herpes 6 and autoimmune disease, and then of course the varicella-zoster, chickenpox virus. About 95% of the world's population is infected with Epstein-Barr virus and most people get it before the age of three and they are asymptomatic.

Dr. Brady: What was the percentage you gave, Nick?

Dr. Hedberg: 95% percent.

Dr. Brady: Okay.

Dr. Hedberg: Yes. Most people will get it by the age of three, but there's no symptoms. And then, there's about 100% infection rate of those individuals, of course, by the time they reach adolescence. It's usually because they're stressed. The immune system is compromised or they get a higher viral load. Because EBV is the cause of the classic kissing disease, mononucleosis, and a lot of people will get that in adolescence, in high school and into college. So it is transmitted by saliva, and the first place that it infects is the B cells in the tonsils. That's where it germinates and that's where it really sets up shop.

Dr. Brady: If so many people, it's almost just universal that we're infected, what makes one person progress on to autoimmune disease or some other type of chronic illness and the majority of people not?

Dr. Hedberg: Right. That's what I'm talking about tonight, Dr. Pender's hypothesis of Epstein-Barr virus and autoimmunity. He has these eight-step hypothesis. Dr. Pender is out of the University of Queensland, School of Medicine in Australia. He breaks in down into eight steps. I just want to go through these briefly. Step one is a genetic CD8 T cell deficiency. So basically, these viral infected B cells are normally metabolized and controlled by cytotoxic CD8 T cells. If there's a genetic deficiency there, then it allows for an uncontrolled environment of the EBV infection. So you start with the genetic deficiency. The second part is of course the primary EBV infection.

Step three is a decreased cytotoxic CD8 T cells control of the infection. Step four is an increased EBV load and increased anti-EBV antibodies. Then step five is EBV infection in the target organ. So for example, these infected B cells with EBV actually would enter, for example, the thyroid gland and germinate in that area, and progress in maintaining a low-grade infection in the thyroid gland as an example. Other examples would be say the salivary glands and Sjogren's, the gut and Crohn's disease, examples like that. Step six is clonal expansion of the EBV-infected B cells in the target organ. Step seven, infiltration of autoreactive T cells into the target organ.

Finally, step eight, you get these ectopic lymphoid follicles in the target organ. So for example when you see a follicle on the thyroid, what they found is that that follicle was actually filled with EBV-infected B cells. So it's a really fascinating hypothesis that when you put it all together, it makes sense and it also would explain why if everyone has it, why doesn't everyone have autoimmune disease.

Dr. Brady: Can you pick up this genetic lack of those specific CD8 cells with lymphocyte subset testing or do you have to do genetic testing? Can you just look at the cell population in some way? Can you offer any wisdom there?

Dr. Hedberg: Yes. Let's just talk about the testing. And just on a side note, the Epstein-Barr virus panels that are offered through the major labs like LabCorp and Quest, et cetera, they're looking at the three main things which is the nuclear antigen, the viral capsid antigen and the early antigen. Unfortunately, in their standard panels, they leave out the IgM from the nuclear antigen and then early antigen. So when I started doing these testing, IgG and IgM for all three, and so I'm seeing a lot more activity when I do that. Yeah, you can do, basically, just a CD4/CD8 ratio and what you'll see, and this is one of the things he talks about it in his papers, there's one common theme among almost everyone who has autoimmune disease and that's a low CD8 count. So their CD4/CD8 ratio is elevated. CD4 is high,...

In this interview I discuss the connection between infections and autoimmune disease which I call the Infection Connection.

That being said, let's get on with it. Let me introduce our speaker for tonight. Dr. Nikolas Hedberg is a good friend of mine. I've known Nik for, I think somewhere around 10 years now, we both went to one of the same schools in our careers, not at the same time, but we, I guess, met at a, I think, an internal disorder conference in New Orleans, I think was the first time about 10 years ago. I've followed Nik's work and his career and he's done some outstanding work. Nik is a board certified Chiropractic Internist by the American Board of Chiropractic Internists, he received his bachelor training in Exercise Science from the University of Florida, received his Doctor of Chiropractic from the Texas Chiropractic College in Houston. He currently practices in Asheville, North Carolina and focuses on Lyme disease, thyroid disorders and autoimmune disease. He's the author of the book "The Complete Thyroid Health and Diet Guide", which is a comprehensive guide to diagnosing and treating thyroid disorders. He lectures at a lot of integrated medicine conferences, and he's published in a lot of journals. He teaches Functional Medicine concepts through many forms including Functional Medicine Town, Professional Co-op, and with Hawthorn University. His particular interests lately is the role of stealth infections in chronic disease and in that effort to get this message out, he's created a program called "The Infection Connection" and does some online training in these concepts, and he'll tell you more about that as the night goes on. Little known to everyone in the professional world but known to me, Nik is an accomplished opera singer actually, so you'll hear that when you hear him talk, you can hear that come through in his voice. Anyway, Nik thank you for being on. I know you've been on Clinical Rounds before and thanks for coming back and being a guest again.

Nikolas: Thanks for having me on David, it's good to be here.

David: Great. I mean this is a fascinating topic and a topic that's been really been, sort of, obsessing me for the last couple years. As you can see by the content or the topic of our Core III seminar. I've recently written pretty extensive articles on these concepts in Townsend Letter and Naturopathic Doctor News and Review and in other forms. I'm really interested and jazzed about tonight's call and interviewing you because I hope to learn more about this as well because it's literally emerging science day by day. I think it would be a full time job just to keep adequate surveillance of the literature on just what we're going to talk about tonight and stay current with it. Anyway, I know that I kind of started having to really school myself on this stuff out of sheer necessity by virtue of my patient population and how it's changed over the years. I guess we'll talk about that a little bit more but I wanted to really learn a little bit more how you got started in managing patients with chronic infections or stealth infections and how you found your way into really almost sub-specializing in this area of functional and integrated medicine.

Nikolas: Right, it was actually about eight or nine years ago that I was actually listening to you, David talk about the connection between [inaudible 00:08:55] and autoimmune thyroid disease, and ever since then this has really been an interest of mine. I knew it was something that I need to learn a lot about, started seeing more and more patients with Hashimoto's, and chronic fatigue and various autoimmune diseases. You start doing all the things you know in functional medicine, sealing the gut, vitamin D, you know etc. etc., and you can do all that but there's that group of patients, that population that they just don't respond to those things and I found with a lot of those patients when you dig a little bit deeper, a lot of times you'll find an underlying infection that's been overlooked.

You know, I saw my first Lyme patient back then and didn't really know how to treat it. Sent the patient out for treatment, you know, heavy doses of antibiotics, to an integrated medical doctor, and the patient came back about nine months later and she was just worse off than she was going in, she couldn't handle the treatments. Started seeing some more Lyme patients after that and realized that I had to learn to treat that as well, you know, from a functional medicine perspective, The way I think about it is a lot of times it's not that there are more infections out there, obviously there's more Lyme infections, but a lot of us have these infections in us and it's the consequences of our modern day lifestyles, high stress, poor diets, environmental toxins, things like that and our immune systems just can't keep up with it. Then the infections that we have either emerge, because they are opportunist infections, or we're not just able to fight them off. That's how I got started in treating these types of disorders.

David: That's interesting because, you know, it is food for thought. I often wonder, are these infections more prevalent, are we just better at finding them, are we more aware of them since people have started talking about them and connecting the dots with the associations between certain infections and certain chronic pathologies? Is it, like you just said, you know just another straw on the camel's back, and the back is so ladened with different stresses and pressures in modern patients that the infections that otherwise wouldn't really cause much of a problem in a stronger individual become clinically significant? I don't know what the right answers are but I can tell you one thing, I've been practicing now for 21 years and I think, personally, I think patients are getting sicker in many more complicated ways.

I've sat back and tried to analyze that too, it's just because compared to 20 years ago even 10 years ago, I get probably more complicated patients because almost virtually my entire patient base is referrals from other practitioners and a lot of it is from other integrated and functional practitioners and I tend to get sent, I think, the worst of the worst or the complicated ones, the ones that just don't respond and don't get better. Maybe my patient cohort is skewed but overall I just think patients are more complicated in their illnesses and whole systems biology are wed, if you will, or swirling around their presentation is more complex.

I wonder, you know I practice in Connecticut too so it's even more complicated because the whole Lyme and co-infection thing is so prevalent here and it's so hard to really treat this stuff and it's hard to test adequately for it, it's hard to treat it adequately, it's hard to know you have it. How much is that in play that we're just not aware of? You mentioned fixing the gut and vitamin D and all the normal functional medicine kind of approaches that used to work almost miraculously with the majority of chronically ill patients, I find that it works with a smaller and smaller percentage of my patients, we've got to go digging into other very complicated stuff. Do you see that same phenomena, do you have any feelings on that?

Nikolas: Definitely see the same phenomenon. Doing all the functional medicine things that we should be doing, patients aren't getting better, and they're coming in with just all kinds of, they're almost things that you can't even label. So-called mystery illnesses, chronic fatigue, fibromyalgia, all the different autoimmune diseases, and then in some cases there's nothing really showing up, even on a comprehensive blood chemistry. I mean there is nothing there but they're still sick. When we scratch a little bit deeper, you know, a lot of times you do find infections and a lot of these infections will mimic those conditions that I was just talking about. Where conventional medicine says, well, you know, we don't really know the cause of chronic fatigue syndrome or autoimmune disease, it's just a consequence of the relationship between genetics and our environment. There's also not a lot of profits to be made in long term antibiotic use and that could be another reason why it's not as looked at as heavily as it should be. Speaking in regards to the connection between infections and somebody's chronic illnesses.

David: It's also amazing in the history when you do an intake on a patient fact, honest injun, it happened twice today. I had three new patients today in my patient load, two of them had the onset of these kind of chronic things as they tell the story. The onset was immediately after they had a significant, like, kind of viral infection that came out of nowhere like an upper respiratory type of infection that just didn't want to go away and since then they'd never quite been right. That whole connection between a viral insult then it became a chronic smoldering thing. It's been something that's been known in chronic fatigue circles for a long time with CFIDS or Chronic Fatigue and Immune Deficiency Syndrome and people who looked at lymphocyte sub-sets forever, but I think maybe that phenomena is much more broad based than just in that one. How do you go about identifying infections, particularly stealth infections, clinically or in a laboratory?

Nikolas: Of course you start with a comprehensive history, like you just said, I'm finding that as well someone will have a really bad cold or flu or GI infection, tick bite you know etc., etc., and they just never were able to recover. That's a good indicator in the patient's history and of course where they live, history of tick bites, and some of these patients will come in and will have just a fever of unknown origin and there's really no signs of cancer so just a basic fever that's an infection, until proven otherwise, and a lot of them will say,...

In this interview I discuss Hashimoto's Thyroiditis and Graves' Disease with Linda Lizotte.

Linda: This Linda Lizotte, I'm the co-founder of Designs for Health, nutritionist and I'm happy to interview Dr. Nikolas Hedberg tonight. Let me tell you a little bit more about his background. Dr. Nikolas Hedberg, he's a D.C., D.A.B.C.I. He's a board certified chiropractic internist by the American Board of Chiropractic Internist. His practice is in Asheville, North Carolina where he focuses on autoimmune thyroiditis.

 

Dr. Hedberg is the author of the book 'The Complete Thyroid Health and Diet Guide' which is a comprehensive guide to diagnosing and treating thyroid disorders that's sitting right here next to me, it's fantastic. Dr. Hedberg lectures at integrative medicine conferences. Has been published in medical journals and teaches advanced functional medicine courses through Functional Medicine Town and as an adjunct faculty member at Hawthorn University. Health care practitioners of all disciplines consult with Dr. Hedberg on the most difficult cases, his practice philosophy can be summed by this quote by Sir William Osler, "It is much more important to know what sort of a patient has a disease than what sort of a disease that patient have." Wow, very good. Okay. Let's work to getting started. So thank you Dr. Hedberg.

Dr. Hedberg: Thanks for having me again Linda. I really appreciate it.

Linda: Again the book 'The Thyroid Alternative: Renew your Thyroid naturally' he's got some nice write ups in here by some doctors that we know. We have Dr. David Brady foreword. He's got a really nice write up by Dr. Daniel Taylor, chiropractor, he's been in clinical rounds. Dr. Ernest Colin and... who's a clinical director of Holistic Medical Clinic of Carolina. And Dr. Geoffrey Moss from Massachusetts that a lot of you know so well. So fantastic book.

It's definitely... we're going to go through a lot of it, what's in there tonight. Obviously, we'll... the book is more patient friendly and I know that was difficult for Dr. Hedberg to do as it is for any of your practitioners to try to bring this to patients. That's where this book might be really useful to you because you're trying to explain the same stuff. So get the book and if it's something that you're trying to explain to your patients on a regular basis you can just hand it to them. You don't have to explain it all saying it a 100 times.

Dr. Hedberg: Thank you.

Linda: So, all right. So I know that that's why probably why you wrote the book Dr. Hedberg no?

Dr. Hedberg: Yeah. There's some good thyroid books out there but I wanted to give a broad overall picture of functional medicine and all the on causes of thyroid disease because a lot of people seem... the feedback have gotten already is, they [inaudible 00:03:03], 'Wow, I never even knew that the adrenal is going to affect the thyroid and the Lyme disease can cause thyroid problems. So it's... I think to me a good job educating people about thyroid disorders.

Linda: Yes. We're going to learn some new things and learn some things like you just mentioned that I wasn't really up on before so... I would love for you to start with some of the statics that you state in the book and just some great information about autoimmune thyroid disease. That probably would make a good start to all of this.

Dr. Hedberg: Right. Now is the best time to be a functional medicine practitioner because autoimmune disease is on the rise. We're really the only ones who can identify why it's there and really get these patients under control and improve their quality of life. Autoimmune thyroid disease, it's the number one autoimmune disease in the United States. Actually about 10% of the US population has autoimmune thyroid disease. So if a huge number of people, almost one of every 10 people you brought into is going to have it. Twenty-seven million Americans, mostly women, about 50% of them will go undiagnosed. And 90% of the hypothyroidism you're going to see in practice is actually due to Hashimoto's.

So when we see someone and you think that they have a thyroid problem there's a good chance there's going to be autoimmunity involved. Conventional treatment it's the same whether you have autoimmune thyroid disease or not. We have the hypothyroidism it's not autoimmune. You get medication Synthroid. If you have Hashimoto's it's the exact same treatment. That's why a lot of conventional physicians they don't run thyroid antibodies because it's not going to change how they treat it. We know that when someone does have Hashimoto's, it's not necessarily an issue with the thyroid gland, it's really an issue with the immune system.

Linda: Good point. So I do want you to go into that a little bit more, but before you do, you might want to just talk about the diagnosis and how that might... maybe differs from diagnosis of just plain old type of hypothyroidism or any other thyroid condition.

Dr. Hedberg: Right. So usually you'll pick up on some of the symptoms but usually that's TH8 thyroid stimulating hormone's going to be elevated. Looking at total T4, total T3, 3T4, 3T3, many times those are going to be decreased. But the two antibodies you want to run to really make the diagnosis are thyroid peroxidase antibodies and antithyroglobulin antibodies. You've got to run both. I see a lot of blood work done from other practitioners and they just do thyroid peroxidase. But you're going to have antithyroglobulin antibodies positive.

Thyroid peroxidase antibodies could be negative so you really have to run both. If any of those are elevated then you know how to... know to diagnose [inaudible 00:06:19] which is kind of the opposite. You can run what's called a TSI, thyroid stimulating immunoglobulin and then also TS8 receptor antibodies. If any of those are positive then you also have the diagnosis of graves.

You can also see a mixed Hashimoto's and graves. You will have thyroid... say thyroid peroxidase as positive and they'll have the TS8 high positive. So they'll actually have both.

Hashimoto's can actually start of as like a grave's presentation because there's a lot of information. The thyroid gland is producing a lot of extra hormone so they actually have... they actually has symptoms of too much thyroid hormone. But it's actually the beginning stages of Hashimoto's and then they eventually fall into the hypothyroid category overtime as the thyroid gland gets destroyed from the immune system.

Linda: That's very interesting. I did not know that the thyroid peroxidase can be negative and say really all... absolutely [inaudible 00:07:25] antithyroid antibodies, that's fascinating.

Dr. Hedberg: Exactly.

Linda: And then I have seen patients where they seem to be over producing but then they go into like a complete hypothyroid. Of course they like to use that as a treatment to kind of bring thyroid out to and then treat them with the thyroid hormone, but I've never heard before that that's the beginning of the Hashimoto's. That's very interesting.

Dr. Hedberg: Yeah. We can certainly present that way.

Linda: All right. So you got this thyroid gland and you've got... you were mentioning this is a really an immune system disorder and you also mentioned that autoimmune is on the rise and we're all seeing that. So we absolutely cannot disagree with that. So the thyroid glands, right in the throat, right in the center [bone 00:08:17] between the head and the rest of the body, why is this gland so prone to autoimmune disease?

Dr. Hedberg: There's actually a paper I once quoted, it was just published this year in 2011, out of a journal hormonal research. And actually the title was a paper is "Why is the thyroid so prone to autoimmune disease?"

Linda: Really?

Dr. Hedberg: So it's out there and everyone even in conventional medicine and research they're trying to figure out why is it so prevalent now, why is it growing? Basically the authors say that these are basically preventable environmental factors like high iodine intake, selenium deficiency, pollutants such as tobacco smoke and industrial smug, as well as infectious diseases and certain drugs. They've all been implicated in the development of autoimmune thyroiditis.

So you really have to have three things for autoimmune disease. Number one is a genetic predisposition. There's not a lot we can do about that at least not yet. The second thing is usually gut permeability, leaky gut. And with our modern day high stress lifestyles, electromagnetic creation, computers, cell phones. We're all under more stress. We're working longer hours, there's more pollution. As you know and our food is hollow. You can pick up an orange off the shelf and it might not even have a single milligram of vitamin C in it. Medications, infections, toxic metals.

So they're recognizing this in conventional literature that it is the environment and our modern day lifestyles that are triggering this. Now thyroid is just is just... it's very sensitive to toxins and it's the largest endocrine gland in the body because of very, very high blood supply right directly from the heart. Over time there's enough environmental insults and the autoimmunity can be triggered.

Linda: Fascinating. So you remind me of the... Dr. Loyd did a lecture at out Glacierfest this summer, in August and he talked about the perfect storm. He was referring to autism. I think a lot of us came out of that lecture saying, "Wow, the perfect storm is... correlate to fibromyalgia, can relate to Hashimoto's, can relate to so many other... probably most of the disorders that functional medicine practitioners like yourself deal with. It's never just one cause not typically. I think that's far as of our medical doctors as to why they can't just put everything under a tiny little simple blanket.

Dr. Hedberg: Exactly. The thyroid...