The Dr. Hedberg Show

In this episode of The Dr. Hedberg Show, I interview Niki Gratrix in a discussion about adverse childhood experiences, overcoming trauma, PTSD, EMDR, somatic experiencing, relational trauma, anxiety, depression, emotional freedom technique, ADHD, chronic fatigue, and psychedelics.  Niki speaks with great passion about her work which is why I wanted to interview her.

Dr. Hedberg: Well, welcome everyone to the Dr. Hedberg show, this is Dr. Hedberg. I'm very excited today to have Niki Gratrix on the show. I heard her on the 15-Minute Matrix with Andrea Nakayama and just really enjoyed that interview. So, I wanted to have her around today. So, Niki, she's actually an award-winning nutritional therapist, bioenergetic practitioner, and transformational coach. She helps people to optimize energy. And in 2005, she co-founded one of the largest mind-body clinics in integrative medicine in the UK. The results with patients at the clinic were published as a preliminary study in 2012 in the British Medical Journal open. In August 2015, she hosted the largest ever online health summit on overcoming fatigue, interviewing 29 world leading experts on optimizing energy with over 30,000 attendees. So, Niki, welcome to the show.

Niki: Thank you so much for having me. It's awesome to be here.

Dr. Hedberg: Great. So a lot of my listeners are familiar with the material I've been putting out on average childhood experiences, but why don't we just lay some bedrock for that? Can you give us just an overview of what adverse childhood experiences are?

Niki: Yes. So, it's very interesting. It's based on a lot of data that's been done actually. It's been a lot of mainstream research that should get more attention in my view. So there were some big studies done by the CDC and Kaiser Permanente, looking at what they were calling adverse childhood events, and they called them ACEs. And they were looking at if you had a high level of ACEs, the sort of correlation with illness in adulthood. The sort of things they were looking at were sort of parents separating, divorce, that would count as an ACE, things like physical, sexual, or emotional abuse, physical or emotional neglect, domestic violence, mental illness in the family, substance abuse, or things like incarceration of a family member. So those were the particular categories that were chosen by the researchers that were working on this. It's about the mid 1990s, they started that work. And it's important work because it really... I'm sure you've covered some of the data, it never does any harm just to mention, you know, if you had a high level of ACEs, you have an increased risk of 7 out of the top 10 causes of death, 67% of all the people in these studies. And it was a huge study, they were like...it was almost seventeen and a half thousand people in the study. Sixty seven percent had said, "Look, we had exposure to some degree of this." And that was probably an underestimate, which we can talk more about why that is. I got into this topic because things like chronic fatigue, you have a six-fold increased risk of chronic fatigue in adulthood if you had ACE's in childhood. So I called fatigue and the kind of fibromyalgia and those kinds of related illnesses, I like the poster children for adversity and childhood. You know, and if you have six ACEs, you have a 20-year reduction in lifespan. So you that gives people a bit of an idea about why we're talking about it and the types of things we're talking about.

Dr. Hedberg: Yeah, it's a big issue. And in my 15 years of functional medicine practice, I do admit that it's something that I overlooked, you know, early on for many years, just no one was really familiar with it or talking about it. So one thing I wanted to ask, you had mentioned... So one of the questions on the ACE questionnaire I'm having difficulty getting a good answer on this, so maybe, you know, but, how come an ACE is if your parents get a divorce, but death of a parent is not considered an ACE or is it? Can you elaborate on that?

Niki: Yeah, so this is an area where the researchers, you know, they didn't come out with an exhaustive list, they weren't expecting the results that they got. And they really just chose 10 categories a bit arbitrarily to kind of, you know, start...they had data already on those areas. And so they just picked 10 areas, and they held their hands up afterwards and said, "Listen, we missed a lot of different ACEs." And this is why I said there was also an underestimate in that 67%. So they missed out by being a victim of bullying, for example, and definitely death of a parent would count for sure. So, yeah, there were lots of things. And, you know, they didn't mention this is the whole topic we could touch on, but an intergenerationally inherited trauma. So when they were asking people, you know, "Did you have any ACEs?" You might say no in your childhood, not realizing you've actually inherited the psychological and physiological expression of trauma because your parent or grandparent actually experienced the trauma. And we know that because of the survivors of the Holocaust victims, and there's been a lot of research done in around the world, whether it's been famine or genocide, and so on. The third generation survivors of their grandparents who were in the trauma have the same physiological and psychological expression. So that's another area that people can underestimate as well. Yeah, so it's a big area.

Dr. Hedberg: Yeah, so I just count that...I've been counting that as an ACE if they had a death of a parent because to me, I mean, at least from my understanding that when your parents divorce, that's obviously very traumatic, but I would think death would supersede that. So what about the...? So let's say someone knows they have at least any score of one or higher, how do these ACEs actually affect health?

Niki: Yes, what are the mechanisms? So again, they did research looking at the impact of early life stress on the biology and they started with actually looking at rats, and things like this, and they literally found that there's a neuroendocrine-immune system reset. There's a shift that happens in the epigenetic expression of your sensitivity to stressful events that happen, really from the date that the trauma started. And remember, we need to talk more about this, but we are not talking about necessarily, at all, a one-off event. That can definitely be... A one-off event can definitely cause that neuroendocrine-immune system reset. It's also more of the chronic, just lack of emotional connection will create biological changes in the baby. So we have these things called mirror neurons, where a baby will actually learn to feel empathy because mom can feel empathy. So the baby actually develops these mirror neurons, so she or he is reflecting what's being expressed to the baby from the mother. Mirror neuron is another fascinating area of how, again, social relations, OP, other people, how they affect us. And the brain does not develop in isolation, it develops in response to our social interactions, our social environment. And the interesting thing about trauma is, most trauma is relational. It comes from other people. The very rare form of trauma is what we always kind of assume when we say the word trauma, people think of maybe a car accident or a natural disaster, or maybe hospitalization as a young child for some kind of procedure. Now, definitely those things are all traumatic, they're just relatively rare. Most trauma comes from a child's attachment relations, usually, that's the parents, or its key caregivers, or authority figures, and so on.

So in response to what's happening in this social interaction, it's not only this biochemical change, usually, it essentially is upregulating the stress response system. Most people know that stress is bad for you, that stress kills, but really the ACEs study shows that, you know, the developing brain is particularly vulnerable. The developing brain is below age 18. So the brain is still highly imprintable. The neurons are literally there to respond to external stimuli. So as an event that could happen as an adult will just become a state, it might lead to PTSD, Post Traumatic Stress Disorder, which is a stress response to that specific event, or anything that triggers, or reminds you of that event. The issue with a developing brain is that the states, really that should stay as states become traits, they become part of the personality type. So we've got this multifactorial impact. We've got this neuroendocrine-immune system reset where our system is in a state of stress, it's reset from the date the trauma starts to happen. Our biology and neurology changes as well. And also, very importantly, we won't forget this, the identity of the child changes. So this is where we call, like, sort of survival adaption mechanisms kick in. So when a child, for example, doesn't get emotional bonding from the parents... And by the way, the statistics on that are incredible. I think it's only 55% of babies securely attached with mother. So this was done in a strange situation study, the 6,000 mother-baby interactions were observed, and only about 55% will securely attach, the other sort of 45% are split between insecure attachment, which is, where there's a lot of anxiety from the baby, and they find it very hard to calm themselves, so they lose the ability to self-soothe.

And the other group is they actually shut down from the emotional connection, like mom leaves the room, the baby doesn't really care, mom comes back in the room, baby doesn't respond, and that's more reflective of being rejected by the mother, which is very sad. So these kinds of attachment issues, it causes, not only social interaction problems, but it causes a sense of isolation and alienation in the child, they're not building up a sense of ability to self-soothe in safety, the expression of the glucocorticoid receptors reflec

In this post, I'll cover everything you need to know about ferritin and hypothyroidism. The ferritin test is a simple blood test, and it is one of the most important tests you should have if you have Hashimoto’s disease, Graves’ disease, and hypothyroidism. Ferritin is a storage form of iron, and the ferritin level test can tell you if your iron stores are low and need to be increased. The ferritin test is rarely ordered by conventional doctors, so many patients are left with the signs and symptoms of hypothyroidism when it is actually their low ferritin levels that are causing their health problems. The first issue with iron is that iron deficiency may be quite severe, but blood markers such as hemoglobin and the red blood cell count may be normal. This leaves many patients, especially women, misdiagnosed as not having anemia.

What are the symptoms of low ferritin?

Weakness

Fatigue

Difficulty concentrating

Poor work productivity

Cold hands and feet

Poor short-term memory

Difficulty remembering names

Dizziness

Pounding in the ears

Shortness of breath

Brittle nails

Headaches

Restless legs

The above symptoms overlap with Hashimoto’s disease and hypothyroidism, so it can be difficult to ascertain what is causing the symptoms.

What causes iron deficiency and low ferritin?

A lifelong history of blood loss due to heavy menstrual bleeding, blood donations, pregnancies, surgeries, accidents, atrophic gastritis, antacid medications, and celiac disease. If you have gut problems that are causing malabsorption of nutrients, then your ferritin levels may be low. Additionally, if someone is a high-level athlete or vegan/vegetarian, they are also at risk for low iron. These lead to excessive loss of iron or poor absorption of iron, leading to low ferritin levels.

What are optimal ferritin levels for thyroid health?

Once ferritin gets below 30, this is considered iron deficiency, despite the fact that the lower end of the laboratory cut-off range is usually 10-20. However, even the ferritin level can be normal, around 50-100, and the patient may still actually be iron deficient. This makes the diagnosis somewhat tricky in certain cases.

According to Dr. Esa Soppi of the Eira Hospital in Helsinki, Finland, optimal ferritin levels for hypothyroidism are >100 and iron therapy should be continued until symptoms have resolved. He also recommends that the ferritin level should be checked regularly to be sure the levels stay normal.

He also states that if someone has restless leg syndrome and their ferritin is <75, then they should be considered iron deficient.

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

According to Dr. Soppi, 10-20% of menstruating females are iron deficient. If we think about the reasons why this could be prominent in those with Hashimoto’s disease and hypothyroidism, we can see what a big problem this may be.

Hashimoto’s disease is very common in those who have celiac disease, and celiac disease often leads to iron deficiency due to malabsorption in the intestine from the damage that gluten has inflicted on the intestinal barrier. Not only that, but hypothyroidism can lead to low stomach acid, which would also impair absorption of iron. Thyroid hormone is also very important for the utilization of iron, so you can see what a vicious cycle this could be for someone with Hashimoto’s disease and hypothyroidism.

“Hypothyroidism based on symptoms is indistinguishable from iron deficiency,” stated Soppi.

Dr. Soppi has a special interest in thyroid disease and hematology, and he points out that many patients come in with the following symptoms:

Fatigue

Brain fog

Muscle and joint pain

Weight gain

Headache

Difficulty breathing

Heart palpitations and arrhythmias

Sleep problems

Lump in the throat

Difficulty swallowing

Restless legs

Often times these women are diagnosed with subclinical hypothyroidism, chronic fatigue syndrome, fibromyalgia, chronic Lyme disease, overtraining, and burnout despite their blood tests being normal. If the ferritin level is <50 with no obvious reason for iron deficiency, then we need to think about liver and kidney diseases, blood in the stool, IgA deficiency, calcium disorders, and vitamin D and B12 deficiencies.

Why is iron so important for the thyroid?

Iron is required for the production of the thyroid hormones T4 and T3 in the thyroid gland, the conversion of T4 into the more active T3, and iron is required for the utilization of T3 inside the cell. So you can see how devastating low iron stores can be on the thyroid gland as it affects the production, conversion, and utilization of thyroid hormone.

Even if the TSH, Free T4, and Free T3 all look normal, low iron stores will impair utilization of thyroid hormone in the cell at the receptor level, thus creating a picture that all your numbers are normal, but you still don’t feel well. Additionally, low ferritin levels can increase the production of reverse T3 which is an inactive form of T3 that binds to T3 receptors, thus blocking T3 from binding.

Low ferritin levels can increase TSH levels which gives the picture of hypothyroidism, but it is really just low ferritin levels.

Low ferritin levels have also been linked to the formation of goiter in children, according to this study. This is because iron deficiency has been shown to decrease the effectiveness of iodine supplementation, and we know that iodine deficiency can lead to goiter. This means that in order to prevent goiter properly, iron and ferritin levels should also be checked to be sure those levels are adequate for effective iodine supplementation.

Thyroid hormone replacement can increase ferritin levels quite quickly, as indicated in this study. The question of whether or not to supplement with iron alone is a question for you and your doctor. However, if you are not responding to iron supplementation, then you may need prescription thyroid hormone.

Thyroid hormone is required for the proper utilization of iron in the liver, so your liver health must be checked as well. Too little thyroid hormone can lower ferritin levels, and too much thyroid hormone, such as in Graves’ disease, will increase ferritin levels sometimes above normal. This study also found that hypothyroidism can lead to low ferritin levels.

If your ferritin levels are actually elevated, then it could be something serious like cancer. Other reasons for elevated ferritin include inflammation, infection, and exposure to large mounts of iron such as from well water, iron cookware, or supplements.

I get great results with patients when we balance their iron and ferritin levels, which oftentimes leads to rapid improvement in symptoms. Some patients even will require much less thyroid hormone or none at all once their iron and ferritin levels are in the optimal range.

To learn more about the ferritin level test itself and how to improve your ferritin levels, read my detailed article here on the ferritin level test.

This is one test you don’t want to miss if you have Hashimoto’s disease and hypothyroidism.

In this episode of The Dr. Hedberg Show, I interview Lynne Farrow the author of the book, "The Iodine Crisis:  What You Don't Know About Iodine Can Wreck Your Life."  We had an in-depth discussion about iodine and how important it is for your body.  We covered many topics including why iodine deficiency is so prevalent, bromide, fluoride, sources of iodine, the best iodine supplements, how to test for iodine deficiency, breast cancer, iodized salt, goiters, iron and ferritin, hypothyroidism, Hashimoto's disease, seaweed, and conditions associated with iodine deficiency.

Lynne Farrow and The Iodine Crisis Transcript:

Dr. Hedberg: Well, welcome everyone to the Dr. Hedberg show. This is Dr Hedberg, and I'm excited today to have Lynne Farrow on the show. So, Lynne is a journalist, researcher, former college professor and a speaker. And her own experience with breast cancer led to the discovery that someone had stolen a medicine with proven benefits reaching back 15,000 years, a medicine that not only helped her, but has helped millions. She currently serves as the Director of Breast Cancer Choices Inc., a non-profit organization dedicated to the scrutinizing the evidence for breast cancer procedures and treatments. So, Lynne, welcome to the show.

Lynne: Thank you. It's wonderful to be here.

Dr. Hedberg: So, I heard about you when I recently started doing some deep research into iodine and your book came up, and your book is called "The Iodine Crisis:  What You Don't Know About Iodine Can Wreck Your Life," and it's an excellent book. So, why don't we kind of jump in there and talk about the iodine crisis. So, what exactly is that? And what can we do about it?

Lynne: Well, when I started doing research on iodine, it took me in a long and winding road back into history, but it came up until 1970 when I was able to really comfortably say that there was an iodine crisis, because in 1970 iodine fortification was removed from bread or flour. Now that might've been okay, but they replaced it with bromide, which is, for purposes of this discussion, is an anti-iodine. So that was the first thing that happened. And then NHANES, which is a government group decide... discovered that we were now consuming 50% less iodine, say, in the year 2000 then we were in the 1970s, and that's a huge drop. Now that's just one thing, but it's sort of a perfect storm because at the same time in the 1970s you have bromide pesticides, fire retardants, all these bromide products are being introduced into the culture in a sort of ubiquitous way. I mean, your car seat has fire retardant on it. Your rug, your children's pajamas had it at that time. It's now removed.

But, upholstery, everywhere you go, if you go in airports, it's hard to look at anything that doesn't have bromide in it. So, this kind of bromide storm you could characterize that came after the 1970s when iodine was removed. And what happened at this time when you have this perfect storm of iodine being reduced in the diet and consumption of it being reduced. And bromide being added, there's a kind of... since they compete with each other, there's a bromide dominance effect. It's a way of characterizing it. And at this time, if you go back and look at the statistics, all sorts of, especially endocrine disruptor diseases, thyroid cancer went up 182%. It's a different breakdown for men and women, but that was Hashi's went up. Just a lot of different endocrine problems seem to happen as the bromide storm came along, when iodine was reduced in our diet and bromide began to just suffoca...

One of the main priorities in my practice is to stay on top of the latest cutting-edge research in Hashimoto’s disease and thyroid disorders. My latest round of research reviews involved six clinical studies that examined inositol and selenium and how they conferred major benefits in those with Hashimoto’s disease and subclinical hypothyroidism. The highlights of each study are summarized in a table at the end of this article for ease of reference.

What are Inositol and Selenium?

Before we get started, let’s do a quick review on the supplements inositol and selenium.

Inositol is referred to as Vitamin B8 but is not actually a vitamin but a sugar. It naturally occurs in foods such as fruits (especially citrus), beans, grains and nuts. It helps provide structure to your cells and also affects the hormone insulin and how chemical messengers work in your brain.

Some of you may wonder if myo-inositol and inositol are the same thing and the answer is yes. So if you buy a product that is just called “inositol”, this is the myo-inositol form.

D-chiro-inositol is another form that works equally as well as myo-inositol, but the d-chiro-inositol has a slight edge in reducing excessive androgen levels in PCOS whereas the myo form is better with insulin resistance.

I have mainly used inositol over the years with excellent results for the following:

Polycystic ovarian syndrome (PCOS)

Insomnia

Anxiety

Insulin resistance

PMS

Depression

Fibrocystic breast disease

Uterine fibroids

Selenium is a trace element that is essential to well-being. It plays a role in the immune response, cell growth and viral defense as discussed in previous research including the studies of Huang et al. and Brownand and Arthur. Selenium also plays a huge part in the synthesis and function of thyroid hormones. It has antioxidant and anti-inflammatory properties and has been shown in previous investigations including those headed by Gartner et al., Landucci et al. and van Zuuren et al. to reduce an inflammatory condition in patients with Hashimoto’s thyroiditis.

The first study I’d like to cover on inositol, selenium, and Hashimoto's disease came out of Italy in 2017 by Nordio and Basciani.

That study was published in the European Review for Medical and Pharmacological Sciences entitled “Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto's patients with subclinical hypothyroidism.”

In that study, 168 patients ages 22 to 62 years had a TSH level between 3-6 mIU/L, elevated thyroid peroxidase antibody (TPO) and/or thyroglobulin antibodies (TgAb) and normal free T4 and T3 levels. They were randomized into two groups and were given either 83 mcg of selenium or a combination of 600 mg of myo-inositol and 83 mcg of selenium for six months.

After six months of taking these supplements, all participants taking myo-inositol and selenium showed improvements in their TSH, free T4, thyroid peroxidase antibody (TPO) and thyroglobulin antibody (TgAb). The group taking only selenium had a decrease in TPO levels which we have known for a while now based on previous research. Thyroglobulin levels, however, decreased only in the inositol+selenium group.

Additionally, subjects filled out a symptom questionnaire before and after which showed significant improvement in their thyroid-related symptoms.

In 2013, the research team of Nordio and Pajalich examined the effects of supplementation with myo-inositol and selenomethionine on patients with subclinical hypothyroidism. Their article was published in Journal of Thyroid Research and was entitled, “Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis.”

This study recruited 48 women with autoimmune thyroiditis with blood levels of thyroglobulin (Tg) and thyroid peroxidase (TPO) antibodies above 350 IU/L and TSH levels that were elevated between 4.01 mIU/L and 9.99 mIU/L. They had normal free T4 and free T3 levels.

Two subjects subsequently had to drop out so the group of 46 was split so that 22 patients (Group A) received 83 micrograms of selenomethionine/day for six months. The other group of 24 subjects (Group B) received a combined treatment of 600 mg of myo-inositol with 83 micrograms of selenomethionine supplement for six months.

The patients took the soft-gel supplement with water either 2 hours before or after a meal.

What did the researchers find?

TSH levels decreased only in the subjects that took the combined inositol and selenomethionine (Group B). There was actually no change in TSH levels in the group that took only the selenomethionine (Group A).

What does this mean?

Inositol made the difference when it came to positively impacting TSH levels.

In both groups A and B, thyroid antibodies (TPO and Tg) “significantly decreased”. What is notable is that almost half the patients in Group B that took the combined inositol and selenomethionine supplement demonstrated a drop in the level of thyroglobulin (Tg) antibody that fell below the original criterion for the Tg antibody level to qualify to be in the study. That means that these subjects wouldn’t even have been part of the clinical trial with the levels of thyroglobulin antibody that they ended up with after the six months of supplementation! That’s how much this particular thyroid antibody was reduced!

In 2017, Ferrari and colleagues published a study that appeared in European Review for Medical and Pharmacological Sciences entitled, “Myo-inositol and selenium reduce the risk of developing overt hypothyroidism in patients with autoimmune thyroiditis”. The authors recruited 21 patients with subclinical hypothyroidism and autoimmune thyroiditis along with ultrasound readings that demonstrated “hypoechogenicity” or basically, some structural abnormality in their thyroid which is an indicator of autoimmunity in the thyroid. All patients were treated with 600 mg of myo-inositol and 83 mcg of selenomethionine twice a day for 6 months.

What were the findings?

TSH was significantly reduced in these patients. Thyroid peroxidase (TPO) antibody and thyroglobulin (Tg) antibody levels were also lowered with Tg antibody levels dropping more significantly than TPO levels.

No change in free T4 or free T3 was observed but a marker of inflammation (called CXCL10) was reduced!

To summarize, the combination of myo-inositol and selenium taken by the patients over a 6-month period improved thyroid function by lowering TSH and also reduced autoimmunity and inflammation.

In another study, Benvenga and his team of researchers conducted a clinical trial that was published in 2017 entitled, “Favorable effects of myo-inositol, selenomethionine or their combination on the hydrogen peroxide-induced oxidative stress of peripheral mononuclear cells from patients with Hashimoto’s thyroiditis: preliminary in vitro studies”.

They examined lymphocyte activity (involved in the inflammatory response in Hashimoto’s thyroiditis) and tried to determine if cells would be protected in any way from oxidative stress by supplementing with myo-inositol and selenium in the form of selenomethionine.

The researchers collected blood samples of lymphocytes from 8 female subjects with Hashimoto’s thyroiditis with no other autoimmune disease but with measurable levels of thyroid antibodies (TPO and Tg) along with signs of inflammation detected by a sonogram. Three healthy female subjects were recruited as controls. Please note that this study involved the use of cell samples (in vitro) and how the supplements impacted the cells collected from the subjects.

Tissue samples of lymphocytes were exposed to hydrogen peroxide (H2O2) as the source of oxidative stress. There were measurements taken before the use of the supplements and again after supplementation with myo-inositol alone, selenomethionine alone or a combination of myo-inositol and selenomethionine.

What were the findings of this particular study?

When both inositol and selenium were introduced to the blood samples, the levels of cell toxicity from the stress were reduced “with myo-inositol+selenomethionine being the most potent addition”, or having the greatest therapeutic effect compared to just myo-inositol alone or selenomethionine alone.

When the researchers examined the activity of the cells that are triggered to fight infection (chemokines), with the addition of selenomethionine or the combination of myo-inositol and selenomethionine, there was a drop in the response of these special infection-fighting cells which went below what was measured with exposure to stress that even fell below the baseline condition! It’s not that these infection-fighting cells became less effective. These cells were able to lower their level of activity because they weren’t needed as greatly by the body. Inositol and selenium were at work in protecting the cell samples!

Specifically, the higher the concentration of selenomethionine or the combination of myo-inositol and selenomethionine, the more protective the effect on the cells. What is truly remarkable is that in the Hashimoto’s thyroiditis group, the infection-fighting cells responded even more significantly to the supplementation of myo-inositol and selenomethionine (combined) compared to the control group.

As you may have been able to glean, this study did have a clear weakness: only eight subjects were treated. To add more weight to the findings of these researchers, a larger group of subjects would have been meaningful not only in seeing what would have happened to blood levels of TSH and thyroid antibodies but in the reporting of the subjects’ “quality of life”.

In the fifth article, Nordio again teamed up with Basciani to look further into the role of these two supplements in restoring a normal thyroid function state in Hashimoto’s patients with subclinical hyp

In this episode of The Dr. Hedberg Show, I interview Chris Kresser about his new book "Unconventional Medicine" as well as "The Paleo Cure."  We discussed many topics including how to reform our healthcare system, functional medicine, gut health, SIBO, social isolation, diet, psychoneuroimmunolgy, social media, ancestral diets, and eating seasonally.  I think you'll find many excellent takeaways from this interview whether you're a healthcare practitioner or someone interested in health.

Dr. Hedberg: Well, welcome, everyone, to the "Dr. Hedberg Show." This is Dr. Hedberg, and I'm really excited today to have Chris Kresser on the show, been following his work for a long time. And Chris is the CEO of the Kresser Institute, he is a licensed acupuncturist and he's also the co-director of the California Center for Functional Medicine. And chriskresser.com most of you who do any kind of reading on the internet have most assuredly come across Chris's website for some excellent health information there. And he recently published a book called "Unconventional Medicine" as well as "The Paleo Cure" and this was a New York Times best-selling book. And Chris was also named one of the 100 Most Influential people in Health and Fitness by greatist.com. So Chris, welcome to the show.

 

Dr. Kresser: Thanks, Nick. It's a pleasure to be here.

Dr. Hedberg: Great. So why don't we jump in and just talk a little bit about conventional health care because obviously there are some big issues there with conventional medicine. And so what are the areas that you see in conventional medicine that really need to really be changed and really worked on to get people in this country you know, much healthier.

Dr. Kresser: Yeah, I think the biggest issue with our current system is that it's not set up to address chronic disease. It was...the conventional medical system really came out of a time and a place where acute challenges were the biggest issues that we face. So if you look at the turn of the 20th century top three causes of death were all acute infectious diseases: typhoid, pneumonia, and tuberculosis.

And you know, conventional medicine today is remarkably effective for those kinds of problems. If you...I always say if I get hit by a bus, I definitely wanna be taken to the hospital. You know, we have pretty amazing medical technologies and interventions that allow us to even reattach severed limbs. You know, we're starting to maybe be able to restore sight to the blind. And you know, if I get an infection, I'm grateful that I can, if necessary, take antibiotics that might save my life. So there have been some incredible developments in conventional medicine that have extended our lifespan and, you know, basically eliminated certain causes of death that were the scourge of humanity for many years.

Unfortunately, that's not the biggest problem today. Today we are suffering from an epidemic of chronic disease, in fact, seven of 10 deaths are caused by chronic diseases. Things like cardiovascular disease and lung disease and cancer and now Alzheimer's and dementia at a growing rate. And our conventional medical system was really never set out to deal with those conditions because they weren't as big of an issue at the time when the medical system developed. So now we have this huge burden of chronic disease and the conventional health care system really, its main approach is to prescribe medication. And these medications though they might be somewhat helpful in addressing the s...

In this episode of The Dr. Hedberg Show I interview Dr. Carrie Jones of Precision Analytical on hormone balancing and testing.  We cover a lot of detail about reproductive and adrenal hormones including testosterone, estrogen, progesterone, cortisol, DHEA and more.  Dr. Jones explains the causes of elevated and decreased hormone levels and some strategies on balancing these issues.  We also discuss the best way to test hormones including the DUTCH test which is my favorite hormone test offered by Precision Analytical.

Dr. Carrie Jones, ND, MPH is an internationally recognized speaker, consultant, and educator on the topic of women’s health and hormones. She graduated from the National University of Natural Medicine (NUNM), School of Naturopathic Medicine in Portland, Oregon where she also completed her 2-year residency in women’s health, hormones and endocrinology. Later she graduated from Grand Canyon University’s Master of Public Health program with a goal of doing more international education. She was adjunct faculty for many years teaching gynecology and advanced endocrinology/fertility and has been the Medical Director for 2 large integrative clinics in Portland. She is the Medical Director for Precision Analytical, Inc, creators of the DUTCH hormone test.

Dr. Hedberg: Well, welcome everyone to the Dr. Hedberg Show. This is Dr. Hedberg, and I'm excited today to have Dr. Carrie Jones, on the show. I've been listening to her and reading her material for some time now. And I've also heard her speak in person. So Dr. Jones, is a naturopath and she's definitely an expert on hormones, we'll be talking about all the different hormones today. So Dr. Jones welcome to the show.

Dr. Jones: Thank you Dr. Hedberg, I appreciate you having me on, hormones is my favorite subject.

Dr. Hedberg: Great. So, why don't you just fill everyone in on what you're working on these days and your area of expertise.

Dr. Jones: Yeah, so like you said hormones is it. So I went to school and did my residency in all things women's health, hormones and gynecology. And expanded a little bit into men's health and hormones, just by default as women would bring the men in in their life, and they would say, "He has a hormone problem too." So I always joke and my ongoing joke is that if something's wrong with your child, don't ask me. And if you hurt yourself, like you hurt your knee, don't ask me that either. But if you're a hormonal mess I can help you with that, that's what I'm good at.

Dr. Hedberg: Right. So you work for Precision Analytical which is the lab that I use for hormone testing and they do the Dutch test. So why don't we jump in and excuse me. Why don't we jump into the first hormone which is, I always like to start with start with progesterone. So why don't we start with cycling females. So when you talk a little bit about what may be some of the reasons why we would either see high or low progesterone, in a cycling female?

Dr. Jones: Yeah, and actually will start with a level because I think that's well, a lot more common. So there are two reasons that a cycling female will be low. One is she does not ovulate. So when a woman releases an egg she has two sets of cells around her follicles, and they convert into a third set of cells called the lutein cells. And that's what makes progesterone. So if she doesn't release the eggs, then she's not gonna get that little conversion and she's not going to make progesterone. Now the other reason the second big reason is she may ovulate. She might release an egg, she feels it, she notices it, her mucus changes what have you. She does the you know, ovulation predictor kit from the grocery stores, it's positive. And still her progesterone might be pretty low, pretty weak. And then the reason for that is that those cells that are supposed to make progesterone, they themselves are weak. And so we have to do something to pump up the cells.

So if you don't ovulate and/or these cells are pretty weak you get low progesterone. And most women they'll feel...well, let me tell you what progesterone does, progesterone is our calming, soothing, relaxing, kind of everything's gonna be okay, hormone. So if you don't feel calm, and soothed, or relaxed especially in that second half of your cycle then it's potentially a low progesterone problem. Progesterone helps with sleep, it helps reduce anxiety, and it's our pro-gestation hormone. So it helps with fertility and it's one of the primers for the uterus, it helps with implantation. It helps maintain a fetus in the first you know, 6 to 10 weeks until the placenta is strong enough to take over. So we need progesterone but those are the two big reasons why it might be low. You don't ovulate or your actual cells aren't doing so well.

Dr. Hedberg: And where would you factor stress into that and how that might be affecting the pituitary. Wouldn't that also be a potential factor?

Dr. Jones: Yeah, it will block ovulation...and not so much block, but it will...I mean in the body if it's in fight or flight then reproduction is not it's first thought. In fact there's this really great quotes it's probably one of my most favorite quote that I've read in the research. And it's talking about norepinephrine, the hormone, which is also known as noradrenaline, it's one of your adrenal hormones besides cortisol. And the quote says that if you are a norepinephrine dominant person, if you have a lot of stress in your life, then your body will direct you away from repair, maintenance and reproduction. And it will direct you towards mobilizing your resources to dealing with the stress, to running, you know, to handle the fight or the flight.

And I think that's a really key quote because if you have a lot going on in your life, if you're very stressed out, if you've you know, either physically or you know, emotionally. Or you know, you've got viruses and bacteria and things you're fighting internally, the relationships you're in, your body will direct you away from reproduction. And when you get directed away from reproduction you don't ovulate well, often, regularly like you're supposed to. So yes, stress can absolutely redirect ovulation.

Dr. Hedberg: So as far as I'm aware if progesterone is low in a cycling female as far as interventions other than using progesterone itself. I know Vitex, chaste tree berry, has been used. Are you aware of anything else that can help balance progesterone?

Dr. Jones: Yes. So a vitamin B6 is a really good one, that one is helpful for FSH and LH stimulation. If you're not ovulating, obviously, trying to figure out why, is it a thyroid problem is it a brain problem. Are you taking something such as you know, a steroid inhaler, steroid medication, or steroid nasal spray that's inhibiting ovulation. Are you on pain medications pain, pain medications will block ovulation. You know, there's a huge number of factors for ovulation, but the chaste tree I love vitamin B6. I do use something called glandulars, do you use glandulars, do you like glandulars?

Dr. Hedberg: A few. Yeah.

Dr Jones: So people are more familiar with sort of adrenaline glandurals. But there are ovarian glandulars. And so I will use those, sort of more nourishing to the ovaries. And I also use some oils, so even in primrose oil which is a good one, borage oil, which is another good one. And then to support the cells themselves, the cells that make progesterone are called lutein cells. And they are collectively known as the corpus luteum or luteum. And lutein being they're from your orange and your red family of foods. They're high in lutein and you know, carotenoids, sort of beta carotene vitamin A, lutein, those sort of things. So I tell people you know, eat your orange and your red veggies, eat your tomatoes, eat your orange sweet potatoes, eat your apricots. Eat those things, your red and orange peppers because it can be really nourishing for those cells.

Dr. Hedberg: And let's not forget about the guys, when it to comes progesterone. So throw your little curveball, maybe it's an easy answer for you, but what are you thinking when you see high progesterone in men? I know it's pretty rare, but I've seen it here and there.

Dr. Jones: On the Dutch tests we see high progesterone commonly associated with high estrogen and high cortisol. And then we see men get their estrogen under control and their cortisol goes down. Their progesterone tends to follow suit. I don't know if you're noticing that as well, but usually when people say, "What do I do about progesterone?" I say, "If you just address the estrogen and the cortisol in this man his progesterone will improve."

Dr. Hedberg: Exactly, yeah, we see that quite a bit,.elevated estrogen and then elevated beta-glucoronides on their stool tests and things like that. So excellent, why don't we shift into estrogen so we have estradiol, estrone, estriol. What are you thinking, let's start again with the cycling female when you see highs and lows in those those hormones?

Dr. Jones: Yeah, so if I see high estrogen then a couple of things. One, she's either...much like men, women make their estrogen from a conversion of testosterone which is called aromatization, testosterone converts into estrogen. But two, which I don't think people realize, the you know, the estrogenic chemicals in our environment, the endocrine disruptors, research is showing that things like BPA, bisphenol-A, which are in our plastic water bottles and you know, with our thermal receipts and they line our cans or caned foods, can actually raise estradiol (E2) itself.

We used to think it was more just an endocrine receptor binder, but it will actually increase estradiol. So we need to be really careful there. And then the third thing I really think about is just core detoxification. So maybe you're making totally normal levels of estrogen, but you can't clear it, you're phase one,...

In this episode of The Dr. Hedberg Show, I interview Sara Lewis in a discussion about the health benefits of yoga.

If you struggle with pain, fatigue, depression, anxiety, insomnia, gut issues, or have adverse childhood experiences, this is one episode you should really listen to.

Sara spent 25 years providing program management expertise to international public health projects in South America, Eastern Europe, Africa and South Asia.  The work included directing, managing and planning projects in maternal, newborn, child health and nutrition.  After her career in public health, Sara began a second career as a Holistic Health Coach and Yoga Instructor.  As a Health Coach, she helps clients discover the benefits of using food as medicine and making small lifestyle changes that have big impacts.  She has been practicing yoga for over 15 years and teaching since 2014.  Her passion for cooking and food led her to yoga when she began studying the connection between mindfulness and stress eating.  Sara teaches both vinyasa flow and yin/restorative classes.  Her yin classes include pranayama (breath work) and deep relaxation.  When she's not on the mat or working with clients, Sara can be found in the kitchen fermenting foods, experimenting with locally sourced ingredients from the farmers market or out exploring the hills of Western NC on a bicycle.

Dr. Hedberg: Well, welcome everyone to "The Dr. Hedberg Show." This is Dr. Hedberg and I'm excited today to have my good friend and colleague Sara Lewis on and we're gonna be talking about yoga. So I've known Sara for quite a while and she's actually my yoga teacher and she's also a health coach. So Sara, welcome to the show.

Sara: Thank you Dr. Hedberg, great to be here.

Dr. Hedberg: So why don't we just start off by you filling everyone in on your background and what you do and what you've been working on lately?

Sara: Sure. So I had a career in international public health for about 25 years and I traveled all over the world. I was in Latin America, South Asia, Eastern Europe, and Africa. And I worked mostly in maternal/child healthcare and nutrition and it was a very gratifying career, but at the same time, it was very stressful with all that travel. And so I looked for support from the health coach and I got so much from my health coach that I decided to become one myself. And one of the healing modes that my health coach suggested was to increase my yoga practice and that led me to become a yoga instructor in addition to the health coaching.

So now I have a business called Simply Sara Wellness and Yoga, and I teach about six classes a week at the Waynesville, North Carolina Yoga Center and I provide health coaching to individuals and group clients. So sometimes people will say to me, "Well, what is health coaching?" Health coaching is similar to a personal trainer, but I focus on food and nutrition and lifestyle. So if you came to me and you said, "Sara, I need help with insomnia or my IBS, or I want to prevent type two diabetes because it runs in my family," then I would work with you to create short-term and long-term goals and I would support you and I would challenge you. I'd probably gave you some homework. I'd wanna know about your life's ambitions and your fears. I'd probably ask you what you had to eat today. But health coaching is much bigger than food and nutrition. It's about finding balance in your life and feeling your best.

Dr. Hedberg: Excellent. So I've been doing yoga for many years. It's been very beneficial. Some of our listeners are probably already doing yoga or have done it so far. And even those who have been doing it, they might not really know the background of it. So for those who have never done it before and don't really know about it, can you just kind of break down the basics of yoga and where it comes from?

Sara: Sure. So the word "yoga" is an ancient Sanskrit language word and it means "yoke" or "union." And yoga began in India about 5,000 years ago as a comprehensive system for wellbeing. So it wasn't really an exercise program. And there are multiple branches of yoga, but there's only one that uses poses or asanas and that's called Hatha yoga and that's typically what we practiced in the U.S., Hatha yoga. So in addition to these various branches of yoga, there's also a lot of different styles of physical yoga. So you've probably heard of Iyengar, Ashtanga, yin yoga, but all of these different styles work towards improving your quality of life and relieving stress and improving mental clarity.

Dr. Hedberg: And one of the ones you listed here as the Bikram yoga, is that the very hot yoga?

Sara: Yes. That's hot yoga. It's usually practiced at between 90 to 105 degrees temperature.

Dr. Hedberg: Yeah. I've seen, you know, quite a few patients who have done that or try to, seems to be a little bit too traumatic actually for some people who are under a lot of stress. You add in the intensity of the yoga and then all of the extra heat and it just seems to be a little bit too much for some people. Have you seen that?

Sara: Yes, I would agree with that. I think for some people it can be too much. It depends on your personality and it depends on the studio. Some studios keep the heat very high, others not quite so much. Depends on the teacher as well. You really need a good introduction about what you're getting into. You need to be careful about drinking a lot of water and not going too deep. Sometimes you can go into a pose a little too deep for your body.

Dr. Hedberg: So when a lot of people think about yoga, they think about flexibility. Someone who is extremely flexible, you know, when you look at some of the different yoga poses, people might look at it and think, wow, I don't think I could ever get into that position. So can you just talk a little bit about how yoga can improve flexibility and what people should be thinking about as far as how to improve their flexibility?

Sara: Sure. So I always tell my new students that during their first class, they probably won't be able to touch their toes when they're bending forward in a forward fold. That it's really never about touching your toes. As we say, it's about what you learned on the way down to touching your toes. And so if you stick to it and you have a regular practice, you will notice that you start to loosen up and your hamstrings will gradually loosen and you will eventually be able to touch your toes and bend your knees as much as you need to. So flexibility is really the ability to move your muscles and joints through their complete range, which is something that you're born with. So if you think about a baby and how easy it is for them to reach their feet while they're lying on their back or how toddlers just sort of squat down there.

As we age, we start to lose that flexibility and that's especially true if you sit a lot or if you're sedentary, so your bones and your joints and your ligaments kind of settle in if you don't challenge them. And that's the beauty of having a yoga practice because you noticed that as you start to become more flexible that your aches and pains might even start to disappear. So if you have tight hips, for example, you're gonna put strain on your knee joints. And then also, for example, if you have tight hamstrings, it's gonna affect your lumbar spine and that can cause you back pain. But once you start to move and get that flexibility, then your aches and pains will start to disappear.

Dr. Hedberg: Right. So pain is pain, and chronic pain, it's actually the number one reason why Americans go to the doctor. So it's an area in medicine that has really failed the population if we look at the current opioid addiction epidemic and how pain is approached. So yoga can definitely relieve pain. Can you talk a little more about how yoga can help with pain?

Sara: Exactly, right. So yoga is particularly helpful for back pain. And as you mentioned, that's a big issue here. Back pain is one of the main issues that we have in our society. There was a study that was conducted at Boston University School of medicine that found that yoga was just as effective as physical therapy for improving back pain. They have a beautiful curriculum that I've used in my class before. It's called Back to Health. And so one of the reasons that that back pain is relieved with yoga practice is because we focus on diaphragmatic breathing. So the diaphragm muscle is positioned in the middle of the torso from the nipple to the navel. And when you use that diaphragmatic breathing, then you're really using all of that, the...I'm sorry, if you don't use the diaphragm, then you're losing the strength and the other muscles take over, your back muscles take over and they can tighten up. But when you use your diaphragm, then you're actually strengthening it and strengthening that whole core area. So if you were to right now, say, put one hand on your belly and one hand behind you, and your listeners could do this too, and just take a really deep, deep inhale and then notice how both of your hands are expanding or moving. And that's using your entire, your diaphragm. So then there...I'm sorry, go ahead.

Dr. Hedberg: No. Was there anything else you wanted to add there to pain?

Sara: Right. So there's some other studies that show that yoga poses or meditation or combining both the yoga poses and the meditation can reduce chronic pain in people who have, for example, arthritis or fibromyalgia or other conditions. And their mood starts to improve through a regular yoga practice. And so then they don't need as much medication to relieve the pain.

Dr. Hedberg: So many of our listeners work sitting at a desk all day. They might have developed bad posture, bad habits. And so along with pain reduction and improved flexibility, can you talk about how yoga could improve posture?

Sara: Yes. I am a huge proponent of proper posture....

The Therapeutic Effect of Cordyceps on Hashimomoto's Disease and Graves' Disease

In 2016, a clinical trial was conducted in China that aimed to investigate the therapeutic effect of cordyceps on Hashimoto's disease and Graves' disease.

The research paper was entitled, “Dual-Directional Effects of Corbrin Capsule on Autoimmune Thyroid Diseases” and was published in the journal Evidence-Based Complementary and Alternative Medicine.

Let's find out what this research paper showed if cordyceps could help Hashimoto's disease and Graves' disease.

What is Cordyceps?

Cordyceps, also known as Cordyceps sinensis Sacc., is a fungus closely related to the mushroom. While it is not officially classified as a mushroom taxonomically speaking, it has been described as an exotic medicinal mushroom used in traditional Chinese and Tibetan medicine for over 2,000 years.  This fungus has active components that have been determined to have highly positive effects on human health including these roles:

Increased oxygen utilization of ATP production

Stabilization of blood sugar metabolism

Regulation of the immune system by exerting anti-tumor effects, modulating the immune system in organ transplantation and the prevention of kidney, liver and heart disease.

In recent years, studies have revealed that cordyceps has immune-mediating effects on autoimmune inflammatory diseases including lupus, chronic hepatitis, chronic kidney disease and diabetes.

The active constituents in Cordyceps include: cordycepin, polysaccharide, cordycepic acid, nucleosides, ergosterol, aminophenol, and trace elements.

Background Information on Autoimmune Thyroid Diseases

Autoimmune thyroid diseases come in a few forms. They include:

Graves’ disease

Hashimoto’s thyroiditis

Idiopathic hypothyroidism (atrophic Hashimoto’s)

Graves’ ophthalmopathy (GO)

Post-partum thyroid dysfunction

A main characteristic of autoimmune thyroid disease is an elevated level of auto-antibodies and hyperactive T and B lymphocytes that are reactive to thyroid auto-antibodies.

The researchers in this study identified a unique opportunity to investigate the effect of cordyceps on autoimmune thyroid disease because despite the administration of anti-thyroid drugs and thyroid hormone replacement to control symptoms of autoimmune thyroid disease, a means to actually target thyroid autoimmunity has been lacking in scientific research.

The study authors pointed out that if the immunoinflammatory process in autoimmune thyroid disease cannot be intervened, what will consequently occur is that the disease will just end up progressing and become full-blown in afflicted individuals.  Likewise, those who had success managing their autoimmune thyroid disease at earlier stages could inevitably experience a higher recurrence rate if the immunoinflammatory process is not curtailed.

In 2013, there was one study conducted in China that demonstrated that cordyceps could significantly reduce blood levels of thyroid antibodies in both Graves’ disease and Hashimoto’s thyroiditis and that it could play a helpful role in cell-mediated immunity in animal models in many diseases.  The authors of the current study then wanted to build upon existing research by seeking to investigate the effect of cordyceps on the hyperactive lymphocytes seen in autoimmune thyroid disease since after all, it is not only antibodies that play a role in autoimmunity.  Lymphocyte dysregulation also is a factor in autoimmune diseases. Yanaba et al., Norman and Hickey and dozens of other research teams have confirmed this fact.

How Was the Study Done on Cordyceps and Hashimoto's Disease?

A random selection of subjects with “newly definitely diagnosed” Graves’ disease and Hashimoto’s thyroiditis were recruited.

Study participants with the following conditions were excluded:

Unclear diagnosis of autoimmune thyroid disease

Any clues of other autoimmune disorders

Recent infections

Presence of tumors

Fever of any cause

Significantly elevated erythrocyte sedimentation rate (a marker of inflammation)

History of taking immunosuppressive or immunomodulatory drugs in the last 6 months

No recurrence of Graves’ disease

Forty-four patients with Graves’ disease and fifty-six patients with Hashimoto’s thyroiditis were recruited.

Twenty-eight Graves’ disease patients were placed into a treatment group and 16 were assigned to the control group.

Thirty-nine Hashimoto’s thyroiditis patients were placed into a treatment group and 17 were assigned to the control group.

Control patients were administered methimazole or levothyroxine while the treatment groups were given the medication and cordyceps in the form of a Corbrin capsule consisting of 2.0 grams of cordyceps in a fermented powder form taken three times a day.

What Thyroid Markers Were Measured?

Thyroid hormones: free T3, free T4 and TSH

Thyroid antibodies:

thyrotropin receptor (TR) in Graves’ subjects only

thyroid peroxidase (TPO) in both Graves’ and Hashimoto’s thyroiditis subjects

thyroglobulin (TG) in Hashimoto’s thyroiditis subjects only

T-lymphocyte subsets: total T-cells, helper T-cells (CD4+), cytotoxic T-cells (CD8+)

Blood draws were taken at the start of the treatment and after 24 weeks.

What Were the Hashimoto's Disease and Cordyceps Study Results?

In the Graves’ disease subjects:

There was no difference in free T3, free T4 and TSH levels between the Graves’ disease treatment and control groups.

The thyroid antibodies declined by 40.06% (TPO antibody) and 46.94% (TR antibody) in the Graves’ disease treatment group which indicates an improvement in the thyroid autoimmune condition (less autoimmunity).

In the Hashimoto’s thyroiditis subjects:

There was no difference in free T4 or TSH between treatment and control groups but there was a slight improvement in free T3 levels in the Hashimoto’s thyroiditis treatment group compared to controls.

What was notable was that the thyroid antibody levels declined by 51.3% (TPO antibody) and 39.49% (TG antibody) in the Hashimoto’s thyroiditis-treated group compared to Hashimoto’s thyroiditis controls which signifies less autoimmunity or an improvement in the thyroid autoimmune condition.

In both the Graves’ disease and Hashimoto’s thyroiditis subjects:

A significant drop of thyroid antibodies (specifically, thyroid peroxidase or TPO antibody) was observed in both Graves’ disease and Hashimoto’s thyroiditis patients.

In this clinical trial, the Graves’ disease patients prior to cordyceps treatments had a higher ratio in the form of T-helper cells (CD4+) compared to cytotoxic T-cells (CD8+).

Existing research has demonstrated that the primary defect of immunoregulation in Graves’ disease consists of an increase of T-helper lymphocytes with a simultaneous decrease in the number of T-cytotoxic/suppressor cells.

Following cordyceps treatment in the Graves’ disease group, there was a drop of the helper-T cells to cytotoxic T-cell ratio to more of a normal range!

Before treatment, the Hashimoto’s thyroiditis patients had the inverse seen in their lymphocyte subsets where there were more cytotoxic T-cells (CD8+) than helper T-cells (CD4+) which would mean a lower ratio of helper T-cells to cytotoxic T-cells.  Another study that examined Hashimoto’s thyroiditis patients corroborated the reduction in ratios of CD4+/CD8+ lymphocyte subsets.

Following cordyceps treatment in the Hashimoto’s thyroiditis group, there was an elevation of the helper-T cell (CD4+) to cytotoxic T-cell (CD8+) ratio!

What Does All of This Mean for Hashimoto's disease and Cordyceps?

While the discussion about specific lymphocyte subsets and their ratios may be confusing, the bottom line is that cordyceps could restore the balance between helper T-cells and cytotoxic T-cells in both Graves’ disease and Hashimoto’s thyroiditis patients “with [a] dual-directional immunomodulatory effect”. Additionally, “it could significantly reduce the auto-antibody levels in both Graves’ disease and Hashimoto’s thyroiditis.”

This is truly a remarkable phenomenon!  What this means is that seeing less inflammation that is characteristic of a certain disease is highly favorable.  In Graves’ disease, the ratio of helper-T: cytotoxic T-cells tends to be high but with cordyceps treatment, that ratio was lowered and resembled more normal readings.

In Hashimoto’s thyroiditis, the ratio of helper-T cells: cytotoxic T-cells tends to be lower without intervention, indicating imbalance and yet with the cordyceps treatment, we saw the ratio become higher which is a sign of the supplement modulating the lymphocyte activity and inflammatory condition to a more balanced state.

Looking at the body of research that exists on the subject, the exact and intricate mechanisms by which autoimmune thyroid diseases occur are not fully known, but there is strong evidence that the immune-mediated mechanisms of disease that include lymphocyte hyperactivation and infiltration are critical processes in the onset of Graves’ disease and Hashimoto’s thyroiditis.  The authors state that in both Graves’ and Hashimoto’s, “there is a broken balance between the lymphocyte subsets (T-cells)” but based on the study’s results, cordyceps appears to exert a therapeutic effect by restoring more balance!

Hashimoto's Disease and Cordyceps Study Conclusions

Combined with conventional therapy, the researchers demonstrated that cordyceps had a beneficial effect on the autoimmune condition by suppressing the lymphocyte activity in both Graves’ disease patients and Hashimoto’s thyroiditis patients.  While the ratios of lymphocyte subsets (CD4+/CD8+) were reversed in Graves’ disease and Hashimoto’s thyroiditis patients before treatment began,

In this episode of The Dr. Hedberg Show, I interview Dr. Lindsey Berkson in an in-depth discussion about hormones, brain health, gut health, Hashimoto's disease, post-birth control syndrome and much more.

Dr. Berkson had breast cancer 24 years ago and has made remission her mission. Dr. Berkson now specializes in working with breast cancer survivors to do the same; addressing food, herbs, hormone balancing and sometime protective replacement as well as nutraceuticals. Dr. Berkson formulated Metagenic's female hormone protective nutrient line. Dr. Berkson is considered a thought leader in functional medicine and now teaches MDs, Nurse Practitioners, pharmacists and other health care professionals continuing education courses. Dr. Berkson has authored 21 books, hosts the Dr. Berkson's Best Health Radio, writes the Berkson Blog (see it at DrLindseyBerkson.com) and is a research fellow with Health Sciences Collegium. Dr. Berkson has published original research with the University of Houston Medical School and Nathan Bryan PdD, the world's authority on nitrous oxide.  Dr. Berkson was a scholar at an estrogen think tank at Tulane University and worked with the scientists that discovered estrogen receptor functionality and endocrine disruption.

Dr. Berkson is a best-selling author; Healthy Digestion the Natural Way (Wiley 2000) was the first gut, nutrition, mind book.

Her newest book SEXY BRAIN explains environmental castration and how to test, detox and protect your hormones and brain.

Below is a transcript of my interview with Dr. Lindsey Berkson

Dr. Hedberg: Well, hello, everyone, and welcome to the "Dr. Hedberg Show." This is Dr. Hedberg. I'm excited today to have a very special guest, Dr. Berkson. She's been in practice for many years, has a lot of experience. And welcome to the show, Dr. Berkson.

Dr. Berkson: Very nice to be on the show with you. You have such a nice radio voice that it's like an extra audio candy here. So, thank you.

Dr. Hedberg: All right. Well, thank you for that. So why don't you, just fill everyone in on your work and what you're focused on these days.

Dr. Berkson: So, I've been in practice for many decades. I've got 21 books out and one of the big deals in my background is that I had the honor of being a hormone scholar at an estrogen think tank called the Center for Bioenvironmental Research at Tulane University. So, I got to work academically with the scientists that discovered the first and second estrogen receptor, Elwood Jensen, and Jan-Ake Gustafsson. And they taught me so much about how hormones really work. So, really knowing about hormones isn't just getting a blood, urine, or saliva level. It's whether the hormone can really deliver its signal and all of the bigger picture that's involved in that. I've written many books on hormones. Hormones have been my love. I did my very first rotation in integrative medicine in 1977 with Dr. Jonathan Wright who's now called the father of bioidentical hormones. So, I've been testing, running, looking at, writing about hormones and hanging out with the scientists that have really changed the way we understand hormones. And even Elwood Jensen was responsible for how we profiled breast cancer tumors.

So, besides that, I have a lot of background and degrees in nutrition, so I merged all of that together and I wrote one of the very first books on the concept...

Can Genistein Help Heal Hashimoto’s Disease and Hypothyroidism?

In the fall of 2016, a study was conducted in China and published in the medical journal Immunobiology. The researchers looked at the compound genistein and Hashimoto's disease to see if it affected thyroid function in patients with Hashimoto’s thyroiditis.  The research paper was entitled, “Genistein improves thyroid function in Hashimoto’s thyroiditis patients through regulating Th1 cytokines.”  To clarify, “Th1 cytokines” refer to a type of thyroid-helper cells that indicate how much inflammation there might be in the thyroid gland.  In other words, they are markers of inflammation.

The results of this study were very exciting so you might want to pay close attention.

What is genistein?

Genistein is an isoflavone which is a plant-derived compound with estrogenic activity.  It falls in the class of phytoestrogens and is found in soybeans.  Clinical studies in the past have demonstrated that this compound has immune-regulating properties by exerting anti-inflammatory effects in certain health conditions including encephalomyelitis (inflammation of the brain and spinal cord), cardiac inflammation resulting from diabetes, coronary obstructive pulmonary disease (COPD) and other serious diseases.

In this study, Zhang and four of his colleagues began by pointing out that Hashimoto’s thyroiditis is now considered the most common autoimmune disease in the world.  It is believed that excessively stimulated thyroid-helper cells play the main role in giving rise to the autoimmune condition in Hashimoto’s thyroiditis patients.  While conventional treatment has typically addressed only the symptoms of the illness via oral administration of a thyroid hormone replacement, the fact remains that there is still an autoimmune condition in Hashimoto’s thyroiditis which can be a concern.

Why is it problematic for an autoimmune condition to persist in an individual with Hashimoto’s disease?

Previous studies have demonstrated that in those with fully or partially functional thyroid glands but not “fully hypothyroid Hashimoto’s patients”, long-term Hashimoto’s thyroiditis closely correlated with the prevalence of thyroid cancer.

Chronic inflammation is never beneficial for the body so if someone is invested in his or her health, mitigating any autoimmune condition would be prudent.  In this investigation, the researchers wanted to evaluate any beneficial anti-inflammatory properties of genistein for those with Hashimoto’s thyroiditis and examine what impact it might have on the chronic inflammatory condition associated with Hashimoto’s disease.

How was the study done?

Two-hundred eighteen female subjects between the ages of 20 and 80 were recruited, all with Hashimoto’s thyroiditis.

These requirements had to be met in the subjects:

1. Normal levels of free T3 and free T4 with or without thyroid replacement therapy

2. Normal TSH levels or slightly elevated TSH levels below 20 mU/L

3. Increased blood levels of thyroid antibody (thyroid peroxidase) greater than 100 U/mL

Subjects with any of the following conditions were excluded:

1. Prior use of immunoregulators

2. Presence of infection

3. Presence of thyroid nodules

4. Thyroid hypoplasia

5. Prior treatment with radioiodine

6. Pregnancy

7. Presence of serious illnesses such as cancer, kidney or liver failure.

The 278 females with Hashimoto’s were split into two groups with 143 in the placebo group and 135 in the genistein group.  Patients in the genistein group were given 600 mg per day of genistein as a purified soy extract taken orally for thirty days.

What lab work was required?

To measure thyroid function:

1. TSH

2. T3

3. T4  (total T4)

4. fT4 (free T4)

To measure thyroid antibody levels:

1. Thyroid peroxidase - TPOAb

2. Thyroglobulin – TgAb

To measure inflammation:

Thyroid-helper cell bodies (Th1 and Th2) which we will refer to henceforth as inflammatory markers.

These blood draws were taken before and after the genistein treatment.

What were the results?

Significant differences in thyroid function were observed in the group that took genistein.

How was this manifested in the bloodwork?

T4 (total) concentration increased.

fT4 (free-T4) concentration increased.

T3 remained unchanged.

TSH decreased.

What do all of these observations mean?

When T4 and fT4 go up and TSH goes down, this means that thyroid function is improved.

When the thyroid antibodies were examined in the genistein-treated group vs. placebo, those who took the genistein after one month showed a decreased level of thyroid antibodies.

What is the takeaway message from this study?

A month of supplementing with 600 mg of genistein was effective in improving thyroid function and reducing the autoimmune condition in Hashimoto’s patients!

What was the impact of genistein on the inflammatory markers (TH1 and TH2)?

Previous studies had concluded that genistein works by regulating the immune response in Th-cells.

In this study, compared with placebo, two of three Th1-producing inflammatory markers did change significantly after the genistein treatment.  While there was no change in Th2-producing inflammatory markers, genistein did play a significant role in modulating inflammation in the Th1 cells so basically that means less inflammation was seen in thyroid tissue.

Conclusions

The immune-regulating effect of genistein on Hashimoto’s thyroiditis patients was mediated through the function of Th1 cells only.  Th2 cells were not affected.  But this is still great news.  Any time you reduce an inflammatory condition in Hashimoto’s thyroiditis patients, you reduce the risk of thyroid cancer.

Based on prior research, even if someone has taken a thyroid replacement to improve symptoms of Hashimoto’s thyroid disease, the tendency towards higher inflammation in whatever thyroid tissue remains in a Hashimoto’s patient increases the risk of thyroid cancer.

What has been done about this cancer risk in the past?

The conventional method of treatment for the chronic autoimmune situation of Hashimoto’s thyroiditis has been any of the following:

1. short-term steroids

2. supplementing with selenium and synthetic T4

3. the administration of low-level laser treatments

The notable news here is that these researchers found that just 600 mg/day of genistein over a 1-month period improved both hypothyroidism and the chronic thyroid autoimmune condition.

What is also significant about these results is that because the T4 levels and free T4 levels increased, this might mean that a Hashimoto’s patient could lower one’s replacement thyroid dosage if taking synthetic levothyroxine.

TSH was also lowered.  Why would an increased TSH level be of concern?

TSH, as with the inflammatory marker TH1, has a role in the development of thyroid cancer in Hashimoto’s thyroiditis patients as demonstrated in studies by Fiore and Vitti and Fiore et al.

Zhang and his team of researchers determined in this study that genistein reduced TSH levels markedly which the authors concluded may help to reduce the prevalence of thyroid cancer in Hashimoto’s thyroiditis patients.

The thyroid antibodies are another measure of autoimmunity. In this study, genistein lowered both thyroid antibodies (TPO and Tg), suggesting that genistein mitigated the autoimmune condition in Hashimoto’s thyroiditis patients.

Overall, genistein was shown to be effective in improving thyroid function and reducing autoimmune activity as measured by the decreased presence of thyroid antibodies and the decreased levels of the inflammatory marker TH1 in Hashimoto’s thyroiditis patients.

This was the first trial that demonstrated the efficacy of genistein in Hashimoto’s patients.

Doesn't soy inhibit thyroid function?

Genistein is an extract from soy so it doesn't contain any goitrogenic activity.  Goitrogens can inhibit thyroid function but only if they are consumed in excess.  You would have to eat large amounts of raw vegetables and other plants that contain goitrogens to see inhibition.  Also remember that many goitrogens have compounds that actually improve thyroid function which can offset the goitrogens.

So, do we all want to include genistein in a Hashimoto’s disease healing plan?

By now, all of my followers know that we need to take into account any weaknesses of the study before making the decision to supplement with genistein for Hashimoto's disease.

The researchers noted that a longer-term clinical trial, beyond 1-month’s time, would be recommended to see if there are any side effects or issues with taking genistein.  Additionally, the authors pointed out that genistein has a chemical structure that lends itself to a rapid decline in blood levels when taken orally.

Would thyroid function and autoimmune activity be improved if genistein is taken over a year’s time, for example?  Would the improvement in thyroid function and a decrease in the autoimmune state that we saw in a one-month trial period end up plateauing or leveling off if genistein were administered over longer periods?

Given the study’s brief time frame, I conclude that genistein offers favorable short-term potential in improving not only thyroid health but reducing one’s risk of developing thyroid cancer by reducing the autoimmune condition (and chronic inflammation) but studies of greater duration would be highly recommended to evaluate if the benefits of genistein would endure.

If you are a patient of mine you can try the genistein product under the favorites section in my online dispensary: