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How to Optimize Your Thyroid

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Happy Spurling - Regular Font

Kayla Lanier - Bold Font   


Hey guys, today we are talking about thyroid disease and how to optimize your thyroid health.

Thyroid health seems to be the topic of the day for most days of the office because so many women and men struggle with thyroid health. So a lot of times when you think about thyroid, I think it's probably one of the most frustrating things that women deal with because they're diagnosed with a thyroid problem.

They're given the typical medication, which is generally Synthroid or Levothyroxine, and then their TSH levels are adjusted according to their medication dosage. The problem with that is it's a way to help, but it doesn't fix the problem entirely. So what you're left with is women who have a normal TSH, and I say that normal in quotation marks because it's within reference range, but all of the symptoms are still there.

And they might go 10 to 20 years adjusting their dose of thyroid medication and still having the same symptoms that they were diagnosed within the first place.

Right, so What can we do about this? I mean, yes, the medication helps to some extent, but how can we live optimally with thyroid disease?

Yeah, and I think even people who have diagnosed thyroid disease and then there's a great host of people that have undiagnosed thyroid disease where you're falling within a normal TSH level, but you know that there's symptoms that the thyroid is not functioning optimally.

So, there's a lot of things that you can do. I'm gonna outline a few of them today because it is a pretty deep topic. I really like Dr. Westin Child's website, . A link will be on the bottom of the podcast there if anyone wants to check out his stuff. He does have a really great educational website on that and has tons of information to kind of help you be able to be your own advocate with your primary care provider.

One of them is to optimize the key nutrients that are needed by the thyroid and that is a deficiency that most people have when they're diagnosed with thyroid disease. They actually have these depleted nutrients way before it ever becomes a problem because the body will use what is stored until it just isn't there any longer.

And one of those is zinc. Zinc actually helps to convert T4 to T3. So inadequate levels will make your body more likely to convert T4 into reverse T3. And that actually makes your thyroid function worse. Zinc is also a powerful anti-inflammatory agent, and it helps to regulate the immune system. And that's very important with thyroid health because I've said this before, the thyroid is like the canary in the coal mine.

It's telling us that there's a problem. It's either a hormone regulation issue, insulin regulation being one of those, or it's trying to tell us that it does not have what it needs to function properly in the body.

Selenium helps convert T4 to T3 and it balances the immune system too. And this one is really important for people who have Hashimoto's. It's important for everyone who has thyroid condition or If you don't, in order to prevent from it, but selenium is actually very effective to reduce the antibody level in Hashimoto's, but you do need to be careful that you get like the base value of that's 200 micrograms a day. So if you're doing like a combo supplement to get these minerals in, you want to make sure that it has enough to get your daily levels into sufficiency.

I know you mentioned that you can get too much selenium when you are not we're talking before the podcast and that happens a lot when people do combo supplements where they do a multivitamin that has some selenium than they'll do a trace mineral and then when you start looking at the totals you're actually getting too much selenium and selenium toxicity is real. It usually happens when people are eating like a lot of Brazil nuts, which are phenomenal to get your selenium in without having to actually take a supplement for that. But you can actually get too many of those. I feel like they need to have a warning label on Brazil nuts.

Two Brazil nuts is enough to supply 333 micrograms of selenium, which is It's phenomenal, but if you're eating six or eight of those a day, you do it long term, you can get selenium toxicity.

So of course, too much of a good thing isn't a good thing, but just looking at your supplements and knowing that you're not getting more than 200 micrograms total in all of those.

And then also vitamin B6, which actually helps create thyroid function. It also helps to maintain neurotransmitters in the brain.

One of the key ones for serotonin. So a lot of people who have thyroid disease, or before it starts to become an actual condition, they have depression. And that's one of those problems is that B6 is used to convert serotonin into a usable form and it's also what is needed by the thyroid to make that function happen. And so a lot of people have a B6 deficiency. It's actually good to get that in a B complex if you can and a methylated B12 and a methylfolate and a B6 together. And then have as a trace mineral where you're getting zinc and selenium.


You can't take zinc because you...

Yes, I get violently ill. I'm not really sure why. I think it's because I do eat a lot of trail mix and a lot of nut butters. That's all I can gather.


But, I would love to take it, because I know it's good for me, but...

Well, and it's kind of with zinc, you're able to test it like that, so...

Yeah, don't take it on an empty stomach.

Oh no, that's terrible.

Yeah. I'll be sick forever.

Yeah, even if you're pretty hardy about taking supplements on an empty stomach, it's better for absorption to have most of them with food, but zinc is definitely one of those that you're going to know it if you do that. So if you have nausea, if you're taking a supplement with zinc, a multivitamin or anything, you need to make sure you have it with a full meal because it is rough on your stomach. But if you're eating a lot of nuts like you do, and you're getting that mineral profile, selenium and zinc, you don't usually need to supplement unless you have a true deficiency.

Right. Yeah, I eat Brazil nuts probably every other day, so.

That's a good pattern to actually break it up.

And they're, I'd say they metabolize better as well.

Yeah, you're getting the whole profile, but they're so good for you, and they're very powerful for regulating cholesterol. Eating one to two Brazil nuts a day has been known to reduce your overall cholesterol level by 40 percent in two months.

That is wild. I never would have guessed.

So I did have a lady that I just shared that with, and passing one day, not as a client years ago. And so she came in to church not long after that. It was probably a month in and she said her stomach was hurting and she was like, I've actually been losing some hair. And I was like trying to think about what was going on. And I said, how many Brazil nuts are you eating a day? And she said, Oh, I love them.

I eat probably 12 or 15. I said, I think you have selenium toxicity and that's too much. And she said, well, you told me it would lower my cholesterol. And I said one to two, I didn't tell you like a pound a day. Like so I need to be more specific about things, which is when I kind of stopped trying to do self-help when you were passing by church.

It's probably not the best idea, but they don't have a warning label on Brazil nuts. So they are phenomenal, but I guess I've beat that horse already, but you do need to be careful not to get too much. And if you are consistent to eat Brazil nuts every other day or one a day, you really don't need selenium and anything else because it does a great job of meeting that.

One of the things I was looking into a lot lately is gut health and how it's connected to the body's ability to convert or activate thyroid hormone. And it's really amazing when you think about why do we have people taking their thyroid medication and they're not doing any better.

It's usually a conversion issue, where they're not actually able to convert that synthetic T4 into T3, which is the active form of thyroid hormone, and the gut has so much to do with that.

Right, this was very interesting, because you were reading and you told me earlier, that the gut is made up of a hundred trillion microbial cells distributed in complex site specific communities.

Yeah isn't that crazy that the microbiota has a hundred trillion cells that's like amazing.

Yeah that's insane I never even would have thought but anyways obesity has been correlated with reduced bacterial diversity, altered expression of bacterial genes and metabolized pathways in the gut.

Yeah, that it actually can affect that whole thing. So we look at obesity being related to thyroid disease because it disrupts the metabolic pathway. What they do know is that a lot of people who have thyroid disease and also insulin resistance have a very high level of the wrong kind of bacteria in their gut, but not enough of the beneficial bacteria that can actually keep insulin levels regulated and help the thyroid convert.

20 percent of your thyroid hormone is converted in the gut by these bacteria. So when they're not present, then you don't have what you need to actually utilize your T4, whether it's coming in through a medication or through your own production.

Okay, so your gut may help your body activate up to 20 percent of your thyroid hormones.

Yeah, that's crazy.

That's wild. So like what can we do to help with our gut and just like boosting those good bacterias?

So one thing that happens is that In a normal system, the thyroid hormone helps your stomach produce stomach acid, so hydrochloric acid, and it also helps your intestinal tract move forward at a normal pace, which is why when thyroid hormone's low, your intestines move slower, so you get The likelihood of constipation becomes elevated when you have thyroid condition.

And that makes you more likely to develop conditions like SIBO, which is small intestinal bacterial overgrowth, yeast overgrowth, and acid reflux. So, the thyroid not having enough hydrochloric acid production inhibits that. So one thing that's really good to do is to get a good digestive enzyme that has HCL or hydrochloric acid in it, and actually to take that capsule like five minutes before your meal so that it can kind of open up and be present for the meal that's coming in.

If you have low HCL, you're not making the proper digestive enzymes to break down your food and it affects how you carry nutrients, which affects your thyroid. Another thing is a very good potent multi-strain probiotic, making sure that you're getting all of the good strains of probiotics for support in there.

And then this one's really good to use essential oils to kill off excess bacteria in the gut. I know I've talked about oregano oil before being anti bacterial and viral and parasitical. I mean it's just such a good all around. So, doing that three or four times a year. Also, thyme as an essential oil can be used and berberine which is actually kind of twofold in thyroid support in that it can actually regulate your blood sugar, which can help with the insulin resistance that accompanies thyroid disease, which is pretty amazing where you just kind of start working on gut health all around in order to help your thyroid medication work better or to help your own T4 convert into T3.

To treat gut imbalance is one of the first steps and we often don't think about that. I think we, we know a lot of people now with social media and all are starting to learn that TSH isn't everything and that T4 isn't the number to watch necessarily, but T3 and we get focused on that, but you have to go deeper than that.

Like, even doing one of the T3 medications, which can be very helpful, can help with T3 uptake and the actual conversion of it. But if you start rebuilding from the ground up with the gut, then you should be able to do a lot more converting on your own. So the gut work is definitely worth doing when you're dealing with thyroid.

Okay, so typically it would help you heal and boost your thyroid function.

Yeah, absolutely. And prevent a lot of the leptin and insulin resistance that's happening. They've been doing some really phenomenal research on insulin resistance and the people who actually have obesity because of insulin resistance, do not have the bacterial diversity that people who are thin actually have in the gut.

So that's very interesting in that there's certain probiotics that can actually help you to lose weight and people promote those often, but the strains are real. The premise is there. I think it's more complicated than just giving yourself a probiotic. Wouldn't that be nice though? You could just put one thing in and fix a hundred things, but...

Unfortunately, the body doesn't work in a vacuum like that. But it doesn't mean that it's not beneficial to do. I think it's part of the answer.

Right and the right probiotic is definitely necessary. Not one from Walmart.

Yeah, and that's a good point too. You know, supplementation, I think, is very overrated. And that it really does matter what type of supplement you're getting because you're not able to utilize it.

So sometimes where people will say, well, I took that, I took a trace mineral, it didn't work. I took this, it didn't work. Well, first you have to define work because it takes time to rebuild something. But second, what kind of supplement are you taking? Because if it isn't third-party tested and you are getting it sourced really cheaply, then you're probably not getting something that's actually going to benefit you. So, supplements can be very powerful or they can be a big waste of money. So, it's really important to source those well because they are powerful if you get the right, you know, the right dosing.


The other thing we talk about a lot is, uh, having people check the reverse T3. So often you'll check on a normal thyroid panel, TSH, T4, and T3, though they'll do total T3 or free T3. And that number's extremely helpful, but you need to be asking 'em to check your RT3, which is your reverse T3.

And that's basically a category that is an antithyroid metabolite that your body creates under certain conditions. So the way I think about T3 is that your T4 thyroid stimulating hormone is making T4 and T4 should convert into T3 and actually T2 and T1 as it goes down the cascade. But a lot of people are taking T4 and then it doesn't convert and they're storing it all in this antimatabulite.

So in this reverse T3, so you get people who have low T3 as a total or free T3 and really high reverse T3. If you're seeing that number where you have high T4, your TSH is normal, but your T3 is low, then your medication is storing. You are not using that the way that you should in the body. And that's the difference in having thyroid function healed and just having it passable on a TSH.

Alright. Just like surviving.

Yeah. It's really important to look at what could cause reverse T3 to be high because it directly inhibits or blocks the actions of free T3. So basically it's a roadblock that's created. So if you're looking at your TSH numbers and there may be even within range, but you're showing a high T4 level and a low T3 and your reverse T3 is high, you're a typical pattern to where that thyroid medication is not able to do its job.

And that's where you need to have a conversation with the primary care provider about am I a candidate to have T3 brought in as a medication because they have that, Sidomil is one of those. There's another medication that also can be used. I think it's called Liothironine, which is actually another form of T3 only medication.

And it can actually help with that conversion. And you need a practitioner that knows how to actually dose that because typically it's starting at a five microgram dose. It's dosed daily up to 25 micrograms. Some practitioners may increase the dose weekly until you kind of get this happy medium between T4 and T3 coming in.

And it can be a game changer for people because you're actually converting that. And that's the difference in having a really healthy thyroid even in spite of TSH numbers being what they are or not. So you have to look at the whole picture of that.

The medication still plays a role.

Yeah, and can actually be used together much more accurately, which is why a lot of people will go to Armour or to the desiccated thyroid prescriptions because they do have the full thyroid, so they actually have T4 and T3.

Not in as high level as you would get from a straight on T3 medication directly, but it is often enough to stimulate thyroid function. Because what you don't want to get into is having a thyroid that's like, I'm getting my Synthroid or Levothyroxine, I'm getting that T4 in, but nothing ever changes in your conversion.

That's where you just get stuck on a med your whole life, but you still have all the symptoms of having thyroid disease. And you have the tiredness and the hair thinning and the depression and the weight gain and the heart palpitations, and yet they look at your numbers and go, well, your thyroid's fine.

They just...

Yeah, if it were fine, you wouldn't be having those symptoms. The other thing I would encourage people to do is to optimize their iron and ferritin levels. So get your complete iron tested. Ask for a iron saturation, a total iron bonding capacity, a UIBC, which is another bonding capacity number, and then also your ferritin level because the thyroid needs iron and often people are iron deficient or they're in those low normal patterns where they're in reference range but yet they have such a low normal that their thyroid can't function optimally and we kind of, it's just like a very well oiled machine.

It wants to work well, but it would be kind of like expecting your car to drive around on one quart of oil instead of four or three or however many. I know nothing about mechanics, so don't quote me on those amounts. It's like you've got to optimize it, so it's much better to have. A full measurement of oil than it is to run around on two quarts or whatever.

Struggling on this analogy, but anyway, being able to do that, the car can still run, it can still function, but it's not going to do it well and it's not going to do it very long. And that's where I think as patients, people need to say, look, I understand that my thyroid is within range. I get that, but within range does not mean that I'm optimal.

And that's where you want to really be your own advocate and try to find out the things that you can do to optimize it. You want your serum ferritin level to be between 40 to 60 minimum. I prefer 70 to 100, honestly, for optimal function. And get those levels checked. They're your labs. You have every right to ask for them to get those done and optimize them.

It's important. I did it and I'm still working on it myself.

So many women have less than optimal iron levels and that can be corrected. You can do a whole food iron supplement and get those iron levels boosted. And you can do it very safely with like a 26 milligrams, generally a day is what you're looking at for a supplement.

And just do it short term. Recheck your levels and then see the difference. Because the thyroid requires stored iron in order to make... T4 and T3 and that whole conversion.

I hear it so often and it's heartbreaking to hear people have everything supposedly that's going to fix their thyroid problem, which is that one medication, that one hormone and yet they walk around never feeling optimal because that's not the whole picture. There's so much more to it.

Unfortunately, it is very complex. The answer is not going to be found in one drug. Often, you may need to incorporate T3 with T4. Talk to your practitioner about that. You may actually need to look at supplementation and get, you can get your selenium and zinc levels tested, see if you're in optimal range. So having somebody look at those things with you and be very individualized in your care can be a really big life changing move for people. So yeah, getting these things in check can help you with the insulin resistance that accompanies hypothyroidism that makes such difficult issues with trying to lose weight, and it can really help a lot.

Yeah, and even those that don't have thyroid issues, it's nice to get ahead of it and to make sure that you can at least optimize your health where you're at in your life right now, especially if you're young. I mean, I know I'm going to try all this for myself, especially if you have like I have a history of restricting food or exercise or like low iron like mom said.

It's good. You brought up a good point about calorie restricting.

It's like the worst thing.

Yeah. It does signal to the thyroid that something's wrong and so the thyroid slows down metabolism because honestly, it thinks you may need it because there's an emergency, so it slows down that rate. It's so sad to have a true thyroid condition and know that you literally eat less food than anyone, and you gain weight, and you can't lose weight.

And when you get into this place, cycle, you have to find a way to break out of it because otherwise, it's just going to produce more of the same results. And that takes some time. I mean, it's a very complex problem. I think we have oversimplified it with one medication that doesn't work, where we should have said, here's a medication as a tool.

This T4 can be used short term to sub in what's not there, but let's get your body making it on its own. And that's of course going to require a shift in diet and also incorporating fasting windows and getting insulin resistance back down to normal. It is difficult, but it is so worth it when it's done.

And it can be done. So...

Right. You're not just treating the symptoms or the... We're trying to silence the condition you're actually living optimally, and I think that's what this episode is really about.

Yeah, and like, for my age group coming at this, we're looking at what's wrong with the thyroid, how can you fix it, but what you brought up is looking at it from a younger perspective, which is, What can I stop doing right now that's going to affect my thyroid later on because it does come down the line.

If you can catch mineral deficiencies before they become a problem, if you can keep those optimized, if you can work on proper nutrition and calorie intake instead of falling into that trap, there's a lot you can do.

And the last thing would be to ask for liver function tests. You know, I said 20 percent of the thyroid activation happens in the gut. Well, their number that could be as high. 60 percent as quoted by Dr. Westin Childs is that the liver converts the rest of thyroid function. So when you don't have adequate or optimal liver function, then that medication again, in theory, is doing the job, but you've got to have all of that working together.

Right, so it's not storing the medication and yeah, I would definitely, if you're not in this boat with thyroid disease, maybe get levels checked out, your minerals checked out, your vitamins. I'm still working on that myself, trying to raise my iron and my vitamin B and D and magnesium. It's just, it's something to get started on, especially if you have a history of calorie restriction.

And if you have thyroid disease, there's hope. There's an optimal life just ahead of you.

Yeah, don't settle into that, well, I'm on levothyroxine for the rest of my life, and that's just how it is, and I have these issues. You know, work to find out your answers if they're not coming to you, because you deserve to be able to have optimal life in that.

And of course, optimizing your adrenal function, managing your stress levels, cortisol plays a huge role in all of this. So this would be a much longer podcast if I go into all that. So I'm not going to. But if you have issues with all of this and you need someone to help you work through that, usually functional medicine, a naturopath, something like that is going to give you a more deep rooted answer than just the surface answer. So, you know, find someone.

We do that in our office, and I'm sure if you're in other areas, we do virtual and Zoom. So a little plug for what we do here. One of my favorite quotes, and it's in my office, is from Hippocrates and it says it is more important what sort of a person has a disease than what sort of a disease a person has.

So when you look at someone, you want someone to help you with your health, they need to be able to sit with you as a person and know who's in front of them and say, okay, this is what's going on. Let me help you with a plan that's tailored to you because there is no set answer for everybody. If there was, every person on levothyroxine would not have a thyroid problem anymore.

But I think it's important to look at who you are and say, how did I get here? What is my story in this? And how can I begin to fix the roots and address the problem to it?


Dr. Westin Childs Website:


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