Hyperthyroidism with Dr. Eric Osansky: Rational Wellness Podcast 321
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Dr. Eric Osansky discusses Hyperthyroidism with Dr. Ben Weitz.
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Podcast Highlights
3:51 Hyperthyroidism. Hypothyroidism or Hashimoto’s is a lot more common than hyperthyroidism. Hypothyroidism is when you have low thyroid levels and TSH or thyroid-stimulating hormone is elevated. With hyperthyroidism there’s too much thyroid hormone and TSH will be low. With such patients you might see an elevated resting heart rate, heart palpitations, weight loss, hair loss, and thyroid eye disease that may include eye bulging and double vision. While the optimal TSH should be between one and 1.5 or 2, TSH below 1 and esp. at .5 or below is reason for concern for hyperthyroidism. For most patients with Grave’s disease (Autoimmune hyperthyroidism) the TSH is undetectable.
7:54 Grave’s Disease. Most patients with hyperthyroidism (at least 80%) have elevated thyroid-stimulating immunoglobulins (TSI), which means that it is an autoimmune condition that is referred to as Grave’s disease.
9:13 Medical treatment. The most common medical treatments for hyperthyroidism are the use of anti-thyroid medications including Methimazole or Carbimazole, which converts into Methimazole, and several other anti-thyroid medications, including Propylthiouracil. The other medical treatments are radioactive iodine, which obliterates the thyroid gland, and surgery to remove the thyroid gland. Some endocrinologists feel that the surgery is the way to fix the condition and that is their primary treatment for this condition.
11:25 From a Functional Medicine perspective, what happens is that the immune system is attacking the TSH receptors. There are four main categories of triggers for such autoimmune diseases that we can look at: 1. Food sensitivities, such as gluten, dairy, and corn, 2. Stress, 3. Toxins, including environmental toxins, heavy metals and mycotoxins from mold, and 4. Infections that includes viruses like Epstein-Barr, bacteria in the gut such as H. pylori, Yersinia Enterocolitica, and potentially even parasites.
14:02 Dr. Osansky was diagnosed with Grave’s disease in 2008 and got it under control without the use of surgery, radiation, or medications. When Dr. Osansky sees a patient for hyperthyroidism, he takes a very thorough health history. Then he will run some lab tests, including a CBC, a comprehensive metabolic panel, vitamin D, iron panel, etc. Dr. Osansky also likes to look at adrenals, either through saliva or urine with the DUTCH test. He also likes to test hormones and run a comprehensive stool test and perhaps organic acid testing. He also likes to test hair minerals, including heavy metals. When Dr. Osansky was diagnosed with Grave’s in 2008, he did salivary cortisol testing and found out that both his cortisol and DHEA levels were quite low most of the day. Grave’s causes you to feel hyperactive, so he did not feel fatigued like patients normally do with adrenal fatigue. He worked on improving his ability to manage stress, changed his diet, and he took certain herbs, including liquorice root and certain nutrients, which helped his recovery.
20:49 Anti-thyroid nutritional strategies. While we are using the Functional Medicine approach to search for the underlying causes for their hyperthyroid condition, there are certain herbs and nutrients that can help to manage the excess thyroid hormone, including the herbs Bugleweed and Motherwort. Bugleweed is an herb with anti-thyroid properties, that helps to lower the thyroid hormone levels. Patients often get heart palpitations with hyperthyroidism and Motherwort is an herb that can help with that. It has been found to calm the heart, sort of like a natural beta blocker. Lemon balm can also have a calming effect. He prefers the liquid tinctures in an alcohol base and with a two to one ratio. Dr. Osansky likes the MediHerb product with Bugleweed and Motherwort, but there are also products on the market from HerbPharm, Hawaii Farm, and Wise Women Herbals. Dr. Osansky usually recommends taking the herbs 15-20 min prior to meals typically 1/2 to one teaspoon twice per day but they may need two teaspoons if taking a less potent product like HerbPharm, which is a five to one ratio. Bugleweed dosage depends upon the thyroid testing, while Motherwort dosage should be titrated till the heart symptoms are calmed. If Bugleweed doesn’t work, L-carnitine at a higher dosage–2 to 4 grams per day–has anti-thyroid properties and it inhibits T3 and T4 from getting into the cell nuclei, according to some research. If the symptoms are not under control with Bugleweed and L-carnitine, sometimes lithium orotate (low dose lithium) is helpful at a dosage of 5-10 mg. Selenium may help to lower the TSI and TPO levels if elevated and it could help with thyroid eye disease. He typically recommends a dosage of 200 mcg but may go up to 400 mcg. Dr. Osansky does not like using high dose iodine with patients with hyperthyroid, even though it may suppress thyroid function at higher dosages, but it creates a lot of oxidative stress, so he usually discourages his patients from taking iodine supplements or even eating a lot of seaweed. Cholestyramine is a prescription binder often used in mold detox programs that can bind to thyroid hormone and help lower levels. It is up for debate whether nutritional binders like activated charcoal and zeolite, etc., may be able to do the same thing to lower thyroid levels. Low dose naltroxene (LDN) may also be effective though modulating the immune system.
Dr. Eric Osansky is a chiropractor and one of the leading experts on a natural approach to hyperthyroidism. He was personally diagnosed with autoimmune hyperthyroidism, also known as Graves’ disease, and he was able to overcome it using a natural, Functional Medicine approach. He avoided both the prescription antithyroid medications and the radioactive iodine treatment as well as thyroid surgery. He has a Masters of Science degree in Human Nutrition and Functional Medicine, is a Certified Clinical Nutritionist, is a certified nutrition specialist and a certified functional medicine practitioner for IFM. In 2011 he published his first book, Natural Treatment Solutions for Hyperthyroidism and Grave’s Disease, in 2018 he published Hashimoto’s Triggers on hyperthyroidism, and he is currently editing the third edition of his first book, to be released soon. Dr. Eric Osansky can be found at SaveMyThyroid.com and at NaturalEndocrineSolutions.com.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts, and researchers in the field, to bring you the latest in cutting-edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more check out my website, Drweitz.com. Thanks for joining me, and let’s jump into the podcast.
Hello listeners, I’m very excited today to be speaking about hyperthyroidism with Dr. Eric Osansky. We’ve had a number of discussions on this podcast about hypothyroidism, or Hashimoto’s Thyroiditis, which is a condition marked by underactive, sluggish thyroid, and this is the most common thyroid disorder. But some patients have an overactive thyroid, which we refer to as hyperthyroidism. Like with hypothyroidism, most patients with hyperthyroidism have it as part of an autoimmune condition. Unlike hypo, when the body does not make enough thyroid hormone, in hyperthyroidism the thyroid produces too much thyroid hormone. Hyperthyroidism speeds up the body’s metabolism, and this can result in many symptoms, including weight loss, hand tremors, rapid heart rate, irregular heartbeat, anxiety, sweating, et cetera. Not too many functional medicine practitioners talk about hyperthyroidism, so I’m thrilled that we’ll be talking to Dr. Osansky today. Dr. Eric Osansky is a chiropractor, and one of the leading experts on the natural approach to hyperthyroidism. He was personally diagnosed with autoimmune hyperthyroidism, also known as Graves’ Disease, and he was able to overcome it using a natural functional medicine approach. He avoided both the prescription anti-thyroid medications and the radioactive iodine treatment, as well as thyroid surgery. After seeing how well natural treatment methods helped with his autoimmune thyroid condition, Dr. Osansky began using these natural thyroid treatment protocols to help others with different types of thyroid and autoimmune thyroid conditions, such as hyperthyroidism and Graves’ Disease, and hypothyroidism, and Hashimoto’s Thyroiditis. While Dr. Osansky realizes that conventional medical treatment is necessary in some cases, there are millions of people with these conditions who’ve been told they need to be on prescription drugs on a long-term basis, or receive thyroid surgery or radioactive iodine, when this may not be the case. Dr. Osansky has a Masters of Science Degree in Human Nutrition and Functional Medicine, he’s a certified clinical nutritionist, is a certified nutrition specialist, a certified functional medicine practitioner for IFM. In 2011 he published his first book, Natural Treatment Solutions for Hyperthyroidism and Graves’ Disease, and he’s currently editing the third edition, to be released soon. Dr. Osansky, thank you so much for joining us.
Dr. Osansky: Dr. Ben, it’s a pleasure being here, thank you for having me.
Dr. Weitz: Sounds good. So perhaps you might want to put a little more on the bones of explaining what is hyperthyroidism, what is Graves’ Disease?
Dr. Osansky: Sure, definitely can do that. As you mentioned, hypothyroidism is… First of all, hypothyroidism, Hashimoto’s a lot more common than hyperthyroidism. And so with hypothyroidism, that’s when you have low thyroid hormone levels, even though some cases of Hashimoto’s it’s more subclinical where they’re within the range but less than optimal. But typically, you’ll have thyroid hormone levels on the lower side or overtly low, and then there’s a thyroid-stimulating hormone, or TSH, that’s a pituitary hormone, that signals a thyroid gland to produce thyroid hormone. But with hyperthyroidism, as you mentioned, there’s too much thyroid hormone. There’s the excess secretion of thyroid hormone, and you could get multiple symptoms, you mentioned some of them. So when I dealt with Graves’ Disease I had elevated resting heart rate, also known as tachycardia, had heart palpitations, I lost almost… Actually I lost 42 pounds, I have that specific-
Dr. Weitz: Ouch.
Dr. Osansky: I have that down, 42 pounds I lost, which was a lot more than I was hoping to lose. Because actually, prior to being diagnosed I was trying to lose weight, so that’s why I didn’t catch on right away. I was dieting and detoxifying, but yeah, I lost 42 pounds, had increased appetite, my stools were a little bit on the looser side. So yeah, the metabolism was sped up, accelerated, and hair loss is common, even though I don’t have a lot of hair. But again, I work with a lot of women who it’s really noticeable. And sometimes there’s thyroid eye disease, which is associated with Graves’ Disease, where someone could get eye bulging, double vision in some cases. And so on a blood test, that will present as elevated thyroid hormones, so T3, T4, the main thyroid hormones. And I mentioned TSH, so with hypothyroidism TSH is elevated, with hyperthyroidism TSH is low. And the reason it’s low is because it’s trying to slow down the production of thyroid hormone, so TSH in this case doesn’t want the thyroid glands to produce thyroid hormone. But-
Dr. Weitz: So, what particular level of TSH do you really get concerned?
Dr. Osansky: Well I mean, I would say optimal TSH would be between one and 1.5, and even between one and two depending on the person. If someone’s like 1.8 and everything else is great, I might not panic. For hyperthyroidism, I mean, if it’s a little bit below the reference range, like if someone’s like .8, I wouldn’t be too concerned. But really, when it gets like .5, .6, I start paying attention. But I’ll say this, with most cases of especially Graves’ Disease, the TSH is undetectable. So by the time they’ve seen me, usually the patient has already been diagnosed. It’s a little bit different with Hashimoto’s, as you know with Hashimoto’s it’s a long process. People could go like five, 10, 15 years before getting diagnosed, they might attribute the symptoms like fatigue and brain fog and waking to something else.
But when someone is having an elevated resting heart rate, and palpitations, and losing weight, it’s scary. So a lot of times they’ll go to the medical doctor not knowing what’s going on, get diagnosed. So usually, they’re already diagnosed when they see me. And then I’d say probably like 90% of the time, the TSH is non-detectable. There are some cases actually, I saw a patient today who had more sub-clinical hyperthyroidism, and the TSH… Actually, the recent TSH was undetectable. But more recently it was like .4 and .6 were some of the other readings. And I mean, that also is a little bit of a concern, but I mean, the thyroid hormones are to me more of a concern when they’re elevated. But yeah, like I said, a lot of people, arguably most people with Graves’ have undetectable TSH levels.
Dr. Weitz: And do most of the patients that you see with hyperthyroidism have the antibodies, the TSI?
Dr. Osansky: Yeah. I think you mentioned before, most of the time it’s autoimmune. So yeah, with hyperthyroidism most of the people who see me have elevated thyroid-stimulating immunoglobulins, or TSI levels. I do see some people with toxic multinodular goiter, where they don’t have the antibodies. And then there’s some other hyperthyroid conditions, like sub… Well, subclinical hyperthyroidism, even though you could have subclinical Graves’, where it’s not too common, where someone could have normal thyroid hormone levels, low TSH, elevated TSI. But yeah, to answer your question most people do test positive for TSI.
Dr. Weitz: Right. And so, would you say 80, 90% of patients with hyperthyroidism have Graves’?
Dr. Osansky: Oh yeah, definitely, I would say that, yeah. At least like 80, if not more, like [inaudible 00:09:04].
Dr. Weitz: Okay. And that’s basically when the TSI, when the antibodies are present, that’s when you diagnose Graves’, correct?
Dr. Osansky: That is correct.
Dr. Weitz: Right, okay. So what are some of the most common medical treatments for hyperthyroidism?
Dr. Osansky: Yeah, so typically most people with Graves’, hyperthyroidism will go to an endocrinologist, and there are three main treatments that they recommend. One treatment, anti-thyroid medication, and the most common medication at least in the United States is Methimazole. Some other countries will give Carbimazole, which converts into Methimazole. And then there’s another PTU, which is a different type of anti-thyroid medication. So a lot of endocrinologists will recommend the anti-thyroid medication, but then there’s two others. Another one is reactive iodine, which obliterates the thyroid gland. It involves a small amount of radiation, radioactive iodine. Well actually, the radioactive iodine does…
It depends on how much they give, so they give enough to obliterate the thyroid gland. Unfortunately, some people need multiple doses of the radioactive iodine. But I was thinking, there’s also what’s called a radioactive iodine uptake test, which we could talk about. But that involves a small amount of radioactive iodine, the radioactive iodine treatment actually involves a good amount of radioactive iodine, which you need to destroy the thyroid gland. So, that would be the second treatment. And then a third treatment would be surgery, some doctors recommend thyroid surgery, and there’s some reasons why they might recommend surgery instead of radioactive iodine. Like if someone has thyroid eye disease, and they receive radioactive iodine, it’s more likely to exacerbate the thyroid eye disease. So a lot of endocrinologists will not recommend radioactive iodine for those with thyroid eye disease, they’ll either give the person anti-thyroid medication, or if they think that… If the anti-thyroid medication isn’t tolerated, or if they just… It depends on the doctors, but some just are more aggressive than others, and some will just shunt to the surgery. So, depends on the-
Dr. Weitz: And when you say surgery, essentially you mean remove the thyroid gland?
Dr. Osansky: Exactly, remove the entire thyroid gland, mm-hmm.
Dr. Weitz: Right. So, what are some of the, from a functional medicine perspective, what are some of the most common underlying triggers, or root causes for hyperthyroidism? Because there’s a reason why the body’s gone wrong, why the immune system’s attacking the thyroid. In this case, attacking the thyroid TSH receptors, correct? Or thyroid hormone receptors?
Dr. Osansky: Correct, yes, exactly. So what happens is the immune system attacks those TSH receptors, and that’s… Yeah, so as far as… I’d talk about four categories of triggers or four main categories. So one, food, so certain foods can cause problems. Obviously we’re familiar with gluten these days, I’m sure your listeners… And same thing with Hashimoto’s, gluten can cause problems, and in some cases dairy, in some cases corn. I mean even salt, if you look at the literature, just with autoimmunity too much salt could raise Th17 cells, increase Th17 cells, which are associated with autoimmunity. So, food could be a trigger. A second one, stress. And when it comes to Graves’, there’s literature that shows the correlation between stress and Graves’. And we can’t say the… Or stress, I think, is a factor with all chronic health conditions, but just the research, like if you do some research on the PubMed, some autoimmune conditions, there’s really no correlation, according to the research. Now again, we know even if it’s not in the research it could be a factor. And that was, stress was a big factor with my Graves’ Disease condition, and we could talk more about that if you like. A third potential trigger, environmental toxins, we live in a toxic world and it’s not getting any better, and there’s heavy metals such as mercury, there’s xenoestrogens, Bisphenol A, there’s… I mean, glyphosate, which disrupts the gut microbiome. And then a fourth category of triggers, we have infections. So viruses such as Epstein-Barr, bacteria such as potentially H. pylori, Yersinia Enterocolitica, potentially even parasites. And it doesn’t mean that in everybody it’s a trigger, like we could have someone who has Graves’ Disease have H. pylori, and it might not be the trigger. But again, it potentially could be, and like I said there’s also literature to support that as well.
Dr. Weitz: So, patient comes in, you take their history, you go through. And then how do you decide which direction you’re going to go?
Dr. Osansky: Yeah, that’s a good question. I mean, I definitely do what I’d consider some basic tests, I do blood testing, complete blood count, comprehensive metabolic panel, vitamin D, need healthy levels of vitamin D to have a healthy immune system. I mean, even things like iron, like for example even though most people with hyperthyroidism, including Graves’, are women, men like myself could have Graves’. And when we think about iron deficiency, we might think of more cycling women. But we also don’t think of iron overload, which could cause oxidative stress, and also could be a factor when it comes to autoimmunity. And then I do look at adrenals, either saliva testing, or I’m sure you’re familiar with Dutch testing, dried urine testing.
Dr. Weitz: Sure, yes.
Dr. Osansky: So I look at adrenals, hormones, sometimes comprehensive stool testing, sometimes organic acids testing. So it does depend on… I can’t say I recommend all of these tests to everybody, but the basics like blood testing, saliva testing, I actually do some hair testing too, which goes back a number of years. Don’t rely on it completely when it comes to minerals and heavy metals, but I do still like looking at that. But yeah, sometimes I’ll do organic acids, sometimes I’ll do like I mentioned, comprehensive stool panel, I do a lot of those. And yeah, and sometimes other tests as well.
Dr. Weitz: Right, yeah. I saw where you’re doing that hair and mineral analysis, I remember doing that. We kind of went away from it, partially because I was concerned about the accuracy given all the exposure of hair products and everything else. But it’s also a little tricky, especially if you have somebody who doesn’t have that much hair, and now you’ve got to cut a big chunk out from the base of their neck or something. And then we tended towards some of these bigger nutrition panels, where they look at functional status of nutrients as well. So let’s start out with stress as a factor for hyperthyroidism. You said you like to do either the salivary adrenal stress testing, or the Dutch testing for that?
Dr. Osansky: Correct. When I was diagnosed with Graves’ back in 2008 I don’t think there was Dutch testing, if there was I wasn’t aware of Dutch testing. So I did saliva testing, and in my situation cortisol was low, like very low, DHEA, which is another adrenal hormone was low. I mean, everything was low. And the thing that-
Dr. Weitz: So, low the whole day, whereas it’s supposed to be elevated in the morning and then slowly come down?
Dr. Osansky: Correct, yeah. I mean, the first two levels were below the reference range, the third and fourth were on the lower side. But because, as you mentioned, yeah, it’s supposed to be lower later in the day it was still within range. But yeah, the first two are very low, and yeah, DHEA was also low. And I didn’t feel like that’s what some would refer to as like an adrenal fatigue pattern, when you have everything low. And I mean, probably because of the Graves’, again, I felt more hyper, I felt… Again, I didn’t feel low-energy at all. And so that’s why I’m a big believer in testing, and one could make the argument, “Well, maybe Graves’ is a little bit different because you have that hyper component, and you can’t always go by how you feel.” But yeah, I did saliva testing. And then these days I still do saliva testing, but it depends. I mean, if someone wants to do a deeper dive into the hormones, and what I like about the Dutch is that it also looks at the metabolism of the hormones, so a real-
Dr. Weitz: You do that Dutch complete?
Dr. Osansky: Correct. When I do the Dutch, yeah, I will do that Dutch.
Dr. Weitz: So what did you do in your case when you realized that you had low cortisol levels?
Dr. Osansky: Initially I was in denial, so I was surprised that my adrenals looked as bad as they did. Because I knew stress was a factor, I just thought I was doing a good job of handling the stress, which is another reason to do the test. That sometimes you have to convince people that their adrenals aren’t looking good either, and that definitely was the case with me. So I definitely started blocking out time for stress management, I mean I changed my diet even prior to doing the adrenal testing. And I took certain herbs, I took liquorice root, which extends the life of cortisol, [inaudible 00:19:00] complex, I took nutrients that helped support the adrenals. So a combination of herbs, nutrients, diet and lifestyle.
Dr. Weitz: So it’s interesting, because it’s a little bit counter-intuitive, because as a functional medicine practitioner I’m thinking, “Cortisol in the morning is what gives you energy to wake up, you’ve got hyperthyroid, you’ve got too much stimulation, too much energy already.” This seems like it might make it worse, but actually when you go by the testing, and you see what the body needs, and you give it what it needs, things balance out.
Dr. Osansky: Yeah, exactly. Yeah, right. I mean, cortisol is supposed to give you energy, and I definitely had energy when I was dealing with hyper. It’s funny how it works though, I will say going back to the symptoms, I should say that not everybody… I do work with people with hyperthyroidism that do experience fatigue, and there’s reasons behind that. Like it does affect the mitochondria and depletes CoQ10 in a lot of people, which, that could lead to low energy. And I also should add, before I mentioned I lost 42 pounds, and we don’t have to get into great detail with this. But some people actually gain weight with hyperthyroidism. I mean, sometimes it’s due to the anti-thyroid medication, but sometimes there are other factors. But yeah, getting back to the cortisol it’s just, you’re right. I mean, even though my energy levels were fine, increased cortisol could potentially increase even further. I think it played a big role in my recovery, and I can’t say I felt more hyper when addressing those cortisol levels.
Dr. Weitz: Yes, that’s really interesting. And so, while you’re searching for these underlying causes for their hyperthyroid condition, looking at stress, looking at toxins, looking at infections, looking at gut health, there are certain nutritional supplements and herbs that can help to manage the excess thyroid hormone, if you want to try to take a natural approach instead of either removing your thyroid or taking those drugs that block the thyroid.
Dr. Osansky: Exactly. So I mean, there definitely is a time and place for the anti-thyroid medication. And there are some people where the herbs aren’t effective, I’d say maybe like 20, 25% of the time. So if there’s a choice between taking the meds or receiving radioactive iodine surgery, I would say like go on the meds. But in my case, I took the herbs bugleweed and motherwort. And so bugleweed, it’s a herb with anti-thyroid properties, so it does help to lower the thyroid hormone levels. And so I started just with the bugleweed, but I was still experiencing some heart palpitation. So then I added the motherwort, and that did help with the palpitations. Motherwort focuses more just on the cardiovascular system. There’s lemon balm, which has a calming effect.
Dr. Weitz: I think in your book you describe motherwort as sort of a natural beta blocker?
Dr. Osansky: Yeah, it’s obviously a different mechanism than a beta blocker. But yeah, just to make a comparison, exactly.
Dr. Weitz: Right. And bugleweed is an anti-thyroid herb, right?
Dr. Osansky: You got it, yep.
Dr. Weitz: Now, what particular products do you like for this? I’ve used… Herb Pharm has a combo with bugleweed, motherwort, and lemon balm. But I know in your book you were saying that you’ve got to get the right dosage, and you like to see, I think you said sometimes a two to one ratio. And I noticed on the Herb Pharm, they don’t list the ratio.
Dr. Osansky: Actually, I think they… Well, they used to, it used to be one-to… It’s one-to-five, it should be, Herb Pharm. So yeah, I look for a one-to-two. It really depends on the person, I mean, there are people that, when they’re seeing me, the first consult they’re already taking something, because they just went online, and they got the Herb Pharm thyroid-calming formula, or someone’s… Actually someone I spoke with today, they were taking, it was something called Thyroid Soothe, which has the bugleweed, the motherwort, the lemon balm. And in this case, the person today, she seemed to be doing okay with that. So I won’t always switch into… The one-to-two is more potent, so it does depend on the person. And I’m a little bit biased, because that’s what I took when I was dealing with Graves’. I took the one-to-two extra [inaudible 00:23:49]-
Dr. Weitz: What product did you take?
Dr. Osansky: I took MediHerb, MediHerb has bugleweed and motherwort. But there are others, there’s Hawaii Farm has one that’s a one-to-three extract. And then yeah, there’s actually… There’s not a lot of, as you know, not a lot of companies that have bugleweed, because it’s not as popular as other supplements out there.
Dr. Weitz: Right. I saw Wise Woman Herbals has a combo product.
Dr. Osansky: Yeah. And one thing I should say too, which really, those were all formulas. But with bugleweed, or again, other herbal formulas, ideally you want to take the alcohol extract if you can tolerate it. Like, they use ethanol as a solvent, and if I have people… Like if someone goes to, let’s say some people, they might choose like Hawaii Farm because they have options for glycerine-based without the alcohol, but the alcohol extracts… It does a better job of extracting the phytonutrients, so it actually will do a better job. So if someone were to take an alcohol-free version of the bugleweed and it doesn’t work, it could be because it’s just not effective. Like maybe it doesn’t matter what bugleweed they would take, but it could also be because they took the glycerine-based version. So, that’s something for people to keep in mind as well.
Dr. Weitz: Oh, okay, okay, interesting. And what is the typical dosage, and how many times do you have them take it, and is it okay to take it in the evening, is it okay to… I guess it’s good to take it in the evening, because it’s going to be blocking the thyroid hormone. You want to take it apart from meals, before meals, after meals?
Dr. Osansky: Usually I recommend it 15 to 20 minutes before a meal, so away from meals. If someone can’t tolerate it on an empty stomach then they could take it with food, but it works a little bit better if the herb’s away from food. And then yeah, usually I recommend divided doses, like one in the morning, like one before breakfast, one before dinner. And then I mean, if someone’s having sleep issues also I might give lemon balm like right before going to bed, which has mild anti-thyroid properties, but just more of a calming effect. And as far as dosing, it does depend. Maybe an average dose would be a teaspoon twice per day, or five milliliters twice a day, sometimes I’ll give like half a teaspoon. And if they’re taking like Herb Farm, which is less potent, I might have them take two teaspoons, or 10 milliliters twice per day.
At least with the bugleweed. The motherwort is more based on the symptoms, so the bugleweed, we’ll put someone on a dose, and then we’ll see what the next thyroid panel looks like and see if we need to adjust it, similar to like anti-thyroid medication. With the motherwort it’s more symptom-based, so if someone starts with let’s say half a teaspoon twice a day, and it helps with their symptoms, their palpitations, then they might be good with that dose. If they’re still experiencing palpitations, then they might need to go up a little bit.
Dr. Weitz: Okay. What other natural agents are there?
Dr. Osansky: For symptom management?
Dr. Weitz: Yeah, for symptom management. I know you talked about L-carnitine.
Dr. Osansky: Mm-hmm, yep. So L-carnitine, typically L-carnitine tartrate in higher doses. The literature shows between two grams and four grams per day has anti-thyroid properties. So, that’s what I’ll give now. Again, sometimes people… Like I just took the bugleweed when I dealt with Graves’, just honestly I didn’t know about the L-carnitine back then. But some people will take bugleweed and L-carnitine. I had someone just recently I consulted with that they’re just taking L-carnitine without the bugleweed, but yeah, L-carnitine is also another option.
Dr. Weitz: And so, in your book you explain how it inhibits T3 and T4 getting into the cell nuclei? That’s kind of interesting.
Dr. Osansky: Correct. Yeah, at least that’s from the research that I did, yes.
Dr. Weitz: Okay, yeah. And we know cardiovascular problems often go along with hyperthyroid, and L-carnitine seems to be particularly beneficial for cardiovascular health as well.
Dr. Osansky: Mm-hmm, yep, yeah. It has a number of different benefits. So you’re right, bugleweed, I mean, all herbs have multiple properties. But still, it’s really known for the anti-thyroid properties. But you’re right, L-carnitine does have other health benefits as well.
Dr. Weitz: Okay. What other things can help with symptom management, natural agents?
Dr. Osansky: Lithium, so I can’t say I give lithium. And it’s really just based on more a habit than anything, just because the other agents usually work. But lithium carbonate, now that’s prescriptions. I don’t give lithium carbonate, but they discovered years ago that giving lithium carbonate can lead to hypothyroidism. That’s how some functional medicine practitioners like myself recommend lithium orotate, and it’s like a small amount, like five, 10 milligrams. And that’s not my first go-to, it’s probably like my third go-to after the bugleweed, L-carnitine. But it is another option if for any reason someone is unable to get the bugleweed, or unable to tolerate the bugleweed, and for whatever reason maybe can’t tolerate the L-carnitine, even though that’s not too common.
Dr. Weitz: And it could be helpful for mood disorders as well.
Dr. Osansky: Yeah, yeah, exactly. Yep, yep.
Dr. Weitz: And you also mentioned selenium is having some benefit?
Dr. Osansky: Yeah. I wouldn’t say so much as like an anti-thyroid agent, but selenium is… And I’m sure you know this with Hashimoto’s too, just, there’s a good amount of research. First of all, there’s research that shows that it could help lower TPO, or thyroid peroxidase antibodies, and then there is evidence that it could also help with the thyroid-stimulating immunoglobulins, there’s evidence hoping that it could help with thyroid eye disease by helping to reduce those TSI levels. So, yeah.
Dr. Weitz: Yeah, there’s an oxidative storm that occurs when there’s a lot of thyroid being produced, and it helps clear out some of that excess oxidation too.
Dr. Osansky: Exactly, yeah. So selenium is something that I recommend to just about everybody, usually starting at like 200 micrograms. Sometimes I’ll go higher, I try not to go too high, just fear out of toxicity. Most people could tolerate between like two, 400 micrograms. Some people go higher, but again, I get a little bit nervous if someone’s taking six, 800 micrograms per day.
Dr. Weitz: Right. Now, what do you think about iodine? We know that iodine is an important nutrient for the thyroid, in fact the difference between the different thyroid hormones, T4 and T3, is based on the number of iodine molecules in that hormone. So, we know iodine’s really important. What do you think about using iodine in such patients?
Dr. Osansky: So there, it’s interesting with iodine. And again, I definitely have experience with iodine in the past. And so I’ll say this, iodine, as a mineral it’s important. Like you said, it plays a big role in the production of thyroid hormone. And when you think about that you might wonder, “Well, why would you want to take it for hyperthyroidism if it helps with thyroid hormone production?” And with hyperthyroidism, you want lower thyroid hormone levels. But actually in higher doses, it could suppress thyroid production. The problem with iodine, and again, personally I’ve had a good experience with… I have not had any negative experiences personally. But the problem with iodine, especially like higher doses of iodine, is it can cause a good amount of oxidative stress, which you mentioned before.
And speaking of selenium, that’s why a lot of practitioners that recommend high-dose iodine will recommend selenium to try to offset that. But still, many times it’s not enough, and in some cases it could actually exacerbate hyperthyroidism, in some cases it could exacerbate the autoimmune response. So I mean, if someone is taking a multivitamin with iodine, I’m not going to tell them… I think that’s fine, I see most people doing okay with like a multi with iodine. If they’re eating regular food sources of iodine, I’m okay. If they’re eating higher dose, like sea vegetables, I’ll tell them to take a break from that. And again, everybody’s different. There are some people that eat seaweed, they do perfectly fine. But same thing with some people taking Iodoral, and they might do okay. But, just trying to be more conservative.
Dr. Weitz: So essentially, what you’re saying is, is taking what we would consider a modest amount of iodine, like 100 to 200 micrograms, MCG, is not a problem. But some who advocate higher dosages, say in a milligram level, that tends not to be helpful, is what you’re saying? In most patients.
Dr. Osansky: It could be a… Yeah, yeah, it definitely could be a problem. Again, I mean, when you say not helpful, like I said there are some practitioners who successfully use it as an anti-thyroid agent. And I guess you could make the argument that if someone is unable to tolerate the anti-thyroid meds, and the herbs aren’t effective, and they’re faced with taking high-dose iodine, versus radioactive iodine or surgery, I mean, I haven’t really faced that. There are other things like LDN, cholestyramine. But yeah, it is playing with fire. Again, I’m not anti-iodine, but it’s something where if someone takes especially like the milligram doses they could run into trouble.
Dr. Weitz: You mentioned cholestyramine, so that is binder that is sometimes utilized in programs to help bind to mycotoxins to get them out of the body when someone’s suffering from mold toxicity. If you could talk about that, and for those of us who can’t get a hold of cholestyramine because it’s a prescription, can other binders like nutritional binding agents have some benefit? And my understanding is the mechanism with the cholestyramine is, it’s binding to the thyroid hormone and reducing some of the levels?
Dr. Osansky: That is correct. So cholestyramine is, like you said, it binds to the thyroid hormone, and it could bind to mycotoxins. So you are correct, some practitioners who have prescribing rights might give cholestyramine in the case of toxic molds. And I will say this, if someone is listening to this, they have hyperthyroidism, and they can’t tolerate the anti-thyroid meds, and maybe the natural agents aren’t effective, if they go to the endocrinologist and they present the research, because that’s how I found out about cholestyramine. I don’t remember exactly, it probably was because I was looking into the cholestyramine and mold connection, and then just came across how it could help with people with hyperthyroidism.
Up until then I didn’t know, it wasn’t in my first or second edition of the book because I didn’t know at the time. But if you showed the research [inaudible 00:35:47] endocrinologist, well they will recommend. Now, if you show him like my book or my website they probably won’t, because they don’t want anything to do with functional medicine. But again, I’ve had endocrinologists prescribe it to patients, and it does seem to be pretty effective. Now, as far as natural binders, I haven’t gotten too aggressive. I have used some things like activated charcoal and zeolite, and I haven’t seen the same effect. But to be honest, I haven’t had a person take really high doses of the binders.
Maybe if I dramatically increased the binders, something that… Yeah, it’s one of those things where when someone’s dealing with hyperthyroidism too we want to try to lower the thyroid hormone levels as quick as possible. So I’ll give the bugleweed first, if that doesn’t work the L-carnitine. And again, I’ve tried regular doses of binders, like G.I. Detox, there’s different products out there. And I’ll go maybe like a capsule or two on an empty stomach, and I haven’t seen the same effect, maybe if I gave like five to 10 capsules [inaudible 00:36:54]-
Dr. Weitz: Yeah, yeah, you’ve got to use the powder, or yeah, give more capsules than that, yeah.
Dr. Osansky: Yeah. But it’s a good question, it’s something that I probably need to do more experimenting for for someone who is unable to… Where the bugleweed doesn’t work, and maybe the L-carnitine isn’t working either, maybe trying something like really high-dose binders, like natural binders for someone who either can’t take the cholestyramine or just doesn’t want to take the medication.
Dr. Weitz: Right. Somebody needs to do that study. And sometimes you recommend low-dose naltrexone? Or you’ve seen patients do well with that, because I know that’s a prescription?
Dr. Osansky: Yeah. I mean, it’s hit or miss. I mean, cholestyramine works with most people, anti-thyroid medication… I mean, methimazole, PTU work in most people, the problem is side effects are common. With LDN, low-dose naltrexone, side effects aren’t as common. I mean, some people will get insomnia, mild side effects. But it’s, again, a flip of the coin, maybe even less with Graves’. So LDN modulates the immune system and could be used for different autoimmune conditions, including Hashimoto’s. But again, there’s like an urgency to try to get the thyroid hormone levels down. And so usually if I recommend it, it’s when, again, someone can’t take the anti-thyroid medication and the natural agents aren’t working, then I’ll talk more about the cholestyramine, the LDN.
LDN is easier to get usually, because you could even just hop on a phone. There are I guess like ldndoctor.com, there’s different websites where you can just schedule a consult with a practitioner and just get a prescription for LDN, where you can’t do that with cholestyramine. But the LDN’s typically not as effective, but if it works it works well, because it modulates the immune system, and obviously Graves’ is an immune system condition. So if someone takes the LDN and it works, then they might not need to take any of these other things that we mentioned while they’re trying to address the cause of the problem.
Dr. Weitz: So let’s go into some of the other root causes besides stress. We’ve got toxins, infections, gut health, take it where you want to go.
Dr. Osansky: Sure. I mean, let’s talk about infections. So just a few years ago we got hit with a big virus, and-
Dr. Weitz: Oh, what are you talking, about what virus? Oh.
Dr. Osansky: Well I mean, the thing is with the COVID situation, it actually… I mean, business definitely increased when it came to hyperthyroidism. And it’s in the literature too, where… And there’s Epstein-Barr, there’s other viruses too. But yeah, I mean, [inaudible 00:39:56]-
Dr. Weitz: Yeah, a little bit of stress too.
Dr. Osansky: Yeah. I mean, with that question, I mean, and that’s a good point. When someone has, whether it’s COVID in the past, whether it’s Epstein-Barr, these other viruses, I do think of them more as immune system problems. And usually it’s other factors dragging down the immune system, and they’re like the-
Dr. Weitz: I mean, think about the level of stress. “Oh my God, I’m going to die, I have to wear this mask, and gloves, and I have to wash my bags before I bring them in, I have to wash my Amazon box.” It was like, oh my God, it was crazy.
Dr. Osansky: Yeah, no, I get… Yeah, you’re right. I mean, the stress… Yeah, that was a big factor as well.
Dr. Weitz: I got stressed just watching everybody else being stressed out, and scared [inaudible 00:40:43] to walk down the block without a mask on. I mean, it was crazy.
Dr. Osansky: Yeah. No, I agree. I mean yeah, we definitely can’t discount the stress, as we just had that discussion earlier on. But then there’s other infections, there’s like I said, the literature, H. pylori, Yersinia Enterocolitica. I understand correlation doesn’t always mean causation, so as I mentioned earlier just because you have H. pylori doesn’t mean it’s a trigger. But if I encounter someone with Graves’ Disease, and if they test positive for H. pylori, at least up until this point I’ve been one to treat it, and I’ve seen people go into remission. Now, I’m not only getting rid of H. pylori, so I could make the argument, “Well, maybe it’s because I’m not just getting rid of the H. pylori, but improving their adrenals, and healing their gut, and doing everything else.” But again, that’s what’s worked with me, and-
Dr. Weitz: So you’ll do say like a GI map, and see an elevated H. pylori. Let’s say you see slightly elevated H. pylori, but no virulence factors. Well, is that something that you’ll consider targeting?
Dr. Osansky: Yeah. I mean, if it’s red flags, yeah. I mean, with GI map, as you know it’s quantitative PCR, so a lot of times I’ll pick it up, but it won’t be elevated. And [inaudible 00:42:02]-
Dr. Weitz: Right, so it’ll be above detectable levels, but it’s not in the red?
Dr. Osansky: Correct, yeah. So I mean, it’s great when I see it less than DL, less than detectable limits. But yeah, if it’s above the range I’ll treat it. But again, it’s like the treatment’s going to be… It’s going to be like probiotic therapy, some herbal therapy, I definitely wouldn’t… I’m not advising the person to get the triple therapy with two antibiotics and the PPI. I mean, some people opt for that, and usually I’m telling them, “Well…” I mean, the thing with the natural approach, it does take longer and it’s not always effective. But the problem with the medication, as you know, it disrupts the gut microbiome, and it’s also not always effective. That’s why they use two antibiotics with H. pylori.
Dr. Weitz: Right. So you’re going to typically use some product that has mastic gum in it?
Dr. Osansky: Correct, yeah, exactly. So mastic gum, use some probiotics in there as well, use some other… Black cumin is one that works good, I mean, even garlic. Not supplement-wise, but there’s some evidence and research that eating raw garlic, like a few… I think it’s like two cloves twice a day, which I did try on patients. And sometimes if they’re symptomatic I’ve seen it reduce the symptoms, but-
Dr. Weitz: You don’t see fewer patients coming in after eating all that garlic? No, I’m just kidding. Okay, so we got gut health. Talk more about toxins, I mean infections. And you were talking about the big infection that we had, and it turns out that reactivation of infections that are sitting there, like Epstein-Barr, turns out to be one of the things that’s involved with long COVID.
Dr. Osansky: Yeah. I mean again, Epstein-Barr, cytomegalovirus, I mean, as you’ve mentioned, yeah, those-
Dr. Weitz: HSP, yeah.
Dr. Osansky: Yeah, so all those could potentially be factors. Parvovirus in the literature, hepatitis C, there’s some evidence with hepatitis C, and I believe both Graves’ and Hashimoto’s in the literature. So yeah, I mean, again, a lot of people have… I mean, everybody has viruses, most people have Epstein-Barr. So again, we can’t always make that relationship. And like I said, it’s different with H. pylori because I can’t say I never use antiviral, like natural antiviral agents, but most of the time I’m just looking at the weaknesses in a body, like trying to focus on improving adrenal health and gut health, reducing the toxic load rather than trying to directly attack the virus.
Dr. Weitz: So will you, say, order a viral panel?
Dr. Osansky: Yeah. I mean, usually I’ll… I mean, I’ll test for Epstein-Barr. It depends on the person too, sometimes they won’t want to test, sometimes they’ll just test Epstein-Barr. But I don’t go crazy with all the viruses, because like I said it doesn’t necessarily change my approach. Like Epstein-Barr I’ll test for, just because it’s notorious when it comes to being a potential factor when it comes to Graves’. But I can’t say like I have everybody test for all the viruses I mentioned, everybody test for Hepatitis-C, and Parvovirus, and all these other viruses.
Dr. Weitz: Right, right. Yeah, some of the companies offer like a panel of a number of the most common viruses, like we use Vibrant a lot.
Dr. Osansky: Yeah, I’ve used medical… If you’re familiar with Medical Diagnostic Laboratories, they also look at viruses. I’ll use them more if I’m thinking maybe the person also has Lyme, or Bartonella, which also could be potential triggers too. So then I’ll-
Dr. Weitz: Right. What’ll tip you off that maybe that’s a factor?
Dr. Osansky: Well, I have a history of chronic Lyme. In 2018 I was diagnosed, and it was tricky because I didn’t have the classic Lyme symptoms. Mine was more neurological, there was no evidence of a tick bite. So in my case, I wasn’t sure at first if it was Lyme, but it just was atypical symptoms. Like I was having neurological symptoms that was jumping around in my body, and with Lyme you get the… Usually it’s the pain, like the migrating muscle and joint pain. With me it was more the migrating neurological symptoms, and I spoke with a few practitioners that I knew, and I thought maybe it was MS. They were like, “No, it doesn’t sound like MS.” And then yeah, so I ended up testing for Lyme. I was thinking, “Well, maybe it is Lyme.”
And sure enough I tested, I tested positive for Lyme, Bartonella, a few other things. So with a patient it’s similar, like most people I’m not going to test for Lyme. But if they’re having some unusual symptoms… I mean, if they have like a history of a tick bite… Again, even then I can’t say I always test for Lyme, but that would be a red flag. But if they’re having some type of neurological symptoms, and things that just doesn’t tie into the hyperthyroidism, the Graves’ Disease condition, then I’ll at least bring it up as a possibility, if they’re having… Just because someone has neurological symptoms doesn’t mean they have Lyme or Bartonella, just because someone doesn’t…
If they have even fatigue with migrating muscle and joint pain, I’ll highly suspect Lyme, but it doesn’t guarantee. Today, one of the patients I spoke with, they had… In the middle of the night they woke up with night sweats, but they were drenched in the middle of the night. And she has subclinical hyperthyroidism, so her thyroid hormone levels are normal, TSH is low, which again, most of the people I deal with that’s not the case. So I didn’t think in her, I don’t think it’s the hyperthyroidism causing that. It could be hormonal potentially, she’s in post-menopause. But again, Babesia, if you’re familiar with Babesia parasite, that could also cause that too. So that was like, I was thinking, “Ah.”
You know, I wasn’t pushing it hard and saying, “Yeah, you definitely have Babesia.” But I’ve mentioned it to her that it could be a possibility, it could be hormonal, possibly thyroid, but just because her thyroid looks good… But yeah, so those are some of the things I look for.
Dr. Weitz: So in that case, you might do say like a Lyme and co-factors panel?
Dr. Osansky: Exactly, it’s something at least I’ll bring up, like when sending her followup recommendations. I mean, I spoke with her about it during the consult, I’ll bring it up with the followup again, and really leave it up to her. She might decide to look more into the hormones, but yeah. So it’s a possibility, is what I left it at with her. So [inaudible 00:48:52]-
Dr. Weitz: And how did you treat the Lyme in yourself?
Dr. Osansky: With the Lyme, when I dealt with Lyme I did panic a little bit, and I underwent IV ozone. I should backtrack, so first I thought it was acute Lyme, so I did take the doxycycline for a few weeks, which, I regret taking that. But a few weeks prior I was in upstate New York with my dog, and my dog was all over me that night, we were at a park, and I thought I got bit by a tick. Even though there was no evidence of tick bite I was putting the pieces together, because I developed like a low-grade fever right around that time. And I’m like, “Okay, this must be acute Lyme.” And of course I try to avoid the antibiotics, but one thing… Up until that point I was terrified of getting Lyme, and I’m like, “All right, I don’t want to take the doxy, but I don’t want it to turn into chronic Lyme.”
It turned out it was already chronic Lyme, so maybe it was like a reactivation or something of a past Lyme infection that I wasn’t aware of. But when I was diagnosed I worked with a functional medicine practitioner who was a Lyme specialist, and she told me I could take like long-term antibiotics, which I don’t want any part of, and she was talking about the ozone. And prior to my Lyme diagnosis I was doing research on ozone, and I was already sold. I knew it wasn’t a cure for the Lyme, but I was just looking to get aggressive, to try to make sure it didn’t turn into a real bad case of chronic Lyme. So I got IV ozone and UV light for a few months, and I took some homeopathy, I took herbs as well.
If I had to do it all over again… I mean, I can’t say I have regrets because everything turned out okay, but I probably would have been okay just the herbs, the homeopathy. I mean, I was already eating somewhat clean, the stress. I mean, stress is always going to be a factor, but based on my Graves’ experience I thought I was doing a better job of managing the stress and all that. So, that’s why I probably got aggressive with the ozone, because I felt like I was doing a lot of the things based on the Graves’ disease diagnosis, I was still doing things to maintain my health and I was like, just I want to… Yeah, so anyway I wouldn’t say it’s something that everybody should get, but that’s the approach I took.
Dr. Weitz: So let’s hit on the toxins a little bit.
Dr. Osansky: Sure. So heavy metals, mercury is probably the biggest culprit in the literature. I mean, aluminum is known to stimulate the immune system, but as far as like a relationship between Graves’ and aluminum there’s nothing in the research showing it. But I will say in hair testing though-
Dr. Weitz: I just want to make a comment, it was really annoying. I take a lot of supplements, and some of the companies put an aluminum little cap, when you unscrew the cap there’s an aluminum sealing thing. And you have to rip that off, and it’s so annoying handling aluminum. Anyway.
Dr. Osansky: Yeah. Yeah, no, I agree, yeah. But I was saying, hair testing, actually that’s one thing that it picks up pretty good. Almost everybody with the hair tests I do, it shows aluminum-
Dr. Weitz: Oh really?
Dr. Osansky: … which is interesting.
Dr. Weitz: Do you use Doctor’s Data, or who do you use for the hair testing?
Dr. Osansky: No, I use… I don’t know if you’re familiar with Analytical Research Labs?
Dr. Weitz: Okay, I’ve heard of them, I haven’t used them.
Dr. Osansky: Yeah, yeah, so they’re like almost everybody shows some levels of aluminum. I mean, not everybody like sky high, but it usually picks it up pretty well. So yeah, there’s mercury, there’s, again, aluminum that stimulates the immune system, cadmium, lead, arsenic. Again, not a lot of literature when it comes to thyroid and autoimmune with the other ones. With mercury there is, so if someone has mercury amalgams, again, I’m not going to push heavily to get them out. But I will bring it up, and talk about biological dentistry, and suggest even if they don’t get it out now something maybe to work on in the future. Like if they have like five silver fillings, even if they get out like one or two a year, before they know it they’ll all be out.
Whereas if they don’t do anything, in a few years they’ll still obviously be present. And then xenoestrogens, so bisphenol A from plastic water bottles, and other endocrine-disruptors. Just even things like… I mean, we don’t tend to… I mean, I’m sure you think of it, just like I think of it. But like the mattress, trying to use more natural mattresses.
Dr. Weitz: Absolutely, yeah. They’ve got the flame-retarding chemicals that they [inaudible 00:53:45] mattress and the [inaudible 00:53:45].
Dr. Osansky: Yeah, exactly, those flame retardants, and bringing your clothes to the dry cleaner. I don’t do a lot of dry cleaning, but if I do it’s, we use an organic dry cleaner. And then of course in the house, just trying to use natural products like cleaners and fluoride-free… Even though fluoride is more associated with hypothyroidism, disrupting thyroid function, but still using a… So one could make the argument, maybe we should take fluoride if we have hyperthyroidism. So seriously, I do recommend avoiding the fluoride, since it’s also a neurotoxin. Yeah, I mean, glyphosate I mentioned earlier, glyphosate, which disrupts the gut microbiome, which is a factor with all different autoimmune conditions, not just Graves’ Disease. And just, unfortunately we can’t completely avoid glyphosate in this day and age.
Dr. Weitz: Well you know, the reason why some people advocate avoiding fluoride for the sake of hyperthyroid is, it blocks the iodine because it’s in that same family. So therefore, even more reason to avoid supplementing with a lot of iodine, if you have hyperthyroidism.
Dr. Osansky: Yeah, yeah. Good point, with the halides competing with each other. So yeah, that’s [inaudible 00:55:01].
Dr. Weitz: Right, yeah. Consume more bromide on purpose.
Dr. Osansky: There you go. But yeah, just again, as you know… So there’s no shortage of environmental chemicals, and there’s so many we’re just not aware of also. So we’ve just got to do our best, and most of the things we can do are in our own home. Once we step outside, there’s not a whole lot we can do.
Dr. Weitz: Yeah. Vibrant Labs offers this Total Tox-Burden test through urine, that includes heavy metals, environmental toxins, like 30 different ones, as well as mycotoxins.
Dr. Osansky: Oh, interesting, okay. So it includes the mycotoxins too? Yeah.
Dr. Weitz: Yeah.
Dr. Osansky: Because I know Great Plains out there, Mosaic Diagnostics I think, they changed their name. But they-
Dr. Weitz: I think they got bought out, yeah.
Dr. Osansky: Oh, did they get bought? Okay, I didn’t know they got bought out. But anyway, so you have to purchase… I think you could get them as a bundle, but they have the separate mycotoxins test. But also it’s interesting, which I’m sure you know, they also now… They have Cyrex Labs, that does like immune system testing for environmental chemicals, to see your immune system response [inaudible 00:56:15].
Dr. Weitz: Sure. Yes, yeah, yeah, yeah. You can do immune system reaction to foods, to chemicals, to toxins, to infections, yeah.
Dr. Osansky: Yep, yeah. So there’s a lot more options these days than there was 10, 15, 20 years ago.
Dr. Weitz: Yeah. In testing, tests don’t guess. So, yeah. I think we’ve covered the topic pretty well. There’s any final thoughts you have for our listeners and viewers?
Dr. Osansky: Well, I would just say for those listening who have hyperthyroidism, I mean, the big thing initially is to be safe. You want to make sure, whether it’s the natural agents, or if you absolutely have to take the medication, just do what’s necessary to make sure those thyroid hormone levels are lower. So, you don’t have a resting heart rate of like 120 or 140. And it also affects bone density, we’ve got to keep that in mind when the thyroid hormone levels are too high. And then while you’re addressing the cause, whether it’s doing it naturally or even if you have to rely on a medication, obviously you want to do things to find and remove those triggers, correct those underlying imbalances. Because again, [inaudible 00:57:32] and thyroid surgery, I’m not saying there’s not a time and place for surgery. But, it’s not doing anything for that immune component of Graves’.
Dr. Weitz: You know, we should cover one more thing real quickly. We didn’t really talk about diet for hyperthyroid, and I know that that’s something that you take seriously.
Dr. Osansky: Yeah, no, that’s right, we didn’t cover… I spoke about food when we talked about triggers, but I just spoke about gluten and common food allergens, but you’re right. So yeah, diet when it comes to really any autoimmune condition, yeah, there’s no single diet that fits everybody perfectly, and I think you probably would agree with that, Dr. Ben. But yeah, I mean, I will say I do like paleo, I do like autoimmune paleo, but they’re starting points, they’re not… And we don’t want anybody to get really stressed out, so if I talk about autoimmune protocol, because it is quite restrictive. And the goal is not to reduce calories, that’s the last thing we want to do with someone, especially someone who is in a similar situation that I was when I was losing a lot of weight.
We don’t want someone to think that they can’t eat, they can hardly eat any food. So if they’re following AIP, assuming they’re not vegan/vegetarian, if they are that’s a whole different story. But yeah, definitely make sure you’re getting enough protein, eat a decent amount of meat if… And also I recommend vegetables, fruits. But some people do fine on paleo, where they’re eating eggs, they’re eating some nuts. Of course avoiding refined foods, sugars, the allergens that I mentioned like gluten, dairy, corn, avoiding nightshades, also something that not only I recommend but a lot of people when it comes to autoimmune. But yeah, I do recommend more of a paleo, AIP-type diet. If someone is vegan/vegetarian I’m not completely opposed to them modifying that, where they’re eating some pressure-cooked legumes to make sure they’re getting enough protein. Because a big problem with hyperthyroidism, you’re losing a lot of muscle mass too. So, you just want to make sure you’re getting enough protein.
Dr. Weitz: There’s certain foods, like cruciferous vegetables, that are considered [inaudible 00:59:53], that they block thyroid hormone. Is that a good idea in the case of hyperthyroid, to consume a lot of [inaudible 01:00:05] foods, like broccoli?
Dr. Osansky: Yeah, I’ve actually spoken about this, I think I mentioned in the book too. But on my website and in the podcast, I think I mentioned it in an episode. I tried intentionally to… Especially with pregnant women in the past, when working with pregnant women, and ones who didn’t want to take the medication, and they can’t take things like bugleweed.
Dr. Weitz: Herbs, yeah.
Dr. Osansky: And yeah, so and then even L-carnitine, there’s no research taking like two to four grams, like that high of a dose, I’m more conservative with a pregnancy about doing things like that. So I actually experimented, I figured there’s no harm in having them eat a lot of cruciferous vegetables to see if that will lower thyroid hormones. And honestly, it didn’t have much of an effect. So I would say, go for it if that’s what you want to do, but I wouldn’t expect that alone to have a significant impact on the thyroid hormone levels.
Dr. Weitz: Right. Actually, there is some interesting data on the benefits of L-carnitine for pregnancy, and I know Metagenics now includes a separate L-carnitine supplement as part of their prenatal.
Dr. Osansky: I guess the high dose is what I was referring to, like I don’t know, probably 500 to 1,000 milligrams, yeah.
Dr. Weitz: Yeah, yeah, yeah. I think they’re recommending like five [inaudible 01:01:22] yeah, yeah.
Dr. Osansky: Yeah. But like 2,000, I mean, honestly it probably would be okay if they took like 2,000. I just don’t know, that’s the-
Dr. Weitz: Yeah, I don’t want to take a chance with pregnancy. Okay, great, excellent. So you have two books out, right?
Dr. Osansky: Correct, so Natural Treatment Solutions for Hyperthyroidism and Graves’. As you said, I’m currently as of recording this getting ready to release the third edition. And then Hashimoto’s-
Dr. Weitz: When is that going to be released?
Dr. Osansky: I’m hoping by September, September 2023.
Dr. Weitz: Oh, okay. Are you self-publishing?
Dr. Osansky: Yes, yes, mm-hmm.
Dr. Weitz: Okay, great. And where will that be? Will that be available through Barnes & Noble and all the booksellers, or where?
Dr. Osansky: Yeah, that will be… You could go online to Amazon Online, Barnes & Noble. So yes, they could… Yep.
Dr. Weitz: Good. And then you have another book on hypothyroid, right?
Dr. Osansky: Correct. So in 2018 I released the book Hashimoto’s Triggers, which you could also… Actually, I don’t know if that’s on Barnes & Noble’s. I know that one’s, Hyperthyroid, but I think this one I just… Again, I self-published this as well, but this also is… I think this one is just on Amazon, both print book and Kindle.
Dr. Weitz: Okay, great. And how can listeners and viewers get a hold of you if they want to find out more, or possibly work with you?
Dr. Osansky: Well they could visit savemythyroid.com, and they could click on Work With Dr. Eric is probably the best way if they want to work with me. Or if they’re still not sure, they could click on Podcast, listen to some of my podcasts, and read my books. But yeah, I would say that would be the action they would want to take if they do want to work with me.
Dr. Weitz: Excellent. Thank you so much, Dr. Osansky.
Dr. Osansky: Thanks, Dr. Weitz. Appreciate your time, and thank you so much for having me.
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoyed listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way, more people will discover the Rational Wellness Podcast. And I wanted to let everybody know that I do have some openings for new patients, so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way. And that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective. So, if you’re interested please call my Santa Monica Weitz Sports Chiropractic and Nutrition Office at 310 395 3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.
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