Hypothyroidism with Dr. Jeffrey James: Rational Wellness Podcast 336

Dr. Jeffrey James discusses Hypothyroidism with Dr. Ben Weitz.

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Podcast Highlights

3:17  Hashimoto’s thyroiditis is the most common form of low functioning thyroid or hypothyroidism.  Dr. James noted that he has seen hundreds of women suffering with hypothyroidism and most of these women don’t even get tested for Hashimoto’s, since from the perspective of conventional medicine, if the woman has low functioning thyroid/high TSH levels, they will be treated with Synthroid or levothyroxine, which is synthetic thyroid hormone.  If it has an autoimmune origin, it doesn’t change the pharmaceutical outcome.  But if you have Hashimoto’s thyroiditis you have an immune system problem rather than a primary thyroid problem. We need to try to understand what would cause your immune system to dysregulate and want to attack your own body tissues?  Unfortunately, once you have one autoimmune disorder, you’re 50% more likely to develop another one.  Dr. James explained that a lot of women complain that they’re exhausted, they’re putting on weight, they’ve got brain fog, they’re losing their hair, they’re constipated, their skin is dry, they’ve got brain fog, they have this constellation of symptoms, and they’re cold.  When they go to their doctor, out comes the prescription for Synthroid.  Unfortunately a majority of women end up back in their doctor’s office after a few months or a few years and they don’t feel any better.  Their primary MD or endocrinologist then tries to dial in their TSH.  If they are depressed, then they get prescribed an antidepressant like Effexor or Cymbalta. If they have headaches, they get prescribed Imitrex.  If their blood pressure goes up, they are prescribed antihypertensive medications like Lisinopril or Amlopidipine or hydrochlorothiazide.  Dr. James sees a lot of these women who feel like they are not being seen or their complaints are not being addressed by their physician. 

9:10  Functional Medicine practitioners are not simply treating each symptom with a pharmaceutical drug to ameliorate that symptom but are looking at your underlying metabolism, physiology, endocrinology as well as the root causes of the autoimmunity that is often driving these imbalances that can often be corrected with diet and lifestyle changes.  The patient with hypothyroidism could have an underlying GI infection or a biotoxin illness. They could have a genetic susceptibility to not being able to process mycotoxins that are either in their environment or that are in their foods that they’re eating. They could have a Lyme infection. They could have a viral infection or a gut infection, a parasite or a bacterial infection in their gut that’s driving an immunological response.  Any of these things can create a low level inflammatory response that can affect thyroid production, conversion, or uptake, all of which create symptoms that are very similar.  From a Functional Medicine perspective we want to see which way the physiology is tilting and we want to see if their lab values are optimal and not just normal or not. 

11:05  The medical system in our country where once per year you go in for a physical exam with very minimal testing only to look for a pharmaceutical intervention is a failed system. Just look at how poor the health of our country is.  We need to test more widely to see how well our bodies are functioning.  For thyroid, we need to look at not just TSH but total T4 and T3, free T4 and Free T3, and reverse T3 as well as the thyroid antibodies. We need to trace everything back to the mitochondria of the cell and how our bodies produce energy.  We eat a meal and breathe some oxygen in and that glucose and oxygen mashes up against the mitochondria to produce ATP.  Even if you want to be energetic if your mitochondria are having trouble producing energy, then will make you down-regulate your energy use and your body will tend to keep you in bed and this may occur through thyroid under-conversion and you may see a low TSH and a low T4.  

We also need to look at the immune function and the level of natural killer cells, which are what might go in and attack the thyroid gland.  We need to look at liver enzymes. If there are gut symptoms like constipation or diarrhea we might want to do SIBO breath testing and/or stool testing. Dr. James also often runs genetic testing, including a DRB1, 3, 5, and a DQB test from LabCorp, which will tell you if you are susceptible to mycotoxins or other biotoxins.  If they have susceptibility to toxins, then he will run the Total Tox Burden test from Vibrant America. 



Dr. Jeffrey James is a Doctor of Chiropractic, a Chiropractic Neurologist, and a Functional Medicine practitioner and his office is LA Functional Neurology.  He has been in private practice in West Los Angeles since 1989.  His website is DrJeffreyJames.com. His office phone is 310-396-3100.

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, Rational Wellness podcasters. Today, we’ll be speaking with Dr. Jeffrey James about Hashimoto’s thyroiditis. The thyroid is a butterfly-shaped gland in the neck that’s responsible for the metabolism of every cell in our body. When the thyroid is functioning sluggishly, we refer to it as hypothyroidism. Hashimoto’s thyroiditis is the most common form of hypothyroidism in the US now that iodine deficiency is fairly rare since we started adding iodine to salt in the 1920s. Hashimoto’s thyroiditis is the most common autoimmune disease in the US. From a conventional medical perspective, Hashimoto’s is easy to address. Simply prescribe synthetic thyroid hormones, Synthroid, end of story. But from the functional medicine perspective, it’s much more complicated.   We want to know what are some of the triggers and causes of this autoimmune disease. What has led to a thyroid not functioning properly? What’s led to the progressive damage to our thyroid gland? We want to know what things might be inhibiting the proper production of thyroid hormone and what we can do to help the thyroid to work better and produce optimal levels of thyroid hormone. We want to know what factors are involved in the conversion of T4 to T3, et cetera. Dr. Jeffrey James is here to provide us with some answers. Dr. James is a doctor of chiropractic, a chiropractic neurologist, a functional medicine practitioner, and his office is LA Functional Neurology. Jeffrey, what else do you want to tell us about your background and yourself?

Dr. James:           So actually, the office is actually drjeffreyjames.com if patients want to look.

Dr. Weitz:            Oh, okay.

Dr. James:           Like you have two practices, the functional medicine side and the structural side. So the functional medicine side, they’re going to want to go to drjeffreyjames.com.

Dr. Weitz:            Okay.

Dr. James:           What do I want to add to that, about me? Nothing. You did a good job, Ben. You did a good job. That’s good. People don’t want to hear about me. I don’t care. They want to hear about what they can do for themselves, right?

Dr. Weitz:            Sure.  But you’re the expert, so they want to know who you are. So tell us what is Hashimoto’s thyroiditis, what should we think about it?

Dr. James:           So you already said it, so I didn’t know we were only going to talk about Hashimoto’s, but-

Dr. Weitz:            Oh, well, did you just want to talk about hypothyroidism in general?

Dr. James:           I think we should riff on all of it so people get a better understanding of what-

Dr. Weitz:            Sounds good.

Dr. James:           Hashimoto’s is the number one, the leading cause of hypothyroidism, at least in the United States right now. And as you said, the traditional medical treatment for that… By the way, I don’t know how often you see this, but I am specialized in hypothyroidism, Hashimoto’s for, I don’t know, a long time. I’ve seen hundreds of women with this. It’s primarily a female issue, but like 10, 15% of the cases are even tested for Hashimoto’s. So I guess, it begets the question of, first of all, if it’s the number one cause, why is it not the number one thing being tested? And what I’ve come to realize is because it doesn’t really change the pharmaceutical outcome.

Dr. Weitz:            Exactly.

Dr. James:           So if you have a tool in the toolbox and that tool is Synthroid or levothyroxine, generic form, it doesn’t matter whether you’re diagnosed with your TSH is high and you’re diagnosed with hypothyroidism or Hashimoto’s, the prescription’s going to be the same.

Dr. Weitz:            Exactly.

Dr. James:           But what your listeners need to understand, I mean, I think a lot of your practitioners will understand everything I’m talking about, nothing new there. But if you’re a patient and you’re dealing with this, then what you really need to understand is that if you have Hashimoto’s, you don’t have a primary hypothyroid problem, what you have is an immune system problem. It may eventually cause a primary hypothyroid problem, but really what you have is a dysregulation of your immune system. And then, you really have to start to understand, well, what would cause your immune system to dysregulate and want to attack your own body tissues? And the unfortunate thing is, according to the research, is that once you have one autoimmune disorder, you’re 50% more likely to develop another one and another one. So that’s a good starting place for them, right?

Dr. Weitz:            Yeah.

Dr. James:           Synthroid or levothyroxine apparently does have some protective properties in protecting against autoimmunity against the thyroid, but I think it’s pretty small. I think the bigger thing is is looking at if you’ve been diagnosed with Hashimoto’s. Well, first of all, let’s take a step back. A lot of women come and they’re like, they’ve been dealing with this for years, is the biggest issue, where they’re exhausted, they’re putting on weight that isn’t going away. They’ve got brain fog, they’re losing their hair, they’re constipated, their skin is dry, they’ve got brain fog, they have this constellation of symptoms, they’re cold. It really doesn’t take a rocket scientist and go, “Well, that sounds like hypothyroid symptoms.” So they go to the doctor and the doctor runs their lab tests and it says, “Oh, your TSH is high,” which means you’re hypothyroid. So out comes the prescription for Synthroid.

Dr. Weitz:            Correct.

Dr. James:           So a portion of those patients, as you’ve probably seen them, they get well. The doctor says, “Come back in a couple of months and let’s check you again.” So if you go back in a couple months and everything, you feel good. And your TSH is in that range. And in California, the lab range of LabCorp is 0.45 to 4.5, which is big enough to drive three trucks through side by side. It’s kind of a crazy range. But if you’re in that range and you feel fine, then you’re done. Then you go off to the races. You go off and enjoy your life.  But what happens is a large majority of women go back to their doctor after a bit and they’re like, they don’t feel any better. So the doctor is then playing the game, typically of just trying to dial in the TSH. So if it’s too low, then he’s going to back off on your TSH. If it’s too high, isn’t going to give you a bit more. He might move it from 88 micrograms to 100 micrograms or whatever’s starting places. And they play that game of just trying to dial in your TSH, which is one of about 24 different patterns of hypothyroiditis.

Dr. Weitz:            Correct.

Dr. James:           There are five real primary ones, but there’s 24 different patterns. So once he’s got that TSH dialed in, the woman goes back and goes, “Well, I still feel like crap and I’m not losing the weight.” Well, you must just be depressed. So now, out comes the Effexor or the Cymbalta, and the antidepressants. And then, they start getting headaches. Well, now here comes the Imitrex. Well, now another 10 years go by, the blood pressure’s getting worse, so here comes lisinopril and amlodipine or Diovan or hydrochlorothiazide or one of those.  And then, what I see is a lot of the women that I get to see are typically, they’ve gone down this road for so long, they feel gaslit by their practitioners. They don’t feel seen. And our culture, it’s doubled down for women because our culture doesn’t really honor women as they age, let’s say, so they don’t feel seen in public. I remember my brother saying this to me. It made me laugh really hard, but I was like, “Wow, this is how women feel.” My brother, when he turned 60, he’s like, he goes, “I’m sitting in a restaurant alone.” He goes, “Women don’t even walk in and go look at me and go attractive, unattractive, because it’s like I’m a potted plant.” They don’t even notice.

                                I laughed at him, but I’m like, “God, this is how I think a lot of women feel.” And then, they don’t feel, maybe the health issues and other things are creating conflict in their marriages. They don’t feel seen by their husband, their spouses, their partners, and they go to their doctors and doctors are like, “Everything is fine.” Why? Because they’re looking at the TSH and that’s dialed in, and yet they still feel like crap. So by the time they hit 60s, then the number one thing I see happening with women, and maybe you see this too, is they’re either pre-diabetic or they’re diabetic. So now, out comes the metformin with the glyburide or the glipizide are now the new wonder drugs, Ozempic and Wegovy, and all these new things that are GLP, GLP-1 agonists.

Dr. Weitz:            Of course, you can’t get a prescription of those for diabetes because so many people are taking them for weight loss that there’s none available.

Dr. James:           And you hear about the people who are complaining of freaking out because it causes gastric paralysis.

Dr. Weitz:            A whole series of GI problems. Causes gallstones, causes pancreatitis, gastric paralysis, intestinal obstructions. When a large number of people are taking a drug for a reason other than what it’s prescribed for, you’re sort of asking for trouble.

Dr. James:           Agreed. And even if you’re taking it for what it’s prescribed for, what we do as functional medicine practitioners is not just go, “Oh, that’s not working. Well, let’s give you a drug to replace the thing that’s not working.” Is to go, “Well, why is the thing not working?”

Dr. Weitz:            Right. So basically, what you’re describing is the problem that a lot of people are facing chronic health problems with conventional medicine, which is simply treating each symptom with a pharmaceutical drug instead of looking at the underlying cause of what’s happening to your metabolism, your physiology, your endocrinology, and what can we do to change your diet and lifestyle, et cetera, to get to some of these root causes.

Dr. James:           Yeah, right. So that’s certainly one level of it. And then, the other level of it is, so autoimmunity is its own beast. But then, the problem is is that I think what I see because I treat a lot of thyroid patients is, number one is that we’re often blaming the thyroid for other issues that are going inside the body. It’s a little bit like blaming the thermometer for the weather. So sometimes, the thyroid is dialed in, but the symptoms look the same. So somebody could have a GI infection, they might have a biotoxin illness. They could have a genetic susceptibility to not being able to process mycotoxins that are either in their environment or that are in their foods that they’re eating. They could have a Lyme infection. They could have a viral infection or a gut infection, a parasite or a bacterial infection in their gut that’s driving an immunological response.   And any of these things that create these low level inflammatory responses, not only do they affect thyroid conversion and thyroid uptake and the manufacture of thyroid hormones, but a lot of these things cannot affect the thyroid and just in and of themselves create symptoms that look very, very similar. So this whole idea of this once a year physical is clearly a failed system. Look at the health of our country. It’s just a failed system to run minimal tests. So you have to look wide to go what’s going on with the patient’s body? So I think the model that we’ve all been brainwashed and grown up inside of is one where doctors test in a limited fashion because they’re looking at like, is there a pharmaceutical intervention? And what we as functional medicine doctors are doing, we’re looking at, well, where’s the physiology tilting?

                                So if I see a few things off over here, even if they’re in range, doesn’t mean they’re optimal. And how is that impacting and how does that affect what’s going on over here? Are your liver enzymes too low? Are they too high? How’s your kidney functioning? How’s your carbon dioxide? Oh, one of the things that I see commonly is how if you trace everything back to the cell and you go back to our eighth grade biology, and you look at the mitochondria as an example. So the way that we make energy is we eat a meal, we breathe in some air, and that glucose and oxygen mashes up against the mitochondria to produce ATP. The byproduct of that is two things, well, free radicals and carbon dioxide. So you look at like, well, there’s a lot of free radical production.  So if you drive a car and you don’t change your oil regularly, what happens? Your car becomes less efficient, and maybe you start screwing up your engine. You get less miles per gallon, and maybe it eventually it seizes up or it stops working entirely. And our bodies, when we’re producing free radicals and we live in a more and more toxic environment, and we start to accumulate these in our body, then what I see often is the body is downshifting. It’s saying, “Hey, man. I don’t want to make energy because my primary goal is to survive. So if I increase my metabolic activity, it’s a kamikaze run for me.” If you wake up in the morning and decide and looks up and goes, “Come on, I want to wake up with energy today and I want to lose weight.” And your mitochondria look up and go, “Yeah, I’d rather make you fat, lazy, and stupid, but I’m going to stay alive, so I’m going to keep you in bed.”

                                So the body has a way of compensating. It may create thyroid under conversion patterns. It may create what I would call a pituitary suppression pattern where you see a low TSH and a low T4, you go, “That doesn’t make sense. If you’re going to see a low TSH, you should see the T4 cranked up. I regularly see that.” You’re not going to see this in the books. I call it like a pituitary suppression pattern where it’s almost like your hypothalamus and pituitary see so much inflammation in the body. It’s like, “Oh, there’s enough T4 and T3, we’re just going to keep it like that.” So it’s not cranking out, yet the T4 is low. That’s not a normal pattern. Even if it’s inside of a lab range, it makes you wonder, well, what the heck is causing that? Why would the TSH be on the low end and see maybe your T4 is like-

Dr. Weitz:            Those who are listening, you’re talking about some of these labs like the TSH, the T4, the T3. How about if we do a little defining exactly what those are?

Dr. James:           Sure. So TSH is a hormone produced by your anterior pituitary gland, it’s called thyroid stimulating hormone, so it stimulates your thyroid. The pituitary, if you look behind that, is dependent upon hormones being produced by your hypothalamus, which is dependent upon adequate levels of serotonin and dopamine, iron, all these things behind it. But let’s just stay here at the pituitary level. Rabbit holes go-

Dr. Weitz:            Pituitary’s the master gland that’s kind of directing the other glands like the thyroid.

Dr. James:           It’s the conductor, right?

Dr. Weitz:            Right.

Dr. James:           So pituitary secretes this thing called thyroid stimulating hormones. So it stimulates the thyroid to make two hormones called T4 and T3. The majority, as you know, 94% or something, depending upon who you look at, is T4. A small minority of it is T3, but T3 is the active hormone that every cell in our body has a receptor site for. So really, the T4 is really used for the feedback loop. There’s some T3 there too. So as long as the thyroid’s producing enough T4 and T3, you see that thyroid stimulating hormone inside LabCorp’s range of what, 0.45 to 4.5. For years, we used to say, the endocrine society said the optimal range is 1.8 to 3.0. And lately what I’m seeing is 1.5 to 2.0, very hard to keep somebody, you’d have to be tested them every month to keep them inside that tight little range. I personally feel better when my TSH is closer to one. I just feel better. So we treat people, not labs, but we use the last foremost of what’s really showing up there.  So anyway, so the thyroid produces T4 and T3. So if the majority of it is T4 and the minority of it is T3, but yet every receptor site in our body or every cell in our body has a receptor site for T3, then we obviously need to convert that T4 to T3. So the majority of that occurs in the liver, again, why liver function is so important as it relates to thyroid function. And then, another percentage, that 20% or so is converted in the gut, the rest in the peripheral tissues. So that’s sort of the big story.

                                Now, if somebody has Hashimoto’s, this means that their immune system has targeted the thyroid for destruction. So I don’t know if everybody understands this concept, but having high antibodies is not equivalent to high natural killer cell activity. So natural killer cells are the cells that actually go in and destroy the thyroid. So you can have very high antibody counts and have very low natural killer cell activity. You can have very low antibody counts and have very high natural killer cell activity.

                                So I, like you, meet with practitioners, you’ve been amazing in terms of how much you’ve given of yourself to put all of us practitioners together and invite experts in to speak and it’s been very selfless of you. But sometimes I’ll hear people go like, “Oh yeah, I cure Hashimoto’s.” I’m like, “Really? How do you know?” “Why, I don’t see the antibodies anymore.” I’m like, “You don’t understand how the immune system works. That’s not how this works. Nobody’s found the cure for this.” So I want people to be careful. If you could attest Hashimoto’s, you can see antibodies one day and not see them the next. They can be high and then they could be low. And you go, “Aren’t I amazing?” Well, maybe, or maybe you’ve just screwed up the patient’s immune system’s ability to fight something. So it’s just again, a small piece of the picture. Let me come back to where we-

Dr. Weitz:            Yeah, I do think when it comes to measuring the antibodies too, we have to be careful not to freak out if the antibodies are slightly elevated as compared to elevated a lot.

Dr. James:           Correct, because of that dysrelationship between natural killer cell activity. Now, if somebody has had Hashimoto’s for 25 years and they’re hypothyroid symptoms, then we need to be concerned. And these people would go like, “I don’t want to be on thyroid hormones.” If half your thyroid’s destroyed, you’re going to need to be on some sort of thyroid replacement. There’s no natural equivalent to that. Just like I tell my patients, “If you have type one diabetes, you need to take insulin. Your pancreatic islet cells don’t make insulin. You need some sort of source or you die.” But let me come back to the Hashimoto’s model. So what gets confusing for patients who have Hashimoto’s is the TSH levels, I don’t know if you see this, they’re up and down, up and down, up and down.

Dr. Weitz:            Sure.

Dr. James:           So somebody has a flare up, their immune system gets activated by either a food they eat, something exogenously walk into a room where it’s formaldehyde off gassing, who knows? They’re exposed to mold. So their immune system flares up and it goes after the thyroid. And now, you have this natural killer cell activity. And what happens is in that moment of the flareup, it’s poking holes in the thyroid. So it’s destroying the thyroid, but it’s not destroying the thyroid gland. So it’s like popping a water balloon. So you pop a water balloon, the balloon is destroyed, but you get water all over yourself.  So in that moment, you have the normal production of thyroid hormone, and then you have this excess production from the destruction of the thyroid. And you may have 10 days a week, two weeks, a month of feeling hyperthyroid, where a patient feels anxious and they have this inward trembling and their heart’s beating fast, and they’re wired and tired, and they got all this stuff. And then, when the immune system flare wanes down, and by the way, if you were to do a test, TSH, in that moment, you might see the TSH being really suppressed. So they go to their doctor and they go, “Wow, the TSH is really low. Now we’ve got to back off on your Synthroid.”  So they lower the dose of the Synthroid, and then when the immune system flare wanes down, they’re just, “I’m so depressed, I’m so tired, so I can’t move.” And now, they’ve lowered their thyroid hormone down. Now, if they ran their TSH, it’s actually really high after the flare up, and the doctors in effect made them even more hypothyroid but backing off. So a lot of patients are going and seeing, and the doctors aren’t really necessarily paying attention to that mechanism because they’re just adjusting for TSH.

Dr. Weitz:            Sure.

Dr. James:           So this is one of the big things that I think women in particular need to be paying attention to and looking at. So if you’re feeling anxious, then you’re cranked up and then you’re exhausted, then you feel anxious, and then you’re exhausted, you’re going back and forth that, that sounds very much like a Hashimoto’s patient. You’re not crazy and your doctor’s just trying to dial in the TSH, and the problem is nobody’s really paying attention to why is your immune system flaring.

Dr. Weitz:            Right. So let’s talk about that. When you see a patient who comes in and they have elevated TSH, maybe they’re already on thyroid and you measure their antibodies or TPO, their TGB antibodies and you realize that they have Hashimoto’s, what’s your next step?

Dr. James:           Well, I look at the rest too. So you’re looking at T4, you’re looking at total T3, you’re looking at free T3, you’re looking at reverse T3. You want to see what the body’s doing. I’m looking at a liver panel. I’m looking at liver enzymes. I’m looking at everything to go, “Well, what’s going on here?” So if they have Hashimoto’s, well, we know there’s autoimmunity, and the concern is based upon the patient’s history, are there any other potential autoimmunities? If there are, maybe we’re looking at doing some other antibody testing to see what’s going on there.  But then, really to get to the root of it, it’s based upon a consultation, Ben. So you talk to the patient, they’re like, “I feel like after I eat, I’ve got a brick in my stomach. I’m really gassy. I have alternating constipation, diarrhea.” Well, I don’t know, maybe you’re doing some SIBO testing. Maybe I’m doing a stool test to find out what’s going on there. I also do genetic testing. So I do this with almost every patient now. I always look for any kind of susceptibility genetically to mycotoxins or any biotoxins, really.

Dr. Weitz:            Which genetic panel are you running?

Dr. James:           So I do a DRB1, 3, 5 and a DQB test. And then, you just go, you plug it into a calculator and it tells you, “Hey, are you multi-susceptible? Are you not susceptible?”

Dr. Weitz:            So which test is that and which lab is that from?

Dr. James:           I just use LabCorp. We can just go in there and Google it. I can send it to you off. It’s not a problem. So you run that and you go, “Okay, this is a patient who maybe has a potential for biotoxin illness.” But based on the history, you go, “Is this something I need to be looking at?” If so, then I’m probably running a total tox panel on them.

Dr. Weitz:            Right, the Vibrant America one.

Dr. James:           I like Vibrant America. I used to use Great Plains, but Vibrant America tests more analytes for less money. So you can do, I look at mycotoxins, environmental toxins, and heavy metals altogether.

Dr. Weitz:            Right. I like that test too.

Dr. James:           They’re great tests. You run on yourself, it’s kind of shocking. For me, it was. I ran one 10 years ago and I was pretty good. And then, I ran one four years ago and I went, “Oh, no. Oh God, where’d all this plastic come from in my body?” In any event, so you look at those things because a lot of these things are endocrine disruptors. A lot of these things are carcinogens. A lot of these things affect your kidneys, your livers… Your livers, your liver. So you got to look like… You could have two livers. You could. Unlikely, but you could. Never 100% sure that you don’t. So you start looking around the body and going, “Okay, well, are they regulating their blood sugars or anything going on there? Do they have insulin resistance?”

                                Well, why do you have insulin resistance? Again, I mean, I’m sure you see people particularly out here, some people eat really, really well and you go, “What the heck is going on that they’ve got a high fasting glucose, but their insulin is okay, and their HbA1c is okay, or they’re eating well and their insulin’s really high and their glucose is high, and their HbA1c is high.” And you’re like, “What the heck is going on?” Well, maybe that’s a compensation, as we talked about before, where the mitochondria going, “I’m going to create insulin resistance here. I’m going to shut down some thyroid production because I want to shut down metabolism, otherwise I’m destroying myself.”

                                So I think conceptually, I’m always looking at, is this the body’s compensation or is this a primary issue? And if it’s a compensation, well, from where? So autoimmunity is fairly near and dear to my heart because many years ago I diagnosed my daughter with PANDAS. So for those who are listening, it stands for pediatric autoimmune neuropsychiatric disorder associated with strep, but the strep heart is like nonsense because really it could be any vector. So my daughter never tested positive for strep, but she had the antibodies against her brain, and that’s antibodies against your basal ganglia is not a cool thing. So basal ganglia are what really? Gate perseveration of thought and motor control. So kids can develop ticks, their behavior goes out.

                                I remember my daughter is really bright, and I remember years ago showing her something, and I think it was the word cat, and she was like, “Dad, I don’t even know what I’m looking at.” I’m like, “Oh, wow.” That’s heavy, right? It’s scary. She’s doing great now, but it was like, I took her to the top neurologist, I will not mention on the East Coast, I want to strangle her. And I had done a bunch of tox panel tests on her, and there was a lot of crap in my daughter. And you’re like, “At that young age?” And she goes, “Oh, it doesn’t matter. It’s just in her urine.” I said, “Well, what comes before the urine? Why is my daughter spilling signs?” “No, no, it doesn’t matter.” “What do you mean it doesn’t matter? How can you be a pediatric neurologist and say that?” I was like, grab my daughter-

Dr. Weitz:            Doesn’t fit into her paradigm.

Dr. James:           Made me so depressed. Made me so depressed. We’re like, “We’re on our own here. We’ve got to figure this out.”

Dr. Weitz:            Well, she wouldn’t know what to do with it anyway.

Dr. James:           Well, and I said, “I didn’t even chelate this out. It wasn’t like I gave my daughter glutathione for four days and then did the test. She’s literally spilling this much crap out of her system. How can you say that this doesn’t have an impact on her immune system?” She didn’t have an answer.

Dr. Weitz:            It’s just not a test that’s part of her worldview.

Dr. James:           Clearly, right? And it’s interesting to me because as a neurologist, what got me interested in all this other stuff was when you start to study neurology, then you’re like, “Oh, God, there’s so much to know in neurology.” And then you’re like, “It gets worse, because now you got to understand everything that impacts the nervous system,” which now, you step into the world of functional medicine and look at all these different inflammatory models because there is the neuroendocrine immune system. There’s the psycho-neuro-endo-immune system. This isn’t like the system of neurology only. And I’m looking at this woman going, “Really?” It’s astounding to me that in this day and age, that you could be that locked in.

Dr. Weitz:            Unfortunately, conventional medical specialists are siloed. Neurologists are just looking at the nervous system and the brain and that’s it.

Dr. James:           Yeah, some are. There’s a great guy here in Santa Monica refer crazy cases to, who’s really a terrific neurologist. But I mean, and endocrinology, my mother, part of why I have this interesting is my mother had her thyroid removed when I was probably seven or eight years old, late 60s. And I watched her yo-yo, man. I mean, she was angry and just overweight, and she drank two half gallon bottles of Tab every day, sugar-free type. Remember that stuff? You’re old enough, right?

Dr. Weitz:            Yeah. Absolutely.

Dr. James:           Right. I mean, she did the Atkins diet, she did the grapefruit diet, she did fricking everything, and died at 63. I’m two years away from that. She had cancer. Do I have evidence that the Tab caused that? No. But her diet and everything in her thyroid dysfunctioning, and I guess the point is is I don’t see endocrinology being practiced a whole lot differently today than it was 50 years ago. I just don’t see it. And in what other realm, really, in what other the realm do we not see advances in technology, medicine, science, et cetera? It’s the same game. It’s the same well, we’ll adjust your T4 and your T3. And that’s the scary thing.

                                So I do webinars and stuff and people say, “Well, what’s the ideal range of T3?” I’ll tell you, “It’s 3.2 to 4.3.” But I’m scared to say that sometimes, because then they’ll go to your doctor and go, “Give me Cytomel so that I can dial this into 3-point…” Again, what if your body is downshifting and trying to say, “Hey, there’s too much crap in the system. I’m going to slow down the conversion.” But we’re smarter than our bodies, so we’re going to override that and give you T3 and burn the engine out.

                                So I think when we start to look in those silos, when we start to look at these labs and try to go like, “Well, what are the ideal numbers?” I mean, it’s a good idea to know what they are, but it’s also a good idea to know, well, what’s influencing those numbers and why is the body doing what it’s doing? Is it a primary issue where the body just can’t convert. No matter what, everything else is clean, fine, do a T4, T3. But if it’s not, well, maybe you’re screwing the body up by actually putting them on a synthetic hormone of T3 as an example. Off my soapbox about that.

                                So to answer your question, so the initial question was like, so what do you do? You listen to a patient, I listen to my patients and go, after doing this for a long time, you get a sense of like, well, what direction, what test do I need to go? What roads do I need to go down? What do I need to test to look? Every now and then, it’s pretty rare these days where I don’t find what I think is one of the primary issues in the first round of testing. And I go, well, I need to look further. Every now and then, you get somebody who’s complicated.

                                Autoimmunity is really complicated. Autoimmunity in and of itself is an inflammatory condition, as you know. So if somebody has Hashimoto’s, then in and of itself is an inflammatory condition. And inflammation, we’ve known this since the ’90s, I have an old, somewhere around here, I have a laminated, think in the LA Times like being published, a patient brought it into me because I was talking back in the ’90s about how inflammation connects all chronic diseases together, and somebody brought it into me and I laughed. I was like, “See?” I mean, it’s so cool 25 years later. But we know that. Why do we pretend that that’s not the issue, Ben? In our system, we pretend that chronic inflammation isn’t at the root cause of whether it’s diabetes, it’s hypothyroidism, it’s heart attack, it’s stroke, it’s cancer. That’s what it is. So the name of the game ought to be, ought to be, that’s what we do, is looking for that thing that’s driving the inflammatory.

Dr. Weitz:            I think what’s happened is it’s become a buzzword. People say, “Yeah, it’s inflammation.” And then, they just prescribe the Synthroid and move on, because it’s complicated, because it’s expensive to do all this testing to figure out what’s going on. You have to spend time, you have to make changes to your diet and lifestyle, et cetera, and it’s a lot easier to just take a pill.

Dr. James:           I agree. But the in amenity of it, is it really expensive to get sick?

Dr. Weitz:            Absolutely. Look-

Dr. James:           I think you have a byline in your emails that speaks to that, right?

Dr. Weitz:            Yes, absolutely.

Dr. James:           What does that say again?

Dr. Weitz:            Sorry, I forgot. But it-

Dr. James:           Tell me if you’re like, those who don’t like to take the time to take care of their health now, certainly will like-

Dr. Weitz:            Exactly. Yeah.

Dr. James:           … find out it’s more expensive to take care of it later.

Dr. Weitz:            Exactly.

Dr. James:           I think… Go ahead. Sorry.

Dr. Weitz:            Yeah, I’d like you to address, there’s kind of two issues with this testing thing that I think doesn’t get talked about from the perspective that we have enough, which is on the one hand, patients go to their primary care doctor and get a set of labs, and somehow they’re convinced that all the tests that could possibly be run are run. And I think it needs to be emphasized to people who are listening to this that when you go to your primary care doctor in general and get your labs done, it’s a very limited number of labs, it’s only what the insurance wants to pay for. Typically, about all you’re getting is a CBC, a chem screen, maybe they’re going to do your TSH, maybe you’re going to get a basic lipid profile, and that’s typically all you’re going to get. Now, they might put each test on a separate sheet of paper and make it seem like a lot of labs.

Dr. James:           That’s so annoying, right? Patients come with their phone and go, “Look.” And you got to look at-

Dr. Weitz:            Exactly, you got to go through one thing, WBC on one page, RBC on the next page, and then I show them a Vibrant America labs that we’ve done, and the whole chem screen is on one page, and this is out of 20 or 30 pages of labs. So first of all, patients need to know that the labs that you’re going to get from your typical primary care doctor physical exam are very limited. And that labs can be very helpful in trying to get an idea of what’s going on in your body, trying to determine some of the underlying physiology. I also think there’s a trend in functional medicine where there’s a relatively small number of functional medicine doctors who get on this high horse and say, “Oh, all the other doctors do too much testing. We don’t really need to do testing and just take this probiotic and you’ll be okay.”

                                And so, I think that’s also a limited way of looking at things. And so, I think judicious professional doctors like you and me, we are doing more detailed testing and we’re careful with how much is being spent. We understand that patients have finances, but it’s important to get an idea of what’s going on with your underlying physiology, with these different processes, with toxins, with these things that are affecting your health and over a period of time can lead to all these chronic diseases. And that’s why your patients are just getting treated with one drug for a different symptom after the other.

Dr. James:           Yeah, I mean, we live in a disease management system.

Dr. Weitz:            And the functional medicine model is reasonable and rational and is really the only way to figure out some of these underlying things going on inside our patients.

Dr. James:           Agreed. So there are some doctors, I know some functional medicine doctors that charge, they want $3,500 in testing before a patient even walks in the door. I mean, good for them that they have that kind of practice. I mean, I don’t do that, but patients need to understand that if they want to get well, they’re going to have to spend some money. And I don’t know what’s more important than your health. Honestly, so many people can’t make their health their number one priority and everything in their world falls apart as a result of that. When you offer yourself and you take care of this first, everything else seems to fall into place somehow.

                                And it’s like this lack of, or this expectation, as you said, I guess insurance will pay for my doctor. I mean, I have this saying around here, that was a waste of poke and a hole in your vein, that blood test. A CBC without a differential, a TSH, maybe a T4. And then, you go back or patients will say, “Well, can I get my doctor to run these labs?” Sure. And 99 out of 100 times, we get a third of what we asked for. And then, you go back and you ask them, “Why?” It says, “Well, it wouldn’t change the pharmaceutical outcome.” So we’re looking again, as a functional medicine doctor, we talk about root cause all the time. What does that really mean? It means we’re looking at where is your body not functioning? Where is it functioning and where is it not functioning? Because it tells a story to us of where there’s a breakdown in your physiology and then where to look down, what rabbit hole to go down.

Dr. Weitz:            The other thing has to do with the fact that, I am not sure if everybody’s aware of this, but doctors are not running the healthcare system. It’s insurance companies. And so, I have a good relationship with my primary care doctor and he refers me patients, and I refer him patients back. And patients sometimes come in and want these functional medicine labs and he says, “Look, I can’t do it.” And occasionally, when he tries to run some additional labs, the insurance companies threaten him and they threaten to actually decrease the amount they’re going to pay him because he’s spending more of their money.

Dr. James:           Right. So I don’t like spending a whole lot of time fighting a system that’s way bigger than me. I’m one guy, I can’t fight that. So it’s more of like, “Listen, Mrs. Jones, this is what needs to get done to figure out what’s causing you the last 30 years of your suffering.”

Dr. Weitz:            Right. Yeah.

Dr. James:           “You want to suffer for the next 20 and 30, or do you want to, and just close your eyes and just throw a dart in the dark and shoot in the dark, or do you want to really target and figure out what’s going?” It’s a bit like to continue metaphors. It’s like you go to your mechanic and your car’s making noise and you go, “How much is it going to cost and how long is it going to take to fix it?” Well, the mechanic say, “I need to open up the hood.” “No, no, no. Just like you’ve done this long enough, can you just tell me?”

Dr. Weitz:            Right. So let’s get back to the topic. So how can we help these patients with hypothyroidism? And so, the ones that have autoimmunity, which are the most common form of hypothyroidism in the US, you’ve been talking about toxins, so we can screen for toxins. There’s food sensitivities, we can test for food sensitivities, we can put them on an elimination diet. How do you usually like to handle the food sensitivity issue?

Dr. James:           So depends on the patient’s budget. So an elimination provocation diet is really good, but what I’ve really found recently is I’m seeing a lot of patients come back who don’t notice the change with eggs, for example. And then, I run a food sensitivity panel because I’m not seeing the changes I want. I’m like, “Shoot, there it is.” And then you’re like, “God, if I had done that three months earlier, would I have gotten to it?” I might’ve, but the food sensitivity tests, you can run them all over the place. I do a lab that’s very comprehensive. It’s 450 bucks.

Dr. Weitz:            Which panel do you like?

Dr. James:           I use Infinite Labs because they do IgE and IgG and IgA and IgG3, IgG4. And there’s some correlation between an IgG4 showing up and an IgE where it sort of suppresses the symptomatic experience of an actual allergy. So it’s sort of an interesting test, but if I do a screening, sometimes I’ll just do LabCorp and run a few different basic ones, or use, what’s that, anylabs.com or something. So you can get a few that are, they’re only like six bucks each to run them to get a few. I start typically with an elimination provocation diet to see how they’re doing.

Dr. Weitz:            Fibrin actually has, besides the Zoomer panels, they actually have a multi food sensitivity panel, one that’s pretty reasonable price, I think maybe a couple hundred bucks.

Dr. James:           Yeah, I used to use Cyrex a lot. I’ve not used them for that as much. There’s a variety of different, and every practitioner has a favorite to use. There’s variety, different ways of going about that. I’d say the typical hypothyroid patient, diet’s going to be 40 to 50% of it. The other 50% of it is going to be going down these different rabbit holes and unwinding the physiology and figuring out, well, what’s broken and why did it break and what needs to work. And for some people, they’ll get fixed in better in a few months. And some people, it’s going to take a couple of years. I mean, it just is, depends on how-

Dr. Weitz:            Right. How do you approach these food sensitivities? Let’s say you have a patient who tests as sensitive to gluten or eggs. Do you take them off that food? Do you ever bring the food back or you tell them they have to stop for the rest of their life, or how do you approach that?

Dr. James:           Sensitivities, I have them, eliminate them hardcore for six months. And then, in six months, add it back in and go, “Is there a problem?” If they’re really addicted to something and they want to spend the money, they can go back and retest. Allergies, sorry, it looks like that’s probably a lifelong thing for you.

Dr. Weitz:            And by allergy, we’re talking about IgE.

Dr. James:           Correct. So an IgE is like, yeah, you probably don’t want to go near that. And again, it depends on, we’re always dealing with, I find we’re having this conversation just prior to the podcast. I find that a lot of what occurs for patients, particularly when they start getting to their 50s, 60s, and 70s, is you’re dealing with a lot of psychology. So there’s a lot of unresolved emotion here from just the medical system of feeling gaslit for a lot of women, where they just don’t feel seen inside the system. Most of the thyroid patients are women. So it clearly tells you that there’s a hormonal aspect of that. We haven’t even discussed that. And then, most of the endocrinologists and the doctors seeing are men who were just looking at them like, “You’re fine. Your TSH is fine. It’s all on your head.”

                                And they go back to their husband and the husband’s like, “The doctor says you’re fine.” And so, there’s 30 years of being suppressed and feeling angry about all this, and it’s really frustrating to them. And then, when I start showing labs and showing their husband, a lot of times the husband’s like, “Oh, God. Am I a heel, man? I suck.” Or sometimes they’re still stubborn and antagonistic. And those patients, I often don’t like to take on because I don’t want to create issues in the marriage. There’s got to be like a, “Hey, we’re all in this together.” And that’s really the bigger difference too. This, when we’re talking about lifestyle and diet and fixing things the way that we do is that it takes a village. Everybody has to be on the same page with it.

                                So we’ve got to deal with women’s and men’s, also, psychology and the psychology around food. Because how many people come and go, “I’m a foodie.” I don’t know what that even means. We all love food. There’s like 1 out of 1,000 who goes, “I don’t really care. I do it for fuel.” But most of us really enjoy eating and we enjoy eating what we enjoy eating. And it really sucks when you find out that there’s a food that’s causing you a health problem because you really enjoy that food. “But when I eat it, I feel so much better.” Right, probably because you have an allergy to it and it’s causing a cortisol response, which makes you feel good temporarily, or it’s creating an epinephrine response because your adrenals are fatigued or beat up or whatever vernacular you want to use around it. It creates that kind of a sympathetic response, which makes you feel like awake and alive for 15 minutes. It’s like beating a tired horse.

                                But there is a lot of dealing with that. And then, there’s a lot of ways in which people are disappointed in how their lives turned out and they get to be in their 60s, 70s, it’s like, “This isn’t what I expected.” So now you want to take away the one thing that allows me to feel good, which really equates to really not necessarily feeling good, but maybe being numb and not having to feel what they don’t want to feel. So I would not underestimate how much psychology and emotional stress also plays into thyroid patients, particularly when they’ve been dealing with this for 30 years. Because that emotional stress, that inability to feel self-expressed is an internal type of stress that’s going to dysregulate your blood sugar, cause more cortisol response, which is going to affect your hippocampus, which is going to give you brain fog and short-term memory, which is going to dysregulate the hypothalamic pituitary adrenal axis, which is going to cause your cortisol to be high in the evening and low in the morning so you can’t sleep. And now, you’re all effed up.

                                Sorry, that’s not clinical, but this is for me, I think that helping people restore their health, when we talk about people throw the word alternative and holistic around. To be holistic means you do have to address that aspect of it too. You have to address the emotional aspect. You have to address sleep hygiene, you have to address your relationships or you’re miserable.

                                Quick story here. I had a patient I was treating years ago. She had MS and Hashimoto’s, and those two things you do see a lot together. It’s scary, it’s unfortunate. So I’m treating her, and it was like the end of the summer, and I looked at her after a consult and I was like, “You’re not looking good today.” She goes, “I’m not sleeping.” I said, “Why aren’t you sleeping?” She goes, “Because it’s so damn hot.” I go, “Well, turn on the damn air conditioner.” She goes, “I can’t, my husband won’t let me.” I said, “What do you mean he won’t let you?” He goes, “It’s too noisy. And he says like 73, 74 is cool enough.”

                                And I go, “Let me talk to him.” “No, no, no, I don’t want you to talk…” I said, “He said he was supportive of you in the initial consults.” “No, no.” I said, “Listen, you’ve got MS. You need to sleep and rest. If he gets cold, he can put on… There’s only so many clothes you can take off.” And she goes, “I’m literally lying in a pool of sweat at night.” I’m like, “Well, how about…” Said, “No, it would create conflict.” So this is what I was dealing with at the end, which was her relationship was not good. And what a selfish dude to be like, “Yeah, I don’t want to hear the noise so you suffer with your MS.” Really? Put earplugs in, dude. Put on pajamas.

Dr. Weitz:            He probably didn’t want to spend the money.

Dr. James:           On earplugs or pajamas?

Dr. Weitz:            No, no. I mean, for the electricity.

Dr. James:           Oh, maybe. Here’s the interesting, she had kids in England. She went away to England for a month on a vacation. Her symptoms were magically like 100% better. Not only was she sleeping, but the stress of her relationship. As she came back, “I get this is really confrontive for you. I get it. You’ve really got to look at what your marriage is doing to your health.” And she said, “I know. I’m praying about it.” You can pray, but I think you know what you need to do. Pray about what the next step is for you. But it’s no joke, when somebody’s got a life with a partner for 30 years and you’re looking at the dissolution of that, that’s no joke. So we laugh about it. I’ve been divorced. It’s not a joke. It’s not fun. But if you don’t address those things, it has a really terrible effect on your health.

Dr. Weitz:            Absolutely.

Dr. James:           You know the author, the psychologist, Gabor Mate, have you heard of him?

Dr. Weitz:            I’ve heard of him.

Dr. James:           So he wrote a book called When the Body Says No, and it’s all about how there’s all this research coming out, not a surprise, how when we suppress our emotions and our inability to say no to things, that it creates disease in the body. Anyway, end of that part.

Dr. Weitz:            Yeah, no, very important. Okay. And where else do you want to take this discussion? Any other parts of dealing with thyroid that you want to talk about?

Dr. James:           I think there’s two things that, particularly if you’re a woman listening to this podcast right now and you’ve been suffering for a lot of years and you don’t know where to go and you’re feeling like some of the things that we talked about, what really needs to be addressed, and you’re probably not going to find it unfortunately, your general practitioner, what needs to be addressed is do you truly have a hypothyroid problem? If you have Hashimoto’s, you know that your thyroid is affected, but then you have to look at what’s causing the immune system to be overactive. So you have to look at blood sugar issues. You’ve got to be looking at your joint. You’ve got to be looking at these toxins, digestive issues. You got to look at hormones. We haven’t even talked about hormones today.

Dr. Weitz:            Right.

Dr. James:           All of these things have a really big impact on your immune system and therefore your thyroid. But also, even if you don’t have Hashimoto’s, all of those things can impact thyroid production, thyroid conversion, thyroid uptake, and in and of themselves create symptoms that look just like a hypothyroid patient, but aren’t being addressed. So your thyroid actually is dialed in, but you have these other issues that typically, again, don’t get looked at. So when you’re in a traditional model, as long as things fall inside of the lab range, you’re fine. But you and I know that just because something falls inside of a lab range doesn’t mean it’s optimal. And so, it’s not typical that somebody’s health is dynamite and then they just fall off a cliff. There’s patterns that you see of things shifting and moving over time that you go, “You’re not going in the right direction, pal. We need to change some things up.”

                                So you’re going to need to just grab the snake by the head and go, “Okay, I obviously have to bite the bullet. If I want to get, well, A, I’ve got to make it my number one priority. B, I’m going to have to do some testing so I can get to the accurate root cause of where the dysfunction is. And then, C or three, I’m going to have to be patient with the process of unfolding and healing, because healing is a process.” Injuring yourself and getting injured as an event. Getting sick is often a process too. So can be an event, you can get COVID, and then that wreaks havoc with your body and does all this other stuff. And that’s another podcast, happy to talk to you about that. But there’s all these different influences impacting us right now in the environment. And so, it isn’t always… The thyroid is not a simple problem.

Dr. Weitz:            Sure. You’re talking about toxins. One thing, I don’t know if everybody’s aware of it, but there are substances like fluoride, which is added to the drinking water, which people are brushing their teeth with, chlorine, which is added to the drinking water as an antiseptic, bromide-

Dr. James:           Bromides in flour.

Dr. Weitz:            Exactly. And so-

Dr. James:           Can I interrupt you here? Because you said-

Dr. Weitz:            Yeah, go ahead.

Dr. James:           … in the beginning and I made a mental note of it, and then we went off and I forgot. And that is actually, I see a fair amount of iodine deficiency these days. So I would not say that we’re iodine-sufficient, but that’s another tricky game when you have Hashimoto’s. I don’t recommend iodine for my patients who have Hashimoto’s. If I’ve tested multiple times and it’s not there and I’m no longer suspicious, and there’s other things, I may do like a urinary test to look for, are some of these halites interfering and blocking iodine uptake. You mentioned fluoride, bromide, right? So that’s an important aspect of it too so I’m so glad you came back to that again. Thank you.

Dr. Weitz:            Yeah, I have Hashimoto’s. I don’t really have any of the symptoms, but I’ve had elevated TSH for years. And so, one of the things I tried was the high dose iodine because we have certain doctors who are really big on recommending a typical dosage of iodine that you’ll find in a multivitamin is maybe 150 mcg, so that’s like 0.15 of a milligram. And so, these doctors are recommending 15, 20, 30 milligrams of iodine. So my TSH stays somewhere around 7, sometimes I can get it down to 4.5, and it had gone up to 9. So I decided to take 12.5 milligrams of iodine and it went up to 25. So I got off that, added selenium, added some more magnesium. I got it down to 4.7.

Dr. James:           So you’re getting there. You just reminded me of another thing I want to talk about. And that is another thing that happened with me is many years ago I went through a really stressful event and my TSH went up to 95.

Dr. Weitz:            95. Wow!

Dr. James:           I was freezing all the time. Like, “Oh, I don’t feel quite right.” And the denial factor went in really strong. And then, I ran my own blood and I was like, “Oh shoot, I’m going to have a heart attack.” And it’s the same fricking thing. They’re just trying to dial in the TSH and they didn’t fix any of that. I’ve tested myself 50 times, never tested for Hashimoto’s. I take 50 milligrams of iodine every day. It works for me.

Dr. Weitz:            50.

Dr. James:           Like massive amounts. But I ran those tests. So it’s important to look at, and then you think like, “Oh, Brazil nuts are great because they’re high in selenium.” So I ran a food sensitivity test on myself. Guess what I test positive for in terms of food sensitivities?

Dr. Weitz:            Brazil nuts.

Dr. James:           Right. So when people go like, “Well, what’s the thyroid diet?” I don’t know how it is for you. For me, there is no general diet, there’s what’s right for you, because what I said, just have a Brazil nut every day. Now, I’m causing an inflammatory disorder for myself. There is maybe a general thing, and everybody knows if it’s an inflammatory issue, you go on an autoimmune paleo diet, but then that has to be dialed in more perfectly for what’s specific for you for it to work for you. So you found out iodine didn’t work for you. I see that pretty classically with Hashimoto patients. And I know the doctor you’re talking about who likes to use high dose that way.

Dr. Weitz:            Dr. Brownstein, right?

Dr. James:           I wasn’t going to mention his name, but I tested myself and I was really freaking deficient. I was kind of mind blown by it. So I started taking a really high dose and it seems to stabilize me and do really good when I’m like that. I rarely use that with patients, rarely. But sometimes, I have patients who are-

Dr. Weitz:            You got to find what works for each person.

Dr. James:           So this is the key to it, which is there is no generalized, let’s give everybody levothyroxine and have it elevate their TSH. That gets a very small percentage.

Dr. Weitz:            And same thing with diet. There’s some people put out the thyroid diet or don’t eat these cariogenic fruits like broccoli because that will inhibit-

Dr. James:           You have to eat so much freaking broccoli. Who eats that much broccoli? You put in a blender and drink broccoli soup all day long. I know, I love that. I get that on webinars like, “Isn’t broccoli a goitrogen?” Or I’ll have an ad up and it’ll have broccoli. “That’s a goitrogen and you’re a thyroid [inaudible 00:53:15].” Yes, yes, true, it is.

Dr. Weitz:            Okay, great. I think we hit the topic pretty good.

Dr. James:           I think we did. Thank you, Ben, for having me. This was fun.

Dr. Weitz:            Good, good.

Dr. James:           I hope your listeners got something out of this conversation.

Dr. Weitz:            I’m sure they did. Those who want to get a hold of you to have you help them. What’s the best way to get a hold of you?

Dr. James:           Thank you. They can call the office 310-396-3100, 310-396-3100. They can also go to drjeffreyjames.com.

Dr. Weitz:            That’s great.

Dr. James:           [inaudible 00:53:54] there. Thank you.

Dr. Weitz:            Thanks, Jeff.

Dr. James:           Thank you for the plug.



Dr. Weitz:            Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy 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 White 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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