Ep. 77: Hyperthyroidism, Hashimoto’s, and the Gut–Thyroid Connection with Dr. Eric Osansky

If you’ve ever been told your only options for a thyroid condition are medication, surgery, radioactive iodine, or a restrictive diet… this conversation will open your eyes to what’s possible when you focus on root causes.

I’m joined by Dr. Eric Osansky, a chiropractor, clinical nutritionist, and certified functional medicine practitioner who reversed his own Graves disease naturally and has been helping clients do the same since 2009. We’re sharing both sides of the thyroid spectrum: Dr. Eric’s journey with hyperthyroidism and my own with Hashimoto’s, plus the powerful gut–thyroid connection that changed everything for us.

You’ll hear:

• Why gut health is central to thyroid autoimmunity
• The most common gut-related triggers for hyperthyroidism and hypothyroidism
• How herbs like bugleweed and motherwort can support hyperthyroid symptoms
• The role of stress, adrenal health, and lifestyle foundations in recovery
• How functional testing (like stool testing, adrenal testing, and HTMA) can uncover the real drivers of your symptoms

 Listen to part 1 of this episode on Dr. Eric's podcast here! 

Connect with Dr. Eric

Dr. Eric's Website

Dr. Eric's Newsletter

Dr. Eric's Books

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Dr. Heather's Website 

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Transcript

Dr. Heather Finley: 0:03

Welcome to the Love Your Gut Podcast. I'm your host, Dr. Heather Finley, registered dietitian and gut health specialist. I understand the frustration of dealing with GI issues because I've been there and I spent over two decades searching for answers for my own gut issues of constipation, bloating, and stomach pain. I've dedicated my life to understanding and solving my own gut issues. And now I'm here to guide you. On this podcast, I'll help you identify the true root causes of your discomfort. So you can finally ditch your symptoms for good. My goal is to empower you with the knowledge and tools you need so that you can love your gut and it will love you right back. So if you're ready to learn a lot, gain a deeper understanding of your gut and find lasting relief. You are in the right place. Welcome to the love your gut podcast. Welcome back to the next episode of the Love Your Gut podcast. I am so excited to be here today with Dr. Eric, and if you're jumping over for part two from his podcast, welcome. And if you miss part one, jump on over. But Dr. Eric is a chiropractor, a clinical nutritionist, and a certified functional medicine practitioner. Who has been helping people with thyroid and autoimmune thyroid conditions since 2009. He is the author of the Book's Natural Treatment Solutions for Hyperthyroidism and Graves Disease. The Hyperthyroid Healing Diet and Hashimoto's Triggers is the host of the Save My Thyroid podcast. And the creator of the Healthy Gut Healthy Thyroid Newsletter, Dr. Eric was personally diagnosed with Graves' Disease. After seeing how well a natural treatment approach helped his condition, he began helping others with thyroid and autoimmune thyroid conditions. So welcome to the show. Yeah. Well, um, thank you so much Dr. Heather. Great to chat with you again. Yeah. Well, so the name of your podcast is Save My Thyroid, which is a pretty bold statement. Uh, and you have a very popular podcast in the thyroid space. So why was saving your thyroid so important to you personally? Yeah, so great question. So, my personal journey relates to having Graves Disease, and that's how I started doing what I'm doing today and what led to me writing, uh, the books related to, um, hyperthyroidism and, and the one on Hashimoto's. Uh, just, uh. SI was, I was diagnosed with Graves back in 2008. At that time, I didn't really know anything about Grave or didn't know much about Graves. My background's a chiropractor, so I had a traditional chiropractic practice for about seven and a half years. And, um, and I, as a chiropractor, I would always attend for my continuing education credits. I would always attend nutritional seminars, functional medicine seminars, never attended chiropractic seminars where we learned technique. Um, so it was always nutrition or functional medicine. And there were a couple of. Functional endocrinology seminars I attended. And when I attended those, they did speak very little about graves. Most of it was of course, um, like diabetes and Hashimoto's, but they, they did talk a little bit about a natural approach for hyperthyroidism and Graves disease. So, I mean, little did I know that one day I would need that information, but when I was diagnosed with Graves, uh, I. I knew I was going to at least give it a try. I, I was a little bit skeptical even with my background.'cause again, I didn't know anybody who had graves. Um, but sure enough I started, um, say just, uh, changing my diet and lifestyle and did some testing and, and took some supplements. And, uh, and yeah, long story short, I restored my health and I mean. The purpose of the term Save My Thyroid. I mean, really it applies to both Graves and Hashimoto's. Um, with graves, so many endocrinologists recommend radioactive iodine that destroys the cells of the thyroid or a thyroid thyroidectomy, thyroid surgery, which completely removes the thyroid. And so that's, um, but even with Hashimoto's at Hashimoto's. You get the damage from the immune system taking place to the thyroid gland. And most endocrinologist or regular medical doctors, they just give thyroid hormone replacement, which again, there's the time and place for that. But if that's all they do and they're not addressing autoimmune component, then you're just getting further damage to the thyroid. So, so again, either way, whether you have hyperthyroidism Graves disease or. Hypothyroidism, Hashimoto's. You know, I think it's, um, it's important to at least attempt to save your thyroid. Yeah. And you, you kind of mentioned this a little bit, that Hashimoto's is talked about a lot more. Even hypothyroidism is more common, commonly spoken about. I know, even on my podcast. So for someone listening, you know, they may not even really know what Graves disease is. Can you give us just a little. Download of what the, the difference, like kind of distinguishing factors between Hashimoto's and hypothyroidism and Graves disease and hyperthyroidism. Yeah, no, definitely. I think that's a great idea. So. So again, your, most of your listeners are familiar with hypothyroidism, so that's when someone has low thyroid hormones. So the main thyroid hormones, at least the ones we could test for at a lab, are T three, T four, and then there's what's called TSH, which is thyroid stimulating hormone, which is a pituitary hormone that communicates to the thyroid gland. And in the case of hypothyroidism. You typically have elevated levels of TSH and the reason for that is because when the thyroid hormone levels are low, either they might be within the lab range but less than optimal or they might be overtly low. But either way, you're getting more TSH production because pituitary is telling the thyroid gland, Hey, we need more thyroid hormone. And so you present what hypothyroidism you have, typically an elevated TSH, or again, it might be. Higher than optimal. It might be like a 3.5, which is within most lab reference ranges, but greater than optimal thyroid hormone levels on the lower side or overtly low. So hyperthyroidism is the opposite. That's when you have too much thyroid hormone. So T three, T four will be elevated. And as a result, the pituitary gland is telling the thyroid gland, Hey, we don't need any more thyroid hormone. Let's stop the production. So you see low T, SH, many times undetectable, TSH, like less than 0.01, for example. And so that's really the difference between hypo and hyper, at least on a blood test. I mean, symptom-wise. Um. I mean, when I dealt with Graves with hyperthyroidism, everything is sped up at the metabolism. So I was having increased resting heart rate and palpitations and tremors and um, looser stools are common, and anxiety and insomnia are some of the more common symptoms, hair loss. Common with both hypo and hyper. But um, and then hypo of course the opposite. You get the slower metabolism. So fatigue is very common. Weight gain is common. Actually, actually, I didn't mention weight loss. I lost 42 pounds when I dealt with. With hyperthyroidism, but weight gain with hypo coldness. Um, the, uh, the brain fog, constipation, uh, again, brittle hair, sometimes hair loss as well. Uh, and then, and we could talk more about the symptoms, but as far as like Graves, Hashimoto's, so. Most cases of hypothyroidism are autoimmune. And same thing with most hyperthyroid conditions are autoimmune. So the, so we got Hashimoto's where you have certain autoantibodies, and with graves you have different autoantibodies. So graves, you have what's called thyroid stimulating immunoglobulins, um, which are, is the type of TSH receptor antibody. And what happens is that th the, the thyroid stimulating immunoglobulins, they bind to, or, or attack, stimulate the TSH receptors of the thyroid gland. And that what causes, that's what causes the elevation of thyroid hormone. And then with Hashimoto's, you have. Antibodies such as thyroid globulin, antibodies, um, and or thyroid peroxidase or TPO antibodies and the antibodies themselves aren't causing damage and more of a consequence. But when you have those antibodies, that means that the immune system is damaging the thyroid gland and, um, which could lead to hypothyroidism. But in a nutshell, that essentially is the difference between hypothyroidism, hyperthyroidism, graves disease, Hashimotos. Yeah, that's super helpful to, to understand. And one thing that I've heard from patients and read, online and doing research and, just talking to people is that Graves disease often hits pretty fast and people will often say like, I feel like my body's kind of spinning out of control. You mentioned like anxiety or rapid heart rate, feeling, insomnia. Everything just feels fast. What was. Like being inside your body kind of at the height of your symptoms or what led you to go get testing finally and figure out what was going on? Yeah, great question. So I was, so late 2007, I started to, I was. 180 2. My weight was 182 pounds. Ideally, I would like to have been, and still even now, like 1 65, 1 70. And so I was trying to lose weight. So I started, um, exercising intensely. Just, uh, too intensely. I was, I was dieting, pretty much dieting, detoxifying, exercising vigorously, and uh, everything was going to plan according to plan. I was losing weight. Um, and, uh, again, eventually the, the weight loss became extreme. But even then I didn't really catch on. I just thought everything was just because of what I was doing.'cause it, I mean, it wasn't like I was losing 10 pounds per week, but I mean, just, I was. Losing weight and had increased appetite, but I wasn't eating as, uh, a lot. I was restricting, um, calories, which I shouldn't have been doing. But, uh, then one day I was walking around a retail store, a Sam's Club specifically, and they had a blood pressure machine and I, um. Took my blood pressure at one of those sit down machines and my blood pressure was fine, but my heart rate was about 90. And I was wondering, well, maybe it's just because I'm walking around. And so I took my heart rate the next few days and it was anywhere between 90 and one 10 beats per minute. And so I'm like, okay, this is not normal. And um, and then I was. Kind of put in the pieces together. But again, at that point I really didn't have much experience with hyperthyroidism. So I just, um, went to a primary care doctor and he just ran some blood tests and diagnosed me with hyperthyroidism. And, uh, and then eventually I saw an endocrinologist who, um, tested the antibodies. And, I mean, knowing what I know now, if I had to do it all over again, I could have done all that on my own, but. Just, again, just didn't have the know, I mean, again, just wanted to get that, that the so-called expert exper, um, opinion when it comes to is, you know, the hyperthyroidism graves. And, and I'm glad I did. I mean, it's, you know, just, um, at, at, like I said, at that point, I didn't work with people with thyroid conditions, let alone hyperthyroidism. I just again, practiced chiropractic and just adjusted, um, patients. So, um, but yeah, that's how my journey began. That's how I found out. That I had hyperthyroidism as far as like how I, how it felt, kind of like just being in the, you know, that state. Um, like I said before I was diagnosed, you would thi, you would've thought that I would've known because again, a lot of people, you know, they feel the anxiety, they feel certain symptoms. Um, but I honestly didn't, you know, before taking the heart, I mean, once I took the resting heart rate, I became more aware. You know, just coincidentally, I, I, I started noticing the palpitations. Maybe I was experiencing them before that, but just wasn't really paying. I mean, you know, quite frankly, it was so long ago, I forgot, but after. After I got diagnosed, I started realizing I was having the palpitations, or again, being more aware of it, the weight loss, you know, I realized that at least in part was due to the hyperthyroidism and not solely due to, you know, just, um, the diet and exercise. But, um, but yeah, I mean it's, um, it's, it's hard to explain. Um. Just, uh, like when you're dealing with hypo, you know, it's, it might be easier with the, and, and maybe even that, I mean, you could, you could, I didn't ask you that question when you were on my podcast, like how specifically you felt, but again, I've also worked with a lot of hypo patients, so I kind of have an idea. And with hyper, it's just, I mean, and everybody's different. Not everybody experiences the, um, exactly the same. And, um, I mean, the anxiety I don't think was crazy high with me, where it's like, some people, it's like really extreme, uh, with me. I think a lot of it was just honestly just also a state of disbelief. Like just, um, as, and maybe that was the case with you when you got your diagnosis, although. I know you said on when I interviewed you that you went to a few different doctors, so you in a way was probably more relief maybe. Yeah, for sure. That you got the diagnosis with me. Uh, you know, I wasn't expecting to get diagnosed with hyperthyroidism le and, and Graves disease, so it was more like a, a shock. So now that you know what, you know, and you've seen probably thousands of patients at this point, what is one thing that you wish more practitioners understood or that you understood at the time about how the gut plays into thyroid autoimmunity, especially, you know, related to graves? Yeah, great question. I mean, yeah, I, I, I wish that I knew. J just simply the relationship that most of the immune system cells were located in the gut and just ha you know, the, the impact of having that increase in intestinal permeability. And I guess how common it is. I mean, this was going back. I mean, we're talking about 2008 into 2009, so now everybody has heard of leaky gut, you know, increasing intestinal permeability. And we know, and there's so many, I mean, there's the, the stool tests now are definitely better than the stool tests from years ago, and a lot more practitioners are doing them. And so, I mean, just overall, I wish I had greater knowledge of how big of a factor the, the gut played. In autoimmune conditions. Um, just it beca again, just wasn't, I mean, that information wasn't, I mean, not to say it wasn't available, but now of course also it's good and bad with everything on the internet. You could find everything, which not everything's reliable, but back then there weren't podcasts there. I'm trying to think, was there YouTube in 2008? Um, I think, think so. My my maybe. But, um, but you know, again, it still wasn't what it was today and you gotta be careful even of course today, but. You know, as a practitioner I learned some of that, like some basic endocrinology going through chiropractic school and basic gut health information. But again, they didn't really get into that relationship. So, um, so yeah, I wish when it comes specifically to the gut, I wish I, I did have more knowledge, um, back then. But, you know, again, just that's what any practice, you just, uh, evolve and you, you know, over, over the years you learn more and more. Jumping in really quick to tell you about an exciting offer that we have. I know so many of you have found this podcast to be really helpful on your gut healing journey, and my goal is to help as many people find relief from their GI symptoms as I can. And you are a part of that mission. So when you leave a rating and review on this show, more people can find it. What I would love for you to do is. Go and leave a five star rating and review and share why you love this podcast. Go ahead and take a screenshot of it and then send it to our email. Will be entered to win a free HTMA test with our team. So the hair tissue mineral analysis, as well as a consult to review your results. So once again, just go ahead and leave your five star rating and review, then send a screenshot to our support email and we will pick a new winner every single month. Yeah. So on those, on that same line, like how do you figure out what's actually driving someone's graves? Uh, how do you decide, you know, whether to start with gut nervous system, thyroid, n nutri, like what's kind of your process that you go through with your clients? Yeah, so I mean, the first thing with Graves is, and even with other types of hyperthyroidism, is safe symptom management. So we wanna do more than just manage symptoms. But it's a little bit scary when someone has a resting heart rate and triple digits and mm-hmm. You know, they, you might've heard of like the term thyroid storm where, you know, can become a life-threatening situation if the heart rate becomes really high and un uncontrollable and then they ends up at the the er. So we want to try to prevent that from happening as much as we can. So if I'm working with someone, they might already be taking. Antithyroid medication. Um, I chose not to. I took the herbs bugleweed as well as mother wart. Bugleweed is an herb with antithyroid properties. Doesn't work for everybody, and that's something I learned. When I was attending those functional endocrinology seminars, so I didn't know if it would work with me, but, but again, it did. And so if someone's taking the meds and it's helping and they're comfortable taking the meds, so that's fine. They could stay on the meds and we could still try to address the cost of the problem. Um, if they're not taking the meds, we definitely wanted to do something, whether it's the Bugleweed or um, something else naturally to try to lower those thyroid hormone levels and keep them safe. Um. Then we wanna incorporate the foundations, and I think really with any health condition, graves, Hashimoto's, other conditions that don't relate to the thyroid and immune system. We want to have people eat a. Healthy diet, whole healthy foods and, uh, drink purified water or, or spring water of a glass bottle. So another area of controversy, which water should we, I think we all could agree, avoid the top water, the water from the plastic bottles. Um, stress. So we spoke about stress when, um, you are on my podcast, uh, relationship between, you know, stress and, and, um, Hashimoto's and stress in the gut. And, um, so just trying to do things to reduce stressors and probably more importantly, improve stress handling and, um. Sleep, of course, is important. Another foundation, and a lot of people have sleep issues and sometimes it's intentional because people are staying up late and, you know, just surfing the, the internet or on their iPhone in bed. But, um, but other times people just can't fall asleep or they wake up in the middle of the night. So trying to, um, help people get more sleep, uh, just uh. You know, basic things, at least initially, like to reduce some someone's toxic burden. So those are, uh, so the foundations are important. Uh, and then, I mean, I do like to do some testing. I don't go crazy with the testing in my practice, and not everybody gets the same testing. So, uh, I mean, I do comprehensive blood testing on, so that's something I do on everybody. And even that depends on the per, like if I give. Like what I think is important and then those that I think maybe could be helpful, but maybe more optional, um, in case if someone is paying out of pocket. But, you know, of course I want to do comprehensive thyroid testing, looking at antibodies and um, you know, the basics like a CBC with differential comprehensive metabolic panel, lipid panel vitamin Z. Healthy vitamin D level is important for healthy immune system. Um, I know you mentioned iron panel when you are on my podcast, so I do like a full iron panel, you know, as well. I do, uh, homocysteine, CRP, so again do do a decent amount of blood testing and then, uh, and blood sugar. Look at blood sugar markers as well. Uh, and then I do like adrenal testing, so adrenal testing. You know, I don't know. We didn't talk about really, we spoke about some other tests, uh, like hair testing and spoke about gut testing and, and you know, definitely I like, I like those tests as well, but adrenal testing, some practitioners just assume that everybody has compromised adrenals. Some practitioners test for it. I don't think there's really a right or wrong. I like testing just because. I guess there's a few reasons. So one, probably the biggest reason is when I dealt with Graves, I was in denial that stress was a factor. You know, I, I, I knew, I mean, I knew stress impacted, like, not that I thought I was stress free, but I just thought I was naturally good at handling the stress, and if I didn't see how bad my adrenals looked. I wouldn't have made the effort, I don't think, to improve my stress handling. Just not back, not only back then, but just up until now too. Just making a, you know, just blocking out time for stress management, um, on a daily basis. And so I do like adrenal testing. I did back then, I did adrenal saliva test, and I, I still do that too now. There's. Dried urine test, like the Dutch test, um, that also looks at circadian rhythm of cortisol. So sometimes we'll do, you know that, that test. Um, and you know, we, we spoke a little bit about hair testing on, um, on my podcast when I interviewed you and. So I, I, which is again a controversial test, but I do like hair testing. I like stool testing. Um, again, I don't do stool testing on everybody, but I do a decent amount of them and sometimes I'll do organic acid testing. So, so really it depends on also the health history, but I do like to do testing rather than guessing. Um, and so sometimes you have to guess because the tests aren't perfect, but if you can do testing and see what's on the testing, and then based on. The test, we give recommendations. Um, so, uh, again, I'll give some general support like probiotics and omegas and, um, I mean, again, like sometimes selenium, but selenium could also look at things like hair testing or if someone wants to do like RBC, selenium and the blood, I mean, that's also an option. But vitamin Z we want to test for, uh, again, h Pyl, we spoke about h pylori. Which we could definitely talk more about'cause we didn't, we spoke a little bit about HP Lium parasites, but I think that's a really big factor with Graves and Hashimoto's. I mean, in the re research as a relationship, it's something I see a lot in practice as far as a potential trigger. Um, but yeah, that's my, my, so my, a summary of the process start with symptom management foundations. Testing, you know, to, to try to find triggers underlying imbalances and obviously address those triggers and underlying imbalances. And that, and again, that all ties into the gut too, because I mean, the, the foundations will help with gut healing. Doing some of the testing, you know, could help with gut heal healing as well, depending on what we find. Yeah, well you kind of answered this, but my next question was gonna be what gut related triggers do you see? You know, usually you see things like h pylori and parasites, online about Graves Disease and Hashimoto's. So would you say that that is something that you commonly see, or is there, are there other things on gut related tests that you tend to find? Those are the two. As far as like trigger triggers, I mean, we de, de de. I definitely see other things on. The stool test as you do too. But I don't know if you'd say they're triggers, they're, I mean, they could give signs like, you know, someone has like, I see a lot of. Depressed or lower pancreatic elastase on the stool test, which I wouldn't say that's a trigger, but that's a sign of other things. Again, very common with h pylori to see like that low pancreatic elastase. And, um, you know, we see a lot of, uh, just general dysbiosis. Like, uh, if, like, again, there's different tests. Uh, like I, I do GI maps, but also I've done like the GI effects and, you know, um. Again, a lot of good companies, but streptococcus, for example, is something I see a lot of, but I wouldn't say it's a trigger, it's just uh, um, I think even in some healthy people we would see that even though it's red flagged and it's under the opportunistic and, but again, to me it's even if someone is in remission, it's not uncommon to see some imbalances on a stool test. So I would say H plar is a big one. Um, definitely parasites could be a factor as well and a potential trigger. Um, candida overgrowth, I mean stool, in my experience, it's not the best test to pick up candida. Yeah. But, and candida, I don't know, even if you would call like a trigger trigger, but it can affect, the gut, can increase permeability of the gut. Um, so an organic acid test is actually really good for picking up, uh, yeast overgrowth. Uh, we spoke, uh, when you are on my podcast about sibo, small intestinal bacteria overgrowth, which again, I don't know if you really would consider a trigger, but it can affect. It could cause leaky gut too. So if you have sibo, you have yeast overgrowth, um, one or both of those. Uh, and if you don't address those, it's gonna be hard to heal due to the impact they have on, on the gut. Uh, but yeah, I would say those are, I mean there's, in the research, in the literature, there's uh, a yersinia entera, which is, uh, a bacteria, and I can't say I see a lot of that on the stool test. Um. I know I had Dr. Nicholas Hedberg on the pod on my podcast, and he mentioned like blood testing is actually better for Yesinia. I guess the only concern about that is same thing with h Pylori, if you have it, is it like a current problem or is it a past problem?'cause the antibodies could last mm-hmm. For a while in the blood, but occurrence to the research, that could be a factor, you know, as well. But yeah, as far as the gut goes, I mean, those are probably some of the, the more common gut microbes, gut, gut infections that we would see. So what is the typical timeline that you see? You asked me a similar question on your podcast, and I'm curious just with Graves specifically, you know, if someone's taking antithyroid medication or taking the herbs, like you mentioned, whichever route they choose, how long does it take typically? To kind of stabilize things where you start to see the resting heart rate come down, you start to see just improvement a little bit in symptoms or even just improvement in labs kind of normalizing. Um, or do you feel like it's all over the place? I mean, it is all, excuse me, it is all over the place, but it, it's, yeah, so it does depend on the person, but I mean, it's not uncommon to see, like, I do like to see changes. And how people feel within, I mean, sometimes we see it within a few weeks, but it, it could be a few months. I mean, when I dealt with Graves personally, and I took the bugleweed, I noticed within the first month that it was working, you know, even before doing the first blood test, I, I felt I was able to measure my heart rate and the heart rate was decreasing, and I, I started with Bugleweed. But I was still having palpitations, so I added mother wart and that helped with the, the palpitations. Um, even further. So symptom-wise, I mean, and if someone's taking the meds, it, it'll, it can work much quicker. The, the problem with a medication in the world of hyperthyroidism with antithyroid medications such as methimazole or propal uracil, which is PTU, is that side effects are very common. Um. But they work, they so someone could feel better quickly with the meds if they do take it. The herbs, if they work, they could also, maybe not as quickly, but within a few weeks. Labs. It depends. I mean, again, it's not unreasonable to start seeing some changes with the labs, like even the first test. But it's, everybody's different. Some, sometimes they'll take a few labs and one thing that's very common with. Hyperthyroidism, especially Graves, is that TSH will remain undetectable usually for quite a while. So it's not uncommon for th like, we'll see thyroid hormone levels decreasing, and TSH is staying where it is, um, for a while, and it frustrates people. But what I tell'em is as long as the thyroid hormone levels continue to decrease, again, eventually the TSH will start increasing. It might be three months, it might be six months, it might be longer. But if we see the thyroid hormones trending in the right direction, I wouldn't worry about it. Okay, and I think, a common thing, and you, you mentioned this at the beginning, is that people are often told that they kind of quote unquote, have no choice and they need to have the radioactive iodine or surgery. And why do you think this has pushed so hard? And what do people need to understand before they make that kind of decision? Yeah, I mean it's uh, there's probably a few reasons. I mean, I think one reason is. Endocrinologists feel more comfortable dealing with hypothyroidism than hyperthyroidism because again, there is that risk of a thyroid storm or so. You know, just, uh, just again, there's more, not that hypothyroidism doesn't come without risks, but again, when someone has elevated thyroid hormones, it's more risky. So they feel it's easier to manage. Just get the radioactive iodine thyroid surgery, and we just put the person on thyroid hormone. And, and they'll live happily ever ha after, which doesn't of course always happen, but that's what they're thinking. And um, so that's one reason. I mean, you know, is it profit also? I mean, it's hard. You would hope that, would it be the case, but I mean, by doing that, uh, obviously there's profit with thyroid surgery. Radioactive iodine, I don't think is that profitable. But either way. If someone becomes hypo, they do have a lifetime thyroid patient that they'll be managing and, and um, you know, with a thyroid hormone replacement. But, you know, again, you would like to think that's not the main reason. And, and I, I think the main reason is just because, again, they're very nervous about the hyperthyroidism. And I mean, some of them also, they'll, at least this is what I hear. I mean, when I dealt with my, I just went to the endocrinologist one time when I dealt with Graves.'cause I wasn't gonna follow her recommendation. So I just wanted to get. Diagnosed and I got an ultrasound and, um, and she recomme recommended Antithyroid medication. She didn't push the radioactive eye or thyroid surgery on me. She just gave me medication, which I, I mentioned I didn't take. So I was like, uh, it's no use for me seeing her. But, but, um, when endocrinologist, they, a lot of them will give the antithyroid medication and they'll tell their patients that they can't take the medication for more than. A year and a half, two years.'cause it'll damage their liver. And it does, it can put stress on the liver. So that's not, I mean, they're being honest with that, but it's not the case with everybody. And so, um, I'm not, I'm not saying people should be on the medication long term, but if it's, if choosing between long term antithyroid medication, especially at lower doses, like five milligrams of methol, 10 milligrams of methimazole. And then getting his thyroid removed completely or ablated with the radioactive iodine. The research actually shows that taking something like meth, like low dose methimazole is safe for like 10, 15 years or longer. So it's not, I don't prefer that'cause that means that the person, we haven't addressed the cause of the problem and they're relying on antithyroid medication, but. That just goes back to the question why do some endocrinologists recommend it? Some of them aren't quick to recommend it, like some will will recommend it pretty quickly. But some will say, go, let's go on the meds for a year and a half, two years. Let's see if you get in remission. And they're not doing anything to improve the person's immune system, so the person may, people, may time, will either won't go into remission or relapse. But those are some of the common reasons why endocrinologists are hasty to recommend a radioactive eye on thyroid surgery, or again, maybe not hasty, some of them right off the bat, but a year and a half, two years later, we'll recommend it even when then it's not necessary. Okay. Yeah, that's super helpful. In your opinion, what would you say? Is the number one thing that you see people like holding people back from getting better? You've probably had clients where you're like, you should be responding to this, or, you know, maybe we're not seeing the results that you want. Is there one like common thing that you think is a big barrier to seeing the symptom improvement that they wanna see? Or even improvement on labs? It's hard to pick one. I mean, you know, if I had to like pick one, I'd cheat a little bit and say the foundations, which include a few different things. Yeah, just, just not incorporating either, not. Being strict enough with the diet. And it's tricky.'cause again, I nobody likes restrictive diets. And to me, if someone's gonna be like on an elimination type diet or an autoimmune protocol, it's not a long-term thing. Um, but either way, and again, not that everybody needs to be on like an a IP, like even paleo is pretty healthy. The the point is. Some people have issues or have very difficult time giving up gluten, giving up other common allergens, giving up, um, you know, like, uh, fast food, just things that they shouldn't be eating. So just eating whole healthy foods for some people is a challenge. And then I, I'd say the, the two, I'll, I'll narrow it down to two things, the diet and the stress. If you're gonna say two, like there are other things, but. The stress a lot of times is, I guess you could say overlooked, like,'cause they, I mean, a lot of people do focus on the diet. But overlook the stress. And then of course, some people neglect the diet and also aren't really focusing on the stress. But again, I gave my story where if I didn't see my adrenals, I wouldn't, I also probably would've not really focused on stress management as much. And so I, I think I see that when I do like follow up consults with, with patients, uh, you know, I find that, I mean, some of them are blocking out time for stress management, but some of them. Aren't, or they just consider like walking as stress management, which is, I mean it is walk, but I think sometimes people need to do more need. They need to incorporate some type of deep breathing, some type of mind body medicine. Totally. Yeah. Walking while listening to a podcast and you know, totally distracting yourself, might not actually be. Super stress reducing. Depending on what you're listening to. You might need to walk and not listen to something, listen to the birds and yeah, I totally get that. So if someone just got diagnosed and is feeling, a little bit overwhelmed, what is one thing that you think they could do this week and maybe the answer's kind of obvious to feel a little bit more on the path that they need to be on. Uh, yeah, I guess, uh, I guess we kind of like going back to like just, I mean, what can people do on their own? They could change their diet and lifestyle. That's, uh, and I won't say that's the easiest thing, but that's something that people could do today or tomorrow, is just, uh, clean up their diet. Just with the stress management. I would say, if we're gonna again, say one thing. Block out five minutes per day for let's say just deep breathing. Um, and again, not that that's going to reverse your. Graves or Hashimoto's condition, but it's really about getting in the, into the routine of stress management and just, uh, trying to incorporate it not just a few days a week because I mean, which is still, which is great, but you know, there are a lot of people that don't do, don't do anything from a stress management perspective. But then there are people that say, well, yeah, you know, I do yoga maybe like twice a week and that's it. Um, which is great, but then not doing it at all, but. You know, just incorporate trust management every single day. So I would say take five minutes per day. If you don't have five minutes per day, then you definitely need to do this. Um, so, uh, and then once you're doing it for five minutes per day, then you could gradually increase the duration. Maybe some days you only do five minutes per day, but other days you have a little bit more time, so you do 10, 15, 20 minutes per day. So, so that, again, the diet, I would say, if we had to make a choice, yeah, I would probably say diet, but. It's hard to heal without, you know, if you're in a fight or if you're in fight or flight mode all the time and eating a perfect diet, it's still gonna be difficult to heal. So I really do think they both go together. And obviously the sleep, you know, we could also say sleep, but if you're eating well and your stress is really under control and managing it, that those two things will do wonders for a lot of sleep issues. Totally. You mentioned adrenals and how you wouldn't have necessarily bought into stress being a piece, and we see that a lot with our clients as well. What's the most common adrenal pattern that you see? Do you see people completely flatlined to just burn out or do you see the kind of the opposite cortisol curve that you should? And the reason I ask is because online right now there's this huge trend of like. Cortisol face and cortisol drink, and everybody's talking about cortisol and how you know your cortisol is actually too high and all this stuff, and we actually see a lot of clients that are just so burned out that their cortisol is actually just completely flatlined. So I'm curious what you see. Yeah, I mean, I see a mix, but I, I tend to see more of what you just said, and that was me. When I dealt with graves, I, um, pretty much had like a flat line cortisol, so definitely like low in the morning, and it wasn't high at night. It was low. Pretty much throughout the day. My DHEA was low. My secretary IGA was low everything. Um, so every, everything was low. And yeah, that's not the case with everybody, but I'd say that's more common. We do, we do see some people where cortisol is elevated in the morning and then I gotta see, you know, like, was it a stressful morning or like, are you having sleep issues? And so there's, um. Yeah. So, and, and then yeah, sometimes we do see like low cortisol in the mor, that opposite pattern you mentioned where cortisol is low in the morning, but then kind of spikes up at night. So yeah, we, we see a mixture of things, but I would say the flat line is, is pretty common. The low cor, and then the same thing I mentioned that I had low DHEA. It's not everybody, but that's pretty common too. This has been super helpful and I'm excited to share this episode. So last question before we wrap real quick is because this is called the Love Your Gut podcast, what is your favorite way, or what is one thing that you do to love your gut? Uh, another challenging question. One thing that I do to love my gut, um, oh boy. Um, I. I mean, I'll go back to the stress management just because the impact that stress has on the gut. It, it's, um, again, stress has negative impact. I mean, chronic stress has a negative impact everywhere. But again, the, the stress, I think real,'cause I mentioned how. When I dealt with Graves again, I had that low secretary IGA and um, and it stayed low for quite a while after a few retests and eventually it did get, um, to where it needed to be. Um, probably need to retest it again. It's been a while since I did a retest and looked at what that secretary IGA'cause. Again, that's the one thing about stress. Is, I think I'm a lot better. I know I'm a lot better when it comes to stress management, which has helped my thyroid, my gut, my immune system. But it's always, I think, a work in progress. So, um, so if I, again, diet of course, is a, has played a big role as well. But if I had to choose one thing, I'd, I'd also say the stress is, is probably the biggest factor or stress handling them. The improve stress handling, um mm-hmm is the one way I've really helped to love my gut. Love it. Well, where can everybody find you? Um, with your podcast, website, all the things. Yeah. So my podcast, uh, save my thyroid.com. Um, or just go see your favorite podcast and type in Save My Thyroid. And, um, then I have three books. Uh. Natural treatment solutions for Hyperthyroid and Graves Disease, which is in its third edition, Hashimoto's Triggers and the Hyperthyroid Healing Diet. You could find those on Amazon. And then my newsletter, uh, healthy Gut, healthy Thyroid, um, and then you could check that out by visiting save my thyroid.com/newsletter. Awesome. Well, thanks so much for joining. Thank you so much, Dr. Heather.