Naturopathic Beauty's Clear Skin Sessions
Clear skin and aging beautifully conversations, trainings and challenges by Dr. Stacey Shillington ND.
Naturopathic Beauty's Clear Skin Sessions
From Thyroid Clues to Clear Skin: Testing, Triggers, and Real Fixes
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Welcome to Naturopathic Beauty's Clear Skin Sessions, where we heal your acne from the inside out. Hello, beauties, and welcome to the Clear Skin Sessions. I'm Dr. Stacey Shillington, Naturopathic Doctor, and I've been helping women heal their acne for over 20 years. So this podcast is all about helping you on your clear skin journey. I am here today with Holly Corcan Sears. She is a registered dietitian with tons of functional medicine, you know, experience, really. Holly is like a gold mine of information. She's been with me, working with me for a few years. She's been in my program since 2017. And today we are going to talk about something that we see in almost all of our patients. We were just talking, and we think that it's probably 90% to almost 100% of our patients have a thyroid marker that is off. And that is a big deal. And the thyroid actually plays a pretty big role when it comes to acne. One of the things that it does that directly relates to acne is that it can slow down the rate at which skin cells replenish, and that is going to directly lead to acne, but it does so much more than that. So we're going to do a deep dive into the thyroid today. We're going to talk about what the thyroid does, why it's a canary in the coal mine, why it signals that there's deeper imbalances, the type of testing that we want to talk about, medications, and also the things that are often underlying, you know, the thyroid imbalances. And then, of course, we're going to share what we typically do to help our patients balance and heal their thyroids. Because when we first see our patients and we see a lot of imbalances, more often than not, we are able to fully reverse any thyroid imbalances and bring you back to complete health. So that's what we love to do more than anything. So welcome, Holly. How are you doing today?
SPEAKER_00:Hi, Stacey. I'm doing great. Although I'm a bit cold here in Nova Scotia, but that's okay. Winter is coming.
SPEAKER_01:Winter is coming. I know. It's getting cooler here too. I had last night I actually had to put all my summer clothes away and take out all my winter clothes. And it was a little sad because, oh my gosh, I have so many cute summer dresses, and I only really get to wear them, you know, three months out of the year. So here we are back to sweaters. Anyways, sweater weather. We love it.
SPEAKER_00:Sweater weather.
SPEAKER_01:So what are your first thoughts on the thyroid, Holly?
SPEAKER_00:Like so, this is one of my favorite subjects, as you know, Stacy. I feel like in conventional medicine, it's not taken seriously until it's very serious. Um, I think there's so much, so many pieces to it that it's very difficult to understand unless we look at your own specific, you know, markers within context of everything else that you have going on. So, as we talked about earlier, I would say nearly a hundred percent of our uh patients do have at least one of the six markers that we consider part of a full thyroid panel. Definitely subclinical, if not clinically, you know, outside of range. So I think, yeah, today we'll just explain our philosophy a little bit more about where we see the issues coming from and how we we go to fix them.
SPEAKER_01:Yeah. So let's talk a little bit about what the thyroid actually does. So the thyroid is actually the regulator of the metabolism within your body. So it is going to provide you with energy, it's going to regulate your temperature, it's going to help metabolize fats, and it's also, because we love talking about the skin, it's going to regulate the rate at which your skin cells turn over. And the one thing that I really love about the thyroid, it's kind of like a canary in the coal mine. So when the body isn't fully balanced, when the body is not in a state of health, when there's inflammation, when there's infections, when there's congestion, the thyroid is going to be one of the first organs to detect this. And it's going to kind of turn down the heat in the body. So it's going to decrease its activity in order to preserve energy and to protect vital organs and vital functions in the body. So that is what the thyroid does. So when we see our patients and they're, you know, many things are imbalanced, it's not a surprise for us to see that the thyroid is not working optimally. So, Holly, tell me, tell us a little bit more about what we're actually seeing when our patients come to see us with thyroid issues.
SPEAKER_00:So symptoms of hypothyroid usually are things like losing the outer corner, outer edge of your eyebrows, um, hair thinning kind of all over, not so much in kind of the male pattern areas, but all over. Um, feeling colds, weight gain, resistant to you know, usual things that that help you reduce body weight, um, can also be constipation, which is also something that we see quite frequently with our patients, and it can affect energy levels as well as uh ovulation and and hormone stuff. So we all of those things we do see quite frequently with with acne, and it all a lot of those can be other things as well. So that's why it's really important to test because those symptoms can also be similar to BCOS high androgens or high cortisol. So it's important to look at all of the markers to figure out where those symptoms might be coming from exactly.
SPEAKER_01:Yeah, and I think that that's one of the things that we're pretty obsessed with. We're pretty obsessed with testing, making sure that we actually understand what's going on in your physiology. We're not guessing, you know, we're not running tests that kind of give us a vague idea. We really want to get down into the weeds and we want to understand, you know, what's going on with your thyroid specifically, because that's what we're talking about today. And of course, on other systems as well, we take a deep look at. But specifically, Holly, tell me, tell us about, you know, the different blood markers that we run when we check in with the thyroid.
SPEAKER_00:Okay, so typically when you go to your doctor and you're having hypothyroid symptoms, they'll often run probably two, is what they typically run. The first one being TSH, which is thyroid stimulating hormone. And that is not actually a thyroid hormone, it's your brain speaking to your thyroid. And that when that number goes high, it tells us that your brain is needing to make a bigger signal or yell a little bit more for your thyroid to work. So it takes quite a bit of time for that marker to be, or sorry, the other thyroid markers to be out of range before the brain starts to feel like it needs to kick things into a higher gear. Then the second one that your doctor may test is free T4, and that's kind of like the basic hormone that your thyroid produces, but it needs to be converted to to use. So if you're thinking about oil, T4, free T4 is like crude oil. It's in its kind of basic form. Then one that's also really important that they may or may not run is free T3. So that's the converted usable form. So, say like the gasoline that you then go put in your car. It's it's usable at that at that stage. Um, another one that's not run so often, but is part of what we consider a full thyroid panel is reverse T3. So reverse T3 comes from Free T4, and your body sometimes converts uh to this instead to um attempt to slow you down, essentially, like what you were talking about before. So instead of converting all the Free T4 into Free T3, some of it if there's stress or you know, serious nutritional deficiencies, illness, that sort of thing, it could convert some of it into reverse T3, which blocks the thyroid activity. Um, and then two others that we test, which are autoimmune markers, are uh TPO antibodies and TG antibodies. And one of those or the other can be elevated or both. And if we see those elevated even a little bit, we want those kind of as close to zero as possible. Um that can mean that there's some autoimmunity. And usually we see in our patient population it's gut related. So people that have leaky gut or or intestinal permeability, um, food sensitivities, infections in the gut, that sort of thing. So you know, with with acne patients, those two things really go together. If those two antibodies are elevated above the clinical range, your doctor may diagnose you with what's called Hashimoto's thyroiditis, which is kind of clinical autoimmune hypothyroid. So the six are, I'll repeat them because I was very long-winded there, TSH pre T4, free T3, reverse T3, TP, TPO antibodies, and Tg antibodies.
SPEAKER_01:Yeah, and the important thing to note about all these markers is that when your doc, even if your doctor does run the full panel, they don't typically look at the ranges using functional medicine reference ranges. So you could get all these numbers back and they could fall within the typical reference range, and your doctor could say, you know what, your thyroid looks great. But we look at these markers through functional medicine range, which means it's a much narrower range, and we're able to detect patterns and we're able to detect imbalances before you even sometimes experience symptoms. I mean, so this is what we do, and it's very specific. And as you can see, there's so many different conversions and things that affect the conversion that we're able to understand the patterns that are going on in your body, and we're able to reverse specific patterns and uh, you know, kind of like catch a thyroid issue before it even happens. That's what we're trying to do, and that's what we're able to do when we run these numbers properly.
SPEAKER_00:Yes. And and the thing that your your doctor is trying to discover is whether you need to take thyroid medication or not. So that's why the range is so broad when it comes to what your primary care physician is looking at. There, they don't want to do anything, or they can't do anything because they don't have a tool in their toolbox to do anything, with those numbers being just outside of optimal range, where we we can do that. We can, based on the patterns, we can figure out where you may or may not need support. Um the other thing is they like to take a wait and see approach to thyroid disease, especially if there's autoimmunity. And the problem with letting autoimmunity run in the thyroid is that those antibodies are destroying your thyroid slowly. And it can take 10 years, maybe or more, for that to fully destroy the thyroid before you start seeing thyroid, actual thyroid markers start being out of range where you would need a thyroid medication. And at that point, there's no reversing it. So that's why we are so passionate, especially when there's autoimmunity, to really work on reducing that or reversing that, because it can be something that is not reversible after a certain point.
SPEAKER_01:Yeah. So you really want to do these blood markers. I mean, you do not want to do a test that gives you vague thyroid results. You know, I mean, a lot of people do an HTMA test, which is amazing to assess mineral levels, heavy metal toxicity. But when it comes to evaluating the thyroid, we need to understand it at a deeper level. We need to know if there's, you know, thyroid antibodies present. We need to know where where the cascade is falling apart in terms of your thyroid health. And when we understand that, we're able to target and treat it more directly. So, Holly, give us a rundown of the different medications that are typically prescribed for thyroid issues. We just want to touch on this briefly just so you understand, you know, what's happening out there in the typical medical field for thyroid.
SPEAKER_00:So if your doctor sees that your TSH is high and your free T4 is low clinically, they will suggest uh a T4 medication, which is synthetic called uh levothyroxin. There's some other ones, synthroid is another one as well. And you know, they'll give you that at a basic low dose and you know, check it every few months to make sure your TSH is coming down, which means your brain is happy with the amount of thyroid hormone you're getting. The problem with that one is if you're a poor converter to T3, you're not going to see much symptom relief because you're just gonna be pushing the gas pedal more and not much is happening. You're kind of spinning your tires because you're not getting what you need from that hormone. Um, the other thing that some more functional practitioners or integrative practitioners will give is some a little bit of T3 called leothhyroxin, or if you're working with a naturopath or maybe a functional endocrinologist or something like that. And some of some PCPs will also give natural desiccated thyroid or or NDT. Some of those brands are like armor thyroid, um, thyroid MP, um, that sort of thing. And you know, you have to make sure that you're regularly monitoring people when they're on those medications to make sure that we're not um pushing people into hyperthyroid.
SPEAKER_01:Yeah. And I mean, as a naturopathic doctor, one of my things is that, you know, those medications are good. Sometimes they're very necessary and very helpful, but they're not solving the root cause of the thyroid issue. There's something going on that is, you know, causing the thyroid to turn down the heat. And we have to figure out what that is. You don't want to be dependent on medication if you don't need to be. And that's why, you know, we really have to understand what's going on with the thyroid and dig deep, figure out, you know, what's actually causing these imbalances. And this is what keeps me up at night personally. I know it keeps you up at night too, Holly.
SPEAKER_00:Yeah, yeah, just because we're not prescribers, also, and we don't diagnose any, you know, um, disease. But when people are suffering and we're trying to get their medication sorted out, um, this is always a topic that makes me want to stand up on my soapbox.
SPEAKER_01:Totally. I know, I know. So let's talk about some of the reasons why we are not able, so many of our patients are not able to readily convert T4 to T3. Like, you know, uh in our patient population, uh it's usually the gut, uh, it's usually the liver, it can be nutrient deficiencies, um, uh, it can be high androgen levels. I mean, the list goes on and on. Basically, everything that is present in an acne physiology can tank the thyroid and prevent T4 to T3 conversion. It's like acne is the perfect condition to tank the thyroid. Wouldn't you say, Holly? Yeah, totally.
SPEAKER_00:Totally. They go together for sure. Yeah, and and stress, you know, these infections that we're seeing when we do stool testing and oat testing, mold stuff, you know, all of this is is part of the same picture. Yeah.
SPEAKER_01:Yeah, absolutely. So we've got uh gut infections, we've got poor gut lining, we've got poor nutrient absorption, we've got high cortisol, we've got inflammation, we've got liver congestion. And, you know, I'm I'm really always excited about the liver because as acne patients, we are just poor detoxifiers. That's the that's it. But get this 60% of thyroid hormone conversion takes place in the liver. So this is a really big deal for us as acne, as acne people. Um, caloric restriction, that's another one that we see all the time. You know, women come to us and they have not been eating enough food. This see this over and over again. And when you're not eating enough food, again, you're gonna be shunting T4 down the reverse T3 pathway. You're not going to be able to convert it to T3. Um, heavy exercise, this is another one. Again, you're gonna be shunting towards reverse T3. You're not going to be able to get enough T3 hormone. Um, and stress is something that you've already mentioned. So, yeah, I mean the thyroid is just a perfect place for all the different imbalances for acne to just kind of show itself. Yeah, exactly. Exactly.
SPEAKER_00:So um, I think another thing to talk about maybe is what we do for this. So when we're, you know, healing acne, we're doing all of our functional testing, we're um, you know, identifying nutrient deficiencies where we can, you know, using um Stacy's program uh to reduce stress, um, you know, stop over exercising, stop chronic fasting, regular meal times, regular bedtimes, that sort of thing. Um, and then there's a few key nutrients that we can use to support like things like selenium, um, zinc if you are testing zinc and it's low. We don't suggest taking zinc without without properly testing. And I like to look at RBC or red blood cells, zinc and copper before supplementing with zinc. Um and then uh the other one is iron. And that that iron conversation, we can open a whole Pandora's box if we go there. We'll go there on one of these calls or one of these uh uh podcasts, but not today. Um, but making sure you're getting enough of those nutrients um is super important.
SPEAKER_01:Yeah, and one of the nutrients that people often ask me about is iodine. And, you know, we absolutely need iodine for proper thyroid functioning, but this is not something that we typically see in our patient population. You know, I do not prescribe iodine, and I'm always able to rebalance the thyroid. That's because, you know, there are so many other factors that are involved in the thyroid in thyroid, you know, con proper conversion. Iodine doesn't tend to be one of them. Iodine deficiency is actually pretty rare. There are areas where there is more iodine deficiency, but you know, it really relies more on zinc levels, on selenium levels, vitamin A levels, um, glutathione as well. When glutathione levels are low, we're not going to have proper conversion. And I do organic acid testing with all my patients, and glutathione is one of the main things that needs support when you have acne. So that's another reason uh why conversion isn't taking place properly. And not only that, if there's a toxic load within the body, if there's, you know, hydrocarbons such as bromine, fluoride, chlorine, those are going to compete, you know, for iodine use. And, you know, these are things that are real. And so I do not find that actually supplementing with iodine makes a huge difference in healing thyroid with our patient population. What do you think, Holly?
SPEAKER_00:Yeah, yeah, and iron is or sorry, not iron, but iodine is also something, if taken in large amounts, can make acne worse. So it's really one of those Goldilocks things that you need to you need to get enough, but not too much, similar to other nutrients like like zinc and selenium and vitamin D in acne, you need to test and see where you are. Um, and the thing with iodine, we don't see that as a something that really moves the needle for us. And if anything, it can make things worse with our patients.
SPEAKER_01:Yeah, absolutely. So our approach is to really understand what's going on with the thyroid by doing the proper testing, taking a look at the gut. You know, is it the gut lining? Are there infections going on in the gut? Um, taking a look at nutrients, taking a look at mold, maybe there's yeast. All of these things are going to contribute. Taking a look at how the body is detoxifying, and of course, taking a look at stress levels. So, you know, I don't usually go in and treat the thyroid directly. There's a lot of herbs out there that are specific to the thyroid. I find they're too overstimulating. And when you overstimulate an acne patient, more acne happens. So you have to be very careful. You don't want to go in, you don't want to overstimulate the thyroid if there's a hypothyroid situation. Number one, that's not gonna solve the root-cause problem, but number two, it's often gonna cause acne to come back even worse. So we have to work around the thyroid, and that's how you solve the root problem, anyways, because the thyroid is is like the red flag that's being flown. There's something wrong, there's something going on here, we're being affected, you know. So we have to figure out what's actually going on, solve that, and then the thyroid pops right back into place. And we see it time and time again when we do this deep root-cause work, we see the thyroid come back to life without medications.
SPEAKER_00:Yeah, we do see a number of our patients be able to either, you know, convince their practitioner to change their medication to something that's working a little better, if, you know, in the short term when we're trying to reduce symptoms or even minimizing or coming off their thyroid medication completely, especially in cases where it's autoimmune related, the extra thyroid hormone is not fixing the problem. Removing the antibodies by healing the gut, et cetera, is is where the real um magic happens. And you know, if you need to take thyroid medication, some people do, fine, but we don't want to take it if that's not going to fix the problem long term, just like acne medications. They they may make things better in the short term, um, and but you don't want to be on them forever.
SPEAKER_01:Yeah, absolutely. And actually, we forgot to mention one really big thing that can lead to those thyroid antibodies, and that's gluten. There's such a huge connection between gluten and thyroid antibodies. So something to keep in mind.
SPEAKER_00:Yeah, we see women that have really high antibodies have usually um really strong reactions to gluten or undiagnosed celiac disease sometimes even. Um, so those two are friends.
SPEAKER_01:Yeah, absolutely. Yeah, so just wondering, uh Holly, what's your thyroid story? Maybe we should have told our thyroid stories right off the top, but was your thought were your thyroid markers off at any point?
SPEAKER_00:Well, for me, when my babies were really little and I was under a lot of stress, my thyroid antibodies had started to creep up, but they never got to the point where I would diagnose Hashimoto's. Um my T free T4 and free T3 have always been just under optimal, but I haven't ever had a reverse T3 because where I was living in the UAE, that that test is not really offered anywhere. And I actually just ordered a reverse T3 through through our lab here. Um I'm gonna do it sometime this month, so we'll see. But I've had kind of over the last couple of years, my TSH has been up and down, and that's usually in relation to having the flu or having COVID post those. I seem to have a little bit of a stress in my thyroid, um, but it's something that I keep on top of. I also have um cysts in my thyroid. If if you look at my thyroid under ultrasound, it looks like cottage cheese. Um, and there could be a number of different reasons why that's happening, but they're fluid-filled cysts, and I have them ultrasounded every two years, and they're always fine. There's none that look like they're problematic. But it does take those cysts take up um space in the thyroid, which takes away uh tissue that can produce hormones. So it's something I don't want to get worse for sure, and it's something that I I monitor on a regular basis. But right now, I'm good. I just have to keep my nutrients really stable and stay as low stress and healthy as possible.
SPEAKER_01:Yeah, and I think it's just knowing what we need to do that is so helpful instead of not knowing what's going on. Um, and for me, I think I did my first reverse T3 like in the mid-2000s, like around 2007, 2008. It would just, there was just a book that was written by Dr. Wilson. I don't know if you ever heard of him, but this was a long time ago. Maybe they called high reverse T3 Wilson syndrome, in fact. And so yeah, yeah, long time ago. And so I did a reverse T3. It was super high at the time, but you know, I was full of stress. This was probably the most stressful time of my life. I was not sleeping, you know, I was in the middle of medical school, I was having miscarriages, constant, like it was probably the worst time of my health ever. Um, but yeah, so that's when I discovered I had high reverse T3. But, you know, I've been able to get that under control for many, many years now because, you know, you've I've dealt with the root cause, you know, I understand where, you know, my physiological weaknesses are and what I need to support on an ongoing basis. So that's the work we do. Yep. Test don't guess. Test, don't guess, and do the right tests too. It's very, very rare that there's one test that can give you the overall picture of your health. It doesn't exist. I just want to say that for those of you that are relying on one test to give you the entire story of your body. It's it's really not out there. So we need to do functional blood work. We need to take a look at the gut. We love taking a look at organic acid testing because it tells us what's going on at a cellular level. Um so yeah, that's our story for today about the thyroid. I think we've touched on all the major points. Holly, any final things that we forgot to talk about, do you think?
SPEAKER_00:One thing that we didn't talk about is hyperthyroid, which is also Graves' disease, is kind of the autoimmune version of that. And you may ask about that or be thinking about that because we've talked so much about hypothyroid. But thyroid going too fast is something that we actually very rarely see. It's it's not so rare out there, but with our acne patient population, hyperthyroid is is not something. I think I've maybe seen it one or two times the whole time I've been working in functional medicine. So um, you know, there's different causes for that. Can be similar autoimmune stuff, stress stuff, but it's not something we think too much about with acne patients.
SPEAKER_01:Yeah, it's acne patients and hypothyroid typically go together. So that's what we usually see. Yeah. All right. So thank you so much for listening to this podcast. It is our absolute pleasure to share this information with you to help you on your clear skin journey. If you are interested in learning more about working with us, there's a link in the show notes. You can book a call with one of our team members and ask your questions about how to work with us. I also am launching my seven-week clear skin program. The link for that is in the show notes. And if you would, if you've had a good aha moment listening to this podcast, you want to leave a review? That would be so amazing because that's how we reach other women, how we, you know, encourage them to heal their bodies from within when they're experiencing a condition such as acne. There's a link in the show notes to leave a review. And if you do leave a review, we are going to gift you with the first module in the seven-week clear skin program. So thank you so much for listening. And we will be back with another episode very soon. And I think we're going to talk about maybe histamine, histamine intolerance and acne. I think that that is a topic that a lot of people want to learn more about. So have a beautiful, beautiful week, and we will see you soon.