Hashimoto’s Thyroiditis Webinar

Okay. Well, welcome, everyone to this Hashimoto’s Thyroiditis Webinar. This is Dr. Nik Hedberg, and tonight we’re talking about Hashimoto’s Thyroid. Like I was saying previously, last year I did a lot of teleconferences, but I wanted to open it up, so you could have some visuals as well so you could see some PowerPoint slides. I’m going to talk a little bit and go through the slides and then we’ll do some questions at the end. You can do that by just typing your questions into the chat window on the little Start Meeting screen that you’ll see on the right, and then I’ll be able to answer your questions that way.

Okay. You should be able to see the main slide now with the Immune Restorations Center and Hashimoto’s Thyroid. This is just a really big part of my practice. It’s a very, very common disorder out there, and unfortunately, conventional medicine really doesn’t have any approach or treatment for Hashimoto’s. Conventional medicine basically treats Hashimoto’s like they would just regular hypothyroidism. They don’t really test for it routinely because they don’t treat it any differently whether you have Hashimoto’s or not. This just leaves a lot of people with an autoimmune disease and they usually just give them medication to handle their hypothyroid symptoms, which sometimes people really do need that, but it doesn’t really address the underlying autoimmunity.

Hashimoto's Thyroiditis Webinar

I started seeing thyroid issues probably about nine or ten years ago, and just because it’s so common it became a big part of my practice so I knew I had to learn it in great detail. There were so many people out there who really need help with this condition.

Hashimoto’s, it is an autoimmune condition. Basically, the body is producing antibodies against its own thyroid tissue. You’ll hear some practitioners say, or some people say that the body is actually attacking itself, but really autoimmune disease is the body’s attempt to repair itself. It’s just a different way of looking at it.

Autoimmune diseases are on the rise. They’re significantly on the rise. Hashimoto’s is actually the most common autoimmune disease in the world. It’s very, very, very common. About 1 out of every 10 Americans has Hashimoto’s approximately, so that’s about 28 million people and growing.

This is a really important statistic, that 90% of patients with hypothyroidism have Hashimoto’s. What that means is that the majority of people with hypothyroidism, they have Hashimoto’s. And like I was saying, unfortunately conventional medicine treats them exactly the way they would someone who doesn’t have Hashimoto’s, so the treatment’s really the same. The underlying causes of the autoimmunity are not really addressed so the patient usually has a lot of other symptoms like digestive problems, hormone imbalances, depression, things like that, because the autoimmunity and the reason for it just wasn’t really addressed in the beginning.

Mostly women. One of the reasons why women mainly get autoimmune diseases more than men is because, number one, because they have higher estrogen levels. And the second reason is because genetically autoimmune diseases are expressed on the X-chromosome and since women have two of them and men only have one, they’re at a much greater risk for autoimmunity.

That’s basically what Hashimoto’s is. Hashimoto was a Japanese physician who discovered this autoimmune condition for the first time. We’re going to be hearing more and more about it as it grows, like I said, with all the other autoimmune diseases.

So the symptoms of Hashimoto’s are really the same as that of someone with hypothyroidism. Basically, what we’re looking at is a decrease in thyroid hormone. Thyroid hormone basically controls our metabolism, so it controls burning fat, burning sugar, energy production, so anything involved in that is going to suffer with Hashimoto’s.

Now some people, when they first develop Hashimoto’s and the body is making large amounts of antibodies that are going into the thyroid glands, they may actually have hyperthyroid symptoms in the beginning because there is so much inflammation there and there is a lot of thyroid hormone being produced. Eventually, they drop into a hypothyroid state.

Hypothyroidism, low thyroid hormone, there’s going to be decreased energy production so there’s going to be fatigue, weight gain and then definitely difficulty losing weight. These are the people who, they didn’t change their diet at all and they didn’t change their activity level, but they gain weight and then they can’t lose it no matter what they do. They’re exercising, they’re eating really well, they’re doing everything right and the weight just doesn’t come off.

Depression and anxiety. Cold hands and feet. A lot of these people will also say that, some of them are the people who wear a sweater in the summer. They’re very sensitive to temperature changes. They’re very cold overall or they will have ice cold hands and feet.

Constipation, that’s going to be there because thyroid hormone controls the digestive system. The ability to move food through the intestine is inhibited because of the lack of thyroid hormone.

Then we’ll see dry skin. Skin is hydrated through the metabolism of fat and as we said, thyroid hormone controls fat metabolism. When fat is metabolized, water is released into the cells of the skin and that is what gives us the moisture in our skin. But a hypothyroid patient or a Hashimoto’s patient, they have a difficult time doing that so the skin dries out.

Then the same thing with the hair. The hair will be very dry or brittle and the same thing with the nails. The nails may be very soft, actually, they may be very brittle. There may be ridges on the nails.

And there are going to be sleep problems many times. Sometimes difficulty falling asleep, sometimes staying asleep at night. Some people wake up in the middle of the night multiple times or they have difficulty going back to sleep.

Hair loss is another major sign. These patients will start losing hair. It’ll start coming out in clumps or in the shower. Then you’ll see the outside of the eyebrow, if you look at your eyebrows in the mirror, the outside, the area closest to the ear it starts to become very thin, and so those hairs just start to fade away. A lot of patients with hypothyroidism or Hashimoto’s, they’ll lose that lateral about one-third of the eyebrow.

Initially there may be hyperthyroid symptoms but eventually every Hashimoto’s patients will go hypo.

What causes Hashimoto’s? The first thing is there’s definitely a genetic predisposition. It does tend to run in families. I’ll see patients where the patient has it and the mother has a thyroid problem and their grandmother. That’s definitely part of it.

The genetic predisposition, it also plays into the infections. Infections are a major, major trigger of Hashimoto’s in many cases. It’s probably the most overlooked aspect of, not only Hashimoto’s, but almost all autoimmune diseases. Basically there’s this phenomenon where your immune system identifies an infection and it looks like your body’s own tissue.

For example, there’s this particular gut infection that people get called Yersinia. The immune system, it tags the Yersinia and it attacks it, but the Yersinia looks just like thyroid tissue. They’re very similar in structure and they’re protein structures so the body will go after the Yersinia and then it will also make antibodies that will go after the thyroid as well. Infections are really big; viruses like the Epstein-Barr virus; bacteria; fungi which includes candida yeast; and then parasites.

Gluten is another major player. Gluten is a protein found in foods, in many grains like wheat, barley, rye, oats and spelt, in a lot of packaged foods. One of the things we know is that people who have celiac disease also have very high rates of Hashimoto’s. People go on gluten-free diets. Sometimes they see significant improvements in their Hashimoto’s. Gluten can be a major player with this condition.

Too much estrogen in the body. Basically, this is an issue because this ties in with the infections. If there is too much estrogen in the body, it makes it more difficult for a woman’s immune system to control the infection. Too much estrogen will contribute to Hashimoto’s as well.

Low vitamin D. We’re learning more and more about vitamin D and its connection with many different cancers, bone health, mood, weight loss, diabetes, there are so many things, autoimmune diseases. There are so many things that vitamin D is involved in. Vitamin D deficiencies. Some people genetically have an issue with their vitamin D receptors, so they actually need a lot more vitamin D than the average person.

So-called leaky gut. Leaky gut, it’s also known as, the medical term is gastrointestinal hyperpermeability, basically meaning that the gut is extremely permeable, meaning things can easily leak through it. And leaky gut, basically what it does is it causes significant stress to the immune system and when the immune system is under chronic stress for a long period of time, then an individual can develop autoimmune disease.

Then the toxic metal mercury. There was an interesting study out of the Czech Republic looking at Hashimoto’s and mercury-containing dental amalgams, and they did find that for people who do have Hashimoto’s and they have an actual sensitivity to mercury, so they tested for an actual allergy to mercury – and so when those individuals had their mercury-containing amalgams removed, their Hashimoto’s got much better. That was indicating that the mercury was a major factor in their Hashimoto’s. Not everyone who has mercury-containing dental amalgams needs to have them removed if they have Hashimoto’s, only if they have a true sensitivity to the mercury in the amalgams. That can be an issue as well.

Environmental toxins. There are thousands of them, but cigarette smoke is an example. There are a lot of chemicals out there in our toiletries and in our clothes, the products we use, off-gassing from new furniture, from paints, from glues and dyes. There is just so much out there that people are exposed to. These toxins can trigger autoimmunities as well.

Then iodine. We know that when you add iodine to the food population–this happened in China, it happened in Turkey, it happened in Denmark–when they added iodine to the food supply, the rate of Hashimoto’s increased. There are a lot of factors there that come into play. Obviously genetic, because not everyone who takes iodine will develop Hashimoto’s but it can be a potential risk factor. There are a lot of studies out there on iodine and Hashimoto’s, actually one out of Johns Hopkins. They’re saying that iodine is really the number one environmental trigger of Hashimoto’s. There is a lot of data out there on that.

These are really the main things to look at. These are the things that are going through my head when I’m talking to a patient with Hashimoto’s trying to figure out is it one of these, is it two of these, is it many of these, which is it. That’s just where the detective work comes in.

Let’s go over some things that you can do now that you kind of know what it is and what causes Hashimoto’s.

The first thing that pretty much every Hashimoto’s patient should be taking is selenium. There was a study published in the journal ‘Thyroid’ in 2010. They gave patients with Hashimoto’s selenium for three months. Then they tested their antibody levels again and they found a significant decrease in their thyroid antibody levels. These patients taking selenium, they also reported that they had an improved sense of well-being and mood. It helped them significantly.

Selenium is really kind of known as the thyroid antioxidant. Selenium is an antioxidant but it’s also involved in thyroid hormone production, as well as the activation of thyroid hormone. T4 is about 90% of the hormone made by the thyroid gland and then about 10% is T3. T4 is not active, but T4 is active. Selenium is involved in the conversion of T4 to T3. It’s not only a good antioxidant for the thyroid gland, but it also makes sure and enhances your body’s ability to activate the thyroid hormone that it does make.

It’s really important that if you take selenium it’s in the form of what’s called selenomethionine. About 90% of selenomethionine is absorbed orally. The other forms of selenium that are out there, like sodium selenite and selenate, and those are going to be the standard selenium in a lot of the lower quality multi-vitamins and products. There is a risk of selenium toxicity, but that risk is very, very, very low with selenomethionine. About 200 micrograms a day is plenty, and that’s the dose that they used in most of the studies. Unless it’s selenomethionine, I would stay away from it. Selenium is just kind of number one on the list of things to do if you have Hashimoto’s.

The second thing, like we briefly talked about, was vitamin D. There was a study just published this year, actually 2013, in the journal ‘Endocrinology Practice’, and they measured Hashimoto’s patients’ vitamin D levels. The researchers found that the patients with Hashimoto’s, they had much, much lower levels of vitamin D than average. Then they also found that the lower the vitamin D levels, the higher their antibodies.

Vitamin D helps autoimmune diseases like Hashimoto’s because it helps to balance the immune system. When the immune system is just going crazy, it’s out of balance, it’s making antibodies against its own tissue in an attempt to repair itself, vitamin D just sort of comes in and calms things down. It balances things, so the antibody production is not going to be as strong against self-tissue. Vitamin D, we do blood testing for that as a baseline and then we get the patient on a good dose to get their vitamin D levels up. If their vitamin D levels don’t really respond, that could be an issue with the genetic defect in vitamin D receptors which we talked about.

A few other things to note is that the more body fat you have, the lower your vitamin D levels are most likely going to be. People who are obese or who have large amounts of body fat, it’s harder to get their vitamin D levels up. Then the second thing is the health of the digestive system. You have to be able to digest, breakdown and absorb the vitamin D so if you have a lot of gut issues or if you have low hydrochloric acid, if there’s a lot of inflammation in your intestine, then it’s going to be very difficult for you to absorb the vitamin D. Unless you’re getting 20 or 30 minutes of sunshine on your entire body every day, you’re not really going to get your levels up high enough to where they need to be. I like to see them between 50 and 100 on your blood test. That’s sort of ideal at this point. Vitamin D is really the second most important thing to be doing.

I just wanted to give you three major, major tips tonight–the selenium, the vitamin D and the number three is going to be the alkaline diet. It’s sort of one of the fundamental things that I work on with every patient. Most Americans’ diets are what we’d call acid-forming, meaning that they’re eating too many acid forming foods like a lot of grains, a lot of dairy and a lot of meat. That causes issues with the immune system. It causes a lot of issues with other things like growth hormone production, your ability to burn fat, your bone health. It does negatively affect your adrenal glands, so it does affect cortisol production. There are a lot of things there with the alkaline diet that are important. This helps people with Hashimoto’s because it takes stress off of the immune system.

What we do is we have you test your first morning urine pH with hydro-ion pH paper. You do that for five days in a row. Throw out the high reading and the low reading and then average the middle three, and that gives a fairly decent view of where your pH is. The ideal pH is going to be 6.4 to 7.4. If you’re below 6.4, you’re too acidic and if you’re above 7.4 you’re too alkaline. You don’t want to be too alkaline either. Too much of anything is bad, so you want to have balance. If you are acidic, if your pH comes in under 6.4, then we would have you eat about 80% alkaline forming foods then we would add in some magnesium glycinate and potassium bicarbonate. Magnesium and potassium are what we call buffering agents, meaning that they buffer the acids in your body, they mop them up and they help you become more alkaline.

If you want a chart that has acid and alkaline foods, at drhedberg.com, the resources section, there are a couple documents I have up there for you. The acid chart and then I also have some strategies on how to develop an alkaline diet and how to maintain it. That should be very helpful. Once you’ve achieved a really solid alkaline pH, usually people can stop the magnesium and potassium and then maintain at about 60% alkaline forming foods and 40% acid forming foods. The alkaline foods are mainly going to be plant-based fruits and vegetables, some nuts and seeds, herbs and spices. There are certain grains that are more alkaline than others. Acid foods aren’t bad; it’s just that they should be a lower percentage compared to the alkaline foods.

This is just kind of overall some helpful tips for you. A gluten-free diet. If you have Hashimoto’s that’s definitely number one on the list. Start on a gluten-free diet and see if you see improvements. The other thing that we do is we test patients for their food sensitivities. Other food sensitivities like dairy, corn, soy, eggs, foods like that, peanuts, some of the most common ones, these really stress the digestive system and they really stress the immune system. With autoimmune disease, we’re trying to take as much stress off of the immune system as possible and also heal the gut if the patient does have leaky gut. We want to identify those and also do the gluten-free diet.

The second thing that we want to do is identify if there are any infections involved in the Hashimoto’s. So viruses, bacteria, fungi, parasites that we talked about, if those are in the body and they’re active, the autoimmunity will most likely almost always be there and be active. So we have to identify those and then take the necessary steps to eliminate them.

Optimize vitamin D levels. We talked about that. Really, the minimum dose, what they’re calling for is about 800 to 1200 IU a day, and that’s just minimum. Then in some cases, we’ll go much higher. Make sure that’s in the form of vitamin D3, not D2. The preferred form is called cholecalciferol, not ergocalciferol.

Then we want to avoid iodine supplementation. There are in some multi-vitamins, there’s a very small amount of iodine. That’s not really enough to cause any major problems. Most multis will have about 150 to 200 micrograms of iodine, so it’s really not that much. You want to avoid the milligram dosing – 1 milligram, 6 milligrams, 12 or 50 milligrams that some people are taking – those are the high doses that you want to avoid.

We talked about the alkaline forming diet to help your immune system. Selenium in the form of selenomethionine, about 200 micrograms.

Then if you’re not sure if you have Hashimoto’s, make sure that you’ve had both antibodies tested, so the thyroid peroxidase and the anti-thyroglobulin antibodies. Some practitioners only do the thyroid peroxidase and then they miss the anti-thyroglobulins. You really need to check both.

There are a lot of great resources on the resources tab on drhedberg.com. I have a gluten-free e-Book that I wrote that you can download. There’s quite a lot of information in there on how to follow a gluten-free diet. Then I have all the information I talked about before for the alkaline diet. That should be helpful as well.

That’s mainly what I wanted to discuss tonight regarding Hashimoto’s. I’ve covered quite a lot of material here. I’d like to open it up for questions and you should see the chat feature on your Start Meeting window. If you’d like to ask any questions, you can start typing those in and then I can start answering those.

We have quite a large list of callers tonight. Hashimoto’s, it’s usually a pretty big topic. I think we’ve covered a lot of good material tonight: what Hashimoto’s is, what causes it, some really simple strategies that you can start to do just to start feeling better right away making some small changes.

I’m not seeing any questions coming through in the chat screen. Okay. There we go. Now they’re starting to come in. Some really good questions here.

This is a really good question. She asks, ‘Do you treat patients detoxing from heavy metals, assuming they have Hashimoto’s?’

That’s a really good question. Toxic metals, we talked about mercury. Mercury is really the major player with Hashimoto’s, although cadmium and arsenic can also be involved. Yes, we do heavy metal detoxification in some patients. The most important thing to figure out with toxic metals is the toxic metal really causing a problem because you don’t want a patient to go through a long heavy metal chelation process if it’s really not going to help them or if it’s really even causing any problems in the first place.

Usually detoxing heavy metals is not really the first thing that we do. We usually do that later on down the line if we hit a sticking point. The way that we test for that is with urine testing. It’s called a urinary challenge test. We’ll use different agents like DMPS and those bind to metals, carry them out in the urine. DMPS is really the best mercury chelator. Then in other cases, we’ll do more of a gentle detox in some patients to help the metals to come out much more gently, so to speak, rather than bringing in what we call the bulldozers like DMPS.

Like I mentioned before, if the patient does have mercury-containing amalgams, then we may run what’s called a MELISA test to see if the patient is having an immune reaction to the mercury. That will tell us if they really have to have the amalgams removed. That was a good question.

Let’s check the second question here. ‘How do you find supplements that tell you which type of selenium and D3?’ It should tell you right on the bottle. Cholecalciferol is vitamin D3, that’s the preferred form. Then the ergocalciferol is the D2, which is just not as good, so to speak, as D3. That’s an excellent question.

Okay. ‘Can you talk a little bit about the identification of infections?’ Yes. Basically, when we’re looking for viruses we’re doing blood testing. Blood will give you the best results for all the different types of viruses that we’re looking for with Hashimoto’s. Epstein-Barr virus is really the main one that we’re looking for. Then when we’re looking for infections in the intestinal tracts, we’ll do stool testing. The stool tests will tell us if there are any fungi, candida, yeast, are there any bacterial infections there, are there any intestinal parasites. Those are really the two main ways that we’re trying to identify infections specifically for Hashimoto’s. Great question.

Okay. We have another question here. The caller says, ‘I take selenium 200 micrograms.’ Let’s see. Okay. If it doesn’t say selenomethionine, then it’s not selenomethionine. That should be pretty easy to find on the internet. We have our patients order through Moss Nutrition. Moss Nutrition does carry selenomethionine. You can buy it by itself or you can get a good multi that has selenomethionine in it. That’s a good question.

Here’s another question. ‘How do you handle people that have issues absorbing vitamin D?’ This is a really good question. We use what’s called an emulsified vitamin D, and the emulsified vitamin D is basically a liquid and it’s in a form that really enhances the body’s ability to absorb the vitamin D. Most people, they’ll absorb it pretty well taking vitamin D capsules, but if there is inflammation or if there are digestive problems, we’ll go ahead and use the emulsified vitamin D drops. Those come about 500 IU per drop so it’s very easy to adjust the dose accordingly. That’s a good question.

Okay. A lot of really great, great questions here. Okay. ‘If you are taking a prescription for Hashimoto’s can you still take selenium?’ Yes. There is no contraindication to taking selenemethionine, about 200 micrograms a day. There are really no contraindications there, so that should be fine.

Another question. ‘Regarding vitamin D3 receptors, how do you determine if you have…’ Yes, that’s a good question. There is genetic testing available for vitamin D receptor issues. I don’t have any experience with those. I think that they’re relatively new. We don’t know how accurate they really are at this point. That’s a good question.

Usually if there aren’t any issues with absorption or if there’s a lot of inflammation and we’ve done the best job that we can with vitamin D supplementation, then we might just use higher doses of vitamin D. That’s just kind of how we’ve been doing it. That’s a good question. I am going to look into those vitamin D receptor tests and see how far they’ve come to this point.

Okay. So you’re asking about, here’s a question about the bacteria I mentioned called Yersinia. Yersinia, it’s spelled Y-E-R-S-I-N-I-A, and Yersinia, that’s actually the bacteria that caused the Bubonic plague, also known as the black plague. It’s a little bit different species, but it is kind of in the same family. Yersinia, people get it from contaminated food or water and they swallow it and they ingest it and then it lays eggs in the intestine. That’s tested two ways. Stool tests can identify it and then we also do blood testing to identify Yersinia. It’s pretty straight forward to pick it up with the testing.

Here’s a question. ‘Can you have fungi in your bladder?’ Yes. Fungus, it would take a tremendous amount of yeast in the body for it to actually be in the bladder. That’s a good question. Usually if you look at a urinalysis, when we order a urine test through the lab and they look at it under a microscope, they can pick up yeast but it’s very rare that they’re going to see that. So we just have the lab tech look at it under a microscope if we suspect that.

Here’s another good question. ‘I’ve read people with hypothyroidism should take D2 because the level of thyroxin makes it difficult for the body to absorb D3.’ That’s an interesting question. I’ve never heard of that. If you have any information on that, please send it to me, through my website or email info@drhedberg.com. That’s an interesting question. I’d like to look at that and find out if it’s really true.

Okay. Here’s another question. ‘Should someone with Hashimoto’s refrain from taking iodine?’ Yes. Definitely. I mentioned that in the presentation tonight. If you do have Hashimoto’s, you should definitely avoid iodine. The reason why is because there’s some really great research out of Japan on the effects of taking iodine and Hashimoto’s. What the Japanese researchers found is that if you have Hashimoto’s and you take iodine, you’ll increase the antibody attack on the thyroid gland. You’ll get a lot of inflammation. You’ll see the antibodies sometimes go up very high so you’ll increase damage to the gland itself. There are some practitioners out there who are very maverick and aggressive, who use iodine with Hashimoto’s. I’m not one of them. I like to follow the research, so I avoid iodine in patients with Hashimoto’s.

Okay. Let’s see. Here’s another question. ‘What about the high iodine content of ocean fish? Should one with hypothyroidism avoid seafood?’

If you just have hypothyroidism and you don’t have Hashimoto’s, then there’s really no reason to avoid ocean fish as long as they’re clean, wild caught and they’re potentially low in mercury. One of the things to be aware of is seaweed or seaweed salads. Those contain extremely high levels of iodine. In patients with Hashimoto’s, yes, we do have them try and avoid seaweed or any of the foods that contain high levels of iodine.

Great questions so far. ‘Is it okay to put on your stomach liquid iodine because the body will absorb it?’ That’s a really great question. There’s actually no validity to what’s called the iodine patch test. This is where people paint iodine onto the skin and then they look to see how quickly it disappears. There’s actually just actually no scientific validity to that test. It does not tell you if you’re iodine deficient or if your body really needs it. I would just avoid any kind of painting or putting it on the body all together.

Here’s a question. ‘What would cause excessive heart beating through your chest but still have normal blood pressure? How do I address that?’ Thyroid hormone drives the heart pounding. If there’s too much thyroid hormone, that can cause excessive heart beating.

The other thing is what we call adrenaline. If you’re under a lot of stress, the adrenal gland releases adrenaline and that will cause excessive beating of the heart. The sympathetic nervous system is the part of your nervous system that will really increase your heart rate and beating. Those are a couple of the things to be aware of. Those may not have any… Let me go back to your question. Okay. This was a question about the heart beating. That may not really have anything to do with blood pressure. Those two can be completely separate.

We talked about that. Here’s a question. ‘I realize there is a hormone imbalance, so is that part of the hot flashes going on during middle age?’ That’s a good question. The hot flashes can be related to adrenal hormones. They can be related to your thyroid or they can be related to your sex hormones. Then they can also be related to infections. Your body makes, there are changes in temperature when you have infection, sometimes up and down, up and down if it’s chronic and you’re trying to fight it. That’s why your body makes a fever. Those are the things to think about with the hot flashes.

Here’s a question. ‘Why are there so many differing opinions on the iodine issue? Even on many of the medical programs on television they advise taking small quantities.’ If your diet is deficient in iodine, if you’re eating foods that are from iodine-deficient soils, then you may need a small amount of iodine. Small amounts of iodine, like I mentioned, like the amount just in a multi-vitamin, those can be okay. It’s the much higher doses that you need to be concerned about. There are other things that come into play as well, like fluoride, chloride and bromide, like the chlorine in our water, the fluoride in the water, the bromide is some of the food. Those can all compete with iodine, so those are other things to think about.

We covered the seaweed issue. Here’s a question. ‘Do you recommend detoxing the gut to decrease intestinal inflammation prior to taking any of the supplements recommended?’ That’s a really good question. If there is a gut issue, we work on the gut the same time that we give the supplements. You can bring down the inflammation relatively quickly once you identify what the patient’s food sensitivities are and if you identify any infection in the intestine.

Usually some good anti-inflammatories and some other products that we’ll use for the gut like good probiotics, glutamine, fish oil, things like that, there are a lot of great natural anti-inflammatories out there. But it’s really removing the food sensitivities and getting rid of the infections that really brings down the inflammation. That’s a great question, but I like to heal the gut and use the supplements at the same time.

Here’s a question. ‘Where can a person find a competent practitioner in their area to treat them for Hashimoto’s? These doctors seem to not have a clue where to even start.’ That’s really a common theme with Hashimoto’s. I know you’re definitely not alone. If you just contact our office and let us know what city you’re in, if I know someone there, if I have a colleague there, then we’ll give you their information. Then we also do Skype with patients from a distance if they can’t find anyone in their local area, but we can help you find someone locally if we know someone good there.

Here’s a question. ‘In theory, if following all of your protocols could someone be cured from Hashimoto’s and come off all supplements and/or medicines? Have you seen this?’ Yes, definitely. I don’t really like to use the word ‘cure,’ especially with autoimmune disease because it is… Autoimmune disease, the gene has turned on and some people say once the gene is turned on, you can never turn it off and things like that.

The goal with every patient is to get their antibody levels down, find out why they have the Hashimoto’s in the first place, help them with their symptoms. Ideally, yes, you would want to get them to a point where they’re healthy and feeling well and they don’t have to take anything, whether it’s supplements or if they’re working with their doctor or their endocrinologist and they work alongside them and they think it’s okay to come off their medications, then, yes, that can happen. There’s nothing wrong with having to take thyroid medication if you need it. We’re very fortunate to have that available. It’s readily available and if you need it, you need it.

I’m not familiar with this doctor that you mentioned in New York City.

Here’s another question. ‘Do you think treatment with T3 can help regulate the thyroid back to normal? Yes, definitely. In fact, that’s one of my approaches with a lot of patients because, not to get into a lot of detail, but as I mentioned in the lecture, the thyroid makes about 90% T4 and about 10% T3. T4 is inactive until it’s activated to T3.

There’s another marker that we run on everyone called reverse T3. The reverse T3 is an inactive form of T3 that can actually cause hypothyroid symptoms and bind to the thyroid receptors. If you give someone more T4, you’re just going to raise their reverse T3. You bypass that by giving just T3, and yes, that sort of does get the thyroid back to normal. It kind of re-regulates the connection between the thyroid and the brain. So, yes, that’s a great question. We do use that approach.

‘What’s your opinion of Armour?’ I think Armour is a great product. It works for a lot of people. Some people don’t do well on Armour because it does have corn in it and some other fillers. Also, it does have some iodine in it, although a small amount. Then remember Armour is T4 and T3, so as I mentioned before, if the reverse T3 is high and you take more T4, you’re just going to increase that. Again, I think Armour’s great. It’s not for everybody, but if it works for you then that’s fine.

Okay. Another question. ‘Have any of your gluten-sensitive patients reported large red spots that look like spider bites when exposed to eating gluten?’ Yes, definitely. Gluten we can trace back to a lot of different presentations like that on the skin, various red rashes and eczema and the red spots that you mentioned here.

Okay. Another question. ‘Additionally, do white lips signify anything to you when T3 and T4 levels are normal?’ White lips are mainly going to indicate an issue with circulation, not enough blood flow to the lips. It could be an issue with oxygen, so that could be traced back to the lungs and breathing. Free T4 and free T3 by themselves are not really good markers. We also look at the total T3 and the reverse T3. And the total T3 and the reverse T3 give, I think, a much better picture than just the free T4 and the free T3. Free T4 and free T3 are really important but the total T3 and the reverse T3 combined with the TSH, I think, gives us a really good picture.

A lot of good questions tonight. ‘Before this ends, I just want to thank you for all that you’re doing and for actually caring.’ Thank you. I appreciate that. This is definitely a passion of mine. It is a big part of my practice, so I love talking about Hashimoto’s.

Here’s another question. ‘Are tongue irritations a symptom of Hashimoto’s?’ Yes, that can certainly be a symptom.

Another question. ‘I have symptoms of hypothyroidism and hyperthyroidism with Hashimoto’s, including weight loss with increased TSH. Can you address this issue?’ We can certainly try. If you… Some people have sort of a mixed Hashimoto’s and Grave’s Disease presentation. They’re going back and forth between hypothyroidism and hyperthyroidism. That’s usually an issue with the immune system, so our focus is going to be trying to get that balanced.

Wow. So we’ve been going for an hour here almost. A lot of great questions tonight. Again, this is recorded, so I’m going to make this available to everyone. I’ll send an email out when it is available. Again, this is Dr. Nik Hedberg, and tonight we were talking about Hashimoto’s Thyroid Disease. If you have any questions, just please contact us through drhedberg.com or email us at info@drhedberg.com. I really enjoyed this. I hope you did as well. A lot of great questions. We’ll see you at our next webinar. Take care, everyone, and have a great night.

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