TRANSCRIPTS : MODULE 3 - Amazon S3 Module 3 (Page 1) ... medicine and science are coming together with ... every 3 months is great. So 3 months, 6 months, 9 months, and then 12 months

TRANSCRIPTS : MODULE 3

MEDICAL DISCLAIMER

The information in this program is for educational purposes only. It is meant to as a

guide towards health and does not replace the evaluation by and advice of a qualified

licensed health care professional. For detailed interpretation of your health and specific

conditions, consult with your physician.

Transcripts Module 3 (Page 1)

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Kevin: Alright, welcome back! This is Kevin Gianni from The Blood Test Blueprint. We are now in module 3, so let’s get started. Let’s move onto part #7 now: vitamin tests.

Dr. Williams: The three basic vitamins that we look at in the blood tests are going to be your vitamin B12—we already mentioned that and the anemia—but let me address that a little bit more. The vitamin D-3, which we didn’t talk about, but is also in terms of your immunity, is very important in lowering your risks for cardiovascular disease and cancer, and improving your energy. Having good strong levels of D-3 is important. And then folate level we already talked about as well.

Let me start with folate, because you measure it in the blood either as the B12 and

folate together...and repeating myself just for the sake of clarification—for strong plant-based eaters, folate is almost never low, and for vegans and raw food vegans, I’ve never seen one low. So I never test it. But if you’re listening to this program and you’re eating a standard American diet or you’re eating a good healthy diet, but not a lot of green plants, and no green juices, then when you do your testing, check to make sure that your folate levels are adequate. There’s no optimal range. You just want to make sure that they are within the accepted limits for folic acid and aolate.

On the Vitamin B12, the methylcobalamin form is the preferred form. There of course are

other forms, but they’ve become more expensive and they don’t add a specific advantage by using the hydroxocobalamin or adenosylcobalamin forms. So methylcobalamin in dosages from 1,000 to 5,000 mcg are adequate, and the standard range is 211 to 946 picograms per milliliter (pg/mL). Let’s for the sake of rounding up numbers, make it easy, let’s say 200 to 950. If your levels of B12 are 300 or in the high 200’s, it’s probably too low. I find consistently that there’s vitamin B12 deficiency symptoms that can include memory lapses, fatigue, and many of the symptoms associated with low grade anemia, will occur in those patients—and also chronic inflammation. Higher dosages of vitamin B12 help to manage chronic inflammation. So you want to push the range up—minimum of 400. However, I like to see 600 in terms of getting the optimal, and even above 1,000. The range is up high as 946, and if my patients are taking supplements, and they’re getting 1,100, 1,200, 1,250…that to me is fine. They’re in optimal range, and we’re just going to modulate their...and that’s not going to be a dietary range, it’s always supplemental. Nobody gets that high with food. The dietary ranges tend to be 300, 400, 600 maximum. When you supplement, you can push them up over 1,000. If they’re taking injections and they’re supplementing, or they’re getting IV drips, they can be over 2,000. That’s too high, because too high vitamin B12, as well as too high folic acid, interfere with the metabolism of each other, and they start to throw the balance of not only B12 and folate off in the body, but other B vitamins, and it’s kind of a cascade effect after that. So too high is not good, but strong levels—600 to 1,000, even 1,100 or so is okay for B12.

In your vitamin D-3...now this is very important, because we see more and more

almost an epidemic of vitamin D-3 deficiency. Back in the early 80’s, mid 80’s, when I was teaching clinical nutrition at the University of Humanistic Studies in San Diego, in my master’s degree students, we saw vitamin D deficiency come up over and over and over again, that early on. And then it was almost predictive of a potential epidemic. Low and behold, now we’re finding all over the world really—not just in

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northern climates, but also in southern climates—that vitamin D status is low. We’re also finding about…more and more about vitamin D and it’s importance in the body, and that the old way of thinking that vitamin D is made from the sunshine and that you get enough and taking castor oil is more than enough, and that having a little bit in your blood is great, is completely proven false. It’s one of the big many, many myriad of changes that are happening as we said in medicine, where conventional medicine and science are coming together with naturopathic…with natural, evidence-based medicine. So what we used to think was that, you know, if you had any vitamin D, and it’s sort of plateauing off at about 30 to 40 micrograms per liter, was more than enough. And now we’re finding that, no, that’s actually on the low side, that you need at least 39 or 40 to just kind of not be vitamin D deficient. And the way we measure that in the body is a substance called 25-hydroxy. So when vitamin D is made in the skin or ingested from food, it’s converted into the liver to this 25-hydroxy form. Some labs will measure 2 or 3 forms of it, and that gives you an idea of both your vitamin D-2 and your vitamin D-3 status, but the 25-hydroxy form is what we order, not just...you don’t order vitamin D-3, you order vitamin D 25-hydroxy, and…which is the major circulating form of vitamin D. And it’s the one we use for evaluating vitamin D status. So you want to get that up greater than 40, and if possible, move it up towards 60 to 70, even 80. Now the ranges in some of the labs go from 32 to 100—pretty broad range. And maybe 100 is getting too high. We used to think that vitamin D was very very toxic, but now we know that it is toxic, but it takes an excess of over 100, over a period of 5, 6 months, or longer, to produce any toxic effects at all. In my patients, if they’re over 100, I tell them not to worry. That’s not a toxic level, but we’re going to…just to start reducing their supplementation. Remember again that you do not get high levels from diet alone. Only those high levels come through supplementation. Dietary levels, what I see, is that some people do better in making vitamin D-3 than others. Even from northern climates, some people’s diets are better than others. But the best I see, just from diet and sunshine, is maybe 43…just barely within the acceptable range. So vitamin D supplementation is important, and it’s the vitamin D-3 form that works the best. And the dosages are 1,000 international units as a starting dose, but often we have to give up to sometimes 5,000 or 10,000 units a day in order to get the vitamin D levels up. They go up very slowly, so it takes many months for them to go up. They don’t usually jump up even at high dosages within a month. So again, doing your retesting in three months, you’re going to see a slight movement up, and the serial testing is going to show you: Are you gradually leaning? Is the trend upward, or has it plateaued off, or is it not going at all? And I often see, frequently, almost daily, patients will come in, their vitamin D levels are 5, 10, 14, and they’re taking vitamin D supplements. And I say, “Well here’s another paper, in this case, we’re showing deficiency, and you’re telling me you get a lot of sunshine and you’re taking a vitamin D supplement. Bottom line is something’s not working. Let’s change to a more active form of the supplement, and let’s get a dosage that’s really working for you, and then let’s see if it goes up.”

Back to the serial testing. If you’re really looking at some of these nutrient levels and you want to make the first year my optimal blood test year, and you’re going to start looking at all these markers, and you’re going to be moving them towards




the normal, towards the desirable, towards the optimal. Then that first year testing every 3 months is great. So 3 months, 6 months, 9 months, and then 12 months, and forming a record of your tests. And following your D-3 is important, because you might see a trend—say it goes from 25, and then you test it the second time and it’s at 35. You test it at 6 months and it’s at 45, and you say, “Oh, that’s great! That’s a trend.” Then you skip 6 months or a year, and now it’s 120. So you kind of overshot the mark. So getting it just right is really important.

Kevin: And one last question about B12 testing. I’ve heard a lot about the methylmalonic acid test. Is this something that it this is appropriate as well, or…?

Dr. Williams: Yeah, the methylmalonic acid is very interesting. It’s very expensive, so I find that it adds a clinical dimension, and it looks at B12 and homocysteine from another angle. It’s another view, but I rarely find it abnormal. It’s maybe 1 to 3% of cases who are even B12 deficient have normal methylmalonic acid levels. So I don’t do it that often. It’s…sometimes we use it as kind of a starting point, as part of those testing B12 and anemia status, because…and if we go into iron as the next topic, we’ll see that deficiencies come in stages, and my biggest concern...I have two big concerns with the American and now kind of almost, kind of the Western world diet. And as you know Kevin with my nonprofit work on the other end, in the Third World, I’m concerned about nutritional deficiencies and starvation. But up here, we get too much of nothing sometimes, or too much of the wrong stuff, and that tweaks us in bizarre and sometimes strange ways that you can’t really define when you’re just looking at the basic numbers. For example, deficiencies can occur slowly. If your diet is supporting…has some B12, has some iron, has some D-3, but you already have decent stores, your body will be using from your stores as well as from what you’re taking in, and it won’t appear right away. Symptoms might start to appear…vague symptoms will start to show up, and then fatigue, and light-headedness, and memory and maybe things like that…digestive disturbance…little bit, little bit. And then when you look at your blood, you don’t really see too much, or we start to see…then the next time you look at it, all of a sudden, it’s low. So sometimes it’s good to...especially on some of these extremes, if people have been eating a pure vegan, especially raw food vegan, diets, say for more than a 1 ½ – 3 years, then they might be getting enough of B12 from some of their super foods—enough to prevent their system from totally crashing—but not enough to keep their biochemistry really fine-tuned in an optimal ranges. And then in those cases, the methylmalonic acid can be quite useful. And I’m finding more and more, particularly in like in the more progressive centers, like in New York City, San Francisco…the holistic doctors will include methylmalonic acid on the first test for all the extreme vegetarian, vegans, raw food folks.

Kevin: Let’s move into part 8 here, talking about iron and iron tests.

Dr. Williams: Well Iron tests are important again for people who tend toward anemia, and again for the high plant-based, and for the a vegetarian vegan, and raw food vegan eaters, to make sure that they’re getting enough iron. But also as you get older, your iron levels can go down. It’s the most common deficiency in elderly people. And there’s




also another problem with too much iron. So iron is a very important mineral in the body, and it affects all tissues. It’s present in all cells and it helps carry oxygen to everywhere in the body. And symptoms of iron deficiency can occur even before it’s progressed to iron deficiency anemia. And the need for iron is so important for so many enzymatic reactions in the body, that you have to have enough, but not too much. And it has to...everything has to function normally, and as we’re talking about…move towards not just normal, but towards optimal. Optimal means kind of like totally normal.

So you can have a wide range of symptoms—again very, very generalized—that can suggest low levels of iron in the body. Not maybe totally frank deficiency, but starting to tend to low. And I’ll often see people in this…they have mixed. They’ll have a little bit of anemia, but their iron is okay, or they’ll be non-anemic, but their iron is low. So I know that there’s…we’ve caught them at a point where they’re tending towards more severe anemia, but they came in because they have these vague symptoms including fatigue—not just being tired, but low energy and weakness. They just don’t have the grip strength, their muscle strength, their ability to stay in downward dog in their yoga is weakened. They’re pale, and people always ask them, “Are you okay?” Irritability. You know, unexplained irritability. They sometimes blame it on, “Well, I’m having PMS,” or “I’m hypoglycemic. I’m low blood sugar.” But it can be also low iron. And low immune function is associated with low iron levels. So you may be taking all of the beta-glucan and medicine mushrooms in the world, but if your iron is not right, your immune system is not going to function right. And restless leg syndrome—jumpy legs at night can be iron deficiency. A couple of the things such really show up is people have…they have painful tongue. They say their tongue feels pain or burning in the throat. So when the mucous membrane covering will cause atrophy to the mucous membrane, and the nerves will be sensitive. And sometimes we know that that’s also associated with B12, or B2 riboflavin, and B3 niacin deficiency, but can be also iron. Brittle nails, and ridging nails running upwards from the base of the nail towards the end, and the nails when they kind of split or fracture at the edge, are also associated with iron deficiency. And another one, big one, is hair loss. So many patients say, “My hair is falling out and I must be weak thyroid. I listen to your program and check my thyroid, or I check my thyroid and my TSH is okay, but my hair is falling out.” Or I correct their thyroid and their hair is still falling out. The first thing you also want to look at is protein. And protein is made…hair is made from protein. So we want to make sure they get enough protein, make sure the thyroid is strong, and make sure they’re getting the minerals, but often it’s going to be iron deficiency, especially when they get older. And correcting that solves the hair falling out.

So lots of vague and symptoms that associate with lots of other conditions. And then as I mentioned, it comes on gradually, so clinically we look at it as 5 stages. And the first stage is where you’re just really depleting your stores of your iron. The iron may be normal, but the ferritin levels will start to go down. Hemoglobin levels may be okay. Your red blood count levels may be okay, but your iron binding capacity levels start to trend upward. So then we can say, well, you know you’re…maybe you could call that early stage in iron deficiency. Finally, you start to have red blood




cell formation impairment, so that you’re not making enough red cells and your red blood cell count goes down, your RBCs are low, and then your iron goes down. So…but even then, the iron levels don’t have to be frankly deficient—that just under 50 is kind of showing signs that yeah, this is probably iron deficiency anemia. And then stage 3, the RDW—that’s your red cell distribution width—goes up. And then in the fourth stage, your red cells become smaller and paler. And finally, in the fifth stage, you have iron deficiency throughout the body, and occluding iron deficiency anemia. So iron, as I mentioned earlier, and the forms of taking iron are very important.

Another problem with iron is too much. And that’s a condition of hemochromatosis. So you have higher red blood count and higher hemoglobin, and that’s associated with many types of diseases, particularly liver disease. It can also be a genetic…almost always in men, and it tends to show up in age 30 to 50, in men, if it’s genetic. But what a lot of people know is that iron plays a role in the immune system, and bacterial growth. You need enough iron for your immune system to work properly in terms of reducing bacterial growth in the body. Now you need bacteria—most of your body is made up of friendly bacteria—and so you need iron for the good bacteria, the pro-biotic in the gut as well as throughout your body. And so if your plasma levels of iron tend to be lower, your more prone to bacterial infection. Your body also controls iron, and it will get rid of some of it during fever, and maybe after surgery where there’s some blood loss. So adding a lot of iron to repair anemia due to blood loss, is not wise. You want to provide a moderate amount, but not too much. And having just the right of iron…maybe in terms of iron, the optimal levels are going to be—in terms of the normal range—are going to be towards the low end of the range, rather than the high-end. And the symptoms of levels that are too high include joint pains, fatigue. These patients complain they’re always tired. They’re pretty strong, and these are men, so they’re going to the gym and everything. But they just don’t have the “oomph.” Their sex drive is down. And for women, often will lose their menstruation, so they’ll skip periods or they’ll have long periods without having menstruation. And people can also have discomfort around their abdomen, around where their liver is, kind of in the midsection of their belly towards the right side, and then we have to look a little bit lower. So when you’re looking at your red blood counts and your hemoglobin and hematocrit, if they’re too high, that’s not necessarily means you have strong levels. That means you may have too much oron. So again, checking your iron levels is important. The range for iron is 60 to 170 micrograms per deciliter (mcg/dL), and you want to be in the mid range. You don’t want to be of low, too low, or too high. But a shift down, little bit towards the lower end is important. That a little bit lower, mid-range, is better than too much. And then the total iron binding capacity is 240 to 450, and you want to be within the range. And for your ferritin levels, which go down when you have very severe iron deficiency anemia, you want to be within range.

Kevin: Alright Dr. Williams, let’s get into the 9th module, which is thyroid. A lot of women are experiencing thyroid issues these days. And maybe you have some insight into that. But let’s talk about thyroid tests—the most common TSH, but as you know and as you’ve experienced, and maybe some of our listeners already know, is that TSH is not the only test we want to be taking to…to figure out if our thyroid is functioning




appropriately. So let’s start talking, basically…what are we talking about when we’re talking thyroid test, and let’s get into what we need to do.

Dr. Williams: Alright. The TSH is the basic test—that’s the thyroid stimulating hormone, or also called thyrotropin. It’s a peptide hormone, meaning it’s built on peptides or amino acids that’s made in the anterior—the front part—of the pituitary gland. And the TSH or thyroid stimulating hormone regulates hormonal activity of the thyroid gland. So it’s a pituitary hormone, but it’s the master gland to regulate the thyroid hormone activity in the entire body. The thyroid gland is in the neck, just below the chin, and it’s the one endocrine gland that’s the closest to the surface, and where we don’t have—unless we where turtlenecks all the time—we don’t have clothing over it. So it’s very susceptible to environmental toxins, environmental pressures, climate change, if it’s hot or cold during the day time, and also oxygen levels in the air, and of course for us it’s very accessible to treat or do to ultrasounds, and the blood tests are really well known and they’re really easy to do. However, two things, as you mentioned. One is that thyroid dysfunction of all types—kind of a spectrum of thyroid disorders now—are becoming more and more common. And we used to say that for every five to eight low thyroid or hypothyroid cases, there was one hyperthyroid case. Now they’e about one to one. There’s just an increasing levels of hyperthyroid cases, and there’s an overall increasing levels of all types of thyroid cases, predominantly in women.

Why? We don’t totally know, but we suspect a number of things. One is that the toxic chemicals in the environment and that accumulate in the body, and the lower levels of oxygen—the percentages of oxygen in the air in urban areas—are somehow contributing to thyroid dysfunction. Maybe also accumulation of viruses and other microbes might be causing some of the autoimmune activity. And then in women, all the hormones relate and work together in a highly orchestrated way, like a symphony orchestra—in both men and women—but women’s hormone systems are infinitely more complicated than a man’s, so that their estrogen is a very sensitive hormone. It’s perfuse throughout their body, and of course men have some too, but women have many different types of estrogens. And that…the estradiol—the most common one—seems to be very sensitive to, or even more reactive to, thyroid issues. So we suspect there is some type of endocrine imbalance caused by stress, caused by environmental toxins, caused by heavy metals, caused by diet. And we’ll talk about all of those as we go along. And then the interplay between the thyroid and adrenals. And that’s the 10th module. And that’s why stress plays a strong role in not only adrenal dysfunction, but also thyroid dysfunction, because the one hormone will pick up for the other. If one is low, another hormone—in this case, say, the thyroid hormones are low—the adrenal might pick up the activity and kind of try to help balance off the way the body functions. But after a while, both will start to collapse. The adrenal system will collapse. Thyroid system will collapse. So that’s why it’s so complicated, and why there’s more and more of these conditions. So it’s really important that people…as they’re checking their own lab tests, that they test…and my recommendations for basic panel are testing of the TSH, the thyroid stimulating hormone, and then the bioactive forms are called the free hormones—that’s the T3 and T4—and one autoimmune marker called thyroid peroxidase




antibody, or abbreviated TPO. Capital T, capital P, capital O. So we’re going to be talking about those four tests. And in a comprehensive testing, we would do several others, but this is a good starting point. It will tell you if you’re high or low thyroid, and it will tell you if you’re converting the thyroid in from the bound form to the bioavailable or the “free” for, and it will tell you if you have enough of the most active form, which is the T3, and the relationship between the TSH and T4.

Now let me mention that, as you said Kevin, the TSH is the kind of the gold standard, combined with free T4. So the main hormone that the thyroid produces is T4 or “thyroxine,” and we measure that in the blood, called “total T4” or thyroxine. And that’s the total amount of circulating thyroxine in the bloodstream. Now the free forms are the ones that are not bound to thyroid binding globulin—a protein that grabs ahold of the thyroid hormone. And all hormones have binding proteins. But if you have too much binding protein, and you have too much of the total form, then it’s not going to get into the tissues. It has to be unbound, or free, in order for it to get into the tissues. And the free forms are just a small percentage of the bound forms. So the standard test is to do a TSH with a free T4, and that’s matched to the prescription synthetic thyroxine that is commonly used to treat low thyroid. And it’s a really simple, straightforward, brilliant system. The only problem is, is that it does not address all the other complicated aspects of thyroid disease, and does not address at all the spectrum of thyroid disorders that are showing up in the modern world, and it’s only matched to a synthetic form of thyroxine…which some people respond to very well, and other people don’t respond to at all, or have different side effect issues. So of course in natural medicine, we’re going to try to rebuild the glands, and re-stabilize the whole hormone system and get everything reconnected again, but if we’re going to use hormone, we prefer to use the bioidentical hormone.

So in terms of symptoms, the thyroid dysfunction—very much like anemia or iron deficiency or some of the other things we’ve already talked about—have very generalized symptoms. And thyroid is sometimes called the “great mimicker” because they’re—pretty much any disease can be associated with thyroid. The list of symptoms is extremely long. I go over those in detail in my book, Prolonging Health, the pages of symptoms, but the most common ones are number one, is dry skin. It’s not just dry skin of the winter, so you’re just dry and a little bit itchy and flaky because of the dry heat from being indoors in the winter, or if you dry out your skin from not drinking enough water, or if you’re exercising too much in a hot studio. That’s not what it is. It’s a dry, thickened kind of skin, kind of, and there’s not a smoothness to it. There’s not a resiliency to it. It’s more cardboard-like in texture. So dry skin is one of the first tip offs. Most women will focus on the hair symptom which…and with low thyroid the hair becomes very thin and starts to fall out, a lot of it. It’s just on their shoulders. When they brush their hair there’s the handful in the brush, or when they wash their hair there will be a lot on the drain. So that’s way too much hair coming out. But it’s also thinning of hair. You can lose hair after pregnancy. You can lose hair with iron deficiency, and you can lose hair with protein deficiency. But with thyroid deficiency, then you’re going to have…it’s going to be thin, brittle, falling-out hair. And then of course, fatigue. But the type of fatigue with thyroid is this hard to get up in the morning, you just have a very slow start going.




You don’t feel rested at all, even if you slept well. And it takes an hour, two or three, four hours for you to really get going, even after a full night’s rest—eight, nine or ten hours. And also with thyroid you have difficulty thinking. It’s kind of a slow to respond. Somebody asks you a question and you seem be thinking about it, and then they’re already looking at you like…or they repeat the question, and you say, “Oh no. I’ve got it. I’m thinking about it.” That’s another tip off. Constipation has many, many different causes, but low thyroid is very much associated with constipation. And also fibromyalgia is associated with low thyroid function. And people that have low-grade muscle and joint pain—that they don’t have arthritis, they’re just kind of achy all the time. It’s often associated as well. But fibromyalgia in particular is strongly associated with low thyroid. And then of course the classic—this feeling cold, or being sensitive to cold temperature, always wearing a sweater, even in the warmer weather, and the low basal temperature of so-called low thyroid, low body temperature syndrome, always feels cold type of thing. And other things that come up with thyroid are unexplained high cholesterol. If you’re eating a plant-based diet, you’re not eating a lot of oils, and you still have high cholesterol, often it’s associated with low thyroid. The metabolism is just not strong enough to work with the fats in the body. And then sometimes also unexplained anemia. And then another one is slow reflexes…when the doctor taps your knee, or especially your ankle, and the Achilles reflex…they tap it and then a second later, the foot moves. That’s very strongly associated with thyroid. But as I mention, the list is very, very, very long, and it crosses over to all types of other conditions.

Now we mentioned that—we start with the pituitary and the thyroid gland—that there’s interconnection between estrogen and the ovaries and the adrenal glands, but also in the hypothalamus, where thyroid-releasing hormone is secreted. So there’s a, really a complex biological loop that’s going on between the hypothalamus, the pituitary, the thyroid—we call HPT axis. And then the thyroid and the adrenal, and the thyroid and the ovaries. And then the hormone has to get out into the blood. The primary hormones are T4, thyroxine, and T3, which is called “triiodothyronine.” And the majority of the hormones secreted by the thyroid is the thyroxine, or the T4, and some T3. But then in the body, once it’s out into the blood system and out in the periphery and the tissues, the cells will convert the T4 into T3, and also, as I mentioned earlier, the active form is the free T3, or the unbound T3. And those are the ones we’re going to measure, so let’s take a look at those.

The TSH is the first one. The laboratory range is 0.4 to 5.5. The desirable range is 3.5 or less, so 0.4 to 3.5. But optimal range—and there’s some differences of opinion by doctors specializing in the optimal thyroid medicine is they…in my practice, I’m okay with 0.4 to 2.5. So if a patient comes in they’re first testing, if they’re less than…their TSH is less than 2.5, and their other numbers and okay and they don’t have symptoms, I leave it be. But other doctors think that the range has to be much lower than that for optimal. And I agree in some patients—they are just not functioning well unless they’re in a very, very tight range of TSH at 0.1 to 1.5. And there’s a lot of individual variation in thyroid…how the thyroid hormone works in the body. The free T4: the laboratory range is 0.8 to 1.8. So a very narrow range, and the desirable range will be within the lab range. But the optimal range—you want it above the bottom. 0.8 is




not good enough for my patients. I want the optimal range to be 1.2 up to 1.8, but not higher—not much higher than 1.8. And then the free or unbound T3: laboratory range is 2.30 to 4.20. Desirable is within range, but optimal is 3.5 to 4.5.

On the TPO, or thyroid peroxidase antibodies—several of them—they’re also known as anti-thyroid peroxidase antibodies, or antimicrosomal antibodies, depending on the lab—they work against thyroid peroxidase, which is an enzyme that plays a part into T4 to T3 conversions. So very important that you don’t have too much activity in there. You want just enough and not too much. And elevated levels of TPO are associated with autoimmune thyroid disease—both low and high thyroid. So you want your TPO antibody to be always within the range—the laboratory range—and the range that I’m most familiar with is less than 20. So if it’s 25 or 30, then it’s too high. In my patients, sometimes we see a TSH that’s 10, 15, 30, 65…I have one patient who is over 300. The highest anybody’s ever seen! And their TPO antibody could be 60, 200, 250…those are very, very hypothyroid patients. But for the listeners of this program, what we want you to think about is…If I have a lot of these symptoms and I’m not within the optimal range, what can I do to bring myself to more optimal? And also, if I’m just outside the normal range—if my TSH is a little bit elevated, like 6.5, or maybe up to10, or if it’s a little bit low, like 0.2 or 0.1—are there things that I can do to bring it back to normal without using drugs or without using hormones?

So the first thing we’re going to do is take a look at our TSH. So if the TSH is high, that means you have low thyroid—hpothyroidism. And if it’s low—if the TSH is below the laboratory range—then you have an overactive thyroid. You have hyperthyroidism. So you want to move always towards the…within laboratory range, and then towards the optimal. And then try to move your T3 and free T4 also towards the optimal range, and make sure that your TPO antibody levels are within range. Now if you have, as I mentioned, low TSH and high free T4—that means you have an overactive active thyroid gland—then you should see your doctor, because that’s a serious condition and it can…affects the heart, increase the heartbeat, keeps you awake at night, makes you eat more, and you lose weight, and that needs to be evaluated. It’s not that easy to do it on your own. But if your TSH is high and your free T4 or your free T3 are low, then you have an underactive thyroid gland, and the pituitary is putting out more TSH to try to stimulate the thyroid gland to make more hormone. But it’s not making enough hormone, and you’re going to have all the symptoms above. Then you can start some self treatment to see if you can normalize.

And before I talk about that, on how to help your low thyroid…if your TSH is just a little bit low, or towards the low end, and then your free T4 is a little bit high or towards the high end, in order…there’s many things that you can do that help suppress thyroid hormone, and those include soy isoflavones, and if you’re not allergic, more soy products themselves. They can…they’ll suppress or dampen down thyroid function. And then high dosages of L-carnitine can do that. Two to four grams a day of L-carnitine. So if you’re just on the borderline, you might try some of those, but be sure to be working with your doctor in the process with hyperthyroidism.

Now to help your thyroid if the thyroid gland is under functioning. The first thing we




do is start with diet. And I have my list of I would call the “thyroid friendly guidelines,” and there are many things that you should avoid because they interfere with thyroid hormone metabolism, particularly soy. All soy products in excess amount. Now if you take a little bit of tofu, a little bit of tempe, a little bit of traditional products, and even a little bit of soy sauce, that’s not going to do much. But if you overdo it—if you eat tons of soy nuts, drink tons of soymilk, you will cause a lot of problems often to your digestive system and to your thyroid. Also, some people are very sensitive to cabbage family—the cruciferous vegetables—include broccoli, Brussels sprouts, rutabagas, turnips, and even cauliflower and cabbages and kale that’s so popular now and bok choy and all these cabbage family vegetables. If you eat them in small amounts or normal amounts, fine. But if you start juicing up tons of those, you can dampen down your thyroid. Lima beans also, and peanuts, pine nuts, radishes also have a dampening effect, and so does milk. Dairy products seem to not be good for thyroid—dairy products from cows—and also wheat, and particularly your gluten-containing other grains. They have a dampening effect and they kind of tip—based on the allergenic model of the inflammatory changes in the body that predispose towards autoimmunity—and they disrupt hormones and how the hormone glands function…the endocrine function in the body. So avoiding gluten is a good idea as well.

Now foods that can help you your thyroid are virgin coconut oil, cold pressed virgin olive oil, sea salt, aloe vera juice, flax oil, avocadoes, and of course, most importantly, sea vegetables like kelp and dulse and wakame, because they have the iodine in them. Protein is very important, and getting enough protein. So we do see more incidents of thyroid disorders in women who are… particularly the raw vegans. They’re not going to be excessively low thyroid, but they’ll be just tipped out of balance. And we can usually adjust them back in with natural therapies, and number one, increasing their protein. So let’s take a look at some of the other things. The first is the dietary avoid and friendly foods, and then the next is exercise like we talked about already. Exercise is good for general health. It improves blood flow and oxygenation of your tissues. It’s just what the thyroid needs. The problem with low thyroid people is they don’t have enough energy to exercise. If they exercise they don’t feel better. They often feel the same or they feel worse, or they don’t have the “oomph” to really get much out of the exercise. So that’s why I recommend yoga practice. Because when you do even slow—not the fast Ashtanga type of vinyasa free flow practice—but a slower practice where you tuck your neck, your chin into your throat, like in shoulder stance or modified shoulder stance, you’re actually working your thyroid. Even in downward dog, if you’re doing it correctly, your chin should be tucked right into your little space in your collarbone. That presses on the thyroid, presses the blood out, and then when you lift your chin up and your body moves again, boy, you get a surge of blood and the thyroid fills up with blood, and then you compress and surge and compress and surge, and very, very, very, very helpful. And of course all the inversion postures. I strongly recommend yoga practice.

Nutrients that are very important for thyroid is the L-tyrosine because the thyroid molecule, the hormone molecule itself, is built on the L-tyrosine, and the dosage is usually 1,000 mg a day up to 1,500–2,000 a day. Iodine of course is the key nutrient for thyroid hormone, and the dosage varies. You usually start low and work your




way up. So I start with potassium iodide, 225 mcg twice a day, along with L-tyrosine, and then I work to start working the dosage upward. Some people need very large amounts of iodine. There’s no real clear, definitive clinical test to know if you’re iodine deficient and if iodine will work for you, but in those—and often in more severe low thyroid cases—we use a form called Iodoral, which starts at 12.5 mg dosages, and sometimes we go upwards to 50 or more milligrams. But for the person working with themselves, they should try the 12.5 mg of Iodoral once in the morning and once at mid-day, and don’t take any more than that until they do the serial measuring and see if they’re adjusting their TSH and if it’s working for them.

Now you also want to improve conversion of the thyroid hormones in the periphery of the body so they get into the cell and so they have enough of the bioavailable or free form. And vitamin-A—not beta-carotene, but vitamin-A, the retinol-A—is very important, as is vitamin-D3. So optimal levels of vitamin-A, which come from fish oil, and vitamin-D3, as we talked about in the previous module. And note here is that when your thyroid is low, you often cannot process the beta-carotenoid family. So if you’re drinking lots of green juice and lots of carrot juice, your palms will become orange and sometimes even your face and skin becomes very orange. So people with very low thyroid, even if they’re not drinking a lot of carrot juice or green juices, they will have kind of a funny color, the orangey-color skin, and as their thyroid improves they return to normal, clear skin. But if you’re also drinking a lot of carrot juice and green juice and your thyroid is low, the body can’t process all the carotenoids, so you’re just going to build those up in high levels in the blood, and you want to normalize those. So don’t…if you have low thyroid, don’t overdo the green drinks. And zinc…usually small dosages of 10 mg of zinc sulfate is sufficient. And then selenium. Selenium is very, very important to help conversation of T4 to T3, and the dosage is 200 mcg twice a day. We also have adaptogens. Those are herbs that help the endocrine system work better, and help the body deal with environmental and also psychological stress. And the main one for thyroid is ashwagandha, and the dosage is 500 mg. I like to use the standardized extract and 5% withanolides—that’s the active compound—twice daily with food, and very, very useful. Sometimes we can increase the dosage up to 1,000 to 1,500 twice a day—very safe and can be take over long periods of time. If your thyroid TPO antibody levels are high, that’s something that you will have difficulty taking care of on your own, and you should see your doctor to evaluate any autoimmune aspects of your condition.

Kevin: And this is the end of module three. Look forward to more in module four coming up.


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