Episode 11 of The Living Life Well Show: Thyroid Health
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[00:00:00] Welcome to the Living Life Well Show, the intersection of God's Word, today's science, and healthy living with common sense application, all based on the truth of the Word of God. I'm your host, Dr. Jon Skelton. Now let's get straight to the truth. Welcome back to the living. Life will show I hope you are having or have had a great week thus far. And I hope this is a good kickoff into your weekend or your next week, depending on. When you're listening. So today I want to really talk about thyroid and thyroid health. How does it become a dysfunctional. What are strategies we can do to determine if it is or isn't dysfunctional and [00:01:00] then what things can we do to actually improve it?
What, what kind of. Lifestyle interventions. Can we do besides taking medication? So we'll talk about all that today. And really, I just wanted to ask you today that if you are enjoying this, if you find the information useful, I would ask that you subscribe and leave a review.
That way you will help ensure that other people, um, may be able to get the same information and help improve. Their health and, and their life as well and get them on the road to living life. Well, so, tell me if you have either felt this way or heard this before from friends or relatives, you know, I'm doing everything I can, I can't lose weight.
I'm constantly tired. I go to my doctor and all my labs are really normal, including my thyroid. Is it just in my head? Am I crazy or depressed [00:02:00] or is there something else going on? So I hear this quite often. When, when clients come in to me and thyroid can very well be the issue or as it is many times. It's a piece of the puzzle.
There is a piece of it that there is some dysfunction in. And so that's really what I want to talk about today. So, so. Really. About five. Percent of us have some form of hypothyroidism. And that is really the crux of what we're going to talk about today. Graves' disease and different types of Hashimoto's. Thyroiditis. Can cause you to have hyper thyroidism which typically is going to have more of the anxiety symptoms. More excessive weight loss. Despite not trying to lose weight. Um, and a lot of difficulties with [00:03:00] sleep but today, and what we see much more commonly than hyperthyroidism is , hypothyroidism and that's really what we're going to be talking about today.
So, so several causes of hypothyroidism are a Hashimoto's disease, which is essentially auto-immune disease. Or, or thyroiditis or inflammation of the thyroid. You can just be born with hypothyroidism. That's. That would be congenital hypothyroidism or thyroidism that is present at birth.
And this is something that, that we typically test for as well. And then of course there would be a secondary to surgery, maybe it was determined that you had a goiter or a cyst or something else on your thyroid. And so it was, um, treated with either surgery and or radiation
and then medications medications can cause hypothyroidism as well. We see this. Frequently. With different cancer [00:04:00] medications . But then also, and something that isn't really talked about and some that are really want to get into a more is different infections.
And so we will talk about that a little bit as we go on. So today I kind of want to talk about. The conventional versus the functional.
So, how do we get to a diagnosis of a hypothyroidism?
When do we even suspect it? So if I have somebody that, that comes into me and that is telling me about fatigue or brain fog, difficulty sleeping. Weight gain. Things like this, um, or they're having a cold intolerance and or feeling cold all the time. They're having changes in hair or skin or nails. All those things may be related to thyroid disease. And so we want to check the thyroid now, typical or traditional or conventional. Wisdom would be that you check a TSH and T4. [00:05:00] And so for a lot of people that come into my office, they've had these things check repeatedly and they're repeatedly told that they are normal. So one of the issues that we see when we are testing for thyroid disease is a couple of things in. Inadequate number or type of tests that are being ordered. And or not looking at the optimal ranges.
You see the standard ranges are built upon a society as a whole today. Well, we know in general that our society is not very healthy. So what I like to do is I really want to focus on those optimal ranges of, of your organ function. And so. For a thyroid, we're looking at that TSH and we are, we're looking at that T4 or free T4. As well.
And so yes, those are proper and appropriate tests. [00:06:00] However, they're only part of the story and they're only part of the story if you're really looking at them from the optimal or functional ranges. So an example I always like to get it is the TSH. So a typical TSH is going to be anywhere from one to five on a standard. Laboratory assay.
So if you go in and so you have your TSH drawn and you're having fatigue and having a difficulty with sleep and or weight loss. Brain fog, and your TSH is say four, um, and your T4, you know, also looks to be in the standard range. Typically your primary care provider may dismiss this as a cause for your symptoms. Well, what we really know in the functional medicine space is that really TSH , to be optimized is going to be about one to three. So if you're at a four. That may very well be contributing to your [00:07:00] symptoms.
Now I'm not saying that it is definitively causing it, is it it's a much more robust study that needs to be done. Looking, not just at thyroid, but, but overall health and markers, different hormones and those things that could be leading to this as well. So when we are checking labs, we want to check the optimal or functional ranges.
Those are going to be very important. To do. In addition, we want to be very extensive with our thyroid testing. So when we're looking for congenital hypothyroidism, typically that's all we're looking at is, is the TSH and the T4 when the baby's born, but there are much more labs that need to be ordered to really understand what's going on.
You see, T4 is what the thyroid is making. However, T4 then gets converted in your body to. To the active form, which is T3. So there is a bound form of T4 [00:08:00] and a bound form of T3. Which are transported by thyroxin binding globulin. to, essentially. Deliver the thyroid hormone to the tissues to be used. If we have just a total T4 or a total T3, and those levels are looking good, but our free levels are off.
Then there can be an issue. In addition, we want to look at something called reverse T3. So as thyroid hormone, T4 gets converted to T3. It can get converted to reverse T3 or. T3. And so when it gets converted to reverse T3, It's not usable. It binds to those cells, to that binding site that the T3 would bind to, but it's an inactive form of thyroid hormone.
So if our reverse T3 levels are high, that could be a cause for why we're having underlying issues with fatigue [00:09:00] and you know, weight gain and brain fog and those things, because. Our, our T4 levels look great. Our total T3 levels look great. But when we look at our reverse T3 and free T3 levels. That's where the issue lies.
And so. We really need to, to look at an extensive amount of labs. In addition. What we see a lot of times with Hashimoto's disease is we see antibodies to the, to the thyroid. So, the body attacking itself. Thyroid peroxidase being the primary antibody. But then also we see thyroglobulin antibodies as well.
So when you're diagnosing a thyroid condition, you need to be very extensive in your testing of the thyroid gland.
So one of the things that I alluded to as a cause of thyroid disease was infection. Infections that I [00:10:00] see that are most common nowadays, that people either don't know that they've had. Or didn't know that it could come back is Mono a Mono is a huge issue when it comes to the thyroid. If you've had previous Mono infection, which I'm here to tell you, 95% of you have, um, you can develop an auto immune reaction.
It can set off essentially a Hashimoto's type thyroiditis where you're producing that. Thyroid peroxidase antibody or those thyroglobulin antibodies and, or just generally disrupting your HPA axis or your hormonal axis, which controls the thyroid gland. So. Checking for underlying infection is important.
So I know nobody really likes this word, but COVID actually it appears, and especially with long COVID. Very well may [00:11:00] be Because of Mono. You see, Mono can be reactivated at as well and cause disruption, when it's reactivated, it can cause a multitude of different symptoms . So we want to check for Mono. As well, anytime that we're looking at somebody that potentially has been diagnosed with long COVID and having a thyroid issues. Because there's a specific treatment protocol that you're going to want to look at to knock down that reactivated Mono. So that's going to be very important.
So. Traditional treatments with regards to the thyroid are gonna revolve around medications, right? So whether it's your primary care physician or your endocrinologist this is typically how it goes. They're going to put you on levothyroxine or synthroid which is T4. Your body then has to convert that T four to T3. This is [00:12:00] going to be dependent on a few different things. Things like selenium and iodine as well as D three. Iron and zinc.
And so if you have disruption in any of those pathways, you're going to have issues with converting T4 to T3. So you really want to pay attention to those levels. If you've been placed on T4 and you aren't feeling better, or your physician keeps going up on the dose, trying to treat symptoms without checking further labs to see if you're actually converting. That T4 to T3. Because if you go to the lab and your, your doctor's checking that TSH and T4, but isn't checking that T3. Your TSH and T4 may look great because you've got these high levels of T4, but you're not converting to the active form of T3.
If you're not converting to the active form of T3, guess what [00:13:00] your symptoms are still going to be present. And you're not going to get that benefit from the medication that you're taking. So. Another medication would be is if your doctor is going further. It would be Cytomel. Cytomel is T3 and Cytomel. Would be for those people who either can't seem to convert or just need that, that active, more active form of T3, maybe it's bound up by the .
Thyroxin binding globulin. Or maybe there is reverse T3 that is competing and, or there's thyroid antibodies that are throwing off the regulation of the thyroid hormone as well. So, So those are going to be kind of conventional treatments. Less conventional treatments, but still in the conventional realm. Would be armor thyroid Armour, thyroid, or NP Thyroid.
These are combinations of T4 and T3, so that you're hitting both arms [00:14:00] of the thyroid hormone to try and boost levels. The thought is that. You increase that T4 that helps the conversion to T3, but also supports those T3 levels. Now, what you can have happen is if somebody just needs a little bit of T3 and you're adding that T4 and T3, and you can put them off in the opposite direction and caused some hyper thyroidism.
So if somebody is then starting to have palpitations or night sweats or a difficulty with concentration, anxiety those things you really want to recheck levels. And so it's always important after you were starting an intervention, especially with any type of a prescription drug. To really reassess where you're at anywhere between four and six weeks. Anytime a change is made. Any time that you are having new symptoms or that [00:15:00] you feel as though your symptoms aren't improving you want to, to recheck levels.
So. That's kind of conventional treatment. And I employ a lot of these modalities for clients that, that need them. And so, whether it be a client that has had the thyroid surgically removed, who has Hashimoto's or who's had Mono or long COVID. Many times these, these conventional treatments are needed.
However, there's some other things that we can do that can really help support the thyroid. So selenium selenium is a big factor. in thyroid production and, and thyroid regulation. And so we want to make sure that we're getting of plenty of selenium in our diet. And then iodine is going to be a really big as well.
And so it is involved in converting that T4 to T3. And where that iodine [00:16:00] binds really determines where, whether you're getting that reverse T3 or that free T3. And so we want to want to support ourselves with iodine as well. In addition, vitamin D three is very important for thyroid health. As well as iron and zinc.
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If this appeals to you, scan the QR code so you can get started living life well. So if we have low iron levels or low zinc levels, we are going to have a symptoms of thyroid dysfunction as well, because they are involved in the process of regulating. The thyroid. When we're thinking about increasing selenium or iodine in our diet one of the things that, that we want to look at is do we want to supplement with an over-the-counter supplement? Or is there a way to increase that in our diet? And so that's what I always like to look to first. Before directing people specifically to selenium or iodine.
And so those selenium containing compounds are going to be things like Brazil, nuts, Brazil, nuts are really good. They're a high source. Of selenium. The [00:18:00] issue with Brazil, nuts can be, it is very variable how much selenium they contain. So you could get a batch of Brazil nuts. One time. And they carry a massive amounts of selenium you know, something like 500 micrograms of selenium.
And we really only need about 60 micrograms of selenium daily. And so if they contain a really high batch one time, you may get great conversion. The next time you may get a very erratic conversion because it could be very low. And we don't want to increase our intake of Brazil. Nuts, tremendously.
A, they're expensive. But B you can way overdo it on selenium and have issues as well. So, Brazil nuts are a typically very high concentration of selenium. And so if somebody is wanting to do Brazil nuts I recommend taking about, you know, four to five of those two to three times a [00:19:00] week maybe. And doing that now, a more reliable way to get selenium in the diet is through fish specifically. Like Yellowfin tuna, you're going to get 92. 90 to a hundred micrograms of selenium and a portion of, of Yellowfin tuna.
Other fish products would be things like sardines and clams and oysters . That is going to range as a it's about half. Of what a Yellowfin three ounces of Yellowfin tuna would be about 40 to maybe 60, 65. Um, micrograms of selenium still very high containing, but, in that you're going to get a more reliable level of selenium as opposed to very high or low levels with the Brazil. Nuts. Now pork in general can support a selenium as well, usually around the 30 microgram range there.
And so it can be helpful again for, for other [00:20:00] reasons that we'll get to in later podcasts. I don't really recommend pork as much. Primarily because the way we typically consume it, it is either very fatty. Or it is very processed. And so for those reasons, I typically don't recommend. Pork at least on a very regular basis.
Now beef beef on the other hand does contain some selenium it's lower levels. It's about 20 to 30 micrograms, . That you know, can be beneficial as well. Turkey. Can also have some selenium in it around that 30 microgram range as well. And then chicken, chicken's a little lower.
It's going to be in the 20 to 25 range of micrograms for a serving of chicken. And so. Those are some good ways to, to get selenium. Into your diet. Without really having to take a specific supplement. Now. Having said that sometimes we do need [00:21:00] selenium. And so if you don't want to take an animal products. There are some enriched products, which again, I typically don't recommend because they are primarily going to be processed. And so we don't want to take in processed foods for a host of other reasons. But. Th that is a possibility there.
So. Uh, selenium you can supplement as well. Most of the supplements around 200 micrograms is kind of the range as in where you're going to start. And you can take those and those are usually pretty well. Absorb. Now, one of the other things that we really want to talk about that as specific to the thyroid is iodine.
So when we're looking at iodine, worldwide iodine deficiency is probably the leading cause of hypothyroidism. Iodine is a [00:22:00] very variable in its content in foods. Primarily because of soil makeup, fertilizers that are used or not used and those things. So a lot of animals are supplemented with like salt licks and these things to increase the iodine content as well.
So, you know, beef and chicken. Are both going to have iodine in it, but really the best source for animal protein for iodine is going to be fish. Fish is generally , more frequently going to have a good iodine content in it as well. And so. When we go back and we're trying to cross-reference okay. What can I eat?
That's going to help beef, chicken and fish are going to have that iodine content. Now, for those of us who don't want to really consume as much animal products and prefer to get it. Another way. You know, table salt or it's iodized. Table salt. So table salt in [00:23:00] general will have iodine in it. Now see weed can be a very good supplement. To use, however, seaweed content is much like the Brazil nut. With selenium, it is very variable in the amount that it contains.
We get too much iodine and that can cause thyroid dysfunction as well. So, Uh, we need to be really careful. With regards to iodine. I get this question a lot too. So. What salt should I really use? And so typically I recommend. You know, pink Himalayan salt, or the Celtic, sea salt. Neither one of these. Tend to contain much in the way of iodine. So if we have a a client that has hypothyroidism and iodine is really needed because we're not seeing a lot of conversion of T4 to T3 And we don't want to consume animal products. Really. That's where we are going to look at adding in that table salt aspect to help [00:24:00] with those iodine levels. And as always vitamin D and zinc are going to be a very important factors and to really supporting that thyroid health along with, you know, healthy iron levels as well.
So in addition to foods or lifestyle changes that we can make that can really support the thyroid. And so really helping to heal your gut by eliminating those processed foods is going to help. As we said before, you know, a lot of these quote enriched foods. Contained selenium, which seems like that would help.
The problem is, is they cause so much disruption. And inflammation in the gut. That you're not really getting that benefit. It's a big negative loop. So sugar sugars are generally going to increase inflammation, increase insulin resistance. Anytime we have increased inflammation, we're going to have poor conversion of our. Hormones to the most active [00:25:00] form . And then of course, sleep and exercise are going to be important as well. Um, so when I have clients that have hypothyroidism as part of their dysfunction, We do not jump on a hardcore exercise program. Why. Well, just like we said, in the open, you're having difficulty losing weight, you're having fatigue and, and those things, what I want to do is I want to start you on improvement in that thyroid hormone before we jump into exercise.
So the way I like to approach things is I like to get you on either some replacement or supplementation and or both, depending upon what we decide together. . And then let you run with that for a few weeks. Once you tell me, Hey, I'm feeling better, I'm sleeping better. Then that's when we can start on some exercise programs and really start [00:26:00] pushing that envelope with regards to physical activity. Because until that thyroid level starts coming up. You're going to have. Pretty extreme difficulty with regards to any type of exercise.
And so. I know, push exercise in the beginning because you really have to support it either with a diet. And, or supplements or conventional treatments or treating underlying infections before you're going to see much change in how you feel. And so that is going to be one of the ways in which. I'm going to be a little bit different as to how I proceed. With moving you forward for your treatment of your, your thyroid gland. One of the issues that we see with laboratory testing and how we can get some false values. Even when we're we're testing the, [00:27:00] the right things is we're not taking the supplements properly, or we're not taking the thyroid medication properly.
And so what I like to do when I test is I like to have you take your supplements and, or. Thyroid medication, whatever we're doing at least four hours prior to. The time in which we're drawing the labs. This allows us to make sure that we've had absorption. Of the products that we're taking. And it allows them to come up in the blood work so that we can see whether we're. Really at adequate levels or not.
And so if we take it too soon or too late we're going to potentially miss that and not get as good and reliable results. In addition, specifically, when you're taking a thyroid medication, you inhibit its absorption by inconsistent taking of it. So if [00:28:00] you are not taking it just with water and waiting at least 45 minutes, You're not going to get complete and accurate reabsorption.
So this is where I see clients taking it very religiously one way for a period of time. Then they stopped that for whatever reason life gets in the way. Routines change. And so now they're taking it with say coffee, or maybe at the same time they're eating and, and those things.
And so now they're having decreasing levels of their thyroid hormone. And so then we go and we test, and they're really strict on that day. They take that level. We've increased it now because they were having symptoms. And so now it's showing that it's over the. Range in and they did that on that particular day.
So what's really going to be important. As when you're doing your lab work. Take it the way you can take it. So if [00:29:00] you are on levothyroxine, if you are on synthroid, if you're on one of these other medications, regardless of whether you're doing all the other labs that are very important or not. Make sure that you're taking your thyroid medication. Preferably four hours prior to the lab draw and make sure that on the day that you're taking it, you're taking it the way that you always take it.
And so please. Make sure that you're taking your thyroid medication with just water. Waiting at least four hours prior to the blood draw or if it's just on a regular day, at least 45 minutes to an hour before you're eating or drinking anything else.
So. I hope you found this helpful. I hope. This was enjoyable to you and would love to hear from you if you ever want to get in touch. If you have a specific question that you would like us to answer. On the podcast, you can always reach us at [00:30:00] [email protected]. Thanks.
And God bless.
That's it for this episode of the Living Life Well Show. If you like what you've heard and want to learn more, or want to know how to put this into practice for yourself, go to livelifewellclinic.com. Until next time, this is Dr. Jon Skelton saying, go out and live the truth so you can live life well. The preceding is for entertainment and educational purposes only. It is not meant to be used to prevent, diagnose, treat, or cure any condition. The information contained in this show does not substitute the need for a qualified medical professional, nor is it meant to provide medical advice or services.
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