Dr. Justin Marchegiani and Evan Brand talk about the different causes and triggers of Hashimoto's disease. Find out how it is connected to one's immune system, diet and gut health and learn why women are more susceptible to having it.
The thyroid, adrenals and gut health are important factors to consider in addressing Hashimoto’s disease. Listen to this podcast and learn about the natural solutions and beneficial supplements to support them.
In this episode, we will cover:
01:29 Hashimoto’s Disease
09:24 Socialized Medicine
13:40 Use of Secretory IGA in Measuring the Immune System
15:39 Women and Stress-sensitivity
18:24 Ketogenic Diet, Insulin Resistance and Hashimoto’s
Dr. Justin Marchegiani: And we’re back! Evan, it’s Dr. J. How are we doing, man?
Evan Brand: Pretty good. How are you doing?
Dr. Justin Marchegiani: Good. I’m loving the ambience. My new plantation shutters in the background; just loving that there. Just nice. Ready for an excellent day. Got a little lunch break here. I’m seeing patients all morning. Ready to drop some knowledge bombs, and then get back to patients in the afternoon. How are you doing, on your afternoon?
Evan Brand: Yes. Likewise, same story. I had a female client this morning, who I was telling you over air. We had run her blood work before…
Dr. Justin Marchegiani: Uhhmm–
Evan Brand: …previously. And it was basically just a checkup. I said, “Hey, why don’t we check your thyroids?” She didn’t really have hyper or hypo symptoms, and she showed up with thyroglobulin antibodies, which is one of the type of antibodies you and I test our clients for on blood. And she showed up with a level of 50. And we should see that, as minimal as possible. I mean, hopefully less than 1, but she’s had a 50. And she said, “What’s triggering this?” And, we can go into that today, but I was hoping you and I could really outline a lot of different causes and triggers of Hashimoto’s because it’s so common in our females, we see it every single week. It’s like – well, there different triggers for different people. So, hopefully, we can try to go into a couple of different arenas here, and talk about the big puzzle pieces.
Dr. Justin Marchegiani: I like that. And then people on Facebook, we also got Evan’s audio on the background, too. So, if you’re listening on Facebook, go over, jump on YouTube, justinhealth.– or youtube.com/justinhealth and vice versa with YouTube. Get on the Facebook page so you can get this live feed. We’d like to them and do our Q&A’s too. So this is great. So, a hundred percent. Hashimoto’s the big issue, vex about 30– or thyroid issues, about 30 million people in this country, uh – I’d say, at least, hmmn– I’d say a quarter of probably undiagnosed, or at least undertreated or undersupported because they’re given synthetic thyroid medication. That’s– is T4, right? T4 in origin. And then you have these various enzymes called D2 and D3, that help convert and activate thyroid hormone. And the problem is those enzymes, if you have Hashimoto’s, there’s a good chance that D2, D3 and even D1 enzymes are not working optimally, so then that conversion of T4 to T3 – that inactive thyroid hormone to active T3, about 400 percent increase in the metabolic activity of T3 versus T4, those enzymes aren’t there for the conversion. So that’s a big issue, right? [crosstalk] And not to mention, when you take a thyroid hormone, you’re getting a T4, right? But you’re also getting T3, right? Triiodothyronine, which is your active thyroid hormone, you’re getting T2, which isn’t even tested, right? T2, uh– Diiodothyronine, is a metabolically active hormone, only measure in the research settings, and not even really talked about in conventional medicine, T1, T0, Calciton, which is very helpful for Calcium metabolism. So, again, we’re not getting that in our conventional thyroid medication. The big thing is those D2, D3 enzymes that you’re missing, that T4 to T3 conversion with. So lots of people are being medicated with thyroid hormone, right? Synthroid, Levoxyl, Levothyroxine. Though TSH comes back in the normal range, so they look good on their conventional doctors uh– thyroid test, but they still have all these thyroid symptoms, right there. The thinning hair, the outer third of the eyebrows, swelling of the hands and feet, anxiety, mood issues, constipation, depression, and they’re not getting better.
Evan Brand: So, why? What’s up with these enzymes? What’s happening to them?
Dr. Justin Marchegiani: Well, I mean, there’s the underlying physiology, typically, inflammation, right? Inflammation is what drives people into that disease, or pathological state, right? And that pathological state means more symptoms, right. All the things I just mentioned, the moods, the digestive stuff, uhhmm– the hair loss stuff, the energy, the weight gain, all those things are gonna be affected. Now, a big component we talked about it, ‘cause a lot of these issues, right, thyroid-based things are gonna be autoimmune in nature, so autoimmune means your immune system is actually attacking your thyroid gland, so you have these antibodies, like TPO or Thyroperoxidase, you have antithyroglobulin antibodies, and these are primarily with Hashimoto’s, for instance, and they come and they attack your thyroid gland. And that’s about 90 percent– let’s say 50 to 90 percent are autoimmune in nature, so you and your conventional medical doctor or your endocrinologist says, “Oh, here’s – here’s the conventional thyroid pill.” They’re not actually getting to the underlying immune– immune imbalance, right? They’re not fixing the underlying things, like gluten, right. Grains and gluten, and that molecular mimicry that happens where your immune system can be exacerbated ‘cause of Gluten. That’s the one, one really big component. Couple of others will be gut – the gut issues. So, small intestinal bacterial overgrowth, gut bacterial imbalances, infections, H.pylori, Blastocystis hominis, uh– Lyme or Borrelia burgdorferi, uhm – Yersinia enterocolitica. So those are just a lot of gut infections that can significantly affect your GI. And again, that sulphatase enzyme in the gut made by healthy bacteria, really helps to activate, that thyroid hormone really helps to upregulate those D2, D3 enzymes to get your T4 to T3. So, all that technical jargon, what the heck does it mean? We’re trying to get your– your active thyroid hormone up higher; that’s the goal. Your T3 levels, get them up higher because, just doing it on the conventional side, and say, “Hey, let’s give you uh– a synthetic thyroid hormone.” That may not be enough to actually get the end stage thyroid hormones better. It may make the upstage TSH look better but not the downstream T4 and T3.
Evan Brand: Conventional, like the National Institute of Health, though, say that the Hashimoto’s affects one to two percent of people in the United States. Do you agree? One to two percent or do you think it’s much greater?
Dr. Justin Marchegiani: So you’re saying– repeat that question, one more time for me.
Evan Brand: National Institute of Health– is it – do you heard– are you hearing echoes? Is that messing you up?
Dr. Justin Marchegiani: No. No problem. I just got a comment here. Someone’s saying they’re not hearing the audio on the YouTube site. [crosstalk] You guys are hearing the audio, give me a thumbs-up here, but I think we’re looking good.
Evan Brand: Okay. So, National Institute of Health, they say, “Hashimoto’s affects one to two percent of people in the United States.” I think it’s much, much higher. Izabella Wentz, I think she gave a number that was much, much higher too. What’s your take on this percentage here?
Dr. Justin Marchegiani: Yeah, I think it could be much higher, for sure. I think it could be much higher, and the big issue is that most doctors they aren’t testing for thyroid antibodies. That’s the major issue. Uh– we talked about a patient this morning over in Canada, whose doctors aren’t uhm– they aren’t even testing for thyroid antibodies. And the big reason why is because, think about it, right? If the solution is a synthetic thyroid hormone, like Levoxyl, or Synthroid, or Levothyroid, right, if that’s the ultimate end game, and that doesn’t change whether there’s autoimmunity or gluten issues, or infections, then it stays the same. Why change that, right? Why change that variable up because they’re not gonna do anything different if something else comes back, right? Does that makes sense?
Evan Brand: Yes, it does.
Dr. Justin Marchegiani: Even though 90 percent are autoimmune in nature, right? Even though 90 percent of thyroid issue’s autoimmune, they’re not gonna do anything different anyway, so why even look for it? Because then, it just creates more questions the doctors have to answer, and they don’t like to answer questions they’re not prepared to uhm– to answer. Most people…
Evan Brand: And they’re not trained, because if antibodies do come back, they’ve got nothing. They’ve got no way to talk about Klebsiella and Citrobacter bacteria that need to be treated. Uh– yeah, and so uh – just to give a little bit more back story on the Canada, so– you know, Justin and I both have clients in Canada.
Dr. Justin Marchegiani: Yeah.
Evan Brand: And they’ll say, “Hey, we’ve got health insurance over here. It’s free.” But there’s a catch to that. It’s not that good. All they’re gonna do is they’re gonna run, like, a one-marker, like maybe TSH, and then based on that they may give you a prescription drug. But if you don’t have your free T3, the reverse T3, the TPO, the TG antibodies we talked about, may not always using Algin, maybe you tell me there’s a better analogy, but mine is: if you just have TSH and you’re trying to treat thyroid, it’s like touching the sidewalk and estimating the forecast.
Dr. Justin Marchegiani: Yeah. That analogy sounds really, really familiar. I don’t know why.
Evan Brand: There’s no way you came up with that. I’m pretty sure…
Dr. Justin Marchegiani: I came up – I came up with that one. That’s been around for, like, six or seven years, ‘cause that’s how I teach my patients about TSH– TSH. The receptor sites in the pituitary are hypersensitive. The thyroid hormone, therefore, uhm – TSH will drop– will drop more precipitously because the brain is sensing thyroid hormone being a lot higher then what it is. So, peripherally, the thyroid hormones never get high enough and the periphery in the actual tissues but it’s– it’s high enough in the brain ‘cause the brain’s more sensitive to thyroid hormones. So, TSH will always drop faster than what the peripheral tissues need uh– in the periphery there for thyroid hormone. That’s why you don’t want to base your dosing or your support of the TSH 100 percent, ‘cause the TSH is so sensitive. Touch the sidewalk outside when it’s a hundred degrees out, it’s gonna be able to fry an egg on it, right. But again, the air temperature will always be a lot cooler. The peripheral tissues will always be less saturated with thyroid hormone uh– than the latter. Make sense?
Evan Brand: I’ll give it– I’ll give you a credit. It must have rubbed off of me then, if you had that one before. [laughs]
Dr. Justin Marchegiani: It did. I do– that’s mine. That’s uh– that’s a Dr. J-ism. But I’m– getting back on your thing, man, yeah. Socialized medicine for the most parts thinks– Okay, I’ve seen patients from all over the world. All over the world, Europe, Canada– Socialized Medicine’s great if you only need it for acute traumatic issues, right? You sprain your ankle, right? You have to go to the ER, ‘cause of some reason. But outside of that, if you getting stuck on that chronic conventional model, all you have for options are conventional drugs, right? And then number two the waits are like, three to six months to get in. Again, this is what happens. I have hundreds of patients where I’ve had this story, literally had this story they literally told me over and over again. And then because everything is socialized, the government says we’re not gonna reimburse. Reimburse then guess what happens. There’s not a market place for it, right? There’s less people going underground. Now, I do have people over in Canada that are functional medicine doctors and they’re doing– they’re thriving even in a socio uh– even in a uhm– sociological medicine society there, right? Even with a socialized medicine society because, people aren’t getting better even though the medicine’s free they’re still going in paying a lot of functional medicine doctors. And again, we start today. Why am I hampering on this is because, that doctor wasn’t running TPO or any of the thyroid antibodies. So, the socialized medicine said, “Nope. We are not gonna test your thyroid antibodies. We deemed that not appropriate, and this person needs to know they have Hashimoto’s so they can make changes with their immune system, with their gluten, with the gut, with a lot of the converting nutrients to help T$ and T3.
Evan Brand: So let’s– let’s go through a list. I know, we could kind of jump around but, maybe we could do like a top five [crosstalk] or maybe even like a top ten.
Dr. Justin Marchegiani: Yeah. Let’s do it.
Evan Brand: So, number one– in no particular order, but number one, you already mentioned gluten. So, this would include any grains, right? ‘Cause even like our Amaranths, our Buckwheat, our Kiwa. That Kiwa could still be cross-reactive and trigger the antibodies, right?
Dr. Justin Marchegiani: Correct. I would still stay away from all grains. Grains probably being number one trigger becau– partly because of the amino acid sequence in the grains, I very similar to the surface proteins of the thyroid. That’s number one. So [inaudible]…
Evan Brand: What about now? Are you seeing issues with him?
Dr. Justin Marchegiani: Well, I mean, that’s a cross-reactive thing so, if gluten is like, you know – if gluten is like the brother and sister, you know, Hamp’s kind of like, maybe the cousin, right?
Evan Brand: Yeah.
Dr. Justin Marchegiani: The second cousin once removed, so to speak. S, again uhm– it may be something that needs to be pulled out with someone on an autoimmune kind of elimination provocation diet for at least a month or two. So, the grains component’s really important. Got to get that out. But not just the molecular mimicry thing. There’s uh– some research looking at Non-Celiac Gluten sensitivity, where they talked about gluten. Even in people that aren’t really Celiac or aren’t even a gluten, like, sensitive person, so to speak. Where just taking that gluten in, they still get gastrointestinal permeability. The guts gets a little bit leaky even with uhm – the fact that they aren’t really gluten-sensitive, so to speak. They aren’t gluten-sensitive but that’s the gut permeability that’s driven by the gluten. And prior, what’s happening is, we’re getting this protein called Zonulin increased. And Zonulin basically unzips, so it’s like an unbuttoning my shirt. That’s Zonulin, right? Unbuttoned zip, right? Opens that gut lining up, and then all these digestive proteins you get right through there.
Evan Brand: So, Zonulin goes up in the presence of grains. We had a question in the live chat about Brown rice. Absolutely, Brown rice would still be in a category of grains that you would want to remove.
Dr. Justin Marchegiani: Yeah.
Evan Brand: If you want to avoid Hashimoto’s. I tried to justify with you for a long time, “Oh, I love my white rice.” You know like, man, it’s just not worth it. And now uh– saw this stew– sweet potato now, and…
Dr. Justin Marchegiani: Yeah.
Evan Brand: …my skin. My skin’s actually gotten better, too. You know, Even though I’ve pulled out – I’ve pulled out the rice.
Dr. Justin Marchegiani: Yeah, man. You go back to your old uh– YouTube videos, you had some– some stuff going on there, [crosstalk] and you like’s porcelain skin.
Evan Brand: I tried gut bugs, too.
Dr. Justin Marchegiani: Yeah. Use some gut bugs, man. You’re almost up to a runway model status, Evan.
Evan Brand: I don’t know about that but I appreciate it.
Dr. Justin Marchegiani: You’re getting there. Good.
Evan Brand: Oh, so gluten, [crosstalk] so gluten grain…
Dr. Justin Marchegiani: Gluten and the Zonulin – gluten, the Zonulin stuff and then also other grains still may have some gut irritating compounds, right? The Lectins, some of the Phytates, some of the Oxalates, some of those things, which can be irritating on the gut. So, really, it comes down to like, getting the immune system in the molecular mimicry going. But then it also has some impact on the Zonulin and the leaky gut.
Evan Brand: Okay, so you already said the immune system. Let’s hit on that piece. Let’s make that like our number two or number three. Uhm – we can measure the immune system with the secretory IGA on the Stool Test that we’re running on people.
Dr. Justin Marchegiani: Yeah.
Evan Brand: Uhm – can we go on that number and just use secretory IGA as our immune system, kind of our first line of defense?
Dr. Justin Marchegiani: Yeah.
Evan Brand: And if we see IGA’s low, can we say, “Okay, you’re more susceptible or…”
Dr. Justin Marchegiani: A hundred percent.
Evan Brand: …this will trigger?
Dr. Justin Marchegiani: Yeah. We’ll see low IGA levels. IGA is that mucosal membrane barrier. It’s that first line of defense that lines the gastrointestinal tract, all your mucus membranes, your mouth, you know, our anal cavities, flatulent tract, urinary canal, everything. Every little surface there, even your eyes have IGA in the surface there. Your first line of immune defense. So, when that gets weakened, typically, it will go up and there’s an acute infection. You’ll see it there. We run Stool Test while measuring the stool, and then we’ll actually see it drop down for Chronic Stress. So IGA’s really important, ‘cause that’s a good measurement that your immune system is under stress.
Evan Brand: Right. So, a lot of times, more often than not, you and I are gonna see chronically low IGA, indicating that someone’s been dealing with these issues for a long time. So, Chronic Stress, overwork, maybe they’re not sleeping as well as…
Dr. Justin Marchegiani: Yeah.
Evan Brand: Maybe they have gut infections that are damaging that IGA because people may say, “Well, if I’ve got Hashimoto’s, how did I get a low immune system in the first place?” Well, chicken or egg, all of it– I mean, you could have had adrenal stress, which then weaken the gut. Then you picked up gut bugs, or vice versa.
Dr. Justin Marchegiani: Yeah, absolutely.
Evan Brand: Okay, what’s– what’s next?
Dr. Justin Marchegiani: Yeah, typically it’s a combination of emotional stress that tends to set people up. That tends to be it. So, there’s, you know, you choose with whatever’s happening with your life: work stress, financial stress, family stress, kid’s stress. Whatever’s happening there, that tends to set things up, and that will weaken the immune system.
Evan Brand: I had a female client did uh– that I talked with earlier. She’s a teacher, so she’s on summer break, right now. She’s feeling much, much better. But when she’s back in school, she’s done. She wants to get out of the field of teaching. Everything kind of gets worst, symptom-wise.
Dr. Justin Marchegiani: Yeah.
Evan Brand: So that’s a good example of work stress…
Dr. Justin Marchegiani: Yeah.
Evan Brand: …right there.
Dr. Justin Marchegiani: Yeah, absolutely. And then, women are a little bit more prone to it, because there’s actually a research on this, where their immune system can go out of balance. Like, one emotional, like, you have an emotional argument with the woman, their IO6, their Intergluten-6 can go out of balance for up to two days after a fight. For some of the men, they can go out of balance for like a few hours, but then it’s back in. So I always– this is part of the mechanism why women are more prone to autoimmune conditions. Their immune system probably just a little bit more, I should say, a little more sensitive. And there’s also the Estrogen issue, right, because, Estrogen can affect the CD4 to CD8 balance. And they can skew that balance. So, the more women are Estrogen dominant. That can throw off their immune system. Their CD8, CD4, their natural killer cell, to help her cell ratio. CDH’s your natural killer. Your CD4’s your helper cell. And they could skew that ratio uh – up.
Evan Brand: So, I’m guessing the– like the ancestral view of why woman’s immune system would be more sensitive. Would you say just because of uh– uh– having children, where the immune’s got to be able to modulate itself not to attack and kill the fetus, for example. So, their immune system’s a little bit more variable than a man. Or what do you think is the ancestral lenses?
Dr. Justin Marchegiani: Yeah. I think, it probably has to do with uhm– I think it probably has to do with just raising children in that extra level of empathy, being able to take on other people’s feelings, and kind of be able to uuuh– what’s your need, right? You got, like, you know, you’re raising a child. You have to be to really sense what’s going on. I think that may play into it. I’ve zero evidence outside. That’s just my opinion; just observation. But there’s research and studies on that. Also, blood sugar can throw people’s immune system off to. So like skipping meals, and not giving enough nutrition, and just going long periods of time. So, that’s a big thing, right. That’s a big thing, so, I just, you know, I tell people just make sure you get your communication and your relationships kind of dialed-in. If you’re having issues with the spouse, get the communication down. Try to get, like, try to create a really good environment, where you can communicate, and you’re not gonna get flooded and drive people’s immune systems off.
Evan Brand: Right.
Dr. Justin Marchegiani: You know, that’s kind of, that’s number one. Number two, so let’s get meals, right. Now, when you’re healthier, you can play around with intermittent fasting, okay. That’s a good tool, but you got to get it dialed-in with your hormones good first, and you feeling good first. I may get that dialed-in later on.
Evan Brand: Oh, how about Ketosis too. Like, I tried it with Dr. Mercola, and he’s like– he’s like concerned that a lot of people are going into a ketogenic diet but they’re doing it for too long. So, he’s kind of a proponent of, like, five days on and then two days off. Or hold his go and eat potatoes, and things like that. And really kind of carb-griefy. So, how much of this thyroid epidemic, Hashimoto’s even kid of in the Health Space where you and I are working. These women come into us. They have triggered Hashimoto’s, do you think Ketogenic diet could be a trigger, potentially?
Dr. Justin Marchegiani: Well, I think, Ketogenic diet has actually helped a lot of people with Hashimoto’s, especially ones that are insulin-resistant, because insulin-resistance can actually block thyroid conversion. So, that’s my issue– is if your insulin-resistant, you may do really well with the Ketogenic diet for a while, but then you may hit the wall.
Evan Brand: Yeah.
Dr. Justin Marchegiani: So, then the question. When you hit the wall, that’s where you may start gradually increasing your carbs up. Maybe 10 grams a week, and maybe do a couple of low carb days, like Keto days, and then come out for one or two days in the higher carb side. But, I think, if you’re coming into this, being overweight, with uh– hips circum– you know, waist circumference greater than 35 for a female, 40 for a male. There’s probably some level of insulin-resistance that a Ketogenic diet will help reverse. But then you may have to refine or retune your carbohydrate thresholds afterwards.
Evan Brand: Okay, and that will always be based on adrenal health, and that would be based on, maybe, Vitamin D status or gut infections, depressants, of those. There’s always more, more things, so when people find, “Oh! Ketogenic diet,” It’s like there’s so many different variables out there and these other pieces of the puzzle.
Dr. Justin Marchegiani: Yeah, yeah. I mean, Atkins was sniffing around the right area when he started talking about Ketogenic diets in the 70’s. the problem with Atkins is, he didn’t put enough qualifiers on it. I mean, okay, great. So I eat a whole bunch of meat now, is that gonna be hormone antibiotic, free, you know, laden meat, or is it gonna be organic grass-fed. Oh, Atkins says soy protein’s okay. Eeh! Aspartame’s splendid, okay. Eeh! Right, not good. So, protein quality’s really important. So, if you’re gonna do protein powders, you know, Collagen peptides, you know, P protein, like maybe– maybe some really good grass-fed wheat protein, right. Choose really good protein sources if it’s powder. Or choose really healthy meat souces, or really fat sources. Lots of toxins are stored in the fat, so if you’re eating diseased animals, you’re not gonna get high quality of uh– of a meat product passed down to you from a nutrient perspective.
Evan Brand: Yep, well said. Okay, so we hit the secretory IGA, we hit the Zonulin, we hit the gluten.
Dr. Justin Marchegiani: Also, we talked about thyroid nodules too, right. Someone on uhm– Facebook here, had commented here. So, thyroid nodules are just like these little abnormal tissue spots in the thyroid, but typically gonna be driven by autoimmunity, right. So, Hashimoto’s gonna be the major thing. Hashimoto’s, typically, is an autoimmunity that is involving TPO antibodies, and antithyroglobulin antibodies. Now, again, all autoimmunity, for the most part, will end in low thyroid. The difference is grave disease has a couple of antibodies that can jack up thyroid functioning. Keep it up to the point where you may stroke or you may have an issue if left untreated. So, we that with TSI or Thyroid Stimulating Immunoglobulin and also TSH Receptor antibodies, so, which you want to make sure under control. Why? It helped saved many thyroid uhm – from going into uh – graves or a thyroid storm state by using specific nutrients to help it. and also…
Evan Brand: What happened with uh– with thyroid nodules? Let’s say, someone…
Dr. Justin Marchegiani: Yeah.
Evan Brand: …has antibodies at that point. Maybe we suggest they go get a thyroid ultrasound. They say– Okay, hey. Can you palpate? Like, would you suggest an ultrasound, or can you palpate and figure out whether you have nodules?
Dr. Justin Marchegiani: Oh, great. Let’s go into that. So, try to palpate the thyroid is – Find the Adam’s apple, so like, mine’s right here.
Evan Brand: Get a little closer to the mic, so people can hear good.
Dr. Justin Marchegiani: Yeah. This is your Adam’s apple right here. Right. So, I feel here. I go down, about one centimeter, and then out a centimeter. And, you know, I would do it by standing behind myself, who I can step out of my body. About be here. I touched each side and I press it into the other. And I would have myself swallow water. And I would feel, just for any irregularities in the surface. It will be almost impossible to do it to yourself just as I demonstrated with the angle. But you would stand from behind someone, and you have just nice flat palms, and you just go through the surface, and you touched, you pushed, and you want to feel it come out in the other side. And basically, you want to just feel a smooth surface, and you want to not feel it as an inflamed puffy. You have to feel a couple normal ones to know but, that will give you a pretty good idea.
Evan Brand: The ultrasound sounds easier though. I mean, let’s just say, that you come back with nodules, what happens? Do you just – do you just play the waiting game? You just watch him or how do you approach it?
Dr. Justin Marchegiani: Yeah, I mean, it depends where you’re at, right? There’s always that increase chance of potential thyroid cancer, right. So, it’s good to get that screened, ‘cause of the increased risk. But it’s not the first thing I worry about. Because if you just do all the things that we tell you, I can’t tell you how many patients whose nodules have just significantly reduced. Significantly reduced.
Evan Brand: Yep.
Dr. Justin Marchegiani: Though, I’ve seen that happen so many times, so, hey, you know, just run it by your endo. See what they say. And then just let them know that you’re gonna do some things on the functional medicine side. And, come back and monitor it. you just want to make sure it’s moving in the right direction. Now, some nodules can be caused by low Iodine, too. Again, w tend to get enough Iodine, a couple hundred MIC’s really odd. You need like 200 MIC’s is like they already– hey, you may need a little bit more, but you got to be careful with supplementing Iodine because the Iodination process that happens, so– Iodination is nothing more than the Iodine bonding to the Thyroxine molecules to make your thyroid hormone, right? Like T4 is your Thyroxine, your 4 molecules, your Thyroxine bound to four molecules of Iodine. That process of binding it and pulling out the sticking glue getting stuck there. That’s called Iodination. That process spits of a lot of Hydrogen peroxide which can be inflammatory. And that can drive a lot of B cell infiltration. Your immune cells into your thyroid and exacerbate that autoimmune attack. So you got to be careful off the bat when giving any Iodine. So I always like to get in the Selenium in there first, get the diet dialed-in, get the lifestyle stuffed-out then, and then really lower the information first before I go after it. And if we go after it, we’ll titrate that slowly. We won’t go at it hard. There’s a lot of docs out there that go really high in the Iodine I don’t recommend going high of the bat. I think it’s better off going slower, and work on the foundational stuff first.
Evan Brand: Yeah. Love it. Uh – I was gonna ask you a question about Iodine. I forgot what it was. Tsk. Darn. I lost my point. Alright. Let’s keep moving on. What else comes to mind for triggers.
Dr. Justin Marchegiani: Yeah. So we talked about the food stuff. We talked about blood sugar, we talked about emotional stress. That’s still a big one, okay. Because, emotional stress taps in to your sympathetic nervous system and your sympathetic nervous system wires right down to the adrenals. And that’s umping out Cortisol. Pumping out Adrenaline. And your body will always sacrifice sex hormones for stress hormones. It’s just the hardwired adaptation. Right? If you don’t survive today, you’re not gonna have to worry about reproducing tomorrow, right?
Evan Brand: Yep.
Dr. Justin Marchegiani: So, gut component– the gut component’s very important. We talked about gut bacteria, and how the healthy bacteria’s really helpful with the Sulphatase. Also, that’s where we absorb nutrients, right/ that’s where we absorb a lot of our B Vitamins, a lot of our minerals, a lot of our amino acids, right. Thyroxines and amino acids, that’s part of making thyroid hormone. Also, 70 to 80 percent of your immune system is located in your gut, right? So, you want to jack up your immune system, you know, just get your gut in bad shape by not digesting food, putting a lot of inflammatory things in there. [crosstalk] And uh – throwing off your gut bacteria and uh – whole bunch of steroids from the foods, antibiotics from the foods, anantibiotics in your uh – medicines for maybe, reasons that, maybe be unwanted, so to speak.
Evan Brand: Right. Yeah, the gut’s huge. I mean…
Dr. Justin Marchegiani: Yeah.
Evan Brand: I don’t really like the term SIBO because it’s so generic, but you and I, we see so many different species of bacteria. We can assume that most of them are going to be growing up from the colon to the small intestine.
Dr. Justin Marchegiani: Yeah.
Evan Brand: So if you’ve never been diagnosed to SIBO, or any type of bacterial overgrowth, like specifically, Justin and I are gonna be looking for, like, a Citrobacter or Klebsiella, or there’s two species of Proteus. Those are all autoimmune trigger bacteria. That’s in the literature too. So, if you’ve got bacterial overgrowth, bacterial infections, parasites, Yeast, or like we see many times a combination. So it could be a Citrobacter, plus Blastocystis hominis, a parasite, plus Candida. That’s uh – that a – that’s a triple whammy there.
Dr. Justin Marchegiani: Yeah.
Evan Brand: That could definitely cause the antibodies to go up. The good thing is this is reversible, right. Now, would you say– I know for us, you know, we’re not medical doctors so we can’t use the term uh– cure. Uh– but is it possible for a cure for Hashimoto’s or when you get your antibodies down, let’s say, you were at a 50 on your TG antibodies, and we do all the good work with you. We get the antibodies back down, let’s say, below a five. Are you cured or can you always just rebound quicker than the average person back up to that bad state of Hashimoto’s again?
Dr. Justin Marchegiani: Yeah. I mean, you can always ramp back up, but it’s all about adaptation, right? The healthier you are, the greater ability you have to adapt to stress. So, when you have the susceptibility for a certain disease. So, someone posted on Facebook, I have anti-NaN antibodies, that’s kind of a very broad sense, but your predisposed to certain conditions, certain diseases. Maybe Rheumatoid arthritis, maybe Lupus, maybe Scleroderma, maybe CREST, right. So a lot of autoimmune conditions you may now predispose for. But that just means you have the genetic triggers, those genetic switches, are kind of right in the middle, and if those stressors flick it down, right, that stress could flip that gene on and they could activate. So we managed all the things that we talked about, right? Blood sugar, nutrient density, stress, grains, gut health, uhm – being infection-free, ideally, healthy probiotics, healthy gut bacteria, and then making sure that if there’s thyroid damage already, we support that, making sure we support thyroid activation, right. Zinc, Magnesium, CoQ10, Selenium, maybe the right Iodine, use your functional doctors resource, making all those nutrients and things are dialed-in. That’s gonna significantly help improve your resiliency, so if you do have a disease, you may be able to– your body may be able to keep it in check enough, were the symptoms aren’t even visible. But some they say you’re cured, but legally we can’t say you’re cured.
Evan Brand: Right, exactly. What about the liver? What’s the role of the liver?
Dr. Justin Marchegiani: Yeah. Yeah. So the liver’s really important ‘cause a lot of those deionized enzymes. They come from the liver, right. So, the liver’s really stressed and taxed dealing with the whole bunch of fructose coming in there, ‘cause your Insulin-resistant or toxins, and round-up and pesticides, and a whole bunch of junk. It may not be able to do its job, activating and converting thyroid hormones, so we want to make sure, number one, that we are uhm – keeping the stress off it. ‘Cause a lot of liver stuff is more about to stop adding crap to the system, right?
Evan Brand: Exactly.
Dr. Justin Marchegiani: And then number two, I know, Izabella Wentz talks about it in her book, the Hashimoto Protocol. She starts a lot of her patients on a liver cleanse that first month, which can be helpful. So, Liver Support Phase 1, Phase 2, detox support. In my line, it’s uh– Phase 1 is either uhm– Antioxidant Supreme or Liver Supreme, and then Phase 2 is gonna be Detox Aminos. That supports all the Phase 1 and Phase 2 pathways that run your liver. The fat-soluble, the water-soluble, and the water-soluble to excretion in Phase 2. That’s really important.
Evan Brand: So, list of some ingredients. So this is like your Methionines, your Taurines, your milk fissles, [crosstalk] your Vitamins A, you Beet powder, your Artichoke extract.
Dr. Justin Marchegiani: Artichoke, yeah. And then your Phase 2 is gonna be more of your amino acids. That’s like an acetylation, methylation, uh– glutathione conjugation. All that stuff. So cysteine, glutamine, glycine, uh – taurine’s in there, methionine, uh– We throw Calcium-D-Glucarate in there. Those are really good compounds.
Evan Brand: Cool, cool. Uhm–
Dr. Justin Marchegiani: So I think we hit some good triggers. We talked about some things to help about things to help with thyroid conversion too. We talked about the liver, we talked about the infections and the leaky gut, and then yeah. The whole thing about gluten– oh by the way.– uh– I’ll tell you off the air.
Evan Brand: Alright. Alright.
Dr. Justin Marchegiani: But I’m–
Evan Brand: Hey. Let me tell you something that– before you – I want to – I want to mention two things. I believe we hit it already, but the adrenal piece, uh– with Cortisol stress, with adrenal problems. You can also pack the conversion of T4 to T3 hormone there. So you got to get your adrenals checklist.
Dr. Justin Marchegiani: Yes. Oh yeah. We got to hit that, man.
Evan Brand: Yeah. So…
Dr. Justin Marchegiani: Yeah.
Evan Brand: So, if you’re working on your thyroid, but you’re not working on your gut, and your adrenals, your results are likely going to not be very good, because adrenal stress is gonna reduce the conversion rate. And then, you can go back to it. But let me say one other thing. I had a client this morning. She was trying to justify uh– eating gluten, and grains, and crackers and stuf like that, because of her food-sensitivity test.
Dr. Justin Marchegiani: Exactly where I was going, man. You’ve read my mind.
Evan Brand: Alright. Her food-sensitivity test said, “I’m not sensitive to gluten.”
Dr. Justin Marchegiani: Yeah.
Evan Brand: And so, she’s still doing gluten. I said, throw your food-sensitivity test away.
Dr. Justin Marchegiani: yeah. I mean the big issue, right. Some of the non-celiac gluten sensitivity research. People that weren’t even gluten-sensitive, they have increased gut permeability.
Evan Brand: Say that again. Just to make sure that it’s like super clear for people.
Dr. Justin Marchegiani: Yeah. People that weren’t gluten-sensitive, right, they weren’t like celiac, they weren’t like having any gluten issues, based on conventional standards, when they got exposed to gluten, they noticed some level of leaky gut, some level of permeability in the gut. Based on the study’s objective criteria diagnosis for it. So that means, more leaky gut, means more immunogenic compounds, undigested foods, LPS, Casein, right – all these things. Dysbiotic bacteria may get into that bloodstream, may start to cause some immune system kind of pissed off, right? Then it may go out looking for that thyroid tissue, or maybe even uhm– the pancreas, or other tissues, or other autoimmune tissues.
Evan Brand: Or even if it doesn’t go straight to that, the gluten could still cause a leaky gut situation, which then sets you up. So, when you go to Sushi Night, you could go pick up Blasto, or some other parasite, which then causes even more damage…
Dr. Justin Marchegiani: Yeah
Evan Brand: …which then leads to the antibodies. SO, one way or another, you’re setting yourself up. There’s really just no justification for gluten in the diet.
Dr. Justin Marchegiani: Yeah, exactly. I won’t give any press to the book. It’s out there right now. We’ve talked about it before.
Evan Brand: [inaudible]
Dr. Justin Marchegiani: Yeah. People say, “Oh. Gluten this and that, maybe okay.” Not necessarily okay. I don’t think it’s uhm– something that people should be consuming. Some people may be able to handle it. Again, if you’re gonna consume gluten, you better off doing it and uhm– sourdough form, if you’re gonna do it. Or, you know, if you are healthier, right, and you’re on the right track. Every now and then you wanna do a little bit of white rice, as a treat. As long as you’re doing good, as long as you’re on point, right, then I think that’s okay.
Evan Brand: Yep. Yeah, for sure. Alright now, uhm– there was something else. I interrupted you. I hit the Adrenal piece, and I had to talk about the food-sensitivity testing and the lady trying to justify gluten.
Dr. Justin Marchegiani: Yeah, that was it. I think we hit it, and I think just the– the adrenal imbalance, whether high Cortisol or low. So, Chronic stress, low cortisol, with the reverse Cortisol rhythm, or acute stress, really high Cortisol, both can affect your thyroid conversion and activation.
Evan Brand: Yep, yep. Got it. So, I mean, yes. You can take adaptogenic herbs. We love, we promote those, but that’s still not addressing the root cause. So if you hate your job, we can give you all the Ashwagandha, Rhodiola, uh– Siberian Ginseng in the world, and we’re gonna help you adapt to the stress, but you still got to remove the stress. It’s like I know you see the analogy of the engine life, putting the tape over the uh – the check engine light in the car. I like the analogy of like a doorbell too. Like if you keep pushing the doorbell. Uh– your still gonna have issues. You can try to like disable a doorbell, but it’s still being pressed. Like, you hate your job, or you’ve got a turbo relationship. I had a woman, who she told me. She said straight up, “Evan, until I divorce my husband, I will not get better.” And I said, “Well, I fully support you in that decision.” And now, she’s going through the divorce. She’s already starting to lose weight, just based on the reduction of the emotional stress. So I think that’s just amazing, and unfortunately, that happens. But, if you wanna be healthy, you got to make some tough decisions, sometimes.
Dr. Justin Marchegiani: I agree. I appreciate you’d actually given me credit for that analogy. I thought you were gonna pawn that one off of yourself.
Evan Brand: [laughs] No, definitely not.
Dr. Justin Marchegiani: Good, ‘cause I wasn’t gonna give you, like, two Paleo demerits for that, but I’ll hold those back.
Evan Brand: Appreciate it.
Dr. Justin Marchegiani: Good. You got a credit in a bank of Dr. J here. Excellent. So, I think we hit everything: the Cortisol stuff, we hit the gut stuff. Someone over here, I’ll try him in. So, someone talked about this is functional medicine on demand, can Candida hang around in the thyroid? Candida can create things known as acetaldehyde. Acetaldehyde can be inflammatory, right. Like, it’s one of the products of alcohol. So that can be inflammatory and really affect things. Candida can also get the immune system wrap up. Uhm – Candida or acetaldehyde in the gut can convert in the Salsolinol. Salsolinol’s known to increase uhm– antibodies to uhm– receptors for dopamine in the substantia nigra midbrain. So, that can create other issues with autoimmunity, so yeah. Candida is not a good thing either. And that’s, you know, that’s according to conventional medicine, not really to exist at all. But we see it all the time.
Evan Brand: Oh, yeah. I mean, Honestly, and I think I may have mentioned this. I told you this or I told people on the air already, uh– sorry if I’ve repeated myself. I’m sure we do that all the time.
Dr. Justin Marchegiani: Yeah.
Evan Brand: But, when I first started learning about Candida and yeast, I thought, “Oh, candida, Yeast.” You know, I kind of put it on like the bottom of the totem pole, below bacteria and below parasites, in terms of the effect on the body. But I’ve seen all kinds of crazy stuff with Candida alone, where it’s like, whether it’s brain fog, depression, fatigue, cravings, I mean, something that sounds so benign. “Oh, Candida,” “I’m gonna do a Candida Cleanse.” It’s like, a lot of people promote it, kind of like– almost like it doesn’t exist, or almost like, it’s a trendy topic, and you can just do some type of, like, “Candida Cleanse smoothie”, “go buy my online candida program and you’re gonna get better”. It doesn’t work that way. But, candida can affect almost everybody’s system, whether it’s adrenals, whether it’s gut, whether it’s Lewd…
Dr. Justin Marchegiani: Totally.
Evan Brand: …depression, anxiety, etc., It can all stem just from a Yeast overgrowth. And I would say, you tell me if your stats are different on your side of clients, but for me, I’ve seen about, nine out of every ten people, shows up with Yeast.
Dr. Justin Marchegiani: Yeah, and the big issue with Candida and Yeast is that, some people have it but, it’s just the tip of the Iceberg. The other infections that may trumpet, so to speak in the hierarchy. So, Candida may be an issue in some people, it can be a main issue. Right? Like, we’ll run a Stool Test, and we’ll see it like, “Oh. We have some Candida there.” And then we’ll look at another test. Nothing else comes back. And then on uh– Organic Acids. We’ll see the Arabinose, or the Arabinitol, really high, so we’ll, “Okay. This really maybe a Candida issue.” And then we’d see some clinical symptoms, like uhm– Seborrheic dermatitis or Cradle cap, or just you know, dandruff. You may see some yellow-discolored fingernails, maybe some white coating in the mouth, maybe some tinea versicolor rash. Right? We may see some of those things that may say, “Hey. This may be a primary Candida issue and we hit it hard.”
Evan Brand: You said that a bit quick. The tinea– what’s that? Yeah. It’s like little blotches on the skin.
Dr. Justin Marchegiani: Okay. They just look like little blotches, and it’s uhm– it’s pretty smooth to the skin. It’s not really itchy. It doesn’t really spread but you want to kind of gross yourself out. Just put it in the Google images, and you’ll see the umpteenth degree of it. But it’s just gentle blotches on the skin. They tend to be a little [inaudible]and scarred.
Evan Brand: I know sometimes people may think it’s that but it could be like Keratosis pilaris instead.
Dr. Justin Marchegiani: Keratosis pilaris tends to be a little bit more flaky, and uhm– that tends to hit the back of the arms. [inaudible]…
Evan Brand: Yeah. Such like on your triceps he’s pointing to.
Dr. Justin Marchegiani: …like little back here. Right? That tends to be essential fatty acid stuff. So again, if you’re having issues digesting fats, someone in our live chat, so they don’t break down fat well. Hope you get the gut work done, ‘cause that’s a big, big component. ’Cause if you’re not breaking down fat well, you’re probably not breaking down protein well, either.
Evan Brand: So that would mean, if you’re spinning your heart and money on a good quality fish oil, then you could be potentially wasting your money even if it’s triglyceride form, if digestion’s compromised.
Dr. Justin Marchegiani: Yeah. I mean, most underrated supplements out there, if you were to start on two things: enzymes and HCl. That’s it. Enzymes and HCl get the diet. [clears throat] Excuse me; frog at me. Get the diet a hundred percent dialed-in so, you can actually break down that food. Put the money on the food quality. Get the food quality up.
Evan Brand: Yep. I had a lady tell me, she’s like, “I feel so much better by doing Apple cider vinegar. I don’t notice taking enzymes and HCl.” And I was like, “Okay. You can try it. But I– I’ve still think HCl and enzymes do better than just …
Dr. Justin Marchegiani: Oh.
Evan Brand: …apple cider vinegar but– so…
Dr. Justin Marchegiani: Yeah. Apple cider vinegar’s a great starting point if someone’s like, “Ooh. I don’t know. I’d had some bad reactions to HCl.” Okay. Great let’s just start with the teaspoon of apple cider, but, we’re gonna go with food in your belly first. And then they’ll do good, alright, let’s go to a tablespoon. [crosstalk] Okay, let’s go to–
Evan Brand: You know what I’d do? I make a little tonic. I’ll do like uh– apple cider vinegar. I recently got uh–
Dr. Justin Marchegiani: Yeah.
Evan Brand: …a lime, or like a citrus, squeezer. So, I’ll do like uh– a lime or lemon and uh– apple cider vinegar in there. And then, sometimes, I’ll add like some Vitamin C, or I’ll add that adrenal tincture I told you about. I’ll add that tincture to it. And it’s like a great little tonic.
Dr. Justin Marchegiani: Yeah. I think that’s great, and then, typically, then we do a little graduation ceremony when we go from that apple cider vinegar to the HCl. That’s the next step.
Evan Brand: Yep.
Dr. Justin Marchegiani: Any of the comments said? What do you think, man?
Evan Brand: I think we should wrap it up. I think we’d hit a lot of different triggers here. And if people want to learn more, you’ve done plenty of videos on Hashimoto’s. We’ve done more podcasts on this, so there’s hours of more content, I’m sure, that we’ve created on this. So, just go on justinhealth.com. You can search Hashimoto’s or search thyroid. You could check out my site too, Evan Brand, and make sure you’re subscribed. So, if you want to join in on the conversation, we can answer your questions on the fly. And, of course, if you want to work with Justin, visit his site too, jusyinhealth.com. You can schedule. If you want to schedule with me, same thing, evanbrand.com. And, we’re available. We deal with this stuff all the time, and don’t take no for an answer. Somebody says, “No, I’m not gonna run these antibodies, then you leave.” You fire them because, if you want to get on the root cause of your issue. You have to have the biomarkers. If you’re guessing and checking, you’re building up your supplement graveyard, you’re not gonna get better that way. You really got to get these number on a piece of paper first, because you got to be able to track them and we have to be able to see. “Okay, look. Once we did this, we fix your gut. We got the adrenal support.” And look at the antibodies, drop, drop, drop, drop. And then eventually, “Hey. Maybe you don’t have a thyroid problem anymore.” And it’s totally possible we do it all the time.
Dr. Justin Marchegiani: Awesome. So, here’s the sequence. Ready? Instead of buying crap food, you increase the food quality, and you choose the right kinds of food. That’s number one. That will start to get– that will start to lower inflammation, and give you more energy. As you start having more energy, you can start cutting the emotional stress out of your life. Get used to it with your spouse. Work on it with your spouse. Get a book on communication. Get it– things fixed with your kids. Do your best to fix things at work. Whatever other stressors, all dealing with emotional stress takes energy. So most people that have a lot of emotional stress, typically they don’t have the energy to deal with it. So, get the energy up by just getting the food right. Then you can start to deal with the emotional stress. And then, once that’s kind of dialed-in, you can start adding in some supplements to fast-track it. first set iss gonna be digestive support, and after that, you really want to work with the functional medicine doc to get everything else dialed-in. But work on the foundational stuff first, and then make sure while you’re doing all that, you’re not causing yourself to spin around in a rabbit wheel. While you’re doing excessive exercise, too much CrossFit, just so you’re getting drained with that. And then if you can combine in the good sleep and the good hydration, now you’re set. So, now, when you go see a functional medicine doc, it’s like, “Boom!” You hit the ground running.
Evan Brand: Oh, man. We could– we could have done a whole podcast just on CrossFit and thyroid issues, so maybe for a future day. But yeah, over exercise – I have a lady last week. She said, she exercises CrossFit six or seven times a week. She’s doing CrossFit, and like, “Gosh!” way too much.
Dr. Justin Marchegiani: Yeah. And a CrossFit may be great if you’re – if you’re already healthy, if you’re diet’s spot on, if you’re resting hard, if you’re doing some good things, post-workouts and pre-workouts to recover. But if you’re not there, it’s not gonna be the best thing for you to start off. Unless, you’re a gym’s got a really good On-Ramp Program, and they get the Arm Wrap style in, where they’re not doing some, you know– they have some great timing with their Arm Wraps, then it’s probably okay. But you got to go somewhere where there’s a good Arm Wrap Program.
Evan Brand: But even then, even if you were optimally healthy like you were talking about, would you still tell somebody, “Go do seven days a week in CrossFit?”
Dr. Justin Marchegiani: No. No,– the only– I mean, professional athletes do that if they want, but they’re taking naps, and that’s their job during the day. But, the average person, typically, I would say, maxes four times a week.
Evan Brand: Working, living a life, being a parent or uh– spouse, I mean, it’s tough.
Dr. Justin Marchegiani: And, ideally, spread it out. Right? Monday, Tuesday– Monday, Wednesday, Friday gig, you know. During the week, trying to keep a day off in between.
Evan Brand: Yep, yep. Well said. You said something else in your, in your small rant. I forgot what it was. I was gonna– I was gonna ping off of it. But I guess we should wrap this thing up.
Dr. Justin Marchegiani: Yeah, I mean, it’s funny, like, you ping me at lunch time, “Let’s do a podcast, alright.” And then we’re like “Only fifteen minutes. Only. That’s it.” Then, it’s all like, an hour later, “Damn it!”
Evan Brand: I know.
Dr. Justin Marchegiani: “What happened?”
Evan Brand: I know.
Dr. Justin Marchegiani: We tried to be disciplined.
Evan Brand: I know.
Dr. Justin Marchegiani: Alright. Well, I think we hit all the good stuff on the foundatinal side. Is there anything you wanted to add to the foundational piece?
Evan Brand: That’s exactly what it was. Blood sugar balance, make sure that that’s keep.
Dr. Justin Marchegiani: Yeah.
Evan Brand: That was exactly a blood sugar balance, hydration, you’re getting your good minerals, using your good salts, uh – using trace minerals if you have to, trace mineral supplements if needed.
Dr. Justin Marchegiani: Yeah.
Evan Brand: Uh– we talked about the fatty acids with the fish oil. Optimizing HCl and enzymes, supporting the liver, gull bladder, supporting detox pathways, supporting methylation if you have to, uh– and looking for the root cause, getting the testing. Without the [crosstalk] testing, you’re guessing.
Dr. Justin Marchegiani: Love it. [crosstalk] Love it. Excellent. Alright. Evan, I’m gonna go hang up here on YouTube. I’ll go say goodbye on my Facebook peeps, and we’ll talk real soon, my man.
Evan Brand: Take care.
Dr. Justin Marchegiani: Take care.
Evan Brand: Bye.
Evan Brand: Bye.
REFERENCE/S:
“Hashimoto’s Protocol” by Izabella Wentz
https://www.youtube.com/user/JustInHealth
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