Hashimoto's Triggers Quotes

“Do you ever recommend low-dose naltrexone to your patients? For those reading this who aren’t familiar with low-dose naltrexone (LDN), I’ll give a brief explanation. Naltrexone is an FDA-approved medication, approved to help heroin and opium addicts by blocking opioid receptors. In 1985, Dr. Bernard Bihari experimented with lower doses of naltrexone and realized that it can modulate the immune system. Soon thereafter, it was found that LDN can benefit many people with autoimmune conditions, certain types of cancers, and some other chronic health conditions. While at times I recommend LDN to my patients, it’s not something I jump into for the following reasons: 1. LDN doesn’t do anything to address the cause of the problem. Although LDN can modulate the immune system, it doesn’t do anything to address the underlying cause of Hashimoto’s. However, some people choose to take LDN while simultaneously trying to detect and remove their triggers. 2. LDN isn’t always effective. Although I can’t say that I’ve had a lot of patients who have taken LDN, I’ve worked with enough people to see that LDN sometimes is effective, but, at other times, it doesn’t seem to help at all. 3. LDN can have a negative effect on sleep. Initially, it is common for LDN to interfere with sleep. However, this seems to be more common in those people who start with a higher dosage (i.e., 4.5 mg); thus, if this occurs, you would want to lower the dosage. Better yet, start with a lower dosage of LDN and then gradually increase it if necessary. When Do I Recommend Low-Dose Naltrexone? In most cases, I will recommend a natural treatment approach first, and if the person isn’t responding after a few months, then I’d consider LDN as an option. In addition, before someone takes LDN, it’s important to address certain imbalances in order to increase its effectiveness. For example, low or depressed vitamin D levels should be corrected before someone starts taking LDN. In addition, according to some healthcare professionals, having a Candida overgrowth also can make LDN less effective.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Thus, there is a chance that taking the natural antimicrobials that can help with SIBO can also help to eradicate SIFO. However, there is also the chance that this isn’t the case, and prescription antifungals such as nystatin or fluconazole might be needed.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“The Role of Prokinetics in Preventing a Relapse Prokinetics help to stimulate the MMC, and, since most cases of SIBO are caused by a dysfunctional MMC, taking prokinetics can be important to prevent a relapse from occurring after receiving treatment for SIBO. The MMC works in a fasting state; thus, while many people in general eat regularly throughout the day, those with SIBO probably shouldn’t snack in between meals, and should go at least 12 hours overnight without eating. Here are some of the prokinetics that can be used: Iberogast Ginger 5-HTP Low-dose naltrexone (LDN) Low-dose erythromycin Low-dose Prucalopride”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“One course of treatment with prescription antibiotics is two weeks, while one course of treatment with the natural antimicrobials is four weeks. Frequently, more than one course of treatment is necessary with either prescription antibiotics or natural antimicrobials. As for how to determine how many courses of treatment you need, doing another breath test is a very good idea, although if your symptoms have completely resolved, then you can usually assume that the SIBO has been eradicated. However, it’s important to keep in mind that not everyone will achieve 100% resolution of their symptoms, which is especially true if their condition is due to an autoimmune process involving the MMC. The”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Three Ways to Eradicate SIBO Three main methods are used to eradicate SIBO: taking prescription antibiotics, natural antimicrobials, and the elemental diet. Let’s look at the pros and cons of each of these treatment methods. Eradication Option #1: Prescription antibiotics. Rifaximin is the antibiotic most commonly recommended for SIBO. Xifaxan is a brand name of Rifaximin that is commonly prescribed. While I’m not a big fan of antibiotics, Rifaximin is different than most other antibiotics. First, it is a nonabsorbable antibiotic whose activity is localized to the small intestine due to its minimal systemic absorption. Thus, unlike most other antibiotics, Rifaximin doesn’t go through the bloodstream, but only acts in the small intestine and won’t harm the bacteria of the large intestine. Evidence shows that Rifaximin might actually increase good bacteria (e.g., bifidobacteria) in the large intestine.[4] In addition, bacterial resistance isn’t too common when using Rifaximin. However, some people with SIBO will respond to Rifaximin, and they will need to consider either the elemental diet or herbal antimicrobials. Also, if someone has high methane levels, Rifaximin alone usually won’t successfully eradicate SIBO, which is why most medical doctors will recommend an additional antibiotic, such as metronidazole or neomycin.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Glutathione. The CYP450 enzymes convert mycotoxins into reactive intermediates, and glutathione S-transferase catalyzes the conjugation of these intermediates with reduced glutathione, which leads to the excretion of the mycotoxin. Thus, having healthy glutathione levels is essential to eliminate mycotoxins from your body.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“2. Eliminate the mycotoxins from your body. This can be accomplished through either prescription drugs or natural agents. Cholestyramine. This is an FDA-approved medication used to lower elevated levels of cholesterol. Dr. Ritchie Shoemaker accidentally discovered how cholestyramine binds to mycotoxins in the small intestine (along with cholesterol and bile salts). The recommended dosage is 9 grams, taken four times per day on an empty stomach. Some forms of cholestyramine include aspartame, so you might want to consider getting a compounded form. Constipation is a common side effect; thus, you want to make sure to stay well hydrated and to consume plenty of fiber. Here are some natural treatment options for binding mycotoxins: Bentonite clay, zeolite, and activated charcoal. These natural agents can bind to aflatoxins,[1] which we’re commonly exposed to through the food. However, according to Dr. Shoemaker, these natural agents aren’t effective when binding to other mycotoxins. Thus, while you can always start by taking these natural binding agents, if you don’t notice a significant improvement in your symptoms, then you should consider taking cholestyramine.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Phosphatidylserine. This is essential for nerve cell membranes, and also supports cognition, including the formation of short-term memory, the consolidation of long-term memory, the ability to create new memories, and the ability to retrieve memories.[57] Supplementation with phosphatidylserine has been shown to lower cortisol levels by normalizing stress-induced dysregulation of the hypothalamus-pituitary-adrenal axis.[58] Suggested Dosage: 100 to 500g taken before each high cortisol episode Ashwagandha. This is also known as Withania somnifera, and it is an adaptogenic herb. It supports both the HPA and hypothalamic-pituitary-thyroid (HPT) axes. Thus, it can help people who have HPA axis dysregulation because of chronic stress, and by supporting the HPT axis it can also benefit thyroid function. As I mentioned in Chapter 27, ashwagandha is part of the nightshade (Solanaceae) family, and nightshades are excluded from an autoimmune Paleo diet. Ashwagandha can help with sleep issues by lowering cortisol levels, although one study showed that this herb might help with insomnia by increasing levels of the neurotransmitter GABA.[59] Suggested Dosage: 250 to 500mg taken before each high cortisol episode”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Neurotransmitter Imbalance. When imbalances in serotonin affect the production of melatonin, taking tryptophan, a precursor to serotonin, can help some people in this area.325 5-HTP is the immediate precursor of serotonin, and, therefore, also might benefit some people with insomnia. Increasing serotonin levels by taking 5-HTP can frequently help with sleep because serotonin is a precursor of melatonin. Low serotonin levels will usually lead to low melatonin levels. While someone can take a melatonin supplement, this isn’t doing anything for the serotonin imbalance. Gamma-aminobutyric acid (GABA) is another neurotransmitter that plays a role in sleep. GABA is the main inhibitory neurotransmitter of the central nervous system, and it is well established that activation of GABA receptors favors sleep.[26] Studies demonstrate a reduction of GABA in the brain in primary insomnia.[27],[28] Many people take the herb valerian root to help them sleep, as this herb binds to the GABA receptors.[29],[30] A few other herbs also appear to affect the GABA receptors, including kava, Scutellaria baicalensis, licorice root, and lemon”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Which Microorganisms Are Known to Have Biofilms? Many different microorganisms have biofilms. I’m not going to list all of them here, but some of the more common ones include H. pylori,[54],[55],[56] Borrelia burgdorferi,[57] Yersinia enterocolitica,[58] Escherichia coli,[59],[60] Klebsiella pneumoniae,[61] Mycoplasma,[62],[63],[64] and Candida albicans.[65],[66],[67],[68] You’ll notice that some of these were mentioned earlier as being associated with Hashimoto’s. Natural Agents That Can Disrupt Biofilm A few different natural agents have been shown to dissolve the biofilm matrix. This includes N-acetylcysteine (NAC), which not only can increase glutathione, but can also reduce and prevent biofilm formation.[69],[70],[71],[72] Some studies specifically show that NAC can inhibit biofilm formation by H. pylori[73] and Candida albicans.[74]
Proteolytic enzymes, which break down proteins, can help to degrade biofilm when taken on an empty stomach.[75],[76],[77] Examples of proteolytic enzymes include serratiopeptidase, endopeptidase, and exopeptidase.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Saccharomyces boulardii. Saccharomyces boulardii is another well-researched strain with many different health benefits. It is well known for helping people who have a Candida overgrowth.[44],[45] It also can be useful in the maintenance treatment of Crohn’s disease.[46] It can help to improve intestinal permeability,[47] and help reduce inflammation and dysfunction of the gastrointestinal tract in intestinal mucositis.[48]”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“What causes hypochlorydria (low stomach acid)? Some of the different factors that can cause low stomach acid include nutrient deficiencies, hypothyroidism, and intestinal dysbiosis, including SIBO. Signs of a HCL deficiency: sense of fullness during or after eating, bloating or belching immediately after eating, undigested food in the stool, one or more nutrient deficiencies (especially iron and vitamin B12), and brittle fingernails Recommended dosage of betaine HCL: 350 to 3,500 mg/day Note: If taking betaine HCL, please make sure you do so with meals high in protein (at least 15 grams). You also want to start with a low dosage (i.e., one capsule with each meal), and if you experience heartburn or any other type of burning sensation, this is a sign that you are taking too much and should decrease the dosage.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“In a perfect world, those with Hashimoto’s should avoid gluten and dairy permanently. Of course, we don’t live in a perfect world, and, while some people will do everything they can to avoid gluten and dairy, some will either accidentally or intentionally be exposed to these foods.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Candida overgrowth, SIBO, etc.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“I take this approach with most of my patients; although, at times I will recommend a comprehensive stool panel or other types of testing initially.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“If a problem with gluten is suspected, you want to test the gliadin antibodies, the antibodies to tissue transglutaminase, and the anti-endomysial antibodies. It’s also a good idea to test both immunoglobulin A (IgA) and immunoglobulin G (IgG) because if one of these immunoglobulins happens to be depressed, it can result in a false negative result, causing the person to think that their body doesn’t react to gluten when the opposite is true.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Local blood testing. I use local blood testing to measure some of the nutrients. First, I recommend a 25-OH vitamin D test for most of my patients. I also usually recommend a complete iron panel, vitamin B12, and RBC folate. I discussed this in Chapter 24. RBC magnesium and RBC zinc can also provide some value. However, there are limitations when it comes to testing nutrients through the blood, although this is the case with other methods as well. Micronutrient panels. Some companies focus on micronutrient testing, which involves evaluating all of the vitamins, minerals, and antioxidants. One of the more well-known labs tests the micronutrients through the white blood cells, specifically the lymphocytes. These lymphocytes are supposed to represent a history of an individual’s”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“SIBO breath test. Prior to the breath test, the person will follow a “prep” diet for 24 to 48 hours, and then fast 12 hours. Then, in the morning after the fast, they will start with a baseline breath test, followed by the consumption of a substrate (i.e., lactulose or glucose). After the baseline breath test, they will measure a breath sample approximately every 20 minutes. What the lab is looking for is bacterial fermentation by measuring the levels of hydrogen and methane. In other words, if someone has SIBO, there will be more fermentation, which will lead to higher levels of hydrogen, methane, or both gases. Let’s take a look at the two main breath tests used: Lactulose breath test. Lactulose can’t be absorbed by humans, but it can be broken down by bacteria. As bacteria consume lactulose, they produce hydrogen and/or methane gases, which are measured with the breath test. This is most commonly used because it can diagnose SIBO in the distal end of the small intestine. Glucose breath test. The benefit of using glucose as a substrate is that all bacteria will ferment glucose, which isn’t the case with lactulose. However, this test isn’t as commonly used because glucose is absorbed in the beginning of the small intestine. Thus, if SIBO is occurring in the distal small intestine, then it is less likely to be detected.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Viral capsid antigen (VCA)-IgM. The presence of these IgM antibodies indicates a recent infection with EBV. VCA-IgG. The presence of these IgG antibodies indicates a past infection. Epstein-Barr nuclear antigen (EBNA). These antibodies will develop 6 to 8 weeks after being infected initially with EBV, and will remain detectable for life.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Intestinal permeability test. The classic method of determining whether someone has an increase in intestinal permeability (leaky gut) is through the lactulose-mannitol test, which is a urine test that involves swallowing a solution of lactulose and mannitol. Lactulose is a larger sugar molecule, and if someone has a healthy gut, this molecule shouldn’t be absorbed. Therefore, if someone does this test and has large amounts of lactulose in the urine, then this usually confirms that the person has a leaky gut.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“GASTROINTESTINAL HEALTH TESTING Comprehensive stool panel. A comprehensive stool panel is one of the best, and perhaps THE best test, for determining the health of the digestive system.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Ragland’s test. This involves testing your blood pressure while lying down and again after you stand up. Under normal circumstances, the number on top (systolic) should increase by 6 to 10 mm. However, if someone has weakened adrenal glands, this number will drop from 5 to 10 mm upon standing. If it drops more than 10 mm, then this is usually an indication of more severe adrenal problems.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Regarding your thyroid health, I would prioritize the following markers: TSH Free T3 Free T4 Thyroid peroxidase antibodies Thyroglobulin antibodies As for the other blood tests, at minimum I would order the following: Complete blood count with differential Comprehensive metabolic panel Lipid panel Iron panel (serum iron, ferritin, iron saturation, TIBC) 25-OH vitamin D High sensitivity CRP”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“reactive protein (CRP). This is one of the main inflammatory markers commonly tested for. It increases as interleukin 6 (IL6) is secreted by immune system cells. CRP is not a specific test. Thus, if it is positive, it means you have inflammation, but it won’t tell you where the inflammation is located. When getting this test, it’s best to order “high sensitivity” C-Reactive protein, also known as hs-CRP. Labcorp: 0.0−4.9 mg/L Quest: <8.0 mg/L Optimal reference range: <1.0 mg/L”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“I have most of my patients with Hashimoto’s follow an elimination diet initially in the form of the AIP diet. I have them do this for the first month, and if they are doing well, I’ll encourage them to follow this diet for a longer period. Eventually, I’ll have them reintroduce some of the excluded foods, as the goal isn’t to keep them on this diet permanently. However, at times, I will order an IgG food sensitivity panel. If someone insists on ordering this type of testing, then I’m fine ordering it. Another situation when I might order such testing is if the patient started out with an elimination diet and followed my other recommendations, but a few months later they still aren’t progressing. Another scenario where I might order a food sensitivity panel is if the patient is progressing but then they hit a roadblock and don’t show further improvement.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Since neither an elimination diet nor food sensitivity testing is a perfect method for detecting food sensitivities, in some cases, it might make sense to combine both. You can choose to do a food sensitivity panel initially, and combine this with an elimination diet. For example, before starting the elimination diet, the person would get the blood draw for the food sensitivity panel. Then, while waiting for the results, they can follow an elimination diet for 30 days, and then upon receiving the results of the food sensitivity test they would stop eating any foods they test positive for. For example, if they tested positive on the food sensitivity panel for broccoli, carrots, and a few other “allowed” foods, they will not only stop eating these foods, but they won’t reintroduce these foods until their gut has been healed.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“and this is the order she has them listed: Egg yolks Legumes with edible pods Fruit- and berry-based spices Seed-based spices Seed and nut oils Ghee from grass-fed dairy”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“For those looking for a specific order of foods to reintroduce, Sarah Ballantyne has put together a very helpful PDF entitled “The Paleo Approach Quick-Start Guide to Reintroducing Foods.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“First, while many people are able to identify foods they are sensitive to, this isn’t always the case. For example, someone who follows an elimination diet and reintroduces a certain food might experience obvious symptoms, such as bloating and gas, headaches, an increase in fatigue, brain fog, or other symptoms. However, some people don’t experience any symptoms upon reintroducing foods, and the lack of symptoms doesn’t always rule out a food sensitivity.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers

“Essentially, you want to follow a strict AIP diet for a minimum of 30 days, and then after 30 days, you can choose to reintroduce certain foods one at a time, every three days, and pay close attention to symptoms. Another benefit of the elimination/reintroduction diet is that it is more cost effective than doing food sensitivity testing. Testing for food allergens can be expensive, which would be fine if the information provided was completely accurate. However, as you’ll read shortly, food sensitivity testing is far from perfect.”
― Eric Osansky, Hashimoto's Triggers: Eliminate Your Thyroid Symptoms By Finding And Removing Your Specific Autoimmune Triggers