[05:05] About Elle Russ
[10:27] Why Elle Call T3 The “Hormone of Life”
[19:00] How to Find a Doctor Who Actually Knows How to Run Thyroid Test
[23:53] Why Most Thyroid Supplements Don’t Actually Contain Thyroid Glandular or Thyroid Hormones
[25:30] The Confusing Hormone “reverse T3” and The Ancestral Reflex That Causes Your Body to Make It
[38:10] Whether Body Temperature Tests Really Work, and If There Any Science to Back Them Up
[44:20] What Vitals You Should Track and The Best Way To Do It
[50:30] What Elle Thinks Is The Best Natural Over-The-Counter (OTC) Thyroid for People Who Want To “Self-Test” and “Self-Medicate”
[51:50] Why Coconut Oil Can Help to Heal Thyroid Issues (and Whether or Not Marijuana or CBD Should Be Used)
[54:55] The Best Prescription Form of Thyroid Hormone to Use and What Elle Personally Takes
[68:27] The Shocking Link Between Chiropractors, Acupuncturists and Thyroid Hormone
[70:27] What To Do If You Have Tried Everything and You’re Still Having Issues
Ben: Hey, it’s Ben Greenfield. No podcast would be complete without us talking about West African peanuts chicken. Why is it that my voice drops when I accentuate my s’s when I’m talking about food? I have no clue. Because I don’t really watch the Food Network. I don’t know how they talk on those shows. It’s just like my built-in evolutionary mechanism to wanna sound sexy when I talk about food? Anyways, I digress. West African peanut chicken with sautéed kale and rice. Yeah, we’re talking about a hearty peanut stew with paprika and coriander. And two, count on not one, but two different kinds of pepper corn. A vinegar-infused rice and a rich peanut butter and coconut milk sauce. This is a meal that is getting delivered to my house this week. Well the meal isn’t getting delivered. All the ingredients are getting delivered and the recipe card that shows me how to make it. It’s all from today’s sponsor: Blue Apron. Now Blue Apron doesn’t just send you crap to your house. We’re not talking about chicken that's been raised in a farm in a tiny little cage and or like peanuts that are covered in mold. No. They actually get all their beef and their chicken and their pork from responsibly raised animals. Their seafood is sourced sustainably. Their produce is from farms that practice regenerative farming and they send these meals to your house with the recipe cards then you just cook ‘em. It’s less than 10 bucks per person per meal. Super easy. And to get your first three meals totally free from Blue Apron along with a freshness guarantee, that means there's not going to be nasty mold growing on your food, you go to blueapron.com/ben. That's a blueapron.com/ben. First three meals free. I'm telling you got to try the West African peanut chicken with sautéed kale and rice. Check it out.
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Today’s show is all about the thyroid. Thyroid issue, thyroid tissues, thyroid confusion. The topic near and dear to my heart. You're going to learn why in today’s show. So enjoy!
In this episode of the Ben Greenfield Fitness Show:
“Eighteen hundred genius, English physicians was like, ‘what’s all these people with goiters on their neck and hyperthyroidism?’ He extracts cheap thyroid gland. He injects it into a human and it works. Thus comes natural desiccated thyroid which was the treatment for people up until the 1950s when drug companies could not patent desiccated thyroid. So what’d they do? They created C4, synthroid. And they touted it as the one-stop only answer.” “He can’t afford to have children right now. We’re gonna cut his sex drive and decrease his testosterone. Same goes for females. She’s not in a position to have a baby right now. She’s starving or running from danger. We need to shut this down.”
Ben: Hey folks, it’s Ben Greenfield and I will admit it. I have thyroid issues. I’ve had thyroid issues pretty much ever since I went through about a 12-month stint where I combined, what I would say is called ‘Extreme Ketosis’. We’re talking like a 90% plus fat-based diet without like cycling carbohydrates in or anything like that just full-on fat based diet for about a year. And I combine that with really hard and heavy training for Ironman Triathlon. Now granted a big part of this was for a study that I participated in called the ‘Faster Study’ over at Dr. Jeff Volek’s laboratory which at the time, was at the University of Connecticut where we were trying to see like what would happen to the human body in terms of fat oxidation rates and becoming a fat burning machine when you’re essentially restricted carbohydrates pretty intensively, and combine that with a lot of endurance exercise and, sure enough, I became a really intensive fat burning machine. But at the same time, since then, I’ve actually had to battle rock bottom. Your relatively rock bottom T3 levels and really high TSH, Thyroid Stimulating Hormones, over the past several years.
And so, hypothyroidism and the thyroid in general is a topic near and dear to my heart. And I know there's other people out there. I mean there's over 200 million people in the world and 20+ million Americans who have some kind of thyroid issue, and 60% or more of those are undiagnosed or completely unaware of their condition and it causes things like poor sleep and constipation, and in women, gynecological issues like miscarriages and fibroids that causes hormone imbalances. It can lead to anemia. It can lead to different forms of adrenal fatigue. It can even lead to things like type-2 diabetes and insulin resistance.
And so, whenever I see a good book on thyroid come out I like to look through it and frankly, in the past several years there has been like a dearth of books about the thyroid. However, I recently got my hands on a book that I would say is one of the most comprehensive resources that I found in terms of not like, not insulting your intelligence by spitting out what every other book out there, I think, tends to say about the thyroid. But instead taking a really, really deep dive in the world of thyroid hormones and then teaching you how to fix your thyroid for good.
And the author is right here on the show with me. So the book is called “The Paleo Thyroid Solution: Stop Feeling Fat, Foggy, And Fatigue, a little bit of an alliteration there, At The Hands Of Uninformed Doctors – Reclaim Your Health”. The author is Elle Russ. And Elle is of course an author. She's a health coach. She’s the host of a different podcast called the Primal Blueprint Podcast. She does that with Mark Sisson. That’s kinda like part of his brand, the whole primal brand. And she actually sits on the advisory board of the Primal Health Coach Program that Mark Sisson has created. So, she wrote “The Paleo Thyroid Solution” recently. I recently read it and I had to get her on the show to talk about not only that her intriguing journey fighting thyroid, but also some of the fascinating topics that she delves into in this book. So Elle, thanks for coming on the show.
Elle: What a great intro. Thank you so much for having me. And I was unaware of your personal thyroid issues and we can either, I have some ideas as to why that happened to you once you describe what you went through for a year, and also we can cover anything off the podcast afterwards if you wanted to talk blood work and look at stuff.
Ben: Sweet. I love being a podcaster. I get free medical consulting from experts.
Elle: (laughs) That’s right.
Elle: Exactly. From, you know, like non-MD holding experts yet but…
Ben: That’s right. So I can sue you. Or no actually I wouldn’t. I think that means I can’t sue you if you’re not an MD, but you give me medical advice. I’m pretty sure that’s how it works.
Elle: I’d love someone trying to sue me for malpractice. (laughs)
Elle: And I don’t want it to be like a mismatch. I’m not surprised based on what you said that you had thyroid problems that year, so we can get into that later. But as you were describing that I was like, “Oh! Well of course you had thyroid problems.” So we can talk a little bit about that in detail later about your personal experience, but yeah, where should we start?
Elle: This is a huge topic and thank you for the review of my book. And one of the reasons is best book I couldn’t find when I was looking for it. And I am tired as well of the same thyroid information given to in every book, but they don't tell you what to do, how to look at labs, what should stuff look like, all the different nuances. They don't really tell you what to do. And I really wanted to empower people to understand this because there is a world of uninformed doctors out there, and you need to kind of come armed with your own knowledge.
Ben: And I know when you like have a hammer the whole world looks like a nail, the saying goes something like that in the book, and you obviously wrote a book on thyroid and you had thyroid issues and you use this term in the book. So I’m curious like how you can justify using this term but you actually call Thyroid and specifically, I think, it’s T3.
Ben: The ‘hormone of life’ in the book.
Ben: How can you justify actually calling it the ‘hormone of life’ when there’s so many other hormones like testosterone and cortisol and all these other hormones that we depend upon. Why is T3 the ‘hormone of life’?
Elle: All those other hormones you just talked about will be useless without proper thyroid function because thyroid function is the master gland of the entire body. You will die without a gland. Can't have one. If you don't have one, you have to take the hormones that you otherwise…
Ben: I thought some people like get it, take, can you get it… bladed?
Elle: Well, here’s the thing. The people who have their thyroid removed. A couple scenarios. Thyroid cancer? Cut it right out. If you have Graves’ disease and you have hyperthyroidism, oftentimes that cannot be controlled for a very long time. What they do is they’ll either remove the thyroid or radioactively zap it. Thus, making the person hypothyroid and they have to go on thyroid hormone replacement anyway. But the bottom line is this: you literally will not live without the gland at all. Period. End of story. Now, sometimes people have like a partial or a little bit of their thyroid gland removed, but as far as the entire gland goes, you can’t live without it. Most people are not born without it. It’s very rare to be born without it. So, you would die without this gland. It’s the master gland of the human body in charge of every single metabolic function because everything stems from it. So, you won’t even have cortisol production or testosterone or anything else if the thyroid and T3 wasn’t working properly.
So, if you would die without a thyroid gland, what do you think's going to happen to you when you have suboptimal or sluggish or even really severely low levels of thyroid hormones? You’re dying slowly and that's literally what it feels like when you’re severely hypothyroid. And everything in the body will start to breakdown. The hormones will get thrown off, then you’ll get fibroid, you’ll get low testosterone, you won’t get hard-ons in the morning as a dude. All these things go wrong because it's like a domino effect.
Ben: So let’s use what you just talked about like guys not getting a hard-on in the morning.
Ben: ‘Cause that happened to me when I was going through that time but I wasn’t sure if it was the low testosterone and something like adrenal fatigue causing low thyroid production or if it was the opposite. But what you’re saying is it was the T3 that kind of starts the cascade to everything else?
Elle: Well not necessarily. So, here’s the thing. Your adrenals could have affected the thyroid, right? And adrenals can also affect testosterone. But at the end of the day, when a guy who's of age where you should be waking up with erections, if you're not having that then you really should be looking at, not only just the testosterone, but the DAGA. The DAGA is also another factor here and often people are very, very low. So you probably exhausted your adrenals and in the end that came a thyroid and an adrenal response that messed with your testosterone. Now, you could naturally corrected that testosterone would come back naturally, unless you had a true thyroid problem, but it sounds like you ignited yourself into a thyroid problem. And I don't know if you’ve naturally gotten out of it or not. We can talk about the details on that later, but why do I say T3 is the ‘hormone of life’? Okay. So, there's really two primary thyroid hormones that are really of consequence here and one you can live without and the other you cannot. You can live without T4. In fact, I have spent the past four years with no T4 in my body. You cannot live without T3. Now, T4 converse to T3. So if you're not converting probably or there's an issue, bottom line is you need enough T3 to function and free T3, which is a test, is absolutely related to how people feel.
So, someone who is a total mess and seriously hypothyroid would have free T3 in the bottom of the range or even under. It’s individual, so you know the most of human population have normal working thyroids, have a free T3 in midrange, but essentially this is the metabolically active thyroid hormone. T4 is not. Okay. So you can give a person all the T4 you want or they can have all the greatest T4 levels on planet earth and they’re like “I still feel crappy.” Well, have you tested the free T3? Because all that matters is that the T4 converted into the thing that matters which is T3. Why is T3 the ‘hormone of life’? Well, it’s the difference between too hot, too cold. No metabolism, metabolism. Inflammation, you know, and no inflammation. It is a Goldilocks scenario. It is the regulator of our temperature/everything else that follows that. So…
Ben: So how are you able to have T3 without having T4, if T4 is what gets converted into T3?
Elle: Because I take T3 only. Which is very rare. It is something that is used to…
Ben: You take it like a supplement?
Elle: Oh no, it’s not a supplement. It’s the actual hormones. You can’t buy it over the counter.
Elle: I take like actual T3 hormones. And now that’s rare. A lot of people aren’t on T3 only. You actually want this conversion process to happen. You want the T4 to dish out and decide when you need T3 throughout the day and hopefully that process is working correctly. And it’s all testable by the way. You can see whether or not these things are converting properly and you can, you check levels. These things are absolutely discoverable. So T3 only is a very rare place to be and it is one of the options that is used when you cannot resolve a reverse T3 problem naturally or by other means because I don't know if you want to give, I can give a snapshot of how the thyroid works right now if that'll help everybody. Essentially what happens is this.
Ben: Yeah. And by the way before you delve in, I mean like you have like a deep deep dive. One of the most comprehensive dives I’ve seen in the book. But yeah, give us the overview again. Like I know a lot of people listening right now, you’re pretty smart cookies. You’ve probably, especially if you click play on this, you kind of know a little bit about the thyroid, possibly. But go ahead and give us that overview.
Elle: Sure. So what happens is, the first order of business is that the base of your brain, the pituitary, senses when your body is low on thyroid hormones. And when it senses that it sends a signal to the thyroid that will say, “Hey, wake it up. Produce more hormones.” And that signal is called TSH, Thyroid-Stimulating Hormone. Now, it’s not a thyroid hormone, it is absolutely 100% not supposed to be used as a soul assessment measure for hypothyroidism. That is one of the mistakes all the uninformed doctors use over the years. I went undiagnosed for two years because they kept testing my TSH and I’ll explain that in a minute.
So, the brain senses the body is low on hormones. It sends a signal to the thyroid to wake up and produce more. When the THS signal is sent to the thyroid, the thyroid can take that signal and, if you have a normal working thyroid, it pumps out the right amounts and those right amounts get converted properly and everything's metabolized properly in the body.
You've got good levels of selenium and D and B12, and there's all these other factors adrenals, etcetera. Sometimes the thyroid doesn't take the bait and so the problem lies in a few areas. Doctors in the past were only testing the TSH which absolutely makes no sense. It’s a 1973 protocol. It’s useless when used with other labs, and I’ll just rattle off a good comprehensive list which is TSH, free T3, free T4 and then you're looking at the two Hashimoto’s antibodies TPOAB and TGAB and then reverse T3. Those tests right there…
Ben: Those are all the ones that you should get tested.
Elle: That's a comprehensive, now there are other you know factors and you can do a million food sensitivity test and hormonal tests, but that’s the basics right there. Everybody should know the basics. Now go to an endocrinologist, they're only going to test the TSH and the free T4. They’re not even testing the thing that matters which is…
Ben: Why? The more expensive to do the other test?
Elle: No! It’s because they're indoctrinated in an old belief system. It would be like someone telling you today, “Ben, you should not eat fat off the steak because you're gonna have heart disease.” You would laugh in their face. Because you and I know that that is all old outdated bunked medical wisdom.
Ben: Unless it’s a crappy grain-fed cow.
Elle: That’s right. But it's the same with thyroid hormones. The doctors that are in the know are up on the latest and the doctors that are not, including endocrinologists, who are the most indoctrinated, and I suggest nobody go see an endocrinologist for your thyroid health. They want to see everybody’s free T3 in the middle of the range if they even test it. Most of the time they don't test it and they happen to be quite ignorant on a lot of the subjects that are on thyroid health. Whereas functional medicine doctors, DOs, integrative doctors and anti-aging doctors, those are the people that are usually up on the latest and understand how to take and evaluate and assess these tests. So…
Ben: Is there like a directory somewhere that people could use if they wanted to actually find a doctor who they didn’t have to tell to run those tests, but the doctor would actually know to run those tests. Like is there like a practitioner, director or somebody like that where somebody's listening, they can actually find the right kind of doc?
Elle: Good question, and yes. And I would go to the NTH Yahoo group. That’s Natural Thyroid Hormones Yahoo group. And within there, if you join their free Yahoo group and they have files and they have a good doctor list compiled by thyroid patients all over the country and I think they have an international one. That’s a great place to go and look to see about an informed doctor. I can’t guarantee that everyone on there is gonna be great, but that's a good start. And that's kind of where I tell everyone to go.
Ben: And by the way, for those of you listening in, I'll put a link in the show notes. The show notes for this particular episode you can find. It’s just Elle’s name. You go to bengreenfieldfitness.com/Elle. That’s E-L-L-E. And if you go to bengreenfieldfitness.com/Elle. I'll put a link to like the Yahoo group and Elle’s book and all that jazz.
Okay. So most docs are not testing for the full spectrum of thyroid hormones. T3 is the ‘hormone of life’, but you still have to test, what you said, TSH, T4, free T3, free T4, all of your thyroid antibodies, etcetera.
Elle: And reverse T3. Yeah. So for example if you were to take my blood right now, my TSH would be zero, my free T4 would be zero, my reverse T3 would be zero , and the only thing that would really show up would be my free T3. That’s very rare by the way. I'm not suggesting T3 to anyone. That is the last resort and it's very hard to find a doctor who even knows what they're doing with T3. So if anyone thinks they're going to go out there and buy some T3 and like lose weight and fix their problems, you're asking for a lot of trouble. Now if you were to go online…
Ben: Crap. ‘Cause I order T3 from this online pharmacy every week. No, I'm just kidding. Okay, so what were you saying?
Elle: Here's the thing, if you go online and you were to research Cytomel which is the brand name for T3 or liothyronine sodium which is T3, a hundred thousand bodybuilding websites pop-up and your like, “Oh, that's interesting.” Well, here’s why. T3 is the only metabolically, it is metabolism. So why do bodybuilders take it? They jam themselves for six to eight weeks with T3 so that they can burn as much fat as possible before a competition. Is that smart? No, it’s not! They can really F up their thyroids. However…
Elle: They do it because it is the most…
Ben: Is it just like a negative feedback loop thing?
Elle: Right. Well here's the thing, when you take T3 directly, specifically it really shuts down the TSH and everything else, so now they're overriding the system. And if they wean themselves back off, does their system come back? Or they may suffer a little while, while you know the body goes, “Oh okay, so we’re doing this again now?” versus having it shutdown. There's where you can get into a problem. And also it's dangerous. It kind of is dangerous the way that they do it. They’re not doing it, in my opinion, in a smart effective way if they were going to do it like I would probably have some advice for those people a way to do it better if they we're going to do that. But the bottom line is this, it's a fat burner. So why do you think a little T3 levels hypothyroid patients get fat? Hello! No T3. Why do hyperthyroid patients like pretty much have trouble putting on weight? There you go! Over T3. They’re pooping and burning fat constantly. They’ve got higher body temperatures. That’s not healthy either because that’s hypermetabolic and can be inflammatory, etcetera. But you go the other way, and you go hyperthyroidism and, again, it’s all about T3 and T3 metabolism essentially. So that's why, I mean I say it’s ‘the hormone of life’ cause without it you're done. You know what I mean.
Elle: And if the T4’s not converting properly into the thing that matters then it doesn't matter how much T4 you ever give somebody.
Ben: Well, as much as I am a fan of lurking on bodybuilding forums and taking the advice of broheads. It kind of makes me think, you know, if so many of these people are like using T3 as a way to get a nice body or to burn more fat, what about like eating thyroid gland? Like can you order and eat like thyroid gland like you can order like kidneys and liver, and stuff like that?
Elle: Well, desiccated thyroid gland is thyroid hormone replacement in the form of Natural Desiccated Thyroid or NDT. That's what natural thyroid hormone is.
Ben: You mean like the capsules?
Elle: Not something you can get over the counter! If you’re talking about the Glandular, there's glandulars where they might chop up a little bit of adrenal or chop up a little bit of thyroid. But the essential natural desiccated thyroid is sort of the best option for a majority of patients. It's natural. It’s…
Ben: And you have to have a prescription to get that? Like you can’t like go to Amazon or other websites and get like a desiccated thyroid?
Elle: You can. You can actually, you can order it online without a prescription but you have to seek out and kind of look around a little bit further because you know, there's a lot of BS by the way. You know there’s a lot of BS supplements out there like, “Oh T3 power!” and you’re like, “Ah I’m taking T3.” No, you’re not. The most important element in any of those supplements is selenium and why is that? Because selenium is ultimately responsible for the conversion from T4 to T3.
Ben: I've actually noticed that when I’ve gone to like super supplements or GNC, and you go on and you grab the bottle that says that it’s like the “thyroid booster” or “the thyroid support”. Usually it's like a coleus forskohlii is one that I see in there a lot. And then like selenium, like you mentioned, usually like iodine is in there, a whole bunch of B12. But when you look at the label there's no actual thyroid in most thyroid supplements. It’s mostly like a bunch of stuff that supposedly theoretically not according to like peer-reviewed clinical research, but it's supposed to support the thyroid. It’s like a shotgun of stuff that the thyroid supposedly uses, right?
Elle: Well, certainly. In vitamin D and selenium and B12, of course. There’s all these things that synergistically there’s, you know, not just thyroid hormones. You can literally give a person all the correct thyroid hormones, but if they have a low ferritin, low iron storage, or adrenal insufficiency then they're not going to do well. They're not going to be able to, here's why. You can give someone all the hormones no matter what hormones they are all you want unless they are being properly metabolized and distributed and getting into the cells. So back to the TSH and the way things work. Throughout the day what normally happens is your body, your thyroid, if your normal, dispenses about 80% T4, about 20% T3, and about 40, 50% of that T4 will be converted in to T3 throughout the day as you need it. Whatever is not used of the T4, gets flushed out through a system called reverse T3. And that’s a natural, that's why I have no reverse T3 results because T3 does not convert into reverse T3. Well, what is reverse T3? Why is it important? It’s really really important and this is probably what happened to you.
Ben: Yeah. That one’s kind of confusing for a lot of people. Reverse T3.
Elle: It is confusing. So, now we know, okay, it's this way we're excess T4 is flushed out through the body. Why do we have that there? Here's why. Reverse T3 is literally the marker of wellness and unwellness in most people. For example, if you are have horrific morning sickness as a pregnant woman, likely you have elevated reverse T3. If you have just gone to a huge car accident and went through a lot of trauma, you’re reverse T3 is going to probably be high. Why is that? Because your body wants to save you at all times. And reverse T3 is there as an emergency alarm and an emergency brake to make sure you do not become hypermetabolic in times of stress or inflammation. So, let's take the example of you. I’m willing to bet it was not the high-fat ketosis that screwed up your thyroid. It was probably the overtraining combined with maybe 2) lack of calories because your appetite was probably very suppressed on the fat. Or also could’ve been a selenium deficiency, ferritin, I don't know the other, I don't know your other blood values before you started that train, right?
Elle: So those elements. However, here's the thing. Here's the Primal perspective, the paleo Primal perspective of our bodies. “Oh my god,” So, you're running like whatever, 50 miles a day. They’re like, “Oh my god, this guys either running from danger. He doesn't have enough fat on his body. We ‘ve got to reserve all the, and he might not get food soon. We're not going to, this T4’s going right to the reverse T3 because we don't want to increase his metabolism.”
Ben: Oh okay, so it’s down regulating metabolism.
Elle: That’s right. “Not only that, he can’t afford to have children right now. We’re gonna cut his sex drive and decrease his testosterone.” Same goes for female, “She's not in a position to have a baby right now. She's starving or running from danger. We need to shut this down.”
Ben: So it's like an ancestral mechanism.
Elle: It's a wonderful saving mechanism for us.
Elle: That is why, and I’m just gonna cut you really quick, we don’t have to get into a whole conversation on T3 only. But that is why being on T3 only is a pain in the ass to manage and difficult and not optimal because you're making the, I mean literally how can I decide what my body needs at what times. There are certain things I can measure temps and, you know, symptoms and go by pulse and things like that and that's how we can, I can manage T3. However, when we think about this sort of like slow release mechanism that is T4 which is a storage home in a prohormone. Ah, that's a better system, right? That's more elegant. It's choosing for me and if it's choosing correctly then I'm getting all the right amounts of T3 when I need it and I'm not getting any more or any less. Now I gave myself hypothyroidism by chronic exercise. I'm pretty convinced because it doesn’t run in my family. And, you know, now that I look back and see what kind of life I was living, I was a sugar burning, eating every 2-3 hours Zone South Beach type of philosophy and I was doing a crapload of chronic cardio probably became iron deficient at one point and I knew I was selenium deficient at one point. All of those things could’ve just caused me to get a thyroid problem, but it was probably the body saying, “You're starving.” And so in that sense we caught like euthyroid sick syndrome. Starvation can absolutely increase reverse T3 and cause a thyroid problem. So a lot of people who extreme dieting, Do you know what I mean?
Elle: Its, yeah…
Ben: How long ago did this happen to you?
Elle: So I’m 43 and then it happened when I was 30, then I had a second bout a reverse T3 problem of like six years later. And both I had to absolutely correct myself without the help of a doctor at all which is why I wrote the book because that’s unacceptable to me. Totally unacceptable.
Ben: In your book you actually publish a whole bunch of like your lab results and you have for example like, you know, when your body sounded that emergency alarm and you were producing a whole bunch of reverse T3. But I just flipped open to the book where you talk about. Where you’re making a whole bunch of reverse T3. But I'm looking at your values and your free T3 and your free T4. They're both high. This is July 2011. Did something happen after that? Because you keep saying that like your body doesn't make any T4, like what happened there?
Elle: Oh well, no wait. Those results are from when I was on natural desiccated thyroid. I was on T4 and T3 at the time of that table that you're looking at.
Ben: So what was it that caused your body, like what led to you having to take these supplements to get your free T3 and free T4 up? Was it just this overtraining and under-eating you were talking about?
Elle: No, the reverse T3 problem was separate. I was already on natural desiccated thyroid and doing quite well after many years I already solved it. However, I was still a sugar burner. Was not aware of, you know, getting fat adapted and following this train so I was still in an over exercising, you know. I had an extremely stressful year preceding my reverse T3 issues. That severe stress can, I mean normal people who aren’t even on thyroid hormone get reverse T3 thyroid issues going through major stress and adrenals. So you don't, and the answer’s not always thyroid hormones. Minus the answers, fix the adrenals, decrease the stress and the whole symphony gets back in and again the body sensing a stress of some kind and again the stress could be chronic underlying infection like Lyme's disease. You know, any kind of acute infection or stress that's going on in life can screw up a thyroid. So, it doesn't have to necessarily be like a thyroid assault. Specifically, it can just be life or over-exercising.
So, when I got the reverse T3 problem, I believe it was just a cascade of things. I later found out I was selenium deficient. Everybody who’s taking thyroid hormone and people in general only should shoot for 200 to 400 micrograms of selenium every day. That was something I didn't do. My iron dropped. There is a lot of things that maybe I didn’t keep up with as a menstruating female over those years and then you know ran into this reverse T3 problem. Now, I tried to correct it naturally but when I could not find success there then the only answer at that point is really to go on T3. And that's because T3 doesn't convert into reverse T3. So the idea is you wean yourself off of the T4. It clears out of your body. You replace it with T3. Those receptors, well this is how we can look at reverse T3.
Reverse T3 is like in a guard that stands in for the T3 cells and protects anything from going in it. Because it's like we don’t want his cells to be affected right now for whatever reason. So what we're going to do is we’re going to block the cell receptors and we're just, and it's going to pull in your blood, which is why the reverse T3 problem, will show that you might even have a decent or high amount of reverse T3 in the blood and the, I mean, of T3 in the blood. And so the only way to really detect a reverse T3 problem is to get reverse T3 and free T3 done at the same time and we do a ratio between the two and 20 or higher is considered healthy. So when I had a reverse T3 problem, my ratio was like 12. Severely hypothyroid even though I was taking thyroid hormones every day.
Ben: Okay. Got it.
Elle: Now, stagnant liver, you could do a liver cleanse and try to, you know, get rid of a reverse T3, there’s lots of natural protocols that can absolutely do it but I just happened to try all them and it didn't work. So, reverse T3 is really there to protect us and to prevent us from becoming hypermetabolic in situations where that would be dangerous for us if that makes any sense. And so for you, I'm not surprised, and this is what happens to a lot of people training for marathons and marathon runners often very thin, over exercising. That's the wrong messages you're sending to your whole thyroid process.
Ben: Oh yeah. Like my body fat at about two to three percent and I was doing a lot of training and no carbohydrates and yeah. I mean it took a while for me to get myself back to health and back to like where I wouldn’t, I used to spend like the first four to five hours every morning like during work like shivering wearing like three layers of clothing because I was just like so freaking cold from very low thyroid hormone production. So and like constipation and then like poor sleep was a biggie. Like having a really hard time like staying asleep. What you think that's kind like counter intuitive, right? If you think of your body was like all sluggish that you’d just like collapse in bed at the end of the day and you’d be tired but the body doesn't fall asleep. It’s really weird. Really frustrating.
Elle: Well here’s why. Because when you’re hypothyroid, often you have adrenal issues because when you have low T3 then the adrenals are trying to take over to give you energy that's why when you have low T3, you're craving carbs and sugar. Very hard to even, first of all, you’re metabolically inefficient for losing weight when you’re hypothyroid, but then the crapper is also that, because you have, now your body is screaming for energy. So, you are like craving, you know. And it’s very difficult. So now you’ve got this added extra horrible like sugar addiction food obsession issue going on as well because your body’s like, “I need energy from somewhere. You’re not giving it.” So what it does is it over pumps the cortisol, now you’ve got adrenal fatigue. That happens with most people, Do you know what I mean like who have hypothyroidism that goes unchecked for a while. And so…
Ben: Even though I had like through the roof cortisol. I still do. I would like, my cortisol is still quite high. So like my adrenals never really like quit producing what they're supposed to produce. It’s just like my thyroid hormone just pooped.
Elle: Well and here's the thing so getting back to why you were having trouble sleeping. So often people of these cortisol issues. You’d think, you know, you're sluggish and you're sleepy all the time then why can't you go to bed if you have hypothyroidism. I never had issues sleeping, but people who did have usually have a combination of low and high cortisol and what happens is they might start to feel a little bit of pep and better after 6 p.m. And then they have nighttime, high nighttime cortisol and can’t go to sleep. So that's where the sleep comes in. It's adrenal related usually.
Ben: Okay. Got it.
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Ben: Now, speaking of being cold like one of the things that you talked about in the book is this whole idea of taking your body temperature to figure out whether or not you are hypothyroid. Is there actual research behind that? I mean, well first of all, explain how you were tested, but then I'm also curious like is there anything to that like as has that ever been correlated with thyroid blood levels?
Elle: Okay, well let's just take a second. So why if you go anywhere in the world to a doctor they take your temperature? The reason is because humans have a general thermostat of being about 98.5, 98.6 in the afternoon and there's an average too…
Ben: It’s also ‘cause they like to make you stick your, like to make you stick your tongue out and look silly…
Elle: They’re just trying to antagonize you as well. So yeah, so we're all like 98.6 degrees Fahrenheit usually in the afternoon and then in the morning there's also a range of basal body temperature and anyone can look up Broda Barnes who kind of invented this.
So, here's the thing there's so many, human body temperature I mean, it's an extension of basic body metabolism, right? Heat is a form of energy, every reaction in the body has it so, low T3 now you're cold, now you're freezing, now you're sluggish, now you're producing less hydrochloric acid, now you’re digesting less, now you're absorbing less nutrients, now you're constipated, see the cascade of things that happen? Now your hormones are off, now, you know I've had low testosterone twice even as a woman that's very important too. So I know how that feels. So body temperature is really important. Now, for example, you know people can have the flu and you can have a hundred-and-two-degree fever, but you have the chills. Okay? Now, or you could be waking up in the morning like you're freezing, well how do you know you don't have a fever or not? How do you know you don’t have chills coz you're sick? Well you can go “I don’t feel bad so maybe I don't have a fever.
The only way to test your body’s temperature is to take the temperature. You can feel cold, what’s your temperature? Sometimes you can feel hot but maybe you just spent a day in the sun and your actual body temperature isn't abnormal. Now what we do know, is this, when you take temperatures for like 5 days in a row and you do an average, what we're looking for when you're testing this at home, and I do tell this in my book, is really stability within temperatures versus crazy fluctuations because for females for example, second half of our month after ovulation our body temperature naturally rises and of course you know…Why do people do ovulation predictors with temperatures, I mean these things are all mapped up already, now, correlation with thyroid? Obviously, there are a million things in this world that can lower or increase temperature, but assuming the person is a generally healthy person with no acute crazy infections, and diseases, and they're just having hypothyroidism, one of the ways to either: a.) see if you have adrenal issues or hypothyroidism, and this is to test at home and you can really, like do this with body temperature and go “Okay, I think this is suspect” and then go from there and actually get tests.
The other thing that we use it for is it's imperative when it comes to increasing and getting and reaching your optimal dose. When you start thyroid hormone replacement, you don’t just take your optimal dose, you graduate up to what that is and along the way when you take them, you can kind of decide “Am I closer?” or “Am I too far?” for example, I’ve been Hyperthyroid before. When I was hyperthyroid my basal body temperatures indicated that they were 98.3 in the morning. That's at the top end of that range. That's pretty suspect of hyperthyroidism. The other thing too is in the afternoon I’d be like 99 degrees, so, not to mention my pulse, so there's like a lot of different ways to assess “Am I on too much?” and “Am I on too low?” versus just looking at lab results, because everyone functions at different T3 levels, like my friend Kara functions really well when hers is towards the top of the range. I know someone who functions well when it's just mid-ranged. Everybody's individual, but you can assess labs with symptoms and also tends to get a fuller picture, so that's how temperature is involved and then also just in general, when you're too cold you've got mitochondrial impairment, there's not enough energy being created. When you’re too hot, too much energy being created right? It's a Goldilocks scenario.
Ben: What kind of thermometer do you use? Like, is there a certain thermometer that works best for doing like a…
Ben: Like, you know, you have all your instructions in the book about how to run yourself through the whole-body temperature protocol, but what kind of thermometer do you use?
Elle: I mentioned in the book: “Do not use a digital thermometer.” Patients have found out that those are just unreliable and not as accurate. What, and since we don't have the old school mercury thermometers anymore, there's something very similar called a Geratherm Thermometer, G-E-R-A-T-H-E-R-M, it’s like 3 or 10 bucks anywhere, Amazon or you know, the local Walgreens, and it looks kind of like a Mercury where you have to kind of shake it down and it’s got that ball in the end, and what you really need do is hold it under your tongue for like seven minutes but you know you get more accurate temps this way, and of course, I detailed the protocol in my book. So temperature is really important not only as your increasing your optimal dose but, let’s say you’re on Thyroid Hormone, and you're feeling something's off. Well, you can take a couple weeks of temps and kind of gauge what's up.
Elle: There are people that need a little bit more Thyroid Hormone in the winter and a little bit less in summer and there's lots of nuances, so temps is always a great way to go. Now, there are some nuances to this. There are some things that make temperature really high, there’s adrenal issues and iron issues that can make temps high when it’s not indication of hyperthyroid, and there’s a lot of variables there that I don’t know…
Ben: So it’s basically like, giving you kind of a clue.
Elle: It’s giving a great clue. Not only for thyroid status but adrenal status as well.
Ben: I track my temperature every day. I actually use a ring now, have you tried one of these? The Oura ring?
Elle: No, I haven’t.
Ben: It measures your temperature 24/7. So, I can like wake up in the morning and it’ll be like “Hey, your body temperature peeked” at whatever, like, 4:00 AM last night, and it usually peeks at 2:00 AM, this can be a sign of over-training or under recovery and so, on this day, it’ll set like your recommended number of steps lower or tell you that it needs to be like an easier recovery day. It’s kind of cool cause it’s skin temp, it’s not this Geratherm Thermometer that you’re talking about, but that’s what I use now and it’s really interesting. It’s just like, it’s constantly measuring body temperature and it’s…
Elle: Another thing that’s a great resource is, aside from the thermometer, I’m a huge fan of continuous heart rate monitors, particularly when it comes to thyroid dosing…
Ben: And just like walk around with a strap around your chest all the time?
Elle: No, I just do the wrist one…
Ben: Oh, yeah.
Elle: They have the wrist ones now. Pretty damn accurate and good at this point.
Ben: Yeah, well this ring does that too!
Elle: Oh, nice!
Ben: I’m not trying to turn this into an advertisement for a ring but…
Ben: But it does my heart rate too. But you talk about a whole bunch of other vitals that you track, or that you recommend tracking that go above and beyond just temperature. Like, other things that, whether you’re fixing your thyroid or whether you’re trying to figure out if you have thyroid issues, that you personally recommend tracking. Like, which vitals you track in addition to just temperature.
Elle: Yeah, you know, I wish I actually, and then maybe in the second edition I'll put even more. You know, the book could have been eight-hundred pages because there's so many variables and nuances and tangents to every aspect of everything I say in there, and I would love to have gone into more detail on this. But for example, I track, so pulse, blood pressure and temps, so you’re looking at heart rate…
Ben: Why blood pressure? Does blood pressure respond to thyroid?
Elle: Yes it does. So for example, a lot of people who are misdiagnosed who are treated with uninformed doctors are like on blood pressure medications, statins, antidepressants, by the way, all related to thyroid. Thyroid affects the brain if you think you are having depression or bipolar issues, check your thyroid first before going on a Prozac or something like that because it won't last longer than three months you’re going to be back to the same problem. Same goes with blood pressure and any kind of cholesterol issues. Those are always resolved once your thyroid gets fixed. So this is another problem too, about people going into a doctor right? “So I thought you’re depressed, we’ll put you on an SSRI.” “Oh you've got horrible cholesterol we need to put you on statins right away.” They're not even looking at the thyroid and that is the master gland, it controls everything right? ‘Cause it's controlling our metabolic process, how every organ functions, so of course, you're not going to be processing fat correctly when your body is at 96 degrees, which mine was constantly all day when I was severely hypothyroid. I was freezing all the time.
Elle: You know?
Ben: I’ve definitely run into that.
Elle: And the constipation is horrific. So anyways, let's talk about heart rates and so, for example like, basically, above 60 and below 90, you know, that’s kind of what you’re looking at for people. Everybody's different, athletes are going to have a lower resting heart rate. But, for example, a normal heart rate for an average person might be between 70 and 80 so for example: for me, when I was on too much T3, like I might just be hanging out talking to you right now and my pulse could be like 96. That's insane. That’s…
Ben: How much T3 were you taking? Like what's the actual amount? How is that measured?
Elle: That actually has nothing to do with it. ‘Cause it’s too much for me is what it really was.
Elle: Because there are people that can take 175 micrograms and that would like kill somebody, or you can take 30 and be fine a day, so it just depends you know, on individually.
Elle: But for me at the time, and that's how I noticed. I started to become really warm, you know, I’m just like “I'm too warm” and then I noticed my pulse and I also noticed a level of anxiety because when your pulse goes up, and then the core is on the adrenals right? So, I was kind of like on edge. When your hyperthyroid, not only are there overstimulation symptoms with pulse and things like that, but there are overstimulation symptoms as well like, with feeling aggro or agitated or, do you know what I mean? There's other things that you can tell whether you’re over-stimulated.
So, that's why pulse and heart rate and things like that are normal, and I just feel also it's great to get a good baseline for people of where they’re at before they start, where they're at midway and when they finish. Then you kind of know what's right for you, do you know what I mean? And so, for example, when I lowered my T3 and then my pulse went back down and temps went back down, totally different ballgame. Also, you could be hyperthyroid and feel chilly because you essentially are mimicking a fever into your body. You know what I mean? And then that causes inflammation. So getting back to just anyone out there who’s thinking they're going to take T3 to lose weight. Good luck. You’ll run into problems, you’ll screw yourself up and you can actually get fat. So, it’ll totally backfire!
Ben: But you’ll have something to say on the bodybuilding forums.
Elle: (laughs) Right.
Ben: ‘Cause everybody's gotta pipe in there with their own N equals one story, otherwise you’re just useless on the forums and your little avatar of biceps just is not going to have any credence to it. So, that's the one exception. I'm just saying. You’ve gotta mess round with some form of like self-experimentation if you wanna be taken legit on those bodybuilding forums. Anyways though, we digress. You mentioned…
Elle: Let me just throw one thing out there…
Ben: Oh, go ahead.
Elle: I just want to throw a whole thing out there. So, for example, like a low heart rate, or a low normal, but a raised blood pressure and lower temps? That might be an indication of hypothyroidism, okay? A high heart rate with a raised, you know, blood pressure, maybe an indication of adrenaline production. You know, due to weak in adrenals and low cortisol. So, there's a lot of variables here that can go on with temp, blood pressure and pulse. And so…
Elle: It's just you know, I think important to not monitor and see where you're at and what’s going on and, you know, even for example, like, recently I put my heart rate monitor on my brother who’s got perfect normal thyroid function just to see, like, what his pulse was while we were hanging out together, we’re roughly the same age, and I was like “What’s he got?” You know what I mean?
Elle: And mine was roughly about his. And I'm not saying I’m trying to match his pulse, but I’m saying, you know, with mine higher than his I would feel it and it doesn't feel good either.
Elle: So there’s other somethings involved, you know?
Ben: So what, in terms of thyroid medications and thyroid supplements, let me first ask you this: like, in terms of like over the counter thyroid for people who wants to, let's say, not that there's anybody out there that wants to do this, let’s say somebody want to like, self-test and self-medicate. Where, they're going to go to DirectLabs, they're going to get all the thyroid tests you just talked about and they maybe don't want to go through a doctor but they want to like try one of these, like, over the counter medications. ‘Cause I know like I've talked before, like, about desiccated thyroid, and for example, one company I’ve talked about in the past was Natural Thyroid Solutions where like they have a supplement called Thyro Gold, and I think it's like T1, T2, T3, and T4. It’s like a desiccated thyroid like we just talked about. That’s one example. There’s a whole bunch of others out there but, are there any over the counter natural thyroid supplements that you recommend or that you endorse?
Elle: No and yes. The no answer is: Anything that actually has the thyroid hormones in it, you know, should be natural desiccated thyroid. Just so you know, because we go by grains. But let’s say 60 milligrams of natural desiccated thyroid usually is starting dose for most people, equals 38 micrograms of T4 and 9 micrograms of T3. Now, as I told you earlier, that 38 micrograms of T4 is going to be converted 40 to 50% into T3 throughout the day, and what's not used will get flushed out through reverse T3. So, each pill of desiccated thyroid is standardized to equal these amounts, okay? So, anything that's not that? I wouldn't trust as far as natural thyroid. You know, I don’t know about “Thyroid Gold”, it's not something I hear about often. The major brands are really: Armour, Nature-throid, WP, Acella, and you know, of course there’s countries everybody has a…
Ben: Aren’t those all prescription?
Elle: They are, and you can get them without a prescription.
Ben: Oh, really?
Elle: So, talking about the best over the counter for thyroid?
Couple things. Vitamin D, B12 or Methyl CPG if your homocysteine is high, Selenium in the form of Se-methylselenocysteine, which is supposedly the most absorbable form, and then also, you know, things like coconut oil. People have noticed that taking coconut oil sometimes can stimulate things.
Ben: Really? Why is that?
Elle: People have said that. I'm not so sure exactly the mechanism behind why that is the case.
Ben: But it’s not the fact that it’s just like a copious number of calories that are helping, do you think? Or is there something unique in coconut oil…
Elle: It could be that or it could be the actual saturated fat that people are, you know kind of eating less fat anyway, and they do so little good some healthy fat and then, you know, saturated fat as we know, cholesterol, production of hormones, right? everything is involved with that, so maybe that’s part of it too is that they're getting some good straight fat. Eliminating things like raw cruciferous vegetables. Those have always been a point of contention and argued over but at the end of the day, they say that raw cruciferous vegetables might have an anti-thyroid effect, so you could either cook them or avoid them altogether while you're trying to heal a thyroid issue. I would.
So yes, selenium is really the biggest one. And then also, lifestyle. Again, you can take all of these things but then, are you running 3 miles a day? You know what I mean? Like, how are your adrenals? Are you sleeping? What do you, so, you know what I mean? ‘Cause that all, like we talked about earlier, is really this primal perspective of your body and the signals that are being sent, and you have to make sure, and this goes into the whole people are like: “low carb causes thyroid problems” No, I'm not willing to agree with that and I have a million thoughts on that subject, but one of the reasons is, I think part of the problem with that is when people go low carb and their appetite gets suppressed and then sometimes they just really don’t eat enough calories in general ‘cause their appetite is so suppressed, and that could be the problem. Right? Do you know what I mean?
Elle: Also we don't know if people came to the fore…
Ben: That’s an easy fix. You just smoke weed.
Elle: Just smoke some weed and eat some coconut oil together.
Ben: Right. Exactly.
Elle: Or just do cannabis coconut oil and…
Ben: That’s what your next book should be. “The Coconut Oil Marijuana Diet”
Elle: Oh, alright, listen. I’m a huge fan of THC. Would love to write that book. I don’t like alcohol. (laughs) But yeah, I don’t know if THC can help the thyroid. That might be something to look into, but yeah…
Ben: I don’t know if there’s been any research on that. I would be curious. Like, I’ll usually go to, typically it's CBD that you tend to find more of the therapeutic components in and there's ProjectCBD.org is a website that has just like a ton of research on whether or not CBD is useful for a variety of different medical conditions, but I actually haven’t explored that for a, you know, any link between the endocannabinoid system and thyroid. That’d be interesting.
Elle: I just did a whole interview with Stuart Tomc from CV Sciences on CBD and fat-burning. They're discovering some new elements there and that's recent on our podcast if anyone's interested, but yes, CBD for anti-inflammatory, that could always maybe be an assistant. Most people who are hypothyroid are inflamed in some way.
Elle: And again, this goes back to, so, everything slows down, sluggish, nothing’s being processed, constipation, and so now what do you have? Insulin resistance and type-2 diabetes. So this is just a train of nightmares unless you set.
Ben: Now what about medication, you like, let's say you were going to get prescribed something. You talked about levothyroxine and centroid and getting like just T3 all by itself is perhaps not being the best solution?
Elle: It's not the best first order of solution ever, for anybody. And it should never be considered a first order of business. Now, here's the thing, you go to an endocrinologist, you go to an uninformed doctor, the first thing they’re going to suggest is Synthroid or T4 only or Levothyroxine. Now, let’s just look at this for a second. As I’ve told you our own bodies do not rely on conversion alone. Our bodies actually pump out some T3, okay? So right off the bat, that's just not endocrine mimicry anyway. Can it work for a lot of people? Yes. It often fails a lot of people, and I’m gonna say this: To everyone out there in levothyroxine or T4 only with levothyroxine generic name, Synthroid’s brand name, the doctor in my book said one thing about that. Which is: he will never ever prescribe levothyroxine generically. He only prescribes Synthroid because he has seen that with that particular medication the brand name is far superior. That says a lot. A doctor who’s, the only thing he won't prescribe generic is that. He has seen people's liver results be totally off and screwed up from generic levothyroxine, Thyroid levels all over the place. So if you are on T4 only levothyroxine, it would behoove you to go call and get the brand name right away. I would.
Elle: Based on what the doctor on my book had to say. So, that’s one thing. T4 only is the…
Ben: And that’s the doctor you interviewed at the end of your book?
Elle: Yeah. Dr. Gary Foresman. He’s a primal doctor and also a functional medicine doctor, really highly…
Ben: That’s a really good interview, by the way. I think the book’s worth it just for that interview.
Elle: You know, I totally agree. And I’ve had several podcasts with him. So, anyone, if they just can't tolerate the reading and their brain can't comprehend it, which when you’re hypothyroid happens, just go listen to some of the interviews with Dr. Gary Foresman. But, that's one thing, now here's the other thing. So brief history. Eighteen hundreds genius, English, physician, was like “What’s all these people with goiters on their neck and hypothyroidism?” He extracts sheep thyroid gland, he injects into a human and it works. Thus, comes natural desiccated thyroid, which was the treatment for people up until the 1950s when drug companies could not patent desiccated thyroid.
So, what do they do? They created T4 Synthroid and they touted it as the only one stop only answer. So the propaganda behind that is what has ruined patients for years. So, then people got moved to T4 Synthroid only. Then years would go by. It was not doing well. People still having problems. Doctors were like “What’s happening? We thought this was the only answer.” Turns out there's all these other elements they figured out, right? And then they’re going “Uh Oh” and now really, the move has been back in the past 10 – 15 years to get people really natural desiccated thyroid in my opinion, is the best first choice of business unless there's other things that would dictate otherwise that it is. And it's also the most endocrine mimicry. It's giving you a little direct T3, it's also giving you enough T4 in the ratios that our bodies would normally do it anyway. Pigs are very similar to humans that way, so…
Ben: So is that like Armour Thyroid?
Elle: That's right. That’s Armour Thyroid, that’s Nature-throid, NDT natural desiccated thyroid, it comes in lots of different brand names. Every country has a generic form of it. Thailand has one called thyroid, like it’s very generic, it’s very cheap it's been around for a hundred years.
Elle: That’s really optimal, now, so here are the options. You take T4 only, you can take natural desiccated thyroid, you can take compound T3 T4 combination. That would be because you cannot separate the hormones in natural desiccated thyroid because they kind of come locked in that ratio. But you can, to the microgram, adjust synthetic T4 and T3. So, there are some patients who have compounded T4 T3 to couture to them specifically. And these are people that really either need, are allergic to fillers or have issues with fillers and certain pills like natural desiccated thyroid might have some, or because their doctor really needs to adjust it to the microgrammer too. The only way to do that is through a synthetic T4 T3 compound and scenario or there’s T3 only.
Elle: So there's really four main choices. Now, you can take T4 only Synthroid, add a little T3 to it. You could take NDT add a little T4 in it. And you know, you can make adjustments to all of it but those are the four main categories for treatment.
Ben: And what do you take?
Elle: I just take T3 only. Slight amount.
Ben: Okay. And that's like, you take T3 only. Why? As opposed to desiccated thyroid.
Elle: I did take desiccated thyroid, but then I got the reverse T3 problem. So, then I corrected that and I've been on T3 only for 4 years. I absolutely am going back on NDT. I'm going to attempt that 100%. I would prefer to be an NDT. It's very difficult to manage T3 only and it gets really old after a while, However, it's a lifesaver so not gonna knock it. But the reason I haven't tried to go back on NDT is because I was writing a book and I was like “If it fails me, if that T4 fails to convert, I don't need to become hypothyroid right now.”, while I'm writing a book trying to, you know what I mean? So, that was really my main reason for delaying it. And the other reason was I got a bunch of tests with the doctor on my book and we found some factors that had been screwed up while I had had that last reverse T3 problem. And I needed to get rid of some inflammation and high homocysteine, and was able to do all that, but I wanted to correct all of potential underlying problems, so that when I go back on a T4 T3 combo in the form on natural desiccated thyroid, that I am primed for that to be converted and work properly just as it once did for me.
Elle: And f it doesn’t, I can always go back on T3 only right? That's like the savior. If it doesn’t work, and, I’ll know right away in the first 6 weeks whether this is converting correctly and whatever, and so, but there might be a week or two where I might feel hypo and so I didn't want to really risk that while I was being interviewed and writing a book of course, because you want your mental sharpness there.
Ben: Yeah, sure. Now what if somebody has tried all these things you’re talking about like they’ve quit over-training and they amped up their food intake, and maybe they’ve even started into either a desiccated or a compound, or they’re working with a doctor to get on the correct thyroid, and they're eating their coconut oil and smoking their weed and doing all these things that you talk about.
Ben: What if somebody tries everything and they’re still having issues? Like what are some of the things that could still be causing problems?
Elle: There's a couple things. First of all, high HBA1C. Too many carbs, insulin resistance, you know? Do you really have it?
Ben: So HBA1C being like the three-month snapshot of your blood sugar levels.
Elle: That’s right. You want it to be 5.2 or lower.
Elle: And if it's not, you're looking at having to adjust carbs. Mine was 5.7 which was pretty pre-diabetic. So that had been lingering even though I went paleo primal, I still, for me, didn’t lower the carbs enough to resolve that. So, that was something that…
Ben: Now, a lot of people think that's countering too. Like, you're saying eat fewer carbs to fix your thyroid.
Elle: I’m saying eat fewer carbs to fix the insulin resistance.
Ben: Okay. Got it.
Elle: Right, like I’m saying that’s what happened to me. So, if everything hasn’t worked, right? Well, first of all, medication should work but if everything has not worked, what I said in the book, there’s so many underlying factors. For women, the number one is iron storage which is ferritin. It should be between 50 and 100. If it's not, you’re likely a candidate for iron supplementation. That can scrub a thyroid. You don't have enough iron storage no matter what thyroid hormone you take or no matter what thyroid hormone your thyroid is dispensing naturally, it will not get to go, and, where it needs to go without proper ferritin. So Ferritin, B12, Vitamin D these are all things that are very important in underlying in this process. So, you’ve got to look at those things if nothing's worked. The other thing I say is: Look at the insulin resistance. Because people might be like “Well I’m eating low carb and I'm eating Paleo Primal Paradigm.” but maybe it's not enough to nip that in the bud over there, and that's what happened to me.
So, insulin resistance, another thing would be Candida, Epstein-Barr, now, those are easily resolvable, but they usually take canceling out all sugar switching up probiotics every month and, you know, maybe even dosing yourself with a little oregano oil. Those things can absolutely affect and mimic thyroid symptoms. So can low ferritin. Brain fog, depression, energy and issues with eating. So if you're still having all these issues and you're on thyroid hormone, then likely, you don't have the diet and nutrition dialed up, or you need some gut repair. Most people with hypothyroidism get screwed up guts during the process. And that needs to be corrected. You know? And so there's where the Paleo Primal sort of lifestyle, cleaning it out, comes in, and repairing, you know, but while you heal. It's not to say you'll never be able to enjoy a piece of pizza or, you know, but while you're healing is an anti-inflammatory program and protocol. So there's that. There’s the Candida, Epstein-Barr. I, for example had something called excess fibrinogen. So while I was hypothyroid, apparently my blood got extra sticky and all this extra fiber in there and it's really kind of a stroke/heart attack causer and no amount of diet or exercise can turn that around. But systemic enzyme therapy turned that around for me and…
Ben: Would that be like Wobenzyms and proteolytic enzymes things like that?
Elle: Yes, Systemic Enzymes, like, I took Vitalzym XE, the professional version, and my fibrinogen went down from like 500 down to 300 and so now…
Ben: That stuff can be useful for soreness too.
Elle: Oh, well they give it to all the Olympic athletes in Germany and Japan. I mean, if you look in to systemic enzymes they are very expensive, but I swear by them based on my experience. So I had horribly fibrocystic breasts and terrible PMS, and they’re also used for inflammation, but I noticed that, I didn't take it for this, but I noticed that after a month of taking the systemic enzymes, my breast were like amazing and perfect and no PMS at all. I couldn’t believe it, and I was like “What happened there?” Well, the excess fibrinogen in my body essentially was fibrocystic breast, fibroids, right? fibrin, fibra, right? There we go. So, it's like I needed the brush cleaners of this, clean all of that out. And what fibrocystic breasts are is estrogen dominance that often happens to women, you know, we get estrogen dominance and you get low testosterone issues, and also estrogen dominance. There are some men who go through hypothyroidism, they start getting boobs, and they’re like “What is going on here?”. You definitely don’t want that, and if it happens, call me. (laughs) That went to a new avenue.
But, so there’s all these other factors that can be affecting. There could be food sensitivities. I took a food sensitivity test and chocolate or cocoa was number one severe intolerance and it was the only one I had on the severe intolerance list.
Elle: But I didn’t know that. I never felt the difference between cocoa but when I looked back, as a kid, I hated chocolate. I hated chocolate, I hated hot cocoa. Didn't understand why anyone liked it so that kind of is a tip-off.
Ben: Yeah. You were a weird kid.
Elle: Yeah, then also it's just like, well, you can do as many tests as you want but there might be some element here that can help. For example, I never had a problem with eggs. I don’t have celiac. I'm not even technically dairy or gluten sensitive in terms of what blood tests will tell you, but I am affected by them.
Elle: So you know we have to go by both. You can do some diagnostics. I did an organic acids test and my serotonin was zero. Well, it looked as though the serotonin of a person who’s up all night, stressed out and, you know, and I wasn't, I was sleeping every night great, but I was like alright well this is a problem. I know serotonin. That has to do with weight issues and energy. And so there's all sorts of other things out there that can mimic thyroid issues and that's why you have to take a comprehensive approach, and that's why anyone who just takes a pill from their doctor and goes “Oh, I’ll just take this Synthroid and I’ll be fine.” you're asking for trouble because a.) those things need to convert and get metabolized properly, but then you also have these other factors that can be inhibiting or taking you two steps forward five steps backwards, you know? Low B12, low ferritin. So, I detail all this in my book but, again, those are some other factors that can come up where it’s like “Well I’m still not better. I still can't lose weight” well, it’s like, look at the Candida, look at the HBA1C, maybe go get some more testing like food sensitivity or, for example, I'm not sensitive apparently, on paper, to anything but I did have a genetic test done and someone pointed out that I had a genetic marker that said that I might have an issue processing high-sulfur foods. And then I was like “Oh that’s interesting! I do actually kind of have an issue with broccoli and garlic.” Those are high sulfur and someone said “Well, do you have a problem with eggs?” and I said “No, I’ve been eating eggs all my life it’s fine” then I stopped myself and I thought “You know, now that I think about it, there’s been a few times when I’ve had eggs by themselves, and I just kind of felt gross for hours afterwards.” Not sick, not any major symptoms, just kind of like a “Ugh. I just want this to digest and be over with. Eugh. I feel gross.” and then I thought “Maybe I should try cutting on eggs and seeing how that goes.” I cut out eggs for a few months and then I was like “ Oh. Well let me see what happens.”, reintroduce them? Nightmare. Nightmare.
Elle: Distended stomach like an Ethiopian starving child, bloated gas, horrible. It was almost an instant horrific reaction. I couldn’t even leave the house. Again, nothing else was wrong, it was just “This is awful”, and so sometimes it takes, you know, like, you know a lot of biohacking and experimentation, along with some tests to see what's right for you. You know what I mean? If you’re eating chocolate every day.
Elle: So of course, you’ve gotta look at these things and that’s why I say a functional doctor, or a medicine doctor, or a D.O. or an anti-aging doctor is really what you want because they're going to be looking at all of these things. And so anyway, inflammation is one of those underlying things that sometimes can't totally be dissipated through diet and lifestyle, like my excess fibrinogen, but then you can get tested for it and then use other supplements to, you know, help that out.
Ben: One thing that I thought was really interesting in the book is, you say that you’ve seen situations where people's thyroid issues were totally fixed with chiropractic visits or acupuncture visits.
Ben: What is the mechanism of action that would cause something like that?
Elle: Well, you know, I'm not an acupuncturist but I will say this: When I was severely hypothyroid I developed a fibroid and a polyp in my uterus. Now when I went the acupuncturist, and she was the head of gynecology in Shanghai, and so this is like her specialty and she's really famous in LA. And she said “I can get rid of this fibroid but I'm probably not going to be able to get rid of this polyp, then you’re probably going to have to get it operated on.”, and I was like “Alright, that’s interesting.”. She did get rid of that fibroid, and when I went to the doctor and they took a second ultrasound, they were like “Oh the fibroid is gone”, and I go “Yeah, and so you think acupuncture is a bunch of BS?”. Do you know what I’m saying?
Elle: So I don't know the mechanisms of 3000-year-old medication, I mean, a medical system and herbs and whatnot that can bring things into balance. But at the end of the day that acupuncturist did tell me to take thyroid hormone. So…
Ben: Well, I mean, you have different meridians…
Elle: That’s right.
Ben: And I won't even deny the existence of things like Chakra just ‘cause I've done a ton of Kundalini yoga and have found that it seems to just like, open up different parts of your body and we’ve done previous podcasts on Kundalini and talked about chakras and how that works, but I know when you needle certain points in the body like during acupuncture, you actually can invigorate what they call, like, the Yin or the Yang or they like the energy to specific areas, and so maybe it is, for example, enhancing the energy delivered to something like the thyroid gland area or something along those lines but it was something that…
Elle: Also liver cleansing. Also liver.
Elle: They’re also very about liver and kidneys, and liver and gut health and all that stuff is responsible for, partly involved with conversion. Stagnant liver might also be an issue there too, so there's where acupuncture might help.
Elle: Chiropractic work, sometimes if someone has a pinch or something's off, it can be affecting an area that could affect the throat or the neck or the thyroid that's there. Do you know what I mean? So…
Ben: So if nothing else is working, basically: quit eating chocolate, stop drinking booze, and go get needles stuck in your thyroid gland.
Elle: Go get a bunch of needles, go get a human pin cushion, but yeah. I believe in trying everything, and listen, a lot of people don’t want thyroid hormone replacement. There's nothing wrong with it. I don't want people to be scared of it, but of course if you can get your body to work the way it should work, hey, you know, I'm all for that, I absolutely want to tell everyone how to do that and there is a way to do that.
Elle: Particularly with Hashimoto’s by the way, when teenage kids and people first get diagnosed with Hashimoto's, when you go completely grain-free and adopt a real strict Paleo Primal protocol, you can almost turn that around and not have to go on thyroid medication and keep it at bay.
Elle: That, you can have a lot of success with.
Ben: Yeah. Awesome. Well there is obviously a ton of information in this book, especially ‘cause I'm like a total nerd, like the stuff where you talk about the science of the thyroid gland, I was just drooling over that section and everything from like, lab tests to, like, case studies, to this really interesting interview at the back. We even talked about this Dr. Gary Foresman where you and he basically take a deep-deep-dive into the state of modern medicine and treatments for thyroid, and what works and what doesn't. So, if you are listening in and you suspect you have thyroid issues or someone you know has thyroid issues, or you want to fix your thyroid or you’re a doctor or just want to like, educate yourself on thyroid, I mean, I would say I would love for doctors to read this book as well.
Ben: It's called The Paleo Thyroid Solution. It’s written by Elle Russ, and I’ll put links to some the stuff that Elle and I talked about. If you just go to bengreenfield.com/elle, that's bengreenfieldfitness.com/elle, and there you can get the book, there you can delve into the resources and also, I’ll put a link to Elle’s podcast where she interviews a lot of people about this kind of stuff. So Elle, thank you for coming on the show and for telling everybody why they're so freaking cold every morning.
Elle: (laughs) Thanks so much for having me.
Ben: Feeling fat, foggy, and fatigued I guess I should say. That’s your trademark alliteration, right?
Elle: That’s right. And also on the note of, like you said, even the book, if you look at the Q&A, that's something you could actually bring into a doctor so a doctor can read and hear what another doctor is saying about why they don't know what they're talking about. It’s pretty powerful ‘cause no one’s going to listen to me right? That's why I brought the doctor in on that one. And also, if anyone wants to know about more about me, E-L-L-E-R-U-S-S dot com so.
Ben: Awesome. Cool. I love it. Alright folks, well, until next time I'm Ben Greenfield along with Elle Russ. Signing off from bengreenfieldfitness.com, again, you can access the show notes over at bengreenfieldfitness.com/elle. Thanks for listening in and have a healthy week.
I'll admit it: I have thyroid “issues”.
I've had them ever since I combined extreme ketosis (e.g. 90%+ fat based diet) for a full year, combined with hard and heavy training for Ironman triathlon.
So in light of the fact that I've had to battle rock-bottom “T3” levels over the past several years, hypothyroidism is a topic near and dear to my heart.
And I'm not alone. Over 200 million people worldwide and 20+ million Americans have some form of thyroid disease, but 60% are undiagnosed and unaware of their condition. Undiagnosed or mistreated hypothyroidism can put people at risk for serious conditions, such as: depression, high blood pressure, high cholesterol, type 2 diabetes, insulin resistance, cardiovascular disease, osteoporosis, gynecological issues (infertility/miscarriages/fibroids/PCOS etc.), hormonal imbalances, adrenal fatigue, anemia, and other diseases.
My guest on today's show has written one of the most comprehensive resources I've ever read for deciphering the confusing world of thyroid hormones, and fixing your thyroid for good. Her name is Elle Russ and her book is called “The Paleo Thyroid Solution: Stop Feeling Fat, Foggy, And Fatigued At The Hands Of Uninformed Doctors – Reclaim Your Health!“.
Elle is a writer, health/life coach, and host of the Primal Blueprint Podcast. She is fast becoming a leading voice of thyroid health in the burgeoning Evolutionary Health Movement (also referred to as Paleo, Primal, or Ancestral Health). Elle has a B.A in Philosophy from The University of California at Santa Cruz and is a certified Primal Health Coach. She sits on the advisory board of The Primal Health Coach Program created by Mark Sisson. Originally from downtown Chicago, Elle lives and plays in Malibu, CA.
Elle wrote The Paleo Thyroid Solution after consulting with over two dozen endocrinologists, internal medicine specialists, and general practice MDs…only to find that her thyroid condition was getting worse – and nothing from doctors resembled a solution, or even hope. Exasperated and desperate, Elle took control of her own health and resolved two severe bouts of hypothyroidism on her own – including an acute Reverse T3 problem. Through a devoted paleo/primal lifestyle, intensive personal experimentation, and a radically modified approach to thyroid hormone replacement therapy…Elle fixed her thyroid.
Her new book The Paleo Thyroid Solution dispels outdated, conventional thyroid wisdom still practiced by uninformed doctors, and instead provides the in-depth guidance necessary to solve hypothyroidism, achieve vibrant health, and optimize thyroid fat-burning hormone metabolism. It provides the only lifestyle and weight loss plan specifically targeted for maximizing thyroid hormone metabolism in harmony with paleo/primal/ancestral health principles.
In The Paleo Thyroid Solution, you will learn:
- Primal/paleo protocols for naturally optimizing and even possibly reversing low thyroid function
- How to work with your doctor to get the correct blood tests to diagnose hypothyroidism and accurately interpret results
- How to work with your doctor to optimally treat hypothyroidism with thyroid hormone replacement
- How to find a good doctor or work with your current one to diagnose and treat Reverse T3 issues (including T3-only treatment)
- How to lose the insidious fat and weight gained from hypothyroidism
- An MD’s perspective on why and how some doctors are uninformed and still practicing outdated thyroid protocols (in-depth commentary from integrative physician Dr. Gary E. Foresman, MD)
During my discussion with author Elle Russ, you'll discover:
-Why Elle call T3 the “hormone of life”, and what happened to hers…[10:30 & 13:20]
-How to find a doctor who actually knows the right parts of your thyroid to test…[19:00]
-Why most thyroid supplements don't actually contain thyroid glandular or thyroid hormones…[23:53]
-The confusing hormone “reverse T3” and the ancestral reflex that causes your body to make it…[25:30]
-Whether body temperature tests really work, and if there any science to back them up…[38:10]
-What vitals you should track, such as heart rate and blood pressure, and the best way to do it…[44:20]
-What Elle thinks is the best natural over-the-counter (OTC) thyroid for people who want to “self test” and “self medicate”…[50:30]
-Why coconut oil can help to heal thyroid issues (and whether or not marijuana or CBD should be used)…[51:50]
-The best prescription form of thyroid hormone to use and what Elle personally takes…[54:55]
-The shocking link between chiropractors, acupuncturists and thyroid hormone…[68:27]
-What to do if you have tried everything and you're still having issues…[70:27]
-And much more!
Resources from this episode:
-Book: The Paleo Thyroid Solution
–The Oura ring for tracking body temperature (use coupon code “ben” and you’ll get 5% off your purchase and free shipping within the USA)