A Personalized Thyroid Support Protocol - Dr. Michael Ruscio, DC

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A Personalized Thyroid Support Protocol

Discover the diet and supplements that work best to improve your thyroid health

Should you follow the Autoimmune-Paleo, Paleo, or low FODMAP diet to optimize your thyroid health? Are iron and HCL supplements needed to improve your thyroid symptoms? In my new thyroid course, I’ll be providing answers to these questions based on your labs, symptoms, health history, and previous response to treatment. 

In this episode, I outline how the modules in my thyroid course will help you avoid over-supplementation, broaden your diet, and ultimately find the treatment that works best for you.

In This Episode

What’s Covered in Module 8…03:54
What’s Covered in Module 9…09:36
What’s Covered in Module 10…11:53
What’s Covered in Module 11…16:24
What’s Covered in Module 12…20:09
In Close…23:00

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Welcome to Dr. Ruscio, DC radio, providing practical and science-based solutions to feeling your best. To stay up to date on the latest topics, as well as all of our prior episodes, make sure to subscribe in your podcast player. For weekly updates, visit DrRuscio.com. That’s DRRUSCIO.com. The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor. Now let’s head to the show.

Dr Ruscio, DC:

Hey, everyone. In today’s podcast, I’m extremely excited to announce that we are launching a thyroid self-help course. We’ll go into some detail in the body of the podcast regarding what you will learn, but if you sign up early beforehand, you can get 20% off. This discount is only running up until September 8th. If you head to DrRuscio.com/thyroid-course, you can get that early bird discount. And I cannot wait for you to go through the materials. We’ve talked about many of these concepts on the podcast before, but this course will put them all together with additional details that sometimes are beyond the context or practicality of a podcast, because some of the nuances of care are really personalized to the individual (their symptoms and their labs), which this course does exactly.

Dr Ruscio, DC:

That pre-registration or early bird is up until September 8th, and then the course officially opens on September 9th. So if you want to get the 20% off, go over to DrRuscio.com/thyroid-course and sign up. And I am so, so excited to be releasing this. As you know, a thorn in my side is the way many thyroid patients are treated, not with mal intent, but because there is such a better way. And now there is a way for you to access that and go through it at your own pace. So very excited about that and more to follow here during the body of the show. Okay. Thanks.

Dr Ruscio, DC:

Hey everyone. Welcome back to Dr. Ruscio, DC Radio. This is Dr. Michael Ruscio, DC. And today let’s talk more about the thyroid course, the offering that I am incredibly excited to finally be bringing to you. It’s a one-stop-shop for what do you do about your thyroid, including how do you take the academic information, the theory, the mechanism, the observation, the cool charts and the graphs, the lab values, and synthesize that into an action plan. This is the thing I think, above everything else that I and we do best at the clinic. And it’s also the most important because it’s really how we translate science into action. That is the responsibility of a clinician. And this is also why I’m so thankful that I am still in a clinical setting and seeing patients on a weekly basis. Not only that, we now thankfully have a team of doctors who are sharing in the clinical work as part of the same clinical model. And it’s really accelerating our learning because the more patients we see, the faster we can learn.

Dr Ruscio, DC:

And so, as I’ve mentioned before, this course is a 12 module series. And when we get to module eight, the modules 8–12 are all about putting the information into action. This is akin to what I did in “Healthy Gut, Healthy You”.

What’s Covered in Module 8

Dr Ruscio, DC:

And so the first part of the modules, module eight, is the personalized action plan, which are the foundational aspects along with the aspects that support the gut-thyroid connection. So we outline where [to] start with diet. And this is one where you would be surprised. A number of people will be on the autoimmune paleo diet (AIP) who don’t need to be. And by making a pivot to an easier diet, a perhaps relaxed paleo template, or even a low FODMAP diet, will notice they are on an easier diet, they’re eating more foods, and they feel better. So making sure that we don’t make ironically the reductionistic mistake of making all of your thyroid care decisions through the prism of thyroid, but rather that we broaden this out and we look to a number of facets that we want to optimize for that impact thyroid.

Dr Ruscio, DC:

So as we’re helping to personalize and determine what diet is best for you, we are going to make sure to take into account your symptoms and your presentation to steer us to the diet that’s going to be the best for you. So one of the aspects of this module is if you’re someone who’s experiencing X, Y, and Z, then this diet is likely best for you. However, if you’re experiencing more, so A, B and C, then this diet is best for you.

Dr Ruscio, DC:

Now that may sound easy, but this is something that has taken nearly 10 years of clinical refinement to determine. And again, I want to keep underscoring that these are derivatives of actually seeing patients. And I don’t mean to twist this knife too much, but this does matter, right? This matters that I’m having a chance to see how what is published in journals translates in the clinical practice, or maybe in some cases doesn’t well translate and might have, let’s say, applicability if you’re in a hospital setting, but doesn’t really have much applicability if you’re someone who, I’m assuming like many listening to this are, are fairly well educated, fairly healthy. [T]he optimum intervention is going to shift a little bit.

Dr Ruscio, DC:

So we go into the personalization of the diet, making it quite simple, to know what diet you go on. And along with that, we tie in a few simple things you can do to improve your gut health. Now, again, remember that the reason why gut health is weighted is because improving gut health can reduce thyroid autoimmunity, improve thyroid hormone medication absorption, reduce the dose required of that thyroid hormone, and reduce symptoms of either poor thyroid hormone metabolism or conversion. Or symptoms that were not from the thyroid at all, and were actually coming from the gut. And in some cases, this is things like dry skin, fatigue, and depression. So we give you the on ramp for simple protocols to improve your gut health.

Dr Ruscio, DC:

Now at the end of the first module, and after you have gone through the protocol, there’s a time point check-in. Okay. After X many weeks, we are going to reassess. And there’s a very important bifurcation point. You’re either happy with how you’re feeling, or you are still experiencing an appreciable number of symptoms. This is a key bifurcation because if you’re happy with how you’re feeling—and we give some specific guidelines—happy with how you’re feeling doesn’t necessarily mean you are at 100% resolution, but are we taking notable steps forward? Is the plan working? Therefore, are you happy with how you’re feeling? That’s one path at the fork in the road.

Dr Ruscio, DC:

If you’re not happy with the path you go down a different fork. This is what clinical medicine and personalized care is. It’s not treating lab values. Again, lab values do have a time and a place, but this is really where the magic is. If there was a magic bullet, this would be the magic bullet.

Sponsored Resources

Hey, everyone. Just a quick reminder that if you have or suspect you have a thyroid problem, I have now released a full thyroid course that will take you A to Z in terms of what lab testing should you do, how do you interpret the lab testing; we even have a calculator to make it foolproof. And based upon your symptoms and your labs, what do you do from the perspective of diet, lifestyle, and supplementation. And as you know, a lot here, in my opinion, and there’s a growing body of evidence to back this up is done incorrectly.

Yes, in conventional medicine, but also equally, if not more so in alternative and functional healthcare. And for many years in the clinic, myself and our clinical team are fixing these problems and I’ve wanted to have something that was a broader offering that you can do it yourself right at home. Finally, that is here.

Go over to drruscio.com/thyroid-course and you can learn more and get the help that you need so that you can feel better and not succumb to all of the rigmarole and ridiculousness that often times permeates thyroid care. So check it out, very excited about this and happy to be offering this resource to help you on your road.

What’s Covered in Module 9

Dr Ruscio, DC:

So after this first interventional step, we give your body some time. And then there’s this fork, depending on how you are doing you either go left or right. And that takes you to the next module, which is personalized based upon what path you choose left. Or right now in module nine, we go into the natural thyroid supports. This is where we use things based upon the lab panel that we had done early on, and the interpretation, correctly, of those labs to let you know [if] you have to worry about Hashimoto’s, subclinical hypothyroid, hypothyroid. Or [do you have a] normal thyroid?

Dr Ruscio, DC:

And depending on what combination of these you present with, there is a different supplement plan that helps with symptoms with autoimmunity and with thyroid hormone metabolism and with optimizing naturally TSH levels and T4 output. So this is laid out. And again, the crucial thing here is just knowing what path you should be on and what situation you are in based upon correctly interpreting your lab work.

Dr Ruscio, DC:

So we give this next step a few weeks, and then we reassess again, we come to another fork in the road. Are you happy with how you’re feeling or are you still experiencing an appreciable number of symptoms and not much is changing? Another key point. If you’ve heard me discuss on the podcast in the past, how for patients, we make these series of decision trees. This is what those decision trees look like. All right, we don’t just treat the labs vacuously. We use the labs to inform our approach, and then we listen to how your body responds. And that tells us, are we on the right track? Or are we not? Because again, the labs give us some information, but it’s incomplete if it’s divorced from listening to the patient. So depending on how you’re feeling, we go left or right again.

What’s Covered in Module 10

Dr Ruscio, DC:

And then this takes us to module 10, the third part of the personalized action plan. This is where things like hydrochloric acid or HCl comes in. And we give you some guidelines to help you determine [if you] would likely benefit from HCL or is this one supplement of many I don’t need to use? And this is fairly important in a thyroid cohort. We also give you the right dosing protocol for hydrochloric acid. If I had a nickel for every time someone went on a ridiculously high dose and misused HCl, I’d be a rich man. Yet again, there’s like a handful of these scenarios.

Dr Ruscio, DC:

The other aspect here is adrenal support. Adrenal support does have a time and a place, not necessarily because of adrenal fatigue or cortisol output aberrancies, but because some people will benefit from both the hormone HPA and immuno adaptogenic impact that adrenal supplements produce. The reason why we don’t start out with these is because many of the symptoms that may be attributed to immune dysfunction, HPA access dysfunction, improper cortisol output—although, I don’t agree with that conceptually—a lot of those symptoms may clear once we’ve gone through the first two interventional steps. Things like insomnia, fatigue, brain fog, exercise intolerance. So in attempts to make sure that you’re not over supplementing, we position this at the right time in the sequence. And we give you a specific product to use for a specific duration with a specific dosing protocol.

Dr Ruscio, DC:

This is also where an examination of iron comes in. Now, iron, as we’ve discussed, has two general camps of thought in terms of how we interpret the blood panel from earlier. And we give you our recommendations. We combine that with (surprise, surprise) how you are feeling to help refine and enhance the accuracy of the recommendation to either use or not use iron, along with a product that tends to be the best absorbed and minimally likely to cause constipation, which some iron can. And again, along with the dosing protocol is the duration and a retesting interval for ferritin. Also, we provide dietary sources of iron to make sure that you’re not eating your way into an iron insufficiency.

Dr Ruscio, DC:

We also provide a reassessment fork at the end of this step, along with some additional resources, if one is not feeling well. And also this is the time and the place to consider some nuance adjustments to thyroid hormone medication. And we provide some insights and resources for the specifics of thyroid hormone medication personalization at this point in time.

Dr Ruscio, DC:

Again, the reason why we want to wait until now, this is something that we’ve in a journal article that we wrote wherein it can be very difficult to determine what is the ideal medication for a patient until we’ve laid this groundwork. Now, once we’ve laid this groundwork, that the course will have taken you through up until this point, most people will not need a more expensive or a different, highly personalized form of thyroid hormone. Their levels will be normal, their symptoms will be gone, and oftentimes they may actually need less thyroid hormone. However, a small subset may do better on in combination or desiccated thyroid hormone. And this is when that makes sense to consider.

What’s Covered in Module 11

Dr Ruscio, DC:

And then this takes us to the final step in the intervention or personalized action plan. And this is how do we pivot to maintenance? Let’s make sure to broaden our diet and (yay) celebrate the improved food tolerance that you will almost for certain have obtained because we’ve made sure to improve your gut health and therefore allow you to expand your diet. And we give you some confines and some guideposts to help you with reintroduction, because if we make the reintroduction too meticulous, people start thinking they have food intolerances that they don’t. This is if we get way too micro with our examination, as I was guilty of at one point in my life. So I’m with you there. We can start seeing correlations that are not there.

Dr Ruscio, DC:

And in addition to that, we help with, well, how do we go from the supplement protocol to help me feel better to a minimal protocol? How do I know if I need something or if I don’t need something? For how long do I need some of these things? What items do I come off? What items are best to maybe stay on at a low dose? And we go through all of those recommendations along with revisitation of medication, because hurray, hurray, hurray, there are some people who will not need medication. This is the best time to go through that withdrawal.

Dr Ruscio, DC:

Now, to be careful, you want to do this with your local doctor, right? You want to have someone overseeing you. But we give you the three different options for weaning off thyroid hormone that have been published and that you can discuss with your doctor.

Dr Ruscio, DC:

Now, the reason why we wait to do this until this time point is because we want to have gotten out of the way anything that can deter this or make you doubt this experiment. If your gut’s not healthy, if you’re not consistently able to have no symptoms and feel well, if there’s all this up and down, then if you decided to wean off and you also went into a few day period where you were feeling poorly just because of the baseline up and down, then it can be hard to know. [It can feel like] “well, I was feeling okay, and now I’m feeling worse and I’m three days into my ween. Maybe I did need that medication.” So if we can get you to a point where you’re feeling great and you’ve been consistently doing so for a number of weeks, now we have a new baseline from which it makes sense to go through the thyroid hormone withdrawal under the supervision of whoever’s prescribing.

Dr Ruscio, DC:

And remember there’s a roughly 37–61% chance that you will be able to come off of thyroid hormone medication and put the thinking that you have hypothyroidism behind you in the rear view mirror. And in addition with that, if you do have Hashimoto’s understand that the risk was minimal, and you’ve also done everything you can to manage and dampen any potential problem that may pose in the future. So a huge amount of empowerment. There will be some, of course, who need to be on hormone. But again, you should be devoid of symptoms and somewhat likely on a lower dose than when you started the course. So we give you the specifics there of weaning off.

What’s Covered in Module 12

Dr Ruscio, DC:

There’s also a few notes regarding medication and the final module is some closing thoughts. How do we move forward? And I think this is where it’s important to dot these Is cross these Ts and put a period. Because if we don’t, people can drift back into the thinking that, well, maybe my thyroid now is a problem, or maybe there’s something else that I have to do, or maybe I need to go back on this restrictive diet. So we want to help give you the paradigm going forward. Some closing thoughts, some outlooks, some prognostic indicators, some of what we see in the clinic. So as to give you hope, because again, depending on who you read and what you’ve listened to, you could have a very fear based and pessimistic outlook on your health. And so we’ll really provide hopefully a nice overview of the road ahead and encourage you to look forward, put ill health behind you.

Dr Ruscio, DC:

And we also give you a few resources to plug into the clinic. If you ever wanted to have somewhere where you can pop in yearly, just to have someone review your blood work and check in on you. Of course there is zero requirement to do that, but it’s just one more resource in case you wanted to have a sounding board for how you’re feeling, what you’re doing, checking in and having someone that you truly can vent to and bounce things off of, if you need that.

In Close

Dr Ruscio, DC:

So that takes us through the thyroid course. I want to again, say how excited I am about this, because I really do mean it. When I say that at least once per week, there is someone who’s been misdiagnosed or incorrectly handled, and it’s really twofold. You know, I think some of this comes from a good place trying to get more people on hormone because it might help them. Okay, I get that, but like we’ve discussed 30–60% of people actually don’t need the hormone. And then also a frustration that conventional medicine is just not really built for dietary and lifestyle-based interventions. So the thyroid patients have not a lot of options. They go to conventional medicine and conventional medicine does some things very well, but certainly when it comes to chronic issues that are dietary and lifestyle-based, the offering there is a little bit flat.

Dr Ruscio, DC:

And like we’ve talked about in natural and functional healthcare. This field I think is more so in its infancy. And there is some bugs in the system that still have not been worked out. And what we’re trying to do at the clinic and with the research that we’re publishing is bring more to the forefront, the things that are right, and the things that we should carry forward, right? The dietary and lifestyle changes, the nutritional supplementation, the herbal supports. Yes, yes, yes. However, the incorrect interpretation of the lab is making people think that they have hypothyroid who don’t? Not that. The way overzealousness with which antibodies are interpreted? Definitely not that. And this matters, right? Because if you’re someone who’s been given incorrect advice, it’s not going to help you.

Dr Ruscio, DC:

So the whole aim of this is to get you healthy and healthy in multiple domains, psychologically healthy. So you don’t have a diagnosis or think you have a diagnosis that you actually don’t financially healthy. You’re not spending money on lab work and supplements that you don’t need. And also from a time perspective and an opportunity cost perspective, getting well as soon as possible and all this should lead to you feeling well and also feeling empowered.

Dr Ruscio, DC:

So that is the thyroid course. I am very confident about this again, because this is simply what we’ve been doing in the clinic. So you are not a guinea pig. And maybe I should say that just to make sure this stuff is incredibly vetted, tried and true. And it’s what myself and our awesome team of doctors at the clinic have been working on day over day, week over week, year over year. I finally just got around to putting this together for our audience so that there was another resource, and probably should have done this sooner. But as you can imagine, there’s only so many things I can do at one time.

Dr Ruscio, DC:

But all that being said, excited to offer this, please plug in and purchase a ticket for the course. Like I’ve said before, I stand behind this with a 100% money-back guarantee if it’s not helpful, if it’s not insightful. And again, hope you’ll join up with us in this new paradigm for thyroid care that puts you first and exises out of the model anything that is antithetical to you feeling well as quickly as possible. All right, guys. Well, I hope this helps. I’m excited to offer this and I hope you’ll join up. Okay. I’ll talk to you soon. Thanks guys. Bye-bye.


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➕ Dr. Ruscio’s, DC Notes

How a Personalized Thyroid Support Protocol is Designed

Understand the Baseline

  • Thyroid lab test results
  • Symptoms list
  • Medical history
  • Response to previous treatments


Start with Diet 

  • Find the diet least-restrictive diet that works best for the patient and their symptoms. 
  • Focus on first improving gut health to reduce autoimmunity and inflammation and to improve digestive issues and nutrient absorption.


The Role of Supplements

  • After laying the groundwork first, see if HCL, adaptogenic herbs, or iron is needed. 
  • Find the minimum effective dose to get symptom relief and avoid over-supplementation.
  • Discover how long supplements are needed and when to wean off.


Recognizing Protocol Success

The protocol is working if the patient experiences:

  • Improve food tolerance.
  • Less or no thyroid medication is needed for symptom relief. 
  • An improvement in overall thyroid and gut symptoms.

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