Graves’ Disease – Episode 11

In this episode of Dr. Ruscio Radio, the doc brings us information on hyperthyroidism and Graves’ Disease. We tend to focus on the hypothyroid conditions by hyperthyroidism can be deadly. He discusses symptoms of hyperthyroidism and Graves’ Disease, medications and supplementation to manage the symptoms and treating the underlying causes of Graves’ Disease and hyperthyroidism.

In This Episode

Intro … 00:01:31
Symptoms of Graves’ Disease … 00:02:02
Medications for managing hyperthyroid symptoms … 00:05:16
Supplements for managing hyperthyroid symptoms … 00:11:13
Treating the underlying cause of Graves’ Disease … 00:19:49
Episode wrap-up … 00:31:30

Graves' Disease - Episode 11 - RuscioRadio FMF

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Welcome to Dr. Ruscio Radio, discussing the cutting edge of health, nutrition, and functional medicine. To make sure you’re up to date on this and other important topics, visit and sign up to receive weekly updates. That’s

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 to your doctor.

Now, let’s head to the show!

Dr. Michael Ruscio: Hey everyone, welcome to Dr. Ruscio Radio. This is Dr. Ruscio. I am here with the lovely Susan McCauley. Hey, Susan. What’s going on?

Susan McCauley: Graves’ Disease – Episode 11 Not much. Just recording podcasts today; this is my second. I was a guest on Simply Human Radio earlier today.

DR: Nice, nice.

SM: Yeah. So, I’ve been in my podcast room. The room under the stairs is my podcasting room.


DR: Little dungeon/podcast room, nice.


SM: Yeah, so I’m pretty excited about this topic today because I think that my grandmother had this, because she had her thyroid irradiated. But nobody really knows because people don’t talk about illnesses in our family. So, I’m curious to hear everything you have this hot topic.

DR: So, today we’re discussing Graves’ disease. For those of you who aren’t familiar with Graves’ disease, essentially, Graves’ disease is kind of the opposite half of Hashimoto’s hypothyroid – it’s an autoimmune thyroid condition, but this one causes hyperthyroidism instead of hypothyroidism. So, it speeds you up, so speak.

SM: But not in a good way.

DR: Yeah, yeah. I was just going to say that some people may be saying ‘Oh, that sounds pretty good.”

SM: I know. I got excited, but… no.

DR: Right, yeah. It’s really not good because some of the symptoms are anxiety, irritability, feeling hot, racing heart rate, tremors, insomnia – So, you really get sped up. When these people come in on physical examination, for example, when we take their pulse, their heart is just like boom, boom, boom, boom, boom, boom, boom, boom, boom, boom, and they are just sitting in there in a chair.

SM: Wow.

DR: Their heart is going like they are running a marathon or something; they are just sitting there.

SM: That seems like it would be very hard on your heart…

DR: It is.

SM: …because I think you only have a certain number of beats in a lifetime, right?

DR: Yeah, but there’s an app where you can increase your lifetime beats, so, I’m going to buy that as soon as they make it available.

SM: Oh, awesome.


DR: Totally kidding in case people didn’t catch that.

SM: There’s always an app for that, right?

Symptoms of Graves’ Disease

DR: Right, yeah. So yes, one of the main concerns with Graves’ disease, or hyperthyroidism, is damage to the heart. But I want to make a quick interjection here before I forget to mention this for people who are listening, deciding whether to stay on board or tune out: If you have hypothyroid or you’re concerned about your thyroid health, in general, many of the therapies and tests – much of the stuff we do for Graves’ disease –  also applies to Hashimoto’s. So, if you have Hashimoto’s or hypothyroid, stick around because a lot of this discussion is very relevant to both hypo and hyperthyroidism.

So, hyperthyroidism or Graves’ disease I really think is a population of thyroid disease that’s really under-served. It’s kind of like Hashimoto’s is the cool kid and Graves’ disease is the nerdy cop that no one likes nor talks to, right?


And to some extent, rightfully so – Hashimoto’s or hypothyroidism is much more common than Graves’ or hyperthyroidism is, but these people, to some extent, are playing a more high-stakes game – because, if the initial therapies don’t work, the second-line therapy for Graves’ disease is either essentially destroying your thyroid gland with what is known as radioactive ablation therapy, where they essentially just microwave your thyroid to death, or they surgically remove your thyroid gland.

SM: Uhh…

DR: And, a lot of these patients will then become hypothyroid, because they’ve either damaged, destroyed, or removed the gland, and then need thyroid hormone replacement for the rest of lives. So, certainly it is something we want to try to prevent. So…

SM: You always need organs. Like, Dr. Sal, you don’t need that organ, or you can live without that. It’s nice to have all your organs.


DR: It is. I’d prefer to keep mine if I could. This is a is a big deal for people, because, potentially, they are going to be confronted with this decision, where the endocrinologist is saying, “OK, we need to either remove or irradiate your thyroid. Oftentimes, it’s a high-pressure situation, also, where people are really kind of pushed to make a decision quickly. Here’s how I approach this, and I think this is a very pragmatic, logical way of looking at it. The first thing we do is to try to manage the symptoms or manage the hyperthyroidism, right? So, this doesn’t necessarily treat the cause, but it gets you to a point where you’re not having symptoms and you have a little time to breathe or some time to think, right? So, let’s hear some it’s having all these symptoms – like your heart is racing all day and you can’t sleep at night. We treat the symptoms for a little naturally, and that calms things down, give you some time to think, do some research; and, what I also recommend is treat the underlying cause of the hyperthyroidism. So, part one/step one/phase one, however you want to term it, get the symptoms under control. Then, along with that, we want to investigate and treat the underlying cause of the Graves’ disease.

Step one, them: What can we do to dampen the symptoms in the short term, so that you feel better and also buy yourself some time to figure your next step?  I want to mention also that I wrote article about this in. So, when this podcast and podcast transcript post, there will also be a separate post for the article. I will put a link to the article in the transcript along the podcast page. So, if people are listening to this, of course listen away. But, if you’re someone who prefers to read, instead of reading the transcript, you may want to read the article, because the article will probably be little more nicely laid out, easier to follow.


Medications for managing hyperthyroid symptoms

DR: There are about 48 medical references. It’s a very easy-to-read article, but I gave you all the science so that people…you know, I just like to not just make stuff up and say, “Hey, do this.” So, there are about 48 medical references substantiating what I am advocating. And so, to the first point: What can you do to quell the symptoms? There are conventional medical therapies that are recommended. These are usually anti-thyroid drugs, and usually the most-popular anti-thyroid drug is methimazole, which is just, essentially, (an) anti-iodine or iodine-blocking medication that slows down your thyroid. And so, if you’re hyperthyroid – you’re too high – this medication slows things down and gets you back to normal. There’s also some evidence that these medications may help with autoimmunity. The mechanism may be the iodine blocking, because remember in the two-part podcast series on thyroid and iodine, we discussed how iodine is a very, very well-established provoker or causative factor in thyroid autoimmunity. And there is also some evidence showing that low iodine diets can help with thyroid autoimmunity.

SM: We will put links to those two podcast in the show notes as well so people can go back and listen to those.

DR: Right, yes please, let’s definitely do that. So that may be how these medications – like the methimazole – are working. Now, there are some side effects to these – black stools, chest pains…

SM: Uhhh

DR: …cough, fever, sore throats, shorts of breath. To be honest, I haven’t noticed that people have these symptoms a lot.


DR: So, at least from the patients I’ve seen on these medications, I see these as somewhat of a well-tolerated drug. I’ve had patients come in and say, ‘What should I do? My doctor has already got me on methimazole. And, I want to come see you to investigate the underlying cause. Should I come off the methimazole and use your natural version of it?’

I just say to them, ‘Well, it’s really up to you. If you are on it and you’re not having any reactions, you can stay on it for another few months while we investigate the cause or go on the natural version. I don’t think it makes a huge difference one way or the other. It’s just a decision that the patient makes depending on what they are most comfortable with.

SM: OK. So it seems like it’s one of those drugs that there are possible side effects, they’re just not as common.

DR: Exactly. Sorry, I’m going to lower my shades here because the sun is in my eyes. Hopefully that’s not too loud on the microphone. OK, what did you say? I think I caught the brunt of it but I was…

SM: I said, it seems like there are side effects but they’re just not as common.

DR: Yes, yes.

SM: You know how you read the back of… or see the commercials and it goes on for five minutes about how many side effects there are. But some are more common than others, so it seems like you said a pretty well tolerated drug.

DR: Exactly. And we don’t want to be anti-medicine just for the sake of being anti-medicine.

SM: No.

DR: If a medicine has good plausibility to it and good tolerability, then I am all for it, as long as it doesn’t cause any nasty other side effects or other problems.

SM: Right.

DR: That seems to be the case with the anti-thyroid medication like methimazole. Beta-blockers can also be used. Essentially, beta-blockers block the effect of adrenaline on the heart.

SM: Uh-huh.

DR: Those seem to be a little less will-tolerated…

SM: Right. There are a lot of side effects.

DR: …because they can really slow you down, right? Maybe in the short term to protect your hear… OK. But, there are definitely some side effects. If someone was looking at a beta blocker compared to the natural version that I will recommend in a moment, I would say the natural version in this case may be a little bit better.


Supplements for managing hyperthyroid symptoms

DR: So, what about the natural version of these? Well, there are a few options:  l-carnitine, selenium – in either Bugleweed and/or lemon balm. My favorite of these is l-carnitine. L-carnitine has been use the double blind, placebo-controlled trial looking at 50 women. These researchers were trying to substantiate how well l-carnitine worked in treating hyperthyroidism. And l-carnitine was shown to significantly improve weakness and fatigue, shortness of breath, palpitations, nervousness, insomnia, tremors, heart rate, and even bone-mineral density. So, had a lot of good effects. The authors concluded, and I will quote them: “l-carnitine is effective in both reversing and preventing symptoms of hyperthyroidism.”

SM: That’s so funny because I’ve always… in nutrition school, we were always taught that be careful with l-carnitine because it can slow the thyroid down, and so you want to be careful at hypothyroid. But like you said, it’s that hyperthyroid or Graves’ disease is like the cousin we never talk about. They never said if you have a client with Graves’ disease, maybe l-carnitine might be a good idea.

DR: Yes, exactly. And I think we’ve got some pretty darn good data – the study being the data – that this works pretty well. So, l-carnitine is usually my front line therapy. Oftentimes, I will combine selenium along with this. Now, selenium is noteworthy because selenium very good – or I shouldn’t say very good. Selenium is good at helping to dampen thyroid autoimmunity. I’m sure most people who have looked into treatments for Hashimoto’s thyroid autoimmunity have heard about selenium. And there’s a good body of data suggesting that selenium works very well. There’s also some data showing the same thing with Graves’ disease. Now, of course, that makes some sense – if the underlying mechanism for both of these autoimmune – it would  makes sense that selenium would work for both because it works on autoimmunity. Now, people may be a little bit tenuous as I was initially about using selenium because selenium actually helps increase T-3 levels.

SM: It’s a co-factor, correct?

DR: Yes, it helps with the conversion of T-4, T-3. So, that may be something that… my initial thought process on this was, ‘Ughh, I don’t know how I feel about using selenium because of that.’ But, I looked into some of the literature. This has been safely used in human studies for Graves’. It’s been shown to lower the antibodies. And, the other thing I think is really noteworthy about selenium is that it’s been shown to protect against what’s called Graves’ ophthalmopathy or the damage that can occur to the eyes Graves’ disease. In case people aren’t aware of this, one of the things can happen in some, not all, but some with Graves’ disease is you can have a bulging of the eyes, and you can have damage to your ocular tissue. It can be somewhat irreversible. Now, selenium has been shown to help prevent that, so it’s another really nice kind of side benefit, I guess, of using selenium.

SM: OK, so what is the mechanism of the eyes – do you know? Because I had a friend in high school that had Graves’ disease and then his eyes were kind of bulging like that. Unfortunately, people made fun of him. How does that happen?

DR: Gosh, you know, this study I picked through – the particular study that really detailed this… I mean, there’s been a few but, there is a proposed mechanism. And I can visualize the diagram in my head, but I I can’t from memory pick out all the details from about a year ago. If people look out the references, they will be able to pull up… there are three references that I cite in the article version for the Graves’ ophthalmopathy. If you go to those references, click on them – click on the link – you’ll go to PubMed, and I believe there is a free article, and I believe you can even just click on the image that shows a proposed mechanism for how it protects the eyes.

SM: OK, cool.

DR: This is when I wish I had a photographic memory because that would be nice. Damn. So, those are usually my first one-and-two go-tos, and I typically use those together. Now, there is a third – a third and fourth, I should say. But, I usually will use those in combination, which is Bugleweed and lemon balm. They are not as well studied, but they do seem to help with symptoms and some of the other hyperthyroid-related complaints and have a very low incidence of side effects. So, I usually start people off with carnitine and selenium. I give that a week or so, reevaluate if things are really moving in the right direction or much better, than I’ll potentially add in Bugleweed and Lemon balm.

SM: And then, at the same time, are you doing dietary interventions as well?

DR: Yes, of course. Everyone is going to be on the autoimmune paleo diet, and we are going to want to be tending to the other lifestyle factors like stress, sleep, and exercise, definitely. The other thing that is a noteworthy mention, although I would not recommend this: High-dose iodine. We talked about how high-dose iodine can actually do the same thing is being iodine deficient..

SM: Right.

DR: …in the podcast series. High-dose iodine has been shown to help treat hyperthyroidism, but the affect only seems to last for a number of weeks, and the dose is very, very high. In fact, I looked for some kind of iodine formulation that would allow me to get to the dose used in the studies, and there is no way to get there without having people take like 20 pills of iodine a day.

SM: Oh wow, that’s a lot.

DR: With these other more well studied therapies available, I didn’t really think iodine was worth it. But, I included in the article because there has been some studies done showing it can be helpful

SM: OK, cool.

DR: So, that’s kind of the one can do initially to help with the symptoms of hyperthyroidism. You have some medications can be somewhat wrote well-tolerated. You have some natural agents that seem to work really well also. The one thing I should mention –  I forgot to mention – about carnitine: There is one potential side effect of carnitine which is, if you take too much, it can cause loose stools or diarrhea. It’s not that carnitine is causing damage to your intestines or irritation or something like that, but carnitine can act as a laxative if the dose is too high. If that’s the case, if someone can’t tolerate carnitine, we may break of their dose to first thing in the morning and then maybe in late afternoon. Or, if they still can’t tolerate it, then we may just use half of the normal dose that we use of carnitine and then relay more heavily on the lemon balm and Bugleweed. So, that’s something I should mention for carnitine.

SM: And then do you ever use the method is the metha….

DR: Methimazole?

SM: Methimazole. Do you ever use that with the carnitine and selenium? Or, you don’t combine them?

DR: You can combine them. I think I’ve had one patient, actually, where we did both. So yes. I’m not aware of contraindication – in the carnitine studies it was never mentioned. I wasn’t able to ever find anything showing that there was a contraindication to be used together. There maybe some contraindications that I’m not aware of, but knowing the mechanisms of how they work, I’d be hard-pressed to think that they would cause any kind of negative reaction when used together.


Treating the underlying cause of Graves’ Disease

DR: OK, so then the second thing we want to do is try to treat the underlying cause of the autoimmunity, because you don’t want to be on this carnitine, Bugleweed, (or) wherever it is  – you don’t want on that forever, right? I mean, it’s not the worst thing to be on the long term, but, ideally, I like to get someone where they need little-to-nothing in the long-term. So, we’ve got to address underlying cause, right?

SM: Right.

Graves' Disease - Episode 11 - causesofautoimmunity

DR: Now, as we’ve discussed, the autoimmune paleo diet may be really helpful for thyroid autoimmunity because it is inadvertently also a low iodine diet. As we discussed in the last podcast series, a low iodine diet has been shown in some cases to be able to reverse hypothyroid and even Hashimoto’s. So, I think the same thing certainly holds true for Graves’ disease. By eliminating dietary iodine, we can have a beneficial effect. And, of course, the autoimmune paleo diet also removes other dietary antigens, or dietary factors like gluten, dairy, processed foods, things that can certainly provoke an autoimmune condition. So, the autoimmune paleo diet is a great place to start. Now, what did you do second to that? And this is what I mostly have to look into and treat in the clinic, because the dietary piece is fairly easy, but people are usually coming to me for more than just diet, right? So, there are… I put together, and we can probably put this diagram in the show notes, and this diagram also appears in the article. There was a study published a couple years ago that the researchers constructed a Venn diagram of the causes of autoimmunity. And, I’ve added to their diagram and made my own modified Venn diagram with maybe like 20 additional references to put a little emphasis on things they may have missed in their review, even though it was very good. So, you can look at that diagram if you want more of the nitty-gritty. But I think probably the most important first thing for people to do is to figure out if they have any kind of chronic infection, right? The infection connection to autoimmunity is a very exciting area because I think it really helps a lot of people get that lingering autoimmune condition under control – that has been responded to dietary and lifestyle factors.

SM: When you say chronic infection, are you talking about chronic gut infections or like those chronic secondary infections like Lyme, Epstein-Barr – those type of infections?

DR: Well, both and the infections that have been most well-documented to be associated with Graves’ disease, and actually pretty much thyroid at-large, are h-pylori, and I believe we’ve already discussed the study where it was an Italian study where they treated half of the patient so all the patients had thyroid autoimmunity and had an h-pylori infection, but only half of the patients were actually treated for the h-pylori infection. And what they found was that in the patience that were treated for the h-pylori infection, there was a significant reduction in thyroid antibodies. So, h-pylori has certainly been probably the best, well-documented associated with autoimmunity. Also, though, another bacterium that… I can’t say this bacterium is super well-addressed on some of the more alternative functional medicine stool labs or gut tests, and this pathogen is known as your sanera and enterocolitis.

SM: Oh, yes.

DR: And that one may have better scientific documentation for its connection to Graves’ disease than even h-pylori does.

SM: Oh, wow. That’s interesting.

DR: It’s just another gut pathogen – it been very well documented in association with h-pylori… or, I’m sorry, with Graves’ disease. Then, also viruses – Epstein-Barr virus, cytomegalovirus, and also some herpes, other herpes simplex family, HSV… there are a few different restrains of HSV or herpes simplex virus that are also implicated. There’s a mix in terms of is it just an association? Most of it is just association data at this point, but there are some studies starting to be published, and there is certainly a large body of clinicians who are treating patients and seeing the improvement where it starting to be suggested that these things are causal – meaning they are causing the worsening of the thyroid autoimmunity. So, there was one meta-analysis – and a meta-analysis is essentially a review paper, and people probably heard me harp on why I love review papers, because the researchers go and look through all the evidence, or most of the evidence available on the topic, and then they try to summarize it. Well, when you have a review with a meta-analysis, they do a pretty robust statistical analysis on the data and give you some really nice reporting in terms of how strong mathematically that the associations are. So, I’ll just quickly quote here a systemic review with meta-analysis. They essentially said: “Overall, h-pylori infection was associated with autoimmune thyroid disease. The association was significant for Graves’ disease. These findings suggest that h-pylori infection potentially plays a part in the development of autoimmune thyroid disease.”

SM: Wow.

DR: We see some pretty powerful words…

SM: That’s pretty definitive.

DR: Yeah, yeah. We see some pretty powerful words. I’d love to see more science on this, but I think were starting to see these studies be published because I think it’s not a connection that’s been very well understood until recently. I don’t know; there may not be a lot of drugs that you can use because, unfortunately – let’s look at it from a medical/pharmaceutical perspective: You use antibiotic for two weeks and then you treat this and you don’t need any more treatment. I hate to say it but, pharmaceutical companies are more interested in a drug that can produce a high yield of income, right?

SM: Yes.

DR: And so, a drug that has to be taken everyday for the rest your life is more attractive. Unfortunately, there is a business to the back end of these things. And so, these are really cause-based treatments. I don’t think there’s all this conspiratorial agenda per say. It’s just more an economical one.

SM: Yeah, it’s just simple market economics.

DR: Yeah. So, to quickly pull us out of the political here, there’s not a lot of studies on this, but there are some, and they are very highly suggesting that there’s a connection. So, that is one of the most important things that I look into next. To date, I have been able to help every Graves’ patient that I’ve seen avoid needing radioactive ablation or surgery.

SM: Wow.

DR: So, I have a good track record – and I say that half to boast, yes (laughter), and the other half is hopefully to give to people a ray of light, meaning there are definitely… this is highly treatable. I’m sure, just like everything else, there is a spectrum of responsiveness where some patients will do phenomenally well and never need to destroy or remove their thyroid. And there may be some cases that even after doing everything we can, they still can’t avoid that. But, I think it makes a whole heck of a lot of sense to try first and then hope you come out on the better end of the bell curve on this.

Episode wrap-up

SM: So, how soon… So you get your Graves’ diagnosis… So, I guess it would depend how much damage is already done to the thyroid? To go through this process, how soon do they need to get to somebody like you to get working on this? Or sometimes, is it too late – they are too far gone with their thyroid and they don’t have enough time or their health is being affected too negatively, that they need to go ahead and get the ablation or the removal?

DR: Well, there are two answers to that question. Even for people whom have already had their thyroid gland removed or ablated, these causative factors are still important to look at. The main reason for that is because, if you have your thyroid removed or ablated, then you’re likely going to be a thyroid hormone. And if you are not healthy, thyroid hormone doesn’t work that well. And so you are going to be one of those people likely that are on thyroid hormone, but you still feel like crap.

SM: You have all of the symptoms, and they keep upping your dose and upping your dose and upping your dose.

DR: Right, and what I would advise against is getting sucked into this extremely robust thyroid panel, and trying to treat your levels individually. As someone who did that for awhile, I’ve just found that it’s not that complicated. If you don’t feel well, yes you probably have a conversion issue, you probably have lower T-3 higher reverse T-3. But the answer to that is getting healthy.

SM: Right, what’s behind that.

DR: Exactly. And once you remove whatever factor it is – like a gut infection, for example – then your body will be able to process a thyroid infection more effectively, and you’ll feel a lot better without even doing much adjusting to the thyroid hormone. So, these causative-based things are important for people even if they are post-surgery or post-ablation because you’ll probably feel a whole heck of a lot better after you address them. For people on the other side of the coin, it really depends on a number of factors: It depends how aggressive your doctor is; it depends how aggressive your hyperthyroidism is, right? If your hyperthyroidism is extreme, you may be pushed to act right away.

SM: Yeah, because you could die.

DR: Yeah. So, there are numerous factors to weigh there, but something like carnitine can start working within days to a little over a week. So, you’ve got to take it on a case-by-case, but the agents that help to treat the symptoms in the short-term, they can work pretty quickly, and they can buy you some time. So, there’s not a definitive answer to that question, but you can definitely deftly buy yourself some time by treating the symptoms initially. And, hopefully, when we do the causative-based treatments in conjunction with that, we allow someone to maintain whatever improvements they’ve gained from treating the symptoms in the long-term without having to treat the symptoms any longer. Hopefully that makes sense.

SM: SO, to kind of wrap this up – So, the first thing you do is you want to kind of calm the hyperthyroid symptoms down, either using the prescription medication or something like l-carnitine (or) selenium. Then you want to address of course our favorite topic, diet and lifestyle.

DR: Right.

SM: And then, we are going to look at the underlying causes of autoimmunity, the chronic infections.

DR: Right. Chronic infections are one of most important. And then, also, things like selenium, stress, of course gluten, mercury… I’ve done a lot of research on the mercury issue for the book –  God knows whenever that’s going to be published, but…


DR: … but, that chapter has been… like, I am sweating by the end of reviewing the notes because there’s so much data available. We will do probably a podcast series on that at some point – I’ll publish it as article as well. Mercury would, in my opinion, would be one last things you want to address. I think mercury has been hyped quite a bit…

SM: A lot of people start with heavy metals. And it’s…

DR: That’s why so many patients that I’ve seen, anyway, have said I spent $3,000 and didn’t feel any different.

SM: And did like three chelation… I mean, just chelation after chelation after chelation with no change.

DR: I think, for a small number of people, that will probably be helpful. And there is evidence to support that. But, for most people, it doesn’t appear to be a major issue. And so, that’s why when we are looking at a hierarchy of treatment, or a treatment algorithm, that would be one of the last things that I do.


DR: Also, leptin levels, which leptin comes back to body fat and blood sugar. That comes back to just healthy diet and lifestyle. Leaky gut – but, again, leaky gut is usually a symptom of a crappy diet and a gut infection, right?

SM: Uh-hum.

DR: So, it’s not like we aren’t going to treat the leaky gut; it’s always secondary to something else. That’s some of the major points. So, to kind of wrap it up like you were saying, you may want to start with managing symptoms with a natural or pharmaceutical approach to treating hyperthyroidism. In conjunction, you want to try treat the cause of the Graves’, which diet, lifestyle, gut health, gut infections, systemic infections. And then some of the things we just mentioned would be what you want to do. And approach has worked very well, and with this next week, when this podcast goes out, the Graves’ article is also going to go out. And then I’m also going to release a testimonial with the patient who came in with Graves’ about a year-and-a-half ago, and she’s done great. So, next week is kind of like Graves’ week.


DR: All about Graves’. We kind of talk through her story. She was a typical case where she was discouraged because she said everything I see is on hypothyroid, but I was hyper. And then, I was so glad to come to you learn that there’s a lot of commonality in how you treat both of those. And, my endocrinologist was trying to get me lined up to do radioactive ablation. She came in with a very high heart rate, insomnia, and sweating and everything else. So, she’s just a real-world example –  we kind of talk through her case and what she saw and felt learned, and all that stuff. So, that will to out too.

SM: Oh, cool.

DR: Now I feel like I’m rambling, and I think maybe you should reel me in.

SM: One more thing – I just want to caution people because Graves’ disease can be such a serious condition, that, if you’re going to want to manage your symptoms with some of the supplements, you need a practitioner to walk you through that. It’s not something you want to do on your own.

DR: Yes, I would absolutely agree because you don’t have a lot of leeway or cushion with this. So, I wouldn’t try to fumble through it yourself. And my clinic is still accepting patients and we are able to see people via distance, via phone or Skype. So, if you are out there struggling, feel free to reach out and happy to help whenever we can.

SM: I guess that’s it for this week…

DR: Oh, oh, one thing I wanted to make sure… I almost forgot. I was super excited to see a few days ago in the iTunes Alternative Medicine category we were ranked fifth.

SM: No way! Did you get a screenshot? My friend says when you see, you have to get a screenshot on your phone can never be able to find it again.

DR: I did.

SM: Yea!

Graves' Disease - Episode 11 - Top 5

DR: I got a screenshot and it went out on the newsletter this week, or by the time people are listen to or reading this, it would be last week. But I sent that screenshot out. And, I know things oscillate from day-to-day.

SM: Oh yeah.

DR: But we’ve been oscillating pretty high on the list. So, everyone listening to this and everyone supporting the podcast, thank you because, if we were doing all this and it wasn’t helping anybody, it would suck.

SM: It’s only been, what, we have 10 episodes? This will be the 10th episode, correct?

DR: Ten episodes, and the podcast has only been out I think about three weeks or so.

SM: Since April 8, yeah, so, just almost a month. So, thank you everybody. That’s awesome.

DR: Yes, thank you everyone. A hardy hat-tip to you listeners. You are awesome.

SM: So, stay tuned next week when Dr. Ruscio will have another hot topic.

DR: And soon, everyone, I’m working very hard on a series on the microbiota. There’s a lot of BS on that topic…

SM: I’m looking forward to it because I saw your presentation at PaleoFX and a jazzed me, and I know it jazzed other people. So, I’m really looking forward. I’ve seen other presentations that didn’t jazz me, so…

DR: I’ve had my head down for a while on this issue, and to be honest, I haven’t really… I’ve been just going right from the medical literature and from the researchers. When I picked my head up and looked around a little bit, some of what’s being said on Internet was… to be frank with you, I was pissed off because people are being really misled. And I try always to be positive, but it’s hard when I’m watching a group of people take notes on something I know is total BS. And you are the only person who knows it’s total BS, and you’re just like ‘Arrrggghhh’. I wanted to get on stage with one of the presenters say…but, you know, that would be a kind of Kayne West sort of thing.


DR: I couldn’t bring myself to do that.

SM: That would have been awesome.

DR: I just walked out because I had a hard time.

SM: I didn’t stay for the whole presentation. I think we’re talking about the same one, and I don’t think I stayed for the whole presentation either.

DR: I appreciate people looking into this issue and researching and presenting on this issue, and I don’t want to get to on my soapbox here. When we come back to this with an article series on the microbiota, and a podcast series, there are a few tenants that people can use very simply to navigate if the information, the quote/unquote expert is using to substantiate…do this was test, do this treatment. There’s really easy ways you can cut through – ‘Is this good information? Should I follow it or not?’ I’ll help people with a very simple, very practical way of kind of cutting through the BS and getting to the bottom line. You don’t have to be a researcher; you don’t have to be scientifically inclined. It’s a very simple, pragmatic process. And, we will outline that soon with a microbiota. So, sorry to give you guys so many cliffhangers, but there is a lot of good stuff coming up the pike.

SM: The cliffhangers are good – it keeps people coming back.

DR: Well, I think they are working because people seem to be coming back despite all of our faults


SM: OK, thanks everybody.

DR: Thanks, guys.

Thank you for listening to Dr. Ruscio Radio today. Check us out on iTunes and leave a review. Visit to ask a question for an upcoming podcast. Post comments for today’s show and sign-up to receive weekly updates. That’s

➕ Resources & Links
  1. (8:25) Thyroid & Iodine podcast series:
  2. (11:34) L-carnitine and hyperthyroidism
    1. Trusted SourcePubMedGo to source
  3. (23:03) Autoimmune thyroid diseases and Helicobacter pylori: The correlation is present only in Graves’s disease
  4. (25:09) A meta analysis examining the association of H. Pylori infections and thyroid autoimmunity
    1. Trusted SourcePubMedGo to source

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6 thoughts on “Graves’ Disease – Episode 11

  1. Amazing episode!!! It’s so nice to know that there are positive doctors out there like you Dr Ruscio. My endo is great however she doesn’t believe in supplements and finding out what the cause it to my graves so I had to do most of the leg work myself, I keep track of meds and supplements and my diet and it’s such a HUGE part of recovery. Your amazing thank you for Helping us see the light at the end of the tunnel !

  2. Amazing episode!!! It’s so nice to know that there are positive doctors out there like you Dr Ruscio. My endo is great however she doesn’t believe in supplements and finding out what the cause it to my graves so I had to do most of the leg work myself, I keep track of meds and supplements and my diet and it’s such a HUGE part of recovery. Your amazing thank you for Helping us see the light at the end of the tunnel !

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