How to Diagnose Hypothyroid & Hashimoto’s and Reliable Symptoms - Dr. Michael Ruscio, DNM, DC

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How to Diagnose Hypothyroid & Hashimoto’s and Reliable Symptoms

Introducing My Thyroid Care Course & Taking the Guesswork Out of Thyroid Health

In This Episode

Intro…00:08
My New Thyroid Course…00:50
What’s Covered in Module 1…07:56
What’s Covered in Module 2…12:19
Outro…26:42

I’m so excited to announce that I have finally put together a course on thyroid health. I developed this course because of what I see in my clinical practice every single week: patients who have seen conventional doctors and alternative or functional medicine doctors, who have done their own research, and who still have symptoms. My clinical team and I have learned so much by obsessing over all of the latest thyroid, gut, and autoimmunity research, and by working with patients every day. I’m proud to say that we have developed a practical, evidence-based model for treating patients with persistent thyroid problems, and it works. Now, I’m sharing everything we’ve learned with you, to empower you to take back control of your thyroid, your gut, your overall health, and your life.

In today’s episode, I’ll walk you through the first four modules of my new thyroid course, which focus on the current state of thyroid care, some of the most pervasive myths in the thyroid community, real cases studies from our clinic, how to really define your thyroid condition and interpret your labs, where the gaps are in both conventional and alternative medicine, and more. 

Later, we’ll cover the treatments and diets that do and don’t work, and how to properly sequence them and put them into action so that you can feel better.

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Intro:

Welcome to Dr. Ruscio 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.

My New Thyroid Course

Dr Ruscio:

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. That pre-registration or early bird is up until September 8th, and then the course officially opens on September 9th.

Dr Ruscio:

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:

Hey everyone. Welcome back to Dr. Ruscio radio. This is Dr. Michael Ruscio, and today I am exceedingly excited to announce I have finally put together a thyroid course, and I want to tell you a little bit about it today. And I suppose, let me start with, I’m so confident that this will be helpful.

Dr Ruscio:

And this confidence is a derivative of seeing how many patients are not getting competent thyroid advice from both sides of the spectrum, both conventionally, a little bit myopic and shortsighted in what they are willing to do for many patients (not because they’re illintended because of the paradigm), but conversely, as we’ve discussed so many times on the podcast, when you go to the integrative alternative and functional camp, it’s equally as bad for different reasons, right? Over zealous positions on food… Just an egregious misinterpretation of Hashimotos and what that means and how to resolve it, diagnosing people with hypothyroidism who do not have it, promising people that your symptoms are because of your thyroid, when in some cases they definitely are and we need to improve the situation there, but in other cases, you’re not actually hypothyroid and the medication may be making you feel worse. Like we discussed on the podcast, not too long ago, a 1.6 and 1.7 increased risk of heart failure and stroke in those who were on combination therapy as just one data point that should bridle us with how quickly we say you have symptoms, therefore you need thyroid hormone.



Dr Ruscio:

So because of all that I, and we, offer this course with a confident money-back guarantee. So just to make it as easy for you as possible purchase a ticket to access the course. If you don’t say, “wow, this is great information,” gladly, we will give you your money back because this is all about getting you competent, helpful information that will empower you and allow you to resolve your symptoms first. And so to make this as easy as possible, I want to lead with that.

Dr Ruscio:

Now, the way this course is set up is 12 modules. If you head over to the URL, DrRuscio.com/thyroid-course you’ll be able to get there. We’ll put the link in the podcast description also. And it should be fairly easy to navigate there through the homepage as well. There’s 12 modules, and this will take you through really everything that you need to know, including a custom-built thyroid panel that we have put together. It’s essentially the same thing we use at the clinic with a specific interpretation guide and even an interpretation calculator, thus taking the guesswork out of [what your] labs mean.

Dr Ruscio:

Now, medical/legal disclaimer here: All of these diagnoses need to be verified by your local doctor. But we can at least give you [some clarity] in terms of “my TSH, my free T4, my T3, do they mean I’m hypothyroid? Do they mean I’m subclinical hypothyroid? Do they mean I don’t have a thyroid problem at all and my symptoms are coming from somewhere else? I’m not sure, I hear conflicting things.”

Dr Ruscio:

We’ll simplify all that for you and give you a very specific (you put in the numbers and the calculator gives you the diagnosis, or at least the suggested diagnosis to be checked) A, B, or C. And then correspondingly here is what you do if you have condition or situation A, B or C. So with that in mind, let’s go through some of the information that is contained in the course. And many of these concepts are concepts that we have discussed on the podcast in the past. It’s just really putting this all together so that you have all of the information. It’s complete enough to give you that “I am A, B, or C, and now what do I do? […] And perhaps most importantly, what sequence do I follow so that I’m not putting the cart before the horse or so that I get the recipe right?”

Dr Ruscio:

And this is also something that I cannot overstate the crucial importance: You have to make sure you’re using the right sequence of therapies. And this is, I would estimate for at least 30% of the individuals at the clinic that we work with, the difference between their success and their failure is the sequence and the recipe with the ingredients, rather than just the ingredients themselves. Elimination diet, selenium, vitamin D, gut health HCl, ferretin—knowing the right way in order to have all these variables come together to produce the desired outcome. The recipe tastes good = your health be improved.

What’s Covered in Module 1

Dr Ruscio:

Okay. So the first module we go into: The current state of thyroid care. And [we] really give an overview of where we are. And the short synopsis there, as we discussed in the podcast before, is this is an area where I think there’s an equal degree of erroneous information, both in conventional and in natural medicine. And it’s important that we give that overview because much of what we’ll discuss in the body of the course will counter what you hear in integrative circles. And this is been evidenced by the fact that two recent studies have found roughly anywhere from 30–60% of people have been incorrectly diagnosed.

Dr Ruscio:

And what is so disheartening about the natural medical community. And you’ll, you’ll see this in thyroid blogs and podcasts. “Did you go to your endocrinologist? Did he say your labs were normal? Do you still have symptoms? It’s because he or she is not digging deeply enough. He or she is not doing a complete thyroid panel.” This is incorrect. And this harms people because the deeper lab work does not quantify dysfunction with thyroid. It quantifies dysfunction in thyroid metabolism, which is very different than the thyroid gland itself being dysfunctional. But nevertheless, these people are told it’s your thyroid gland because of these perturbations in T4 or the T4/T3 ratio. And then they’re put on hormone they don’t need. And then the metaanalyses come out and show 37%–61% of individuals could come off their hormone and feel just fine.

Dr Ruscio:

Yay. This is good. This means you don’t need medication for the rest of your life, but it’s presented in such a specious argument. You’re not feeling well, this medication is why. But unfortunately this experiment has been run for a number of years and now the chickens are coming home to roost, so to speak, and you’re seeing this pop up in the data that people are being incorrectly diagnosed. And sadly, this also supports them from finding what is actually at play.

Dr Ruscio:

So we start with some hope in terms of these things can be addressed. There’s a simple path forward. The simple path forward may not be quite as easy as, “you have this medical condition that requires lifelong thyroid hormone, here’s a pill.” Right? Sound familiar? It’s the “pill for an ill” mentality. Ironically, now, yes, for some people they are hypothyroid. They do need to allow their body to better utilize better absorb, or just generally feel better through thyroid care amongst other things. But we want to be careful not to shoehorn everyone into that box. So we share a couple case studies from our clinic that substantiate that as part of the first module.


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What’s Covered in Module 2

Dr Ruscio:

Module two [is] really important: Defining thyroid disorders. How do we define, based upon lab work, hypothyroid, Hashimoto’s, subclinical hypothyroid, and the infamous sluggish thyroid? So we give you […] the correct criteria. And this, like I’ve said before, is half the battle, getting the right information. How common is it? What is the treatment for each one of these? And I think when we combine this with the lab panel where you’ll have the specific markers and you can look at that through the calculator, that gives you the answers in terms of [options based on your markers and patterns].

Dr Ruscio:

What’s also nice about this is sometimes you’ll see these seemingly annoying and somewhat spurious [things like] “The 27 patterns of thyroid dysfunction.” This makes things far too complicated. And as you’ve probably heard me say before, if we make healthcare too complicated, we do not get good results. It might sound cool. The speaker or the guru may seem smart. But in application and in practice, these highly complicated models of thyroid care do not produce good results. And we’ve documented this in the case series that we’ve published recently in the IMCJ journal.

Dr Ruscio:

So we go through these syndromes and here’s one data point I’ll share. I think this is really worthwhile. We have this nice infographic. It’s entitled “Everyone with Hashimotos will become hypothyroid? Don’t fall prey to the fear, do the math. The prevalence of Hashimotos is 5–19% of the population.” 5–19%. Now, one of the ways we could determine, “well, how at risk am I for hypothyroidism if I have Hashimoto’s?” By looking at how common Hashimoto’s is next to how common hypothyroid is. Hypothyroid prevalence is 0.3% of the population. So the Hashimotos prevalence 5–19%, and the hypothyroid prevalence is 0.3%.

Dr Ruscio:

I also want to underscore that this is a very fair synthesis and interpretation of the data. If we wanted to, we could skew these numbers by maybe selecting from a young cohort or an older cohort or a disease cohort. But this is based upon cohorts or groups of people that are most representative of the people listening to this podcast. Meaning not people in their eighties, not people in their teens, but the body of the population, those in their twenties up through to about their sixties, right? So middle-aged individuals in the United States. This is what the prevalence data looks like. Now, this is not to say Hashimoto’s doesn’t matter. But what it’s to say is that, yes, there are things that we can do to reduce your antibodies and to improve Hashimotos.

Dr Ruscio:

However, this is also empowering in the sense that you don’t have to be the person who’s now constantly afraid of food, of gluten, of dairy, of nightshades, because you’re mistakenly thinking that if you have Hashimoto’s, there’s this stick of dynamite in your throat, that’s eventually going to explode into this autoimmune condition or the fire of the autoimmune condition is going to rage until you become hypothyroid. And it’s something that has to be vehemently guarded and fought against. The good news here is it should empower you to understand that Hashimoto’s is not as bad as it’s often portrayed to be. Now you can do with that what you will.

Dr Ruscio:

And some people make get angry and say, “What do you mean? I feel poorly.” Listen, I’m with you. I want more than anything to help. And this is what we’ve done at the clinic. We’ve helped so many of these patients, but we don’t help people by making them think their situation is worse than it is. We want to have the appropriate level of weighting of the risk so that you don’t have undue fear and you have the empowerment that I think so many with Hashimoto’s should have. A) There’s a lot that can be done to lower antibodies and to improve how you’re feeling. B) Even at baseline, the data support that your likelihood of becoming truly hypothyroid is quite small. And so this is an antidote to the fear that often accompanies this conversation.

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Dr Ruscio:

Okay. So, moving on. We also have a, I think, very helpful interpretation chart for your antibodies. We’ve discussed in the past, similar to how a fasting blood glucose of 103 is not the same as 163, this same thing applies to antibodies. And it’s a real travesty how many people (again, fear, fear, fear) are walking around thinking that their antibodies that are 100 or 125 or 344 or 415 are highly problematic when the data just do not bear that out. There is a value cutoff at which yes, okay, now the Hashimoto’s is out of control, so to speak, and we need to bring some water to that fire. But interpreting this correctly allows you not to feel like you have a problem when you don’t. And the same thing with some people, again, using the blood sugar analogy, they may not understand the Dawn effect or the fact that some people who’ve become very well adapted at a moderate to lower-carb diet and or have a moderate to higher protein diet normally will have a slightly elevated fasting blood glucose.

Dr Ruscio:

With the right information they go from thinking “there is something wrong” with me to “this is completely normal”. And this impacts, obviously, stress and, more importantly, your perception of yourself and unburdens you from feeling like there is something wrong when there is not. Now, if there’s something wrong, yes, let’s fix it. If there’s not something wrong, let’s not shackle you with that false belief. So the antibody interpretation helps us determine, depending on the value, is there something that needs to be managed or addressed with the autoimmunity, or is it good? And it’s not this binary of the lab cutoff value. There’s a scale, right? And that’s, what’s important here.

Dr Ruscio:

And then we go into the panel. We give you a blood panel, but also more importantly to mention, it’s not just thyroid markers. It’s other markers that tie in with this. One of which is ferritin. Now, there’s debate regarding ferritin, which is a functional marker for iron status. Now the lab cuts off at 15. If you’re below 15, you’re iron insufficient, iron anemic, and this can cause things like low energy, exercise intolerance, potentially brain fog, potentially fatigue. Some of the integrative community, and this is something that we had discussed years ago from the research, mainly from Sapi, who I believe is in Finland, believe that your ferritin should not be below 100. Now this is where being in a clinic and actually seeing patients, not masquerading or representing myself as such because I did that 10 years ago and now I just do media for a living, but actually trying this with patients, we have a different cutoff. And in the clinic, we’re using a different value for when we say, okay, the iron now is insufficient and we should have this person undergo iron supplementation.

Dr Ruscio:

This ties in with something that we introduced in a paper we published in the journal Nutrients, which is the gut-thyroid-nutrient axis. Because if you do have hypothyroid or Hashimotos, there is an increased prevalence of low hydrochloric acid. And this can cause things such as B vitamin and iron insufficiency. However, we want to be careful if we use a cutoff that’s too liberal, we’re going to be pumping everyone full of iron, and they’re not going to feel better. This is the balance that always has to be struck with interpretation of lab values. If we’re overly liberal, everyone has the thing, everyone’s positive, and very few people respond to the therapy because we didn’t set the right value. Now, as the healthcare consumer, you lose from this because if you undergo therapy well, firstly, if you think you have a problem that you don’t, not good psychologically. And if the parameters of interpretation for the lab value are erroneous, then you have a very low likelihood of improving.

Dr Ruscio:

So when you combine psychologically harmful, along with not being clinically helpful, this is where you see a fair amount of what’s happening in the integrative medical field. Now, I also want to thank the integrative and, and functional medical field for doing a lot of good work, right. But I just can’t. And we, the clinic cannot ignore how often patients have been mislabeled, misdiagnosed, and mistreated. And I really want to make sure that this is not happen to you, which is why I’m trying to call these things out as tactfully as I can. Okay. So that takes us through the first three modules. And I’ll probably do a couple more podcasts walking through other facets of this, but this gets you out of the gate. We start off with some hope and some case studies showing the current state of thyroid care, where the gaps are in the offering in both conventional and alternative medicine and how, when handed correctly, these people who’ve seen the best doctors in conventional and alternative medicine and are suffering can be helped fairly quickly.

Dr Ruscio:

We help you to better understand what these conditions are. [We] give you a simple model of A, B, C, or D, hypothyroid, subclinical hypothyroid, Hashimoto’s, sluggish thyroid, or what combination of those do you have by giving you the specific lab panel that you can go and do on your own, through a direct-to-consumer lab company, and then punch that data into the calculator, get your score, and then understand what your values mean. And what your values mean in a correct fashion. Meaning no fear about, let’s say a slight elevation of TSH. That really means nothing, because guess what? Over 50% of slight elevations of TSH correct with no treatment at all. Or making sure that you avoid the mistake of thinking that there’s a major Hashimoto’s autoimmune problem when you may really not have that. So giving you the straight talk, the combination, the needle thread between the extremes of conventional and alternative medicine, bringing you the best of both camps.

Outro

Dr Ruscio:

And this is our starting point. So more to follow on this. Just wanted to put this out there so that you could head over to the page and sign up for the course and get started. And like I said, I’m exceedingly excited to release this because there’s at least one case a week in the clinic that’s been mishandled. Patients are always so appreciative of having competent advice. And now I’m just so, so excited to be able to give this to you in a nice linear 12 module self-management course. So you can get the competent care and really just improve your health and not have to worry about inflammation, thyroid, or whatever symptoms are a derivative of that brain fog, fatigue, depression, etc. So that’s it guys. DrRuscio.com/thyroid-course. And hopefully this helps. And more to follow on the other module soon. Okay. Thanks.

Outro

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