Today we speak with June, a patient who has done quite well in terms of symptomatic improvement. As we have been monitoring June, we noticed her thyroid antibodies were increasing slightly and that she has H. pylori. We then treated both of these and documented her response. Her case teaches us some valuable lessons. Let’s discuss.
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Thyroid Autoimmunity and H. Pylori – One Patients Story
Dr. Michael Ruscio: This is Dr. Ruscio. I’m here with June. And we had spoken maybe a year, year and a half ago.
June: Something like that.
DrMR: When you first came, you did really well. Had a number of common symptoms. I think you had weight gain, fatigue, thyroid autoimmunity, hypothyroid. And you had done really well with that. And June has been maintaining pretty much all of her improvements, really.
But recently, we saw something on her lab work. And I thought it would be interesting to kind of follow up on this now and then again in a number of months.
Her thyroid antibodies are starting to kind of creep up. And we had seen evidence of H. pylori in the past but never anything definitive up until now. And now, the evidence of H. pylori is definitive. And interestingly, some of your thyroid antibodies are starting to go up.
And so we had the conversation, what does that really mean? And I like to give you kind of both sides. And the conservative stance would be to do nothing because you’re feeling really good.
June: Good, yeah.
DrMR: Yeah, you’re feeling really good. The more aggressive, I guess you could say, would be to treat the H. pylori and perhaps go under an intervention to help with the thyroid antibodies. And you asked me what the risk associated with not doing anything is.
June is already hypothyroid. She’s on thyroid medication and feeling really well on it. The main thing that we’d be trying to prevent would be further deterioration of the thyroid gland, which may equate to needing an increased dose of thyroid hormone.
So that’s certainly something that we’d want to try to prevent. But we’ve already kind of gone over that edge, so to speak, where you need a little bit of thyroid hormone.
So we went through that dialogue. And we decided to start treating H. pylori today with some herbals and to go on the — you may remember from one of the previous videos that we did. A recent protocol using selenium, CoQ-10, and magnesium has been shown to lower thyroid antibodies. So we’ll be starting on that today, too.
And then we’re going to retest in a number of months, see what the H. pylori looks like, see what the thyroid antibodies look like, and also see what your symptoms look like.
Your symptoms, I don’t think, can get much better because you’re doing really well.
June: I’m doing really well.
DrMR: But maybe we’ll see if anything additional changes. So I thought it’d be nice to get this snapshot and then check in again at the end. Anything that you want to share in terms of comments, concerns, kind of the patient end, things that are going through your mind in this regard?
June: Well, as we talked about, I’m feeling pretty good. My energy is good. I’m sleeping way better than I was several months ago. Probably the biggest thing is that my body doesn’t seem to want to burn fat.
June: And so last time — what was it? — almost 2 years ago, when we started the first protocol, I lost a bunch of weight. My waist got smaller. My body burned fat. I hate to say “losing weight.” And then I just came kind of to a standstill.
June: So I always think about what is happening inside. It’s not just a matter of diet and exercise. There are hormones and whatever your chemistry is.
DrMR: Right. Your diet and exercise — we should just clarify — are really good.
June: Really good, yeah.
DrMR: Really good, yeah.
June: So I’m interested in trying this new protocol. Maybe that will shift something.
June: And we’ll see. I feel good, but there’s always better.
DrMR: Yeah. And I think you make a great point, which is framing these things as such, which is not giving you this alarmist spiel. You have to do this. I think you’re at a point where you’ve gotten your health the majority of the way restored. And now, as I said, this is kind of like an optional add-on.
The most conservative thing we could have done from here would be just to monitor you and see if your GI symptoms start to regress or your hypothyroid starts to regress.
We decided to be a little bit more proactive and intervene today, which I think we have pretty good justification to do. And yeah, I’ll be curious to see if any weight loss is produced or anything else.
One other thing you said — this came to me. I wanted to make a note of this. Symptoms are really important as part of this. And I asked you how digestion was. Overall, really good. You did say, just a couple times — and this could be coincidence. But just a couple times, you’ve noticed heartburn.
DrMR: Which can be one of the keynote symptoms of H. pylori. So again, a few times over the course of a month or two is not enough to really say, “Hey, this is diagnosable as anything.”
DrMR: But interesting to see that that correlates with the resurgence of the bacteria that’s known to cause heartburn.
DrMR: So I’m being super nitpicky there.
June: Yeah. Yeah, why not?
DrMR: But maybe something that tells us that that could get worse if left unaddressed.
DrMR: Cool. All right. So we will check back in in a few months and hopefully have some additional improvements.
June: Something new, yeah.
DrMR: But if not, we’ve done, I think, a good service to you by just preventing this from maybe going forward any more.
DrMR: So we’ll see.
DrMR: All right. Thank you, June.
June: Yeah, you’re welcome.
DrMR: Hi, again, everyone. This is Dr. Ruscio. I’m back with June about six-ish months later from our original video.
June: Yeah, something like that.
DrMR: And nothing huge to report. But I think maybe just an important lesson here.
If you remember back, June had been doing very, very well the last time that we had spoken. She had initially, well over a year and a half ago, presented with a number of symptoms. We essentially did our functional medicine stuff and got those things pretty well remedied except, at your last visit, some of your thyroid antibodies were slightly elevated. And we also saw H. pylori present in both a breath sample and in the blood antibody sample.
So we decided to act. Even though June was feeling great, we said, “Well, let’s see if we can drive down the thyroid antibodies a little bit more.” So we did a round of treatment for H. pylori. And we also did a thyroid protocol that has been clinically shown to help lower thyroid antibodies and preserve thyroid tissue structure.
And it’s a number of months later. And there is actually no change at all in her thyroid antibodies. And there is no change in her H. pylori markers. And so I thought that it would be nice to show kind of the other side which we love to highlight when there are these huge changes and cathartic improvements. But there are also times where you need to know when it’s time to stop. That’s kind of the conversation that we just had.
DrMR: Symptomatically, you’re feeling great.
June: Yep, feeling good.
DrMR: There’s really no more improvement that we can get symptomatically.
DrMR: So what we’re after is to see if we can improve the lab values even more. And I think in your case, what we’ve hit with your thyroid antibodies is normal for you.
And the TPO antibody is probably between 70 and 80-ish. And they’ve kind of maintained there for the past year and a half. And the thyroglobulin, which we were talking about, is one where I’m not quite sure what I think a successful level is just yet. That’s been hovering around 300-ish.
So TPO, I think, being below 200-300 is a clinical win. Thyroglobulin (or TG), I’m not quite so sure. But the fact that you’re presenting so healthy—your thyroid dose has been consistent. I believe you’re even on less relative to when you first came in, in terms of your thyroid hormone dose.
June: Right, yeah.
DrMR: There are no gastrointestinal symptoms. I think you’re doing really well in that regard. The other thing is the H. pylori. And that’s another thing to speak to. And we were just talking about this.
But essentially with H. pylori, it’s not necessarily always about strict eradication of H. pylori. Sometimes, it’s more so an issue of just rebalancing it so that it’s not crowding out or running amuck, unchecked.
DrMR: And as long as it’s in the right balance, it shouldn’t cause symptoms. It shouldn’t cause problems. And so in your case, H. pylori for you is probably, at this point anyway, commensal—just one of the group—rather than being pathogenic.
So a good of example of when there’s not really a need to do anything more. You have some labs that we could act on. But you’re feeling great. And this is a point where we just let you go out there and live your life.
June: In the world.
DrMR: And not worry about any of this stuff.
June: Yeah. Yeah.
DrMR: Anything you want to add to that after I blow five minutes of hot air here.
June: No, I agree with everything. I could be anxious about it and say, “Well, no. We have to get everything just right.”
June: But I’m thinking that maybe the numbers that we have now are the just right for me.
June: Since I’m not really symptomatic.
June: And I’m feeling good. And I live a healthy life. So as long as I keep doing that, hopefully, things will stay on an even keel.
DrMR: Sure. And we’ll follow up maybe about once a year just to keep tabs on things. And if we see any major discretions of her lab values, then we can act. But for right now, you’re solid. I anticipate you’re going to continue to be solid going forward.
We just talked about how there will probably be a setback or a speed bump somewhere.
DrMR: There’ll be some bad food somewhere or a stressful event. And that’s going to happen. And you’ll probably bounce back after a few weeks, normal.
DrMR: But if something starts to reappear symptomatically or appear for the first time in terms of a new symptom and is consistently there for several weeks, that’s a good time to check back in.
June: Yeah, good.
DrMR: So pretty simple stuff. June is doing great. And just wanted to give everyone an update. A good example of when you’re done and when you don’t need to do anything more.
DrMR: And thanks, guys, for tuning in. And thanks for letting us speak about this, June.
June: Sure. My pleasure.
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