#228 How we are missing subclinical hypothyroidism: "Your labs are fine, but you're not fine" thyroid edition" with Christa Biegler, RD

Hair loss, cold hands and feel and feeling tired are the big three for a sluggish thyroid. But relapsing gut issues, slow motility, sleep disruption, brain fog, slow metabolism, inflammation, low mood or anxiety, and dry skin can all be symptoms of a sluggish thyroid.   In this episode, we talk about how we’ve had to change how we’re approaching thyroid health in practice to ensure clients feel their best and maintain their results.   We talk about “dead ringers” of thyroid symptoms, blood versus tissue labs, thyroid nutrient cofactors and steps to take if you’re checking the boxes but not getting answers yet.  

If you’re experiencing the issues mentioned in this episode (tired, gut symptoms, etc) and want testing + support, you can get it from our program Food Sensitivity Solutions & The Fatigue Fix. In it, we correct imbalances in the gut with testing and fill in the nutrient gaps (based on testing) depriving the thyroid of working properly.   ****Learn more & apply here: https://www.christabiegler.com/fss  

This episode is sponsored by RUPA Health, my favorite lab concierge service that brings over 25 different functional medicine labs to one dashboard and saves me loads of time with it’s amazing interface and saves my clients money by being a low cost blood lab facilitating option.  If you're a health practitioner, get a free account at https://www.rupahealth.com and let them know I sent you! 

Transcript:

Christa (00:04):

Hey, welcome to the Lesss Stressed Life podcast, where we believe that everyone deserves a less stressed life without food, sensitivities, fatigue and overall inflammation. So today I'm telling you about something that I think is so important and is so missed, and that is sluggish thyroid 1 0 1. Now don't stop listening to this. If you have had blood labs and everything is normal, that's really who this is for. I had a woman tell me about a month or two ago. She said, but your website doesn't really talk about thyroid. I said, that's a great point. I don't need the people who know that they have a thyroid issue. I need the people who don't know that they have a thyroid issue. So today we're gonna talk all about learning and relearning <laugh> and how we're never done learning how a lot more people have sluggish thyroid than who's diagnosed with thyroid issues.

Christa (00:53):

We're gonna talk about issues with gut health and why people relapse, how I handled thyroid issues years ago, and now, et cetera, et cetera, et cetera. So we'll go through some checklists, what you can do. Co-Factors all the things. First, man, I've had a lot of humbling this last year or two as I, as I have just relearned biochemistry, just because your bloods labs are normal. Doesn't mean everything is normal. So many years ago when I started practice, this is how I handled thyroid versus how I'm handling it. Now I would say if someone's really wrecked. So thyroid is kind of like a gray cloud. That's gonna cover everything up. And even if you're seeing success in other places, it's going to kind of just follow you're own like a dark cloud, like a dark storm. So if that was happening with someone, because often people would come into my practice and they would already either be on thyroid medication.

Christa (01:47):

I would say their doctors got this, right? Like that is what the doctor is there for. They are diagnosing thyroid issues and treating that with medication. And that's, that's, that's the role of their provider that was then I can't diagnose anything. So I didn't see how I could be supportive in that role. So once upon a time, my best friend who's a pharmacist told me that the most prescribed medication was Throid medication. And so if the most prescribed medication is thyroid medication, at least anecdotally, then what does that do for the rest of us that have a sluggish thyroid overall? So when you go to the provider, when you go to your provider, you can ask for thyroid testing. And what commonly happens is you have a TSH drawn. If you say, I would like thyroid testing, you'll usually have a TSH drawn. Usually at maximum, there will be a TSH reflex to a T4.

Christa (02:36):

So what that means is that you have a thyroid stimulating hormone. So not, not even a thyroid hormone, but a pituitary hormone, a, a thyroid stimulate, it's like an alarm clock to send up messengers, to wake up things you're having that measured. And if it's a little bit out of range, then you have this TSH measured now, Ts I'm sorry, T4. So T4 is inactive thyroid. And I always say, TSA is kind of like the alarm clock. T4 is getting ready for work and taking all the co-factors putting makeup on getting dressed, brushing your teeth, eating breakfast. And then when you go to clock into work, it's T3. That's the active hormone. But here's an interesting thing when you, you know, how if you drive to work, you've kind of got that on autopilot. You got a neural pathway carved that way. If you have cortisol stress hormone coming into play, now the thyroid hormone goes off into like the wrong freeway.

Christa (03:26):

So if you have reversed, T3 elevated, that means that there's elevated cortisol. So things aren't checking into work overall so many years ago, I would just say, okay, go get your, go, have your thyroid tested by your provider. So people would go ask for a full thyroid panel. That'll include T3, T4 TSH, thyroid antibodies, et cetera. And sometimes they would get that fully drawn. And sometimes they wouldn't because it's not the standard of care. I'm not complaining about it. Just saying, this is how it is. So that TSH should be drawn, maybe a T4. And I actually had a client tell me one time. I just was wondering what the cost of this looked like. And she told me that her insurance was billed $2,000 for that, which made me fall over because when I order blood labs through our lab concierge, which is called Rupa health, if you have a private practice, it's like $10 for those two markers.

Christa (04:15):

So blows my mind. So what was happening was they go to the provider, not get it ordered, or they would get it ordered and it would be normal or they wouldn't, they weren't able to get it ordered. So at that step, you could actually, the PR the client can actually order tests on their own. You can go to request, to test.com or direct labs.com and order with irate testing or in our practice, we help facilitate that through our lab concierge. And so then they go and get that drawn. And then we get the blood labs back and things often still look normal. Sometimes we catch something. And then when we catch something, because we don't diagnose, we send you back to your provider and say, Hey, these antibodies are really elevated, you know, and then the provider's gonna recheck. So that's how thyroid is being handled in practice years ago.

Christa (04:57):

Versus now, now I'm realizing that even if your blood labs look okay, you are not okay. So if you have any of these symptoms, you can just go ahead and raise your hand. <Laugh> virtually. But if you have a, I would say sluggish, thyroid is more common. We'll talk about elevated or hyperthyroid later, but hypo or sluggish, thyroid symptoms look like the big three would be feeling cold, either your whole body or hands in feet, hair loss and fatigue, but there's also brain fog or just inability to concentrate. It's overall slows the metabolism down and makes it easy to gain weight, or you'll have trouble losing weight or have weight loss resistance. Some people have disrupted sleeping. Sometimes you'll see a lower heart rate puffy face overall. Like if you're feeling kind of swollen, it's a weird feeling. It's like an inflamed feeling where you just don't feel like you fit in things or that your face feels just puffier.

Christa (06:04):

Dry skin, dry hair, predisposition to fungal over growth. So slow motility. So if your motility with your gut health is slow. So the huge spoiler alert here is that a lot of these symptoms overlap to gut health. And so if your overall motility has slowed down, that's constipation, that's not having a, a beautiful type four banana style bowel movement every day. And so if you have sluggish motility, you now are breeding a problem. So it's just like stagnant water with stuff in it. It will like grow and create microbes. And so what happens is you'll have relapse of gut issues if there's a sluggish thyroid. So this is where my interest really began because we would get people better. Their gut health would be beautiful. We would discharge them. And maybe two years later, and this wasn't extremely frequent, but it was enough where it bothered me because I like people to get better and then just be better.

Christa (07:01):

And I think there's a lot of things that go into that. Our stress is huge. And so, and that's usually where a lot of things come from in the first place. But if the thyroid is sluggish, what would happen is if they go off of stimulating supplements that make the gut health look beautiful, they would be slowed down. Okay. So the motility would be slowed and it would be masked by the fact that they're on supportive gut health, nutrients. So it would be masking the overall motility issue. The other thing that would happen dead ringer is needing coffee to use the bathroom or increasing carbohydrates and having bowel moments in those are all three like dead ringers. Absolutely. I know this person has SL a thyroid in conjunction with these other things. Okay. So we were talking about hair loss, cold brain, fogger trouble, focusing, sleep, disruption, feeling inflamed slow motility over, which is overall gonna be poor digestion, dry skin, brittle hair predisposition to fungal overgrowth, like fungal issues.

Christa (07:58):

Come back again and again, and then 33% of people who have thyroid issues struggle with anxiety and 25% have depression. And I just think right there that's enough where we should be checking this more. But the problem is that if the blood labs are normal, then what tools do we have? So unfortunately we don't have a lot of tools conventionally that that really blows. It really does because it kind of feels like there's not a lot of options, but blood labs show you what's in the blood right now. It doesn't show you what the cell is using. What's happening inside the cell. So a couple years ago, I explored adding tissue. Mineral analysis to practice felt a little goofy, little hokey. The research on it is so old. And the first person I learned it from, I had like highs and lows, my CA my friend, Kaylee.

Christa (08:49):

And I did our, we did some continuing education. We, we were going through a program together and we were like, oh, this could be awesome. And then it would be so supplement heavy. And anyway, then we'd have lows. And like, I'm not applying the I'm not implementing this. This like just feels like not gonna work for people. Fast forward, my friend, Amanda, who is the hormone healing RD is a huge advocate of mineral testing. I had gone on a, a dietician trip with her and she kind of opened my eyes to a different way to read it using whole foods. And so what really became was that it allowed us to see sluggish thyroid issues. It allowed us to see adrenal issues before, without the use of other testing. That can be a little bit hard. People always went through hormones tested, and I used dried urine tests for comprehensive hormone analysis or the Dutch test.

Christa (09:34):

And it sounds so fun to just like test your hormones, but hormones are really secondary to what your gut health is doing. Your stress, your micronutrients, your blood sugar and your toxic burden. So it doesn't in my mind, I like to do things. I like to be a good steward of finances. And so I, it doesn't make sense to me to have someone do that debt chest, because it's, it's a lot of information it's kind of overwhelming if we could be working on all those root causes. And so that's where we look at that cortisol or what the cortisol and the adrenals are doing. So anyway, mineral analysis allows me to see what the adrenals are doing even before things are awry on the saliva, urine testing for cortisol, et cetera. So when I've implemented tissue analysis, I can now see what, what nutrients have been depleted from stress, because I did know that the only people that didn't get better fast were as fast as I wanted or didn't get better is as, as good as I want.

Christa (10:25):

I mean, I can count them on both hands <laugh>. It was the stress was a common denominator, like every single time. So I knew this, but trying to communicate that to them was actually more stressful for them. So you're really kind of up a Creek. When that happens. When I look at the mineral analysis, it allows me to see the byproducts of what's happened from stress. It allows me to see the deficiencies. So for example, when your cortisol is elevated or when you're using a lot of cortisol, you dump potassium. And when your body is trying to control blood pressure, it uses aldosterone. And that dumps sodium and through stress also magnesium is dumped cetera, et cetera. And so when these things get out of balance, different things happen like calcium will stand in front of the doorway for for nutrient stent or the SU or the thyroid, et cetera.

Christa (11:13):

And if you have a deficiency in potassium, because, and again, you're not gonna see this on blood, but you see it in tissue. Cuz if it, if you see that on blood, you're basically falling over, like you're faint, cetera, et cetera. Like you're just not gonna see that those are markers where like, if you're really, really sick, you may see that, but it's pretty much not gonna happen in the, in the blood cuz our body is so amazing. But in the tissue, you'll see that it's you're the tissue is actually inside, inside the cell is actually kind of starving for those nutrients. Because they've been used up by stress. So now that I use mineral analysis, I can see the cofactors needed for the thyroid support, the cofactors through food voila, we're doing a lot better <laugh> so this is an issue for me because there's such an overlap.

Christa (11:58):

All almost all of the symptoms I'd mentioned for thyroid are also symptoms of suboptimal gut health. That means imbalances of bacteria, fungus, et cetera. And that's because one leads to the other really. So if you have a sluggish thyroid, you're going to have gut issues later. So for us in our practice, we address gut issues and mineral issues to support the thyroid and the adrenals all at once. Because I don't really understand how in this stressful world, your thyroid could work optimally. So I feel that the grand majority of our clients fit into this overall picture overall. Okay. So we've gone over symptoms of sluggish, thyroid, the dead ringers of sluggish thyroid. Like I mentioned, you need coffee to stimulate bowel movements going off a gut protocol or gut supportive, like going off of let's just pretend going off of you're on a probiotic and helping you be regular and you go off of any Cano and then also eating carbohydrates.

Christa (12:51):

So let's actually talk about how sometimes we create a sluggish thyroid. So I have another episode coming out where we talk about just destroying metabolism, but destroying metabolism and, and, and having a sluggish thyroid are, are almost one and the same. So destroying your metabolism looks like this. Every version of it is under nourishment and overactivity or overstimulation. So let's say you're not eating breakfast or carbohydrates. Well, that's a whole thing, but like, let's just say you're just generally under eating, which unfortunately, if you are, you may not realize it, but if you're intermittent fasting, most days of the week, you're probably undereating because we're just, it's not common for Americans to like go be super nutrient dense for one or one and a half meals and have it be enough. So our thyroid requires carbohydrates digested well, which is reliant on good gut health in order to work optimally.

Christa (13:49):

And so sometimes taking in those carbohydrates will just make the bowels work better in general. So carbohydrates are a huge cofactor for supporting thyroid. So when we're talking about broken metabolism, it's uncomfortable because we've kind of adopted these things slowly. It's like drinking coffee for breakfast, skipping breakfast, cuz I'm not hungry. Well, you're not gonna have much of an appetite if your thyroid is sluggish and your metabolism is sluggish and what's, it's gonna look like is that you used to be able to restrict and lose weight. And now you restrict and you get puffy and you continue to gain weight. That's literally the transition of a thyroid being sluggish. So fun. Right? So what are some other nutrients that the thyroid needs? Well, I've alluded to some kind of tangent tune around, sorry about that. But there's lots of nutrients needed. So I talked about potassium being huge.

Christa (14:36):

So potassium foods I've talked about carbohydrates, but other nutrients needed for hormone production or for thyroid health include iodine, which is a whole topic. Let me come back to selenium found in Brazil, nuts, oysters, et cetera, zinc found in oysters. Nuts, cetera, tyrosine B vitamins, which come from well processed carbohydrates, often beli, et cetera, vitamin C in a whole food form, vitamin D vitamin E. This podcast is not about you going to take those supplements. Not at all. That's not what this is about. It's about you couldn't get those nutrients. If you weren't eating rich sources of those foods, which would be uncommon foods. It would be animal products, some animal products oysters and carbohydrates and digesting those well, et cetera. And then also vitamin a is really important. So if you've been randomly supplementing vitamin D on its own for a long time, we should make a podcast about that.

Christa (15:32):

You're driving down vitamin a they're competing for receptor sites. So this is important for you converting T4 to T3. This is the whole thing in my brain too, because when you have actually deficient thyroid by conventional standards, what's what the, the standard of care is to my understanding is prescri prescribing levothyroxine or Synthroid, which is a T4. And then how does that T4 become T3 if you don't have the nutrients? That's my question. So the conversion from T4 to T3 is improved from exercise, vitamin a zinc potassium. And if you take zinc by itself and vitamin D by itself, you're driving other deficiencies. So you really do need to get those from food sources. Unfortunately, the food sources of these are just not as common or we don't eat enough of them to compensate for the stressors that we're giving them. So so I have all kinds of questions about thyroid and how we're doing this.

Christa (16:26):

And I just think to myself like, oh my gosh, no, one's thyroid is okay. That's that's my current state. <Laugh> no one's how could the thyroid be okay in this modern world where we have stress. So this entire year I'm devoting as the year of thyroid to understand it better. So I've talked about assessing for hypothyroid, some of the nutrients that support it. And I wanna also give a little lip service to speedy thyroid or elevated thyroid hormone. So the symptoms for that look like shakiness, trembling, hands, heart, palpitations, unexplained, weight loss, loose stool, also anxiety, also sleep issues, excessive sweating, increased appetite, bulging eyes are greater, but what happens is when people have elevated thyroid hormones, sometimes they get diagnosed with graves and then they're given a medication to destroy this excess thyroid hormone hormone. And so you'll actually kind of swing to a hypo state or you'll have start to have those symptoms of a low thyroid state.

Christa (17:23):

So it can be a little bit complicated. So I was actually discussing with a friend recently just about we, we can't metal with medications. That's where the provider I'm really looking for like partnerships <laugh> or with providers and really looking at how we can empower people to understand how to support their thyroid more. So if I could tell you one, do you have a potentially sluggish thyroid despite your blood levels, two advocate for a full blood level workup or panel three, if you can't get one from your provider, order your own through direct labs or request a test it includes TSH free, T4 free T3, thyroglobulin and thyroid peroxidase antibodies. I think that's everything. Some people reverse T3 we talked about because if you go down the cortisol pathway, reverse T3 is elevated. Some of my other thyroid expert friends rec recommend even more labs, but from there, if that's okay, what can you do to support thyroid conversion and that's nutrients?

Christa (18:23):

So I was gonna actually tell you about iodine also. So selenium sink, tyrosine beef, I mean just looking for rich sources of these foods overall, but I wanna talk about iodine for a little bit, this, and I'm gonna give you some resources on how to like, keep this learning going for yourself. Iodine is a whole topic and guy Abraham made that a little bit, but he was an early iodine pioneer. And now I would say David Brownstein is the current pioneer that's alive. David Brownstein has a great book on iodine. And so iodine is a halogen and we learned in sixth grade science that things in the same line on the periodic table compete for space from each other. So sometime in the seventies, they were putting iodine in commercially processed bait goods as a do conditioner. And then the FDA's like, Ooh, it's a little much iodine.

Christa (19:13):

You know, we've had this whole, like, we used to use iodine for an antimicrobial and other things in, in medicine. And then we stopped using it. We tend to be like all or nothing type of people, but anyway, so it was being used in commercially processed baked goods. The FDA was like, Ooh, I think that's a little too much iodine. They took it out and put bromine in it. And so now the bromine and commercially processed baked goods competes for the iodine receptors and then the chlorine and the water is another halogen. So all of these halogens are in the same line, iodine, bromine fluoride or flooring. And I hope I got 'em all. I don't think I did flooring flooring. So we see a lot of fluoride or flooring and chlorine or fluoride in our water supply. Or if we sit in a hot tub and every time we do that, I'm not saying it's right or wrong.

Christa (19:58):

I would just say that our lives compete with iodine. And so where are we getting sources of it? We get really tiny microgram sources and food. And so anyway, this is a to be dis continued discussion on iodine, but it seems that every organ needs it. There's a whole lot of data that shows like if we have enough, we may have less instances of certain cancers. Why would that be? Because it's helping with estrogen breakdown, histamine breakdown, et cetera. And so it's a whole rabbit hole for another day, whole different podcast on iodine and the appropriate use of it. But it's just fascinating. And by the way, before I close out here, apparently urine iodine testing is the most accurate method of finding out. If you have adequate iodine, you get a loading dose of the iodine and a tablet, and then whatever you urinate out is extra, your body is getting rid of and what it's not urinating outta the percentage is what it needs to utilize.

Christa (20:55):

So I hope this has been kind of interesting for you. I think we're really missing subclinical, meaning not showing up on blood labs, thyroid hypothyroidism. I think that there's so many people experiencing symptoms of a sluggish thyroid, and it's looking like can't concentrate. I mean, I have my own story. Like I let an iodine loading test sit in my bathroom for a year. And then I thought this box is annoying. I should get rid of it. So I peed in the urine jug for an entire day, like you're supposed to, and my iodine was so stupid low. And the three days following the loading dose, I was like so focused. I never really thought, oh, I have brain fog. I just thought I have ADHD. Like I obviously have ADHD. I cannot focus. I like need to be on appointments. I can stay focused and get my things done.

Christa (21:40):

Cause I wanna squirrel around hope if you guys ever hear that <laugh> here. But it was just so remarkable my own experiences and then some of my client's experiences. So if you feel like you've got hypothyroid symptoms, test your blood labs, hears some books for you to read and learn a little bit more. And if it's a good fit for you, we have a program called food sensitivity solutions and the fatigue fix. It's two kind of separate programs that go together because I feel like if you have, if you feel like you're having food, sensitivities, it's gut issues overall, and other things going wrong, going awry. And I think fatigue is the other big thing. Even if you, I would just want you to feel younger as you get older <laugh> as a person who wants to also feel younger as you get older, I, once you have sustainable good energy.

Christa (22:26):

And so thyroid stuff, assessing that with mineral analysis, etcetera is all part of that program. This year, we're writing the program just three times in April. At the end of April, we start this version of this program, and then we'll start again in August. So here are some books for you to read. If you're just learning about this topic, why do I still have thyroid symptoms by dice? Carra? His last name is spelled K R K H a R R a Z I a N. I'd love to have him on the podcast. He's a mentor I've had of mine. I've learned from him and then overcoming thyroid disorders by David Brownstein MD. And this is one, that's a lot of case studies written by many, many people. It's kind of a cool one called to stop. The thyroid madness to how thyroid experts are challenging ineffective treatments and improving the lives of clients.

Christa (23:11):

So this episode is a cry for you to be a good advocate for your own health. And to let you know that even if your labs are fine, you don't feel fine. You're probably right. So this episode is sponsored by Rupa health. Rupa health is a lab concierge service that combines 25 labs. All in one dashboard saves me boatloads of time, freaking love Rupa health. And I love using them for conventional lab testing because the markers are often about five bucks. There's so much, they're like two-thirds, less than other direct-to-consumer sites. We use those for the programs I just mentioned in food sensitivity solutions and the fatigue fix. And if you're a practitioner and you're in private practice, I just implore you. Like, it's such a good thing. You can let me know if you have questions about it. I love, love, love, or be health Kerry Jones, who was at precision analytical, the founders of the Dutch test and Dutch Test is in charge.

Christa (24:04):

Or she's the medical education director at Rupa health now. And I, I mean, that says a lot. She's pretty incredible. So I love her. Go to Rupa health.com, and sign up for your free account. Let them know I sent you because they sponsor the podcast. And I love you guys. You're the best. I hope this episode is insightful for you. And I wish you well talk to you soon. Oh. And if you're interested in food sensitivity solutions and the fix, you can find out all about it on my website, over to christabiegler.com. I'll have the link in the show notes.