Your Lifestyle Is Your Medicine
“Your Life Style Is Your Medicine” is a podcast that focuses on how a person's lifestyle can be the key to health and happiness. Routed in the principles of lifestyle medicine, Ed Paget, osteopath, and exercise scientist, interviews area-specific experts on how lifestyle impacts well-being, focusing on purpose, physical activity, nutrition, sleep, and stress, which could lead to a longer, happier life. Edward now runs immersive lifestyle medicine retreats, with the purpose of helping others take back control of their lives to live longer and healthier.
Your Lifestyle Is Your Medicine
Podcast Episode 55: Dr Brittany Henderson
What if one of the most important keys to your energy, mood, and long-term health was hiding in plain sight — your thyroid?
Dr. Brittany Henderson, a board-certified endocrinologist specializing in thyroid health, joins me to unpack the truth about autoimmune conditions like Hashimoto’s, Graves, and Hashitoxicosis — and why conventional medicine often misses the bigger picture.
In this eye-opening conversation, we explore how a whole-body, root-cause approach can restore balance and help you feel like yourself again. Dr. Henderson shares practical strategies to support your thyroid naturally and insights that can improve not just your lifespan, but your healthspan.
Whether you’re navigating a thyroid condition or simply want to optimize your hormonal health, this episode is full of actionable tips and expert advice that can make a real difference in your daily life.
🎧 Discover how taking control of your thyroid can transform your energy, metabolism, and overall well-being.
Click here to Watch the Podcast Video.
Welcome to the your Lifestyle is your Medicine podcast, where we do deep dives into topics of mind, body and spirit. Through these conversations, you'll hear practical advice and effective strategies to improve your health and ultimately add healthspan to your lifespan. I'm Ed Padgett. I'm an osteopath and exercise physiologist with a special interest in longevity. Today's guest is Dr Brittany Henderson. She's a board-certified endocrinologist and leading expert in thyroid health. She's completed her fellowship at Duke University and later led thyroid programs at both Duke and Wake Forest. She now runs a dedicated thyroid clinic focusing on autoimmune conditions like Hashimoto's, thyroid nodules and Graves' disease.
Speaker 1:Dr Henderson combines mainstream medicine with a root cause approach, including advanced, minimally invasive treatments. She's also co-founded the American College of Thyrology and has been published in top journals, including Thyroid and Endocrinology. Her mission is simple help people with thyroid disease feel better and take control of their health. Now, I didn't know this when I interviewed her, but she is actually one of only a handful of endocrinologists specializing in thyroid disorders. So it's such a treat to speak to her and pick her brains about how she does this and also the future of thyroid medicine. So enjoy this episode, take notes, because she is a firecracker and she gives so much information on this podcast. So, Dr Henderson, welcome to the show.
Speaker 2:Thank you so much for having me To start with.
Speaker 1:I want to give my listeners an idea of what an endocrinologist is, to sort of paint the picture for them of who you are. So can you do that for us?
Speaker 2:Absolutely so. Endocrinology is basically the study of endocrine organs and your endocrine system is a very complex system. You know, in medical school when we're learning all of the different systems, it's probably one of the ones that people dislike the most because it can be complex. I liked it the most because I have a chemistry background and it all makes sense. You know, the hormones have negative feedback loops where they feed back onto the brain, and hormones affect pretty much all bodily systems because they travel in the bloodstream to different organs and they have different effects in different organs.
Speaker 2:So it is the study of hormones and there are multiple endocrine organs. Thyroid is one of them. Pancreas is one of them. Pancreas affects blood sugar and insulin. Diabetes is an end organ issue with the pancreas. Adrenal is one of them and that is associated with cortisol and stress hormone. Pituitary is a big one in the brain. That's the master endocrine organ. Um, and your gonads are all hormonal as well. So, like female hormone overlap is an endocrine organ as well. So, um, I I really enjoy, um, abstract thinking and thinking through how all of these hormones can affect multiple different parts of the body and maybe seemingly be unrelated to each other. But all hormones, I always tell my patients all hormones affect all other hormones. So piecing this together as one person and one puzzle is what we're here to do as endocrinologists.
Speaker 1:So you're 100% right. I remember studying the endocrine system when I was at school and the abbreviations, the anacronyms, all the interactions. It was beyond me. So my hat is taken off to you because I just don't remember any of that. Okay, so an endocrinologist, a regular endocrinologist, would they specialize in just one endocrine gland, like you do, or would they have a wider approach?
Speaker 2:Typically endocrinologists are general endocrinologists, you know they don't typically subspecialize in just one organ, although in an academic institution or like a, you know, bigger institution sometimes they do have a pituitary specialist or thyroid specialist, but in like your regular community, usually an endocrinologist will specialize in all of the different endocrine organs. And typically, you know, because there's such a huge need worldwide for diabetes doctors, endocrinologists are pigeonholed into becoming diabetes doctors because a majority of their practice is there for insulin resistance or for type 2 diabetes or type 1 diabetes and organs like the thyroid, for example, gets pushed to the side. So being a specialist in the thyroid or in one of these other endocrine organs that are not pancreas or not related to diabetes is kind of abnormal.
Speaker 1:Yes, how did you get into this, as you say, abnormal route, like, what was it about the thyroid that attracted you to it?
Speaker 2:So I don't have a personal thyroid story. I know a lot of people get into thyroid medicine because they're affected by it and that completely makes sense because it is life altering. When you have a thyroid condition it can affect all parts of life. I do have a family history. I have a sister with thyroid issues, I have a sister with thyroid issues, I have a mom with thyroid issues but I don't have anything myself.
Speaker 2:The reason I liked it so much is because when I was in residency I worked with an endocrinologist who was a general endocrinologist and he saw diabetes and thyroid and adrenal and all of these things. I really like the fact in thyroid that it affects women primarily. You know, 10 to 1 women to men. We don't always understand why that is, but it definitely affects women more than men and it affects all different things, from everything from hair to fertility, to weight, to extreme fatigue, fatigue to GI tract. I mean the thyroid hormone is rampant throughout the body. It has effects in all of these bodily systems and I like the fact that if you get it right as a thyroid specialist and as an endocrinologist treating this, you actually can make a huge difference in quality of life for patients.
Speaker 2:So I went into medicine because I wanted to help people and fix things. I don't love the chronic disease management part of endocrinology. A lot of diabetes clinics. It's just like, okay, let's see your blood sugar, you know. Okay, let's go up a little on your insulin, and there's no time to talk about diet and lifestyle and all of these really important things that actually fix the underlying problem. So I'm a fixer and thyroid can be fixed and I love that part of it. And I also really like the fact that there's procedures involved. You know like we do all of our own thyroid ultrasounds at my clinic and we do biopsies and we treat thyroid cancers and we can do all of that too. But I like the fact that it can be fixed. I like the fact that people can regain their life and their quality of life and that's, to me, is it helps me keep going, because being in medicine can sometimes be really hard.
Speaker 1:Yeah, I really liked that analogy you gave there of diabetes, where I can see that if someone has diabetes and they manage it with either injections or metformin, whatever, their lifestyle doesn't change hugely. And I see it in my mom's diabetic. She has been for years but when she gets it right, nothing really changes. But I see what you're saying when the thyroid's out of whack and you get it right, everything can change for the better.
Speaker 2:Everything of whack and you, you get it right. Everything can change for the better, everything. Yeah, I have had success story after success story with you know 70 year olds coming in being like I haven't felt this good since I was 22, like crazy. And then fertility like fertility and the thyroid is a big deal and, if you get it right, people don't need ivf and that is huge. Like if you can impact somebody for to be able to have a family. I mean like those kinds of things are life changing and to be part of that is rewarding.
Speaker 1:Hugely. So let's talk about thyroid, because I think it's becoming more into the public zeitgeist the awareness of thyroid problems. Is that because thyroid problems are increasing in frequency, or is there another reason for that?
Speaker 2:I think that thyroid problems are increasing in frequency. So autoimmunity in general, which a majority of thyroid issues are autoimmune, typically either immune system attacking the thyroid and becoming hypothyroid, or immune system attacking the thyroid and becoming hypothyroid, or immune system attacking the thyroid and making the thyroid produce extra thyroid hormone, hyperthyroidism. And they even you know, world Health Organization and some of these other health organizations have started autoimmune task groups to look at this, because it's not just thyroid that's a problem. It's all of these hundreds of different autoimmune issues that are on the rise and continuing to increase. I think it's because we live in a very dirty world with dirty food supply and our immune systems are like what the heck's happening? But autoimmunity is increasing. Thyroid is increasing as a result.
Speaker 2:And even if somebody doesn't have an autoimmune disease or an autoimmune thyroid issue, there's so many reasons why people might have abnormal thyroid function and one of the main drivers of that is inflammation. Inflammation in general can mess up thyroid hormones. Obesity can mess up thyroid hormone metabolism. So there's many reasons for abnormal thyroid and the reasons are rampant. Like almost everybody has inflammation, almost everybody you know has something that is driving their immune system to be active at some point in their life, whether it's a virus or a viral infection or whatever it could be, but very, very common and increasing.
Speaker 1:And does stress play a role in that as well?
Speaker 2:Yeah, so stress and chronic, we call it HPA activation. Hypothalamic pituitary adrenal activation is very it's very activating to the immune response. So stress hormone can activate an autoimmune response. We see that in kids and like the pediatric population when they get type 1 diabetes and they present with type 1 diabetes Typically it's after either a viral infection or extreme stress and that's because that activation is impactful for the immune system and it can skew the immune system so that it starts down this autoimmune pathway, usually with TH17 dominance or TH2 dominance and a decrease in TH1. It's part of the immune response. But yeah, I mean, there are so many things that we as humans are exposed to. Compared to back in the day when we didn't have all this exposure to dyes and additives and food stabilizers and shelf stabilizers and many different viruses that never were a problem back then, it's crazy how rampant it is.
Speaker 1:And has there been any research to say that this particular chemical causes thyroid? Or is it just this sort of onslaught that we have on our sort of on our systems that we can't handle it anymore?
Speaker 2:We know that the thyroid uses iodine, you know, in order to make thyroid hormone. That's the main element that it uses to make T4 and T3. So any halogen, any halogenated chemical can disrupt that process. So if you look at, if you remember back to chemistry in the periodic table, that's your bromide and your fluoride and your iodine, your chloride, all of the chemicals that are in our society are brominated. So it's everywhere. You have fluorinated chemicals on your nonstick pans and your cookware, you have PFAS and you have PCBs and PCBs those are brominated chemicals. Those are your flame retardants that are in your mattresses, they're in kids pajamas, they're in couch cushions, um, and then fluoride is in the water supply.
Speaker 2:So, like pretty much, we're all being exposed to all of these chemicals all the time. And once you're exposed, a lot of them are forever chemicals. They're fat soluble, they stay within the body and they accumulate with aging. So as you age you're, you have a higher and higher toxic chemical load. It's really hard to avoid them. But all of those chemicals we know are associated with thyroid dysfunction.
Speaker 1:Okay, now, before people start freaking out, I want you to give us some good news, because that sounds to me like oh, I've got to throw my mattress away, I've got to redo my water supply, or what can people do just on a very practical day to day level to clean up their environment in their house?
Speaker 2:I mean, we can't live in a bubble, that is true, and we live in a very dirty world. We really like messed it up with all these chemicals. But what I usually recommend is, if you like, do easy things, like if you're cleaning with cleaning products, use either like natural products or, if you're not using natural products, please wear goggles, wear gloves, you know, wear a mask, because you can be exposed to these chemicals just by inhaling them. You know, if you're cleaning the bathroom and you're inhaling a bunch of this stuff, it's probably not good for you. Cleaning the bathroom when you're inhaling a bunch of this stuff. It's probably not good for you.
Speaker 2:You can do easy things like put a filter on your faucet or put a filter on your shower head. Those are easy things to do because some of these chemicals, like organophosphates and pesticides, they're in the water supply. They don't have to be removed and you can get exposed through your skin. So that's an easy thing to do. When you're showering, you know, consume clean water. Also, you know the air supply is hard, but doing like a HEPA filter or something in your bedroom or in your house as much as you can, that's helpful. Don't go spraying Roundup all around your garden and the. You know like I mean those kinds of easy things to do, um, and if you have to spray chemicals, make sure you wear protection. Um, but those are, you know, easy ways to kind of minimize your total toxin burden.
Speaker 2:Cook with nonstick cookware. Cook with, you know, cast iron skillet or something instead, um, and cook with, you know, cast iron skillet or something instead. And, and do your best to eat as organically as possible, by by the dirty dozen, organically, you know. Do those little things where you know you're gonna get the biggest bang for your buck because you can't do everything. Try to maybe not use fluorinated toothpaste too, but those little kind of tweaks can make a big deal and help regain health.
Speaker 1:Perfect. And does thyroid or do thyroid issues run in families as well?
Speaker 2:Absolutely so. In our clinic we always ask about family history. Usually there is a family history of thyroid. So that is one really easy thing. If you are listening and you're, you know, thinking, oh, do I have a thyroid condition? Ask your parents, ask your aunts and uncles, you know, ask people in your family if they have a thyroid issue. Many times because people didn't used to talk about this stuff so many times you'll ask and find out oh yeah, I've had a thyroid issue for 15, 20 years. It's not a big deal, but it is.
Speaker 2:When you're trying to figure out your family history. It's very, very commonly in women, in families. But I always tell families that if there's a man in the family, like your dad has it or your grandfather, it becomes extremely highly penetrant, meaning that everybody gets it Men, women, kids. It starts at a younger age. So if there's a male in your family with Hashimoto's or an autoimmune disease, everybody should be screened below that in that line.
Speaker 2:And I always tell people like if your kids are 10 years old, screen them. You know, you don't want to just screen their TSH or their thyroid number. You want to look at the antibodies for Hashimoto's or for Gra want to look at the antibodies for Hashimoto's or for Graves, because it's the antibodies that come up first and start to attack the thyroid gland. It can take five to 10 years to attack the gland enough where TSH comes up or they become hypothyroid. But if you catch it early you can make these small little tweaks to lifestyle that can really make a big impact, especially for kids, because kids have the ability to regenerate thyroid tissue and they have the ability to go into remission versus older people really don't.
Speaker 1:Okay, so we mentioned a few things there as well. So Hashimoto's, which is a hypothyroidism, and Graves' disease, which is hyperthyroidism, and some of the markers you look for in blood tests. Okay, but what I'm interested in there is, let's say that there's a male in the family who has a thyroid problem. You want to check the kids before they have symptoms, Is that correct?
Speaker 2:Yes, and especially if they have symptoms, because I use 10 as a cutoff age but kids can have Hashimoto's down to four or five, six years old, years old, I mean. It can start early In kids and in adolescents it usually presents more as anxiety, depression, mood swings, fatigue, you know. But because of that antibody load and because the immune system is attacking the thyroid, the thyroid can basically secrete extra thyroid hormone randomly in a destructive thyroid process and that can manifest as mood changes in these kids. So mood issues, you know, fatigue in a child, growth problems all of those things can be thyroid, and especially if there's a strong family history we screen families all the time and if you can catch it early you can save these kids from having to go on lifelong thyroid replacement. And if you can catch it early you can save these kids from having to go on lifelong thyroid replacement medicine if you can make lifestyle changes and get the immune system to calm down.
Speaker 1:And what about in adults? Is there a sort of early screen that adults could do to potentially catch something early?
Speaker 2:Absolutely. They can do the same, you know, if they don't have a known thyroid issue and their TSH still looks good. If there's a strong family history, then checking the antibodies against the thyroid is the way to go. Many primary doctors or regular doctors don't check those routinely. So they may check your TSH and your TSH might be in the normal range, but they're not checking the thyroid antibodies, which is the problem. That's what happens first, the antibodies and the immune system starts attacking the thyroid and it can take years and years and years before a TSH becomes abnormal or before you develop hypothyroidism or hyperthyroidism, which is the end organ damage from an autoimmune condition.
Speaker 2:So the two most common antibodies in Hashimoto's something called TPO, thyroid peroxidase antibody, and TG or thyroglobulin antibody. They can be easily checked at any of the major labs. There are even some finger stick kits that you can even order on the web. There's one called let's Get Checked. You can just order it and it checks the antibodies and it's a finger stick, so you don't even have to involve your, your doctor, but easy things like that.
Speaker 1:Especially if there's a family history, it's it's worthwhile to check it off the list yeah, that's really interesting because sometimes well, I mean, we're in Canada and the UK as well, has it there's a socialized medicine where you can ask for things, but you might not get it because it's not part of the routine screening. So it's good to hear that there's other ways around that, that you could take that into your own hands and then perhaps go back to the doctor again and say, hey look, I did this. Is that enough evidence for you to ask for an antibody test?
Speaker 1:Yeah, they're really good, good, so absolutely yeah what we haven't talked about are the sort of two most common um forms of uh thyroid autoimmune, um diseases like Hashimoto's and Graves. So could you give?
Speaker 2:us an overview of Hashimoto's, some of the symptoms a person might get, and then what you would test for and how you would treat that prevent the thyroid from making thyroid hormone. So because the thyroid can't make thyroid hormone, the patient becomes hypothyroid or underactive thyroid, so not making enough. And then on the other end is Graves' disease, which is an autoimmune attack on the thyroid and the immune system basically tells the thyroid make extra. So the patient becomes hyperthyroid or overactive and then there's everything in between. So two ends of the spectrum. But there's a lot of gray in autoimmune thyroid disease.
Speaker 2:So people with Graves' disease can have Hashimoto's antibodies. People with Hashimoto's disease can have Graves' antibodies. We call that Hashitoxicosis. It's a middle kind of one. So there's a ton of crossover and in addition to that, one person's antibody is not equal to another person's antibody. So some people can make really really strong antibodies and it can just be right outside of the reference range. It's not very high, but they're terrible antibodies and they make somebody feel terrible. And then some people can have antibodies in the thousands, you know, really really high, but their antibodies are very weak and they don't do anything and so the patient feels fine.
Speaker 2:It's a whole spectrum of disease. It's your immune system that's making those antibodies and we're just reading it on the lab. Because I even have some people whose antibodies for Hashimoto's or Graves' disease cannot be read at a regular lab, but you have them check it at a different lab and then that lab can read the ones that they're making. So it's definitely nuanced and there's not just one-size-fits-all approach to this. It's very, very individualized. But to kind of simplify it, hashimoto's is hypothyroidism, graves is hyperthyroidism and Hashitoxicosis is in the middle. It's both okay.
Speaker 1:So someone comes to you and they think they've got a thyroid problem. What symptoms would they would they present with if they had a hypothyroid or Hashimoto's?
Speaker 2:So typically, the most common is fatigue. Everybody, though, has fatigue, so that's hard, because fatigue is like coming to the doctor and saying I have a temperature, you know, I have a fever. Why do you have a fever? You know why are you fatigued? It could be thyroid, it could be a vitamin deficiency, it could be that you're not sleeping well. There's many reasons for that, but this is described by thyroid patients as like extreme fatigue, to the point that I'm not just like tired, like I didn't sleep, like I have to go to bed at two o'clock in the afternoon. I cannot keep my eyes open.
Speaker 2:Kind of fatigue, weight changes or weight gain is a very common symptom that patients present with. Also, brain fog, not being able to think clearly or think about correct words. That can be multifactorial as well, but hypothyroidism is one of the more common things. Hair loss, skin dryness, nails breaking nail, brittleness, constipation, um. Irregular periods are very heavy periods, um, and then fluid retention, feeling like they're really inflamed, um. So those are some of the most common presenting. There are multiple issues, you know. There there's low heart rate, there's high diastolic blood pressure, there's low temperature, basal body temperature. So, again, this is an endocrine issue. It's a hormone that affects all of the different bodily systems, and things that you wouldn't think really are related at all can be related and can be fixed when you're on the right thyroid medicine.
Speaker 1:That's interesting. You mentioned blood pressure there as well. That's not one I've actually heard of before. How does that work?
Speaker 2:Because thyroid hormone has receptors in the vessel wall, so the arterial wall is a muscle, so there's receptors within the cells and it does impact cardiovascular function. There are thyroid hormone receptors on the heart and in the vessel wall.
Speaker 1:Interesting. Okay, so listen to that. I've got three sisters all over the age of 50, and I can tell you that each one of my sisters will be like that's me, that's me, that's me. So how do you differentiate between a lady going through menopause and thyroid problems?
Speaker 2:Hard. There's a lot of overlap and I started this with saying all hormones affect all other hormones, so really it can be kind of a gray area that there the brain fog issue can be seen in menopause and perimenopause, that's, estrogen deficiency, so that improves. Like on hormone replacement, sleep issues can be primarily menopause. Weight changes can absolutely be menopause because of deficiency in estrogen and the fact that fat tissue is metabolized differently and you basically deposit a big fat around your stomach. It's lovely. But you know there is a huge overlap between female hormones and thyroid hormone and it is a really, really hard time for patients who have both. So if they have a thyroid condition and they have menopause going on, we're seeing each other a lot because there's a lot of changes going on. But again it boils down to like knowing your family history, knowing what your symptoms are, being open minded that maybe it's not thyroid but at least we should check it. You know we should double check. That that's not the issue because it's a very fixable problem if you're on the right medication and you're with the right provider and then you know female hormone replacement is life changing for a lot of patients. You know it's terrible, like some of the studies, like the Women's Health Initiative and like all of the scared tactics that were used against women for hormone replacement.
Speaker 2:Now, you know, with some of the new research coming out showing, like, how much benefit there is to estrogen and progesterone replacement. And I always tell my patients you know, of course, like anything that you do, there's risks and benefits, but but hormones, hormone replacement, does not cause like breast cancer or endometrial cancer. That's a failure of the immune system. Yes, estrogen, progesterone can drive those cancers if they're estrogen or progesterone receptor positive. But being up to date on your screening, like make sure, making sure that you're living a healthy lifestyle, you're not spraying Roundup all over, you know like those kinds of things can prevent cancer. But, you know, replacing these really important hormones that affect quality of life and are really, really helpful for people, it's really important to weigh that benefit.
Speaker 1:Yeah, I think that's really well said, and I can see how teasing out the symptoms from the blood tests with the correct replacement hormones or the correct thyroid hormones is. That's really is a skill and probably an art form as well.
Speaker 2:I call it a 4D puzzle because they all affect each other, so you have to like piece it together and it's not not everybody's the same and you know, I tell people that like sometimes it really isn't the thyroid and that's okay. But like, let's at least point you in the right direction to figure out what it is so we can fix it.
Speaker 1:Let's go to the other end Now. Let's go to grave disease. So what would, what would the symptoms be and what would you look for in the in the blood work of someone who has Graves disease?
Speaker 2:So Graves disease, you're gonna really know something's wrong. Um, so when the thyroid is overactive and you have too much thyroid hormone, you are, you feel terrible first of all. Um, so you can have heart palpitations, heart racing, a resting heart rate. If you have, you know, an apple watch or something where you're watching your resting heart rate, it's going to be high, it's going to be in the nineties hundreds, you know, one tens at rest. That's not normal. Um, you're going to have potentially shortness of breath. You're going to have, um jitteriness or tremor. Um, you can have skin changes and hair changes.
Speaker 2:You can have actual like bugging out of your eyes in Graves' disease, and that's a crazy symptom. But it's because there's homology between the TSH receptor antibody, which drives Graves' disease, and something called IGF-1 receptor which is behind the orbit, and so basically it increases the fat and the muscle behind your eye and there's nowhere for your eye to go but out. So these patients have what we call proptosis, or just bug eyes. It can affect vision. People lose their vision from this and then you know, diarrhea is another very common symptom insomnia, not being able to sleep, just feeling like you're revved up as opposed to fatigued, and some patients don't have a ton of symptoms.
Speaker 2:If you've been hyperthyroid for a while, you may not really have a ton of those symptoms or it may be more subtle than what I'm describing. But again, there's a whole spectrum of disease and your antibodies are your antibodies, so they can be super aggressive and super problematic or just a little bit problematic. Regardless, you know, getting the thyroid numbers checked is important and really getting on top of that is important because if it goes untreated it can cause issues. It can cause things like atrial fibrillation, which is funny heart rhythm. It can cause osteoporosis and bone issues and fracture and all of these things. So really important not to let it stay that way.
Speaker 1:What do you look for in the numbers when you're, when you were diagnosed that?
Speaker 2:So that probably is a little easier to diagnose because it's not as subtle as hypothyroidism. Tsh is typically low, and that's again. Tsh stands for thyroid stimulating hormone. It is not a thyroid hormone, it's actually a pituitary hormone in the brain. And so when the thyroid is under, this craziness with the immune system and the immune system is telling the thyroid to make extra T4 and T3. That feeds back onto the pituitary and says hey, we have tons of thyroid hormone around the thyroid's doing extra good, so shut off the TSH signal. We don't need a signal to tell the thyroid to work, and that's you know what negative feedback is. And so that's why TSH is low in that situation.
Speaker 1:So a friend of mine recently got diagnosed with that and her symptoms to start with were the racing heart rate, just like not going down all through the night, and she went to emergency. And then that's eventually. She went to that diagnosis but interestingly she also got very sore shoulders, like what I would describe as the beginning of a frozen shoulder, but ultrasound suggested bursitis. What's the connection there?
Speaker 2:It's funny you ask that because I do actually get referred patients from many of the orthopedic sports medicine physicians in the area for frozen shoulder for those very issues and the overlap there is inflammation. So inflammation is the driver behind frozen shoulder, no matter what the underlying cause is, and inflammation drives autoimmune disease. Autoimmune disease drives inflammation. So when you have Hashimoto's or when you have Graves, you're in a state of active inflammation and the thought is, if you can reduce inflammation, not only can you maybe get frozen shoulders under control, but you can get the autoimmune process to settle down against the thyroid and hopefully obtain remission. And what I mean by that is getting the antibodies into the negative range or at least low enough that you're not getting all of these symptoms.
Speaker 2:But there's a huge overlap between joint pain and back pain and muscle pain when the thyroid is off. We see that all the time. Also, in menopause there's a huge issue. So there's muscle pain and joint pain with menopause as well and you get on the right hormones and that gets fixed too. But figuring out what's driving inflammation, that's the key to autoimmune disease in general. That's the key to chronic orthopedic issues and inflammation in general and the key to all human disease. Inflammation is the cause for all of it, and figuring out whether it's, you know, like total toxin burden you're being exposed to a chemical every day, or whether it's your GI tract and gut microbiome, or whether it's a food or something that you're sensitive to, but all of it boils down to inflammation.
Speaker 1:Yeah, well, let's get. Let's get our functional medicine hats on and talk about the gut for a little bit, because Maybe my listeners have heard this as well, but this is something that seems to be doing the rounds that inflammation starts in the gut, and you've mentioned a few different ways that inflammation can happen, and one of those was the gut. Do you feel as though the gut is one of the key players in autoimmune disease, or is it sort of a player equal to the environment on the outside? What's your thoughts on that?
Speaker 2:It is a major player. Um, there are other things like viruses that are a big component to autoimmune disease, but gut microbiome and gut health is in. If it's not right, it could lead to a skewed immune system at baseline, which a virus then comes and skews even more into autoimmunity. So gut health is probably one of the most important things to be right in a human person, whether or not you have an autoimmune condition. I wish everybody could look at their gut microbiome multiple times a year. You know, right now at least, it's cost prohibitive for a lot of people to look at a gut microbiome test, but it really is that important If you think about it.
Speaker 2:I mean, your gut microbiome is composed of billions and billions of bacteria. It's like if you had an infection in your sinuses or urinary tract infection or a skin infection full of bacteria. If that is going rampant, if you have a lot of bad guy bacteria and it's driving inflammation and in your immune system, then you're basically causing an upregulation of your immune response because of the bacteria that is in your gut. So you have to have beneficial bacteria there. You have to have a calm microbiome. You can't have an overgrowth of E coli and H pylori and all of these things that drive an immune response, and you have to be eating food and being exposed to, like you know, environment stuff that isn't basically activating your immune response to try to kill off the artificial whatever that you're ingesting.
Speaker 2:So gut health, I do believe, is probably the most important thing. You know, viruses and stuff can cause autoimmunity, but your immune system's probably already primed to go the wrong way because of GI health and gut health, and we all have worsening and worsening gut health because we're all exposed to all of these chemicals and environmental exposures and food issues. Even organic food has problems now with, like you know, it's supposed to be organic but there's a farm next to it that isn't organic. So so, yeah, I think, in summary, the gut microbiome is probably the lowest hanging fruit in all inflammation and all autoimmune disease.
Speaker 1:So if you're working with someone, do you just give them the replacement therapies or the ablation if it's, you know, hyperthyroid, or do you look at the whole person and the whole body and try and help them with their gut microbiome as well?
Speaker 2:Yeah, we look at the whole picture. That's the only right way to do thyroid disease. It's the only right way to do human health in general. I was trained as a conventional MD. I went through the regular stuff but obviously I realized just by listening that we're not doing a complete job and it shouldn't honestly be two silos, with conventional medicine doctors over here just pushing pills and integrative or functional medicine over here doing the hard work of like figuring out what the underlying root cause is. It should be both married together. That's correct medicine.
Speaker 2:There's only one right way to do it and that should be a conversation that you're having, especially with somebody coming in with an autoimmune disease, where you know something is driving the immune system to activate. You have to figure that out or else they're not going to be able to because the antibodies in the background are going to be wreaking havoc even if your medicine is perfect. So a big part of our conversation when we see them initially, we run through a whole list of questions and gut microbiome is one of the biggest ones. Um, but trying to figure out what can we impact lifestyle wise, what can we impact immune system wise and inflammation wise, to try to obtain wellness, because if we do that we get into remission. You know, 10 to 15 to 10 to 15, maybe even up to 20% of my patients get off their medicine eventually their thyroid medicine, once they obtain remission especially if you find it early so much easier to do that and then you know, their GI tract goes back to normal, they, their other hormones get back to normal, they are able to lose weight better.
Speaker 2:You know it's a whole downstream effect and we're able to get people off their chronic medications instead of continuing to add and add and add, because the whole point of being in healthcare is to help somebody get well and I think conventional medicine really does patients a disservice, especially like conventional endocrinologists who are the general endocrinologists and are treating this chronic diabetes situation. How many of those doctors have time to talk about diet and exercise and gut microbiome for diabetes patients? Like none of them. None of them. And that's you're never going to fix the problem until you fix the underlying problem issue and gut health, environmental health, food, all of that is that's what needs to be fixed I agree, I agree, but uh, there is a a problem in that.
Speaker 1:Isn't it just easier to take the pill, get the levels tested every now and again and not think about it like or too easy?
Speaker 2:it's not the right approach and and it's honestly easier to fix the problem and have somebody feeling so much better, you know, six to twelve months down the line then manage somebody who chronically gets worse and worse and worse, starts to lose limbs and has a diabetic foot ulcer and is losing their vision Like that's terrible. Nobody went into medicine to do that, you know. People went into medicine to fix people's health and some of it's not fixable. Some of it is chronic disease. But many of these metabolic issues and these hormone issues are fixable, especially thyroid.
Speaker 1:So, with that in mind, if someone was considering some sort of zapping of their thyroid, like the radiation pills I think they used to take, is that right? So it went to the thyroid with iodine. Is that something that's still done? Because once that thyroid has been damaged, it never regrow. Is that correct?
Speaker 2:that's right. Yeah, so that is conventional medicine solution. Yes, and I guess one question you could ask me is I've been, I've had my own practice for now seven years. Before that I was in academia and stuff. So I have my own thyroid practice now and if you ask me, how many times have I ordered radioactive iodine to zap a thyroid? It's probably one or maybe two in like seven years and I have lots of Graves patients.
Speaker 2:So we get people into remission is what we do. Or you know, if it's too far gone we will recommend surgical removal over radioactive iodine, just because you basically get better control over antibodies and you don't have the risk for recurrence and you don't have the risk for worsening thyroid disease. But many of these Graves patients, especially if their antibodies are reasonable, can get into remission. We do that all the time and I use a special technique called block and replace which is in the literature, but there's not a lot of literature. But if you do it right, people will get into remission if they're not starting from a crazy place and their antibodies. Sometimes people are so far gone with their autoimmune disease that you can't get remission, and same thing goes for Hashimoto's. I tell people that all the time, but it is definitely doable. And yeah, I don't do a lot of radioactive vitamin, but that is something that is conventionally taught and it's not unreasonable. It's just not my favorite way to do it.
Speaker 1:So you hinted at something there block and replace. Tell us more about that.
Speaker 2:Block and replace basically means that you use an antithyroid medicine, like it's something called methimazole or PTU, to block the thyroid from making extra thyroid hormone, and then you replace what you're blocking. So you go on thyroid medicine to replace that. It's kind of like simulating a thyroid surgery. So you're kind of hiding the thyroid from the immune system and you're allowing the immune system to quiet down against the thyroid. And while you're doing that you're also working on these underlying root causes of inflammation, like the gut microbiome, fixing all of those things so that you can calm the immune response down, so that the antibodies for Graves which are a little different than Hashimoto's antibodies, antibodies for Graves' disease are TSI, thyroid stimulating immunoglobulin, and TRABS, thyrotropin receptor antibodies. But those will go into remission and then you're good to go. You know so and you know there's a whole process to like titrating and doing all of this, but it's a very effective way to achieve remission for Graves patients and for Graves patients.
Speaker 2:A lot of times they are only given radioactive iodine in surgery as options and this isn't even on their radar because many conventional doctors and many integrative functional doctors don't know about it. They don't use it. It's not very well written in the literature, but it's so effective and it's so easy to do so. When I get time I'll have to write some things in the literature, but it's so effective and it's so easy to do so. When I get time I'll have to write some things in the literature, but for now here's the word out on a podcast and hopefully somebody who treats thyroid will will hear this.
Speaker 1:Yeah. So I can imagine some people listen to this and saying, well, my endocrinologist doesn't talk about any of this stuff and I want an endocrinologist who specializes in thyroid. Are there more of you about, and if so, how do we find you?
Speaker 2:There's not very many of us, unfortunately, but there are. There are some. So I'm in Charleston, south Carolina, and I'm licensed in nine states throughout, like the southeast and north and Minnesota. I'm in Minnesota and I'm in Ohio, so if people are on vacation places sometimes they can see me in those states.
Speaker 2:I have a telemedicine practice called my Thyroid Doctor, but it's really hard to find thyroid specialists who understand like autoimmunity and work on like integrative or functional medicine in addition to the thyroid. There's not like a really good website, although I will say like I don't know. If you know Dr Isabella Wentz, she has like a whole list of providers on her website that kind of you can look at like where you're located and if there's somebody near you that does that, the Institute for Functional Medicine is a good resource. They have a find a provider page where you're located and if there's somebody near you that that does that, the institute for functional medicine is a good resource. They have a find a provider page. Not all of them are thyroid specialists, um, but those kinds of like lists are sometimes very helpful and and whenever I have somebody who's in a specific place and I don't know who to tell them, a lot of times I'll tell them go onto Facebook and join the thyroid group in your area or the mom's group in your area and ask the question, because people talk and they know who the good people are in your area.
Speaker 2:But yeah, we have patients who come in from all 50 states and internationally. We have Canadian patients, we have patients from Europe come in because it's so hard to find good thyroid care and we're working on that. You know, I really am trying to educate more. Get on podcasts, educate providers. I have a whole Instagram where I educate patients. But really, as a patient in this crazy world where there are there's not good thyroid care, being your own advocate and pushing for these labs, pushing for, like you know, knowledge of what are my options. Don't just stop at what your endocrinologist suggests, cause that may not be the only thing that's out there. It may be the top of their knowledge. They're not doing it like on purpose to not give you the information but they may be more of a diabetes specialist and they may not know all of these things. So, with the, with social media and with being able to ask questions to people all across the world, there are resources to be able to find out this information.
Speaker 1:And aren't you forming an association of thyroid specialists, or did I hear that somewhere?
Speaker 2:an association of thyroid specialists or did I hear that somewhere? Yeah, we are, and like a lot of these things take time and, like I said, there's not very many of us, so like I could probably count on like one hand the amount of people I know that know thyroid well, it's not it's that bad and obviously we can't treat everybody in the world. So there has to be an educational portion to this where we train providers, endocrinologists, you know, nurse practitioners, pas, and so that is in the works and in process. We have a whole thyroid course for both patients and for providers. It's on my website and we can maybe put that in the show notes, but there's a whole like six week course about all of this and you know what kind of medicines are available and how to impact the microbiome and things. So so that's out there already. And then you know a lot of this is so nuanced that being able to kind of like work with a provider so they can understand things is important and we're working on that whenever I get more time.
Speaker 1:But that's what needs to happen.
Speaker 2:You know that's. What needs to happen is more education for providers.
Speaker 1:And do you feel like there's a something coming in the future for thyroid care or will it be this more education for providers approach?
Speaker 2:I know that they are working on different ways of delivering thyroid medication, which I think would be very helpful. So I know they're working on like a once a week injection for T4, which might mimic normal thyroid hormone a lot better than our fake little medication. That might be really helpful for patients. I know they're working on different ways to administer T3, because the T3 that we have available is not the best. It's very instant release. It doesn't mimic the normal thyroid the way that it should.
Speaker 1:Right, the rhythm of the thyroid within the circadian rhythm. If it doesn't mimic that, you're going to feel jittery sometimes, right, yes?
Speaker 2:Yeah, it's not a perfect product. So, as they maybe improve some of the administration of thyroid medicine, that's going to hopefully improve patient symptoms. But the way that we're doing it now and the way hopefully, you know, this next generation of endocrinologists and practitioners will be more open to other ideas, because the older crowd is not, you know they are, you know, put everybody on the same medicine. It's one size fits all. That is not true and there are a lot of people that have suffered because of it. There are a lot of people still suffering because of it. But I would say, like, as an endocrinologist who started out, seeing those people in charge, versus what's happening now, I really do think like advocacy groups and patient groups and patients speaking out have changed things and there are more and more endocrinologists that are treating thyroid better better that maybe they're not perfect, but they're actually using combination therapy or they're looking at a full thyroid panel like that's huge. That's something that did not used to happen. So we're making progress.
Speaker 1:That's awesome to hear that there's progress being made and there's people like you flying the flag and leading the way as well.
Speaker 2:Yeah, no, it's interesting to be at the forefront of something where you know the people who used to be in charge look at me like I'm crazy, and then the people who understand are like, okay, let's go and it's just. You know kind of to be right, but have people understand why that's the case, because there's really only one right way to do this. It's not rocket science, it's just doing it correctly. And there's a lot of bias and prejudice and old thought in the thyroid community.
Speaker 2:You know the guidelines are are using, like, the available data, but the clinical studies were not even done correctly. I mean, they used patients who were all different types of heterogeneity and Hashimoto's, Hashitoxin, like all these patients, are not the same. So you're not going to find great data if you're looking at a heterogeneous population of patients and they're not treated right. You know when they're given thyroid medicine, so obviously if you're treating somebody with a wrong dose, they're not going to feel great, you know. So there's so many nuances to how the studies are done and what data they're using to make recommendations at, like the national and international level, and all of that will change eventually. It's just how quickly is the question?
Speaker 1:Yeah, I think that's the case in many areas of medicine at the moment, that there's these huge sort of leaps and bounds and understanding that the research that we base our guidelines off, you know, aren't done on healthy college age males, most of them, so not females, not older ladies and so on and so on, and so we can't be accurate in the prescriptions we're giving because the data that we're basing our prescriptions off might not be representative of the whole population, and I understand that.
Speaker 2:I honestly, as a clinician and I was I was at an academic institution for many years. I did clinical trials, I did basic science. You know I was doing all of that and I'm published in multiple journals, but there's so much to the clinical experience as well. Like I'm a clinician, I see patients every day. With this I know a lot more than somebody who's sitting in an academic practice seeing two patients a week and I'm not exaggerating it's and it needs to be kind of there needs to be a weight to that. You know what we as clinicians know. That's just as important, if not more important, I think, than what they're finding in these clinical studies that are not designed well and have major flaws.
Speaker 1:Let's say you're treating someone with a hypothyroid. Inventionally, there's going to be medications that this person will be given by their standard endocrinologist. Is there something different that you might be doing with them when it comes to medication?
Speaker 2:So this is a really important question and a lot of the thyroid patients and a lot of the thyroid community is given T4 only, which T4 is basically inactive thyroid hormone. It's 80% of what your thyroid makes is T4. And the T4 is then taken up by your muscle or your liver or these other cells and it's converted to T3 or active thyroid hormone. It's the active thyroid hormone that makes you feel good. So as long as your body is taking that T4 product and making T3, we're good. Unfortunately, in real life that does not happen, so a lot of people do not take the T4 medicine and convert it appropriately to T3. There's many reasons for that, but the biggest reason again is inflammation. Inflammation stops that process from happening. It does it on purpose because it's trying to save your body, or save the inflamed parts of the body, from seeing too much active thyroid hormone which could stress it out oxidative stress and things. So it does that on purpose. But because all of us in the world live in a chronic state of inflammation for one reason or another, a lot of us don't convert T4 to T3. Well, there are other reasons as well. There's medicines like beta blocker medications for the heart or chronically inhaled steroids for asthma that mess up that T4 to T3 conversion process. Also, if you're overweight or obese or if you have extra fat tissue, which many women have and many postmenopausal women have, fat tissue takes the T4 medicine and converts it to reverse T3. Reverse T3 is inert thyroid hormone. It doesn't work. It's like throwing it in the garbage can instead of activating it, versus muscle tissue, which takes it and converts it. So if you're a muscle person, you're good, you can convert it. But a lot of humans nowadays are not, you know, in the best shape and so that's a problem. You know, a lot of people can't convert their medication correctly and they don't feel good because they're not doing so.
Speaker 2:So in my clinical practice we look at a full thyroid panel and we assess that. We assess how they're doing with conversion and then, if they're not doing well, you know, first of all we're looking at sources of inflammation and ways to reduce that. But we will use T4, t3 combination therapy, and what that means is, you know, either T4 and T3 by itself different medicines dosed correctly or we will use something like natural desiccated thyroid, which is pig or bovine thyroid extract. It's basically thyroid taken from a pig or a cow and put into a pill. Weird, I know, but it does work. It's T4 and T3. It just has to be dosed properly and that's a whole other like podcast.
Speaker 2:But we use all different forms of thyroid medicine and we try to ensure that T4, t3, reverse T3, tsh is all within reference range or normal range, because when that happens the patient feels better, the patient is cured. So again, not rocket science, but actually looking at the numbers and treating the patient in front of you. It is not a one size fits all approach. Not everybody does well on T4 alone and there are multiple different tools in the toolbox. They're not perfect either, but at least they're better than not treating somebody. And that's why it's so important to really work with a thyroid specialist who knows what they're doing with dosing. Because if you're just looking at TSH and it looks normal, it doesn't mean you're processing the medicine right. It just means your TSH is normal. And TSH can be normal just on a T4 product, but you could be not converting it well at all and that's a very common problem that people have that are on medicine.
Speaker 1:And what about the other end, the treatments for Graves?
Speaker 2:Those are less nuanced, so there's only a couple. There's PTU and there's methimazole, and tapazole is the name brand for methimazole. So not a big variety of treatments as far as prescription medicine goes, but they're effective and typically patients are on them shorter term, you know 12 to 18 months, before they achieve remission or before there's something like definitive therapy performed like surgery or radioactive iodine. But yeah, that one's not as nuanced as the replacement part, which is a big deal and it has to be right.
Speaker 1:And can you explain what ethanol ablation is? Is that also a treatment for graves?
Speaker 2:ablation is that? Is that also a treatment for graves? No, that one is more for thyroid cysts, so thyroid nodules that are full of fluid, where we basically drain the fluid and we inject ethanol or pure alcohol to kill off the blood supply to the cyst wall. It's very effective and easy, um, and so patients can basically save their thyroid by doing that. They don't have to undergo thyroid surgery or removal of the thyroid tissue. They can do a minimally invasive procedure like that that helps take care of the problem. Um, we also use it for thyroid cancer, lymph nodes and things too.
Speaker 1:Okay, so those wouldn't necessarily be to do with the um, the grays or the Hashimoto's, but uh, is it? It's my understanding. I think that the cancer or the cysts can temporarily cause Graves or Hashimoto or Graves. Is that correct?
Speaker 2:Yeah, so thyroid nodules can be overactive, that we call them toxic adenomas and so meaning that they're not under the control of the pituitary, they're doing their own crazy thing and so they can just make random thyroid hormone and that can feel terrible too.
Speaker 2:So that's something that can present with hyperthyroid symptoms, but no Graves disease, antibodies, and it can be confusing. But if you look with a thyroid ultrasound you can see the nodule and you can do something called a thyroid uptake scan which can actually show you that it is an overactive thyroid nodule. Usually that is taken care of with surgery, but there are new techniques. One is called radiofrequency ablation and then there's also like a nanoparticle pulse frequency ablation that can kill it off too, and there's microwave. There's many different like minimally invasive things, but like the key takeaway with all of that is try to do the least possible thing for a thyroid nodule possible, whether that's something minimally invasive like alcohol or radiofrequency ablation, or whether it's just taking half the thyroid and leaving the rest, because it's a big deal to try to replace this very, very important endocrine organ, which is why we don't go straight to radioactive iodine first graves.
Speaker 1:Well, okay, on that happy note, I'm wondering whether we should draw this to a close. But what I would like you to share, though, is you've mentioned your program and that you do tele medicine as well, but can you just give us your contact details so that people can find you on the socials or on the website?
Speaker 2:Yeah, you can find me on social media. It's Dr DR Henderson MD. Dr Henderson MD. And then my website is charlestonthyroidcentercom or mythyroiddoctorcom spelled out. You can find me there and you can find how to contact me there as well.
Speaker 1:Okay Well, Dr Henderson, it's been an absolute pleasure and really eyeopening having you on the show. Thank you for coming.
Speaker 2:Thanks for having me. I appreciate it.
Speaker 1:Thank you for joining me with my conversation with Dr Henderson. Now. If you've enjoyed listening and learning from this podcast, please leave a comment and also leave a suggestion for a future guest, and if you're an Apple, you can also leave us a comment and a five-star review if you're so inclined. Remember, if you want my help, send me an email, ed at edpadgettcom, or visit my website, edpadgettcom, where you can find a little bit more information on how I can help you make your lifestyle your medicine. You.