How to Prevent Thyroid Surgery and Radioactive Iodine Ablation Therapy

How to Prevent Thyroid Surgery and Radioactive Iodine Ablation Therapy | Dr. Osansky and Dr. Childs

Interview with Dr. Eric Osansky, Chiropractor and Clinical Nutritionist

Show notes & links from the video

Dr. Eric Osansky is a chiropractor, clinical nutritionist, a certified functional medicine practitioner, and author of the book “Natural Treatment Solutions for Hyperthyroidism and Graves’ disease. Dr. Osansky was personally diagnosed with Graves’ disease and has been in remission through the use of natural therapies. His focus is helping people with hyperthyroidism do everything they can to avoid radioactive iodine ablation and thyroid surgery.

During our discussion, we talk about hyperthyroid conditions including Graves' disease and toxic multinodular goiter. We talk about the importance of doing everything within your power to PREVENT the progression of your disease to thyroid surgery and/or radioactive iodine.

We spend a lot of time talking about natural therapies including supplements, diet, the triggers of Graves' disease, why hyperthyroid patients gain weight, and much more.  

If you want to learn more about Dr. Eric Osansky, you can cheeck out his website as well as other links mentioned in this podcast episode:

Audio Transcript

Dr. Childs:

Hey, guys, Dr. Childs here. Today, I have with me Dr. Eric Osansky. Dr. Eric Osansky is a chiropractor, clinical nutritionist, a certified functional medicine practitioner, and author of the book Natural Treatment Solutions for Hyperthyroidism and Graves' Disease. Dr. Osansky was personally diagnosed with Graves' disease and has been in remission through the use of natural therapies for quite some time. His focus is now on helping people with hyperthyroidism, do everything that they can to avoid radioactive iodine ablation and thyroid surgery. So Dr. Osansky, welcome to the show.

Dr. Eric Osansky:

Thanks for having me, Dr. Childs. Appreciate it. I look forward to sharing some great information with your listeners.

Dr. Childs:

Absolutely. I think we're going to have a good time here. I don't know if this is the same as you, but well, maybe not for you, but I get accused a lot of not talking enough about hyperthyroidism. So there's this group of patients who have hyperthyroidism who I think get a little bit neglected, right? Because a lot of people, more people, if we're talking statistics, have hypothyroidism than they do hyperthyroidism. So I tend to focus more on the hypo group, but for those people who have hyperthyroidism, Graves' disease, thyroidectomy, RAI, this one is for you and so we're really grateful to have Dr. Osansky with us today. So, Doc, I want you to, if you could, just maybe introduce yourself to the listeners here, tell us a little bit about your own personal story because I know you've had a personal history with Graves' disease. So maybe you could just dive in there and explain what happened to you briefly and then how that informs what you're doing now with your patients.

Dr. Eric Osansky:

Sure. So back in 2008, I was dieting, detoxifying, and in my case, I was losing a lot of weight. A little bit, we'll talk about weight gain in hyperthyroidism, but a number of people also lose weight and that was me. I lost 42 pounds when I was dealing with Graves' disease, but at the time, I didn't know it was hyperthyroidism until one day I just checked my resting heart rate. Actually, what happened, I checked my blood pressure which also measured my heart rate and the blood pressure was fine, but the resting heart rate was elevated and so I wasn't sure what was up. So the next few days, I just continued to check my heart rate and it continued to be initially like 90, but it would fluctuate between 90 and sometimes going over 100.

Dr. Eric Osansky:

And so I was thinking maybe hyperthyroidism, but again, I didn't have experience at the time working with other patients. So I went, I saw a primary care doctor and he did some blood tests, and sure enough, I had hyperthyroidism, and eventually saw an endocrinologist. She tested antibodies and I was diagnosed with Graves' disease. And even though I didn't have experience at the time with Graves' disease or hyperthyroidism, I knew I was going to take at natural approaches, because as part of my continuing education credits, I would attend nutritional seminars. And I attended a few functional endocrinology conferences. So I knew there were there was a natural approach for thyroid conditions. As you mentioned, hypothyroidism is more common, so they spoke more about hypothyroidism, but they also spoke about hyperthyroidism a little bit.

Dr. Eric Osansky:

And so long story short, I took a natural approach for hyperthyroidism and we could talk more about that if you'd like. And since 2009, I've been in remission and just it's been a challenge maintaining ... Well, I shouldn't say been a challenge maintaining my health, but it's always a work in progress. Once you get into a routine, it's not too bad. Again, we could talk more about this, but getting back to 2009, I realized that there's a lot of people with both hyperthyroidism, hypothyroidism, so I started working with people with both hypo and hyper, Graves', Hashimoto's. And just over the years even though I've seen both hyper and hypo patients, people with hyperthyroidism tend to resonate with me more just because that's my personal story.

Dr. Eric Osansky:

As you mentioned, I wrote a book on hyperthyroidism, actually wrote a book on Hashimoto's as well in 2018, but just over the last couple of years, I've made more of a shift to hyperthyroidism even though I still see some patients with Hashimoto's. Even though there are a lot more patients, a lot more people with hypothyroidism, there's still a lot out there with hyperthyroidism, Graves' disease, toxic multinodular goiter, and that in a nutshell is my story.

Dr. Childs:

That's awesome. I appreciate you sharing that. And actually, I want to go back to one point that you mentioned, so for those listening as well, maybe we could talk about this a little bit, but you said maybe it's been a struggle and that probably was the right word that you wanted to use there, but I do think that's actually pretty important because a lot of patients, I think, know that there is this opportunity to naturally treat their conditions, right? And I think people know that it exists and know that they can do it, but I think maybe what they kind of fail to understand is that it is a process. Going from a state of autoimmunity to a state of remission, once you get there, that's a feat unto itself.

Dr. Childs:

However, it's going to take some iteration and changes to your diet and therapy over the long term to stay that way. And you're always going to have, at least in my experience, a propensity to go back to that autoimmune state. Maybe if you're not careful, if you have too much stress, if you have these factors and triggers, you might see your antibody start to creep up and whatnot. So I do think that's a really important point. So for those people who are listening to us, to this discussion, we're going to have, if you are able to get yourself into remission, continuing education, continuing to learn, and figure out what's going on your body is still very important. Is that true? Does that ring true to you in your personal experience?

Dr. Eric Osansky:

I agree. What I was actually looking to get into remission, that was very challenging, both mentally it was challenging, emotionally it was challenging, and then as you mentioned, making the dietary changes. And since then, I don't want to use the word struggle to stay in remission, but I still have to try to eat well most of the time. Nobody's going to be perfect 100% of the time, but most of the time, eat well and manage my stress which was a big factor, I think, in my Graves' disease condition and get proper sleep, so a lot of the basics and a lot of it becomes routine. And so yeah, without question, when you're trying to get into remission, it's definitely not a quick and easy process, and even when you're trying to maintain a state of wellness. I can't say it's easy, but it's easier, I guess, compared to when trying to achieve that state of remission.

Dr. Childs:

For sure, and I would agree with that. I think it's very difficult to get to that point, but then, it becomes a little easier but still something you have to pay attention to, to maintain it. And so that really brings me into the next topic, so we can tie in your own personal history of the natural treatment because I really want to hear more about them. So as a backdrop, I'm going to explain something to the listeners, I know this, Dr. Osansky, but I'm going to explain this to them and then we can talk, we can pick what we're going to be talking about here. So when I talk a lot about Graves' disease, there's a lot of confusion among thyroid patients, right? Because we have people who have maybe just been initially diagnosed with Graves' disease, who have a certain set of symptoms. Then we have people who have been diagnosed and are now taking antithyroid medication who have a different set of symptoms because that treatment interferes with thyroid function.

Dr. Childs:

And then, heaven forbid this occurs but it does occur, if this area fails with the antithyroid medication and the natural treatments, then you move on to thyroid surgery or radioactive iodine ablation and that comes with a whole new set of problems. So we have three groups, three areas here. Now what I want to do is extract out the middle one here and this includes people who have been recently diagnosed and who are using antithyroid medication. And the reason I want to focus on them is because we have the opportunity through treatments to potentially prevent the progression to thyroid removal and radioactive iodine ablation and I think that's really the key here.

Dr. Childs:

So what I want to do is talk about natural treatments. And again, I'm just giving the backdrop for those people listening, because again, I know you know this, Dr. Osansky, but let's talk a little bit about the natural treatments that people can do to try and prevent that radioactive iodine and thyroid surgery. So you talked a little bit about yourself, you talk that you use some natural therapy, so maybe what you can do is intertwine what you use and how you look at patients when it comes to natural therapies during this time, so if you can expand your philosophy on that area.

Dr. Eric Osansky:

Sure. So I also want to add that while a lot of my patients take antithyroid medication, not everybody, so I chose to take an herb, bugleweed, which I'm sure you're familiar with, bugleweed. It doesn't work and everybody. Everything comes down to risks versus benefits in antithyroid medication. Without question, it's more effective, but it also comes with greater side effects. Some people just choose not to start the antithyroid medication and take the bugleweed or someone might experience side effects and switch to the bugleweed. I never tell someone to stop taking the medication and to take the bugleweed, but bugleweed from a symptom management option, bugleweed is one option that can help lower thyroid hormone levels and I also took motherwort, which I relate to natural beta-blocker. It's not directly affecting the thyroid but can help with palpitation.

Dr. Eric Osansky:

So when I was taking a bugleweed, it definitely helped with my resting heart rate because I would monitor it on a daily basis, but I was still having some palpitations, eventually introduced motherwort but then as far as additional supplements to try to correct triggers underlying imbalances. So there are some general supplements that I recommend, and then, I do typically recommend certain tests and then other supplements are based on the test results. So for example, some general supplement recommendations I might give include omega-3 fatty acids, so for example a fish oil and people could even test. They could do like an omega-3 index to see if they're deficient, which many people are, especially if they're not supplementing or if they're not eating fish regularly. And so that's one supplement which can greatly help with inflammation.

Dr. Eric Osansky:

Probiotic, when we think about probiotics, a lot of people think about gut health which is true, but it also modulates the immune system and vitamin D. So vitamin D, I definitely want a test for which is an easy test, as you know, doing a 25-hydroxyvitamin D and a lot of people are deficient in vitamin D. And some people are within a lab range, but they're not within an optimal range. So vitamin D, selenium and there's a number of research studies when it comes to thyroid health, thyroid autoimmunity, even thyroid eye disease, the benefits of selenium.

Dr. Eric Osansky:

But then again, as I mentioned, I like to do testing too. So when I was diagnosed with Graves', one of the tests I did was an adrenal saliva test. And at the time, I was in denial because I didn't think stress ... I knew stress was a factor, but honestly, I thought I was good at handling the stress, so I honestly didn't expect the adrenal testing to look as bad as it did. And so when it comes to supporting adrenals, before we talk about supplements, of course, diet and lifestyle are important. So you want to eat well, whole healthy foods. You want to block out time for stress management, trying to make sure you're getting sufficient sleep which sometimes is a catch-22 because you might have adrenal issues that are preventing you from getting sleep, so we might have to …

Dr. Childs:

Absolutely.

Dr. Eric Osansky:

... work on that. So I had low cortisol levels and so I took B vitamins. I took vitamin C. I also took an herb, which you're familiar with, licorice root for which helps extend the life of cortisol. And people want to be cautious though, because if someone has high blood pressure, that is contraindicated, but I think that was helpful. And I took another herb and adaptogenic are called eleuthero, also known as Siberian ginseng. And there are other adaptogenic herbs like Ashwagandha, Rhodiola. So those were some of the ones that I took. There are also in some cases adrenal glandulars.

Dr. Eric Osansky:

If someone has elevated cortisol, some of the same things, you could definitely take an adaptogenic herb, but there are other natural supplements to help lower cortisol. And again, they'll assist in lowering cortisol, you still have to do things to manage the stress response, and again, do everything else from a diet and lifestyle perspective like phosphatidylserine for example, or Alora or some other supplements. And again, it depends on the findings. If someone does a comprehensive stool panel and let's say they get tested for H. pylori, so H. pylori in the literature has been shown to be a potential trigger, not always a trigger, but could potentially be a trigger for both Graves' and Hashimoto. So if I do see H. pylori, whether it's a comprehensive stool panel or if someone does just a stool antigen test or urea breath test, then I will put them on a protocol or a natural protocol unless if they choose to take antibiotics.

Dr. Eric Osansky:

One of the supplements I commonly give is NAC, N-acetylcysteine which supports the liver. It helps it converts into glutathione. And again, so there are some general ones I give, but there are also some that are based on the testing such as some of the examples I gave.

Dr. Childs:

That's really awesome actually. For those listening, that's a great spectrum, an array of supplements and nutrients that can be used. In fact, it reminds me, in fact, I was mentioning this to you earlier, when I first started out, I was working with somebody and this particular person had a lot of experience in using supplements. And I remember when I got into the office, people would comment on this person's ability to put supplements together in such a way that would solve most problems. It was actually really impressive. And I came from this world where it was predominantly medication, right? Because that's my training was. I was like, "Yeah, give him methimazole, give him a beta-blocker, right? That will solve the problem."

Dr. Childs:

But this guy was intertwining and weaving in the supplements together and having profound results and I was really impressed by that. So I liked the way that you're presenting this information, the various types of supplements that can be used. In fact, I want to talk about several of those, but what I want to do before I do that is ask you. In terms of your approach, and it may be it sounds like we're on the same page here, but what I found to be true, especially in a lot of thyroid patients, is that if you start with a baseline level of tests and we look at nutrient deficiencies, we look at just through a history, we can get an idea of someone's gut health, we can get ideas to their stress level, to their sleep.

Dr. Childs:

A lot of the time what I'm doing is I'm not saying, "You have thyroid problems. Therefore, you need these supplements." Instead, I'm saying, I'm looking at this person and thinking, "Well, you're not getting enough sleep. You have gut problems. Maybe you have H. pylori. You have these things." So I'm just fixing the obvious problems and I see the body helped respond in kind in that way. So is that a similar approach that you're taking or is it a little bit different? What's your philosophy on how you come to the conclusion of what therapies and treatments somebody needs?

Dr. Eric Osansky:

As I mentioned, so some, and not just supplements, but for example, diet, with all my patients, I, of course, focus on diet. And we can talk more about the diet as well.

Dr. Childs:

We will.

Dr. Eric Osansky:

There's no perfect diet that fits everyone, but to me, there's a starting point for my patients. Again the stress management, I think, is important. But again, with supplements, as I mentioned, yeah, I think it's important to ... When I mentioned the fish oils, the omega-3s, the vitamin D, the selenium, what all those have in common is that they modulate the immune system. In a condition such as Graves' disease, that's very important, but not everybody ... Many people have a vitamin D deficiency, but usually, at least in my experience, correcting a vitamin D deficiency alone usually won't get the person into remission, same thing with giving the person selenium.

Dr. Childs:

Agree.

Dr. Eric Osansky:

Usually, I find that we need to dig deeper and that's where, in my experience, the testing comes into play, whether it's doing adrenal testing, which again that I commonly recommend. Of course, certain blood tests, I recommend. Sometimes other tests like a comprehensive stool panel, organic acid testing. And the testing they get is based on their finding. Just like any practitioner, I do a comprehensive health history and try to figure out what supplements they may need. And then once they're on a certain supplement, then, of course, we monitor, not only their blood says primarily, but then sometimes we'll do a follow-up and renal test.

Dr. Eric Osansky:

And of course, a lot of people even without the testing will notice that they're doing better. And that was me when I was even just taking the bugleweed and the motherwort and not addressing the cause of the problem at that point, I noticed my symptoms getting better. And that's also a trap, you can't always go by symptoms, because if someone's taking, especially antithyroid medication such as methimazole or PTU, that, of course, is masking the symptoms. So it might cause other symptoms like hypo symptoms, but yeah, I think we do take a similar approach. No practitioner takes the exact same approach, but just really trying to find, remove triggers, trying to address underlying imbalances, nutrient deficiencies, all these things.

Dr. Eric Osansky:

Sometimes it's complex. Sometimes it is a smooth process where someone progresses without any setbacks, but sometimes it is like a rollercoaster ride where someone maybe takes a few steps forward, a step back, a few steps forward, a step back. Sometimes a person hits a roadblock and we might need to do additional testing. As you know, everybody is different.

Dr. Childs:

And I appreciate you mentioning that sometimes you go backwards, right? And that actually happens a little bit, two steps forward, one step backward. That's actually pretty common, especially among treating most patients. In fact, the way it was described to me is that sometimes you feel worse on the right therapist for a short period of time. I've had people who will say that to me and they'll think that that's a reason to stop doing whatever they're doing, when in reality, it could be the reason or it could be an indication that you keep doing it, right? It also could be a sign that maybe they're not in the right thing, but it can't just be automatically a blanket statement, "This is wrong because I feel bad for a couple of days. Therefore, we got to get rid of it." So I appreciate you mentioning that.

Dr. Childs:

So what I want to do also is ask you, what kind of effectiveness, how common Are you seeing people go into remission if they catch it early? Are there any signs or telltale signs that you can identify and somebody that maybe gives them a higher chance of going to remission? Is this something that you can achieve in 70, 80, 90% of patients? Is it less? Is it just? What kind of effectiveness do you tend to see with these therapies?

Dr. Eric Osansky:

It's pretty effective for those who follow the recommendations. As you know, again being a practitioner, just compliance sometimes is a shocker, but I would say about 75%, yeah. And as far as whether predicting if someone is, let's say, a good candidate to go into remission, it honestly does vary. So if someone has, for example, the antibodies associated with Graves' disease, thyroid-stimulating immunoglobulins, TSH receptor antibodies, and some ... I know you can't always go by antibodies like TPO antibodies. If they're really high, that doesn't always correlate with the recovery of the person. TSI usually, what I've experienced, the higher the level, the higher the immune response, the more likely they are to have thyroid eye disease, which again, we also could chat about if we have time.

Dr. Eric Osansky:

But yeah, so if someone has high TSI, it doesn't ... Again, I've seen people with elevated, really high TSI levels like over 400% 500%, the units do vary, so now they change the units recently. And I've seen people were really high levels they still get into remission, and then, on the other hand, I'll see people where they might have lower antibodies, even mildly high antibodies and it's more of a struggle. And I think part of that does come with addressing, again finding, removing triggers. Sometimes it's easy with the person or I don't want to use the term easy, but sometimes again easier in some people.

Dr. Eric Osansky:

I can't say in most people that diet alone will get the person to remission, but sometimes that is the case They might just clean up their diet, avoid gluten and avoid other common allergens and manage their stress and might not need to see a practitioner and they get into remission. And then for others, we might do some initial testing and there might be a lot of findings as far as nutrient deficiencies, adrenal imbalances, but even after correcting that, they don't go into remission, so something else is there. So the point is people could have multiple triggers too. Even if someone has a single trigger, sometimes it could be a challenge, finding that trigger.

Dr. Eric Osansky:

So it really does depend. I can't say I could predict ... I feel confident with most people, but I never know how compliant they're going to be. I will also say that, as crazy as it may sound, I think it's easier to get people with Graves' into remission than like toxic multinodular goiter. I have success with that as well, but that seems to be a little bit more challenging to get people into remission with that. But with Graves', like I said, it's not easy, it definitely takes time. But yeah, I wish I could say there was a single pattern, or if someone comes in and their levels ... If someone comes in and their levels are mild, yeah, I like to see that more than someone that has really elevated thyroid hormone levels and sky-high TSI, but it's not always easier to treat the one with a mild case.

Dr. Eric Osansky:

I will say most of my patients are adults, but I deal with, unfortunately, some children, teenagers with hyperthyroidism. And sometimes in them, it could be a quicker process, but it's a little bit of a catch-22 because also when they're that young, it's also could be more challenging to be compliant, especially with the diet. So yeah, like I said, I wish I could say that there was a single pattern where I could look and say, "Yeah, you have a 90-95% chance of getting into remission," where someone else comes and sees me and there might only have a 50% chance of getting into remission, but I can't say I consistently see a single pattern like that.

Dr. Childs:

I appreciate the honesty there and I think that's maybe one of the reasons that conventional doctors don't quite really understand functional medicine. Because of the way that we're talking about this, it's highly individualized. Every person is a little different. The supplements they need are going to be different. Their triggers might be different. And so when you look at conventional medicine, they want to look at things in the aggregate. So if you give somebody a beta-blocker, they want to see it work 95% of the time, right? It's just not going to be the case with some of these supplements. Someone may not need it, right? Not everyone necessarily needs, I don't know, let's just say fish oil for example, or vitamin D if their levels are okay and they're out in the sun all the time, right?

Dr. Childs:

There are situations in which you can't universally apply these recommendations broadly across the population of anyone who has just this single disease state. And so I think maybe that's why a lot of people struggle or at least conventional doctors struggle with this idea that we're talking about, but as a patient, it makes perfect sense, right? You want somebody who's going to treat you individually and unique, in a unique way. You want supplements catered to your situation, to your condition. You want somebody to be searching for the triggers. And that actually leads me to the next question which I want to mention is, what type of triggers are you seeing as the most common cause of, let's talk about Graves' disease?

Dr. Childs:

And if you want to throw in anything else there like toxic multinodular goiter, you can as well, but what kind of main triggers are you seeing for Graves' disease?

Dr. Eric Osansky:

Yeah, so what Graves', stress without question and everybody deals with stress and there are different types of stressors too, but I know, again my adrenals were a big factor with my Graves' disease condition. And it's not just emotional stress. I think one thing that's important to mention, prior to diagnosis, I was also overtraining and that could put a lot of stress on adrenals.

Dr. Childs:

You mean, exercising, overtraining?

Dr. Eric Osansky:

Overexercising, yeah. So yeah, stress, adrenals, that causes dysregulation of the immune system. And again, is it always the direct trigger, or is it sometimes just like the straw that broke the camel's back?

Dr. Childs:

Right.

Dr. Eric Osansky:

That definitely could be the case, but either way, you want to address stress. I mentioned food. Food, I don't see it as a primary trigger. Again, I would say stress is definitely up there, but that being said, it could be a trigger, and then certain foods such as gluten, dairy, corn could be inflammatory. So I think if someone continues to eat those foods, it's going to be difficult to heal. So I do have people avoid those foods and gut infections. Again, just like things like H. pylori is common. Parasites, there's nothing in the literature showing like ... I haven't seen anything of literature correlation between Graves' and parasites. There is a case study on Hashimoto's and Blastocystis hominis that was out there, but I have seen where I've done a comprehensive stool panel and the patient has parasites. We clean them out, they get into remission.

Dr. Eric Osansky:

Of course, again, there are also situations where we see a parasite, and again, we get rid of the parasite and they don't get into remission or… 

Dr. Childs:

Sure.

Dr. Eric Osansky:

... something else out there. And then, there are also flaws with the testing too because sometimes a person might have a parasite, but it doesn't show up on the comprehensive stool panel.

Dr. Childs:

Right.

Dr. Eric Osansky:

The testing, unfortunately, is not perfect. So again stress, gut infections, again I'm going to include food in there, even though I would say it's not the primary thing I see. Toxins, it's hard to really measure. The thing is also I have most people, pretty much everybody and even myself since being in remission, I've been just always working on reducing my toxic load and-

Dr. Childs:

It's always a good thing.

Dr. Eric Osansky:

Exactly. We live in a very toxic world. So with some patients, it might be basic, I mentioned like the NAC, N-acetylcysteine. Sometimes you might have them take liposomal glutathione or glutathione. We might talk about sauna, infrared sauna, to help sweat out the toxins.

Dr. Childs:

Right.

Dr. Eric Osansky:

So again, that could be a factor as well. And with toxic multinodular goiter, the two more common triggers, and this is also in the research, so problems with estrogen metabolism as well as insulin resistance, being two big potential factors with toxic multinodular goiter. So those are two things that I usually address or look into. There is testing obviously with insulin resistance. You can do testing with estrogen metabolism. It's not as easy. There is, you're probably familiar with dried urine testing, DUTCH.

Dr. Childs:

The DUTCH.

Dr. Eric Osansky:

Metabolites.

Dr. Childs:

Right.

Dr. Eric Osansky:

Those seem to be more of a factor with toxic multinodular goiter, and even with Graves', those could be factors too. Again, I don't know if you would say they're always direct triggers if someone has insulin resistance. You also talk about leptin resistance. Those, again, could be a factor, but are they the primary factor or the triggers? Sometimes it is difficult to differentiate like what's the trigger, what's a contributing factor, but most natural healthcare practitioners, we try to correct everything. So if you see three or four different imbalances and maybe a few of them are, maybe only one is a trigger, but again, we don't know. So we just try to correct everything we see and try to get the person in an optimal state of health.

Dr. Childs:

I definitely agree with that. I think it's really hard to ever say, "This thing is primary. This thing is secondary. This thing is tertiary." It's really hard to pinpoint one of those things, but like you said, if it's there, you treat it. Now, in a lot of cases, you can sometimes correct something, and then downstream, you'll see improvement in these things and they clean themselves up. And so I'll pull back the punches in terms of therapy sometimes if I think, "Treating this will treat symptoms four and five," right? So you see a lot of that sometimes as well. The other thing I was going to ask you is, what about Epstein-Barr virus? So there's some connection between these two conditions, especially Hashimoto's. I don't know about Graves' disease, so getting your opinion on that.

Dr. Childs:

Do you see Epstein-Barr virus as a potential cause, trigger it, or is it one of those things that maybe it's just secondary, it happens to be there, maybe it's causing a little inflammation, and if you treat it, you see a little improvement? What are your thoughts on Epstein-Barr and Graves'?

Dr. Eric Osansky:

Yeah, I'm glad you asked the question because I do test for Epstein-Barr like test for the IgM, but then the three IgG, those as well. And I still think we don't understand everything about viruses. Maybe with everything that's happened over the past year and a half or so, we'll do even more research in other viruses such as Epstein-Barr. But yeah, actually the literature the literature shows that there is a correlation. Again, correlation doesn't always mean causation, but Epstein-Barr could potentially be a trigger with both Graves' and Hashimoto's. And I don't see a lot of IgM elevated with Epstein-Barr, but if I do, then, of course, I'm going to get concerned, but even if really high, extremely high IgG markers, there's now ... Just some practitioners are suspecting that that may mean that the Epstein-Barr virus is reactivated.

Dr. Eric Osansky:

And I will say though that even if it is a potential trigger, most people have Epstein-Barr, so I can't say I go crazy with the antiviral protocols, that there's sometimes I will put someone on an anti ... Put them on antiviral herbs. I, even more recently over the last few years, have used some homeopathy, but to me, it's more of an immune system problem. So what I try to do is try to see what's dragging down the person's immune system and then correct those imbalances. If someone again is dealing with a lot of stress and their adrenals are compromised and they have issues with a gut, most of the immune system cells are on the guts, you need healthy gut throughout the immune system.

Dr. Eric Osansky:

So if we're not addressing those, if all we're doing is putting someone on a protocol for Epstein-Barr or any other type of virus like cytomegalovirus is another one, if someone gets on a protocol, but if we're not doing anything to improve the immune system health, then it's really not going to be effective. And what I see is sometimes by addressing these other areas, the person doesn't need to be on an antiviral protocol. Some people do and sometimes I'll put a person on an antiviral protocol. My perception also changed, because, in 2018, I was diagnosed with chronic Lyme disease. And again, I realized, even though I did treat infection, I took herbs, I took homeopathy, actually, I did some ozone, IV ozone therapy too. I was a little bit aggressive with that, just because I was concerned about being debilitated.

Dr. Eric Osansky:

But I realized also that's more ... It's not exactly the same as Epstein-Barr, but still, it's important to have healthy immune system when it comes to these stealth infections whether it's viruses, whether it's a Lyme disease, whether it's Bartonella. So my number one approach is to improve immune system health, but there are times when I will directly treat the infection.

Dr. Childs:

I think the focus on immune system makes a lot of sense. And just for clarification for those listening, when Dr. Osansky was talking about IgM antibodies, IgG antibodies, the IgM indicates a more recent infection, in fact, an acute infection, and the IgG simply means that you had it at some point. It could have been a year ago, it could have been six months ago, it could have been 20 years. You don't really know. And so you get put in this weird situation if you're a provider and you're checking for Epstein-Barr virus via the IgG antibodies, but 70%, 80% of people are going to come up positive. So then what do you do? Do you look at and you think, "Well, I guess I'm going to treat everybody"?

Dr. Childs:

And it sounds like, Dr. Osansky, what you're saying here is, "No, it just depends on the situation," and that's really what I found. Although I can't tell you from experience that there have been a handful of times when I try and do everything I can, they're not seeing improvement, I'm like, "Well, we got this Epstein-Barr virus that we can look at, we treat it," and you see an amazing improvement. And so it's like in some people, it's there and it's a huge potential source of treatment where somebody can feel a lot better if you do it. The hard part is figuring out who's who. It could be one out of 100 or I don't know, one out of 1,000. Who knows?

Dr. Childs:

But it's not as easy to figure out who is going to benefit from that treatment. And so that's why I said, I think this focus on the immune system makes the most sense because if you focus on the immune system, help your body get rid of it on its own or at least suppress it back, prevent the flare-ups or recurrent infections or the chronic smoldering type of infection that can exist, then that probably puts you in the best situation. But if you're somebody listening to this, you have Graves' or Hashimoto's and maybe you've tried everything and it hasn't worked, well, it's worth looking into.

Dr. Childs:

A lot of these therapies aren't necessarily, let's say, damaging or harmful if you're going to look at these antiviral therapies at least in my experience, so I appreciate that. Did you have any other thoughts to add on to that topic before we move on?

Dr. Eric Osansky:

No, I agree. It sounds like you take a similar approach if someone's not responding and those antibodies are sky-high, the IgG, I know we're not going to get rid of them and I make sure I tell the patient they're never going to normalize. But I've seen where the markers dramatically decrease. So we take the same approach, I think. Focus on the immune system first, but if someone's not improving, I have no problems putting them on an antiviral protocol. And yes, that's sometimes what I do.

Dr. Childs:

Good and so we're definitely on the same page there. Let's transition a little bit to diet because we talked about this briefly. There are some things, what you said previously, I'm going back into your conversation, you mentioned that there are some principles and tenets especially when it comes to diet and maybe even certain supplements that most people tend to improve on if they have hyperthyroidism or Graves' disease. So let's talk a little bit about diet. What are those foundational blocks of dietary foods that they may eat or may restrict that can improve that situation or outcome? And then we'll build on top of that from there. So when you look at diet and you look at somebody with Graves', what are you starting with, let's put it that way?

Dr. Eric Osansky:

So I think most practitioners would agree that you want to have the person eat whole healthy foods and try to avoid the inflammatory foods, so whole healthy foods. What I consider a whole healthy foods, so eating a good amount of vegetables and variety of vegetables, some fruit usually is okay if someone eats meat and they're not a vegan-vegetarian, then eating healthier forms of meat like grass-fed beef, pasture-raised chicken for example.

Dr. Childs:

Right.

Dr. Eric Osansky:

And then avoiding certain foods, like I mentioned earlier, gluten, dairy, corn. Some will say to avoid all grains and I honestly take that approach about where I tell, not to say that there are some people that have that struggle with giving up grains completely and that could go with any food and there are some people that still will eat a small amount of grains and they might do okay, but usually, I tell the person to avoid grains while healing inflammatory like unhealthy oils, like canola oil, for example. Try to have them stick with avocado oil, coconut oil, olive oil of course. And of course, avoiding fast food and a big reason is because of those unhealthy oils and of course the poor quality, just in general the food, the refined foods, and sugars.

Dr. Eric Osansky:

There's some research also with salts. I do recommend some natural sea salt, but I did want to mention that too much salt is associated with high blood pressure. At least, that's what we think. If we have too much salt, that's going to raise blood pressure, but there is some evidence that too much sodium chloride can increase Th17 cells which are associated autoimmunity. So you also want to be careful about eating too much salt. And again if you're eating not just salting your food but just eating a lot of packaged foods, because a lot of packaged foods will have, pretty much all packaged foods, a lot of sodium. And so I will say as far as different diets though, I did mention earlier there's no diet that fits everyone perfectly, but I do tend to have at least my Graves' disease patients start on autoimmune paleo or-

Dr. Childs:

AIP.

Dr. Eric Osansky:

If that's too strict, paleo, so AIP as I'm sure you know that is more strict than paleo and you're avoiding eggs, you're avoiding nightshade, you're avoiding nuts and seeds. And I know there are some people that do fine on paleo, they might find AIP too restrictive and it's compromising. They're like, "I could do paleo, but I can't do AIP," and some people do okay. There are some people where they hit a roadblock and they will do AIP. And as I mentioned earlier, food isn't the only factor. So we also do get people who are following AIP. And maybe they feel a little bit better, but they're not feeling that much better. I still tell them, "Don't get discouraged because it's never going to hurt to avoid the inflammatory foods. And if you're eating certain foods, again maybe the eggs, maybe you gave up eggs for no reason, if you follow AIP, maybe you didn't have to give up the eggs."

Dr. Eric Osansky:

But we didn't know until you give them up. There are some people that they'll continue eating eggs until they take a break from the eggs, they won't notice an improvement. So to me, I don't want someone to be super restrictive, but it's, again, another one of those catch-22s where if someone is not restrictive enough, they might hit a roadblock and I'm not sure if it's the food. And to me, that's the easiest place to start. Again, not easy, the challenge and I went through it too when I was dealing with Graves' disease, but it's definitely less expensive than having someone spend hundreds or thousands of dollars on additional testing rather than say, "Well, why don't we just try to avoid these foods that could be factors and do it at least for 30 days? If you could do it for a few months, that's even better."

Dr. Eric Osansky:

But if someone compromises and they want to do paleo or they might even want to do modified paleo, they're like, "Well, can I have a little bit of rice per day?" again it's ultimately up to the patients. No matter what I say, it's going to be up to them. And if they continue doing that or if they drink coffee, I would usually recommend avoiding coffee, but if they could do everything else, but have a little bit of coffee, sometimes it might affect adrenals and prevent them from healing with the caffeine and all that, but sometimes it might not so. So sometimes there is some negotiation, but I think the commonality is again whole healthy foods, plenty of vegetables, try to eat organic whenever possible. Again, some sea salt is okay, but not a lot of salt in general. Avoid the unhealthy oils. Those are some of the recommendations I give.

Dr. Childs:

I honestly agree with almost every one of those. To be honest, in fact, I don't think there's anything I don't agree with. I will say that in my experience, just treating mostly Hashimoto's, I didn't treat a ton of Graves', mostly treating Hashimoto's, by the time people got to me with Graves', it was post-thyroidectomy and post-radioactive iodine ablation. So it was a little bit different of story, but I would use AIP. But I tend to reserve AIP just, because like you said, it's a little bit stricter, it's harder to follow, maybe some compliance issues, and so on.

Dr. Childs:

I usually reserve it for somebody who has multiple autoimmune conditions or really severe conditions. That was just my personal preference. For anyone listening to this, you don't necessarily have to follow that. That's just how I thought about it. And so if somebody came in, let's say, with vitiligo and celiac disease and Hashimoto's, well, now we've got three autoimmune diseases on one. I'm like, "This person is," for lack of a better term, "a mess with their immune system, right? And so this person needs probably a little more aggressive therapies," and so that's when I would pull out the big guns so to speak.

Dr. Childs:

I did want to ask you, what do you think about carnivore? What do you think about keto? Do these have any place in the treatment of Graves' disease or other hyperthyroid conditions or are these things that you've used in the past with variable success? How do you think about those two diets?

Dr. Eric Osansky:

I can't say I've used a lot of it. Again, I'm familiar with both ketogenic and carnivore diets,

Dr. Childs:

Right.

Dr. Eric Osansky:

... overlap with the two.

Dr. Childs:

Right.

Dr. Eric Osansky:

I will say that with AIP, I am low carb, not quite as low as ketogenic and then I do encourage people to eat healthy fats, but yeah, if someone is eating a healthy ketogenic diet and I don't know if there's really research on carnivore diet, but I know that there's been a number of people just doing some searching and even might be just seeing my Facebook group, people posting that they follow a carnivore diet and that really helped with their autoimmunity and reducing inflammation. Of course, if they're doing that, I'm sure they're eating healthier forms.

Dr. Childs:

Right.

Dr. Eric Osansky:

But that's what I was saying, there's no perfect diet that fits everyone. And ketogenic, if someone especially is struggling with losing weight, sometimes that could be a factor. Sometimes, as you know, there could be other factors and ketogenic doesn't help, but I think, again, the commonality of whole healthy foods. So I think ketogenic can potentially work. I think, again, carnivore could work. I mentioned even paleo could work. It's not just AIP and sometimes there's modified. If someone's a vegan-vegetarian, sometimes I'll have them follow, I don't know if you're familiar with Dr. Gundry and his Plant Paradox diet where he has like modifications where he allows certain nuts. He actually allows legumes which is not allowed on either AIP or paleo, but as long as they're properly prepared or pressure cooked.

Dr. Eric Osansky:

And so with a vegan-vegetarian is even more difficult for them to follow AIP or even paleo. So again, I see people respond okay with that type of modified diet. So I think, again, as long as you're, I think the big thing, avoiding the inflammatory foods, the challenge is sometimes healthier foods like, again, eggs is a good example. I think eggs are great, even though there are always controversies if you live in certain places, read certain books, some will say not to eat eggs with our conditions, but I think some people do perfectly fine with eggs, but some people don't.

Dr. Eric Osansky:

And same thing with nightshades like tomatoes, eggplant, potatoes or white potatoes or peppers. So again, some people won't do well with nightshades. Other people, it's not a problem. So that's why I tend to be a little bit more restrictive, but again, you could go either way. If someone could just do paleo, or again, they could do ketogenic, carnivore, just pick a healthier diet as a starting point, and then you could always make modifications.

Dr. Childs:

You're right. You could start with the strict removal of all these things that potentially cause problems and add to it over time or you could start with broader and taper down as you go. So I don't think there's necessarily a right or wrong. I just think it depends. So the takeaway here is you're listening to this is that diet is highly individualized and it's very unique. It's up to the person. And this brings me to my next good topic. This is probably the last one that we talked about just because we're running a little short on time here and it has to do with weight gain.

Dr. Childs:

Hyperthyroid patients can actually paradoxically experience weight gain, right? And it can be confusing for a lot of hypothyroid patients. And in your case, remember when you talked about it, well, of course, you remember, it was your case, but you lost a lot of weight in the beginning, right? However, there are a lot of people taking methimazole, especially these anti-thyroid medications. I don't think people use PTU quite as much anymore, but mostly methimazole or some other antithyroid medication and they experienced weight gain. So can you talk just sort of why that is that some hyperthyroid patients may experience this weight gain? And then maybe we'll talk a little bit about therapies and what to do in those types of situations and how you think about that.

Dr. Eric Osansky:

Yeah, definitely. So as you mentioned, antithyroid medication is one factor. So someone might not have been gaining weight until they started taking, let's say, the methimazole, and you're right, PTU, not as common every now and then, especially if someone can't take methimazole, they might be taking PTU or someone is pregnant …

Dr. Childs:

Pregnancy.

Dr. Eric Osansky:

... first trimester, but either way, whatever type of antiviral medication that could cause problems with weight gain and we see more commonly with higher doses, but even if someone's on 5 mg of methimazole, that could happen. So that can be a challenge. Inflammation, there are a number of different factors, but inflammation alone can make it difficult to lose weight. And these conditions, Graves', Hashimoto's, other autoimmune conditions are quite inflammatory. And that's another reason why you want to do as much as you can through diet and supplementation to try to bring down the inflammation and high cortisol. So I mentioned low cortisol in my case, but high cortisol can make it difficult to lose weight.

Dr. Childs:

Absolutely.

Dr. Eric Osansky:

the adrenals could be very important and insulin resistance and I know you've talked a lot about leptin resistance. So those also could be factors when it comes to weight gain. And again, we could talk more about that. You're the expert on when it comes to leptin resistance, but let's see, estrogen problems and estrogen metabolism also, that could be a factor. Even having increased toxic load can be a factor as well, but I would say more commonly probably when it comes to just people dealing with hyperthyroidism will have the weight gain. All these could be factors, I would say the antithyroid medication, I would say the inflammation, and again, problems with the cortisol, because again, I mentioned how stress is a big factor. And even though I had low cortisol, a lot of people have high cortisol.

Dr. Childs:

They do.

Dr. Eric Osansky:

In my experience, those are some of the more common causes of weight gain. And for those who experience weight gain with hyperthyroidism.

Dr. Childs:

And I think we probably have seen a little bit of a different patient population in a way because a lot of people are coming to me and they're just on methimazole, but probably most of them, I don't think have gone really deep into the supplements we're talking about, touching on the omega-3 to omega-6 fatty acid ratio, reducing inflammation, fixing gut health, doing their dietary changes and things like that. But if you're doing all that stuff, there's a good chance that you could come off of methimazole, right? That would be the entire goal. And if I can go on methimazole, if you're a patient listening to this, it's really putting the brake on your entire metabolism and that's really what it's doing.

Dr. Childs:

And the degree to which it breaks your metabolism is depending upon the dose that you're taking. So if you're taking, like Dr. Osansky said, a high dose, good luck trying to lose weight. It's like pressing the gas while you're trying to press the brakes simultaneously. You're not moving forward. You're going to stand still. And so your number one goal, in my opinion, should be to see somebody like Dr. Osansky if you're trying to lose weight. Because if you can get off the methimazole, if you can fix those underlying problems, the estrogen metabolism, cortisol, insulin, leptin, etcetera, if you can fix those problems, then you're going to actually be able to lose weight.

Dr. Childs:

But trying to lose weight while taking methimazole I think is a losing battle. I just don't see a lot of success there. And I think we're on the same page with that. I guess one last question here I want to ask because I know we're running out of time here, but what do you think about fasting in setting up hyperthyroidism? Is this a therapy that you use a lot? Do you have a lot of success with it? What do you think about it in general for hyperthyroid patients?

Dr. Eric Osansky:

So I will say I'm definitely an advocate of fasting. I do intermittent fasting, but when it comes to hyperthyroidism, I would say it depends on the person more times. Usually no. If someone, definitely not in a case like mine, where someone's losing a lot of weight, but it's not just the weight, it's also the adrenals. A lot of people just have compromised adrenals. What I try to do is just try to improve their adrenal health. And to me, and everybody's going to have a different opinion, but to me, fasting is more something we'll do when they're in a better state of health. Again, there are exceptions like if someone's dealing with insulin resistance or leptin resistance, then maybe doing intermittent fasting and I'm sure it would help, but it's one of those things if someone has really compromised adrenals. There are other ways to do it without the intermittent fasting.

Dr. Eric Osansky:

So I personally don't recommend intermittent fasting. Usually, again, there are always exceptions, but most of the time, I don't go that route. But like I said, I'm definitely a believer. I do a lot of intermittent fasting myself.

Dr. Childs:

That's good to know. And I'm actually really grateful we had this conversation because you've given me a lot more information, I'm embarrassed to say, than I knew previously, so thank you for that. Thank you for sharing your knowledge. And I would strongly recommend, if you're somebody in that situation where you're taking methimazole or an antithyroid medication and you're trying to prevent thyroidectomy, which is surgical removal of the thyroid, or radioactive iodine ablation, which again, these are, for the most part, RAI can be somewhat permanent, but these are permanent, we'll say, treatments to a problem that doesn't necessarily have to occur in all situations.

Dr. Childs:

And my recommendation, my parting words of advice would be to avoid those therapies at all costs if at all possible. And so seeing somebody like Dr. Osansky I think is the way to go with that. And I really mean it. If you don't believe me, go check out the comments section on any video that I do regarding thyroidectomy or radioactive iodine ablation, you will see a ton of people who will regret getting that condition done. So talk to them, look at them because it's permanent. Once it's out, it's out. And your body, no matter how good you think doctors are, they're never going to be as good as your own thyroid gland at producing thyroid hormone. This is something that's working constantly every single day.

Dr. Childs:

And the doctor, at the end of the day once they pull it out, surgically cut it out, or destroy it with radiation, they'll give you one thyroid medication once per day, right? That does not take the place of the function of the thyroid gland. So that's my parting words of advice for you, but I do want to let you, Dr. Osansky, tell people how to reach you if they want to get in contact with you, maybe if they want to read more about your books or get your books or maybe do some coaching with you if that's what you're doing now, so maybe tell people where they can find you.

Dr. Eric Osansky:

Sure. So my website is naturalendocrinesolutions.com. So I have a lot of articles, hundreds of different articles, many of them on hyperthyroidism, some on hypothyroidism, Hashimoto's, and then my book as well, Natural Treatment Solutions for Hyperthyroidism and Graves' Disease that you could find on Amazon. And then also I just have a new podcast, Save My Thyroid Podcast.

Dr. Childs:

Good.

Dr. Eric Osansky:

You'll find that where most podcasts are found.

Dr. Childs:

Give me a link to that. I'll include that below.

Dr. Eric Osansky:

Or actually, go to savemythyroidpodcast.com. So those are some of the places where people could find me.

Dr. Childs:

Awesome. Well, Dr. Osansky, I really appreciate your time. And if people have any questions, wherever you're watching this, go ahead and leave those comments below. I'll do my best to answer those. And if Dr. Osansky maybe has time, he can by as well, but that's all I have for you guys, and otherwise, I will see you in the next one.

preventing thyroidectomy and RAI with Dr. Osansky

Dr. Westin Childs

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 45,000+ people have used them over the last 4.5 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

Leave a Comment

0
Your Cart
Your cart is emptyReturn to Shop
Calculate Shipping