Dr. Alan Christianson: Simple Thyroid Health

Video | Dave Asprey

00:00:00 > today's cool fact of the day is when people view willpower as limited and easily depleted they experience improved self-control after eating sugar but if they view willpower as plentiful they perform at a high level of self-control with or without eating sugar so by believing that your willpower is limited you actually sensitize yourself to physiological cues and it makes you more dependent on sugar for performance today's guest is dr. Alan Kristensen Alan's out of Phoenix Arizona and he's a naturopathic medical doctor who specializes in natural endocrinology with a focus on thyroid disorders I'm really stoked to have him on here because of the quarter million or so people who listen to a bulletproof podcast every week a very substantial percentage of us have thyroid disorders I've struggled with my own problems with

00:01:01 > I roid and if you want your brain to work well you want to be thin you want to have enough energy to get through the day if your thyroid is broken you're going to be really not succeeding the way you'd like to succeed one of the things that stands out about Alan is that he founded Integrative Health which is a group of physicians that really works on reversing complex and chronic diseases I would call them sort of the biohackers of the physician brigade Alan won't be glad to hear that thanks a lot really happy to be here got an awesome show thank you what kind my attention about your work was that you wrote the Complete Idiot's Guide to thyroid disease and healing Hashimoto's a savvy patients guide now a lot of people listening probably think Hashimoto's is a form of sushi and it actually sounds like that it is a condition where your immune system attacks your thyroid and it's surprisingly common and it's linked to gluten as longtime listeners will

00:02:03 > have heard from other guests like dr. Tom O'Brien and actually several other people so Hashimoto's and general thyroid health should be of important - every single person listening to this because when your thyroid is optimized it's like having a spark plug that works well in your car if it doesn't work well the works get gummed up and you just don't perform the way you should it doesn't matter how well you've got the polish and wax in place that the spark plugs aren't connected exactly now you're also you're kind of a weird weird dude like you're competitive mountain road how many proof executive being called weird this could not be cooler that's like the highest honor Mountain unicycling guys like you three times always wearing big shin guards so um you know that is the most unusual sport of anyone who's been on the podcast for sure and you also it sounds like you had some seizures when you're a kid how did you cure them with diet you know it was pretty wild it turned out that foods

00:03:06 > were big triggers it was somehow my whole histamine threshold the whole level of allergens would initiate a seizure and my parents knew about some obvious external airborne triggers they would identify things like horses for example but wasn't apparent early on is that the foods I was consuming would make me more or less responsive to those and toying around with just what affected me in the short term really shifted how I responded to those airborne triggers you know the medications just cause side effects they didn't particularly help all that much but dietary change made such a big difference I only wish when I was a kid that we had known about this kind of thing because I had a mold allergies I had lots of food triggers and it wasn't till I was in my early 20s that I figure this out and your brain forms differently if you're living in in an area eating high histamine foods and you have all these allergies so you're you're lucky you figured it out but how did you do that when you were your young like how old were you when you learned that food did this it was about like

00:04:07 > four or five um so the weird the weird part is that I had seizures they're like zero motor skills that's why I do things like ride Mountain unicycle ah okay I get big love is rock climbing you know and just being able to really move physically and my breath my body respond well it's just such a such a cool high because for so long I was so far the opposite of that spectrum but the weird part was that it worked well in other ways I reading very early on in life I got through encyclopedia set before a kindergarten and whenever I was up against something that wasn't working well I just threw a huge pile of books at it and eventually eventually made some sense out of it you know things things would improve you know if if you weren't so much better-looking than me I'd say we must be a long-lost twins right because you know the same thing I learned to read at 18 months and yeah well that's cool you get the data and lack of motor skills you know I I'm still reap at earning some of my infant movement reflexes because when you spend all the time reading instead of moving

00:05:09 > funny what your nervous system optimizes for right that's pretty cool I did not know that about you and so you're lucky you did this at four and I'll tell you I have a four year old and a six year old and absolutely food impacts how they behave and I've learned out of self-defense don't feed garbage or trigger foods to your kids because they'll misbehave and you just don't need that in your life you know bunch of kids who want to respond but can't respond because their brains are basically misfiring yeah so so you're fortunate your parents figure that out and then you know if you'll fast forward a bit you become a competitive mountain unicycling okay and can you juggle bananas will you do it - I just I can't juggle unfortunately I can I can ride pretty tough terrain but I can't juggle even standing on my own two feet I haven't looked either but it's one of the things on my list for hacking in the brain to just you know get your peripheral vision up and running so next time we talk in a year from now on the podcast maybe we can both be juggling bananas and it'll be a

00:06:11 > goal so let's talk some more about thyroid though why did you or why do you think we're idiots about our thyroid like like why do people not know about this really important thing you know it's such a huge factor and medicine is just so so stuck and not really progressed for decades and decades and decades my bias as far as why that's the case is just that progression occurs from medications and reimbursable treatments you know when the medications were using have been around 100 years and there's no high-end reversible procedures for doctors to chase so they're not highly incentivized to take it more seriously and do a better job with it and it's affecting so many people the numbers are increasing yeah it's just huge it I'm seeing the same thing doctors don't quite understand thyroid I will say the average doctor I know lots of guys who do integrative and functional medicine who really get it but why is the knowledge you have not kind of permeated the mainstream medical side of things because it's relatively

00:07:13 > simple to fix a thyroid you know it's not too tough when you get it and I'm trying very hard to get the message out better and better I'm actually off to Mexico City Saturday two lectures another group of doctors I teach internationally my bias though is that the alternative world doesn't quite get it either you know my my simplification of it is that the conventional world really under diagnosis and really under treats and the alternative world my bias is that they probably overdiagnosis and overtreatment there's a certain amount of finesse to it there's a lot of elements to proper disease management and I think that the canoe alternative world the integrative world is probably closer but there's some good elements in the conventional world that should be regarded and should be acted on so I'm trying to really tie the better elements of both of those together so alternative doctors tend to over diagnosed thyroid conditions regular doctors tend to under diagnose it how would one of our listeners who you know maybe is ill feeling a little tired in the afternoon little sluggish

00:08:14 > immune problems some brain fog of fatigue they're not used to dry skin all the stuff that that I'm guessing you would look for near the symptoms of this how would they know like how do you find a doctor who's not gonna everything is thyroid or nothing is thyroid like what's the what do I do is just a consumer of medical care you know we've got a list that we put together of doctors that I've trained a general thing to think about you mentioned some really important symptoms and I've made a distinction between possible thyroid symptoms and probable thyroid symptoms you know because thyroid hormones literally impact every cell in the body any symptom could be related but statistically some are more probable than others there was a larger study done in 2000 called the Colorado thyroid prevalence study and they screened about 25,000 people in terms of blood levels but also pretty elaborate questionnaires and it was cool because they did some nice number crunching on the symptoms and they saw that some were more highly correlated you mentioned about the dry skin the some other big ones were things

00:09:15 > you might think of like the cold intolerance hoarseness difficulty swallowing chained as an energy level kind of a nuanced thing about the symptoms is that they don't occur in a large number in most cases you know the greatest typical number is between about one and four with two being a real strong median so someone rarely has a high number of symptoms another kind of nuance take on that is these are not really long-standing symptoms these are things that changed at some specific point in time so if someone has this set of two three four suspicious symptoms and they shifted six months ago or something that's that much more relevant and then also family history is a factor thyroid disease the big part that's missed in the alternative world is the structural aspect you know it's caused by and large as you mentioned by Hashimoto's and immune response and that first changes the structure of the gland so part of the diagnosis comes about by evaluating that by ultrasound and the other aspect that's important is that red cancer is the fastest increasing

00:10:16 > type of cancer in North America and everyone who has thyroid disease it's recommended they have a baseline thyroid ultrasound and have those tracked regular intervals so that's a big part that often gets ignored and it's super critical who do you go to see for a thyroid ultrasound is it a specialist or a family practitioner neither the best option for the American third Association recommendation would be a medical imaging Center and those are centers that any doctor can order imaging studies through they tend to have the greatest volume they do the highest number of these procedures they have the latest equipment and they can get the most exacting in terms of quantifying any structural abnormalities but yeah if someone's not had one it's a smart thing to get a baseline about ten plus years ago actually closer to fifteen years ago I was really into acyl sulfate potassium or a CoA the artificial sweetener and I developed the nine nodules on my thyroid which are little known side effect of that kind of sweetener like it tastes just like sugar it's kind of amazing it just has this little thyroid effect but they diagnose

00:11:18 > those just with a straight palpation and I have no idea how the person who did that knew that they were benign versus you know big ugly meaty cancers but not a distinction you can make my palpations so it was kind of someone being a little cavalier with with risk at that point and if I had done an ultrasound imaging of that it would have been more descriptive you would have been able to see if it had the tendrils that made it more likely to be malignant or something for sure there's certain characteristics such as the size the calcification the vascularity but palpation the best examiner's you take a room of people that all has nodules of five millimeters or less the best examiner's will find them about ten percent of the time and yeah skilled ultra stenographers will pick those up much more consistently so I do poke around on thyroids but I still always send out for ultrasounds more definitive evaluation of that and that's a critical part of care afterwards too you know I have done an amazing amount of quantification with radioactive dyes and God knows what else but I've never

00:12:21 > had an ultrasound of my thyroid so next time I go in I'm going to get one so thank you get one done already on on the cool thing too is that they're not radioactive there's no real negative defection of the brain non-invasive with the really useful data okay is that what that's not as important as like a thyroid hormone panel which is pretty doable do you recommend like the blood side or the just a physical how's it look side not an either/or they're both critical aspects you know one evaluates the structure when it evaluates the function and you honestly don't know what good function looks like without knowing the structure you know when there's structural abnormalities there's different benchmarks and different guidelines for the functional markers so they really both need to be looked at to make a good sense of whether or not someone is having symptoms related to thyroid disease but also someone being on treatment if they're at the levels that are the most effective for them and most conducive to good health okay what happens it you know if your thyroids out and

00:13:22 > was the first thing that the average patient sees I know that there's a whole variety and be thyroid you know I sprained my eyelash it was my thyroid um you know what what's the most obvious thing that the largest statistical percentage of people are going to feel or maybe what are the top three even so if someone's listening to this on their drive home and they go my god something's changed you know what what what are the things they ought to be looking for because I think some people know if they're into biohacking and health but there's a lot of people who just have this going on right now and you know their pants don't fit anymore and they don't know so what are the signs things not responding the way they used to and that would include weight in response to activity and diet that would include mood and energy in response to sleep and rest and activity levels and then also connective tissues you know not repairing as well as you would expect based upon otherwise health and nutritional status so yeah some shift in those big areas of the first large suspicions you know one more perspective

00:14:23 > on this there's so much thought into you know hormonal optimization hacking how we want to think about it and a point I like to draw people's attention is that there's real different realms that occur of our endocrinology not being optimal you know we've got dysfunction due to disease we have alterations in hormone output due to more dysfunction more pure pure lifestyle factors chronic stressors and we have dysfunction more so from aging you know our our genes are incentivized for us to be good baby makers but not great at longevity yes so those are all three very different realms and the methodology of understanding and treatment is kind of a different flavor for each of those realms you know so commonly people think about thyroid disease is purely being a matter of dysfunction and it's really more of a disease state it's quite distinct from adrenal dysfunction or alterations in gonadal output from aging so that's a way in which requires a whole distinct set of understanding got it so for people listening it does the

00:15:27 > most important advice of all and it may go beyond thyroid if everything worked for a while and then it stopped working either you're doing something different that you're unaware of the environment around you changed or you changed it's one of those three things and thyroid is one of those simple things that's relatively common that changes about you about your actual body will call it about your meat so well on a tough part too is that you know the common medical intervention is just a quick screen of a very cursory marker looked at at a very broad average you know I always tell patients that there's normal ranges and there's optimal ranges and there's such a big distinction you know if you wanted to know we've got the Phoenix Suns here in our area I tell people that if you want to know how tall the average man was you wouldn't go to the Suns locker room with the tape measure you know you'd get a very meaningful number for that population but it wouldn't be that applicable to other populations and the problem with certain thyroid tests is that they're their normal range is an

00:16:29 > average range and that's an average for the population getting the test done and those are the people that have the most disruptive thyroid levels that are checked the most frequently so that's the area to we're screening up and does miss it when it's at earlier stages that is a really important point in almost all of the labs that I work with unless there are specific anti-aging panels the companies norms are so far off because of the standard American diet and also this whole a curve for aging what I don't want to be old I would like my hormone levels to be where they were when I was thirty I don't care if I'm 80 I want 30 year old testosterone there's really good and pleasurable reasons to have functioning testosterone not to mention you're a nicer person when your testosterone is adequate same thing goes with thyroid hormone now there's a lot of focus on at least in my mind on prevention because I dug myself out of a hole it sounds like you did too you started out with sensitivities if people could do one thing to prevent themselves from having

00:17:31 > thyroid dysfunction what would you recommend I choose your parents carefully and choose the era in which you're born I love that answer all right let me work on that it any other it is I'm sorry you know it's something to where it's caused by inner play between genes the diet the immune system once a small simple step eat a Brazil nut every day you know be adequate on selenium status that goes a long ways towards really helping your body utilize the nutrients needed performing hormone it also goes a long ways towards optimizing your detox pathways to lowering the chance that having waste buildup in the thyroid you know we get so much stuff we're exposed to and the thyroid has a very unique relationship with a single mineral being iodine and it needs so much of it so badly that it's evolved this very powerful pump to concentrate it like 50 to 100 fold over the blood levels and that's that's cool so far but the problem is that so many chemicals have some vague similarity to iodine they

00:18:33 > also get concentrated that badly inside the thyroid so a big variable is just environmental stress environmental toxins did I just hear you say fluoride is bad for you in there you could certainly infer that fluoride does get concentrated along with iodine yeah you heard me say that and from there on the same column in the periodic table they are indeed as well as the bromide that goes in our bread right yeah I love hearing you say that because there's a lot of controversy around fluoride and because you're a thyroid expert like you know what fluoride does to a thyroid gland you know fluoride had huge medical use for blocking overactive thyroid for decades that was the treatment of choice you know it's very straightforward thing that it's a effective strategy to shut down the gland when it's overactive it's probably a little less toxic consume the modern drugs are but its role on suppressing thyroid activity could not be better documented I still am amazed that anyone with a scientific background

00:19:34 > will argue that putting a thyroid suppressing drug in water to prevent a relatively benign thing like cavities cavities suck but low thyroid sucks a lot more so I I just don't get that I'm but the answer and all the rest of the problems yeah all right so if iodine is a key thing you mentioned something of the selenium and Brazil nuts now you and and Tim Ferriss who's another guy who's work I admire our Brazil not fans no I've looked at Brazil nuts and I have looked at the incidence of mycotoxins or mold toxins in Brazil nuts it is hard to find a not moldy Brazil nut and there is a well-documented cross reactivity between gluten and the types of molds that grow on nuts and corn basically members of the Aspergillus and Penicillium family I would be willing to bet that a certain percentage of

00:20:35 > Hashimoto's is not necessarily from gluten specifically but from Krauss but from things that cross react with gluten and there's also documented evidence many studies are done correlating Hashimoto's and gluten know if you go to PubMed and you type into broader terms type in thyroid type in Wooten and you'll find three studies and their studies showing that celiac disease is statistically slightly more probable in the population with thyroid disease than it is in other populations that's that's the end of the studies interesting so do you do you believe the gluten hustling encourage any my patients to live on Wonder Bread okay but I do encourage them to really focus their efforts on what's gonna be the biggest needle movers for them and a huge percent of people have celiac a big percent of gluten intolerance and that's a very big health issue but the data on those reactions actually causing thyroid disease pretty far down the pecking

00:21:37 > order of hypothetical verses documented Wow have you reversed Hashimoto's entirely in patients sure there are those to where it's earlier in the process there's non significant structural alterations they've had minimal change in expression of related hormone function and yeah that happens my big focus is always really helping people identify what their optimal health looks like and help them get back to that it's not really focusing on what pills you take to get there but really just getting there you know I treat diabetes and so often people are on four or five world medications and they're doing horribly and in many cases workhorse of insulin can really help them move back to herself and people are often much very fixated on not wanting a certain kind of treatment and I think it's not really about the kind of treatment it's about the goal in the end the end the outcome it's a word where can you get not really how are you gonna get there don't be attached to that you know use whatever's most logical and most effective and simple do what works do what you can feel and yeah don't do

00:22:40 > what's supposed to work but doesn't work if only I when I was a kid so so often people come in and I'll say hey I've had thyroid disease for a long time can I not be on medicine like well I can help you get healthy I can help you get ridiculously healthy and there are periods of complicated steps you could do that could help your gland output a bit if it's making a lot of hormone if it's not making much at all and it hasn't for some time you know that's not the best expenditure of your energy in all honesty so I ended up reversing my Hashimoto's I tested positive for the antibodies I became militant about avoiding gluten and I'm already militant about avoiding mold toxins but the reverse thing you mean your antibodies went negative yeah I have no moral collies so I mean I haven't done a structural analysis the way you're talking about so I'll go get that done and see if anything else comes out from that antibodies antibodies to me are kind of like psychics if they if they say things that I like and make sense I believe in them you know medical tests they all have certain rates of false positives and false negatives the rate

00:23:43 > of false negatives for thyroid antibodies is upwards of 40% the amount of false positives is below about two or three percent so they are inherently variable for reasons that are not always meaningful so in many cases if you check them dozens of times where we give an individual dope they'll come and go they Leben flow and it takes a lot of reading and a lot of time and a lot of people to see big meaningful trends for that so yeah still still watch off your trip for sure and I will actually realize that it's kind of a fun thing but it's a very different kind of diagnosis you know so many diagnosis were used to are based upon a simple marker or upon a constellation of patterns Hashimoto's is not like that it's a histologic diagnosis and what that means is the only rule for Hashimoto's is the complete removal of a gland and the microscopic analysis of every nook and cranny of it so there's a lot of rule ends but there's not really practical simple rule outs for it yeah that would be sort of a painful diagnosis section your thyroid no

00:24:47 > problem put it back when you're done well before we start vivisecting our own thyroids one of the things I run into I write a lot about actually almost everything is about energy and like mental energy and physical energy and magically when you get your energy right you optimize your weight pretty pretty magically as I'm guessing you've seen with your your patient population what about women though because women have different thyroid issues than men and women have a harder time losing weight in general even on you know bulletproof coffee sometimes we have to tweak the recipe for women not always but what's the thyroid differentiators between women and men yeah that's that's an awesome question and my population of patients is so heavily female your the data suggest that is calm in a thyroid is there's probably about an eight to one female to male predominance and the reasons for that are the same reasons that women have more autoimmune disease in general a couple of theories there's the chimerism model where we think that

00:25:49 > some some cells left over from fetal development may alter the immune response there's also a distinct immune function that women have that allows them to host a foreign foreign body ultimately and not respond to it and that makes them more apt to attack some of their own tissues there's also arguments that just lower androgen levels can be part of that equation too but for sure they're much more apt to develop thyroid disease and because of that they're much more apt to have the weight be a struggle for them you know the whole cyclical process of estradiol progesterone that by itself is very conducive to maintaining some subcutaneous fat maintaining a lower bowel turnover rate higher caloric absorption pattern for better stability of a baby so there they're set up to carry more than one person and that makes them easier to have their immune system attack themselves but also harder to really let go of any stored tissues so women should be more concerned about the incidence of thyroid problems than men should be on average it's more

00:26:51 > common among them you know although if you're a man in a relationship with a woman you might want to care a lot about this you know a funny thing with family history when there's when there's a male relative in the family because it is rarer in males that makes it much more likely for anyone of any gender to have thyroid disease yeah female relatives raise the risk but male relatives raise the risk exponentially greater oh that's interesting because they're less likely to have it correct I can tell you that after my wife who's a careless katraine physician by the way um she's co-author of the better baby book which is our book about epigenetics and what you can do to your environment your food to have better genes and healthier thyroid and your kids awesome so during after our first pregnancy she had thyroid issues and to me it was blindingly obvious because she'd sleep 12 hours and say I'm so tired I'm so tired even after the first few months when all babies make you everyone tired and literally for about 18 months I just

00:27:52 > say your thyroids at your thyroids out and and when she finally went in she was a RAC to be honest and there was barely detectable thyroid hormone it was scraping the bottom of the barrel and so when she went on it was like you know it turned the lights back on it was a huge difference but if a person in your life whether it's a husband or a wife has a thyroid condition it will seriously affect the relationship because one person like if your spark plugs aren't working you don't have the energy to go out and have fun on Friday night you just want to sleep yeah do you see that in your practice where people they turn their thyroid back on and their relationships improve and you know their jobs improve and things like how completely yeah your life is so much better it always blows me away how much of our you know we've got this mystical experience of consciousness of interfacing with the world in our heads somewhere and it always blows me away that that seems to etheric but yet the most subtle microscopic chemical manipulations can have the most profound

00:28:53 > impact upon that experience I mean it's not just a wild idea it really is Oh I mean heck you can go go - advancing Li small amounts of some of the you know illegal hallucinogen sorts of things all the way up to just like 100 milligrams of caffeine and a cup of coffee sure it changes everything but the thyroid we're measuring this in micrograms for for the thyroid hormones so this is potent stuff ya know I happen to give people the idea that if you imagine you know looking at a little grain of grain of salt in the palm of your hand about 1/10 of that represents the mass of thyroid hormone your body makes per day and that tenth of a grain of salt is distributed in all of your tissues if that were absent maybe two to three weeks you can survive before you'd go into a coma from just fluid pressure on your brain and if that were a full grain of salt maybe several more weeks before your heart would give out from over stimulation so you have the most subtle changes in that microscopic compound and just have huge impacts upon

00:29:55 > all aspects of your chemistry and physiology now is there a circadian rhythm to thyroid or a monthly rhythm there is a circadian rhythm now that has a bit of a mirror effect upon cortisol metabolism our biggest output is going to be normally between about 2:00 to 4:00 in the morning that's when we get the TSH surge and the biggest release of T for the conversion and uptake of hormone goes on in a few other cycles throughout the day now there's not a monthly rhythm for what the thyroid does but there's a lot of ways in which in a woman's body there's interactions between the monthly rhythms of estradiol and progesterone and thyroid hormone when a woman is menstruating it was a generalization estrogen heightens a compound called thyroid binding globulin and that lowers the efficacy of thyroid so right before ovulation and about a week before menstruation there's a point at which it's normal to have more impairment of thyroid uptake because of that increase in estradiol and there are also some

00:30:57 > annual rhythms that go on relative to temperature change in seasonal fluctuations of day light and darkness that are relevant oh now we're going to talk about some cold biohacking things all right I'm known to when I'm not an airplane too much to sit in ice baths for thermogenesis have you done a whole body cryotherapy yet I haven't done Jenna with like the liquid nitrogen sort of thing that one when you're in Phoenix I've got a unit well I'm so there you can you can count on next time I go out there for 40 years then I mean I've been wanting to try that forever and I have the form is I have an agricultural stock tank and I put you know 40 pounds of ice and I sit there and shiver for a little while but Yamaguchi was a Japanese rheumatologist and in the early 70s he was intrigued about the benefits of cold therapy and he wanted to hack that he wanted to manipulate it and heighten it in some way and he kept playing with all these methods and you realized that the benefit correlated with thermoreceptors little nerves just the skin surface that responded temperature and he found that

00:31:59 > the colder he could get them and the more quickly he could get them cold the greater was the neurologic response the benefit of cold is not really chilling it's the neurologic shock and it's the after effect that first and so what he found was that the maximum benefit of cold water normally yours thermoreceptors about 90 Fahrenheit 90 degrees Fahrenheit and if you're a nice tub for about 18 minutes you can get them down to 59 Fahrenheit but he showed that with air super chilled to minus 250 fahrenheit liquid nitrogen you can bring them down to about 35 to 40 Fahrenheit within 30 seconds that is so cool I asked target 45 but I'm sitting in ice water for you know good 20 minutes and it's you know ice floating around and sometimes I can't get below 50 yes so all right now I'm intrigued you have one of these units of course you have an anti-aging practice not just thyroid what is it due to thyroid hormone when people expose their skin to these crazy cold temperatures well it helps you know

00:33:00 > and one of the big elements we have that affects our weight and our third output is our lack of thermal variation you know for a long time we got cold at night yeah Alvie feel get cold much if ever anymore so we have less brown fat we have less capacity to modulate our secretion of hormones to elevate our beta oxidation in response to thermal Venice's just because it's not challenged as much so yeah thermal challenges are wonderful they're great the cool thing with the crow therapy is that the effect is powerful but the actual duration is very brief you know it's only three minutes and so it's much more tolerable but it's a greater effect under the therapies because it's a quicker drop of those thermo receptors it's a more dramatic quick plunge that they face so your body goes into this very powerful useful shock response that stimulates metabolism and tissue repair so how much does it cost to buy one of those nitrogen uh Carl sixty to eighty thousand visits you know I think I want a Tesla before that but I'm not like

00:34:01 > either one so darn it I won't one of those is sitting behind me in my biohacking lab here Oh what my clinic so I could have personal access to it I that very much what about the glove they have those gloves you put your hand in that use a vacuum and three cleaning cold water to drop your body temperature it's not thermal receptors on the skin but like is there a hack for the rest of us so we can we can afford to do this or do we have to come and visit you and hang out in your cool cryotherapy chamber I'm gonna do it what you're doing with ice is probably the next best thing you know other therapies the benefit is relative to just how much of the body mass is chilled and how abruptly so the more mass you'd show the quicker you know if you're going from like a sauna to a cold plunge that can be a powerful thing the funny thing about cold therapies though is that you're inducing a stress effect and so like like other stress responses the ideal response like exercise would be a challenging stress but one that induces a heightened recovery response you wouldn't want an overwhelming stress you know you wouldn't just take a new runner and put a gun to their head and make a

00:35:02 > run a marathon that wouldn't make them faster that would just make them sick and sore yeah the same thing with any kind of a stress induced response it should be relative to the person's capacity to compensate and respond to it well in fact a warning is due here if you're listening to this and you're thinking you'll go sit for 20 minutes in a bath full of ice it's pretty advanced talking like seriously listen to these words read the blog first because I got first three ice burns over 15% of my body doing this wrong it took me weeks to recover from that and you need to soak your face in ice water every night for a couple minutes to get your vagal nerve used to this so don't mess around if you do decide to do it it is an amazing thing but honestly if you can get access to a cryotherapy three-minute treatment versus kind of suffering for five minutes before you kind of bliss out in the cold I recommend that so oh I didn't even think we talk about this now d what do you see it is T 3 T 4 by the way we haven't talked about what t3 and t4 and

00:36:03 > TSH are so we should talk about what those are and I want to know what is cold do for for your thyroid and for inflammation in general what is the thyroid relationship so what are these things all the T numbers are basically iodine atoms you know the whole thing about forming thyroid hormone is a matter of packaging iodine onto a tyrosine like molecule you're packing more and more I dine on to this and each iodine gets a new number so there's t 2 there's T 3 there's T 4 T 2 and T 3 are the most biologically active by far in our gland makes T 4 I heard professors say this brilliantly the reason we make an inactive hormone is the same reason that Campbell's makes their soup and cans because if they made it in a big hot bat it wouldn't be easy to transport so they make it as old they make it canned and that's how we make an inactive hormone we send it out that way and we can pop it open and heat it up when and where we need to the body has more peripheral control over that TSH that's the main upstream control of the

00:37:06 > brain telling the thyroid to work you know the thyroid is one of many lazy glands that goofs off and it's not being yelled out so it only makes hormone in response to thyroid stimulating hormone and that's the main upstream control downstream there's a big long list in ways in which the body can change how those hormones are used how they're bound up how they're crossed in the cell membranes there's many levels of upstream and downstream control yeah TSH t3 t4 there are the big numbers that come up with thyroid testing now most of the time when I get a new performance consulting client and if they've even had a thyroid panel it's just TSH because it's quick and dirty how predictive is just the TA TSH level without looking at t3 t2 t4 reverse t3 and si roid binding globulin is all those things those are all very relevant markers you mentioned so the TSH alone we think about the again the positive pretty value and the negative freak eval you so the positive value of

00:38:07 > a very abnormal TSH is accurate it's a very meaningful your TSH is screwed up there's clearly a problem the negative predictive value of a normal TSH is not very high you know it's very probable to have thyroid to sanction for some length of time before the TSH ever moves outside of its range or substantially at all so that means that if you have regular TSH it doesn't mean that you're free of thyroid problems it just means you don't have like the most fubar thyroid possible that's a perfect way of putting it all right so this is one reason that when people are dealing with any sort of lack of energy or focus that I recommend that they talk with their practitioner about getting an advanced thyroid panel that includes all of the things so you can see whether t4 is turning into t3 and all of that and what's the most common the most common problem that you see when you get when you have the full data and you can see t4 t3 t2 and TSH is the one that stands out that's that's more common than others well the most common disease

00:39:09 > issue is Hashimoto's and the funny thing is that this is something else they try so hard educate doctors about because there's really a lack of understanding the free hormones the t3 and t4 their relationship is very nonlinear with the TSH you know in many cases they're looked at as if they're independent issues and very often doctors will see a suboptimal or abnormal levels of t3 and t4 and they'll do types of dosing with those hormones to compensate for the levels and it's really just not how the system works you know those are much more reflective of peripheral thyroid conversion and metabolism than they are of central thyroid regulation so if you manipulate those independently you won't see a very linear response in the other markers so there's a point at where at the greatest level of extremes at the greatest level of excess the TSH being a backwards marker it goes low and avenge those hormones do go high that's after the body is completely exhausted all of its mechanisms of blocking buffering

00:40:11 > negating thyroid to protect itself and at the opposite and it's also true at the greatest deficiency eventually those hormones get low but between those two states they're not linear relationships so when they when those free hormones Rev normal relative to the TSH that's that's different and that's more a matter of interpreting the downstream peripheral regulation than it is trying to change central control or global thyroid hormone levels that was a mouthful I think I need to parse that sentence and usually I'm pretty good at these so this is one reason why you should work with the practitioner in order to look at at these numbers if anything has changed the way you didn't want it to ya know as a biohacker I know that when you're injured you need a little more thyroid hormone when you're stressed you just naturally generate a little more thyroid and I've been known to take you know 2.5 to 5 milligrams of extra cortisol when I'm getting sick and magically I don't get sick I've also been known to take about 1 milligram of time at least t3 on days

00:41:14 > when I'm starting to get sick I assume you mean a microgram guys thank you yes sowhy micrograms I said milligram yeah a slight difference there few zeros life-or-death difference yes really it is and so essentially I'll take a small fraction of a time-released III compounded capsule is this something that only a crazy bio hacker would do or is this something that's probably safe and may keep me from getting sick boy we're short answer diplomatic answer I'm trying really hard in here actually diplomat you can tell me that it's a really bad idea and I might even stop doing it I've noticed it's different everything is compounded thyroid hormones you know the problem there is that the level of quality control I have friends at manufacturer thyroid medications they were they had they actually chief science officer one of the big companies a close friend of mine and he's confided in me that the whole quality control process from raw material to final product about 95 percent of products don't reach the

00:42:15 > market when they're assayed pre production or post-production because of just variability and output and that's with the very best exacting machinery so compound it means that somebody mix it up by hand and there was never quality control processes along the way so what what and I'll actually double check with the guy work with is a pretty high-end of pharmacist but I believe there's a quality control process on the raw material they're just putting it in a in a different dose because I don't want to take lose production there's not a quality control process to see if the mixing was adequate yeah correct right and I'm personally aware of at least eight cases of death or near death because of that exact problem whoa when I manage thyroid disease the targeting of the blood levels is so exacting it's like down to a tenth of a unit to get someone just perfect and I just can't achieve that with medication that's not consistent so I'm just not about which brands you know which products are we thinking I left compound medicine behind so long

00:43:16 > ago for that reason every pharmacist I've talked to claims to have the secret sauce methodology but I've never really had a good explanation and how that how it actually happens it's pretty compounding is great for milligrams but micrograms it's just too big of a fudge factor and the difference is still the mixing problem yeah Wow so but I'm going to have some hard questions for my my pharmacist next time which is which is pretty cool very specific plug you for personal use I'm WP thyroid that is that is like the best brand in terms of standardization no gluten no binders no fillers the only inactive ingredients are medium chain triglyceride from coconut and inulin from chicory root besides that it's only natural desiccated thyroid powder it's standardized to less than 1% variance for t3 and t4 and that's that's the brand that I really stick with alright I will put a link to that in the podcast notes so that people who want to find it can check it out yeah and there's conversion charts you can easily work to a--does it to that from any other kind of medication you

00:44:17 > know send through it alone or a compounded medicine or a combination okay it's interesting about about ten years ago I had a chance to spend some one-on-one time with former head of the FDA and it was at an investment meeting and I was there representing a venture capital firm and I was the only vitamin anti-aging wacko in the crowd we wanted to sell drugs and medical devices so I thought gonna raise my hand and said so why are you hostile to innovation in the supplement business because we have you know hundreds of millions of dollars to invest in supplements you know I kind of you know read him the riot act in the nicest possible way in a room of 20 people right and now disaster afterwards we were having having a drink actually and I said you know I hope you don't think I was you know putting on spot of being rude and he's like compared to a congressional testimony that was nothing and he did explain exactly this thing about at the time was armored thyroid and he said look there are serious quality control issues and this was a decade ago and for him it had been like one of his personal Crusades in the FDA

00:45:19 > in order to focus that and to actually take some things off the market that did have quality control issues so it's interesting that it's apparently still going on and this is something I was entirely unaware of so going on and it's per guidelines the guidelines allow for up to 20% variation for the natural desiccated thyroid products and they allow for more than a 5 percent variation batch to batch on the synthetics so those are both really unacceptable to me and one of the compounding again there's really no standardization for post production this is this is fascinating stuff is probably getting pretty detailed for for somebody out there the the takeaway from this is that if you have symptoms that match a low thyroid things have changed they aren't as easy as they used to have been you do want to get a full thyroid panel not just a TSH and this is a relatively simple piece of advice you want to work with them with a professional and if they're writing just a journal script for a generic thyroid hormone I can personally testify there's a difference between generic and a name-brand

00:46:21 > terms of efficacy and it sounds like I'm not opposed to compounding I know some wonderful compounders who your compounding pharmacies who mix things I cannot buy anywhere else you know preservative free nystatin or whatever whatever the thing is so I think there's a definitely a role for compounding and some of the more innovative people are compounders in my experience but it sounds like for Mike gram dosing of thyroid your arguments are pretty convincing there so and I love compounding too for all the same reasons you do awesome so yet there's already enough of an industry attack on compounding pharmacies I would not contribute that I would simply say write your advice to buy good quality standardized you know industrial grade whatever you want to call it Tyron hormone from WP thyroids Wow okay you've convinced me on that front well there's a question Ellen that I've asked everyone who's been on the podcast and the question is not accounting for your medical practice or any one thing you

00:47:23 > know your amazing careers a semi-professional mountain unicycling um it is what are the top three recommendations you have for people who want to perform better people want to kick more ass who just you know want to feel good and have that limitless power what have you learned in your life that we should know I'll be the number one is just to be persistent with your health you know make it a priority and don't ever compromise on it you know don't ever assume that it can change you know our our bodies are this big collection of pieces that is in a constant state of flux and turnover and there's just ridiculous amounts of of homeostasis and wisdom and capacity to repair that's going on 24/7 and if we have the right building blocks in place and if we have all the obstacles out of the way it can do some pretty cool stuff you know and so often what happens is that we have decades and decades of you know not enough sleep you know not the right nutrients too much waste in our body

00:48:24 > unstable blood sugar whatever these factors are and we call that aging you know and there is a very real element of aging that that we have probably yet can't shake completely but so much of what we think of as aging is really not it's stuff that is totally reversible so yeah my big takeaway is don't give up on your health it's not where you don't want it to be and always expect that it can get better and it can improve and the basic things really yield the biggest results good quality sleep healthy relationships you know great social connections lots of vibrant living simple food that men have had prolonged periods of time no keeping your body low in chemicals the simple stuff it's not heroic effort it's really about Tudor wit consistency over long periods of time that's one that was one there's a couple inside of there I would I would add some element of hacking into it about quantifying and whatever it is you want to change find some way to put metrics on that you know we really can't improve what you can't measure find find

00:49:26 > some way to quantify and score and track and create a good team for yourself that was number two number three create a good team for yourself you know find some great resources podcast like this find good books out there find find professionals find associated friends and really share best practices and really collaborate and help raise the bar for one another so yeah seek out data keep seeking out data and you know there's certain things that we focus our time on that are quite unimportant you know we look at the lives of the celebrities or whatnot and for sure you know your physical health how you're performing the world deserves a certain amount of that horsepower in that attention so make it make it a bit of an obsession or priority or a focus for yourself and it'll yield you so much positive outcome in your life great advice Alan I appreciate you sharing it where can people learn more about your practice and your books integrative health care calm data about the practice my books around Amazon or

anywhere books can be sold both of the thyroid books yeah I'm so easy to find great I will put links to your books on the show notes as well when we post it so people can find them Alan it's been a pleasure I learned something every time I talk on one of these podcasts with an expert in the field but I did not expect learn about compounding pharmacy stuff from you so thank you my pleasure all right next time we talk I'll call you in about a year I fully expect to see juggling juggling I'll put it on the list I'll fully expect to see unicycling all right you win since I'm at have an awesome day thank you you you you