October 15, 2024 • 29 mins
How much do you know about thyroid health? The thyroid gland is a key part of the endocrine system which controls many important body functions. On this show, Karolyn talks with endocrinologist and thyroid health expert Angela Mazza, MD. In addition to being the author of the book Thyroid Talk: An Integrative Guide to Thyroid Health, she is also the host of the popular podcast Thyroid Talk. To find out everything you've ever wanted to know about your thyroid, you won't want to miss this show!
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Speaker 1 (00:00):
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guest should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:40):
Hello everyone, and welcome to Five to Thrive Live. I'm
Carolyn Gazilla and I co host this show with my
good friend doctor Lise Alschuler. Today our topic is thyroid health.
The thyroid gland is so important and I'm excited to
learn more. But before we dive in, I'd like to
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(02:07):
fermentation process. It's a very effective probiotic. Learn more at
doctor Oheiraprobotics dot com. Well I have the perfect guest
for our topic today. Doctor Angela Masa is the founder
of Metabolic Center for Wellness in Central Florida. She is
the author of the book Thyroid Talk and Intergative Approach
(02:28):
to Thyroid Health and the host of the popular podcast
Thyroid Talk. So this is a doctor that definitely knows
about the thyroid. Doctor Maza, welcome to the show.
Speaker 3 (02:38):
Thanks so much, Caroly I appreciate the kind introduction.
Speaker 2 (02:41):
So let's begin with the basics. Why is the thyroid
gland so important to health?
Speaker 3 (02:46):
Well, the thyroid is ours the hormone it makes the hormone,
thyroid hormone, and thyord hormone is our hormone and metabolism,
and a lot of people think, oh, metabolism is just
you know, what we take in as far as food
and drink and burn into energy. But it's really a
lot more than that, you know. It's how we we grow,
it's how we live, it's how we thrive. So we
(03:08):
need our thyroid hormone. And there's really not one system
in the body that you could find that isn't affected
by thyroid. It affects how we our oxygen, metabolism, how
we control our thermostat if you will, how we burn energy.
We have receptors on our heart, on our gut. Our
gut is so tightly linked to thyroid health. We have
(03:29):
effects on blood, bone, our brain is super rich in
thyroid hormone receptors. So really, the thyroid affects every single
part of our life. And you know, sometimes it kind
of can sneak up on us. If it's off. So
it's important to know about some of the signs that
may go along with your thyroid not being insfest.
Speaker 2 (03:49):
Right, So we're going to definitely talk about that in
a lot of detail. But that's a lot, I mean,
so the thyroid is really far reaching in terms of
what it impacts from health perspective, definitely. So what are
some of the more common thyroid problems and their causes?
Speaker 3 (04:09):
Sure, yeah, Well, one of the most common thyroid problems
is underactive thyroid or hypothyroidism underactive. The most common cause
in the United States is Hashimoto thyroiditis. It's gaining ground
as the most common cause around the world. It's an
autoimmune form. They can kind of one of those that
can sneak up on us gradually. So about it affects
(04:33):
women more than men, although men get affected as well.
But it's estimated that one in eight women sometime in
their life is going to develop some sort of undiactive
thyroid issue, specifically Hashimoto thyroiditis. Fibroid nodules are another form
of thyroid issues that are becoming more and more common.
Yroid nodules are masses within the thyroid. They kind of
(04:55):
grow within the thyroid and if we ulter down everybody
that walks down the street, one in three persons sometime
in their life is going to show up with something
on the ultrasound. So thyrol nodules are a very very
common thyroid issue. And then there's overactive thyroid. Thyroid cancer
less common, but very treatable. So these are kind of
(05:18):
the most common thyroid issues that I count on a
daily basis.
Speaker 2 (05:22):
Okay, so let's get into the symptoms. I'm assuming that
the symptoms are different for each one of these or
are there some common symptoms.
Speaker 3 (05:34):
Well, there are some overlapping symptoms, because you would think
if you have an underactive thyroid, it would be completely
different than overactive thyrot how you feel. But there are
some actually overacting symptoms, you know, if we talk about
hype both rotism. Probably the most common complaints include fatigue,
(05:55):
brain fog. Who doesn't have brain fog sometimes, but if
your thyroid isn't working right, you can have brain fog
trouble Losing weight or gaining weight can be associated with
thyroid imbalance, but too much thyroid also can cause fatigue
and weight changes, so it is kind of difficult to
sometimes delineate the two. But there are some symptoms that
(06:18):
kind of make them polar opposite. So persons with hype
both iroidism may be a little more cold all the time,
whereas someone with overactive or hyperth iroidism tend to be
a little on the warmer side. So there are some
kind of things we kind of kind of delineate the
two from. As far as thyroid nodules, some people don't
have any symptoms whatsoever and find them accidentally looking for
(06:40):
other things like a crotted ultrasound or a chest des
ray or a neck MRI. But some thyroid nodules are
very very fast growing, and person may notice a lump
in their throat or trouble swallowing or change in voice.
So not everybody has any symptoms at all when it
comes to thyro and nodules.
Speaker 2 (06:59):
What about thy cancer, You know, our audience is a lot,
we have a lot of cancer survivors and their caregivers,
So talk to me a little bit about thyroid cancer.
Speaker 3 (07:09):
Thyroid cancer as far as symptom wise, it kind of
falls into those. You may not have any symptoms whatsoever.
Your labs may be completely normal. You may not even
feel anything in your neck. If the if the if
the little mass is small enough and we just find
it on ultrasound. When we do find a suspicious nodule
(07:30):
on ultrasound, that's when we do the biopsy, just like
in different other types of cancers. But the great thing
about thyroid cancer, if there is a great thing, is
it's really treatable. It's some some thired not some thyrod cancers.
If they're especially the most common type, which are populary,
if they're very small, we call them micropopulary. These grow
(07:51):
very very slowly and we may just observe them. Other
other thyroid cancers, we may go for surgery or partial
thyroid ectomy, or now we have actually radiofrequency elation or RFA,
which has been approved as a non surgical treatment for
some small cancers. So we do have some great options
(08:13):
and great success rates when it comes to the thyroid cancer.
So it's really advanced in the past few years, and
we're our ability to the question I often get is
is thyroid cancer increasing in frequency? Well, I think we're
looking for it more, but I do think that it
may be increasing in frequency because our thyroid is so
(08:34):
sensitive and we're exposed to many many toxins and chemicals
that we've ever been exposed to, and the thyroid sometimes
tastes the bline of it.
Speaker 2 (08:44):
So let's talk a little bit about causes because you
mentioned the environment. What are some of some of the
common causes for some of these thyroid conditions?
Speaker 3 (08:54):
Great, so you know when we're talking about autoimmune, So
autoimmune thyroed issue can be Hashimoto thyroiditis, which is an
autoimmune process where the thyroid starts to not work as
well because the immune systems almost attacking the thyroid itself.
So we can develop progressive underactive on the other end
of the autoimmune spectrum as graves to sase. So that's
(09:16):
where the autoimmune system turns on the thyroid, so it
doesn't turn off. Believe it or not, these two have
common genetic determinants. But when I talk to my patients
about causes, so why do I have this, Well, when
it comes to autoimmune issues, especially thyroid, I always think
in terms of this triangle. So part of one point
(09:38):
of the triangle is our gene so unfortunately we can't
change our genes yet, so that's one part of it.
The second part of the triangle is things we've exposed
were exposed to over our lifetime, so it can be
you know, viruses, medicines, even how we're born, it's going
to affect this kind of cascade, if you will, toxic metals,
(10:03):
so those sorts of things. So again in past past history,
we can't change that. But a lot of it comes
down to the gut, believe it or not so, and
the guts that one part of the triangle that can
one be the tipping point for developing autoimmune thyroid issues.
But it's also that part part of the triangle that
is a controllable so we can work on our thiro.
(10:23):
We can there's lots of things we can do to
heal the gut, look into what's causing gut issues because
that can be the key to bringing down that autoimmune
attack on the thyroid.
Speaker 2 (10:34):
Great and I do want to get into the gut
because we love talking about the guts.
Speaker 3 (10:38):
Wonderful. I know, it's so.
Speaker 2 (10:40):
Interesting, doctor Malaza, because it seems like when I read
the scientific literature, there's another access. There's the gut brain access,
the gut liver that well, I just recently wrote about
the gut eye access. I mean, this is fascinating stuff. Yeah,
it really is. So before we get there though, what
are some of the biggest misconceptions when it comes to
(11:01):
treating thyroid problems?
Speaker 3 (11:03):
You know, I think there's a number of them. I
think first off is testing. So the gold standard, the
tried and true for testing thyroid function issues is thyword
stimulating hormon TSH. So essentially TSH comes from the pituitary,
so the thyroid hormone is is based off of feedback loop.
(11:26):
So essentially the hypothalamus, which is a specialized part of
the brain, and the petuitary, which is another specialized part
of the brain, make releasing hormones. So when the hypothalamus
or the petuitary sense that there's low levels of thy
word hormones, they kind of produce TRH, which comes from
(11:46):
the hypothalamus, to cause the petuitary to make TSH, which
then in turn causes the thyroid to make ideally to
upregulate and start making more thyroid hormone. Now, the TSH
is an indirect measure of thy word function, it doesn't
really give us the full picture. And the standards that
we use for TSH are based off of huge population studies,
(12:07):
so they don't really they're not individualized according to sex
or age or race. I mean, they're just standard whole
population studies between this range, so that doesn't give us
the whole picture. We also really need to look at
the actual circulating levels. So T four and T three
(12:28):
those are our thy word hormones. So our thy word
mainly makes T four a little bit of T three,
but mainly in the circulation T four gets converted to
T three because T three is the active thyword hormone
that really does the work of the thyroid, that goes
to each of the cells and causes them to do
what they're supposed to do, either activate or repress certain
genes and fulfill their duties as that cell. So that's
(12:51):
the one thing. The misconception that TSH is an accurate
kind of gauge on thyroid hormone now also one of
the big ones. I get a big lot of questions,
especially at conferences, because doctors want to know, Okay, this person,
I know they have antibodies. So antibodies help us diagnose
(13:11):
Hashimoto thyroiditis, So thyrod peroxidase or thyrodglobuline antibodies. But what
if the patient's diyord levels are normal and the thyroid
antibodies are positive, do we just call it a day,
or is it something that we need to follow, Well,
you definitely have to follow it. It's that's the ideal
case that we can do something to prevent the attack
(13:35):
and the decline of thyroid hormone. So those are two
big ones, and I think the other, probably the third
big one is if we're dealing with autoimmune thyroid, especially
hashimoto thyroiditis, that if we just put someone on thyord
hormone replacement, we don't have to do anything else. That's it.
Write the script, take the thyroid pill, and that's it.
(13:56):
But if you don't really look at the whole system,
you don't look at the gut, you don't look at
the whole body wellness, you don't look at micronutrients, you
don't look at stress management or the adrenals, then it's
just a you're just you're not treating the underlying problem.
You're just putting a band aid on it. So those
are kind of the big three.
Speaker 2 (14:16):
Yeah, those are Those are great and I'm I'm my
next question I'm going to ask. I think I know
the answer. So you utilize more of an integrative approach
to treating thyroid cancer. I was going to ask where
do you begin with your patients? But I'm guessing you're
going to say the gut.
Speaker 3 (14:33):
I tend to start with the gut. I'll backtrack maybe
a little bit, so, say I have someone who's sent
to me for abnormal thyroid function tests, I actually look
at micronutrients first. Okay, the thyroid needs certain micronutrients in
order to operate properly. So, especially like when I have
women in like their twenties, thirties, forties, if the TSH
(14:56):
is off a little bit, I not only check, I'll
tell you about the others I check. I check iron
because as women, we lose iron on a regular basis
and sometimes we never catch up with that iron. And
iron is a very important part of the enzyme and
the thyroid that helps us make thyroid hormone. So if
(15:17):
we don't have the right micronutrient for that enzyme to work,
we're not going to make enough. Now, Ionine and soelenium
are the other two that are essential for thyroid hormone production.
So if we are low on micronutrients like these three are,
thyroid's not going to work right. So sometimes we can
just replace those micronutrients and the thyroid actually has what
(15:37):
it needs to work properly, But the gut would be
definitely the second nest, now the close second one, because
the gut is so so important. It really is, and
it sounds like you get it.
Speaker 2 (15:50):
So you know, let's stay with the micronutrients just for
a moment, because I'm kind of glad you started there,
and I know that you do utilize nutrients supplements, so iron, eyelid, selenium.
These are micronutrients that you're testing and then you're trying
to fixed efficiency or whatever. Are there other go to
(16:11):
ingredients that you look to for thyroid health when it
comes to dietary supplements.
Speaker 3 (16:18):
Oh, like go to is just for micronaches. Well, the
thyrod needs magnesium, so I'm sure you talked about you
probably know all about magnesium and the wonderful benefits of magnesium,
but our thyroid is one of the parts of our
body that definitely needs magnesium. I mean, it's kind of
like it's I think magnesium is like one of the
best supplements you can possibly do. Zinc is also very
(16:41):
critical for thyroid hormone production as far as it's a
cofactor and how thyroid receptors work too. It's kind of
a carrier protein as far as other kind of supplement wise,
probiotics are key, a good, good spectrum probiotic in order
(17:02):
because we want to we want to encourage a diverse
microbiome because that keeps up with a healthy gut. So
probiotics are definitely key. So those are kind of my
top ones. And Vitamin D. Vitamin D is also very important,
especially when it comes to hashimoto thyroid itis and autoimmune
thyroid issues because vitamin D is important for immune help,
but it also helps bring down those thyroid antibiodies.
Speaker 2 (17:25):
Yeah, and when you're talking about probiotics, because would you
talk about probiotics a lot on this show. It seems
like the prebiotics are as important or maybe even more important.
Speaker 3 (17:36):
Definitely, and I think they get they we oftentimes miss
them in the whole probiotic talk of things. But pre
biotics help feed the good bacteria the gut. We want
to encourage the growth of the bacteria in the gut
because when we look at studies on thyroid and the microbiome,
the microbiome can actually make us or break us when
it comes to thyroid, because it cannot only affect how
(17:57):
we absorb those micronutrients, but it can also compete. If
we have an overgrowth of bad bacteria, it competes for
those micronutrients that we need, and it can it can
kind of cause a whole cascade of effects. So yeah,
definitely prebiotics especially, and I think as women we don't
we don't stress it enough in just women in general.
(18:17):
That's where our gut we need. We need fiber as
we as we move along through life, at least at
least thirty grands a day.
Speaker 2 (18:25):
Mm hmm, yeah, very important. All right, So let's move
on to other strategies. What other foundation of strategies do
you use to treat thyroid conditions? Where do you where
do you go next?
Speaker 3 (18:37):
Okay, so we've looked at micronutrients. Well, the thorough lab testing,
so I usually do a complete I always check T
s H three T four. So if that's our T
four and our T three, there's something called reverse T
three which is inactive T three, which is essential to
check for because that gives us insight of what's going
on in the thyroid antibodies, the micronutrients, and then the
(19:00):
gut testing. And I should say first and foremost really
a good clinical evaluation because I really have to go
through with my patient what they're feeling, you know, what
are their concerns. I have to take a good inventory
of that because as we move along, we want to
be able to look back and say, Okay, we've we've
solved some of these these clinical symptoms. What's left and
(19:22):
what do we need and what might have gotten worse
as we go along. So the clinical always goes hand
in hand with any sort of laboratory evaluation. And then
depending upon you know, if we do need therapy. So
if it's we're thinking Hashimoto, theort is we need to
add some thyword hormone replacement. That would be the next step,
(19:43):
so we you know, it kind of comes. I look
at everything with my patients as a partnership, so I
go through the options when it comes to thy word
hormone replacement, and we kind of I always try and
manage expectations because there's no overnight fix. But if that
(20:04):
comes to thyroid hormone replacement, we talk about synthetic versus
natural and then and then you know, stress stress management
is is super important because we don't want to forget
about our adrenals because if we fix the next one
possible to fix the thyroid without fixing abnormal cortisol or
or some sort of hype boadrenalism hyper adrenalism. So cortosol
(20:29):
is so important in this whole mix. We don't want
to lose sight of it.
Speaker 2 (20:32):
Yeah, so let me ask you a couple of questions
about some of this. So the thyroid hormone replacement, you
mentioned that there's synthetic and there's natural. A lot of
our listeners do tend to try natural first and lean
towards the natural. So what what does the natural thyroid
hormone replacement look like?
Speaker 3 (20:51):
Sure, yeah, well, the naturals what we call it desiccated
thyroid extract so DTE for SUT, and there's a couple
of different brand them out there, and we can compound
certain ones too, but basically they come from an animal source.
It was really the first thyword hormone replacement we ever
had back in the nineteen hundreds. It originally started as
(21:11):
a sheep extract thy word extract, and then it was
a bovine extract. But it's really just a combination of
all the parts of the thyroid. The good thing about
the thyord hormone replacement. When we do desiccate, it has
T four and T three in it, so there's lots
(21:32):
of people who don't convert teaboard to T three very well.
So that kind of supports both ends. And we have
different dosing and it depends upon the patient what dose
I actually start with, and I always stress the importance
that we need to reevaluate and usually six to eight
weeks after starting anything.
Speaker 2 (21:50):
Yeah, it's interesting. When I started out in the industry
in the nineteen nineties, the early nineteen nineties, I was
reading and writing about glandular X strecs. I'm getting the
sense that they don't call them glandular extracts any longer.
But is this this is what you're talking about with
this desicated.
Speaker 3 (22:10):
Okay exactly, it's the exact same thing. Yeah, and you know,
I it's you know, I get a question about, well,
is it FDA approved, because I think there's some misinformation
about there. The thing is desicated f stract was out
before there was an FDA, so it didn't need to
be FDA approved, so it pretty much was grandfathered in.
(22:33):
So it is FDA regulated, but it never needed any
FDA approval.
Speaker 2 (22:38):
Yeah, what about lifestyle factors like sleep, movement, anything else
that can kind of directly impact thyroid health. Well.
Speaker 3 (22:50):
Stress is a big one because I mean, who doesn't
have stress, because if we have ongoing stress, so ideally
cortisols are stress hormone. It should be highest first thing
in the morning, with a gradual decline towards the end
of the day. But if it's high all day long,
or what's worse, if it's low all day long, it
is going to impact thyword hormone release and hot thyword
(23:11):
hormone conversion to active thyword hormone. So stress the big one.
You mentioned movement. We don't always use exercises a where
we use movement because people like that a little bit better.
But but those those are kind of the big ones,
you know. Trying to eat. We try and encourage organic
foods as much as possible, limiting tox and exposure as
(23:34):
much as possible. I always stressed my patients, you know,
I went to sweat on a daily basis because that's
a great way of detoxification, because you know, we can't
control everything that we're exposed to on a day to day,
but we can help our body handle it a little
bit better. So that's that's the purpose of detoxification.
Speaker 2 (23:53):
Yeah. Absolutely. It seems to me like with your the
way that you're managing this. You have clinical evaluation, you
have the lab testing, you're looking for micronutrient deficiencies, you
have the gut testing. All of these tools help you
individualize this for your patients. So it's not a one
(24:14):
size fits all necessarily.
Speaker 3 (24:16):
Yeah, this is this is personalized medicine at its best,
because it's if it were so easy, it would be
if it was one size fit a'll be too easy. Right.
We're all different and we all carry with us different
things that are going to make it every patient is different.
Speaker 2 (24:32):
Yeah. Absolutely. And then before I leave the medication conversation,
because I asked about the natural when it comes to
the synthetic thyroid hormone replacement. I mean, do you have concerns,
do you like to try the natural first before you
go to the synthetic or is it based on the
patient's comfort level?
Speaker 3 (24:52):
You know, I kind of talk about with my patients
and I kind of go with their comfort level as well.
Sometimes a lot of times when patients come to me,
they may be already on something, so that kind of
gears the conversation if they're having side effects one way
or the other. But you know, I have patients that
are on natural forms of thyrog hormone replacement that do great.
I have patients that are on synthetic forms that do
(25:13):
great as well. So it's it's you know, again gets
back to personal medicine. But there's different and the question
also comes when it comes to synthetics, especially leo thoroxin,
which is T four. There's brands and then there's generics.
So any the brands can have benefits and the generics
(25:36):
can have benefits too from a cost perspective, but you
want to try and keep things as consistent as possible,
if you will, because there's fillers in these in some
of these synthetics that patients have have side effects to
especially patients with autoimmune issues, because every one of these
these pills, these tablets have dyes and they have different
(25:59):
fillers to keep it together. There's only one form of
leletheroxin that isn't a pill, It's called tearsin. It's a capsule,
whereas like synthroid, uniterroid, levoxyl are all tablets and I
oftentimes use synthetic T three along with it. So depending
upon what the when I look at lads, if there's
not if that patient doesn't have enough T three, we
(26:20):
have to give them T three because that means they
are not converting to T three very well. And if
you remember, T three is the active thyroid hormone and
our brain actually needs T three to work. Our brain
is rich in thyroid receptor, so we need that TE
three otherwise we're going to continue having fatigue and brain
fog and mood issues. So lyyothiroiny is the synthetic form
(26:42):
of T three, So oftentimes when I do synthetics, I
use two of them together.
Speaker 1 (26:48):
Yeah.
Speaker 2 (26:48):
I mean you've described it beautifully. This is personalized medicine
at its best. And I really appreciate you sharing your
procedure with us. And I'm just curious. We're where can
people find out more about you and your work? Do
you have a website that you'd.
Speaker 3 (27:03):
Like to share? Sure? Yes, our website is metaboliccenterfour Wellness
dot com. I have a YouTube channel, it's at doctor
Angela NASA. That's where you can also find our podcast
as well as on podcast channels.
Speaker 2 (27:22):
And how about your book? Is your book available on
Amazon or on your website and the book. The book
is Thyroid Talk and Integrative Approach to Thyroid Health.
Speaker 3 (27:32):
Yes, yes, it's available on Amazon. So we've had We've
had great feedback and I'm happy to share this information
with people everywhere. We are also working on a masterclass
that's going to be coming out for people who want
a little bit more one on one, and I have
monthly sessions where I meet with folks online live to
kind of help guide them through certain things as well,
(27:54):
and that's at thrivethyroid dot com if you're interested in
a webinar.
Speaker 2 (27:58):
Perfect Thrivethyroid dot Well. This has been great. Thanks again
doctor Masa for joining me.
Speaker 3 (28:04):
Oh, thank you so much, Carolin. I really appreciate it
was wonderful speaking with you again.
Speaker 2 (28:08):
Yeah. Well, that wraps up this episode of five to
Thrive Live. Once again, I'd like to thank our sponsors
pro Thrivers Wellness Sleep Formula, Amused post biotic to give
your immune system that extra boost, Cognizanceticolon to help enhance memory,
focus and attention, and doctor Ohira's award winning shelf Stable Probiotic. Well,
(28:29):
this has been great. May you experience joy, laughter and love.
It's time to thrive everyone have a great night.
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guest should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:40):
Hello everyone, and welcome to Five to Thrive Live. I'm
Carolyn Gazilla and I co host this show with my
good friend doctor Lise Alschuler. Today our topic is thyroid health.
The thyroid gland is so important and I'm excited to
learn more. But before we dive in, I'd like to
thank our sponsors. Beginning with Amuse, a unique, patented post
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fermentation process. It's a very effective probiotic. Learn more at
doctor Oheiraprobotics dot com. Well I have the perfect guest
for our topic today. Doctor Angela Masa is the founder
of Metabolic Center for Wellness in Central Florida. She is
the author of the book Thyroid Talk and Intergative Approach
(02:28):
to Thyroid Health and the host of the popular podcast
Thyroid Talk. So this is a doctor that definitely knows
about the thyroid. Doctor Maza, welcome to the show.
Speaker 3 (02:38):
Thanks so much, Caroly I appreciate the kind introduction.
Speaker 2 (02:41):
So let's begin with the basics. Why is the thyroid
gland so important to health?
Speaker 3 (02:46):
Well, the thyroid is ours the hormone it makes the hormone,
thyroid hormone, and thyord hormone is our hormone and metabolism,
and a lot of people think, oh, metabolism is just
you know, what we take in as far as food
and drink and burn into energy. But it's really a
lot more than that, you know. It's how we we grow,
it's how we live, it's how we thrive. So we
(03:08):
need our thyroid hormone. And there's really not one system
in the body that you could find that isn't affected
by thyroid. It affects how we our oxygen, metabolism, how
we control our thermostat if you will, how we burn energy.
We have receptors on our heart, on our gut. Our
gut is so tightly linked to thyroid health. We have
(03:29):
effects on blood, bone, our brain is super rich in
thyroid hormone receptors. So really, the thyroid affects every single
part of our life. And you know, sometimes it kind
of can sneak up on us. If it's off. So
it's important to know about some of the signs that
may go along with your thyroid not being insfest.
Speaker 2 (03:49):
Right, So we're going to definitely talk about that in
a lot of detail. But that's a lot, I mean,
so the thyroid is really far reaching in terms of
what it impacts from health perspective, definitely. So what are
some of the more common thyroid problems and their causes?
Speaker 3 (04:09):
Sure, yeah, Well, one of the most common thyroid problems
is underactive thyroid or hypothyroidism underactive. The most common cause
in the United States is Hashimoto thyroiditis. It's gaining ground
as the most common cause around the world. It's an
autoimmune form. They can kind of one of those that
can sneak up on us gradually. So about it affects
(04:33):
women more than men, although men get affected as well.
But it's estimated that one in eight women sometime in
their life is going to develop some sort of undiactive
thyroid issue, specifically Hashimoto thyroiditis. Fibroid nodules are another form
of thyroid issues that are becoming more and more common.
Yroid nodules are masses within the thyroid. They kind of
(04:55):
grow within the thyroid and if we ulter down everybody
that walks down the street, one in three persons sometime
in their life is going to show up with something
on the ultrasound. So thyrol nodules are a very very
common thyroid issue. And then there's overactive thyroid. Thyroid cancer
less common, but very treatable. So these are kind of
(05:18):
the most common thyroid issues that I count on a
daily basis.
Speaker 2 (05:22):
Okay, so let's get into the symptoms. I'm assuming that
the symptoms are different for each one of these or
are there some common symptoms.
Speaker 3 (05:34):
Well, there are some overlapping symptoms, because you would think
if you have an underactive thyroid, it would be completely
different than overactive thyrot how you feel. But there are
some actually overacting symptoms, you know, if we talk about
hype both rotism. Probably the most common complaints include fatigue,
(05:55):
brain fog. Who doesn't have brain fog sometimes, but if
your thyroid isn't working right, you can have brain fog
trouble Losing weight or gaining weight can be associated with
thyroid imbalance, but too much thyroid also can cause fatigue
and weight changes, so it is kind of difficult to
sometimes delineate the two. But there are some symptoms that
(06:18):
kind of make them polar opposite. So persons with hype
both iroidism may be a little more cold all the time,
whereas someone with overactive or hyperth iroidism tend to be
a little on the warmer side. So there are some
kind of things we kind of kind of delineate the
two from. As far as thyroid nodules, some people don't
have any symptoms whatsoever and find them accidentally looking for
(06:40):
other things like a crotted ultrasound or a chest des
ray or a neck MRI. But some thyroid nodules are
very very fast growing, and person may notice a lump
in their throat or trouble swallowing or change in voice.
So not everybody has any symptoms at all when it
comes to thyro and nodules.
Speaker 2 (06:59):
What about thy cancer, You know, our audience is a lot,
we have a lot of cancer survivors and their caregivers,
So talk to me a little bit about thyroid cancer.
Speaker 3 (07:09):
Thyroid cancer as far as symptom wise, it kind of
falls into those. You may not have any symptoms whatsoever.
Your labs may be completely normal. You may not even
feel anything in your neck. If the if the if
the little mass is small enough and we just find
it on ultrasound. When we do find a suspicious nodule
(07:30):
on ultrasound, that's when we do the biopsy, just like
in different other types of cancers. But the great thing
about thyroid cancer, if there is a great thing, is
it's really treatable. It's some some thired not some thyrod cancers.
If they're especially the most common type, which are populary,
if they're very small, we call them micropopulary. These grow
(07:51):
very very slowly and we may just observe them. Other
other thyroid cancers, we may go for surgery or partial
thyroid ectomy, or now we have actually radiofrequency elation or RFA,
which has been approved as a non surgical treatment for
some small cancers. So we do have some great options
(08:13):
and great success rates when it comes to the thyroid cancer.
So it's really advanced in the past few years, and
we're our ability to the question I often get is
is thyroid cancer increasing in frequency? Well, I think we're
looking for it more, but I do think that it
may be increasing in frequency because our thyroid is so
(08:34):
sensitive and we're exposed to many many toxins and chemicals
that we've ever been exposed to, and the thyroid sometimes
tastes the bline of it.
Speaker 2 (08:44):
So let's talk a little bit about causes because you
mentioned the environment. What are some of some of the
common causes for some of these thyroid conditions?
Speaker 3 (08:54):
Great, so you know when we're talking about autoimmune, So
autoimmune thyroed issue can be Hashimoto thyroiditis, which is an
autoimmune process where the thyroid starts to not work as
well because the immune systems almost attacking the thyroid itself.
So we can develop progressive underactive on the other end
of the autoimmune spectrum as graves to sase. So that's
(09:16):
where the autoimmune system turns on the thyroid, so it
doesn't turn off. Believe it or not, these two have
common genetic determinants. But when I talk to my patients
about causes, so why do I have this, Well, when
it comes to autoimmune issues, especially thyroid, I always think
in terms of this triangle. So part of one point
(09:38):
of the triangle is our gene so unfortunately we can't
change our genes yet, so that's one part of it.
The second part of the triangle is things we've exposed
were exposed to over our lifetime, so it can be
you know, viruses, medicines, even how we're born, it's going
to affect this kind of cascade, if you will, toxic metals,
(10:03):
so those sorts of things. So again in past past history,
we can't change that. But a lot of it comes
down to the gut, believe it or not so, and
the guts that one part of the triangle that can
one be the tipping point for developing autoimmune thyroid issues.
But it's also that part part of the triangle that
is a controllable so we can work on our thiro.
(10:23):
We can there's lots of things we can do to
heal the gut, look into what's causing gut issues because
that can be the key to bringing down that autoimmune
attack on the thyroid.
Speaker 2 (10:34):
Great and I do want to get into the gut
because we love talking about the guts.
Speaker 3 (10:38):
Wonderful. I know, it's so.
Speaker 2 (10:40):
Interesting, doctor Malaza, because it seems like when I read
the scientific literature, there's another access. There's the gut brain access,
the gut liver that well, I just recently wrote about
the gut eye access. I mean, this is fascinating stuff. Yeah,
it really is. So before we get there though, what
are some of the biggest misconceptions when it comes to
(11:01):
treating thyroid problems?
Speaker 3 (11:03):
You know, I think there's a number of them. I
think first off is testing. So the gold standard, the
tried and true for testing thyroid function issues is thyword
stimulating hormon TSH. So essentially TSH comes from the pituitary,
so the thyroid hormone is is based off of feedback loop.
(11:26):
So essentially the hypothalamus, which is a specialized part of
the brain, and the petuitary, which is another specialized part
of the brain, make releasing hormones. So when the hypothalamus
or the petuitary sense that there's low levels of thy
word hormones, they kind of produce TRH, which comes from
(11:46):
the hypothalamus, to cause the petuitary to make TSH, which
then in turn causes the thyroid to make ideally to
upregulate and start making more thyroid hormone. Now, the TSH
is an indirect measure of thy word function, it doesn't
really give us the full picture. And the standards that
we use for TSH are based off of huge population studies,
(12:07):
so they don't really they're not individualized according to sex
or age or race. I mean, they're just standard whole
population studies between this range, so that doesn't give us
the whole picture. We also really need to look at
the actual circulating levels. So T four and T three
(12:28):
those are our thy word hormones. So our thy word
mainly makes T four a little bit of T three,
but mainly in the circulation T four gets converted to
T three because T three is the active thyword hormone
that really does the work of the thyroid, that goes
to each of the cells and causes them to do
what they're supposed to do, either activate or repress certain
genes and fulfill their duties as that cell. So that's
(12:51):
the one thing. The misconception that TSH is an accurate
kind of gauge on thyroid hormone now also one of
the big ones. I get a big lot of questions,
especially at conferences, because doctors want to know, Okay, this person,
I know they have antibodies. So antibodies help us diagnose
(13:11):
Hashimoto thyroiditis, So thyrod peroxidase or thyrodglobuline antibodies. But what
if the patient's diyord levels are normal and the thyroid
antibodies are positive, do we just call it a day,
or is it something that we need to follow, Well,
you definitely have to follow it. It's that's the ideal
case that we can do something to prevent the attack
(13:35):
and the decline of thyroid hormone. So those are two
big ones, and I think the other, probably the third
big one is if we're dealing with autoimmune thyroid, especially
hashimoto thyroiditis, that if we just put someone on thyord
hormone replacement, we don't have to do anything else. That's it.
Write the script, take the thyroid pill, and that's it.
(13:56):
But if you don't really look at the whole system,
you don't look at the gut, you don't look at
the whole body wellness, you don't look at micronutrients, you
don't look at stress management or the adrenals, then it's
just a you're just you're not treating the underlying problem.
You're just putting a band aid on it. So those
are kind of the big three.
Speaker 2 (14:16):
Yeah, those are Those are great and I'm I'm my
next question I'm going to ask. I think I know
the answer. So you utilize more of an integrative approach
to treating thyroid cancer. I was going to ask where
do you begin with your patients? But I'm guessing you're
going to say the gut.
Speaker 3 (14:33):
I tend to start with the gut. I'll backtrack maybe
a little bit, so, say I have someone who's sent
to me for abnormal thyroid function tests, I actually look
at micronutrients first. Okay, the thyroid needs certain micronutrients in
order to operate properly. So, especially like when I have
women in like their twenties, thirties, forties, if the TSH
(14:56):
is off a little bit, I not only check, I'll
tell you about the others I check. I check iron
because as women, we lose iron on a regular basis
and sometimes we never catch up with that iron. And
iron is a very important part of the enzyme and
the thyroid that helps us make thyroid hormone. So if
(15:17):
we don't have the right micronutrient for that enzyme to work,
we're not going to make enough. Now, Ionine and soelenium
are the other two that are essential for thyroid hormone production.
So if we are low on micronutrients like these three are,
thyroid's not going to work right. So sometimes we can
just replace those micronutrients and the thyroid actually has what
(15:37):
it needs to work properly, But the gut would be
definitely the second nest, now the close second one, because
the gut is so so important. It really is, and
it sounds like you get it.
Speaker 2 (15:50):
So you know, let's stay with the micronutrients just for
a moment, because I'm kind of glad you started there,
and I know that you do utilize nutrients supplements, so iron, eyelid, selenium.
These are micronutrients that you're testing and then you're trying
to fixed efficiency or whatever. Are there other go to
(16:11):
ingredients that you look to for thyroid health when it
comes to dietary supplements.
Speaker 3 (16:18):
Oh, like go to is just for micronaches. Well, the
thyrod needs magnesium, so I'm sure you talked about you
probably know all about magnesium and the wonderful benefits of magnesium,
but our thyroid is one of the parts of our
body that definitely needs magnesium. I mean, it's kind of
like it's I think magnesium is like one of the
best supplements you can possibly do. Zinc is also very
(16:41):
critical for thyroid hormone production as far as it's a
cofactor and how thyroid receptors work too. It's kind of
a carrier protein as far as other kind of supplement wise,
probiotics are key, a good, good spectrum probiotic in order
(17:02):
because we want to we want to encourage a diverse
microbiome because that keeps up with a healthy gut. So
probiotics are definitely key. So those are kind of my
top ones. And Vitamin D. Vitamin D is also very important,
especially when it comes to hashimoto thyroid itis and autoimmune
thyroid issues because vitamin D is important for immune help,
but it also helps bring down those thyroid antibiodies.
Speaker 2 (17:25):
Yeah, and when you're talking about probiotics, because would you
talk about probiotics a lot on this show. It seems
like the prebiotics are as important or maybe even more important.
Speaker 3 (17:36):
Definitely, and I think they get they we oftentimes miss
them in the whole probiotic talk of things. But pre
biotics help feed the good bacteria the gut. We want
to encourage the growth of the bacteria in the gut
because when we look at studies on thyroid and the microbiome,
the microbiome can actually make us or break us when
it comes to thyroid, because it cannot only affect how
(17:57):
we absorb those micronutrients, but it can also compete. If
we have an overgrowth of bad bacteria, it competes for
those micronutrients that we need, and it can it can
kind of cause a whole cascade of effects. So yeah,
definitely prebiotics especially, and I think as women we don't
we don't stress it enough in just women in general.
(18:17):
That's where our gut we need. We need fiber as
we as we move along through life, at least at
least thirty grands a day.
Speaker 2 (18:25):
Mm hmm, yeah, very important. All right, So let's move
on to other strategies. What other foundation of strategies do
you use to treat thyroid conditions? Where do you where
do you go next?
Speaker 3 (18:37):
Okay, so we've looked at micronutrients. Well, the thorough lab testing,
so I usually do a complete I always check T
s H three T four. So if that's our T
four and our T three, there's something called reverse T
three which is inactive T three, which is essential to
check for because that gives us insight of what's going
on in the thyroid antibodies, the micronutrients, and then the
(19:00):
gut testing. And I should say first and foremost really
a good clinical evaluation because I really have to go
through with my patient what they're feeling, you know, what
are their concerns. I have to take a good inventory
of that because as we move along, we want to
be able to look back and say, Okay, we've we've
solved some of these these clinical symptoms. What's left and
(19:22):
what do we need and what might have gotten worse
as we go along. So the clinical always goes hand
in hand with any sort of laboratory evaluation. And then
depending upon you know, if we do need therapy. So
if it's we're thinking Hashimoto, theort is we need to
add some thyword hormone replacement. That would be the next step,
(19:43):
so we you know, it kind of comes. I look
at everything with my patients as a partnership, so I
go through the options when it comes to thy word
hormone replacement, and we kind of I always try and
manage expectations because there's no overnight fix. But if that
(20:04):
comes to thyroid hormone replacement, we talk about synthetic versus
natural and then and then you know, stress stress management
is is super important because we don't want to forget
about our adrenals because if we fix the next one
possible to fix the thyroid without fixing abnormal cortisol or
or some sort of hype boadrenalism hyper adrenalism. So cortosol
(20:29):
is so important in this whole mix. We don't want
to lose sight of it.
Speaker 2 (20:32):
Yeah, so let me ask you a couple of questions
about some of this. So the thyroid hormone replacement, you
mentioned that there's synthetic and there's natural. A lot of
our listeners do tend to try natural first and lean
towards the natural. So what what does the natural thyroid
hormone replacement look like?
Speaker 3 (20:51):
Sure, yeah, well, the naturals what we call it desiccated
thyroid extract so DTE for SUT, and there's a couple
of different brand them out there, and we can compound
certain ones too, but basically they come from an animal source.
It was really the first thyword hormone replacement we ever
had back in the nineteen hundreds. It originally started as
(21:11):
a sheep extract thy word extract, and then it was
a bovine extract. But it's really just a combination of
all the parts of the thyroid. The good thing about
the thyord hormone replacement. When we do desiccate, it has
T four and T three in it, so there's lots
(21:32):
of people who don't convert teaboard to T three very well.
So that kind of supports both ends. And we have
different dosing and it depends upon the patient what dose
I actually start with, and I always stress the importance
that we need to reevaluate and usually six to eight
weeks after starting anything.
Speaker 2 (21:50):
Yeah, it's interesting. When I started out in the industry
in the nineteen nineties, the early nineteen nineties, I was
reading and writing about glandular X strecs. I'm getting the
sense that they don't call them glandular extracts any longer.
But is this this is what you're talking about with
this desicated.
Speaker 3 (22:10):
Okay exactly, it's the exact same thing. Yeah, and you know,
I it's you know, I get a question about, well,
is it FDA approved, because I think there's some misinformation
about there. The thing is desicated f stract was out
before there was an FDA, so it didn't need to
be FDA approved, so it pretty much was grandfathered in.
(22:33):
So it is FDA regulated, but it never needed any
FDA approval.
Speaker 2 (22:38):
Yeah, what about lifestyle factors like sleep, movement, anything else
that can kind of directly impact thyroid health. Well.
Speaker 3 (22:50):
Stress is a big one because I mean, who doesn't
have stress, because if we have ongoing stress, so ideally
cortisols are stress hormone. It should be highest first thing
in the morning, with a gradual decline towards the end
of the day. But if it's high all day long,
or what's worse, if it's low all day long, it
is going to impact thyword hormone release and hot thyword
(23:11):
hormone conversion to active thyword hormone. So stress the big one.
You mentioned movement. We don't always use exercises a where
we use movement because people like that a little bit better.
But but those those are kind of the big ones,
you know. Trying to eat. We try and encourage organic
foods as much as possible, limiting tox and exposure as
(23:34):
much as possible. I always stressed my patients, you know,
I went to sweat on a daily basis because that's
a great way of detoxification, because you know, we can't
control everything that we're exposed to on a day to day,
but we can help our body handle it a little
bit better. So that's that's the purpose of detoxification.
Speaker 2 (23:53):
Yeah. Absolutely. It seems to me like with your the
way that you're managing this. You have clinical evaluation, you
have the lab testing, you're looking for micronutrient deficiencies, you
have the gut testing. All of these tools help you
individualize this for your patients. So it's not a one
(24:14):
size fits all necessarily.
Speaker 3 (24:16):
Yeah, this is this is personalized medicine at its best,
because it's if it were so easy, it would be
if it was one size fit a'll be too easy. Right.
We're all different and we all carry with us different
things that are going to make it every patient is different.
Speaker 2 (24:32):
Yeah. Absolutely. And then before I leave the medication conversation,
because I asked about the natural when it comes to
the synthetic thyroid hormone replacement. I mean, do you have concerns,
do you like to try the natural first before you
go to the synthetic or is it based on the
patient's comfort level?
Speaker 3 (24:52):
You know, I kind of talk about with my patients
and I kind of go with their comfort level as well.
Sometimes a lot of times when patients come to me,
they may be already on something, so that kind of
gears the conversation if they're having side effects one way
or the other. But you know, I have patients that
are on natural forms of thyrog hormone replacement that do great.
I have patients that are on synthetic forms that do
(25:13):
great as well. So it's it's you know, again gets
back to personal medicine. But there's different and the question
also comes when it comes to synthetics, especially leo thoroxin,
which is T four. There's brands and then there's generics.
So any the brands can have benefits and the generics
(25:36):
can have benefits too from a cost perspective, but you
want to try and keep things as consistent as possible,
if you will, because there's fillers in these in some
of these synthetics that patients have have side effects to
especially patients with autoimmune issues, because every one of these
these pills, these tablets have dyes and they have different
(25:59):
fillers to keep it together. There's only one form of
leletheroxin that isn't a pill, It's called tearsin. It's a capsule,
whereas like synthroid, uniterroid, levoxyl are all tablets and I
oftentimes use synthetic T three along with it. So depending
upon what the when I look at lads, if there's
not if that patient doesn't have enough T three, we
(26:20):
have to give them T three because that means they
are not converting to T three very well. And if
you remember, T three is the active thyroid hormone and
our brain actually needs T three to work. Our brain
is rich in thyroid receptor, so we need that TE
three otherwise we're going to continue having fatigue and brain
fog and mood issues. So lyyothiroiny is the synthetic form
(26:42):
of T three, So oftentimes when I do synthetics, I
use two of them together.
Speaker 1 (26:48):
Yeah.
Speaker 2 (26:48):
I mean you've described it beautifully. This is personalized medicine
at its best. And I really appreciate you sharing your
procedure with us. And I'm just curious. We're where can
people find out more about you and your work? Do
you have a website that you'd.
Speaker 3 (27:03):
Like to share? Sure? Yes, our website is metaboliccenterfour Wellness
dot com. I have a YouTube channel, it's at doctor
Angela NASA. That's where you can also find our podcast
as well as on podcast channels.
Speaker 2 (27:22):
And how about your book? Is your book available on
Amazon or on your website and the book. The book
is Thyroid Talk and Integrative Approach to Thyroid Health.
Speaker 3 (27:32):
Yes, yes, it's available on Amazon. So we've had We've
had great feedback and I'm happy to share this information
with people everywhere. We are also working on a masterclass
that's going to be coming out for people who want
a little bit more one on one, and I have
monthly sessions where I meet with folks online live to
kind of help guide them through certain things as well,
(27:54):
and that's at thrivethyroid dot com if you're interested in
a webinar.
Speaker 2 (27:58):
Perfect Thrivethyroid dot Well. This has been great. Thanks again
doctor Masa for joining me.
Speaker 3 (28:04):
Oh, thank you so much, Carolin. I really appreciate it
was wonderful speaking with you again.
Speaker 2 (28:08):
Yeah. Well, that wraps up this episode of five to
Thrive Live. Once again, I'd like to thank our sponsors
pro Thrivers Wellness Sleep Formula, Amused post biotic to give
your immune system that extra boost, Cognizanceticolon to help enhance memory,
focus and attention, and doctor Ohira's award winning shelf Stable Probiotic. Well,
(28:29):
this has been great. May you experience joy, laughter and love.
It's time to thrive everyone have a great night.
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