The Thyroid-Brain Connection: Hashimoto’s, Brain Fog, and Healthy Aging

90% of people who have hypothyroidism or low thyroid, the reason of them is actually Hashimoto's disease. Why did your body start developing antibodies and start this damage process?

And this is the step one of knowing your root causes. I have identified five major root cause. which leads to triggering of antibodies in a person's body and that starts the whole Hashimoto's process.

So first you need to figure out what are those root causes which is causing, you know, like triggering off your immune system. This is where most people have to realize they're always looking for just one root cause and it is never just 1 root.

Cause it's a combination of 2 to 3 root Causes coming together leading to Hashimoto's disease. Welcome back to the Think Well, Age Well podcast. I'm your host, Dr.

Heather Sandison, and today we're talking about something that affects millions of people, particularly women. And it can have a profound impact not only on metabolism and energy, hair, but also on how we think, how clearly we can think and how well our brains function as we age.

My guest today is Dr. Anshul Gupta, a board-certified family medicine physician. He's the bestselling author, researcher, and functional and integrative medicine expert who has become internationally known for his work in Hashimoto's disease.

Dr. Gupta previously worked in the Department of Functional Medicine at the Cleveland Clinic alongside Dr Mark Hyman. His work now focuses on helping people understand and address the underlying drivers of Hashimoto's and other chronic health conditions.

He's the author of Reversing Hashimoto's and has a particular interest in something that I'm really excited to explore today. It's this relationship between the thyroid and mitochondria and what that relationship means for energy, for brain energy for, brain fog, cognitive function and healthy aging.

Dr. Gupta, welcome to Think Well, Age Well. I am so delighted to have you. Absolutely. Thank you so much for having me over here. You're doing amazing work.

Your podcast, you know, like shares so great information to people, who are looking to age well, improve their memory and things. So thank you for have me.

Well, thank for being here, I want to start with your story because you trained, your medical doctor, trained in very conventional family medicine, but then became deeply focused on Hashimoto's and then functional medicine.

I'm curious what took you down that path. Absolutely. So this is kind of the joke in our functional medicine realm all the time. Any particular MD who joins the functional medicines wagon, he or she has to have a story.

My story was after completing my family medicine residency, I was doing a great work outside Richmond area into a private family medicines clinic. But just a few years into my practice, I started noticing that, you know, my health was getting worse.

So I start gaining weight, without even changing my diet or lifestyle. I was having this horrible stomach pain, which will just hit me randomly during the daytime, during nighttime, doesn't matter what I eat, it will not matter.

Plus, I was tired or fatigued to the point that I had to take a nap during my lunch hour just to function through the whole clinic. And then after my clinic was done, i was just feeling brain foggy, that i could not concentrate on things, my attention span was very less.

And I was like, I don't know what to do. Like, you know, why all these things are happening. My blood work was absolutely normal. You know nothing was showing up, on the scans that I did.

For the stomach pain I started doing a PPI medication just so that, maybe that is an acid reflux issue. But that was not getting better. I tried multiple things for several months.

Nothing was changing. This is where I thought maybe I'm not a smart doctor, and I need to see those specialists. So I started seeing specialists after specialists and they did multiple testing, endoscopies, ultrasounds, scans, more blood work.

Even more medications were added. Nothing showed up. Everything was normal. At one point, you know, like all of my friends told me that maybe it is my head and nothing can be done.

And I was only 32 years of age at that point of time. I had no idea like, whether I can survive how long this way. Then somebody told that, functional medicine is a way to go.

People like you find answers over there. So I started looking into functional medicine, got trained into it and started implementing a protocol. I made a few changes to my lifestyle, changed my diet, started exercise routine, took some supplements.

Within one month, my stomach pain was completely gone. And then within six months, you know, I lost more than 40 pounds. My energy levels increased so much that I even participated in a rugged maniac.

And for me, that was a big thing because I'm never a pathetic person. So that is a huge turning point. Wait, what was it? Say it again. What did you participate in?

It's a 5K rugged mania. Rugged maniac? I don't know that you've ever heard of that. Yeah, these are just obstacle courses, you know, like, it's a 5K and then you have to do multiple things to complete that.

So that was a kind of very interesting thing, a couple of people in my clinic actually wanted to it because they were into all these athletic things and they are joining the gyms.

And I was very early into my fitness journey at that point of time. For me to doing that, was actually a big thing. It was fun. But you probably have that camaraderie and the people around you encouraging you and that's really fun.

How cool, but how brave. I know, yeah. That was my first thing that I did with my fitness journey. So that was huge and that it was nice. But that is very fulfilling.

And that's what I realized that just making these few changes, my body responded so quickly. Not only physically, but also emotionally. Mentally, I was in a better place at that point of time.

And that's where I wanted to share this with people around and everybody else. So I got this opportunity to work at the Cleveland Clinic Functional Medicine Department.

And I want to do more research into functional medicine model of care. There I realized that I was attracting all of these females who had very similar health issues in mind.

They were all gaining weight. they all had brain fog. and one thing was common, they all had thyroid disorders. And they were all taking medications, but still not seeing the results.

Then I looked closer and they're all at Hashimoto's disease. So I instantly obviously connected with them and I started researching into Hashimoto disease, what exactly was going on?

So, I developed my three-step process of helping all of these Hashimatos clients to get their life back, implemented it. We saw amazing results, not only their symptoms improved, but we saw actually improvement in their lab numbers.

Their antibodies improved, their thyroid functions improved. So that's what my journey has been, and that what I do now, help Hashimoto's clients reverse it by following that three-step process.

I want people to understand how to know if they have Hashimoto's, so what lab tests to ask their doctor for. But also, I think this kind of bigger concept of thyroid disease, thyroid issues, because you can have hypothyroid, low thyroid function without having Hashimoto's.

And then you can have Hashimoto's and not really have hypothyroid, but actually have hyperthyroid symptoms. So I want to go into some of that nuance and how you pick that apart in the clinic.

But also, I wanted to connect the dots because I think some people think of thyroid and their metabolism comes up. Weight and body temperature, maybe hair loss, feeling cold or hot, not necessarily the brain.

Can you connect us between thyroid function and brain health? Absolutely. So again, you're so correct that everybody thinks that, people are gaining weight or they are depressed, or hair loss issues, check the thyroid.

But when people have brain fog issues when they have ADHD, when there are dementia or Alzheimer's, nobody thinks about like, okay, thyroid can be the driving factor.

Well, in fact, Thyroid hormone is really important for brain development. to the point that when we were little into our mom's belly, if our Mom doesn't have enough thyroid hormone, we will literally not have any brain development.

So thyroid hormones are so important for brain-development. Now it is not only important when you are little, but even as we age, thyroid-hormone plays a significant role in myelination of our nervous system.

So myelin sheath is very important as we know the myelins sheathe can be damaged in Alzheimer's as well as multiple sclerosis. So thyroid hormone plays a very significant role.

As well, as maturation as will as recycling of several nervous system cells are again under the control of thyroid hormones. Interestingly, our thyroid makes two different hormones.

One is T4, which is an inactive thyroid hormone, and one is the active version. Our brain cells specifically have receptors for this T3 hormone. It controls not only the metabolism of our brain cell, but also the mitochondrial health.

Now, mitochondria is a powerhouse of our body. Specifically, our brain needs a lot of mitochondrion so that it can produce energy and can function properly.

And when our bodies don't have enough T3 hormone, or we have excess amount of T 3 hormone that affects its mitochondrial functioning and again affects how our brains function.

So this is where thyroid hormone is very vital, not only when you're little, but also as we are aging for proper functioning of our brain. And whenever our thyroid is not appropriate, whether it is hyper or hypo, in both situations, brain fog or brain activity gets significantly affected.

So then how does someone know if this an issue for them? What tests do they ask their doctor for? A very important question because most people they will say that yes doctor I got my thyroid check but the only blood test they get is a TSH which is the thyroid stimulating hormone.

Now just going back a little bit to the physiology of how our thyroid hormone is produced will help a lot of people to understand. Well actually starts with our master endocrine gland which is a pituitary gland, which located in our brain, you know which secretes this hormone called TSH which the signaling hormone, your thyroid gland to produce thyroid hormone.

It is not actual thyroid hormones. This TSH goes to your thyroid gland and the thyroid produces a hormone called T4 and as I said that is an inactive thyroid hormone.

What that means is that it circulates in your body and then it needs to be converted to T3 which is a more active form of thyroid hormones which your bodies utilizes.

Now just imagine if a person only gets a TSH test, it is not even actually testing your thyroid hormone levels in a persons body. So we need a complete thyroid profile, that means we T SH, free T3, Free T4, so that first of all we know whether our thyroid hormones is in appropriate level.

Now we need to go to the next level of also checking whether we have Hashimoto's disease by checking those antibodies which are two antibodies. One is TPO which is a thyroid peroxidase antibodies and the other one is thyroglobulin antibodies, and again these are very basic tests each and every lab across the country can do it.

So make sure when you are getting your complete thyroid profile checked, you check your antibodies. Because what research shows is that Hashimoto's disease can go undetected for several years before actually the hypothyroidism finally shows up on blood tests.

And if you have Hashimoto's disease, that means there is inflammation in your thyroid gland which is damaging it. So the sooner you get to know about it, the soon you can work on it and you could safeguard your Thyroid gland from further damage.

These are the basic tests that everybody should get. One more test which does get a little bit of limelight is what we call Reverse T3. So the way to understand reverse T3 is that you know as I shared with you the T 3 is an active hormone so T-3 just imagine that is the gas pedal of your car and the reverse t-three is actually the brake pedal in some people their normal t3 levels are fine but the Reverse T three is very much elevated and this reverse d3 doesn't let your actual t 3 hormone work in your body so this is a little bit lesser known test but if your doctor is open to it and if you can get a reverse D3 level checked That will again help you in determining where your thyroid is having a problem with.

So you talked about a three-step protocol to addressing Hashimoto's disease. If someone sees on their lab work that they are either hypothyroid, hyperthyroid or they're positive for Hashimoto's antibodies, how do you help them navigate where to start and what to do about it?

Absolutely. So first of all, you know, what is Hashimoto's disease? We just go back to the basics of it so that people, everybody understand it. Hashimoto's is an autoimmune condition.

What that means is that your body is making antibodies and that antibodies is starting a slow destruction of your thyroid gland. Now after weeks, two months, and two years, then finally you get diagnosed with hypothyroidism.

What that means now is that your thyroid gland is not able to produce enough thyroid hormone to keep up with your body's demand. And this is where your doctor will start you on a thyroid replacement, which is your levothyroxine.

That's a typical thyroid medicine. But what most people don't know is that Levoteroxine or any other thyroid medicine is not doing anything to work on this underlying autoimmune process, which was the actual reason of starting the damage to the thyroid gland.

The interesting fact is, that 90% of people who have hypothyroidism or low thyroid, the reason for them is actually Hashimoto's disease. So it is rampant not only in the United States but across the whole world.

So that's the reason it's very important to know about Hashimoto's and work on it. Now the next question is that why did your body start developing antibodies and start this damage process?

And this is the step one of knowing your root causes. So I've identified five major root causes which leads to triggering of antibodies in a person's body, and that starts the whole Hashimoto's process.

So first you need to figure out what are those root cause, which is causing, you know, like, triggering off your immune system. And this is where most people have to realize they're always looking for just one root-cause.

It is never just 1 rootcause, it's a combination of 2-3 rootcauses coming together leading to Hashimoto's disease. It is not just me, it is actually research saying that all autoimmune conditions, whether Hashimoto's or anything, is an interaction between your genetic pool with the environment around you.

Now, most people, when they hear about it, they think, oh, well, so Hashimoto's is a genetic disease. Well, no, not really. You know, a decade ago, Hashimoto's was not even prevalent at all.

And now suddenly we are seeing an increase, almost like an epidemic rate, you know of Hashimos all around us. So the main reason is the environment around us which has changed dramatically and that is affecting our genetics in a negative way and leading to Hashimoto's disease.

So very first step, knowing all those root causes are very important and those are five main root cause that are leading Hashimothosis. And can you talk us through the five root-causes?

Absolutely. So let's talk about the root cause number one, which is the food. Okay, so food sensitivities is number 1 over here. We all have heard that food is medicine, which is absolutely great.

But there are certain foods which can actually start damaging and also trigger immune system of our body. The number is gluten or wheat. You already know that so many autoimmune diseases have been linked to gluten and things.

So more and more people are actually reacting to different foods around them. So gluten is number one over here. Second one is dairy. Now again, we have been sold that dairy is really healthy for our body, high in calcium, specifically older women are consuming high amount of dairy so that their bones can be healthy.

But the modern day dairy is completely different from what we had before. And it is very inflammatory. It is filled with chemicals, filled hormones and that's the reason more and more people are reacting to dairy.

So that is the second food most people get sensitive to. And the third food that we are seeing more sensitivity towards is like soy and corn. Because more and more soy & corn are actually GMO food.

So they have been completely genetically modified and our body cannot recognize those genetically-modified food and start reacting against them. So these are like, you know, four or five top foods, obviously, like high sugary food, processed food comes on that list also.

But food sensitivity is a number one factor over here that we need to figure out which food a person is sensitive to, which is leading to leaky gut. And that leky gut ultimately starts the whole autoimmune cascade of things.

So that's number-one root cause. The second root-cause which happens in several of my people over is nutritional deficiencies. So not only our food is filled with chemicals, not Only our Food is genetically modified.

Unfortunately, it is also deficient in nutrients. There was a research study done which compared nutrient density into our common foods. from 1980s to 2010 and what we realized was that several vitamins and minerals like magnesium like selenium like zinc which we need for a thyroid gland is deficient into our current food so even though a person is eating very healthy but the food itself might be nutrient deficent so you might not be getting those nutrients in your food So nutrient deficiency specifically magnesium, selenium, zinc, obviously vitamin D and certain B vitamins are the second trigger which research shows can definitely lead to Hashimoto's disease.

The third trigger over here are toxins. So toxins are everywhere around us. Each and every day we are adding more and more chemicals to our environment.

And all of these toxins, you know, affects our immune system in a negative way. Now we already know what heavy metals like lead, mercury, arsenic, being poisonous for our system for a very, very long time.

But now we are adding new toxins, specifically mold toxins or mycotoxins. In the last 5 to 10 years, you know, we have to came to know about that mycotoxin, which were initially thought that they were only affecting our livestock, is actually affecting humans in a negative way also.

And certain myco toxins have been associated with Hashimoto's disease and triggering of autoimmunity over there. And then we have other chemical toxins, like BPAs coming from plastics, glycosides, which are coming form insecticide, pesticide.

And I can keep going on, obviously, we are at least 100 different toxins which can affect our thyroid gland in a negative way. Almost 90% of my patients will have one or the other toxins triggering their Hashimoto's disease.

So that's the third big root cause over there. The fourth root cause is actually underlying infections. Now these infections can be either parasites in the gut, they can overgrowth of bad bacteria in your gut or it can viral infections like Epstein-Barr virus reactivation.

We already have research studies that support that the Epsteine-bar virus can cause Hashimoto's disease. And now we are actually seeing that post-COVID, a lot of people are being diagnosed with Hashimoto's disease.

And again, there is correlation between long COVID and also having Hashimottos disease too. So again, you know like there are several underlying chronic infections which can again be responsible for Hashimoto's disease.

That's the fourth root cause and the fifth root causes over here is chronic exposure to stress. And this stress can be physical stress, can psychological stress, can emotional stress any kind of stress your body goes through.

and then your adrenals recognize that stress and chronically elevates your cortisol levels that affects your immune system in a negative way and again lead to Hashimoto's disease.

A lot of women actually you know when they see these big hormonal shifts specifically you when their starting their menstrual periods you that is again a trigger for Hashimoto's.

When after pregnancy they deliver the baby and again that hormonal shift happens, they get diagnosed with Hashimoto's and the third trigger can be obviously having menopause.

And again big hormonals shift happen and they again get diagnose with hashimoto. These are hormono shifts but these are literally stress for women's body and that again can lead to Hashimoto.

So these five major root causes. And again, remember not just one root cause, but most people have at least two to three root causes coming together, leading to Hashimoto's disease.

And so addressing these, I feel like we could have a long conversation about each of those root causes and I think many people will recognize that list in this approach to reversing Alzheimer's, right?

There's a lot of overlap and think what turns this on, whether you end up with Hashimoto's or Alzheimer or cancer or whatever MS, like whatever it is that you you ended up dealing with or being diagnosed with as you age, these root causes are true kind of across the board, right?

These are those foundations of health that you have not too many toxins, not much of an infectious burden that your nutrients are and your stressors are balanced, where you went through each of these and very eloquently.

So I really appreciate that. And I think for a lot of people, it's easy to go, okay, so what supplement do I take for that? And I want to first touch on lifestyle because I'm curious, you know, especially when you're thinking about stress and your personal experience, how do you help people navigate the right amounts of exercise and sleep and stress regulation and muscle and metabolic health to influence and protect and help to reverse Hashimoto's or to optimize thyroid function?

particularly I think when they're not feeling well, right? How do you navigate that? Absolutely. So again, a very important point because you mentioned that, you know, people come to see us or anybody like, even to you, just give me that supplement or give that peptide or something which is just going to take care of things for me.

Well, yes, these are great tools, but your foundation is your lifestyle. Unless you improve your life style, your not going see long lasting benefits.

So definitely everybody who works with us, you know, always tell them lifestyle is a foundation. This is where you start doing things. And then obviously you add more along with it.

So the pillars of lifestyle over here, let's talk about food first, because again, everybody's interested into food. What diet is best, and obviously there are so many different diets and everybody claims that their diet the best.

But I go with research in terms of what do we know the research suggests over there. So the basis of the diet is very simple for me is that remove the bad food and include the good ones.

Okay, so that's very simply we need to do those. So first, let's talk about the Bad ones, which is again making sure that we are removing the processed foods.

okay, So all those fried foods all the process foods that were eating, you know in McDonald's Burger Kings and things we didn't remove all that food because definitely that is Very harmful for our body.

Second of all, high sugary foods and also drinks. We actually cannot even imagine how much sugar is being fed to our body in terms of these sugare drinks that we drink as well as sugaring foods we eat.

So definitely we need to stay away from those because they lead to insulin resistance, insulin spike will cause inflammation and triggering on things.

So those are the two basic foods. And then beyond that, certain people who wants to go to the next level, then giving up gluten and also maybe giving of dairy and things might be the second step they can consider doing it.

So, those of the bad foods that definitely people should work on removing those. Beyond that in limited quantities or even eliminating like alcohol and caffeine content can be useful for people, at least in the short term basis when they're starting their journey.

The next step is obviously including foods, which is good for your body. So the first food over here is, obviously, everybody's talking about good quality protein.

Definitely, we need all those amino acids. Amino acid called L-tyrosine is very much important to make thyroid hormone. Again, when you're eating a good, quality, balanced a protein rich meal.

Whether you are vegan, vegetarian or whether you're eating meat products, you can get protein from all different sources. So make sure you do include protein, good quality protein in your regular diet, that will give you all the amino acids.

Second over here is actually including non-starchy vegetables. Because non-starchy vegetables will give you all the vitamins, all minerals as well as all antioxidants needed for your thyroid to function better.

What most people don't know is that each and every colour that you see in a vegetable is actually a different antioxidant which is working on a difference pathway not only to reduce inflammation, not to only address auto-immunity but also supporting your Thyroid functioning.

So the more color you have in your diet, the better it is. So eight to nine colorful vegetables on the regular basis will give you a lot of these antioxidant foods to support your thyroid gland.

Then comes the good fats. Again, we have been fat shamed for a long time. Fat is bad. Everybody should be on a low fat diet. It doesn't work. You know, obviously you might have seen in New York Clinic that, you know literally, your brain is made from fat.

If you are not eating fat, Your brain isn't going to function. So we always need to know that there is good fat and there's bad fat. So stay away from the bad fad, which is the trans fat, all those fried food and things, but you need include good fats, those fatty fishes, avocados, olive oils, if you are eating nuts and seeds, like almonds, walnuts, chia seeds.

All those are good fads that you include on a regular basis. Not only do you support your brain, you also support the thyroid gland. So that's the basis of the diet.

Very simple to follow. Kind of, you know, a few things. Remove, include good quality foods to support your thyroid gland. So, that is the first pillar.

In the second pillar, we talk about the sleep. It's very important. The sleep quality directly affects your immune system. Your immune system is regenerating when you are having your deep sleep.

And lot of people just looking for accountability of five to six hours of sleep, seven to eight hours sleep is very important, but also the quality of the sleep also mattering a lot.

Because we need to get into that REM phase as well as the deep phase so that we can actually rejuvenate our immune systems as our body in that phase. So dedicated time for sleeping, seven to eight hours, very important.

Following a good sleep hygiene. Again, you know, no screen time, one to two hours before you sleep. You know pick up a book or listen to some relaxing music or maybe just kind of do some relaxation exercises like deep breathing before we go to bed.

That is definitely going to help you to sleep better. So pay attention to your sleep if you are using a variable like an Apple watch. or a ring or something, you can track your sleep.

If not, that is fine. Just make sure you have dedicated time for sleep, so that's the second thing. The third pillar as you mentioned is exercising and body movement.

Now this is where again we get confusing signals or information. Whether we should be doing cardio exercises, whether we're doing weight training, should we do HIIT training and things.

So initially when people are too much inflamed and especially for thyroid patients, what I realized was that high intensity training is not really good for them because their body is already broken down.

And if you have too many pressure or stress on their bodies, they actually feel worse. So initial gentle body movement is the way to start with. And again, exercising is different for different person.

A person who's already running a marathon each and every day, for him or her, 20 minutes of exercising, is not much. But a person, who has never done exercising like I was before, never did exercising in my life, so for me, doing 20 or 25 minutes cardio-exercising is still a lot.

So start slow, build it up slowly. What I realized was that, you know, a combination of cardio and strength training is ultimately the best combination for majority of my patients, specifically if you are older age females over the age of 40, because you need that muscle, You need the cardio exercise so that you can lower inflammation and support your thyroid gland.

So those will be the pillars. The fourth pillar obviously is working on your stress. And again, everybody is stressed out, you know, what is going around us, we just get bombarded with too much stress on the daily routine.

So the goal is not to kind of avoid stress, the goals is to create resilience towards how your body responds to that stress Again, that can be very simple.

You can do some deep breathing exercises, you can cultivate a hobby which you know relaxes. Being in nature, just being in the nature outside actually helps you in relaxation also in that way.

If you do meditation, if you pray or any other things which can help you that what we call as a me time for at least 15-20 minutes and working on all the adrenal glands will help definitely in reducing the cortisol levels in your system.

So those are my pillars of lifestyle changes that anybody who wants to start their journey with Hashimoto's should start with these first. I want to ask about iodine, because I think when I look out into the world of thyroid, I see experts who are proponents of even high doses of iodide.

And then you see other thyroid experts, who really caution away from iodides. What is your stance on using iodines to support or really to maybe hurt the thyroid?

Absolutely. And this is one of the controversial topics, you know, like, hot topics and everybody has their own opinions. Okay. I'm going to give you a little bit of a long answer over here.

So, people can pick and choose. Where is my reasoning? So research is very clear over there. That people who are deficient in iodine, they have higher chance of Hashimoto's disease.

People who have high amount of iodines in their diets, They also have a higher chances of hashimoto disease So that's the problem over here. So we have to be right in the middle.

And again, unfortunately, there is no perfect iodine test. Our blood iodide levels changes very quickly. Just getting a blood test to check your iodone levels is not the best way.

The best way, you know, we can check is by 24 hour urine collection of iodine, which is a very painful process of actually checking your iodines. So most people will ultimately not do it.

The bottom line is that there is no perfect test. Again, checking iodin status is also a difficult thing to know about it, so my sense is you do need some iodide in your diet.

I'm not a big proponent of using high doses of iodine because definitely that can trigger Hashimoto's disease. And we have seen, you know, actually people coming to see us, which they actually got worse after they started those high iodide dose protocol.

But there are certain people who do not have iodine and they died at all. You know, specifically like the only source of iodines for some people was that iodized salt.

And again, they either like listen to some Instagram Reel or some YouTube video. They said, well, iodize salt is bad. Everybody's, you know using Himalayan salt, or sea salt which do no have Iodine.

So over the course of time, their iodined levels can also decrease. So first of all, look at your diet and see if you do have iodine-rich foods in your diets.

So if your using seaweeds, sea vegetables or if consume a lot of sea foods, that is great. Then you have enough iodines in you diet, you don't need high dose of iodide supplementation.

But if you're that person who do not have any seafood, you do NOT eat any sea vegetables or seaweeds at all, and you are not even eating iodized salt, then definitely start including some food with iodine in there, whether it is iodised salt or just having sea weeds as a snack option.

Or then you can include an iodide supplement. at a very low dosage, typically around 200 to 250 micrograms of iodized supplement. So at least you can get some iodine to support your thyroid gland.

Yeah. And so the micro grams are the important part there, because I think some people will see, think milligrams. I'm in full agreement with you. When I have people start supporting, if they are low on iodide, and if we think they're low in their diet, then we'll talk about maybe drops of a liquid iodine supplement or very small capsules were not.

You'll see the 12.5 milligram dosing and we are in agreement that is too high, way too, high. you can actually cause problems if you start dosin with those very, very high doses.

What about like using iodide on the skin? Some people use that as a test. Some People will talk about absorbing iodines through the scan. Do you have an opinion about that?

So yes, again, that is very popular trend across the internet world where you can just apply a little bit of iodine on your skin. If it gets absorbed, it means you're deficient.

if it doesn't get absorbed you are sufficient. Well, there is no research behind it. Everybody's skin is different, so that's not a very reliable way.

Even the color of the skin are very different. So you might not even notice a change to it So I don't recommend doing that iodine patch test in terms of determining the iodide source for it.

Now, whether iodines can get absorbed through skin, yes, it can. But again, the absorption levels vary from person to person. So you cannot rely on that.

So that's again the reason oral absorption is the best. So especially if you do have thyroid disorders, I will rely on either oral supplementation or oral foods as your iodine source, not the skin as a way to either test or get your Iodine.

Now, if you're navigating the world of thyroid medication, I know with Hashimoto's you can sometimes swing between hypo and hyperthyroid symptoms. So help us understand.

First, you mentioned levothyroxine, which is going to be most commonly covered by insurance. what the physicians will be most comfortable with, what they will have heard of.

But then we also have synthetic, so if levothyroxine is our synthetic T4, as you mentioned, that's inactive thyroid hormone. We also T3, which we can use prescription Cytomel Liothyronine to support T three levels.

And then there's all the desiccated thyroids. So how do you help people navigate? When do I need this if I have Hashimoto's? How do i know if i need it?

And Which one? Oh, and then what if the pharmacy is out or my insurance doesn't cover it or I need to switch for some reason, then, what do I do and how do i navigate that?

Absolutely. So again, a very important question. Again, let's understand what kind of medications are available. As you mentioned, the most common medication is a levoteroxine.

The brand name is obviously Synthroid. If you go over there, that is only providing you T4 hormone. And the idea behind is that everybody converts the T-4 to T3.

But there are certain people who are not converting all of their T4 to T3, and they need some support in that T-3 level. So either you can add Cytomel or some T 3 hormone along with it, along your T 4. That's a synthetic route.

Then we have these natural desiccated thyroid, which NP thyroid and the most common ones. and they have a combination of both T4 and T3 majorly is T 4 and a minor amount is t3 over there but that gives you both the hormones so obviously people tolerate those better also in that way Now the bigger question is that, you know, which is best?

So obviously there has not been head-to-head trial in terms of one is better than the other. But in term of patient profiles, we do see that small amounts of T3 hormone, our supports our patient in a better way.

You know their brain functions actually better, their mood clarity is, better their energy is. So that way again, if you can add a little bit of t3, I think that is always a bit better route to go in that.

Certain people also feel that when they shift from those synthetic medications to the more natural desiccated thyroid medications, their Hashimoto's disease is a little bit more stable and they will get less flare-ups after that.

The thought process is that because those are more naturally, they won't cause any flaring of your immune system. Plus a lot of these synthetic medications actually have fillers.

Fillers of even gluten and other chemical fillings which again people can react negatively. And the natural version of medications are better with that.

But the downside is that a lot of insurance companies might not cover it. And certain medications come in and out in terms of their formulary. So certain people might be stuck that suddenly now there are an NP-thyroid and their dose of medication is out of stock.

Now what do they do? So that's the challenge that lot people will face with that. But that's where, you know, like working with a local physician who can help you navigating the natural thyroid medication would be the best choice.

But if you don't have one, I feel that, being on the levoteroxine and adding a little bit of T3 hormone actually works equally good for a lot of my patients too.

Oh, great. And sometimes you can find it compounded, which again, a provider can I'm curious, for someone who is listening and is like, this is me, I am tired, my brain is foggy, still don't feel well, probably have hypothyroidism or Hashimoto's.

What are three things they could begin doing today or tomorrow? Also, the first thing that they should be working on is their diet. Okay. So again, first of all, clean up your diet, include good foods, which supports your brain as well as, you know, your mitochondrial health.

Which again good fats are very, very important over here. You know if you can include fatty fishes, good source of omega-3s, You, know your olive oil, Your avocados as Well as your chia, flax and almonds and walnuts.

That's the First thing That you should Be doing. Good quality protein again. to support your mitochondria as well as your brain health. So change your diet, that's the first thing that everybody should be doing.

Second of all, work on your stress. That is the number one thing which is going to give you mental clarity and improve your energy immensely. Just dedicate 10 to 15 minutes each and every day.

Do this deep breathing exercise which called 4-7-8 method. Very popular, you will find a lot of YouTube videos, simple to do. Basically you inhale for 4 seconds, You hold your breath after that for seven seconds and then you exhale for eight seconds.

That's one cycle. You repeat that four, five to six cycles or even ten cycles. There is going to see amazing results with rebalancing your cortisol and also rebalance your adrenal glands.

So do that simple exercise. It's the second thing that is gonna definitely help you in improving your kind of Hashimoto's and brain health. And the third thing will be just a gentle body movement is what I would like to get started on.

Whether it is walking, jogging, running or just kind of doing like you know some weight training at your home itself with your own body. Some squats, some push-ups you can do.

That is again going to help in boosting your mitochondrial health. because that exercise is going to boost your mitochondria which again is ultimately going help you with your brain activity and also obviously how you feel in general.

So those are the three basic things that people can do and then obviously there are supplements and things people do after that but these are three things I would recommend people start doing tomorrow itself.

I also want to know about you personally. Is there something you consistently do because you hope that your brain and body will function 20, 30, 40 years from now?

So for me, actually meditation has been the game changer, you know, because you and me and each and every provider over there, work in a high stress environment, we are taking care of patients and so many other things.

And definitely that meditation kind of helps me in my mental clarity, rebalances my cortisol, give me that break that my body needs on the daily basis.

and definitely rejuvenates, you know, like my brain capacity. I'm able to actually concentrate better, pay attention to more details. So for me, each and every day, even on my busy days, if I have just five minutes in between the patients, I will just quick do either deep breathing or a meditation exercise.

And I think that keeps my mind going, every-day basis. I love it, me too, 20 minutes in the morning and I'm a different person. I am also curious, at this stage in your life, what brings you the most joy?

I think the joy is that, you know, each and every client that comes to see us who have been told time and again that they cannot do anything to improve Hashimoto's, reverse Hashimoto's disease or get the life that the deserve.

and seeing them progress from there to actually, you know, living their life to the fullest. Having so much mental clarity, having so energy, literally feeling that, after so many years, they are able to live their lives again.

So that just keeps me motivated each and every day, keeps my going and that's what the joy that brings me each day now. Oh, that's beautiful. Dr. Gupta, thank you so much for being here.

I just really appreciate the way that you've helped us connect some of the dots between Hashimoto's and thyroid in ways that people don't always think of them.

You know, we talked about mitochondria, diet, immune system and potential infections and the gut and leaky gut, and then metabolism and ultimately how that impacts our brain.

So I really hope that our listeners are here taking away that these persistent symptoms, they are information. And if your labs have been called normal and especially if the only lab you've gotten related to your thyroid is your TSH, but you still don't feel like yourself, That doesn't mean that the conversation and maybe some of the detective work is over.

It may mean there's additional pieces worth investigating with potentially a functional medicine doctor like yourself. So I'm just delighted and grateful that you've taken the time to share your expertise here today.

And thank you for doing the work that your doing and for delighting in the patients that help and joining me today on Think Well, Age Well. Absolutely.

It's an honor to be here. Thank you so much for having me and thank you for all the good work that you're doing. If listeners want to learn more about you and about your book, where can they find it?

So the book is called Reversing Hashimoto's. It is available on Amazon, so you can order from there. And then plus, my website, you know, My YouTube channel is a great way for people to learn more and simple tips that they can do to create to kind of get better.

My a YouTube Channel is Anshul Gupta MD. and that's also my web site. The goal is to again, share every day a few minutes that you do and some simple things that can change your life and improve your health.

So that's the YouTube channel all about. Fantastic. So to everyone listening, keep taking care of your brain you have today so that it can keep take care you for decades to come.

Thank you being here. Please share this episode if it's helped you or you can think of someone else who would get a lot from it. We're so grateful to have you.

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