Why Normal Lab Results Don’t Always Tell the Full Story

Introduction and Elena's Background 0:00

All right. Well, welcome to our next episode of Journey to Thriving. I'm so excited to have Elena with us today and she is a pharmacist in the New York, New Jersey area and is very passionate about functional medicine um based on her own journey. So, I'm excited for you guys to hear more about that today. So, welcome Elena. >> Hi. Thanks for having me. >> Yes. Yes. So why don't you just kick us off by where you are, what you're doing, and sort of how did functional medicine come up be a part of your life?

>> Okay. So, u I'm in between New York City, um Brooklyn, Manhattan, and I'm also on the Jersey Shore and Bradley Beach. Um so I'm having a nice little balance between the concrete jungle and the beach life. [laughter] >> Yeah. >> And Yeah. So, how much time do we have because it's a long journey? But basically, it started with I I it must have been happening for like over 10 years. I had a lot of hormonal imbalances. I was kind of chaotic and I never felt normal. And but it got really to a point during COVID where I was having this crazy hormonal acne. Like I always had acne my whole life, but then during CO I was like, "Oh, well maybe it's the mask." Like I don't know what it is. Um but it just really was taking over my face in a way that it never had before to the point where like I came into my boss's office to help her with something and she was just like I took my mask off and she was like like what what happened to your face? And I was like, "Oh my god." Um, [clears throat] I have no idea.

>> Yeah. >> So, I started kind of and I'm just a regular pharmacist at this point. I really don't know much about holistic and nutrition and anything like, you know, I just So, whatever. I start going to a few doctors. I'm like, "This is obviously hormonal." And I go to an OB and I have every symptom that you could think of, like the hair loss and the

PCOS, Insulin Resistance, and Functional Medicine Discovery 2:06

weird hair growth like on my chin, like those little chin stragglers. Um, and just this really bad acne everywhere. And they come in and they they did like an ultrasound and they find all these cysts cysts on my ovaries and they're like, "Okay, you have PCOS. Um, we can put you on birth control." And I'm like, "I can't go on birth control. I have been on this like journey for the last 10 years on and off birth control and I just can't do it. And they're like, "Okay, well that's all you can do." And I was like, "Okay, bye." And then I started thinking like, "Why do people sometimes come into the pharmacy like you know women my age getting metformin for like their hormonal things." And then I started digging deeper into that and I learned about insulin resistance and I learned about functional medicine and I was like this is this is it like I want to learn more about this and I want to do this. So eventually I figured out that I had insulin resistance and you know maybe in like two to four weeks I started some supplements and my skin totally cleared up and I felt amazing and I was just like I need to learn everything about this. Um so that's what started me on my functional medicine journey and then um you know it's it's evolved um over the last two or three years as I developed Graves disease which is an autoimmune condition um that causes your thyroid to be hyperactive or overactive. And do you want that whole story? [laughter] >> Yes, please.

>> Okay. So, it started with me going into my primary care doctor and being like, I'm really tired. Like, I cannot function. I don't know what's going on. Is this like a low thyroid? I was cold. I was constipated. I just couldn't I had no energy. So much fatigue. >> Um, and she basically did she did a lot of testing on me. Like she tested all my nutrients. I had like OB2 and all this stuff. And she basically I my thyroid hormones were like on the low end of the range but they were still normal. So she was like everything looks good. You are fine. I'm like can you send me a copy of these labs?

>> So I look over them myself and I'm like I have nutrient deficiencies. My feritin literally has an L next to it. It's nine and it says L for low. Like how did you not tell me to take iron? Um, >> and I saw that my thyroid hormones were on the lower end. So, >> I asked her, I was like, "Should I be taking iron?" She's like, "No, you're good." I'm like, "Oh, okay." Anyway, I didn't listen to her and I started taking um like non-constipating iron and I started like a a thyro stem succulent supplement, sorry.

>> [laughter] >> Um, and yeah, it it worked. Like after a few weeks, I was like, "Oh, I feel really good." Like I have energy. I'm not freezing all the time. And then after like maybe two months of taking it, I was like, >> "Maybe I need to cool it down, like lower the dose on this supplement cuz I was feeling really hot all the time." And I was like really jittery and I was like, "Oh, maybe um I'm just sensitive to coffee now." So, I stopped drinking coffee and I lowered the supplement, but the symptoms didn't really go away and I had a really high resting heart rate.

Like looking at my watch, it was like I'd be laying in bed and it was like 130 140. >> Wow. >> Um, yeah. So, that wasn't fun. But I was just like, "All right, I feel feel

Graves Disease Diagnosis and Conventional Treatment 5:48

pretty good. I'm just like a little shaky. It's not a big deal. It's a little shaky. Don't mind that. >> Fine. I just won't drink coffee." which you know and then it it was like a reality check cuz I had like an important meeting that I was nervous for and the second I got on the call I felt the left side of my face go numb and I was like am I having a stroke? It was super strange and then I was like okay let me go to the doctor this is not normal. So I go to the doctor. Um they do my labs. They send me to cardiology. Uh and finally we figure out that it's Graves disease. Um and then I had the lovely pleasure of developing thyroid eye disease which is it has to do with Graves disease. About 50% of people go on to develop it. But yeah, I was one of those lucky ones um that basically causes all these symptoms with your eyes. um some cosmetic like your eyes might bulge. Both of them are one or the other, but then there's also more severe symptoms like vision loss, double vision, blurry vision. So yeah, I was one of the lucky ones >> with that. Yeah. So where did you go? I mean you obviously there's a place with graves that we have to keep people out of danger, right? So we have to like potentially use medications to bring down that heart rate and and make someone in this more safe space. Um, so tell us about that process and then when you were like, hey, like this isn't what I want to do. I want to figure this out naturally.

>> Absolutely. So I started everything conventional because I was freaked out. I was like, I'm >> too young to have a stroke. I don't want any of this. Um, I went to an endocrinologist and he was wonderful and he started me on a low dose of methmazol, 5 milligrams daily and it worked really well. After like a week all of those hyper thyroid symptoms kind of went away and I felt pretty stable, just a little like tired because you know when you have like this elevated heart rate and your hypothyroid like everything is happening really fast in your body and it kind of fatigues you.

So, I had a little bit of fatigue. Um, but everything was fine. And then I would say maybe six months into taking methmazol, I started feeling all of the hypo thyroid symptoms again. And so I went back to him and he was like, you know, it's too soon to take you off of memazol. And I was like, I don't care. >> I'm tapering off. So he's like, "Okay, so start with, you know, half a tablet daily or every other day." And then I eventually figured out the taper on my own because he didn't want it to be such a severe taper. And I was just like, I can't like I don't feel okay and I'm not going to keep over medicating myself.

So it did start to taper off. And at this point when I felt like I was more stable, I was like, "Let me introduce all the functional medicine things." And it was it was like a slow roll. I was like, well, you know, I heard selenium is good for the thyroid eye disease, so I added on the selenium. Um, vitamin D was a little low, so I added on vitamin D. uh fish oil, great anti-inflammatory, added that on and things got a little better, but I was kind of fluctuating because when you're tapering off of meththemol and your thyroid is still kind of >> bursting like it's one day it's hyper and then one day it's hypo and then you're taking the medicine and you get even more hypo and then it bounces back. So it it's like a roller coaster.

>> Yeah. Um, and I was doing some herbal supports with that, some lemon balm because it's a calming um, adaptogen and it also helps lower the T3 just a teeny tiny bit, but it worked really well for me. Um, and then I felt pretty stable. I was at a point where I was taking like a quarter of a methol every two weeks, like I'm basically done. >> Um, and then I got sick. I was traveling in Mexico and we all got a stomach bug and some kind of virus potentially COVID unclear. Um, and then all of a sudden my thyroid eye disease which started with my left

Gut Testing and Root Cause Investigation 10:18

eye bulging and my right eye not as much. My left eye started drooping and my right eye started bulging. And I'm just like at my wit's end at this point. I'm feeling severely hypothyroid. So I stopped the methazol al all together and I think that's like when I took the next step and I was like I need to do functional medicine testing at that point. >> Yeah. Yeah. So what did you uncover? What kind of tests did you do and what did you find? >> Yeah. So I I just had this suspicion. I was like either I'm really hypothyroid or I'm just really low cortisol which could be you know a result of being ill or something. So, I don't know. My thyroid labs were still kind of on the higher end of the range, but I had every hypo symptom. Um, so of course I did a thyroid panel, uh, TSH, freeT3, freeT4, reverse T3 was a little elevated. Um, still had the antibodies, the TSI, and the TRA, but they were trending down at this point. So, functionally, then I was like, all right, let's take a look at the gut. because I was in Mexico and I did a stool test there and I had a parasite come up. So, I had started antibiotics for that cuz that was all I had when I was there. Um, and they were terrible. Oh my god, the side [clears throat] effects were so bad. It helped me for like a week and then it just >> it wasn't enough. >> So, came back, did a GI map and my GI map was a total mess. Um, I had H pylori. I had still had the blastoysis homminous parasite that came up in Mexico. Um, I had like anticocus. I don't even remember. There was like four or five other other uh overgrowths >> and as well as leaky gut. >> So, total mess. Um, I also did a Dutch test which kind of confused me because it had a kind of normal looking cortisol response curve, but um my my uh metabolized cortisol maybe was pretty low and it was >> it was like a little unclear what was happening and I was like you know what maybe we need to figure out the GI stuff and then the cortisol will even out. >> Yeah. Yeah. Yeah. Because I mean the stress that we are going under like in our bodies like some of it is that perceived stress things that never really happen but some of it is or even the things that are happening to us but then there's that internal component right if we have imbalanced blood sugars or gut stuff that's like causing inflammation in the body that inflammation alone is triggering the stress response in our body. And I think people forget about that. I think they think of stress just as the psychological piece, but if our body isn't balanced, that also feeds back and causes stress.

>> Absolutely. And I think like, you know, it's not always just perceived stress, but like people don't understand like they might be like, "Oh, I wake up in the morning and I do a highintensity workout and I feel really good, but your cells inside are like >> alert. I don't like this. Make it stop." You know? Yeah. >> Yeah. If you're not balanced and it can sort of set you over the edge. I think there Yeah. Hit training is a lot of people are overdoing it for sure in a lot of cases. So you did the GI map, you did a protocol, I assume a healing protocol with that and then was that really just like the thing that made a huge difference or is it still just sort of progressive things that are adding up to make a big difference in your symptoms? >> It made a huge huge difference. I it really was like a turning point for me. Um I started like a threemonth protocol with a bunch of antimicrobial herbs, some gut healing herbs and supplements.

Um and just some nutrients. And I'd say after like a month the my eyes just kind of normalized. And by the three month mark, like they were looking amazing. It barely looked like I had thyroid eye disease anymore. And then um I was like, "Okay, I'm going to finish my protocol and then I'm going to retest." So I did a metabolomics test to see like what my nutrient status was and all of that. And it came back pretty good. You know, I had some nutrient deficiencies. So then I corrected those and I feel I feel pretty good now.

>> Good. Good. Yeah. So met M metabolomics or metabolomics is a test from Genova Diagnostics, but there's all kinds of different companies that offer this um just for our audience, the organic acids testing. So these are actually urinary metabolites that show us actually what's happening in the energy in your mitochondria, which I think is like fascinating because I I think back to like biochemistry and like myself sitting there as a probably like 22year-old person like thinking like, okay, why do I need to know this? Like how is this impacting? And certainly drug therapy like impacts different parts of those cycles. Um but it's just fascinating that now we're sitting here looking at your report of your you know KB cycle and understanding it more from a like how do we bring balance to the body through you know people can look at direct blood levels which still is helpful if that's the first step is is looking at a B12 or a B6 or B1 or whatever level. Um but this sort of gets down to the cellular level and also there's so many like things that can inhibit the KB cycle. So whether that's toxins or stress or um other things that are sort of you know causing it to slow down, we might actually need more B6 even though our B6 level is normal or more magnesium or more iron even though like blood levels are normal based on like what our body's experiencing it. So when I was talking to a patient about it yesterday, she was like, "Oh my goodness, I didn't realize like you can like individualize like this as much as you know you are." So I think right now like that test because it's a simple like finger stick urine collection doesn't require anyone to go to the lab.

Um plus doing and there's other companies I mean um Diagnostic Solutions has one. Um Vibrant has some organic acids. There's I think u Mosaic Diagnostics all kinds of places. So different providers have different preferences um for which ones they use and why. But um but adding on inorganic acids to a gut test I feel like tells you so much about a person. Um, and I mean certainly we can add in food sensitivities and other things as

Healing Protocols and Recovery Progress 16:48

driving factors of inflammation, but I think like it's just such a great picture to start with and like how do we bring back balance of of your nutrition and and functional medicine we always talk about it as like I think people think it's woowoo at times because you know there's the integrative part whereas maybe a little more out there of like therapeutic dosing certain things but like with functional medicine we're really just trying to bring back balance to the body and help that KB cycle f, you know, help our energy, help, you know, break down fats and proteins. And one of the test results, um, I got back recently, I think we talked about last night in our grand rounds, this lady like she was missing all kinds of amino acids, which are building blocks to every cell in your body. So certainly you're not going to have a good metabolism and all these things if you are missing those components. So, so super I think it's something I'm just like learn I mean still learning like all of this and how many years I've been into this because I think at first like it was like okay focus on gut focus on gut and then over time it's like okay well that gets people so far but adding in some of these other layers I think really moves the needle for a lot of people. Yeah, it's so true and it's super insightful. Like it's not just nutrients. Like it was checking my fish oil status and how I metabolize things and like you know heavy metals and things. I had some weird heavy metals come up that it just made me really question like okay like maybe I should >> change all my jewelry, make sure it's silver or whatever. And >> yeah, I kind of went a little crazy with that trying to figure out what it was. >> An excuse to buy new jewelry isn't bad, right? [laughter] Yes. Yes. Much needed. Um, and then it it I forgot to mention that I noticed and maybe this is after my GI protocol, but from my metabolomics, I was able to figure out that I had some candidada in my gut, which didn't come up on my GI map. I don't know if that developed later or if it just didn't pick it up. So, I was able to address that. And >> when I did the anti-andidada protocol, I mean, my eyes got even better. Like, I didn't I was already happy. I was like, "This is good." But then it got even better. I was like, "Yeah, >> this is great.

>> Amazing." >> Yeah. Candida is interesting because like I mean we can test it in the blood. We can test antibodies to candida, but we can also test it on a stool sample. Um but I don't think it grows out as well on culture. Um and so or even like when you're doing PCR, you're looking for specific strains of it. Um and so it you're only looking for what you're looking for. And some of the tests look for three or four strains. um actually not even strains like fila like of it and then um other tests look for a little bit more so like it's hard to pick up I think and so when I do see it on a stool test I'm like okay we got to do something about this even though it it might be lower um and it is a normal flora so I think that's the thing people see it and they're like oh my goodness and but so there is you should have some right in your gut but we shouldn't have excessive amounts um but that's where like the organic acids also yeah can shine and bring in that additional component like this byproduct of yeast is really high. The D is diarabinol and there's another one um that are related to yeast. So um so yeah, and I've had people sit in front of us that have a fully coated tongue. They're like thrush, you know, they've got yeast growing in their mouth and certainly if it's growing your mouth, it's going down your digestive system. So those kind of people need to use some antimicrobial herbs in their toothpaste too to help get rid of it. But that person like everything we did, no yeast detected on their stool, on their blood like antibodies, all the things. And it's like okay well you still have yeast right like in this clinical picture. So so it is one that's a little bit challenging to pick up on but symptoms anxiety and um you know gut I we can see it sometimes even on um like barrier panels like looking at permeability panels like the KBMO test too. So, so you find it in different places, but it can be, especially if you've had the highdosese antibiotics or just chronic antibiotic use can be a common thing that definitely can cause damage to the gut lining. So, so yay that it improved your your eyes um as well as probably your thyroid health, which is a little harder to physically see. >> Yeah, but you feel it.

>> Yes, you feel it for sure. So, um, so to close up, tell me a little bit more

Support Community and Resources 21:06

about like what you're passionate about helping people with and sort of how people can find you and sort of, um, just what your next steps in your career are. >> Sure. So um as I was going through this journey with Graves and Ted thyroid eye disease, I was like feeling really really isolated and like you know I was googling things and it was all like really scary and I was like you know what it it doesn't have to be that scary and then I started finding communities and I was just like I want to give back to my community and I want to be more active here. So, kind of just ended up becoming like an advocate for it and um I started hosting a free monthly support group to actually connect with people because I realized there was a real need for this. Like I don't know anyone who has graves like I mean now I do but when it's just starting and like you want to ask questions and you want to be like what's happening to me? Is this normal? Like what can I expect? And it's just like there's nothing out there just like scary things on Google. Mhm.

>> So, yeah, I started this support group. So, we meet monthly. It's kind of like we always switch the days, but I do have it listed on my website. Um, I'm pretty active on Instagram and on Tik Tok. You can find me at soulscript.co. Um, and I'm thyroid love club on Tik Tok. Um, >> so yeah, I just I made a a guide for people who are just starting out or who have been through this for a while, um, and they're just looking for answers. So, I kind of just compiled everything that I've learned in this journey and put it together in like a digital guide. Um, and I'm working on a course so that people can kind like a self-guided course so they can do their own thyroid journey alongside their endocrinologist, alongside their functional medicine provider, their holistic provider, whoever. Um, and of course, I'm available for one-on-one consultations as well to help anyone who needs some guidance on their journey. >> Yeah. Yeah. Selena is part of our farm to table team. And if you are in New York, you can see her as your provider.

Um, and if you're in another state, we have Alina partnering as a health coach, um, and helping alongside one of our other pharmacists licensed in your state. So, we will have information on our website specific to this as well. So, um, thank you so much for joining. I know that what you're doing is definitely making a huge impact and I think we see that by people continuing to follow and engage with you because they are struggling with some of these same things and with our state of our world with the gut health and toxins and all the things I think more people are having autoimmunity whether it's Graves or other conditions more and more so um they definitely need all the support. So yeah well thank you so much and um you can find find her on Instagram and Tik Tok. Do you want to say those handles one more time?

>> Sure. So on Instagram, it's soulscript.co, which is also my website. And on Tik Tok, it's thyroid love club. >> All right. Well, have a great day. >> Thank you so much. Take care.