Episode #1: This Week in The Clinic – Thyroid Health


Hello everyone and welcome to the first episode of this week in the clinic I’m Josh Gitalis clinical nutritionist and functional medicine practitioner and i’m super excited to bring you this this segment that show whatever you want to call it why because every week I’m working with real human beings in the flesh and blood and that there’s many different discoveries that I make there’s many different discovery that we make together and that’s where the true lessons lie, you know you can read tons of books you can read tons of studies you can go to lectures you can attend some s you can do all of this stuff called information-gathering but then when you going to apply it to yourself when you go and apply this your practitioner to other people you realize that things aren’t as simple as they seem you know things take on a different form and it’s not always by the book you know in medicine they have a phrase this is a textbook case and that’s someone who based on what has been written out in the textbook in terms of a diagnosis let’s say 50 that exact description and as humans we love that we love when that happens because we are we really liked happens in blocking way we like to be you know fully yes Foligno we get uncomfortable in my gray area that in-between right when we’re waiting for something more waiting for an answer that’s what we have a little bit comfort so we like to have black light so when we have a textbook case for textbook clients or expectations in medicine wheel of that because then we have a certain set of rules we can follow now in functional nutrition and functional medicine and integrated healthcare that’s where we die beat into working with people with personalized protocols and when we’re dealing with a single person rather than a single disease we see that there’s a diverse set of factors that play into any persons case and you know i always say there’s seven billion people on the planet and therefore there should be seven billion different approaches and protocols you know I’ve seen hundreds of clients that have never given two protocols that are saying because I believe everyone is an individual and it should be personalized for that so that’s what I’m going to bring to you in this segment this week in the clinic as I go through my week and work with people i have discoveries i have revelations i have things that I learned that I want to share with you so that you can so that you can actually learn from this as well because we are all on this constant journey of help and when we can learn from other people we can learn and apply it to ourselves okay so and I just done I’ve got my facebook page just open here in front of me so if you have any questions or comments as you’re coming along or as you’re watching you can feel free to post them below and i’m actually going to see it life so if you’re joining live awesome we can have a little interaction going on if you’re watching this later that’s cool too so we have a little bit of an itinerary i wanted to talk about a couple cases that I dealt with this week and we’re going to first look at you know what happened with those individuals that we’re going to go through a little bit of almost the left and on my right and then we’re going to loop back around and talk about what you can do as a person trying to stay healthy and maybe your thyroid issues maybe you don’t and this is for both groups of people why because we want to prevent these things from happening years before they become a problem you know another another thing that I see is that you know once you’re at a point where you have a diagnosis right what’s the diagnosis diagnosis is naming a group of symptoms so once you get to a point where you can name something you have already developed it over a long period of time you’ve already been manifesting thats the process over probably many years and of course the amount of time doing that nervous with whatever you’re dealing with so I’m again for those of you joining me lace jacket I’ll clinical nutritionist and a functional medicine practitioner and today we’re talking about fire it out some of the lessons that I’ve learned in the clinic this week so we’re gonna get in sweat first you know one client that I’d like to chat about we just started working together and variety of symptoms were presented and one of the questions I asked them was have you had your thyroid checked and they said yeah I think I’ve had to check over the years in life you know I can be and I think well they said that the last time you had sex is about two years ago so I said you know I can be the most recent bloodwork someone take a look I want to see if there’s anything significant there and we’ll see you know what next steps we can take so I was simply blood work and when I sound was that this individual actually did all the right line tap for siren but they have extremely high levels of thyroid antibodies and mrs. two years ago and no intervention or changes were made so that would be great advice for me and the lesson we can learn from that is to first of all keep your blood work all the time too we can learn a lot when we look at blood work over the years and three make sure you get all the right test and that’s what we’re going to talk about today so that was one example and another person that I was working when i recently I’m fire I’ve had quite of your hyper vibrator and revealed by a few be the numbers psh 33 and 34 it showed that recycling is overactive but what was missing was a high-rise antibodies I want to know the body was happening alright because there’s a differentiation between a situation where our immune system is attacking outside in a situation where it’s just a metabolic imbalance so we’re going to dive into that but first we’re going to talk about we’re going to talk about how common Spy rate issues are and i’m just looking online here see what comments have come in and I didn’t see some people thank you for sharing this tracy melanie has joined us and awesome thanks for joining me and job you’re most welcome and this is this is why I do what I do because you know I wanted to bring the clinical aspect of things into York because you can only learn so much from above so first of all how common are sorry issues well based on the amount of stuff that she come out on it is obviously quite common you know 27 these are us tax so 27 million people from the US has some sort by Reuters about 13 million of those people are undiagnosed we’re going to talk about why a lot of those people might be on diagnosed and how to make sure you’re not a statistic you’re not getting into that step about 40 million of those people are flashing mode environment so they have been diagnosed but i don’t have stopped on that but it’d be interesting to know how many of those 14 million are actually experiencing improvement after the treatment and that’s what we’re going to dive a little bit deeper in today so if you’re joining alive and you’re enjoying this so far and you’re engaged you can you can press the like button you can actually the cool thing about decided to learn this is that you can do it multiple times if you like what I’m saying that really gives me an idea that you’re listening that you’re here that there’s actually humans on the other side of this camera that picks up on the upcoming three so I know you guys are alive and ready for the information so we’re going to again as they go through this i want to give you a little bit about what we see in the book and then what actually happens in the clinic so firstly you know if we go into any if we go into a book on my red we’re going to see a list of symptoms they’re going to say ok people with with Hashimoto’s or thyroid issues HYFR hypothyroid typically have the senses and when continues from experience some people have a difference some people don’t have symptoms some people with hypothyroidism actually had symptoms of hyper and some people with high press symptoms of post so there’s this is messing up a lot of symptoms but i want to present you with the top ten symptoms you know this is top 10 things that I look for that is a red flag that tells me hey we need to investigate further you know since of the language of the body they are a way that your body communicates with you tell you you’re doing something wrong right I’m speaking English i think most of you are english-speaking individuals we probably would be watching right now that’s the language have chosen to communicate with you about and the language of the body is symptoms so once we sort of learn that it helps us to target and get a little bit closer as to what our goal is with our individual clients are with ourselves right so symptoms can you can you can give us a very valuable window into what’s happening into the body here in the clinic where we work with clients we actually have a at least 11 page in take care and we asked them over about a four-hour appointment whole bunch of sentence to really get thorough history right and that gives us great insight and then that leads us to where we’re gonna go next week at this we have that do we try this we try that but symptoms are amazing way of learning how what was going on the box so what are the sort of the top ten symptoms that I focus on when i’m looking for possible Tyra dishes and just before I go there for those of you who may not be familiar with Cyrus in your neck right and it is the thermostat the body it actually controls how quickly all the cells moving the body right if it’s over active things are moving too fast is under active things are moving too slow so some of the systems of the Irish is mostly underactive thyroid or fatigue right so if you think about it that pirate isn’t working at hotels you’re going to feel tired you can make energy at the speed and efficiency like you would like to waste games and trouble losing Lee feeling cold so people complained of cold hands and feet even on the hottest days of the year dry hair and skin right I’m hair loss menstrual irregularities and because the sirens controls the speed at which all the cells move it has a profound influence on female and female hormones and the difference steroid hormones that may or may not be produced five those individuals so those are the first five edema the water retention you know getting swelling in your hands ankle toes fingers muscle and joint pain constipation and depression yeah there’s a very strong connection between cyrus and depression so you know these are not such nonsense to experience and and you know a lot of people go to their doctors with the symptoms and they say what’s going on and then the investigative process begins so we’ve talked about how common sorry issues are we spoken about some of the symptoms now we’re going to get into a little bit about why the standard of care is falling short if you join me a little bit later on we’re talking about pirate off today and lessons that I’ve learned in the clinic so we’re going to talk about now why the standard of care of falling short and why do I think the standard tears falling short because many of those people who have gone through the standard of care end up in my office they end up in my clinic and I asked them hey why are you here and they say well i still have these issues i went through the truth the regular standard treatment and I didn’t really find any resolution and that’s how they end up here so we are fasting questions you know why is the standard of care failing and why are they following short now I’m just going to see if there’s any comments or questions coming NSE that there is coming and somet address them in a moment but again if you’re joining me you can give me give me the old thumbs up so i know that you’re listening and it’s not like a regular facebook injury type of one thing you like yes you can do it multiple times just so i know you’re you’re with me or you’re liking or not liking once it so let’s just talk a little bit about what the standard of Paris ok so i go to the doctor say you know how to have somebody symptoms and I’m tired I can’t lose weight my hair is brittle all I have constipation and and I’m just feeling down what do they do they send you for a five myself and the virus x consists of something called psh thyroid stimulating hormone now some of you might be surprised that virus stimulating hormone has nothing well I wouldn’t say nothing but isn’t even the hormone that the fighting produces this is a hormone that your pituitary sends a message to your thyroid to say make my right arm on that eh that’s the messenger and that’s what they measure so they go you get a life together psh love back benefits within range which is a very wide range they say you’re fine if you’re out of the range that may usually will treat you if typeof guy right with a synthetic siren armin and is stuck that’s the standard of care now where does that fall short well the National Academy of clinical biochemistry in 2002 Mason statement saying that the TSA to range is too wide that people in that room this range and the range for those of you are interested is about points52 about five depending on the lab bury the little bit and people in this range still have thyroid issues or viral symptoms are still suffering from some sort of imbalance so the National Academy of clinical biochemistry in 2002 put this information in there and they suggested that’s a new measure be between point 3 and 3.04 which is a much narrower range now we’re getting into what I call the optimal range for Cyrus okay normal range optimal range right still still still feeling symptoms still feeling symptoms decreasing decreasing decreasing optimal not feeling any symptoms that’s where we want to be festival so so they’re they’re suggesting that the range is too big and from what I see in the clinic again this is definitely true people are experiencing symptoms there maybe even on thyroid medication and they’re just dating they’re not finding resolution to further our discussion on gsh the standard of care the one the wine and hormone that tested is there is a study and plot one in 2011 and what they did was they had two groups of people one group were on medications for high-rise pyroxene a synthetic fiber and one and the other group were on no medication that also they weren’t being treated and what they did was they measure their t3 and t4 and what they found was the group on the medication okay so they’re following the standard of care they had III feet free t3 below well about 15.2 percent of these individuals had free t3 below the normal range ok when tested when looked at the free t3 for those individuals and no medications they weren’t being treated they 29.6 percent of them had levels that were below normal for free t3 and freaky for so yeah treatment did help a little bit but there was still a group that was not getting what they need it so let’s further does the discussion a little that we talked about the standard therapy psh but now we’re learning that hey wait a second when we treat psh when we measure entry for it there’s these other things called 33 and 34 that Josh talking about right now that may be important to those that they might be unbalanced what is t3 and t4 well as i mentioned the pituitary sends a message to the fire right vsh saying hey all right can you make some fire alarm on and then thyroid make c4 mostly for a little bit of III but mostly key for and then that c4 circulates in the body and convert into T 3 and T 3 the goals that where the action is that the hormone that’s really going to work magic some of it has converted in the gut so intense and I’m sure we’ll talk about this later episodes gut house is super super important for thyroid house something that has to be addressed before we actually get to the thyroid something that’s upstream and then peace the two most p4 is converted in the periphery is what it’s called so outside of the siren so now we’re learning that there’s no CSH made in the pituitary there’s deformation the siren and t3 and then a good chunk of that c4 is converted in the body so wouldn’t you want to know what the thyroids actually doing because this study published in PLoS ONE and 2011 is saying if we’re just treating TSH we’re getting CSH in the normal range some of these other farmers there’s still a balance and that’s not good ok because that person will still experience symptoms it’s like a student situation you know here’s the here’s an example of of of what’s going on here you you know you have maybe maybe you when you’re young this happen or maybe your children and you give them enough you give them a note take their teachers maybe something important about it and be happy school or like something with your homework or something and you write the note and you give the kid a note and you’re like oh I do because the note they got my note everything should be fine you know i’m i’m positive that kid is going to deliver that note to their teacher and the teacher is going to read the note and and understand what’s going on that’s maybe seems a little ridiculous i think that’s a lot for a six-year-old to anvil ok it’s the same with the fire right we can’t really trust with the fire is doing if we’re just looking at that note at the TSH the message from the pituitary tumor Cyrus that’s lacking and it’s not really getting the full picture we’re dealing with the tip of the iceberg and again i’m not making this up this was first established by the National Academy of clinical biochemistry in 2002 and there’s lots of research one we talked about this study in 2001 and +1 so just a couple quotes from that study when like a couple of their conclusions a subset of patients do not reach serum-free three and freaky for ratio within the reference range these patients therefore living chronic condition of abnormal thyroid hormone availability for the peripheral dishes even if the administrator level pyroxene doses able to maintain the serum TSH within the normal range the insufficiency 350 peripheral production cannot be appropriately corrected by increasing levels are awesome because she 4 inhibits the conversion and furthers the problem so what do they do they try to increase the dose of distant siren Armand but to their dismay it doesn’t really work right because the key for itself that stops the conversion okay so we’re getting into some complicated stuff and i’m sure i have people tuning in that are all level and I’m doing that because we’re going to dial back and we’re going to talk about the key things that you need to do as a as an informed person patients to make sure your thyroid health is up to snuff but also if you want to die since it is the research and understand the why behind them I’m providing that as well so again so for those of you who have not joined me from the beginning we were talking about some lessons that I’ve learned in the class today we’re talking about sorry alpha we started by talking about how common apartment she’s actually started by fighting about a couple case studies couple cases that have come through the clinic this week how Tom and thyroid issues are right some symptoms associated with that why the standard of care is falling short that’s what we were just talking about and how to properly discover imbalances which were about to get you so I want to talk a little bit a little bit more about why and with all the shortest standards Karen I see a couple cost comments and i just want to address one from karen titus and trying to make health changes for the past six months and doing it on my own and presentation on medication for PTSD I’m overweight i have a significant amount of stress in my life because my assignment has a physical disability and mental health issues i’m not able to work ok I follow you and megan and a couple other people so i’m trying to change my diet but my biggest roadblock is financially being able to sustain and I know at too much now and I’m learning so much and I want to make things happier for me and my son i’m doing my best that i can put your any suggestions doing this very small budget or how to do this when there is so much information it’s overwhelming sometimes and I lost because I think a lot of people have that same sentiment and you you know what this will probably be something i discussed in enough in the future episode but when you address the fundamental use can make use changes and it usually doesn’t cost too much so it’s best these important place to start with any condition what are the fundamental drinking lots of clean water getting enough sleep movement keeping your 16 tourism is good and eating you know Whole Foods good foods that are not completed and not processed and started just with those two things you can make a huge impact on everything right I think I could reopen my practice and named it the fundamentals and everyone would just come in and we get some sleeping properly we get some drinking water we get some having all soon as we get moving their body we get some doing some stress management and we probably handle maybe about seven eight percent of people conditions so start with the fundamentals don’t stop trying don’t stop searching as is all great and take care and also mentions I don’t understand why my GP wouldn’t know this and the reason is because the standard of care is is hasn’t updated their information as a yes yes there’s some lighting gps there but mostly following the standard care do not know this information and on average it takes about 17 years 17 years for information information to be incorporated into the standard of care 17 years so as you know who wants to suffer something for 17 years right we have to we have to jump on it a lot quicker we want to take care of myself so let’s move along here now what we’ve been talking about psh free t3 t4 but there’s a whole other area of autoimmune thyroid issues and for that we need to check if we need to check these people have antibodies to the virus they’re attacking the pirate which is a whole other can of worms in dr. ditucci crazy and spot why should i what do I still have siren symptoms we talked about the key study where this individual had normal lab results so they felt within the norm range so they were never treated but they had quite severe mishimoto thyroid is not immune condition in January their ph 4.5 february’s points0 heat moving towards hyper March it was 2.3 closer to optimal a problem is 3.8 may was 8.7 eyesore hypothyroid June 7.4 and July 1.6 so psh again going back on this key measure is just the tip of the iceberg we need to check sorry antibodies as well and another lesson that I’ve learned from this from another lesson that I’ve learned from my clinic is that we need to check these five things because they’re so important these five levels of thyroid because sometimes it’s a metabolic disorder and those hormones are off but sometimes it’s how to amuse and we’re actually making antibodies and so that we check anti-thyroid wobbling and Auntie thyroid peroxidase ok so and I even remember one situation where accent of clients to go to their doctor to get those tested and they came back to me that all my doctor didn’t know auntie toftt GS so now we actually write a full name on our forms ok anyway moving right along how do we probably discover imbalances well firstly see if you have symptoms see if you have the fatigue wasting dryer and in air loss menstrual irregularity to demodulate joint pain constipation depression which are the top thyroid indications next go and get well all of the thyroid test I’m not just the tip of the iceberg so my bare minimum is TSH 3t3 m3 t43 means it’s not bound to any proteins in the blood so it’s free your body can actually use that Auntie tpo and cyber brought face and HCG and sorrow globulus baby that’s all you take away from our discussion here today this week in the clinic know that you need to get some five done you might have some arguments with your doctor but even offered a paper on this super-important if you have symptoms once you get there was results back you want to work with that a healthcare practitioner to understand what they mean and see how you can get in this first of all here in the normal range second if you’re in the optimal range and if you’re not what to do about it and that’s the final thing what we can do so we can first gather that information then we can make changes to help support the siren and there’s many factors associated with good service health many nutrients dr. jeffrey blend called thyroid the sentinel of the body no antenna senses when things are off i’m dr. Bernard Jensen has passed away you know like you know was one of the immigration that an integrated health field Vsauce 350,000 patients he says the Pirates second dirtiest place in the body bowel being the first so he you know also has expressed incredible focus on the thigh right and this is not just a simple as taking some iodine or taking some silentium if a comprehensive process this is something we’re actually covering right now in my hormones course and there’s a lot of factors this is that one of us slide from my course but there’s all these factors are things that I go through when I work with clients to make sure that we checked off all the boxes there’s a handful of nutrients iron iodine zinc selenium vitamin b2 b3 b6 vitamin B as the vitamin a that are critical assignment functioning you have to go through these and figure out if you’re deficient or if you need to replace them and then of course there’s things that that damaged the thyroid and that inhibited activity so you have to make sure that those factors either like chlorine you know making sure your party so there’s not tricking chlorine bromine heavy metals and we can go on and on but really our focus today is what should you do to make sure that you have a healthy by right and that is to make sure you’re testing psh free b4 3c3 antique ppl and an ttg that’s a really great starting point and that we’ve been back around to my clients from the sweet that’s what we had two with one of them she actually had those done two years ago and they proved to be well as range and for another person we have to send back to see if what they’re dealing with this my rice is metabolic or modular music I hope that makes sense everyone give me a thumbs up if that makes sense to you guys i hope this is super valuable for you guys you know if you’re watching on a phone i think you can click like you know this this has been valuable you i appreciate your feedback and I’m just gonna jump in here on the chat box the chat room here to see if there’s anything that we can address any questions I need to address so on Candice mentions that GP wouldn’t know this because a brief visit of a few minutes is not sufficient system is broken yeah so you know in you know the standard of care you know the reason why we’re here today is because and this has been a sentiment of dr. mercola since he started huge website is you have to take control of your health and I’m here to teach you the ways that you can do that the ways that you can become your own practitioner we all have to become around option and i have this conversation at least a few times a week with my clients where they’re just surprised and dumbfounded that was a system that they thought was supposed to take care of them is not really taking care of the health care system or do we care system and I don’t say that in a negative way I actually think that healthcare system is amazing it’s incredible for emergency care and it’s incredible for stabilization and diagnosis and that’s where it shine we just have to know how to use it and that’s why we’re here today to learn how to use it so you know our medical practitioners in the conventional medical system are not able to get up there doing their jobs they’re working within the system the best they can so that’s why we have to take control of our health thank you for that comment Dmitri says Wow seventeen years and that was referring to how long it takes on average to bring something into fruition into clinical practice from the research to clinical practice takes about seven years is that we all know now that folic acid deficiency causes neural tube defects in fetuses and baby that took 30 years the researchers out it took 30 years for you become a regular recommendation for doctors to say hey you want to get pregnant taken the ground folic acid takes awhile comment from Jennifer here my GP just took a hormonal horse and said the ratio of p43 should be 62 one that he hasn’t he wasn’t talking about free version is this useful at all i’ve never heard of it before I feel like we talked to different language than that ratios are also really important and that’s the next level what we’re discussing here today is sort of a first-level what do I get why do I look for what I asked for what numbers are important ratios are important too and I talked about 32 dream 324 but a total featuring seaports might be important to me that as well as certain situations so that’s kind of the next level but also really important to do Stephanie video is asking what are all the ideal level of the blood levels that optimal levels well we talked about psh I like to see people within about a range of 122 if you want to learn about all of the levels my digitalis system that you tallat system.com you can actually go to has a section in the back which goes through every bloody hat and talked about the normal range versus the optimal range obviously in this form I can start going through every single number in there so like that a critical tool that I think everyone should have so that they can be their own practitioner and check on their blood work and you can check out optimal levels in that book as well and Catherine you can see in the chapel upstairs posted the five things that were referring to as things to look at and Karen white said when I told her that I was trying to make changes that were more holistic lifestyle and change things naturally she looked at me like I’m an alien i’m going to mention this to her wish me luck well what I say to my clients is if your doctor looks at you like you’re an alien you’re on the right track and Chris christina is asking is treatment difference for autoimmune vs metabox and yes there are definitely some specific things that we address when we’re dealing with any siren she is some basic factors actually in any condition but when it’s autoimmune vs metabolic yeah there’s a bit of a different treatment plan or treatment goal our monitoring different things were dressing things in this three different way and maybe we’re even making changes in the future that serve you know one of those issues a little bit more but the cool thing about working with the body sometimes the treatment for both is similar even from a natural perspective but i always like to know because it does get targeted a little bit better by for example millennium is critical sorry well no matter what’s going on but lower selenium levels have been associated with higher siren antibodies so you know if someone is presenting with auto Indians Cyrus Cyrus dishes millenniums like you know big one on the list for me just as an example we wrap this up thank you guys so much for joining me this has been the first episode of in the car this weekend cortex and we forgot the name of the first episode this week in the clinic we’re going to try to do this on a regular basis probably next friday we’re going to hit up at the same time will have new lessons learned from the weekend the clinic i want to take what I learned working with real people what I learned in the text box put that all together and present that piece about you to make changes in your life if you want to get more information about any of that of course you could visit Josh Dallas dot-com and thank you all so much for joining me i hope you all have a wonderful day and take control of your help and i’ll see you all again services all the best

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