57// How GI Symptoms are Connected to Hashimoto‘s & Hypothyroidism with Dr. Norm
Norm Robillard, Ph.D., Founder of the Digestive Health Institute, strongly advocates drug-and-antibiotic-free dietary, behavioral, and integrative solutions for functional gastrointestinal disorders and various forms of gut dysbiosis. He helps people who have concerns about side effects and health risks associated with long-term drug-based treatments or whose conventional treatments were ineffective.
His approach is based on the principles of the Fast Tract Diet, including 1. Dietary, 2. Identifying and addressing underlying causes that are specific to the individual, 3. Pro-absorption / gut-friendly behaviors and practices, including supplementation. The Fast Tract Diet (FTD) was presented at Digestive Disease Week (https://ddw.org/) to give gastroenterologists a science-based treatment option for SIBO (Small Intestinal Bacterial Overgrowth) and related conditions. His award-winning Fast Tract Diet mobile app and Fast Tract Digestion book series make it easy to implement the Fast Tract Diet.
In today's podcast we chat about:
We’re going to be talking about thyroid issues and digestive health. But first, I understand you developed something called the Fast Tract Diet. What is it, and how does it work?
2. I’m interested in your view of how hypothyroidism is connected to gut health. First, perhaps we can briefly cover the Hypothalamus-pituitary-thyroid (HPT) axis (only if you think your listeners may benefit from a really brief primer on the HPT axis and hypothyroidism).
3. How do thyroid issues connect to digestive health? I understand there is a SIBO connection.
4. You mentioned that there is also a thyroid connection with stomach acid levels. Can you explain?
5. What would you recommend for hypothyroid patients who have GI symptoms?
6. Is low carb bad for thyroid health – I understand this topic can be contentious, and if you’re not interested in delving into this, that’s fine. The FTD can be used by people on low or higher carb diets, but my position is that a case can be made that LC dieting is fine for thyroid health.
To Connect with Dr. Norm Visit:
Website
Email: norm@digestivehealthinstitute.org
Facebook group
Twitter: @DrNRobillard
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Shannon Hansen
FULL TRANSCRIPTION
FULL TRANSCRIPTION
(00:00):
This is episode 56, how the GI system is connected to Hashimotos and hypothyroidism with Dr. Norm Dr. Norm is the founder of digestive health Institute, and he strongly advocates for drug and antibiotic free dietary behavioral, and integrative solutions for functional GI disorders and a variety and various forms of gut dysbiosis. He helps people who have concerns about side effects and health risks associated with long term drug based treatment. For those who use conventional treatments that were ineffective, his approach is based off of the principles of the fast track diet, including number one, dietary number two, identifying and addressing underlying causes that are specific to the person. And number three, absorption and gut friendly behavior behaviors and practices, including supplementation conversation. You guys is absolutely amazing. I learned so much. I know for many of you, this may be an overwhelming conversation, but I promise if you come back and listen to it over and over again, you'll learn and begin to understand more and more the connection between your gut and your thyroid and how of these things can work together and how really simple these solutions are.
(01:26):
So hang out with me and Dr. Norm, and I'll see you on the other side, welcome back to the thriving thyroid podcast, where we choose to become empowered patients and take our health into our own hands. Hi, I'm Shannon Hansen, a Christian entrepreneur, a mom of three. And after dealing with my own health mysteries, I made it my mission to learn everything I could about the thyroid. I soon became certified as a holistic wellness practitioner, a functional nutrition practitioner and a functional diagnostic practitioner. And so much more after that, I founded the revolutionary thyroid program, the handsome method as a health professional and a mom. I fully understand the importance of having a fun, simple, and sustainable plan for achieving a responsive thyroid. So I share actionable and practical strategies for developing a responsive thyroid so that the ambitious moms and women can gain freedom from fatigue and lose the thyroid weight once. And for all each week, I will be here for you along with my guest experts, we will be sharing simple and tangible tips that work for not only your thyroid, your hormones, your family, and your mindset, so that you can get back to living the life that you envision for yourself. Welcome to the thriving thro podcast.
(02:52):
All right, you guys, I am so excited to welcome Dr. Norm to the podcast episode. Welcome.
(02:59):
Thank you. Nice to be here, Shannon.
(03:01):
Yeah, this is gonna be super fun. So just to give the listeners a little bit of background, who are you, what do you do? What do you specialize in and how did you get there?
(03:11):
Hmm, yes. So I'm a microbiologist by training. Spent a lot of years. I spent some years in academic research and working for biotech companies. The way I got into digestive health, which is what I've been doing for the last 17 years is that I just happened to notice that something about a diet that really helped my own chronic acid reflux. I never paid attention to diets was never on a diet of any kind, but in my 30, I started having terrible acid reflux and found that really watching my carbohydrates made a dramatic impact. And the more I started digging into that, I was curious and researching why, why that would be I ended up coming up with a new theory of the underlying cause of acid reflux, which instead of a dysfunctional low or esophageal Fior, right? You've heard that 60 year old idea that everyone else seemed to be accepting.
(04:06):
It didn't make sense to me. And so I started thinking about it and it came up with this theory that in my case, I was eating a high carbohydrate diet and that perhaps my digestion as I was hitting my forties was not as good as it was when I was eight 18. And I wasn't digesting all of those carbohydrates well, and I knew from being a microbiologist that bacteria in our intestines is a hundred trillion of them. And they're there for a lot of good reasons too, but that they, they prefer carbohydrates as a fuel source, especially early in the digestive tract. And they get a lot of energy from it and they produce a lot of gas, various gases, hydrogen, hydrogen sulfide, and there's a different type of organism that uses those gases uses hydrogen to produce methane. And my theory was that they, I was getting too much gas production in my intestines, was translating into my stomach and the pressure was building up and actually driving acid reflux.
(05:01):
So it was a completely new way of looking at that. And I just got so excited about it. I, I wrote a self-published book late at night you know, read the Amazon reviews. It's filled with typos and so forth, but I wanted to get this idea, this theory out there. And so since then I've really come into the field of digestive health again, you know, using my biology background since the, you know, microbes play such a huge role in, in digestive and overall health. And so I've been doing that ever since consulting in this field and written some more books, you know, with, with an editor this time. .
(05:38):
Yeah, that would be me. I, I tell everybody I don't care out typos. I just, just figure it out. I,
(05:45):
Oh, some people do.
(05:47):
I know I, not me. if I can figure it out and if it's close enough, then I'm good. So exactly. Well, I, I think that that's really interesting that you started to make that connection because for the average person, obviously you have some background, but for the average person, they're not gonna fully understand or even make the connection. And the more I'm working with women with thyroid, the more I see some people are waking up to, Hey, food is affecting me. And then this other group of people of who has nothing to do with it, you know,
(06:21):
That was me, you know, but it, it gets your attention when you're not well,
(06:25):
Yes, yes. So let's talk about thyroid issues and digestive health, but help us first understand a little bit about that fast track diet, what it is and how it works.
(06:39):
Yeah. Right. So initially, right, I was just kind of on a lower cob diet, it made me feel better, but I started thinking about which carbohydrates are the most troublesome it with this model carbohydrate, mal absorption and, and these carbs feeding blooms of gas producing bacteria. And so I, I reason that the more difficult carbohydrates, the more difficult they were to digest and absorb the more they would persist in the intestines with the potential to feed these blooms of bacteria. So I called that fermentation potential, and that's the basis of this diet. And so it's for people with IBS and GERD and other conditions that involve bacterial overgrowth. Like CIBO small intestinal, bacterial overgrowth. That's a big one, but there are other forms of dysbiosis. And so the diet is a way to basically put our microbes on a diet and, and these microbes, as I mentioned, they're good and healthy.
(07:34):
When, when things are balanced, we have a hundred trillion of these bacteria from thousand different species. And they populate mostly our large intestine and they help train our immune system from when we're babies. They protect us against invading pathogens. They help regulate bio levels. They regulate appetite and fat storage. But most importantly, the reason we evolved with these microbes in our, our gut, like other, all other animals is because they're able to process these carbohydrates that we don't right. I was, I was looking at, I don't want to cause symptoms by having too many of those, but when you're trying to survive and, and those, you know, hard to digest carbs from roots and, you know, things, if you can't find other foods and you, you eat what I, you can, you know, twigs and, and ferns, and a lot of these carbohydrates, you won't digest and absorb, but the bacteria can ferment them.
(08:28):
And when they do that, in addition to the gas, they can make to cause symptoms, they also produce fats in the form of short chain, fatty acid, and those fats like prop and ate and is, can nourish ourselves our colon colonocytes that line, the intestines, but also our muscle cells Propan is a great fuel source for our muscles. And so these microbes are producing those fats and that back in paleolithic times, that could be the difference between starving and not starving. So they do all of these great things, but unfortunately, when they get out of balance, we do have these various forms of dysbiosis, unbalanced, bacterial growth overgrowth of these microbes and a lot of gas. So that's what this diet target. And it does it by a couple of different ways. One is that it limits the full range of fermentable, but hard to digest carbohydrates.
(09:23):
And what are those lactose fructose resistant STAs fiber. And there's lots of different types of fibers and sh most sugar alcohols there, there's one kind of gut friendly sugar, alcohol called erythritol. But the other ones they're much like a carbohydrate. We don't digest them well, but they are fermentable. So it, I came up with a strategy to quantitatively limit those five types of carbs in any food. And you don't need to know how much of them are in a food because I created this FP calculation and fermentation potential calculation. It's kind of a reverse of the glycemic index. So you use the glycemic index and nutritional facts for any food, and you can get this FP now in the fast track digestion books is one on IBS is one on GERD in the fast track diet mobile app. Those calculations are done for you there's tables and in the overlap, there's like 1200 foods or so, and you can just punch in what you're eating and the serving size, the app will calculate the points in it.
(10:24):
And you can also put in all of your symptoms and if you find your symptoms are going up, you might realize, wow, I need to reduce my points because FP points, another, another name for those you could use is symptom potential less means less fermentable material it's actually measured in grams. So it makes it easy for you to be on a diet that limits these troublesome co. So that's the main part. That's FP calculation. There's the book and the app contains a lot of Prodi digestion, behaviors and practices, things you can do to improve your digestion. So, so that you'll get more of the carbs of bacteria will stay on more of a diet. And then there's also a section on potential underlying or contributing causes of these conditions. And it's, it's quite numerous, so there's a lot to work through, but it's, it's helpful in that. But my consultation program in particular really focuses on in, on the, these underlying causes to rule most of them out so that you can identify and address the, the ones that remain.
(11:25):
I love that. Well, and I would love to just talk for really briefly about what are some of the connections that you're seeing with that dysbiosis and something specific like CIBO and the reason. So for all the listeners, a little bit of background, everybody knows that my dad died from cancer. He had stage four lung cancer, but prior to that diagnosis, my dad never smoked. So it wasn't , I mean, he was exposed to secondhand smoke growing up. But when I look back at his digestive health, I can't go back and test him now, but I mean, maybe I could be really expensive. And anyways, I look at some of the, his symptoms and I'm like, I think he had SIBO. So for, for the listeners, what are some of the conditions that would warrant, you know, some further investigation in terms of SIBO or gut dysbiosis or something like that?
(12:27):
Sure. Well, you, I mean, the first sign would be symptoms, right? I mentioned reflux that reflux regurgitation belching lo Ringo, Phal reflux, a lump in the throat, a sore throat, respiratory issues, clog sinuses, or uation tubes. Your ears are all plugged up. Those are some kind of reflux related symptoms, but there's also kind of IBS symptoms, irritable bowel syndrome, altered bowel have, and diarrhea or constipation feeling bloated all the time or physically having distension. So there's, there's a whole variety of symptoms. Weight loss, if you have more severe, more severe case. And those were all would, I guess if you had those, you might consider working with somebody or of getting tested to see if you did have small intestinal Al low growth. So you can get, there's a hydrogen, lactose breath test you can get that will, it, it, you, you basically blow in a little tube and, and the gases, if you have SIBO, hydrogen produced from bacteria in your intestines, it's absorbed into your bloodstream, exhale through your lungs.
(13:37):
And so when you're blowing these tubes, if you had a lot of hydrogen and you put the cover on and label it, send it into this company, it would show that you had hydrogen. So you basically blow in a tube at time, zero, put the cover on. Then you drink this Lalo and it's a sugar solution, but it's not digestible at all. It's like a fiber. And so, but bacteria can ferment that sugar. And so then you drink it after your first tube, you drink the sugar and then you, every 50 minutes or 20 minutes, you blow in a new tube, put the cover on, send them all back. And basically what they're looking for is your breath, hydrogen levels over time. If they go up too sharply too, had to sharply say before 90 minute, they'll likely conclude that you have small intestinal bacterial overgrowth.
(14:21):
Now there's also met these Ikea organisms that produce methane from that hydrogen. So it's good. If you can get a hydrogen methane breath test to know what your methane levels are, you may have high methane levels and that be linked to constipation as well. And there's a third gas now, hydrogen sulfide, that's produced by sulfate sulfate, reducing bacteria. And some people have very high levels of hydrogen sulfide. And there's now a test called trio SMOT that measures all three of those gases. So if you're really curious, there is, there is testing out there you can get, but symptoms is the place to start. But also if you have just some of the under potential underlying causes, if you happen to know about those, that might trigger you to look into that further, right? We talked about all these 25 or 30 different things that can underlie these.
(15:11):
So motility, low stomach acid problems with your immune system. Maybe you have low secreted immunoglobulin, a and your stool test, or a low elastase, a pancreatic enzyme in a stool test that says your pancreas might not be working so well. And pancreatic enzymes might be low is just so many of these these different conditions, having a GI infection, you know, any kind of inflammatory condition liver problems, alcoholism just overconsuming carbohydrates. Like I did back in the day. So if you have those conditions or these symptoms, that'd be good to follow up with that.
(15:50):
Yeah. And do you recommend for them to see like a PCP to get this testing or do they need to go to a functional doctor or what would be the best way to get the, the testing?
(16:01):
Yeah, I mean, it depends on what the test is. There are a lot of a different practitioners that can do some of these tests. The, if you were to do a glucose breath test, you can just order a lot of these tests. You can just order directly online, they'll ship it to your house, they'll take the test and send it in. They'll send you the results. However, so you could do a glucose breath test, but if you wanted to do a Lalo breath test and it may vary a little bit by state, but because Lalo is technically a prescription laxative it's too bad. It's, it's silly. So you, you need a prescription for the LA Lalo. So a doctor would have to order the lactulose breath test, which in my opinion, that's the best one to get anyway, because glucose is absorbed too quickly in the intestine.
(16:45):
And so you might miss CIBO if it was in kind of the later part. So I'd recommend Lalo, but that would have to be ordered by a Okta. There's a lot of other ones you can measure your stomach acid with a Heidelberg test. You'd have to find a natural path or some practitioner that actually has that technology in their office that they can do it, but you it's a noninvasive test. You swallow this electronic capsule on a string dangled in your stomach. So it knows what your stomach acid's doing. And then they have you drink solutions of BICO every so many minutes. And they see the, the stomach acid will acid will go away. It'll become neutralized. And then how long does it take your stomach to re to recover that acidity? And then they'll give you more BICO. And then how long does it take to recover?
(17:34):
And if you're too long in recovering, you, you may be diagnosed with hyperhydrate or even Aloia, which is low or no stomach acid. Yeah. another great test, by the way, this one you can get direct by the way, one of my favorites is there are now very good comprehensive stool analysis, and you can order those direct online. They send it to your house. It's just a poop sample. You send it back and it's there's a tremendous amount of activ of information you can get out of that. That's quite actionable if you're working with somebody that really know knows what they're doing. So those, those are some that I would recommend.
(18:12):
Perfect. I did my first stool sample this year. I did a D oh, you did. I did. Yes. . And there was a lot of came back way better than I thought it would , which was really good. But I found out a week later I was pregnant, so,
(18:30):
Wow.
(18:31):
Some of the things, yeah. I, some of the things I would've done, you know, obviously got a little derailed just cause we don't know how that impacts baby, but you know, very cool information regardless of what you guys are doing, I'm a huge fan of those as well. So let's talk, let's kinda shift gears a little bit and talk about how hypothyroidism is connected to your gut health and kind of go over that H P T access and what that is. Mm
(19:07):
Mm. Yeah. So let's get to gut health, but yeah, first you to primer for some of the, some of your new listeners, maybe that haven't thought about a lot of this, right? That it's not just your thyroid kind of floating there, the base of your throat out, out in the middle of nowhere with it's it's highly regulated. And so there is this hypothalamus, pituitary thyroid access, H P T access, as you mentioned the hypothalamus read in your brain produces this thyrotropin releasing hormone T H and then that tells your pituitary gland to start producing tssh, right? Thyroid stimulating hormone. That's the thing most people get tested for in a routine blood test, right? It's not actually produced from your thyroid is produced from your Cland, but that tells the that tells your thyroid to start making T3 and T4 hormones, right. Mostly T4 and then some T3. And then when you make enough of those hormones for your body to use, to regulate the metabolism and so forth, there's a feedback loop that goes right back to the hyper a thalamus and says, you know, shut things down. We've got enough. So it's, it's tightly regulated by the way a bit of trivia for you for your listeners too. I didn't know initially why th thyroxine, T4 and try IO, thy thyronine T3. Why are they called T3 and T
(20:33):
The molecules right? That are attached? Yep.
(20:35):
Yes.
(20:36):
Yep. Okay.
(20:37):
What molecules, iodine, iodine molecules. So T4 has four of these iodine molecules in its structure, and T3 has three, just a little bit of trivia there, but it also points to the importance of iodine in, in thyroid. All right. And, and so it makes sense if somebody's hyperthyroid, which you probably not gonna get into that today, but if they, if they're overproducing thyroid hormones, why they would give them radioactive th iodine, because the thyroid's gonna take it right up, right. It needs four of 'em for T4 and three of them for T3. So it's going to take it up, but that will also inhibit or kill thyroid cells and, and reduce the levels. Yeah. So, so then what happens right? With hypothyroidism, something's gone wrong somewhere and the thyroid isn't producing enough for this T4 and T3. So going to slow down your metabolism, it may slow down your intestinal motility.
(21:32):
A lot of people complain of constipation. You might feel tired, gain some weight, be sensitive to cold. And so, and even, you know, in there's many more possible symptoms, if it gets bad enough, if to including like neuropathy, you know, numb or tingle tingling, hands and so forth. And then there's a number of causes, right? The main one is this, Hashimotos this autoimmune condition where your own body is attacking your thyroid with, with antibodies. That's the big one. But people that are getting hyperthyroid treatments, they can end up overshooting and then they become hypothyroid or have the thyroid removed, and they have no thyroid hormones. They have to be all given to you radiation therapy even some things with your diet, having a loath iodine diet maybe certain medications I know lithium can, can impede your your thyroid. Yeah. So that's, you know, just in a, she, some of the, a little bit of background there.
(22:30):
Yeah, sure. So how is that connected to digestive health? Or yeah. Yeah. How is all of that? How is the H P T access connected to thyroid?
(22:45):
Yeah. So the H PT access, we are, we, we kind of talked about a, how the hypothalamus talks to theit three gland talks to the thyroid gland gland, and then there's feedback. So that's kind of in its own loop. So how it interacts with your gut health, then that's probably more lines lines of what is T4 and T3 doing and all of that. Right. we do that somehow, and, and I'm no real expert on this, but it is, these hormones are regulated. You know, they regulate homeostasis all on metabolism. How, how mu how well, and how fast we process energy and so forth, hence the potential fatigue, how fast things move through a digestive tract, you know, in motility. And, and that's why hypothyroidism can result in constipation. Oftentimes in hyperthyroidism too many hormones can end up giving you rapid transit or diarrhea.
(23:46):
So in a lot of these ways, the hypo and the hypo, the kind of the opposite, not in all, you can get kind of stressed and fatigue from both conditions, but in a, in a lot of ways, they're, they're kind of the opposite. What I've been kind of interested in is the connection between thy, when, when we're talking about digestive health, the connection between hypothyroidism and small intestinal, bacterial overgrowth, and then also the stomach producing stomach acid. I find those are two really interesting connections linking thyroid with, with digestive health.
(24:23):
Yes. And I see that all the time with the women that I work with. It it's like stomach acid is a big thing. So we do not that this is like super what's the word that I'm looking for? I don't even know what the word is. We do the Burt test with baking soda a little bit of,
(24:45):
Yeah, yeah. I, I, I know what you're saying. So in other words, it's not, might not be that sophisticated. Yes. But it's it's kind of a little gut check, right?
(24:54):
Yeah. And most of 'em don't work at all. Oh. You know, so they're coming back interesting. Very, very low with, with stomach acid. So let's, let's maybe kind of dive into that and what are some of those connections that you're seeing between thyroid and stomach acid and all of those fun things?
(25:14):
Sure. Yeah. Let's, let's start there. We, we know that stomach acid is critical for a lot of things. Digesting your food, breaking down proteins, absorbing a iron vitamin D other minerals. It's, it's really a critical element. It protects your body from getting infected with pathogens like salol and clostridia difficile, cause it's an acid barrier. It also protects your lungs from bacteria that are on, in your own intestines, right. Via reflux, which we talked about. You can reflux bacteria from your gut up into your throat. Aspirated in. I used to have that when I had good 17 years ago, I'd wake up in the middle of the night choking. There was acid in my lungs. I thought I was dying. I didn't know what was going on. And so this bacteria in that reflux eight, and so people that are on proton pumping it, but as they get rid of your stomach acid, they have a higher incidence of pneumonia.
(26:12):
No surprise people on, on these Niom type drugs have a higher incidence of see different infections. It's harder to get rid of. It's more likely to come back. So there's, you know, you could write a book well, as, as at least one person has on, on Los stomach acid and all of, you know, updated to all of the new risk factors we know about now for when you get rid of stomach acid. But how does it REA how does it relate to, to hypothyroidism is kind of interesting, right. And we know that stomach acid helps absorb T4, right? So when you take thyroxine, right, it's, it's aided by stomach as acid. And how do I know that there's a study on good patients that had with hypothyroidism that were being treated with a Metzo, which is like the generic version of Nexium.
(27:10):
And they had to take higher levels of T4 medication to maintain the same TSH levels. So we absolutely know that you need stem acid. It helps you absorb this T4 in fact and I guess also, right, there's estimates that one third of Hashimoto patients have antibodies, two par varietal cells. And so you're gonna have to stay with me for a minute to get through this explanation, right? Why is that important? So Hashimo is an autoimmune condition, right? Antibodies you're attacking a thyroid people with autoimmune conditions, oftentimes have several autoimmune conditions. They kind of travel in packs, right? So it might be ankylosing spondylitis or type one diabetes or Hashimotos and so forth. But they tend to have more than one autoimmune condition while one autoimmune condition is called pernicious anemia. And that is where auto antibodies it's an autoimmune condition are attacking the parietal cells that line, the middle of your stomach and the body of your stomach.
(28:26):
And what do those cells do? They produce stomach acid. And so what, what I'm saying is that people with Hamos are at increased risk for this pernicious anemia anemia also known as autoimmune atrophic arthritis, antibodies to the PRAL cells. And you'll have high Aloy, hopefully not Aloy, total lack of stomach acid, but you have a good chance of being, having low stomach acid, like the people you tested with with the burb test there. And so you know, what is, what does that mean? Right? We know that you're going to need more thyroid medicine, number one, and you're gonna have all of these are of the problems I talked about. If you have low stomach acid. And it's interesting that the, the connections go further than that. People with helic back to Py infections, that's a bacteria that infects specifically a stomach, and it can cause not autoimmune, but kind of infectious atrophic arthritis can damage your cells at the line, your stomach, including these par varietal cells.
(29:30):
And you get HypoChlor Chlo for, from HPI a long-term infection. But what's interesting is in studies with a, at least one study with a cured people of the HPI infection, the TSH levels were reduced suggesting that wow, the thyroid levels probably went back up and they don't need as much Ts they don't need to produce as much tssh. So I, I think all of that together makes a strong case that having Hashimotos puts you at risk for having low stomach acid. And in fact, having low stomach acid, this is another interesting connection is also a risk factor placebo. And so you would ask next perhaps to people with how
(30:24):
Well I should let you answer that, but I, I wanna touch on something just really quickly
(30:29):
I'll before we get off, let answer later. Right. Go ahead. What else
(30:34):
That I want the listeners to really kind of hone in on here is as a practitioner, we talking about one of your first lines of defense, which is a stomach acid mm-hmm right. A lot of this, I mean, as I say simple, it's not always like straightforward do a, then you get B you know, sometimes there's a few things that are, that are mixed in there, but stomach acid is so important for regulating GI issues and your thyroid. And this is why we see this huge connection between the two of them. And so oftentimes when we start to balance out stomach acid levels, you see thyroid medication dropping, right. Or the doses.
(31:20):
Absolutely. Yeah, absolutely.
(31:23):
So, and then you're getting off acid reflux, medicine and the PPIs and things like that as well. So your body is creating that homeostasis without the need for medication, you know? So, yeah. And
(31:43):
In your, in your case, you might be talking about two people. Oh, oh, I have low stomach acid. Maybe I can supplement with appley vinegar or a bean HCL, get my stomach acid back. And that would have a positive outcome. Right. which is a great idea, but what I like to do also when I work with people is, you know, really dig into those questions of, okay, you're gonna take some apple CIT vinegar. If, if you don't have a sore throat from LPI, okay. Otherwise you're gonna take BTA HCL, which is basically stomach acid, like a material in a capsule, but long term, what are we gonna do about this what's causing it. Let's get to that and fix that.
(32:22):
Yes. And just a little like side note tidbit. And I think I covered this in one of my other episodes when we talked about birth control, but one of the minerals that is needed to produce stomach acid is zinc. And a lot of women have elevated copper, which pushes down zinc. And so if we can get that copper zinc ratio a little bit better, then we don't need to, like you said, kind of take the apple cider vinegar or take the BTA and HCL to balance it out. Our body's able to do it through the minerals.
(32:59):
Yeah, that makes sense. Just don't go too crazy with a copper can be toxic
(33:04):
yeah. Yeah. Well, a lot of women have elevated copper, so they are toxic and their zinc is really low, at least is what we're seeing. Yeah, I see. So we kind of have to, I
(33:13):
Yeah, that makes sense.
(33:15):
Yeah. Coppers elevated zinc is low. I see. We have tore that into that. We
(33:20):
Do need that zinc, right?
(33:21):
Yep. Yep.
(33:22):
Very
(33:22):
Good. Which is immune, right? yeah. Hamos so we're, we're kinda, hopefully you guys are seeing some of these connections come through with all of this. Okay. So what was the question? Let's talk about Hamos
(33:38):
Seebo
(33:39):
Placebo and Hashimotos.
(33:41):
Yeah. So we talked about low stomach acid and Hashimotos, and there's a pretty good connection there that, that it does seem that people with Hashimotos are at risk flow stomach acid. And in fact, I don't have the source material right in front of me, but I believe there's also a connection for low stomach acid in people that a hypothyroid, but not, but don't have Poti motors, but I crosschecked me in the literature on that one. I don't have the evidence in front of me, but yeah. So, so CIBO the CIBO connection. So you might expect Hashimotos to have a risk placebo for two reasons. There's a risk of having low stomach acid. And one of the things we did didn't mention when you have low stomach acid, or even people on PPIs as a higher incidence or risk of placebo, we talked about C diff and some other things, but also a higher risk placebo because acid is one of those control mechanisms for bacterial overgrowth.
(34:35):
So there, if you had low stomach acid might make sense to that, you'd have to be at higher risk placebo also Hashimo is going to slow down motility in many instances, right? And when the material moving through your digestive tract kind of slows down, stops stagnates bacteria grow, they produce small gas. You can have an overgrowth in your lo intestine. And when you have an overgrowth in yellow, large intestine near the small intestine the Elio valve, it may produce gas and push bacteria into the small intestine. So you could be more at risk placebo from this motility issue. So what, what does the data say, right? What, what's the evidence for this? Otherwise I'm just like shooting my mouth off you. There is some, there was a study done in 2007 and it was with 50 Hashimotos patient and they, they did breath test them, not with the OSE breath test that I said was the best one that we're talking about. They used the glucose breath test, not as sensitive, cuz it's absorbed too quickly. And yet over 50% of those 50 patients were positive placebo via this glucose breath testing versus 5% in the healthy control group.
(35:55):
Amazing. I mean, that's amazing, but a good information to have.
(35:59):
Yeah. And that was using the least sensitive means of measuring cebo glucose breath test. So, and, and by the way, they did the, I don't recommend antibiotic treatment placebo. I, I really would, would recommend something like the fast diet, a diet approach with looking at underlying causes, looking at pro absorption behaviors, limiting these types of carbohydrates. That would be the way I would do it. Antibiotics is a lot of other problems with them and, and they're not very good for your gut microbiome.
(36:29):
Thank you for covering them.
(36:30):
in this study, they did treat these people placebo positive when antibiotics, and it did improve this symptoms and prove her solve their symptoms, but not their thyroid hormone levels. So in that study they were saying, so it might seem that CBOs more of a consequence of hypothyroidism compared to the other way around and they might be right. The only point potential counterpoint talking point I would make on that is that people that have SIBO can also have leaky gut higher levels of intestinal permeability, because not bacteria, they're making protease and toxins and all these things are growing. You get a lot of inflammation, you might get some leakiness in your tight junctions that lining your small intestine and as people, a auto people believe now, including myself, that that leaky gut is probably the way most autoimmune reactions start antigens, proteins, bacteria, to things leaking out of your gut, into your systemic circulation.
(37:34):
Your body sees them as foreign attacks them. But what happens with auto immunity is oftentimes there's something called molecular mimicry. Some of those molecules look like molecules on the surface of your own cells. And there's a belief that's where really all autoimmune conditions likely begin is one instance, one good example where ankylosing spondylitis is an autoimmune in reaction where the cartilage in your lower back is attacked by your own body. But it's interesting that there's pro there's proteins and molecules on the surface of CLE seal and pneumonia bacteria that resemble the molecules on these cartilage cells. And so there's a connection between leaking in and they having a lot of club seal and pneumonia in your gut and this autoimmune reaction. So all I'm saying is there is that connection, but, but yes the, the motility perhaps hypothyroidism predisposes things to to get cebo there is one other study, a more recent study, 2017, where they looked at kind of chats from patients about 1800 patients, but about 175 of them, they had been to the hospital and at some point or another were breath test 175 of them, or so had CBO.
(38:59):
And that in that study, they found that hypothyroidism in particular taking therapeutic T4 was one of the most highly linked things in their study to CBO. So, and that, you know, and it's an association study, but it's still kind of interesting. They had it right up there. The only two risk factors that were more linked to Seebo were, was motility disorders. We know that's in hypothyroid yep. And immune dysregulation. So
(39:32):
Which both of those are connected. Right? Yeah,
(39:35):
Yeah, yeah, yeah. So, so you know, I think there is a strong connection with SIBO and with low stomach acid and hypothyroidism. Yeah. So yeah. So next question be, what do you do about ulcer
(39:49):
? What do you do? Well, actually, I, it just kind of triggered in my brain because a lot of people with thyroid dysregulation also have MTHFR. So I'm wondering if there's also a genetic component to this as well. I don't know if you have a quick answer for that or not, or if that's just,
(40:12):
You know, it's, I've talked about this before. It's a tough topic to talk about because it is, it is complicated, you know, and this is the metabolism of these sulfur containing amino acids and you know, homocystine and Aine and all of that. It, it is complicated. The only tidbit, I guess, I'd throw out there is that most people with the gene variants, right. And their, and the variance not like, oh my God, you're a mutant, you know, no, they're not mutants, they're variance. They just have a different sequence, maybe not good or bad. But in most people that do, and there's certain, you know of these literally these mutations and they can tell you exactly where they are. Most people that have them have only one a, a mutation or a gene variant and one of their two copies of, of the genes for that particular trait. And so there's a lot of speculation that that an industry has grown up around this, but is it really an issue? You know, a lot of people would argue me, but I would just say I'm still in kind of the, the listening mode there to, to gather more evidence.
(41:26):
Yeah, yeah, no, I'm, I I'm with you in terms of that, it was just like a, I don't know, a random thought that kind of came in. Yeah. Cause sometimes I'm like, well, wait, if this is that, and that is this, you know, just trying to put the spiderwebs together,
(41:42):
Making the connections is the first place to stop, but then you need to look for that evidence that really buttons it up or not.
(41:48):
Yes. Yeah, exactly. Exactly. So be before we kind of wrap this up, what is low carb? It is low carb, a good thing, or a bad thing for thyroid. I we've talked about this, I think a few times, you know, on podcasts episodes and yeah, yeah. And Facebook lives and all the things, but I would love to hear your thoughts.
(42:13):
I mean, it's, it's contentious. And just as a reminder, the fast tracked diet system, it's really a flexible point system. So it can be used by people on a high co plant based diet. It could be used by people that are doing keto or even maybe doing carnivore some days of the week. So it is a sliding point system that it's used to control these, these symptoms. So it's not necessarily low carb or keto. Although I do personally, just the circles I run in, I, I feel like there's a lot of evidence that low carb and, and even keto part of the time healthy states and can improve a lot of a lot of health conditions. So that's just my own, my own. I guess you know, preference for myself. I, I tend to be on a lower cob diet, not only for GI issues, but also for, for weight gain helps me, my particular meta metabolism control my weight a little bit better.
(43:13):
But there are, are some points about this whether or not it's low cob is good or bad. So first of all, I guess there are people that say low cob is not good for hypothyroidism because it, or for your thyroid, because on a low cob diet or very low cob diet, your, your T3 are lower mm-hmm . And, and nobody denies that. There was one study God, it was a while back 2001, but they showed that they, they looked at a diet with 15% energy from protein and the, the cob energy was somewhere around 85, 44, and then all the way down two or percent, right. And that I guess fat calories would make up the rest. And they looked at these T3 values and it was significantly lower, like 1.78 at the highest cobs nano per liter just wrote down those numbers here compared to 1.3, three nano per liter T3 on a very low carbohydrate diet.
(44:17):
So it is lower, but really the question is, what does it mean? Does it mean that a low cob diet is bad for your thyroid or that you need less thyroid hormone? That's really what I think the debate best boils down to. And and by the way, in that same study free T4 levels, reverse T3 TSH levels did not increase, oh, I'm sorry, increased, reverse T3 and free T4 increased, but TSH was unchanged and resting energy expenditure, right? Met metabolism on, on the very low end on all of those ranges of carbs did not change. So there is, you know, and, and so Hashimotos a, you know, one of the things they're dealing with is, oh my God, I have no energy and so forth. So I can see, see why you could say on low cob that might give me even lower energy that might be additive.
(45:14):
But I personally think it is probably more along the lines of your body regulating its thyroid a little bit different. I know on, on a low cob, very low or ketogenic diet, there is kind of an adjustment period. So people do complain of like, oh, keto flu, or I'm tired, or it can last for several days or a week or longer. Not everybody is consuming enough fats when they're on a low carb diet. That could be part of the fact because part of the problem, because your body is trying to transition to using fat for energy over carbs. And there's a lot of changes that need to go on for that. At the level of gene expression, all of this, you know, repression and regulation we talked about at a genetic level that happens when you change fuel sources too.
(45:59):
So there are some people that have made you know, some good cases either way. I think Ron Rose Rose deal, he's a low carb keto guy. He has made the point that a doesn't that low cob high fat does doesn't lead to hypothyroidism. Cuz otherwise TSH would go up and it wouldn't because a low T3 would stimulate a higher if you needed it, a higher level of th ha it doesn't happen. So he makes that point he thinks low cob kind of slowing down metabolism is he actually thinks it's the secret to law longevity. And he bases that on looking at cent what do they call centenarians? They have low T3, but they're not considered hypothyroid these people over a, over a hundred. And also the same with calorie restricted animals and studies where they live longer. So he's saying you may be better off with lower T3 if it's on a low carb diet and it might you might live long. So there's two sides to it. I still read about it, but I'm, I'm just kind of interested in, in the debate and, and I tend to fault to the side of a low cob just because there's been so many other health benefits of that type of dieting.
(47:13):
Yeah. Yeah. Well, well, and I think that that's a really good point is looking at the fuel sources and making sure that you're getting enough protein enough, carbs enough fats, because if you take something out, your body has to replace it with something, you know? So it's
(47:29):
So true. Yeah.
(47:30):
Figuring out how to balance
(47:32):
That. And when I work with people, I know our conversations focused a lot on kind of these carbs and so forth. But when I'm working with somebody in my consultation practice, I wanna make sure they're digesting all three food groups, properly, proteins fats, and carbohydrates, because you can have problems with all of those. Yep. And if you, if you're not digesting fats well, for instance you, how can we start changing your diet to cut down on some of these carbs? What are we gonna do? So you have to identify these problems and, and address them as you go. And, and one could, it's not just carbs. It could be fat mal absorption as well.
(48:06):
Yeah, absolutely. And we see a lot, lot of that happening with my clients as well, in terms of we're seeing the clay colored stool, we're seeing floating, we're seeing, you know, things like that where it's like, you're just not even breaking down, you know, your carbs and now your fats. And so we have this really wonderful cycle yeah.
(48:28):
My rule of thumb is us. The board less is more, we eat too much. We dessert too much. We have too much sugar and probably most of us have too many carbs in our diet. That's my, that's my mantra.
(48:39):
I have plenty of carbs, especially right now.
(48:42):
Yeah, yeah. With COVID.
(48:44):
Yeah. And baby, and seems like that's all I want is oh yeah. Potatoes and yeah. I mean, it could be worse, but
(48:55):
Yeah.
(48:55):
Okay. So last but not least, where can people learn more about your work, your books, your mobile app, everything that you have going on? Cause this was amazing.
(49:07):
Yeah. No thank you for having me. I enjoyed it too. The fast tracked digestion books hot burn and IBS they're available on digestive health institute.org, the fast track links to the fast track diet mobile app. Obviously you have to buy that from iOS or, or Google playing. But there's links to that on digestive health institute.org, the books are also available on Amazon. And you can reach us@digestivehealthinstitute.org. There's a consultation tab. If you want to call me up, you can gimme a call and I'll, I'll ask you a little bit about what's going on and decide if there's a, a program I have that might be, might be appropriate for you. You can also join us on the fast tracked diet official Facebook group. It's about 11 or 1200 people are on the diet and, and talking about all the issues. We have some really great admins including a nurse, that's a retired nurse on the site. They're just very, very helpful people. And I'm on there occasionally myself, so amazing. You can connect with us there.
(50:06):
Yeah, absolutely. And all of those links will be in the show notes. For you guys where you guys can book a consultation or, you know, join the Facebook group, read the books, all of those fun things. Thank you, Dr. Norm for being on. Is there any last words of wisdom or anything that you feel like we just didn't cover? Yeah.
(50:28):
Yeah. Thanks for having me. Shannon. I, I should have saved that less is more line and that would've been good eat slowly and chew well is another one. Yes. If you, if you don't do anything else, if you consume less, if you eat slowly and chew, well, that's a good place to start.
(50:43):
We, I love that only because that's one of the big topics in my home. Ah my kids are like, you know, I'm like, whoa, this is not a race. Just slow down to your food.
(50:57):
Right. And there's
(50:59):
More food if you are still hungry, you
(51:02):
Know, and something we didn't even get into was intermittent and even prolonged fastings, just a fascinating area to to think about and to try. I've done some it's
(51:13):
Awesome. Absolutely. Well, thank you so much. We will have all of your links linked up in the show notes and hopefully you guys gained a ton of value from today's episode. I know I learned a few things. I took some notes that I'm gonna have to transcribe in a safe place. but anyways, thank you guys so much for joining. We'll see you on the next.
(51:41):
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(51:51):
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