Thyroid Health, Autoimmune Disease and Blood Testing with Dr Alexis Shields

Naturopathic Doctor Alexis Shields is our guest on Episode 007 of the Optimal Performance Podcast.

Tune in to hear why your thyroid health is critical to your performance.

Dr Alexis Shields is a functional medicine doctor who knows the importance of performing at the highest level, and spends her days helping people bridge the gap from normal to optimal.

On this episode of the OPP, she'll help us optimize our thyroid, recover faster, increase our metabolism, and get more out of life!

What You'll Hear From Dr. Alexis Shields:

• Fact Of the Day: Are you 1 of the MILLIONS of people suffering from this undiagnosed dysfunction?
• What is Naturopathic Medicine and how can it help you #liveoptimal?
• Thyroid - the gland and hormones that govern optimal health & performance
• Normal DOES NOT MEAN Optimal
• The thermostat for the body - discover the throttle to increase or decrease your metabolism
• Testing TSH and signs that YOU'RE not optimal...
• Dr. A's 10-point Thyroid TEST - just for Optimal Performers!
• How to fix your thyroid so you can THRIVE!
• Get the right minerals to optimize thyroid levels - Kelp anyone?
• The SUPER foods to eat and EVIL foods to avoid for optimal thyroid function
• Why white rice is better than brown rice
• Auto-Immune disorders & digestive issues and the right foods for YOU.
• 2 more reasons to avoid soy and Canola Oil
• But wait...there's GOOD SOY?
• What about gluten?
• Where to get more of Dr. Alexis
• Dr. Alexis's 3 Best Tips to #liveoptimal

Links & Resources:

Dr. Alexis Website

Dr. A's 10-Point Thyroid TEST

Dr Alexis' Blood Testing for Biohackers (and her recommendations for Magnesium and Vitamin D)

TRANSCRIPTION

Optimal Performance Podcast #7: Thyorid Health, Autoimmune Disease and Blood Testing, with Dr Alexis Shields

Ryan: You're listening to the Optimal Performance podcast sponsored by Natural Stacks. This is the show everybody who's into performance and bio hacking should listen to. If you want to know more about Optimal Performance check out www.optimalperformance.com.

Alright, happy Thursday all you optimal performers and welcome to another episode of the Optimal Performance podcast. I'm your host Ryan Munsey and today I've got our guest and co- host, Dr. Alexis Shields, with me. Alexis is joining us all the way from Lisbon. So, thanks for hanging out with us, Alexis! Say hi to everybody.

Alexis: Hi, thanks for having me.

Ryan: Yeah, it's our pleasure. So for all of our listeners, Dr. Alexis is a naturopathic doctor, we will get back to exactly what that means in just a minute. In this episode today we're going to talk a lot about functional medicine, thyroid function, thyroid testing and all kinds of performance hacks that we can do through food, medicine, everything like that. So sit back, you guys are going to enjoy this one. Before we do that, we want to read some of our 5* reviews from iTunes and I'm gonna share with you guys a really cool review that we got on CILTEP.

Alright, so, JYY on iTunes says: "this podcast is great to listen to while running, on a long drive or even when I'm cooking. Very informative, I love it. Waiting eagerly for new ones to get released". So thank you, JYY!

Nate G325 says: "Great host and amazing guests, I'm always striving to improve my mental and physical performance and this podcast has become my go-to resource. Highly recommend it".

And let's go one more, iriver088: "loved it and would recommend to anyone and everyone".

So thank you guys for leaving us the feedback on iTunes.

Alright, so now the review on CILTEP. So this is from a virtual coaching client that I work with, a guy that runs two different businesses and has started using CILTEP to replace his ADD medication.

Vince says, "after one week of taking CILTEP I noticed a dramatic improvement in my focus and had an ultra-productive week".

Now, our fun Fact of the Day. Over 20 million Americans are affected by thyroid disorders and about 13 million of those are actually diagnosed. And as our fact of the day that is going to relate back to some of the things we talk about with Dr. Alexis today. We're gonna go right into that.

Always remember with any episode you can go to www.optimalperformance.com and get the video version as well as show notes, links to all the resources and cool stuff that we talk about on each episode. So, let's get down to it. Dr. Alexis, what exactly is a naturopathic doctor? Tell us what you do.

Alexis: Yeah, so in the US, Naturopathic doctors are trained as primary care physicians. So we're family doctors, we prescribe medications, we order lab work, we can perform minor surgery, but the difference is that we also specialize in functional or alternative medicine. So we aren't going through hospital rounds and specialising in things.. You know, we're not doing advanced surgeries and specializing as you know, cardiologists or rheumatologists, or something like this. We specialize specifically in primary care medicine using functional alternative medicine as well.

Ryan: Okay, very cool. And with that, you have a.. Is it a specialty in thyroid or is that just something that you're passionate about?

Alexis: Yeah, it's just one.. Like you said there are so many people walking around with a thyroid disorder that don't know it. And as a primary care doctor, what our job is to kinda identify, you know, how is the person's overall health and how are all their organs functioning, how are all their glands functioning, and to kinda look at the whole picture of the person to see how everything is inter-related and the thyroid is so huge because it's one of the.. You know, it's a gland that basically controls our metabolic rate, and it controls development and growth, and so you know with that, especially for anybody concerned with optimal performance and health and exercise recovery and optimal brain function, if you don't have a functioning thyroid then you're gonna be in lots of trouble. So it's one of those basic functions that with every single patient that I see I'm always concerned with making sure that it's optimal.

Ryan: Well you answered my next question, which was exactly gonna be, 'how does this relate to optimal performance?' So well done!

Alexis: Yeah, thanks!

Ryan: So I mean, with thyroid, even a slight imbalance is gonna cause significant impacts on our health and wellbeing, right?

Alexis: Yeah, well we can actually get more into this when we're talking about how the thyroid works, and you know, getting into the mechanism. But you can essentially have a very normal looking thyroid test and still have a thyroid disfunction. And so we'll kinda talk about how to identify if you're one of those people, but I see so many people and they come to me and they're like 'I have all these symptoms', and they pretty much are the exact, you know, what you would read in the book about somebody that has thyroid disorder, but then their labs come back absolutely normal, and this is so common and it's in part because we're not testing completely enough, and so we're just doing the bare minimum of testing because that testing has been designed to decide if someone needs to go on medication or not. But the problem is, is there's a big grey area before you need medication where you probably need some help and your gland could use some you know, different foods and different nutrients and things to optimize the function. So you can be walking around with these symptoms and not know it.

Ryan: You know, it sounds a lot like something that we talked about in episode 2, where we had John Romaniello on as a guest and he talked a lot about testosterone and with the normal range being so wide, you know, you could get... I think he said at one point he was around 800 or 900 and his levels dropped to a third of that at 300, but he was still in the normal range so he couldn't really get the medical help that he needed. He had to go find ways on his own to get his testosterone back up, so you know it sounds like thyroid is going to have very similar symptoms and ways that we can fix it on our own.

Alexis: Right, and really, the bottom line is anything that we're testing in the blood, there's usually an optimal range for that, and part of that is because the way that we get reference ranges for labs is, it's taken from a sample population that has gone to that specific lab and then they get a range based on the bell curve. And usually people going to the lab to get lab work done are sick, so it's not necessarily representative of the healthiest population. So, the other thing is that when we're kinda determining if someone is within a lab range or not, is it's all based on disease. So it's all: 'do you need a medication, and do you not?', 'are you going to be diagnosed with this disease or are you not?', and now that we're living longer, we're concerned with longevity, those kind of ways of looking at lab tests are kinda outdated because we really wanna increase you know, have a good function.. Have good quality of life, so we have to look at it differently now.

Ryan: Yeah, so I mean, it's almost like for our purpose it's two questions, you know, 'are you dysfunctional, do you need medical help to get it back to normal?', and then you know, the second part of that normal is not the same thing as optimal, it's not the same thing as thriving.

Alexis: Exactly

Ryan: So, tell us a little bit, who is at risk and you know, what's causing this prevalence of thyroid issues?

Alexis: So, what's causing it, as far as research goes, we don't really know. There's been lots of correlations to you know, so many things. But not a lot of causations yet, so I think that there's a lot to do with genetics, just kind of our family history; there's a huge increase in autoimmune diseases and for hypothyroidism, which is what the majority of people that have thyroid disease have. And the majority of those people with hypothyroidism or too low thyroid function, have an autoimmune disease called Hashimoto’s. So autoimmune disease is definitely, I think.. Because those rates are increasing, it's also increasing the rates of all autoimmune diseases including Hashimotos. Smoking increases your risk, ageing increases your risk. Women are at much higher risk than men, in fact I think the current stat is 1 in 8 women in their lifetime will have some kind of thyroid dysfunction or thyroid disorder. That's huge

Ryan: Yeah, that's huge. You're right.

Alexis: Yeah, so certain drugs can cause an increase in incidents of thyroid disorder, radiation, there's so many things but you know, as far as clear and cut we don't know exactly, especially with autoimmune disease. All the research is very murky. We don't quite know yet.

Ryan: Okay, so I know thyroid is.. We've kind of established the importance, but let's geek out a little bit on the anatomy and physiology for us a little bit. So, everybody has at least a working knowledge of what's going on for the rest of this.

Alexis: Yeah, so, basically.. What we kinda mentioned before is that your thyroid regulates your body's metabolism, and so it really you know, it regulates the rate at which you produce energy from the food that you're eating, from the oxygen that you're breathing. So it's sort of like the thermostat of your body, that you can turn up or down your metabolic rate. So it's really important for performance because of that, I mean, your whole metabolism is kind of.. You know, the control is maintained within this gland. So as far as the anatomy goes, the placement of it is, it's a butterfly shaped gland and it's between your collar bone and your chin. So if you find your Adam's apple, if you swallow you can probably find it easier, if you're a man you can find it easier than a woman and then you go down below the Adam's apple and it's a butterfly shaped gland on either side of your neck, here. And it secretes the hormones that every cell of your body, pretty much, will respond to. Thyroid hormone influences the expression of genes in practically every cell. So it's very wide reaching and as far as how it works, it's a whole cascade of hormones, so it can get kinda complex, and there's lots of minerals involved, but the basics is that a gland, the hypothalamus, a pea-sized gland in your brain, will secrete a hormone when you need thyroid hormone for your body. So it secretes a hormone to another area in your brain called your pituitary, which secretes another hormone that creates the thyroid stimulating hormone or TSH which is what what we test in conventional medicine. So this is kind of like, you know, if you go to the doctor and you're like 'I think I have a thyroid problem', or you're explaining your symptoms and they think maybe you have a thyroid problem, what they would test for is called TSH and this is what your pituitary is secreting to tell your thyroid what to do. So that's kind of the first testing point. And then your thyroid itself produces T4 and T3. Mostly it produces T4 and then that's sent out to the body on different carrier proteins, and it floats around the blood in your body to all the cells that need it. And then T4 is also converted to T3 in different areas of the body. 20% of it is converted in your gut and there's various other organs where that happens. So basically, it's this whole cascade and it's pretty much on a feedback loop. So when T4's converted to T3 and T3 is that most biologically active hormone circulating around, it will then make it's way back up to the brain to tell the brain, 'okay, do I need to secrete more of those hormones to tell the thyroid to keep working, or do I need to scale it back?', so that's kind of how that whole cascade happens.

Ryan: Okay, cool. So, now that we kind of have an understanding of that, you mentioned earlier that some of the ways that we test may not be the best ways to find out if people have issues. And then as you walked us through that process you said TSH is what is normally tested. How is that a flawed testing method?

Alexis: So it's not flawed if you think about why we're testing it. The reason why they're testing TSH only is because the reason for testing is to decide if this person needs to go on thyroid replacement hormone, for hypothyroidism anyway, or do they not? And when you're just asking that one basic question, then TSH, a lot of times, will be sufficient enough. A lot of doctors now are adding in a 3T4, so they're adding in another one of the steps of the hormone that the thyroid actually produces in it's free form. So the free form is unbound by protein and able to you know, do work in the body, basically. So a lot of doctors will do that now, although some still don't and so it's kind of, if you're only asking the question: 'does this person need medication?', then it makes sense and in conventional medicine, often times that's all the time that they have, is to ask that one question. But if you're going to someone who's focused more on functional medicine, then we're gonna ask another question, which is: 'why is this happening in the first place? And can we change some of those things that are maybe contributing to the problem?' Whether that's you know, is this an autoimmune disease for example. So another thing that you might wanna have tested is your thyroid antibodies. And most of what I'm talking about kinda relates to hypothyroidism because that's the most common. And there's 2 antibodies that yo would test to really rule in or out if someone has an autoimmune disease to their thyroid, for the most part. And then there's other things like you can test the 3T3 as well, because like I said, that's the most biologically active hormone. You can test those levels so you can see how well you covert from T4 to T3. You can test other things called reverse T3 which increases when your body's under a lot of stress, because what your body does is 'okay, I'm under stress, I need to down regulate things a little bit', so it'll attach to the thyroid hormone to kinda slow you down. So, there's all these other, you know, biomarkers that are super important and from my perspective, you know, a lot of this research on longevity and optimal health is just in it's newer stages as far as research goes. We're not really sure how to study it, number one, because it doesn't really work the same way as studying drugs or studying disease in the conventional model. So we don't really know how to study it, and then when we do study it we're not really sure what to do with the results, because often times they're conflicting. So a lot of this.. Of using testing in this way, is kind of pioneered by people who are doing functional medicine, and who are seeing lots of patients that have these issues and then trying to pull the patterns out of their lab work. And there's some research that does a really good job of kind of, you know, healthy people, what do their lab ranges look like? And there is some of that out there.

Ryan: Okay. So, if we had somebody who was you know, maybe not in medical need of replacement, but how would the average person.. The optimal performer, present if they came to see you but were actually suffering from either not converting well, or maybe suffering from some autoimmune disease?

Alexis: Mmmhmm, sure. So maybe we can put it into a context of somebody that would come into your gym, for example, because a lot of these people are looking to, you know, either lose weight or really help boost up their metabolism, or you know, gain lean muscle mass and these kind of things. And so if you were to.. So a common person that would come into either my office or maybe a gym is somebody that kind of complains of having a lower metabolism in general. And so people with hypothyroidism tend to just feel like no matter what they do, they can't lose weight. It doesn't matter if they change their diet, it doesn't matter how much they exercise, it's just a lot slower. And a lot of their efforts, they get discouraged because nothing's happening. A lot of these people also have poor exercise recovery, and because hypothyroidism is so prevalent in women, often times it's missed in men because people aren't really looking for it. And a lot of men will find that they go to the gym and they have a tough workout and they just get wrecked and they can't really recover. Their muscle recovery is worse, they just feel completely laid out and fatigued, so that's another common thing. Low motivation and depression are... Oh sorry, go ahead.

Ryan: I was going to say that's probably just a really big one for you know, a lot of our listeners.

Alexis: Totally. Totally. And it's you know, if you have that it doesn't mean that you necessarily have a thyroid issue, but it means that you should really assess your thyroid fully and see if that could be a part of it because it's you know, it's very common. Low motivation and depression are also big ones. I think a lot of people have this low lying depression that they just don't really realize is a problem until it changes. And so it's kind of something that they just deal with or feel like it's just normal or it's just 'them', to have this lack of energy or motivation or just a low mood. But that can also be thyroid. Lean muscle mass.. Just not able to maintain lean muscle mass, and more injuries too. People that are very injury prone and have lots of body pain, that tends to kind of a hypothyroid thing. So those are some of the less traditional ways of looking at hypothyroidism, because usually what you think in medicine, in the way that we were taught, is it's people that have a really hard time with losing weight, constipation, hair loss, dry skin, low heart rate, sometimes menstrual irregularities in women. You can get swelling; especially in your legs, cold hands and cold feet. Those are some of the more traditional things. And then the others, they're more like optimal performance based.

Ryan: Okay, so are there ways that you're using blood testing to look at those things as opposed to just TSH?

Alexis: Mmmhmm, yeah. So the way that I do it is, the tests are pretty much the same at this point, I just do more of them. So where, if you would go to the conventional doctor and they would screen you for thyroid illness, usually they'll do TSH, if you're lucky they might add in 3T4. What I do is a test that is 10 different tests. So it includes that TSH, it includes the 3T4, it includes 3T3, also total T4 and T3, the thyroid antibodies of which there are 2, and then reverse T3 and a couple of others, T3 uptake and Free Thyroxine Index. When we're done with this I have a print out that has all of those listed so that somebody, if they wanted to get them tested then they could bring those to their doctor or their lab or whatever and they'll have a list of them right there.

Ryan: Yeah, and what we'll do for everybody listening, we'll get that on the show notes so people can download it and they can take it to their doctor.

Alexis: Perfect.

Ryan: Now I know we talked before we came on air that you have sold your practise, so congratulations.

Alexis: Thank you

Ryan: And you're working mostly virtually

Alexis: Yeah

Ryan: So are people sending you the results? I can't imagine that they're sending you know, blood through the mail to you in foreign countries!

Ryan: And so it's basically all email based, and actually they do! So usually what someone will do is when they schedule an appointment is either they have blood work that they've had done from their doctor already and so they'll send that to me and they'll get it analysed. And one of the biggest things about analysing which I didn't mention when we were talking about the thyroid tests, is the reference ranges that I'm looking at are much narrower. And so you know, that's a huge part of identifying some of these functional thyroid issues that might not be diagnosed or would go kind of hidden, is making sure that you're actually in the optimal range because if you're not then you can have all the same symptoms.

Alexis: But back to lab testing. So, the other thing is that I work virtually but I have a connection with a wholesale lab in the States, and a lot of my patients do come from the States. So what we do is we can order lab packages basically, that are really affordable to a nationwide lab called Lab Corps, and then I order those results from my computer and they get sent to my computer and then I email them to the patient and put it into a Google doc that analyses everything with the optimal ranges. So yeah, essentially I am looking at blood work and I can do it from anywhere. And the great thing with that is that there's a lot of people that are either travelling or are international and don't have access to you know, maybe functional medicine, and it gives them a way to talk to somebody and keep an eye on some of these things without having to be in the States in a major city that has more functional medicine doctors.

Ryan: Right, yeah that's really cool. So as far as treatment goes, I realize that everybody's going to be individual and there's no blanket recovery process that you could explain to us, but give us some typical treatment options, whether it's drug based or natural based? Are there supplements that people can use or take that will help them, you know, recover?

Alexis: Sure. So, as far as the thyroid medications go, they tend to be.. You know, when I was in my practise- I'm not prescribing medicines with virtual medicine any more- but with any kind of drug treatment, the thyroid drugs seemed to cause less side effects when they're used appropriately, when you're following someone's labs and you're making sure that they're not getting too high or too low. So as far as thyroid medications go, sometimes they can be extremely useful or necessary in a person's case, and so it's not that I'm not advocating thyroid medication because it can be very useful, and some people just can't go without it. So there's really good medications, the main ones are providing T4. So T4 is that hormone that your thyroid makes that can then convert into T3, the most biologically active. So most of the drugs like Synthroid, Levothroid, Levoxyl, these are all T4 medications. And then there's a medication called Armour that is taken from usually a pig gland, that combines both T3 and T4. And really, a lot of doctors have a preference, whether they like to use one over the other. I find that it's just super individual. Some people do great when they're on Armour and some people do terrible, and some people do great on Levothyroxine, or some of the medications like Synthroid and some people do terrible. So you just really have to experiment with it and do your labs frequently, every 4-6 weeks and really find that sweet spot where you feel good and your labs are good. But beyond drugs, there's tons you can do, especially if you're one of these people that's kinda in that grey area where you're still having all the symptoms, your thyroid maybe is not optimal, the function in the blood work is not optimal, but you're not really someone who's a candidate for drugs. There's still a ton you can do and sometimes you can kind of catch this progression going towards the need for drug treatment and turn it around. I've seen a lot of people able to heal their thyroid so that it doesn't continue to progress, you know, if it was going to we wouldn't know but I think that definitely catching something like that early is really good. Especially if it's autoimmune related. So, treating the cause, obviously like you mentioned, is the way to go. But the first thing that I look at is 'does the person have enough minerals in their diet?' So are they eating food that's rich in minerals which is usually vegetables, and because of the soil that is growing our food is often depleted in minerals, you wanna make sure that you're eating enough and you wanna make sure that you're not eating vegetables that are depleted in minerals from the soil. Often times, these minerals would include things like iodine, selenium, zinc and magnesium. Those are kind of the big thyroid minerals that you can get in food. You just need to make sure that you're eating those foods and that you're digesting them and breaking them down. And so that's a big thing. A lot of people just aren't getting enough and kind of that optimal amount, is between 6 and 8 cups of fruits and vegetables a day which is a ton.

Ryan: That's a lot!

Alexis: Much more than most people actually consume

Ryan: Right

Alexis: And it's consuming things that are like leafy greens, cruciferous vegetables, and then all the colorful ones. And so Often times people aren't getting any more than a cup or 2 per day. So if you're somebody that has a thyroid disorder and you wanna heal your thyroid, if you wanna improve the function overall, maybe reduce the amount of thyroid medication you need, you might just need minerals and to eat more vegetables.

Ryan: You can also supplement with MagTech from Natural Stacks.

Alexis: Exactly, yeah. Finding a good quality magnesium like MagTech, you know, all of these can be in supplement form, but I think the first thing you really wanna do is eat the food, and then usually in the beginning stages, supplements are really necessary. A lot of people just think, 'oh, I'll eat it in my diet', but the problem is is that a lot of people, either their requirement for that mineral is really high or it's just going to take a really long time to fix and so taking a supplement makes so much sense.

Ryan: Yeah, and I started looking at Iodine, you know, as a mineral missing from things that I was eating. The easiest way that I found to jack that up really, really high was to go to a coop or a Natural Foods store, and get kelp flakes

Alexis: Yes

Ryan: From like the spice aisle is normally where I find it, and I mean I think a quarter of a teaspoon has well over a thousand percent of your daily values, so that's an easy easy way to make sure you're getting enough of that central mineral

Alexis: Such a good idea and that's exactly what I tell people to do. And even sea vegetables is one of the main ways that you get Iodine and who goes around eating tons of sea vegetables these days?! Nobody.

Ryan: Yeah!

Alexis: So, doing kelp, and a way that you can kinda disguise it too if you're really kinda sensitive to fishy or sea sensitive things is to grind it up in a blender like a powder and then mix it in with your sea salt. And then you'll get some additional.. Even though the sea salt should have a little bit of Iodine, but you'll get some additional iodine every time you salt your food.

Ryan: Yeah

Alexis: So I mean, and really, iodine deficiency now is more of a functional thing because we're not really in the 50s where we were super concerned with people that were deficient in iodine, they were getting goiters. So their thyroid gland would grow to essentially have greater function because it didn't have enough iodine to really convert from T4 to T3. So that's not really a huge problem anymore in developed nations, and I think that doing a little kelp here and there to make sure that you're getting your iodine; iodine and salt, obviously, has lots of iodine in a different form. So it's better to get it from kelp and sea salt.

Ryan: So, back up just a second. You said something in there, you know, as far as the minerals go, iodine is crucial because- and this is what you just said- because it assists in the conversion of T4 to T3. Yeah, yeah, there's a deiodinase enzyme that basically does this whole conversion, and that needs iodine attached to it, and so if you don't have enough iodine then you can't cleave those bonds, and you won't get that conversion. Right, okay. So that's the answer to the question, 'what does iodine have to do with making my thyroid work better?'

Alexis: Yeah, exactly

Ryan: Alright, awesome. So any other... So we talked about minerals, what other foods or natural type supplements or treatments..?

Alexis: Yeah, so if you are.. If you have Hashimoto's, so if you have an autoimmune disease, the treatment then is totally different. So in conventional medicine when you go in and get a diagnosis, it's pretty much 'do you need thyroid replacement or not'? And sometimes they'll test your antibodies to see if you have these antibodies to your thyroid to appropriately diagnose it as Hashimoto's, but sometimes they don't test the antibodies, I'm finding, so someone will have this thyroid disorder but they will never have been screened for an autoimmune disease which is really important to know, because an autoimmune disease to a thyroid is not a thyroid function problem, it's an immune system problem which is totally different. From a functional medicine perspective, you would treat it very differently. In conventional medicine you would treat it the same with thyroid replacement, but you can think of thyroid replacement in someone that has autoimmune disease is just kind of a bandaid, because you're replacing the hormone, but you're not really dealing with the fact that your immune system is malfunctioning. So, autoimmune disease testing is crucial to determine if that is an issue for you. And I would say now, more than ever, sometimes they're not able to detect the antibodies in people but they think that Hashimoto's is about 90-97% of all hypothyroidism, so you can pretty much count that you have an issue with your immune system, basically. So you wanna do things that are healing to your immune system, and these are the things like Glutathione, and Resveratrol, and fish oil. The Natural Stacks product that I've been experimenting with a lot myself, and also my patients.. I'm starting to introduce to patients, is the PreBiotic+ with the resistance starch, and the reason why is because there's a huge connection between gut health and your thyroid health, and resistance starch is really amazing at helping to lower inflammation and dealing with maybe an underlying cause to autoimmune disease, which is gut permeability, and having what they call 'leaky gut'. So, you know, 70% of your immune system and your immune tissue is in your gut and so if you think that you have an immune system problem you probably better look to your gut and see if there's any problems. And those problems could be caused by stress, they could be caused by foods that you're eating that are inflammatory- that your body doesn't like- so, essentially you should have this you know, hollow tube that doesn't have these huge holes in it and isn't letting big proteins pass through to the blood undigested. And that's what happens if you have leaky gut.Your gut, instead of this nice strong, hollow tube, becomes kind of like a sieve and it lets things through and then your immune system starts attacking proteins that maybe it shouldn't, and that's when the malfunction happens and autoimmune disease just means that your body is just attacking tissue of your own, thinking that it's a foreign invader or foreign tissue. So that's what kind of creates this cascade of problems where it's attacking your own gland. So that's what kind of creates this cascade of problems where it's attacking your own gland. So dealing with autoimmune disease is another huge component and there's so much to it, but leaky gut and having a good resistance starch in your diet is a really, really important piece to that. Adrenal dysfunction can be a really big thing, because the adrenals and the thyroid both kind of talk to each other; all the glands and the hormones kinda communicate to each other, and so if you have a problem with your thyroid you might also have a problem with your adrenals, or vice versa. So functional adrenals dysfunction anyway, it's whatever insufficiency basically is.. Insufficiency is really rare, and it's a really serious health problem, you have major problems, but I'm talking more from a functional perspective of how well does your body deal with the stressors coming in and how well is it able to adapt to stress.

Ryan: Gotcha, right. So there's a lot of information in there. I wanna highlight one thing that you said in there, which is basically, we don't wanna slap a bandaid on the symptoms, we wanna find the root cause and we wanna attack that. So for everybody listening, just kinda keep that in mind. Real fast, we've mentioned Hashimoto's a few times. Just in case people listening aren't familiar with that, can you give us just the definition.. An overview of what that is? Alexis: Sure. Hashimoto's Thyroiditis is a diagnosis that you would get if you have hypothyroidism, so too low thyroid function, but it's coming from a thyroid disease. It's coming from your immune system attacking your own thyroid gland, which eventually makes that gland unable to produce hormone.

Ryan: So, the way that that's different from hypothyroidism is that it's not actually a dysfunction with the thyroid itself, it's caused by, as you said, either the leaky gut or some other deficiency in your immune system.

Alexis: Exactly

Ryan: Alright, cool. So, you know, now let's go back to digestion, leaky gut; it is exactly what you described it as, it's what the name implies.

Alexis: Yeah, exactly

Ryan: So I actually find myself talking about that to a lot of people when we're talking about brown rice vs white rice, the skin on sweet potatoes, those are things that actually lead to leaky guy syndrome that a lot of people don't realise. They think that they're eating brown rice and it's better for them than white rice, they think that eating the skin on the sweet potato is, you know, healthy, but unfortunately both of those things, they're not digestible, they contain anti-nutrients, and they contribute to leaky gut syndrome. And so, if we're eating sweet potatoes and we're eating rice then actually removing the skin or going for white rice is actually going to be a better option. Now, with the absorption or digestion rate of white rice compared to brown rice, there are very few times when we're eating carbohydrates by themselves. So if you're eating rice with protein, vegetables, other fats, like you would in a traditional mixed meal, then those other things- the vegetables, the protein, the fats, are gonna slow down digestion as much if not more than just eating brown rice by itself. So um, keep that in mind as you guys are eating rice and potatoes for your starches and your carbohydrate needs. So, Dr. Alexis, tell us a little bit more about how you are dosing and prescribing the PreBiotic+?

Alexis: Well I just started actually, actually started using it when we got to Lisbon, so a couple of months ago. I started experimenting with it myself because I have an autoimmune disease myself, actually, and have serious digestive problems that I've had my whole life

Ryan: Okay

Alexis: And so my kind of journey getting into alternative medicine has kind of been through my own searching and trying to figure out how to heal some of these things and appropriately diagnose things because I was not diagnosed or treated. For many years it went undiagnosed. And so I eventually, since finding alternative medicine, I was kind of able to get a handle on some of these things. And so I'm always experimenting myself with a lot of these products. And so I started using it because really unmodified potato starch is really the only thing out there that you know, came close to being similar to this product, and there's really nothing else out there.

Ryan: That stuff is hard to get down by itself

Alexis: It really is! And the PreBiotic+ is actually really good tasting, I was shocked. I just put it in water and drink it like that and you don't even have to put it in anything.

Ryan: And you're taking that like, later in the day?

Alexis: Yeah, I actually take it before bed. I found that's the best time for me to take it, although, you know, it might not be for somebody else. But for whatever reason, that works best for me. So, yeah. So I've been using it you know, myself, but I've also just started recommending it to patients that have digestive issues because that's a lot. Patient base for me is people that have chronic digestive issues since that's what I know, and you know, because it's new I don't really have a bunch of success stories yet because we haven't been using it long enough, but I'm really excited about it because there's nothing else out there that's like it.

Ryan: Well, when, not if, but when you have those success stories we wanna hear about them!

Alexis: Exactly, have a little share

Ryan: Now, you know, with a lot of you patients, are we talking Irritable Bowel Syndrome, Coeliac, Crohn's?

Alexis: Yes, all of the above.

Ryan: Okay

Alexis: I personally have Ulcerative Colitis, an autoimmune disease that affects colon health, and so the resistance starch for me is essential because of creating butyrate and some of these really healing things for the colon. So, yeah. I see people who have all of those issues and others.

Ryan: So if we wanna create butyrate, are you a fan of grass-fed butter in your diet?

Alexis: I am! I am a huge fan! There's just not many other sources for getting a good quality butter. You know, people really underplay fat and getting good quality fats especially for exercise recovery and optimal performance and brain health is essential.

Ryan: Awesome, awesome. So it sounds like a lot of the recommendations so far are in line with whether you wanna call it the Bulletproof diet or Paleo approach. Something that sort of falls under that umbrella as an anti inflammatory lifestyle and diet. Two of the things that we normally commonly think about with that, you know, we want lots of cruciferous vegetables, we talked a little bit about the greens and the leafy stuff earlier, and also trying to avoid gluten. So those are 2 things that may have an impact on what we're talking about here. If somebody has any of those digestive issues, you know, cruciferous vegetables can sometimes be less than friendly. Alexis: Yeah, yeah. It's true, and actually the cruciferous vegetables with thyroid disorders, they've been given a really bad wrap. And so we should talk about that, because I think that's a really important.. It's a big myth for people that have thyroid disorder, that they shouldn't eat cruciferous vegetables because they're said to be goitrogenic; and so that means that they block the thyroid hormone production in some fashion. So specifically what it's doing is it blocks iodine absorption. So where this came from, this kind of myth that's just kept going, is that in the 50s when there was a lack of iodine and people were getting goiters, anything that reduced iodine absorption would have been a problem, which is like raw, cruciferous vegetables. But now that iodine is no longer a problem, they've iodized all our salt and we're usually getting enough iodine in our diet. Even if we avoid processed food we usually get plenty. Plenty to not create goiters, I mean, maybe not plenty for optimal, but plenty to not create goiters. Doing cruciferous vegetables, unless you're doing massive quantities of raw vegetables that you're like juicing or something, there's no way that it's going to create any kind of issue with iodine absorption to the extent of causing any issue for your thyroid gland. So really that's kind of some old nutrition advice that we kinda need to just let go. Cruciferous vegetables, for your thyroid, are totally fine, in the amounts that a normal person would eat them. The only exceptions to that are soy and canola oil, because those are both goitrogenic as well. The reason that I don't recommend them is that over 90%; 93% or 95% or something of soy is GMO, is genetically modified in the US, and then canola oil is I think 90% genetically modified. So these are really processed foods and I don't think that they promote health in any way. So these are 2 things that I tell people to avoid. Soy when it's eaten in small amounts in it's traditional fermented forms is a different story. But the processed soy that we get in the US for the most part, in all processed food, is definitely not something that I recommend. It's goitrogenic and it's GMO, so it's not a good thing. Also, soy has been linked to the development of autoimmune thyroiditis in some studies that are not conclusive, but there's enough connection there that I don't feel comfortable with it. So, as far as cruciferous vegetables with digestive health, yeah, they can be a big problem for certain people that have digestive problems and sometimes it's a matter of trying out different ones, cooking them at different levels, and just, increasing them slowly into your diet. But for some people they do have to avoid them for a while.

Ryan: That's an awesome answer, tons of good stuff there. So, you mentioned traditional methods of soy preparation. You talking like natto?

Alexis: Exactly, yeah. Things that people don't eat in the US. Natto and tempeh and things that are traditionally prepared non GMO and you don't replace your whole protein intake with things like that, you know you eat them in small quantities like you do in other places that eat those. So, yeah, I think that soy is one of those things that's just not good for thyroid health, and the quality that we have in the US is just not how the rest of the world who has shown any kind of health benefit from eating traditional sources really eats it.

Ryan: Right, alright. What about gluten?

Alexis: Gluten is a big one that I see as a huge problem with all autoimmune diseases across the board. That's another thing, with some new studies that are coming out that are showing all these links and things. It's definitely not conclusive in their research, it's hard to study, but I definitely recommend people that have Hashimoto's autoimmune thyroiditis to avoid gluten. There's a really big association between coeliac disease and having autoimmune thyroiditis and other autoimmune diseases for that matter. Autoimmune disease kind of travels in groups so you have to be careful that you're not doing things that are triggering other ones and gluten is a big one. Gluten and the whole autoimmune connection is also associated with diabetes and you know, inflammatory bowel diseases and certain adrenal fatigue and that kind of thing. So you have to be very careful with gluten for sure, it's very inflammatory and it can lead to leaky gut in certain people and I think coeliac disease and then non-coeliac and gluten sensitivity, both of them are a problem in people that have thyroid disorders.

Ryan: Alright, excellent. So, we're almost at the end here. So before we wrap this up, where can our listeners get more of Dr. Alexis?

Alexis: So you can go to my website, it's www.dralexisshields.com, I will also kind of prepare the tests and things so that we can list those out for people, so if they want a resource for testing, for getting cheaper bloodwork, or for bringing something to their doctor to ask about theses tests. I think that it'll be a good resource for people to have it all spelled out, so I'll give you that as well.

Ryan: Yeah, that would be great. And like I said earlier, we'll put that in the show notes. Go to www.optimalperformance.com and you'll be able to see the video version of this and get those resources so you can print them out and see everything that you need. Alright, so, Dr. Alexis, your 3 best tips for our listeners to perform optimally.

Alexis: Perform optimally, related to thyroid function or just performance in general?

Ryan: They can be on or off topic

Alexis: Okay, so the on topic, maybe, I think my biggest point with all of this is that you can be very symptomatic of hypothyroidism, so you can have weight gain, low motivation, depression, constipation.. You know, cold hands and cold feet, all of these traditional things, but your doctor might tell you that your thyroid is normal. And that's very common to happen, and so you might need to take this information and take it one step further and do a little bit more thorough testing and investigating to see if your thyroid is truly optimal, because sometimes the way that it's tested doesn't really give you the full story. So that's the biggest one. If you're suffering from these problems and you've been told it's normal, it might not be and you're not going crazy, so you can definitely take it one step further. There's a great book out there called 'Why do I Still Have Thyroid Symptoms When My Lab Tests are all Normal?' and I can give you the link to that, but it's really good. It goes through all these different types of thyroid dysfunction that might not be picked up by a lab test, and all the different lab testing. It's by a guy, Dr. Datis Kharrazian, who's done lots of thyroid work and he's done some pretty amazing things. And he also talks about lots of natural and alternative medicine, things that he's seen work.

Ryan: Alright, very cool. Two more.

Alexis: Let's see... Two more. So, I think that you know, my biggest thing that I want people to realize with this whole bio-hacking community is that there's some very basic things that kind of get missed. A lot of the time we're looking for like these new shiny tests and tools and we want to, you know I love them, I do them myself. I love doing all this self testing and I think it's so important to kind of take your health into your own hands and really educate yourself on what it means to feel good and experiment with your own health. It's also a really good idea to not forget some of the basics. So some of the basics are things like doing just a basic bloodwork panel on a regular basis for some people that don't have any chronic diseases and are really healthy people this means once a year. And sometimes if you're working on certain health things or you wanna monitor, you know, 'what happens when I take these supplements, to my blood, to my kidneys, to my liver', then you might want to do it more frequently. I have people that test their blood every month. But it's really important to really know what your basics are. So run some of these basic CBC; a complete blood count, and looking at your liver and kidney enzymes and they might not be shiny new tests but they're really important to tell you about the foundation of your health. So super important to monitor those things once you get to a certain age, which, for me kind of depends on what your health is like, but the average healthy person should start looking at some of these things in their late teens and early twenties so that as time goes on they're looking at this progression. And that's my third thing, is really having a way to monitor the progression of your health. So a lot of people, you know, we have this mind frame where we don't go to the doctor until we're sick which is kind of the opposite of how it should be. We should go to the doctor to keep us well, but because we have such a disease driven model, you know, a lot of people aren't getting the information that they want when they go to the doctor it's all drug based and you don't want to go on a drug when you don't need it, so then what's the reason for going? So really that's what functional medicine is all about, trying to change that paradigm so your first point of contact should be somebody who's taking all this into account and looking for underlying causes and ways that you can really improve the function of your body. So, having a way to really track progress is essential. Whether that means getting a blood test every year and comparing the results so that if things are starting to slightly go out of balance you know it. You can catch it early, you can change it. You can change things about your diet and lifestyle to really modify those things very easily when they're in the beginning stages and having a coach, just like you would go to your gym and have a coach, someone who's holding you accountable, who's able to point out things you're doing wrong. It's really important to have a health coach as well, you know, someone who can guide you in that process, that's really functional medicine minded if that's what you're looking for.

Ryan: Very cool, very cool. Well, thank you so much for hanging out with us, Alexis.

Alexis: You're welcome

Ryan: And all of our listeners make sure you go to www.optimalperformance.com so you can see the show notes and the video version of this; we'll have the links to all the cool stuff that Dr. Alexis has told us about, and until then, we'll talk to you next time. You've been listening to Optimal Performance podcast. Remember you can find show notes for every episode along with video versions at www.optimalperformance.com. And also remember Optimal Performance podcast loves your 5* ratings, so head on over to iTunes, show us some 5* love. See you next Thursday.