What supplements do I need to take?

The idea for this episode came to me after I took a digestive enzyme that had 200mg of Betaine HCl and a blend of enzymes to help breakdown food. I had a stomach bug about a week and a half ago and had no appetite for about a week afterwards. I still am not very hungry. I had a heavier meal last night with a lot of beans in it so I wanted to be sure I didn’t have a ton of bloat from it so I took one digestive enzyme capsule at the end of my meal. I think that was my first mistake. I should have taken it at the beginning of the meal because I had the most horrible heart burn afterwards. It honestly felt like there was a huge lump in my chest and it was very uncomfortable. I tried drinking water to dilute the capsule but that did nothing and made me have to go to the bathroom after about a half hour. I went to bed early and read- a super interesting book which I hope to talk about in another episode. The heart burn persisted and got worse as I was now laying horizontal. I fell asleep but never got into a deep sleep and then had to pee so was up twice for that, each time drinking just another sip of water to try to fix the heart burn. Finally at 1am I took about an ⅛ tsp of baking soda in 2-3 oz of water and it helped but did not make the burn totally go away. I was so annoyed. So I was laying there thinking about supplements and how many people take things they don’t even know they need. Clearly I didn’t need that one little capsule last night. 

This episode is going to sound like I’m against supplements and I want to be clear I am not. I take some here and there. I take a mulitvitamin, I have fish oil that I take occasionally and a whole cupboard of stuff for when the situation arises. 

I use magnesium on days when I over do sugar. When I travel I bring melatonin to help me fall asleep. I have done a great evidence based detox program that had me on a few things to support removal of toxins. I have L-glutamine for gut healing (took that last week along with a probiotic after I got sick). 

I’ve got a whole covid protocol in my cupboard, I’ve got homeopathic stuff for things like headaches, fevers, pain, and bug bites. The bug bite one is mostly for my very sensitive dog who gets welts from tick bites and hot spots galore. He currently has an ear infection I’m treating with an herbal formula. Anyway, so all this to say I’m not against them but I am against you just buying stuff thinking it will help you without knowing what you actually need to be taking.  Personally I don’t take anything every day. I probably should take a multivitamin daily but I have been the person trying every supplement over the years and I’m kind of over it. You don’t have to take a bunch of stuff is my point. 

I find that people are often looking for a supplement to fix their health problem. A blood sugar reducing supplement for your blood sugar, curcumin for pain or inflammation, selenium for thyroid problems, vitamin d ‘because everyone is deficient’, and the list goes on. I’m sure you have your reasons for why you take supplements. 

Here’s the thing- when you see a functional medicine practitoner whether it is a medical doctor or a nutritionist or someone who’s certified in holistic nutrition or whatever- they should not be sending you on your way with a $400 bill in supplements. If they are they are taking the conventional medicine model which is a ‘pill for every ill’ and doing the same thing with supplements. 

In these types of cases you might need half or a ¼ of what you were told.

The amount of people I’ve seen who are taking 10 or more supplements is kind of astonishing and the sad thing is that many of these people are not getting better. My gut feeling on this is that these supplements are not doing jack for them. Other things I have seen are women in menopause taking a multi vitamin with iron because her chiropractor just gave her a link to her supplement store. Full disclosure I have also given my dispensary link out on the podcast and the newsletter but I do believe I’ve also suggested you know what you need to take before purchasing. 

The supplement industry is a $39 billion industry with over 150 million people buying and taking them. There are over 85,000 products on the market with 1000 new ones coming each year. 58% of these come from the mass market like your big box stores and 3% come from practitioners. 

There are many reasons to buy from a practitoner as long as they are not selling you on the idea that you need 12 things to take every day. Very few people need to be supplementing in such a way. And I beg of you to avoid big box store supplements as best you can. These things are expensive, I get it but when they are cheap there is a reason. That reason is usually quality. 

A 2014 report by the NY Attorney Generals office showed their investigation found that supplements sold at stores we all shop at had some big problems. 

Ginkgo biloba, often used to support memory and focus, was tested from bottles purchased at these stores and there was no ginkgo biloba found in the products at all 4 of the stores where it was purchased. What was found in the capsules was garlic, rice, spruce, wheat, and a tropical houseplant. 

St. John’s Wort was also tested. This is a popular supplement used as an anti-depressant and again was not found in the capsules from bottles purchased at any of the stores but again had rice, tropical houseplant, and garlic. 

Echinacea was only found in one product from one store. The other stores sold product where it had rice, and garlic. This is a common supplement taken for supporting immune system health. 

A 2010 report by the Archives of Internal Medicine reported on a liquid selenium product, something very popular in the Hashimoto’s community. This product contained a dose over 40,000 mcg where a safe dose is considered to be 200 mcg. The over dose of selenium in this case caused hair loss, memory problems, joint pain, nausea and fatigue.  Do you know anything about the selenium you might be taking? 

Supplement companies are supposed to follow something called Good Manufacturing Process or GMP and a 2012 report by the FDA found there were violations of the GMP in half of 450 companies whose facilities were inspected with violations ranging from rat infested facilities to not having a standardized recipe for their supplement formulations. 

Even more problematic that big box stores are places like Amazon or Ebay where actual prescription medications were found in supplements sold for weight loss or sexual enhancement. 

A former investigator for the FDA found that those cheap supplements on Amazon can be counterfeit, potentially dangerous, stolen or expired product that is repackaged as new.  There are actually people selling on these sites that are creating packaging to look like a name brand or practitioner only supplement brand and selling you a pill that is useless. The most popular supplements on the market are probably being produced by counterfeit and a company from Asia is usually the culprit. The counterfeit supplement industry is a huge industry so buyer beware. 

This is actually why I suggest you buy from my dispensary rather than from a store. You not only save a little money but you know you are getting quality products. I’d recommend a supplement review as well because you may not need what you think you do- though this depends on your diet and lifestyle but just like you can’t out exercise a bad diet, you can’t supplement one either. 

In addition, herbs purchased for ayurvedic products and Chinese herbal formulas have been found to have toxic levels of mercury and arsenic in the past. 

How are supplements made? 

In many cases industrial solvents are used to extract compounds from plants and there is no standard for acceptable limits of these solvents. 

A compound called 1,2 dichloroethan is often used to extract curcumin from turmeric. This chemical can cause lung, kidney, GI and circulatory issues. The FDA rules and GMP do not apply to the suppliers of raw materials which are purchased to make supplements. This means the supplement companies have to police themselves. 

Practitioner grade supplements are often 3rd party tested. This is a big thing in their marketing because the industry is not regulated, the better companies will regulate themselves. They will also often market the efficacy of their products through clinical studies that are often paid for by them so there is clear bias in efficacy. 

Ingredients from raw materials suppliers are often inconsistent with many being of poor quality so you get what you pay for. Third party testing allows for testing bulk ingredients from multiple lots to provide that trust factor. The best products will be consistent, be potent, be clean, and be bioavailable.

Third party testing is looking for things like heavy metals, pesticides, herbicides, microbes, potency, solvents. Facilities are clean and temperature and humidity controlled. Some companies even test the bottles their products go in to be sure they are non toxic as well. 

Quality matters. 

You want to be thinking about the cost and your return on investment. Is the product working for you? Do you have the correct diagnosis for what you are taking?  Are you following an evidence based and informed treatment plan? 

When you self shop for supplements at a big box store you are in the hands of a sales clerk and not a nutrition professional. Know what you need and why you need it. 

Are there any red flags to look for?

Supplement companies cannot claim to prevent or treat disease. Beware of ‘proprietary blends’ where all ingredients are not listed. Is there a purpose for each ingredient? Is the dose appropriate and based on human research, not rats. Often, there are animal model studies where the dose that helped the animal is more than a human could consume in a day. 

Were clinical studies funded by the supplement maker or are there conflicts of interest of paper authors? This is really common in the research. Funding is supposed to be revealed and any one working on the study is supposed to list any conflicts of interest so that there is no bias in producing a certain result. 

So what do you need to take?

This is different for everyone because you are all bioindividual. Your physiology is different than everyone else and what got you sick is not what got someone else sick. Read all your labels so you know what you are taking. If you are a woman in menopause, your multi vitamin probably doesn’t need iron.  If you are taking vitamin D daily, you need to have your levels tested yearly. 

Ask yourself if you are looking for a magic pill. Supplements are meant to supplement your diet until your diet can provide you with what you need. Maybe you need some gut healing so your body can absorb the nutrients you are taking. There is no magic pill and there is no magic protocol to fix your ill so stop looking for it on the internet. 

There is a sea full of information on the internet with every website or article telling you something different. How do you know what is right and what you need?

Get good at listening to your body, when something doesn’t feel right, what is it trying to tell you?

Find out what your cells need by finding your cell blueprint. This is an evidence based questionnaire that will help me figure out what your biggest needs are as far as your cellular health goes. It’s a good place to start. 

At a minimum you might need a fish oil if you don’t eat fish and maybe a high quality mutli-vitamin but even then, the amounts required for you are very dependent upon your needs at the moment so it is still a good idea to work with someone to figure that out. 

I’m only working in 6 month packages right now and there will be a price increase May 1st so now is the time to get on board with your health and getting help for your hashimoto’s! Within that package will come a supplement review- you can take pictures of all you are taking and we will figure out what you need and what you don’t. My whole goal is to have you not need anything but the bare minimum such as fish oil, a multi and maybe extra B’s depending on your needs. 

Download the definitive guide to hashimoto’s when you sign up for my newsletter which for now has been consistently coming out every Friday. 

I’m also working on a little class about how to read your thyroid labs so look for that soon. 

If you could take the time to leave me a review I would really appreciate that. It helps other people find the show. 

High T3, low T4, recommendations on supplements to feel better. Episode 10.

Welcome to episode 10. I hope this day finds you well and that everyday in every way you are getting better and better. 

Let’s get started. I got a question from Jordan. 

Hello Stephanie,     

    I'm very intrigued by your podcasts and enjoyed the free EBook! I was diagnosed with hashimotos auto-immune 2 years ago I've been on levothyroxine and my t3 remains high my T4 remains low but my tsh is always within normal ranges! My hair is terribly dry, brittle and gray and at the ripe age of 30 I'm heading to being bald! My bowels are Terrible to the point I was believing I had Celiac's or a gluten or wheat allergy until I listen to the podcast! I'm extremely overweight and I'm working hard on that as I'm 60lbs down! I have several of the symptoms of the adrenal fatigue except once I fall asleep I stay asleep and want to sleep hours upon hours! I'm writing to you to see if you could recommend to me some vitamins or suggestions so I can feel better. I'm a single mother on a extremely tight budget!  Thank you for your time! 

        Jordan

In the early stages of hashimoto’s people can have symptoms of both hypothyroidsim and hyperthyroidism. You can have palpitations, tremors, be really thin and have anxiety. You can have the dry brittle hair that is falling out and you can feel like you are going crazy. 

In hashimoto’s, your immune system is attacking the thyroid gland causing bits of thyroid hormone to be released in to the blood stream making you feel like you are experiencing hyperthyroidism. 

So what is happening? What will the issues be that you may have?

• food sensitivities

• nutrient deficiencies

• adrenal fatigue

• possibly an infection in your gut

• poor detoxification- you are not able to clear out toxins

Any or all of these will keep your immune system on high alert and continue the attack on your thyroid. 

The high T3 is probably what is causing your hair to fall out. This can be indicative of high antibodies and since you have a diagnosis of hashimoto’s this could be what is going on here. You can ask to have your thyroglobulin antibodies along with the thyroid peroxidase antibodies tested. This should confirm why T3 is high. 

Low t4 can indicate disease in the thyroid or a problem with the pituitary gland or the signal that tells your thyroid to make more thyroid hormone. Your TSH is in the normal range, you said- I assume that is conventional range. If it is above three, functional medicine would consider that high. So, The pituitary gland would release TSH if t4 is low and a high TSH level would probably mean the thyroid itself isn’t working well and you would have hypothyroidism.  If t4 is low and TSH is not high then the pituitary gland is not signaling correctly. This is something you would want to discuss with your doctor. 

You also need to take a look at all of these things to bring down the inflammation and hopefully put your hashimoto’s in to remission. 

You may have deficiencies in the micro minerals like selenium, zinc, vitamin D, iron, B12 and B vitamins in general. First and foremost though you need to see if you have low stomach acid.     

Let’s start with Selenium: 

Many of us with hashimoto’s are deficient in this micro mineral which can be one of the things that causes us to get hashimoto’s. It helps to break down and make neutral the free radicals made during thyroid hormone production. If we are low on selenium, damage to the thyroid can occur and our ability to convert T4 to the T3 (which is what our cells take in) is affected. Take around 200 micrograms of this one. It has been shown to help reduce thyroid antibodies. 

Vitamin D:  

This helps to regulate our immune system and remember that hashimoto’s is an immune system problem first and foremost.  Your levels should be around 60-80 when you have it tested for optimal immune system regulation. 

D3 is the more absorbable form and you should make sure that it is in a capsule or liquid form with some kind of high quality fat like olive oil or MCT oil (a broken down portion of coconut oil). It is a fat soluble vitamin so you need to take it with fat for your body to use it. 

Good food sources for vitamin D are cod liver oil, fish, eggs and sunlight

B12-

If you have major fatigue, you should have your levels of B12 tested. It plays a role in digestion too so you want to make sure you are, again, making enough stomach acid. Most of us with hashimoto’s and hypothyroidism have low stomach acid. 

When you have low stomach acid, you don’t digest your food well which means your body has to work harder to break it down which requires energy. 

One of the possible causes for the low stomach acid is a B12 deficiency. And a B12 deficiency can cause low stomach acid. Vicious cycle. If you don’t have enough stomach acid you can’t get the nutrients including B12 and iron out of your food. You won’t be breaking down your meals as well and this can lead to food sensitivities. 

Betaine HCl with Pepsin. This is stomach acid in capsule or pill form. I recommend starting out with around 150mg pill to see where you are at. It will help you digest and break down your food better so you can use the nutrients in your food. 

Next, Probiotics. 

Intestinal permeability plays a pretty big role in autoimmune disease. One of the things linked to it is having your gut bacteria out of balance. Having more “bad guys” than “good guys” can cause gut issues and anxiety. You have about 100 trillion bacteria in your gut. 

Start with a 10 billion CFU per capsule and increase every couple of days until you see or feel die off symptoms. The die off is the bad guys dying out and the good guys taking over. The bad bacteria will release toxins that might make you feel bad for a couple of days. This can also exacerbate the inflammation and immune response so make sure  you have good eliminations and are drinking plenty of water. 

One of the best ways to get a lot of good bacteria in to your digestive tract is by consuming fermented foods like sauerkraut- not canned sauerkraut but the raw fermented kind found in the refrigerator sections of stores or find it at farmers markets. Or make it yourself. It is so easy to do and really inexpensive. 

Here is a good explanation of what leaky gut or intestinal permeability is and how it affects the immune system from Sean Croxton: 

“think of a window screen. And I say, “It’s a hot day. You open up the windows. And the good air comes through to cool the place off. And it feels nice and good and what not. But it keeps all the bugs, the flies, the gnats and the mosquitos out of the house. And that’s how the gut works. It’s very selective about what it allows through into the bloodstream or wherever.

“But if some kid came over to your house and started poking big holes in your window screen, then what happens is you open up the window. And gnats might come in. Flies might come in. What do you do? You start grabbing a magazine and like whacking away and stuff. And that’s what your immune system does, right? It says, “Wait. This isn’t supposed to be here. So let’s start whacking away.” And now we’ve got a problem. We’ve got an overactive immune system.”

Glutamine- 

This will help heal your small intestine where intestinal permeability happens. It helps to repair the lining of your small intestine where new cells are made every 3 or so days. 

Zinc can also be helpful in repairing leaky gut and in helping you make enough stomach acid. 

If you are dealing with any kind of adrenal fatigue: 

This would mean your brain is not communicating with the pituitary gland to help your adrenals manage stress. This is called the HPA axis and it also helps to regulate the immune system. When we are stressed, this system doesn’t work well. 

If you are dealing with adrenal fatigue you may feel: 

• overwhelmed

• tired even with 8 hours of sleep

• like staying in bed in the morning

• a craving for salty foods

• daily things are too much to handle

• brain fog

• little to no sex drive

• like you can’t make a decision

Adaptogenic herbs like American Ginseng, ashwagandha, Asian ginseng, Cordyceps and Chaga mushrooms, and/or holy basil and licorice root may be helpful. 

You should work with a practitioner to find out if you are in need of supplementation here. 

Some things that can help you manage your hashimoto’s is your diet. 

• Being gluten free, dairy free or try an elimination diet to help you figure out which foods you are sensitive to. This will also naturally help you balance your blood sugar which will also help give your adrenal glands a break.

• Make sure you are eating protein of some kind at every meal, including breakfast and eat breakfast within an hour of getting up. Don’t skip any meals and don’t do any fasting.

• Eat 4-5 meals per day for a week or so to give your blood sugar regulation system a break.

• Have a snack of protein and fat or a starch before bed. Make sure any carbs you are eating are eaten with protein.

• Avoid caffeine

A word of caution on supplements. Please don’t go buy them at your local big box store or the corner pharmacy store. Don’t buy them on Amazon either. I suggest at the very least to buy from Vitamin Shoppe or from your local food coop or even Whole Foods. You should work with a practitioner that can help you find just what you need though

The reason for this is there is no regulation on supplements. They don’t have rules in manufacturing or labeling. Some supplements won’ t even have the ingredients stated on their label or the dose can be way off. Some might have gluten or dairy in them and you might have a sensitivity to it. This is one case where quality really matters. 

A practitioner should be able to find what is most bioavailable for you since there are multiple chemical formulations of certain nutrients and some work better than others. Some are more expensive than others to manufacture. 

You also need to make sure you start with low doses so as not to over do it.  You just don’t know how your body will react to a new supplement. Starting slowly with lower doses will help you catch a reaction to it before it gets too bad. 

There is no magic supplement that will fix the hashimoto’s or anything for that matter. Some of these will definitely help you on your journey to healing or remission or whatever you want to call it. 

My top picks would be Hydrozyme from Biotics which is a lower dose stomach acid supplement and diet changes first and foremost. You can get that by going to www.getbiotics.com and using my practitioner code DFILC163. 

When starting a dose of stomach acid, remember to take a few bites of your protein based meal, take a pill, take a bite of food, take a pill and you do this until you feel a little burning sensation. Then you know to take one less than what gave you the burning sensation. 

Thanks so much for listening. Please tell anyone you know who has been diagnosed with Hashimoto’s to listen in and if you would be so kind as to leave a review on iTunes so more people can find this podcast that would be great too. My goal is to help as many people as possible to feel better and beat this disease. 

Got a question about your thyroid or hashimoto’s? Please send your questions to helpforhashimotos@gmail.com or head on over to my website and fill out the contact form there. 

You can find me at www.outofthewoodsnutrition.com or www.helpforhashimotos.com  I’m on Instagram at @Stephanieewalsntp which is where I post the most and on facebook at Out of The Woods Nutrition

See you next time.