The Thyroid-Menopause Connection with Dr. Eric Osansky - Episode 268

Important Links:

Get in touch with Dr. Eric Osansky here: https://www.naturalendocrinesolutions.com/about/

Check out Dr. Eric's podcast here (on Apple but you can find Save My Thyroid podcast anywhere you listen):  https://podcasts.apple.com/ca/podcast/save-my-thyroid-healing-tips-for-hyperthyroidism-and/id1581868280

Join my Substack:
https://sandykruse.substack.com.

If you want to get in touch, email me sandy@sandyknutrition.ca or sandy@tkgpartners.com

The butterfly-shaped thyroid gland might be small, but its impact on your health is anything but. In this illuminating conversation with Dr. Eric Osansky, we explore how this mighty gland affects virtually everything in your body—from metabolism and weight to mood, energy, and even hair growth.

Drawing from both personal and clinical experience, Dr. Osansky and I unpack the intricate connections between thyroid health, sex hormones, and aging well. As someone who navigated thyroid cancer at 41 and now menopause without a thyroid gland, I've witnessed firsthand how crucial optimized thyroid function is for vibrant health.  

What happens when your thyroid function shifts during perimenopause and menopause? Not a lot of practitioners connect the thyroid changes to perimenopause and menopause and Dr. Eric and I get into it.  

We challenge the conventional approach of relying solely on TSH testing, explaining why comprehensive assessment including free T3, free T4, and antibodies provides a more complete picture. You'll discover why stress might be your thyroid's worst enemy, how digestive health impacts hormone function, and which key nutrients support this essential gland.

Whether you're dealing with unexplained weight gain, fatigue, brain fog, or other symptoms often dismissed as "just menopause," this episode offers clarity on what might actually be happening beneath the surface. Dr. Osansky shares insights from his personal journey overcoming Graves' disease naturally and his extensive work helping others with both hyper and hypothyroid conditions.

Ready to understand your body better and take charge of your hormonal health? This conversation provides the practical knowledge and empowering perspective you need to work effectively with your healthcare providers and optimize your wellness through midlife a

Chapters

• 0:00 Introduction to Thyroid Health and Wellness
• 6:20 Dr. Eric's Personal Journey with Graves' Disease
• 12:17 Understanding Thyroid Function and Testing
• 21:21 Stress Impact on Thyroid Function
• 36:31 The Role of Nutrients in Thyroid Health
• 51:25 Hormonal Balance and Thyroid Connection
• 1:00:10 Finding Balance Through Comprehensive Care
• 1:06:40 Closing Thoughts and Resources

Transcript

Sandy Kruse: 0:02

Hi everyone, it's me, Sandy Kruse of Sandy K Nutrition, health and Lifestyle Queen. For years now, I've been bringing to you conversations about wellness from incredible guests from all over the world. Discover a fresh take on healthy living for midlife and beyond, one that embraces balance and reason, without letting only science dictate every aspect of our wellness. Join me and my guests as we explore ways that we can age gracefully with in-depth conversations about the thyroid, about hormones and other alternative wellness options for you and your family. True Wellness nurtures a healthy body, mind, spirit and soul, and we cover all of these essential aspects to help you live a balanced, joyful life. Be sure to follow my show, rate it, review it and share it. Always remember my friends balanced living works, my friends, balanced Living Works. Hi everyone, welcome to Sandy K Nutrition, health and Lifestyle Queen.

Sandy Kruse: 1:37

Today with me, I have Dr Eric Osonsky and we're going to talk all about the thyroid, one of my favorite subjects. The reason I love this subject, obviously, is because I had thyroid cancer at age 41. I'm now 55 and I am going through or gone through menopause without a thyroid. We're going to talk about the connection between menopause, perimenopause and the thyroid gland. Listen, you guys, you can follow only what one doctor says, or you can do a lot of research yourself to optimize your wellness. I can speak from experience that had I not researched all these different things about the thyroid gland, I would not be as vibrant. I would not be, as let's just say, fit. I would not be aging well if I didn't optimize thyroid function. So this is a really important episode. I ask that you share it with whomever you might feel would find it useful. I'd ask that you share it on your social media or anywhere that you can share it. It's much appreciated and it really gives back so that I can keep having incredible guests like Dr Eric Osansky.

Sandy Kruse: 3:07

I have written my essential thyroid guide. This is a patient advocacy guide. It is not a clinical book. There's enough clinical books out there if you want that. What I have written is a very simplified guide for those of you who just want, like the Cole's notes, you don't want to have a clinical understanding of your thyroid gland. It is available on Amazon everywhere. Follow me on all of my social media channels. It's Sandy K Nutrition everywhere If you want to know more about the things that I write about. I am on Substack, so follow me there.

Sandy Kruse: 3:51

I write short, explorative essays that relate to wellness body, mind, spirit, soul and the reason I write these explorative essays is not to dictate and tell you what your health is, because I really don't believe in that. I believe that health is so bio-individual, but unless you have people who are kind of giving you those breadcrumbs, you're never going to know where to look. I you know I'm not a big fan of what's happened in this wellness industry, where there's it's almost become a dictatorship Like you must do this and you must do cold plunge and you can't eat oxalates, and it's just like. I'm so tired of all of this because you can't make blanket statements like that for everyone. So follow me on Substack it's sandykruse. substack. com. Follow me on my podcast. Wherever you're listening, be sure that you're following, because I come out with a new podcast each and every week on Mondays.

Sandy Kruse: 4:57

And also for those of you who are in business you have a small business and you're doing incredible things and you're really trying to scale up your business. I joined forces with my husband's company and I am now the brand manager of the health and beauty channel for TKG partners and ripple distribution. This is a sales and distribution company and I really want to bring better brands to more people. It was just such a beautiful synergistic move for me to do that. Sandy K Nutrition stays, but I have access to a lot of amazing brands that not many people know about unless you're in the space that I'm in. So if you do have a brand and you are ready to scale up and you want to go into the Costco's the Best Buys here in Canada we have the Source, we have so many and Walmart Canada and Walmart Canada Please get in touch with me, sandy at tkgpartnerscom or sandy at sandyknutritionca.

Sandy Kruse: 6:13

And now let's cut on through to this amazing interview with Dr Eric Osonsky all about thyroid. Hi everyone, welcome to Sandy K Nutrition Health and Lifestyle Queen. Today we are going to be talking about one of my favorite, favorite subjects and that is the thyroid gland. I have Dr Eric Osonsky, who brings over 15 years of chiropractic care, functional medicine and nutrition expertise After achieving remission from Graves' hyperthyroidism.

Sandy Kruse: 6:47

We often talk about hypothyroidism, so this is maybe we'll get a little bit into the hyper side as well and he had Graves in 2009. He has dedicated his career to empowering others to address thyroid and autoimmune conditions naturally, as the published author of Natural Treatment Solutions for Hyperthyroidism and Graves' Disease, hashimoto's Triggers and the Hyperthyroid Healing Diet. He shares actionable insights and evidence-based strategies Now, today, we're going to talk about how to support your thyroid gland throughout perimenopause and menopause, when many women see changes in weight. Is thyroid a part of this cascade of weight gain? You have to stick around to the end of the conversation to find out, but we're going to talk about a few different causative factors. Of course, thyroid is going to be the center of this discussion and I'm really excited to have you here with me today, dr Eric. Welcome.

Dr. Eric Osansky: 8:00

Sandy Kay. Thank you so much. Really excited to be here, sandy Kay thank you so much.

Sandy Kruse: 8:05

Really excited to be here, great. So I kind of gave a tiny little segue on why you have such an interest in thyroid health. But tell us a little bit about your background, because Graves' disease is not as often talked about. So maybe give us a background of your history and how you got into thyroid health.

Dr. Eric Osansky: 8:28

Sure so, and you're right. Hashimoto's definitely more common and, as a result, a lot more practitioners focus on Hashimoto's. And so, as you mentioned, my background is a doctor of chiropractic and I had a traditional chiropractic practice for approximately seven and a half years and then in late 2007, I was a little bit overweight. I was around 182, wanted to be like around 165, 170. So I was looking to lose some weight through dieting, detoxifying, exercising, and it was successful, losing weight. Little did I know some of that weight loss. A good amount of that weight loss was due to the hyperthyroidism, but I actually didn't find out until one day I was walking around a retail store, a Sam's Club. They had one of those automated blood pressure machines and I took my blood pressure, which was normal, but my heart rate was 90. And I thought maybe it was just from walking around. So I took my. I manually took my heart rate the next few days and it was anywhere between 90 and 110 beats per minute, which definitely on the higher side. So I was putting the pieces together a little bit and and eventually I mentioned how my goal was to get to 165, 170. I was down at one point, 140. So I lost 42 pounds of weight and went to a primary care doctor and the primary care doctor diagnosed me with hyperthyroidism. Primary care doctor and the primary care doctor diagnosed me with hyperthyroidism and then eventually went to an endocrinologist and endocrinologist diagnosed me with Graves disease. And at that point I didn't have any experience with hyperthyroidism, with Graves disease.

Dr. Eric Osansky: 10:18

But as a chiropractor, we have to take our CE credit. So for our continuing education credits, I would always take nutritional courses or functional medicine courses, and there were a couple on functional endocrinology and while they focused more on hypothyroidism and Hashimoto's, they did talk a little bit about hyperthyroidism and how you could manage it naturally. In some cases, and just like anything else, there's an underlying cause. So I knew I was going to at least attempt to try to do things naturally, take a natural approach. I had no idea if it would be successful, but I figured I had nothing to lose by giving it a try. And so yeah, long story short, I started taking a natural approach, changed my diet, my lifestyle stress was a big factor and was able to restore my health. And since 2009, I've been also helping other people with thyroid, autoimmune thyroid conditions, more so people with hyperthyroidism and Graves' disease, just because of my personal journey.

Sandy Kruse: 11:19

I want to clarify this because for anybody who's starting to pay attention to the thyroid gland meaning their doctor maybe told them something was off or maybe they have some symptoms. Whatever it is a lot of people don't understand what the metrics are and TSH is, you know? Listen, I'm not knocking our doctors because it's not their fault, but that seems to be the only thing they test, and it's not even the thyroid hormone itself. It's a pituitary signaling hormone for your thyroid to actually make the hormone. Could you explain high TSH versus low TSH? What is hyper? What is hypo for everyone?

Dr. Eric Osansky: 12:16

Sure so with, as you mentioned, tsh. Thyroid stimulating hormone is secreted by the pituitary gland and it communicates with the thyroid gland. In the case of hypothyroidism, where you have low thyroid hormones and T4, t3 are the main thyroid hormones and so when they're low, the TSH tells the thyroid gland that hey, we need to increase thyroid hormones. So we have higher amounts of T3. In the case of hypothyroidism, typically elevated levels of TSH, and with hyperthyroidism you have the opposite. So with hyperthyroidism you have elevated T4, t3. So elevated thyroid hormone levels. So pituitary wants to say wait, hold on a sec, we have way too much than 0.005. But either way, there's a less than because, again, it's not detectable, because it doesn't want to secrete any TSH. So those are the main differences. I don't know if you want me to talk about the different antibodies associated with Graves and Hashimoto's as well.

Sandy Kruse: 13:38

No well, maybe we'll get into it, but I think it's important to note that, basically, very, very simply, if you have a TSH that's low, then that means you're closer to hyperthyroidism, so that's like everything is sped up. If your TSH is high, then that actually means the opposite, where everything's like slow down. You might feel sluggish and tired, and this is why it gets so confusing for a lot of people. But I mean, eric, I've lived in both states and it's not fun, and really it's that whole Goldilocks theory where you want to have the thyroid gland. Just right, and it's different for everybody.

Sandy Kruse: 14:29

Like, your right may not be the same as my right, and this is probably where it can be a big miss with Western medicine, because you know, I know I personally always feel pretty good at about a 1.5 TSH, but I've been at that undetectable state, as I know you have, because after thyroid cancer, they said they had to suppress my thyroid function to ensure that the thyroid cancer didn't grow back. I don't think they do that anymore, though. Do you know if they still do that? I don't know if they do.

Dr. Eric Osansky: 15:07

Yeah, good question. I can't say. I deal with a lot of thyroid cancer patients so I don't think so either. But I can't say a lot from the self-experience. Most people are seeing me. They're trying to those with hyperthyroidism, graves' disease. They're trying to prevent the surgery, usually once they get the surgery. Every now and then I'll get a patient, but very rarely am I seeing someone who actually went through thyroid surgery or had, especially someone who had thyroid cancer.

Sandy Kruse: 15:34

For somebody who's got graves, so hyperthyroid, sometimes they have to get to a point where they ablate the thyroid. They basically destroy it, right. They don't necessarily remove it like physically remove it, like they did with me, but with Graves or hyperthyroidism, if it's not controlled, they ablate the thyroid, don't they?

Dr. Eric Osansky: 16:03

Yes, they have what's called the rate act of iodine, which pretty much it, like you said, ablates or kills the cells of the thyroid gland, and so, yeah, the goal of that is to I mean, in a perfect world, like it's funny with cats, cats are more likely to get hyperthyroidism than hypothyroidism, and I was. I had a number of years ago a veterinarian as a patient and she said what, what cats? They try to get them euthyroid, which means they have like normal thyroid levels. But it would make sense to try to do that with humans too. But more times than not, the radioactive iodine is essentially doing what the thyroidectomy is doing, which is making them hypo.

Dr. Eric Osansky: 16:46

Now, sometimes they might not get a high enough dose of radioactive iodine. So I do every now and then there'll be someone who gets radioactive iodine. They'll become hypo temporarily and then they'll become hyper again just because it didn't kill off enough cells, and then they might end up getting another round of radioactive iodine. It depends. Sometimes I've seen I've had a few patients who received radioactive iodine and became hyper again, and then they came across my stuff and they my information. They're like you know what? I don't want to get another round of radioactive iodine. Let's see if we could save the thyroid, but more times than not it does end up causing hype like long-term, if not permanent, hypothyroidism.

Sandy Kruse: 17:27

So I guess we should. You know, I kind of I kind of started jumping around there, eric, because like this is like I could, I'm trying to pack as much in in this in this one hour. But I think it's really important to describe, because when I had thyroid cancer, I literally did not know what a gland was, thyroid gland. I had no idea on how important this little butterfly gland is. Can you just give everybody a rundown of what the thyroid gland is responsible for?

Dr. Eric Osansky: 18:01

Yeah, of course. So I mean you mentioned metabolism, like with um, with hypothyroidism it slows everything down, uh, and that could lead to lower heart rate, that could lead to coldness, that lead to constipation. With hyperthyroidism it speeds up everything. So I mentioned I had an elevated resting heart rate, had heart palpitations, had tremors.

Dr. Eric Osansky: 18:24

A lot of people have loose stools, anxiety, insomnia, the bones. So it affects bone health. So more so with hypothyroidism, low thyroid affects more bone quality, with hyperthyroidism more bone density. So like if you have elevated thyroid hormone levels it increases the bone turnover and that you're more likely to get osteopenia, osteoporosis, over time, especially if it's unmanaged Cholesterol. So cholesterol metabolism you have if you have low thyroid hormone. A lot of times you'll see elevated total cholesterol on a lipid panel, elevated LDL, hyperthyroidism. Many times we'll see the opposite where cholesterol is low, we talk about cholesterol being too high. I don't like to see cholesterol too low. So sometimes I'll see a total cholesterol of like 120, which to me is too low. But again it's related to the hyperthyroidism in the patients that I see. Thyroid hormone is important for brain function, digestive function, hair growth Again, hair loss, very common with both hypo and hyperthyroidism. Yeah, Absolutely.

Sandy Kruse: 19:36

That's a misconception. People think that you only lose your hair if you're hypo. That's so not true, because on both ends of the spectrum I had significant hair loss. Like I'm talking and here's what's really interesting I was not even thyroid. But, eric, as soon as my TSH goes over about 2.5, I start to have lingering.

Sandy Kruse: 20:13

I call it subclinical hypothyroidism, even though it's not classified as such, because I think you have to be over a 4.5 or a 5 to have subclinical hypothyroidism. This is why I'm always I'm such a big advocate, because, think of it almost like you have a touch of hypothyroidism, you have a touch of hyperthyroidism if you get close to these ranges either way. And so hair loss I mean as soon as I get past two and a half. If I do which I don't, I don't allow it to happen anymore I start to lose hair and I'm like damn, like I'm sorry, but there's nothing more disturbing than when you have clumps just falling out in the shower out in the shower. So I think it's important to note that. You know, some of these symptoms cross over, and some of them cross over even with menopause.

Dr. Eric Osansky: 21:15

Yeah, I mean that is true. I mean thyroid has an impact on the sex hormones and there could be overlap in the symptoms you know you could have, like, for example, low estrogen and associated with menopause, and get the hot flashes, night sweats, but then hyperthyroidism also causes heat intolerance, night sweats. So sometimes it could be confusing Am I entering menopause or am I dealing with hyperthyroidism? And of course you get overlap with hypothyroid symptoms as well, the weight gain, the brain fog, and again, is it the hormone imbalances or is it the thyroid? So it can be confusing at times.

Sandy Kruse: 21:58

Now I don't know if this is anything like. I know that you're more focused on Graves, but I do know there's quite a bit of research that's not often talked about, about how estrogen can affect thyroid function. Do you know anything about that stuff, eric?

Dr. Eric Osansky: 22:19

Yeah, so I mean it goes both ways. I mean, so you know you need healthy thyroid hormone levels for healthy estrogen, as well as progesterone levels and then also adrenals, which I know that's not part of this conversation, but healthy adrenal is also important for healthy sex hormones. There's also estrogen receptors on the thyroid. So, as a result, if you have lower, if, like, estrogen decreases, thyroid function can also decrease and then estrogen also plays a role in the thyroid hormone receptors, so estrogen can affect the sensitivity of the thyroid hormone receptor. So if you have lower estrogen, again associated with perimenopause and more so postmenopause, then again that could also lower thyroid hormones. So, yeah, I mean there's also high estrogen for various reasons that we could talk about. But yeah, if you have low estrogen associated with menopause, that could also cause low thyroid hormone and hypothyroidism and lead to those low thyroid symptoms.

Sandy Kruse: 23:31

Yeah, I know the research that I did. It's again like it's, I swear it's. Everything is about balance. This is life. As soon as things get out of balance, that's when we can start to have problems. Because I've read the same research that you're talking about about really high estrogen can affect the thyroid and really low estrogen can affect the thyroid. So this is why, when we kind of get into that, I know a lot of women who are estrogen dominant and even though technically they may not have really high estrogen, but it is high in relation to progesterone, so that they have problems with thyroid even in their 40s. A lot of women are estrogen dominant in their 40s and then boom, they hit menopause and they're in their 50s and then their estrogen goes down and then their thyroid function goes off again. So this is why it's really important to have practitioners who kind of look at everything like the hormonal endocrinology system doesn't work in silos, would you agree?

Dr. Eric Osansky: 24:42

Yeah, definitely would agree. And what makes it even more complex these days are the xenoestrogens, the endocrine disrupting chemicals. So it's not just our natural estrogens, but the xenoestrogens can also bind to the thyroid receptor and mimic I mean both mimic estrogen and also disrupt the thyroid. So, yeah, I mean, when you factor that in combination with our natural hormones, it gets really complex or can get really complex.

Sandy Kruse: 25:13

Yeah, Back when this was actually way before I had thyroid cancer this would have been after the birth of my second child I started to research what these xenoestrogens did, and the reason I did was only because she was a newborn. She had such bad eczema and so I was trying to figure out okay, well, what can I do? This is going back when I was 35 years old, and back then it wasn't as easy as now. Now we have lots of options that are phthalate-free, that are BPA-free. My sister and I were just talking about how we would warm up the baby bottles in plastic in the microwave and I'm like, oh my God, like what I used to do. But we didn't know any better. But I did know about perfumes and scents and phthalates and SLS. I started to research it. So I think it's important to know that a lot of this might relate to your own genetics and your ability to detox these chemicals. Would you agree?

Dr. Eric Osansky: 26:36

Yeah, no, without question, definitely agree. Everybody's different. And I mean you could do a test like the Dutch test that looks at how you're metabolizing the estrogens. And and yeah, there are some people that, like you said, there's definitely genetic components and because of that, some people do a really good job of detoxifying the estrogens, even if they're exposed to a lot of those xenoestrogens. And then there are other people who they don't do as good of a job and it will have a greater impact. So, and you could the good news you can do, even with the genetics, you can do things to support estrogen metabolism. You could eat more cruciferous vegetables, eat more broccoli, eat more broccoli sprouts. If you have to take supplementation something like DIM or diendylmethane, depending on the situation if someone has low estrogen levels, they probably don't want to take DIM, but yeah, so I definitely agree with you, sandy.

Sandy Kruse: 27:32

Yeah, I've been taking sulforaphane for many years now and it's just there's different-glucrate, there's DM diendomethane, there's sulforaphane. You have to figure out and I agree the Dutch test is a great way to figure out which of these substances that are natural supplements can help you to detoxify. Natural supplements can help you to detoxify because some are better at phase one, some are better at phase two detoxification and you know, I know, for me the sulforaphane is very protective.

Dr. Eric Osansky: 28:08

It just kind of it's almost like it's redirecting that estrogen to go down a healthier pathway yeah, I agree, a lot of people do well on sulforaphane, especially if they can't take the DIM. And then you mentioned the calcium deglucorate. So you could do a comprehensive stool test, see if you have elevated beta-glucuronidase levels, which might indicate that you have problems with estrogen metabolism related to the gut, and then therefore the calcium deglucorate might be an indication in that case. But yeah, how long did you say you've been taking the sulforaphane for?

Sandy Kruse: 28:41

So I'm going to say I'm 55. I probably started at around 49, something like that, because DIM. I found just kind of like you actually pointed to that that DIM may not be great for a woman who's close to menopause because it can almost. It's like you're detoxing too much of it. That's actually what happened to me, and what I needed was more of the support of making sure it was metabolized in a healthier way.

Dr. Eric Osansky: 29:20

Yeah, I agree, and I was guilty of giving them for even those who had low, low estrogen in the past. I didn't know better. I think it was Dr Carrie Jones, who I learned about who she? She was talking about the sulforaphane. If they have the low, if they have low estrogen, you don't want to give them. You want to go with sulforaphane if the estrogen levels are normal or obviously, if they're high. But even if they're normal but you have the high estrogen metabolites and the Dutch test, specifically the 4-hydroxy or the 16-hydroxy, then that could be an indication for DIM.

Sandy Kruse: 29:54

I think that this is a good second to pause, because a lot of women who listen to my podcast are in and around menopause, past menopause. You know, I know we're talking about the thyroid, but all of this connects Like even though, when we get our blood work, we're going to do a panel for thyroid, we're going to do a panel, maybe, for our sex hormones, but it really needs to be looked at by somebody who can look at all of it together. Would you agree?

Dr. Eric Osansky: 30:30

Yeah, I mean 100%. I mean that's the downside of most medical doctors, including endocrinologists. Most endocrinologists you mentioned many of them just look at TSH, more so with hypo, with hyperthyroidism, usually they'll at least do a T4, a free T4, but maybe they'll do, in some cases they will do the T3 as well. But yeah, they won't look at the sex hormones, let alone the adrenals. You try to bring up adrenal health to an endocrinologist and again, they're endocrinologists. They should also have. I mean, not that they don't have the knowledge, but they don't pay attention to the circadian rhythm of cortisol.

Dr. Eric Osansky: 31:09

And you're absolutely right, you want someone that looks at a whole picture. Because even if they look at the estrogen levels, which they almost never do, or not just estrogen at the estrogen levels, which they almost never do, or not just estrogen, but progesterone, testosterone, they're never going to look at the metabolism of these hormones. They're not going to order a Dutch test for you, unless if it's an integrative endocrinologist, which is rare. So yeah, I agree with you 100%. The gut too. I mentioned how the gut plays a big role in metabolizing, helping to metabolize estrogen as well. So if you have a lot of dysbiosis, a lot of imbalances in the gut flora. That also could be the reason why you're not metabolizing estrogen. So that's part of just also not looking, like you said, looking at the whole picture to see why, if you have a problem with estrogen metabolism, why are you having that problem?

Sandy Kruse: 31:58

Mm-hmm, if you have a problem with estrogen metabolism. Why are you having that problem? Now the thyroid is okay. I'm going to just kind of go back a little bit.

Sandy Kruse: 32:14

I think it's really important to note that sometimes that we have a lot of stress going on in our lives. It's very difficult to mitigate the effects of stress on our bodies, but stress and stress is good in little spurts. And I always like to look back because to me, when I look logically at wellness, I look at more or less like a paleolithic lifestyle. You know, what did they do back then? Or I look at my parents, who were farmers back in Croatia, like old country Croatia. How did they live?

Sandy Kruse: 32:48

Well, sure, they had stress, but when you had, when you have prolonged stress like we're talking, I don't know if you could put a timeframe on it, but I did write. I am writing about this because I'm like how stress affects me is different than how it's going to affect you and my resiliency might be different than your resiliency. So you can't really put a timeframe. But back when my daughter was sick, I was, you know, I was stressed beyond belief and it was a long time. And then, even before that, eric, you know, I had a spouse who traveled. Every week I had a newborn and toddler and I was alone a lot of the time and I'm like, okay, I can almost see what was going on, but I couldn't at the time. So I think it's important for women to see the symptoms and know how stress can affect this important little thyroid gland, because now I don't have one. So talk to us about how stress can affect the thyroid function.

Dr. Eric Osansky: 34:07

Yeah, great question. I should start off by mentioning how stress was a big factor I'm pretty certain a big factor in the development of my grave disease condition. And also, it's important to mention, I was in denial at the time. I didn't think I knew stress was a factor, but I thought I had good stress handling skills and did adrenal saliva tests. At the time my adrenals were in the tank, my DHA was in the tank, but also the emotional not just emotional stresses, but the physical stressors. So I was overtraining at the time and that also could impact the adrenals, but I mean one.

Dr. Eric Osansky: 34:46

So there's a few different ways that stress can negatively affect the thyroid. So one is when you're dealing with prolonged chronic stress and you have cortisol, the body pumping out cortisol, adrenals pumping out cortisol for a prolonged period of time. That will affect conversion of T4 to T3. Again, t3, I don't think I mentioned earlier. T3 is the active form of thyroid hormone and so it's important to have both T4 and T3, but T3, if you have low T3, that's really going to lead many times to those hypothyroid symptoms. So if you have prolonged chronic stress that could lead to kind of like a state of hypothyroidism due to that low T3. Cortisol, chronic stress also causes dysregulation of the immune system and so I think that's one of the factors in my health when I was dealing or prior to dealing with Graves and again, I also speak with people with Hashimoto's and almost always stress. It doesn't matter if it's Graves, hashimoto's, even non-automated thyroid conditions, but in this case, when talking about Graves, hashimoto's to median thyroid conditions, but in this case, when talking about Graves-Hashimoto's, we have dysregulation of the immune system, at least an increase in pro-inflammatory cytokines which promote inflammation, and that also is a potential mechanism of how stress will affect the thyroid by impacting the immune system, because most of the thyroid conditions around, most hypothyroid conditions are Hashimoto's and most hyperthyroid conditions are Graves' disease.

Dr. Eric Osansky: 36:22

And then stress also decreases secretory IgA. Secretory IgA lines the mucosal surfaces of the body, including the gastrointestinal tract, and serves as protection. It's not a specific leaky gut marker, but I mean there are other, more specific leaky gut tests, but typically when secretory IgA is low, usually someone has a leaky gut marker. But I mean there are other, more specific leaky gut tests, but typically when secretory IgA is low, usually someone has a leaky gut and that is part of what's called the triad of autoimmunity or the three-legged stool of autoimmunity, which is again a factor in the development of autoimmune conditions, including Graves and Hashimoto's.

Dr. Eric Osansky: 36:55

And so those are a few different ways in which stress. The first one that I mentioned is more of a direct mechanism of effect, that conversion of T4 to T3. But to me the biggest concern is the impact of stress on our immune systems and really, along with other factors of course, are like increased toxic burden, but again, stress is higher than it ever has been and just yeah, that really, I think is a big factor in the prevalence of autoimmune conditions such as Graves and Hashimoto's.

Sandy Kruse: 37:29

You know, I always think the body is just so brilliant and it's like it knows it always wants to look for that. Okay, can I feel safe? How can I feel good? And when you're in that constant stress, like you know, you're like tight and you're wired and you're you're in that state for a long time, it's like your thyroid gland's gonna go okay, I better slow down, and so that's why you'll sometimes see that tsh go up as well. It's like your thyroid gland is going to go okay, I better slow down, and so that's why you'll sometimes see that TSH go up as well. It's like a reaction to saying I need to preserve all hands on deck, right, let's preserve bodily functions, let's slow everything down until Sandy calms down. Like I'm just a big believer that the body is just so intelligent and knows you know how to react until it doesn't know anymore what to do.

Dr. Eric Osansky: 38:29

Yeah, you're right, and we didn't bring up when talking about the markers. There's a marker reverse T3 that kind of looks at that. When you have like elevated reverse T3, that's the body's way of like trying to slow things down. And I mean we see that with hyperthyroidism. I don't test reverse T3 anymore because everybody has elevated reverse T3 levels because of the elevation thyroid hormones. But you're right, I mean the stress, the chronic stress, could also play a big role, which is why if someone has hypothyroidism, including Hashimoto's, it's a good idea to look at that reverse T3, which, again, that's the inactive form of thyroid hormone, whereas T3 is the active form that I mentioned earlier.

Sandy Kruse: 39:11

Yeah, and here that's not. In Canada, that's not even a measurement. Reverse T3, never done. I have an endocrinologist, he's great. He does all the markers for antibodies, free T3, free T4, tsh. He does a thyroglobulin which is really important if you've had thyroid cancer to make sure that there's almost no thyroglobulin. But reverse T3 is never done. And the way like I love this analogy, I've been using it I don't even know I think I must've heard of this over 10 years ago that a good way to think of reverse T3 is back in the days when we used to go to the bar and there would be all the bouncers at the door and they'd be blocking the doorway. Well, reverse T3 are the bouncers at the bar, but to your cells, so it doesn't let hormone enter your cells.

Dr. Eric Osansky: 40:15

That's a pretty good analogy.

Sandy Kruse: 40:18

I know I always like to look back to my youth. You know it's okay. It's okay to do that, right Eric?

Dr. Eric Osansky: 40:23

Yeah, definitely.

Sandy Kruse: 40:25

So we've talked about stress. We've talked about our sex hormones, stress, we've talked about our sex hormones. Let's get into nutrients. Here's a question for you, because you're an expert on hyperthyroidism Is too much iodine, something that could exacerbate hyperthyroidism.

Dr. Eric Osansky: 40:53

Could be. I was waiting to see if you'd get into the iodine question.

Sandy Kruse: 40:58

Yeah, we will talk about it for sure.

Dr. Eric Osansky: 41:01

Yeah, a lot of controversy with iodine. So yeah, I mean to answer your question too much iodine can be problematic. It can potentially increase hyperthyroidism. It can, I mean, in some cases exacerbate the autoimmune response. And we're not just talking about iodine supplementation. I have a podcast episode on iodine contrast agents. That again, that's also a concern as well. So if someone has hyperthyroidism they definitely don't want to receive like a CT scan with iodine contrast, but they also want to be careful with iodine. And. But there's also it's interesting because in the hyper I mean both, really not just the hyperthyroid world, but there's different perspectives. There's the high iodine perspective, meaning that people should supplement with high dose iodine, and then there's the other perspective where you want to just stay away from iodine.

Sandy Kruse: 42:00

You mean, if you're?

Dr. Eric Osansky: 42:01

hyper. Right, I'm talking about both. No, I'm talking about both I'm talking about there are practitioners out there that recommend high dose iodine for hyperthyroidism as well as for Hashimoto's. And the reason I know is because years ago I actually took high dose iodine just and it didn't make me more hyper. But again when I was, when I mentioned I was taking those functional endocrinology seminars now they were talking about natural ways of managing the symptoms through herbs like bugleweed motherwort, which you might not be familiar with, but those are like alternatives to antithyroid medication and the beta blockers. But high-dose iodine actually can have the opposite effect and block thyroid hormone if you take really high doses of iodine.

Dr. Eric Osansky: 42:54

Now again, I'm not recommending to take that. I've actually I've been more definitely more conservative over the years with iodine. I'm just saying years ago I was taught by some of these seminars and other practitioners that you do want to give iodine and people not just what Hashimoto's which again now there's also concern with Hashimoto's and iodine, but what and those with hyperthyroidism and and so when I first started helping people with with thyroid and autoimmune thyroid conditions, including hyperthyroidism, I would do urinary testing for iodine and then if someone was deficient would would recommend separate iodine and then if someone was deficient would would recommend separate iodine supplementation and without question I saw in some cases where it backfired and it would cause it either exacerbate the hyperthyroidism or rarely but a few cases there's engraved disease, that's what's called thyroid eye disease, where the immune system attacks the tissues of the eye. So again, in some cases the iodine can exacerbate the autoimmune response and worsen thyroid eye disease, where the immune system attacks the tissues of the eye. So again, in some cases the iodine can exacerbate the autoimmune response and worsen thyroid eye disease. And that's scary and it's not a good feeling when someone says you know, I've taken iodine, like supplements with iodine, and now I'm feeling like more pressure in the eyes, and so even to this day there's controversy.

Dr. Eric Osansky: 44:09

I mean, I just saw on Substack, like a few weeks ago, a practitioner talking about how you want to take high dose iodine and it's important to supplement separately with iodine. And then there are, like I said, other perspectives, including some people I've been on your podcast to recommend the opposite, like Dr Alan Christensen who has a book, the Thyroid Reset Diet, and he recommends the opposite. So I'm trying to be somewhere in between. I don't recommend like completely avoiding the iodine, but I am cautious when it comes to like just taking 25, 50 milligrams of iodine. And you're right with hyperthyroidism and also even in Hashimoto's can cause problems.

Dr. Eric Osansky: 44:54

But, like I said, you talk to 10 different practitioners and practitioners who have a lot of experience with the thyroid. You'll still get different perspectives as far as who should take iodine, who should avoid iodine. But yeah, I will say I've been on both sides of the spectrum and, yeah, just over the years I have become more cautious with iodine. Again, not telling people not to have any iodine in their food and things like that. I think that's a little bit too extreme. But yeah, so we could talk more about this. But again, like I said, it's definitely a controversial topic.

Sandy Kruse: 45:32

I think it's a massive topic and I think there's massive discrepancies. And I remember doing an iodine loading protocol. This was and I don't have a thyroid, but it was more. So people don't realize that iodine's not important only for thyroid. It's important for women, for breast health, it's important for the brain, it's important for a lot of other bodily functions. But I think you know I always go back to that whole Goldilocks theory that too much is not a good thing. Goldilocks theory that too much is not a good thing. So it's really hard because even I don't even know like is urine? There's some controversy about urine. Testing for iodine isn't there.

Dr. Eric Osansky: 46:26

There is. I mean there's really no consensus when it comes to testing for iodine. There's. I mean, the blood test probably isn't too accurate to do like serum testing, but then there's different types of iodine testing. So, like you, I did the 24 hour iodine loading test where you take a 50 milligram tablet of iodine this was years ago that I did that test and then you look at the excretion of iodine and then there's just regular, just basic iodine tests, like just a spot test we just do where you're not consuming any iodine, you're just doing a test and seeing how much iodine's in the system. And so again, there's.

Dr. Eric Osansky: 47:04

Either way, there's not a lot of research out there. And, and the thing with the loading test, again, I've had a lot of patients over the years, especially the first number of years I was in practice, do the loading test and again, most people honestly seem to do okay, but there is still risk, especially again, like you mentioned, the hyperthyroidism taking the 50 milligram tablet of iodorol before doing that test. But yeah, so there's, like I said there's. I mean, if I see a urinary, the iodine loading test, there's not really anything as far as I know in the actual research, like if you go on PubMed urinary iodine testing. There is some and I mean if someone, I definitely pay attention to it. I mean if someone does a urinary test and they low in iodine, again I'm not going to say, okay, let's go and take a lot large doses of iodine, but I would want to make sure that they are getting some iodine and that they're not trying to, because again there's even endocrinologists are.

Dr. Eric Osansky: 48:08

Sometimes we'll tell the patients with hyperthyroidism to avoid all iodine and again, it makes sense on the surface. You need iodine for formation of thyroid hormone. So let's avoid completely all the iodine if you have hyperthyroidism and for some people that does work. Like some people I spoke about this in my book, the Hyperthyroid Healing Diet there are some people who do better on a really low iodine diet, especially many people with hyperthyroid healing diet. There are some people who do better on a really low iodine diet, especially many people with hyperthyroidism. But there are people who do fine, again, as long as they're not overdoing it and not like overloading. Eating like a lot of really high iodine foods, like kelp, for example, is like one. But I don't tell people to avoid, like, all food sources of iodine, even if they're dealing with hyperthyroidism.

Sandy Kruse: 48:54

Isn't fish too like fish, seafood, anything like that is going to be having a decent amount of iodine. I know kelp and sea like seaweed. You know you can buy the seaweed. They're gross. I've tried them. I can't do it. But you know I will do tiny little doses. And again, we're not giving any medical advice here because you're going to have to speak with your own practitioner on what's right for you. But for me and my family, because we don't eat a lot of iodine rich foods, like we're not big seafood eaters fish, kelp so I'll sometimes no, like all of what I do is Iodoral. You know Iodoral I'll take like there's like the tiny little doses what is it like? Six milligrams or something like that, and I'll just pulse it in like once or twice a week just to make sure I have a little bit of iodine, just to be safe.

Dr. Eric Osansky: 50:01

Yeah, and again you're rotating it, so doing it a few days a week. But yeah, I mean you're right If you're, I mean you are getting some iodine if you eat eggs. If you do eat dairy which again people who are, I can't say I never have dairy, but it's limited and those who I work with usually are taking a break from dairy while healing, so they're not getting iodine that way. So you're right, the fish, the seafood, the shellfish is especially higher in iodine. I mean if you're eating like wild salmon, you're usually not going to get like a lot of iodine, but if you're not eating any fish, you're right. If you're really not eating seafood, again you'll get some from the eggs you eat. And if you eat dairy, but if you're avoiding, if you're dairy-free, not eating seafood, you very well might not be getting enough iodine, even if you're eating eggs.

Sandy Kruse: 50:52

Here's a question Goiters Goiters so it's like the enlarged gland or nodules. Isn't iodine deficiency one of the causes of goiters?

Dr. Eric Osansky: 51:09

One potential cause yeah, goiters. There could be numerous causes. So, like when I dealt with hyperthyroidism, I had a mild goiter but it was due to the. When you have too much thyroid hormone, that can cause a goiter, when you don't have enough iodine, and that could lead to hypothyroidism, which could also cause a goiter. So, you're right, that could that's, that's one could also cause a goiter. So, you're right, that could that's, that's one.

Dr. Eric Osansky: 51:37

One factor what's interesting? Estrogen metabolism like we get them back to estrogen problems with estrogen metabolism could also be a factor with goiters, as well as thyroid nodules. So, getting back to tying the estrogen in with the nodules and the goiters, insulin resistance also could be a factor. Um, just inflammation in general, so that. So yeah, I mean it's definitely a potential factor. Um, as far as iodine deficiency, and when you're looking at a goy, someone with a goiter, you want to look at everything. You want to consider, like, what could be the cause? Is it iodine deficiency is Is it inflammation? Is it insulin resistance? Is it problems with estrogen metabolism? So, yeah, so, but iodine deficiency is definitely one of the potential causes of a goiter.

Sandy Kruse: 52:24

Now there are other really important nutrients for healthy thyroid function. Do you want to? I know vitamin D is like big for any autoimmune. I did a whole show on autoimmune conditions and I mean vitamin D is so critically important and it's really. I don't know how it is in the US, but here in Canada it is not paid for, like we have OHIP in Canada, so it's social, whatever social health care, and it's not paid for unless there is an actual reason to test for it. So I can get mine tested, probably for free, because I don't have a thyroid gland. Maybe there's these little boxes that need to be checked, kind of thing, but it's not common to test for it in Canada and I'm like it is so important to be in a healthy level of vitamin D, even as a preventative factor, one preventative factor for all autoimmune diseases.

Dr. Eric Osansky: 53:40

Yeah, no, I definitely agree. It is crazy for them not to. I mean because, again, vitamin, even in sunny places like Arizona and Florida you have people who are vitamin D deficient. But then as you go further up North, it's it's, it's more common. I mean, pretty much it's widespread. If you go to Arizona, it's hot, but who wants to go outside when it's like 115 degrees? So they're still inside and not getting the sun exposure they need or they're they're wearing sunblock when they're outside and not getting the benefits of vitamin D.

Dr. Eric Osansky: 54:10

Yeah, vitamin D, without question important for optimal immune system health. And then, just like you mentioned the thyroid, you gotta consider lab ranges versus optimal ranges of vitamin D. I know in Canada they use a different unit of measurement, like nanomoles per liter. So, like here, like in the United States, you want at least 50, some will say even like 60 to 80, whereas, like in, if you make the conversion in Canada it'd be like 50, I'm sorry, 125, like nanomoles per liter would be like the minimum that you want. But if you look at the reference ranges I forgot the ranges but some will say if you're like 75, you're good, you're good to go, Maybe from a bone health perspective possibly. But immune system standpoint, it seems that most functional medicine practitioners agree that the lab ranges are way too low. Their lab ranges are way too low. So I supplement with vitamin D, d3 on a regular basis. You probably also know you want to make sure to take K2 to guide the calcium into the bone if you're taking D3. But yeah, so vitamin for both Graves, hashimoto's, other autoimmune conditions.

Dr. Eric Osansky: 55:26

Vitamin D is important. Iron is another important nutrient when it comes to thyroid health and it's one of those like you mentioned the Goldilocks with iodine. Same thing with iron. You don't want. I mean, a lot of people talk about iron deficiency, especially in menstruating women, even though, again, I see iron deficiency in men and postmenopausal women, which it's obviously not due to menstruation but could be other factors. Maybe they're vegans, maybe their gut health isn't optimal, they have low stomach acid, so you don't want iron to be too low. But if iron's too high that could cause oxidative stress, which isn't good for the immune system. But iron is important for thyroid hormone production, so it plays a role in the enzyme thyroid peroxidase. So yeah, you have low iron that could lead to low thyroid hormone levels.

Dr. Eric Osansky: 56:22

Zinc is important as well. Selenium Selenium is so much research with selenium and thyroid just conversion it could play a role in. But then again, immune system. There are a number of different studies showing that selenium supplementation could help lowering thyroid antibodies, those thyroid peroxidase or TPO antibodies, as well as even engraves, those thyroid stimulating immunoglobulins, can help with thyroid eye disease that I briefly mentioned earlier. So selenium, which is a precursor or it's a co-factor for glutathione, so glutathione is the master antioxidant. So you need healthy selenium levels to have healthy glutathione levels, healthy selenium levels to have healthy glutathione levels.

Dr. Eric Osansky: 57:09

Vitamin A Vitamin A is important for immune system health, but also it's important to support the thyroid receptor and there's a condition called thyroid hormone resistance where the thought kind of like insulin resistance, insulin resistance you have too much insulin but it's not getting into the cell.

Dr. Eric Osansky: 57:24

That could happen in some cases with the thyroid hormones, where TSH is maybe normal on the higher side, but thyroid hormone levels on the blood test will also look higher and the reason it's higher is because, again, you have that thyroid hormone resistance and so in that case you might need to do things to support the receptor. Zinc actually supports the receptor, but so does vitamin A. Tyrosine, which is an amino acid, is important when it comes to thyroid hormone production, which is why you see tyrosine in a lot of these thyroid support supplements, and so I mean all the nutrients are important. Magnesium is another one, I mean, but yeah, I mean without question these, the ones I just mentioned, are one of the more important ones when you look at the research when it comes to thyroid health, thyroid hormone production, as well as helping with the immune system.

Sandy Kruse: 58:20

So really, the bottom line is for anybody who's listening, who's perimenopausal or menopausal if you go on a diet that is heavily restricted of any particular food group, you may become deficient in these nutrients. I come from, you know, a bit of a long history of avoiding certain foods, trying different diets, chasing my body pre-thyroidectomy, and I don't think it served me, and I think what serves me is eating a diet that is a variety of different whole foods and having different foods all the time, because then you're going to make it's almost like you're going to make sure that you get those nutrients in the food that you're eating.

Dr. Eric Osansky: 59:15

Yeah, I agree. I mean some diets like ketogenic could be really restrictive and again, not to say there's not a time and place for them. But you got to be careful because some people will be on keto for six months or a year and that could also have a negative effect directly on thyroid. But, as you mentioned also, you might not be getting the nutrients you need and that also could affect not only thyroid but other areas. So, I agree, we want whole, healthy foods, protein, of course. These days a lot is out there about protein and I agree you definitely want to make sure you get enough protein. But I think the variety is really important too. If you're just eating three or four or five different foods, it's going to be hard to get the nutrients that you need.

Sandy Kruse: 1:00:03

Yeah, and you know I want to go back to the whole this is really interesting the stomach acid thing and you mentioned iron. So I was like I was always like on the cusp, my ferritin was low. There were times that my ferritin was like eight. You know, it was really really low and I was in my forties, I had had my thyroid out. I was put on a PPI, eric, and so you know I have I'm not going to get into all the details here, but I was told that because I had, they told me I had Barrett's esophagus and that I had just had thyroid cancer, I was at risk for now having esophageal cancer.

Sandy Kruse: 1:00:55

So I better take these. So, and I didn't even have heartburn at the time. So what I started to do and this was oh, it was probably when I went back to nutrition college I started to fake my own digestion because I'm like I'm on the way to becoming fully anemic if I don't do something. So I started taking higher doses of hydrochloric acid without any side effect no heartburn, no issues and I personally avoided becoming anemic and I'm not saying that's for everyone because there are contraindications to doing this, like if you have ulcers or things like that, but I think it saved me and it saved me from going down an even worse trajectory in health.

Sandy Kruse: 1:01:56

So you know, for anybody who's listening, there are things that sometimes we can't help. Even you mentioned vitamin A is really important. We can't help. Even you mentioned vitamin A is really important. Vitamin D is really important. I carry a number of genetic snips that make it difficult for me to convert and use those nutrients, even though I might be eating it, I might be taking it, I might be out in the sun, you know. And then you know I was reading a research article maybe you read this about how low vitamin D might be such a huge issue, even in the states where it's a little bit warmer and there's enough sunshine, because obesity can get in the way of absorbing the vitamin D, even if you're out there getting it or trying to get it. Have you heard that study?

Dr. Eric Osansky: 1:02:52

I have not. I've not come across that study. So in obese patients or people who are obese, just the absorption of vitamin D is decreased.

Sandy Kruse: 1:03:01

Yeah. So I mean, it's just honestly. It's like you can get into this vicious cycle of issues. Like you know, you're a menopausal woman and then all of a sudden you're like, oh my God, I'm starting to gain weight, so I'm going to exercise my head off so that I can try and keep this weight off, but you don't realize that that's actually exacerbating your issues with stress. So it's like you know, how do you win? How do you win?

Dr. Eric Osansky: 1:03:38

I agree, and again, I was guilty of that as well, with the overtraining at least, and also the dieting and detoxing. So yeah, you're right, I mean you win by balance. I mean balance is the key.

Sandy Kruse: 1:03:51

Yeah, I think that's it. I think that's it. I think, as humans, it's harder to achieve that balance in this modern day life, especially when you don't know what's in your food anymore. And anyway, I think the important thing is to remain balanced in choosing whole foods, organic when possible, and of course, there's always good, better, best with your food choices, choices, and then having a practitioner who understands the body as a whole.

Dr. Eric Osansky: 1:04:36

Yeah, again, we spoke a little bit about this earlier with looking at the whole picture. So, yeah, obviously I'm biased because I'm one of those practitioners, but there are many out there, that's the good news. There are more and more functional medicine practitioners out there who do look at the whole picture. And I mean the challenge is that many of them might not be on your insurance plan so you might have to pay out of pocket. But again, to me it's worth it going, I mean compared to going to a doctor. And again, there's a time and place, obviously, for conventional medical doctors. I will say a lot of my patients with Graves are seeing an endocrinologist because some of them even though I manage it naturally and a lot of my patients manage it naturally some people do need to take the anti-thar medication. So again, that's the time and place to see the endocrinologist. And some people do need thyroid hormone replacement. So again, there's a time and place for the medical doctors. The problem is many times that's all they're doing Just take the levothyroxine or whatever they're recommending, sometimes maybe some Cytomel, but most of the time just Synthroid or another type of levothyroxine, and then with hyperthyroidism, just the three options are antithyroid meds, radioactive iodine thyroid surgery.

Dr. Eric Osansky: 1:05:45

Yeah, diet doesn't make a difference. Diet doesn't make a difference. Stress doesn't make a difference. So, you're right, you really do want to. All this does make a difference. I mean, what you put in your body is important, not just diet wise, but cleaners, cosmetics, the stress that we mentioned, I mean the mold that works. I mean all these things. And because of that, you do need someone who looks at the whole picture. And if there's anybody who not only just dismisses diet, but then there are some people that that's all they focus on Okay, you just eat a healthy diet and that's all you need to do. But again, unfortunately, so many conditions these days are more complex and you need to go beyond diet and lifestyle. That being said, if you don't incorporate the foundations, you're not going to heal. But yeah, so get them back to someone who looks at the whole entire picture. Yeah, I definitely think that's a necessity if you're dealing with really any type of health condition.

Sandy Kruse: 1:06:44

So I would recommend anybody who's listening to this find a functional medicine practitioner who will, if you're going through perimenopause, menopause, who will even just begin with doing blood work. That is all of it. So not just TSH, but we kind of touched on it TSH, free T3, free T4, antibodies If you can get reverse T3, great. And then take a look at all the sex hormones as well. Right, that's important too. So, in closing, how would you like to have anybody who's listening come find you what's, what are the best resources and, if there's anything that we missed, that we didn't cover off, that you'd like to talk about, please do so hit a lot.

Dr. Eric Osansky: 1:07:48

We hit a lot of information. So so, yeah, just as you, as you said, sandy, just important to find someone who looks at the entire picture. And I agree just that, even if it's just starting out with doing a conference, a blood panel and not just doing the basics, I mean, the basics are important, but you want to go beyond the basics and then also like, yeah, looking at it, besides sex hormones, like adrenals, important, but again, maybe at first it's just looking at the blood test and then maybe you go beyond that eventually. But, yeah, people, there's, I guess, three main resources. I would say One would be the podcast, say my Thyroid, which I definitely would love to have you as a guest on that, so we'll be chatting again. So, and you could just visit save my thyroid on your favorite podcast platform or just type in save my thyroidcom.

Dr. Eric Osansky: 1:08:35

Second, my books. I have two books on hyperthyroidism, natural treatment, solutions for hyperthyroidism and Graves' disease Now it's in third edition, which came out in 2023, the hyperthyroid healing diet, which is my most recent book, from 2024. And then I have, for those who have Hashimoto's I have a book called Hashimoto's triggers, which is a really comprehensive book on finding and removing the triggers of Hashimoto's. And then I have a newsletter called healthy gut, healthy thyroid, and so you could check that out by visiting savemythyroidcom. Forward slash newsletter.

Sandy Kruse: 1:09:10

That's great. Thank you so much, Eric. It was such a pleasure chatting with you.

Dr. Eric Osansky: 1:09:16

Yeah, same here. Sandy, Really appreciate you having me on and thank you so much.

Sandy Kruse: 1:09:39

And yeah, I agree, this was a really wonderful conversation. You help to support my content and help me to keep going and bringing these conversations to you each and every week. Join me next week for a new topic, new guest, new exciting conversations to help you live your best life.