Ep. 267 Hashimoto’s: What Is It and How It Impacts Our Health

I am delighted to connect with Dr. Anshul Gupta today! 

Dr. Gupta is a best-selling author, speaker, researcher, and world expert on Hashimoto’s. He educates people worldwide on reversing Hashimoto’s disease. He is a Board-Certified Family Medicine Physician who worked at the prestigious Cleveland Clinic alongside Dr. Mark Hyman.

In this episode, Dr. Gupta shares his personal story, and we speak about the root of autoimmunity, how Hashimoto’s causes the slow destruction of the thyroid gland, and the impact of chronic stress, food, and an imbalanced gut microbiome. We also talk about toxins and infections, labs to look out for, fasting and thyroid disease, as well as medication options, peptides, and the issues surrounding iodine supplementation. 

I sincerely hope you enjoy listening to today’s conversation with Dr. Gupta as much as I did recording it! 

“A lot of women are suffering from thyroid disorders, and the majority of them have no idea they actually have Hashimoto’s.”

– Dr. Anshul Gupta

IN THIS EPISODE YOU WILL LEARN:

• How Dr. Gupta’s personal health journey sparked his passion for thyroid issues.
• What is autoimmunity, and what is Hashimoto’s?
• How increasing doses of thyroid medication indicates a deterioration of the thyroid gland.
• Dr. Gupta shares five major root causes of Hashimoto’s.
• Why do foods like gluten and dairy make it much harder for the thyroid gland to function?
• Why are heavy metals such a big issue?
• The impact of exposure to mold and mycotoxins.
• How the Epstein-Barr virus interacts with the thyroid, to make people more susceptible to Hashimoto’s.
• How does exposure to stress impact thyroid function?
• Some natural ways to detoxify the body.
• Dr. Gupta talks about lab testing for the thyroid and Hashimoto’s.
• The benefits of fasting for mitochondrial health- particularly for people with thyroid issues. 
• Dr. Gupta discusses different medication options for people with Hashimoto’s, including peptides and LDN (low-dose naltrexone).
• Dr. Gupta shares his thoughts on iodine.

Bio:

Dr. Anshul Gupta is a best-selling author, speaker, researcher, and the world expert on Hashimoto’s disease. He educates people worldwide on reversing Hashimoto’s disease.

He is a Board-Certified Family Medicine Physician with advanced certification in Functional Medicine, Peptide therapy, and Fellowship trained in Integrative Medicine.

He worked at the prestigious Cleveland Clinic Department of Functional Medicine alongside Dr. Mark Hyman and helped thousands of patients to reverse their health issues by using the concepts of functional medicine.

His dedication towards his patients was recognized when he was awarded Readers Choice, Best Doctor in Northern Neck Area.

He is now on a mission to help 1 million people reverse their health conditions. To achieve this mission, he has written a best-seller book called Reversing Hashimoto’s. He has also started a virtual functional medicine practice, a blog, and a youtube channel so he can reach people from all over the world. And recently, he also hosted a Reversing Hashimoto’s summit.

Through his innovative approach to Hashimoto’s disease, he has helped several patients reverse their unresolved symptoms and live their life to the fullest.

Connect with Cynthia Thurlow

• Follow on Twitter, Instagram & LinkedIn
• Check out Cynthia’s website

Connect with Dr. Anshul Gupta

On his website

On YouTube and other social media (@AnshulGuptaMD)

Transcript

Cynthia Thurlow: Welcome to Everyday Wellness podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

Today, I had the great fortune of connecting with Dr. Gupta. He’s a bestselling author, speaker, researcher, and the world expert in Hashimoto’s. He educates people worldwide on reversing Hashimoto’s diseases. He is also a board-certified family medicine physician who worked at the prestigious Cleveland Clinic alongside Dr. Mark Hyman. Today we spoke at great length about the root of autoimmunity, his personal story, how Hashimoto’s causes the slow destruction of the thyroid gland, the impact of chronic stress, food, and imbalanced gut microbiome, toxins and infections, labs to look out for, the role of fasting in thyroid disease, and yes, you can fast with thyroid disease, medication options, peptides, and the issues surrounding iodine supplementation. I hope you will enjoy this podcast as much as I did recording it.

Dr. Gupta, it’s so wonderful to connect with you. I’ve really been looking forward to having a conversation about Hashimoto’s, largely because I’ve had quite a few thyroid experts on and this has not been a particular disease process or focus of any of our other podcasts. I’m really excited to have a Hashimoto’s expert on today to unpack what women need to be thinking about when it comes to autoimmunity and the role of Hashimoto’s and it seems to affect quite a few women, especially those of us that are in those perimenopause or menopause years.

Anshul Gupta: Absolutely, Cynthia, thank you so much for having me over here. It’s a pleasure. You are doing an amazing work of sharing all this great knowledge, great experts coming on your show, so I’m really thankful for being over here.

Cynthia Thurlow: Yeah. What got you so passionate about thyroid issues? I believe it was your own kind of personal health journey that probably spurned this desire to focus quite a bit more on this issue that is largely ignored, I think, by traditional allopathic medicine.

Anshul Gupta: Absolutely. Yeah. As anybody who enters this field of functional or integrative medicine, we have our own health struggles which propagate or kind of propel us into this direction. Mine started because I was a regular family physician in a private practice, very busy practice, and suddenly, a couple of years into my practice, I started noticing that I was gaining a lot of weight. I did not change anything into my diet or exercise routine. I was tired during the day to the point that I had to take a nap during my lunch hour just to be functional. By the end of the day, my brain was not functioning. I was just kind of feeling confused, like, forgetting things. I was just 32 at the time. So, that was not normal. And I was having this horrible, horrible stomach pain. I tried to be my own physician, kind of started taking a different kind of medications to help with it. Nothing was working.

I thought, well, I’m not a smart physician. Let me take help from my specialist friends. I went to them, obviously they did all these different kinds of investigations you can think about, blood work, ultrasounds, endoscopies, colonoscopies, everything. Everything was negative. They had no idea what was going on with me. They put me on more medications. That did not help. I was scared. I was scared at the time. I was like, I’m 32, I’m on five medications. I cannot go this way for long. There has to be an answer. So, then I remembered, well, from my residency training, we had this lecture about functional medicine. So, I said, okay, let me explore that option.

I started training into functional medicine. Lot of my answers started coming from there. I made a protocol to kind of reverse these things. Simple changes in my diet, lifestyle, stress management, huge player for me, some supplements. Within one month, my complete pain was gone. Within six months, I was off all medications, I lost 40 pounds, I was able to reverse my fatty liver, I was able to reverse my eczema, I had more energy in my life than I ever had. Even I participated into a 5K Rugged Maniac and I was never an athlete in my life, for me to do that that was a big thing.

So that completely transformed me. I was like, this is huge. I need to share to this other people. Then actually, I started working at the Cleveland Clinic functional medicine department along with Mark Hyman. Suddenly, I’m seeing this big influx of middle-aged women who were having all of these similar symptoms as mine. And one baseline was that they all had Hashimoto’s. I was like, I need to help these women because I know what they’re suffering from. And nobody can help them because obviously, they have been on different kind of medications, they have been to all these different doctors, but nothing was working for them. That’s where I started researching into Hashimoto’s and I’ve kind of figured out that, okay, well, there is something going on. These females are just not complaining for the sake of complaining. There are actually medical reasons behind it, which is causing their body to flare up and causing Hashimoto’s and all of these symptoms are happening. So, that’s where I made up this three-step protocol to help people with Hashimoto’s. Since the time I have helped several thousands of females to help take care of Hashimoto’s and get their life back.

Cynthia Thurlow: Well, I’m so grateful for your journey and so appreciative of the fact that you are kind of spurning things forward. You’ve identified ways to address this autoimmune disorder. But before we dive into that, let’s talk about what autoimmunity is. We know it’s the third most common category of disease in the United States, one out of 10 leading causes of death in women. This is significant and Hashimoto’s thyroiditis is the most common and is the reason why about 90% of women will develop hypothyroidism or an underactive thyroid. And what I find really interesting is that I myself was diagnosed with hypothyroidism about seven years ago, and my very well-regarded functional medicine provider said, your antibodies are normal, you don’t have Hashimoto’s. I’ve come to find out that’s probably very likely not the case. So, let’s talk a little bit about what is this autoimmune issue specific to the thyroid that you are speaking about and that so many women are impacted by.

Anshul Gupta: Absolutely. So, again, you point out a very interesting fact that a lot of women are suffering from thyroid disorders and a majority of them have no idea they actually have Hashimoto’s because most of the physicians are not checking for it right. They’re not getting the right testing done, so they have no idea they’re impacting with an autoimmune condition. And the treatment they are getting is just a hormone which their thyroid is not able to produce, very different scenarios. So, Hashimoto’s is an autoimmune condition. What that means is that your body is producing antibodies which is destroying your own thyroid gland.

Now, over the course of weeks to months to years, this slow destruction ultimately leads to hypothyroidism. And that’s where females get diagnosed with hypothyroidism and they get put on this medicine called levothyroxine. But levothyroxine is not doing anything to tackle this autoimmune process. This destruction continues to happen every day. What happens is that everybody gets started on a very low dose of the medicine and slowly and slowly their doses keep on increasing because the thyroid keeps dying every day. So that’s very important to know that, okay, well, whether you have antibodies or not, whether you have Hashimoto’s or not. And what can you do to actually stop this autoimmune destruction so that you can regenerate your thyroid gland and also feel better?

Cynthia Thurlow: I think it’s really significant because I know when I was an NP in cardiology, we saw a lot of hypothyroidism. I would have patients that would say, I’m not taking generic Synthroid or levothyroxine when I’m in the hospital. They would ask permission to bring their medications from home because it made such a big difference. And I think most of us don’t realize that those increasing doses of medication are really identifying that the thyroid gland is really less optimized than it was when you started medication. And that’s an important distinction.

What are some of the common root causes for Hashimoto’s? Because this is important. We are heading hopefully out of the last two and a half years, an unprecedented pandemic and a lot of extra stress. Imagine additional stress already on top of individuals that are less apt to deal well with stress as they transition from perimenopause into menopause. And I would argue that there’s some degree of adrenal pause that goes along with that. So, let’s start there. Some of the common reasons why women will develop Hashimoto’s at this stage of life.

Anshul Gupta: Absolutely. So, I have basically identified five major root causes which leads to triggering of Hashimoto’s. So, the number one is food. Food is medicine, but food can also cause a lot of diseases, especially the way we are handling food industry currently. We are not being fed real food, so it’s very important to know about it. So, several foods we know that like gluten, dairy, soy, corn, processed food, excess sugar in our diet, all of those things have impact on Hashimoto’s and can definitely trigger Hashimoto’s.

The second one is toxins. Every day, new and new toxins are being poured into our environment, whether those are heavy metals like lead, mercury, aluminum, whether those are environmental toxins like organophosphates or pesticides or mold toxins. Now, mold toxins are a very, very big trigger, and a lot of people are not aware of that they’re exposed to mold. So, second is the toxins, a very, very major cause.

The third is nutritional deficiencies. A lot of people are eating nutritionally rich food or they think so that they’re eating healthy food. But our food itself is low in a lot of vitamins and minerals, especially needed by our thyroid like magnesium, selenium, zinc. Our food is very low into them. And that definitely, again, leads to triggering of Hashimoto’s. Then comes the very important factor of infections. We are obviously going through this pandemic almost hopefully at the end of it but several infections, especially viral infections have been associated with Hashimoto’s. The most common being Epstein-Barr virus infection. But other infections, like parasites in the gut, like Blastocystis, Candida, all of those things can also lead to Hashimoto’s. Then there comes the chronic Lyme disease and chronic parasites which can cause them.

Then the last comes the stress. And you said you know like stress is the last but this is probably one of the number one reasons of triggering Hashimoto’s. Several females if they go back to when they were finally diagnosed with Hashimoto’s, they will always remember that a stressful event happened in their life. Whether it was a personal relationship or it was work related, or even post-delivery. Post-delivery a lot of hormonal shifts are happening, female’s body goes to a lot of stressful moments and they do get diagnosed Hashimoto’s.

The second stressful is when they hit menopause, again, a lot of shift is happening in their body, lot of stress is happening. So, that will trigger Hashimoto’s. Any kind of stress, whether it is emotional, whether it is mental, whether it is physical, any kind of stress on the body definitely will lead to triggering Hashimoto’s. So, these are the five main root causes, big categories which are there, which definitely causes Hashimoto’s.

Cynthia Thurlow: Yeah, that’s a really great place to start the conversation. So, when I have investigated the role of nutrition so let’s start there. The role of food choices and the net impact on thyroid function. The term molecular mimicry seems to come up with some frequency. And so, it’s usually my go-to explanation for why things like gluten and dairy in particular can make it so much harder for the thyroid gland to work properly. Can we touch on this because I think it’s a term that most people are not familiarized with, but one that can help reinforce why those good nutritional choices can make a big impact on how or whether or not your thyroid is properly optimized.

Anshul Gupta: Absolutely. So, like how we discussed that, you know Hashimoto’s is an autoimmune condition where your body is making antibodies against something, let’s say. In this situation, gluten and dairy, because they have been processed so much because they have been completely differently changed from the original form, the body basically recognizes them as something foreign. And whenever you ingest something foreign, your body starts producing antibodies. Now, what happens is that body is trying to produce antibodies against this gluten and dairy, but their molecular structure we know which body recognizes is very similar to thyroid gland.

So, when they are actually producing these antibodies, these antibodies are basically kind of blind missiles which have been launched and they are going to destroy certain genetic sequence. Now, they cannot differentiate between gluten and thyroid gland. So, unfortunately, over the course of time, they start destroying your thyroid gland. So, this molecular mimicry, unfortunately, leads to the destruction of the thyroid gland, while in reality they are trying to target gluten and dairy. So that’s the reason gluten and dairy when you ingest it slowly and slowly, they start building up these antibodies and they start destroying a thyroid gland and that ultimately leads to Hashimoto’s.

Cynthia Thurlow: It’s really interesting because one of the kind of proposed explanations for why my antibodies have never been positive is that I have been gluten-free for over 11 years. And that very likely, maybe, and I’m also dairy free. But it was something that I try to– when women are struggling with these elimination diets when they’re really not 100% in, they don’t really want to remove the gluten, they don’t want to remove the dairy in particular. I just remind them that we have to kind of have these reframes about if we’re really looking to heal our thyroid or get to a degree of thyroid optimization, sometimes we have to subtract in order to improve. And so, that reframe can be really interesting.

I also think that when we reflect on the processed food industry and we talk about processed sugars in particular, and I think the latest statistic I read was that the average American eats 160 pounds of sugar a year and 200 pounds of white flour per year, which was astounding. Is it any surprise, especially with the last two and a half years, that if we’re consuming more processed carbohydrates, more sugar, that leads to more stress in the body, that leads to higher glucose, higher cortisol, higher insulin, can lead to gut microbiome changes, which I know we’ll talk more about, which exacerbates that inflammation, the poor nutrient absorption, all the things that you were kind of alluding to. So, really helping people understand that a lot of the food choices we make can either improve our health or can make it harder for us to optimize our health and I think, unfortunately, in the traditional allopathic model, we don’t talk enough about the role of nutrition. I’m grateful for people like yourself that are talking to patients about the role of lifestyle and how critically important that is.

Anshul Gupta: Absolutely, this is such a missing piece because all of my patients, they have already asked their physicians, what can I do? What food should I be eating? Or is there any impact on any food choices? And the answer, they will say, just eat whatever you like. I was like, there is no way that the poor food choices are not the reason that you are having Hashimoto’s. People are asking the right questions, but they’re not getting the right information. So, that’s very important that we follow like a proper nutrition plan and focus on the foods which are healing for thyroid and removing foods which are actually destroying our thyroid glands, very important to know that aspect. And you pointed out very correctly that a lot of people might have given up gluten or dairy and their antibodies are negative.

So, we have this antibody-negative Hashimoto’s, which a lot of people will have. And obviously, the blood test results will not show it and they will believe that they don’t have Hashimoto’s, but obviously, their body is producing this inflammation which is destroying the thyroid gland. And we know that the number one reason of hypothyroidism is Hashimoto’s. So, definitely majority of the females have Hashimoto’s ongoing, which is resulting in hypothyroidism.

Cynthia Thurlow: Yeah, it’s really interesting. And then when we tie in the piece about toxins and I actually did a webinar talking about this, just talking about personal care products and the toxins that are in those. But I found it very interesting that mercury, in particular, is highly thyroid toxic and are most people that are impacted adversely and I’m sure you’re probably doing heavy metal screening amongst other things. Are most people getting exposure from mercury related to having mercury amalgams or their mother having mercury amalgams? And I say this a little bit selfishly because I’m curious to ask you this.

I’ve never had a mercury filling, but my mom had many. It wasn’t until I had my thyroid diagnosis that my functional medicine provider said, let’s do a heavy metal panel. And my mercury levels were off the charts to the point where she thought I actually needed to have chelation therapy, which is a whole separate tangential conversation. But I thought for the purposes of our discussion, the heavy metals that you’re testing your patients for, are you seeing a lot of mercury in your patients and are they getting it exogenously from potentially foods they’re eating or is there fetal transmission or from their own mercury amalgams?

Anshul Gupta: Yes, so heavy metals are a big issue because unfortunately, thyroid is like a sponge. As soon as any heavy metal gets ingested in your body, it directly goes to the thyroid, because they have a very strong affinity towards the thyroid. So, slowly over the course of time, the amount of these heavy metals increases in your thyroid and obviously one day the threshold is gone and that leads to Hashimoto’s. Now definitely we are seeing very heavy levels of mercury, high levels of lead in a lot of thyroid patients. Toxins are a very major issue. Sometimes people who do not want to check, I always tell them, I know that you do not have a history, but trust me, there has to be a toxin which is causing this Hashimoto’s or your thyroid problem.

And the problem is that our research with these heavy metals is still very rudimentary because all this research follows the toxicology protocol where, okay, well, if a particular dose is lethal for your body, then only it is considered that it can destroy your body. If it is anything lower than that, they will not even consider doing further testing for it.

So, that’s the reason that we do not know where all this mercury is coming from. We definitely know it comes from amalgams. We definitely know it can come from our environment, especially eating fish, which is high in mercury. We definitely know it is being added to a lot of spraying, which is happening around our environment, organicides, all these pesticides. As you mentioned, a lot of skincare products are adding mercury without even mentioning it on their labels.

And this interesting piece of fetal transmission from maternal transmission to fetus. We do see that happening also because women which are high in mercury and become pregnant, we see that they excrete these toxins not only through placenta, but unfortunately, through breast milk also because all of these things are basically kind of getting out of your body. And whenever everything leaves out of your body, sometimes they can have toxins. By no means I am saying any woman that they should not be doing breastfeeding, so please don’t take it in that way, but I’m just mentioning that these all things are present.

So, it is very important for women to even realize that if they are getting pregnant, to take care of their body because it is not only for themselves, it is also for their baby or for their children that they’re doing a service. Unfortunately, these toxins are being hidden all of these places. Sometimes to find a perfect source is very difficult because sometimes they can be multiple sources, not just one. Again, very important issue is that fish oil supplements. A lot of people hear a lot of webinars or a lot of places and they will start taking fish oil supplements. But those supplements itself can be contaminated with mercury. So, it’s very important to kind of get a good supplement from a good source, which they do check themselves for mercury. It’s a very important thing. So, as you said, these things are hidden in so many different places. You have to be real detective to know where they’re coming from.

Cynthia Thurlow: No, it’s such a good point and it’s interesting. Years ago, I used to recommend fish oil a lot. And then as I started learning about the degree of rancidity and contaminants, it really gave me pause about recommending it. And now I’ve actually started recommending just having a certain amount of fatty fish a week, wild-caught fish. It really begs to understand that starting with nutrients, starting from the food first and then adding in supplements only if they’re really necessary.

Now, I do want to just briefly touch on mycotoxins and mold. We know that 25% of the population is more susceptible to mycotoxins. I happen to be part of that 25%, which is why I wanted to make sure I interject that. You could have a whole community of people all exposed to the same mycotoxins. And the 25% of us that are the canary in the coal mines, we are going to react much more significantly.

Do you find that when individuals are removed from where the mycotoxin exposure is, whether it’s their office or their personal home? I know much more of an issue if you have mold exposure at home because it can impact whether or not you can take your belongings with you. And that’s a whole very challenging situation to be in. But do you find for those that are more thyroid and mold susceptible that removing them from whatever environment they’re in, that they’re getting the exposure can be helpful in and of itself?

Anshul Gupta: Well, definitely. So, again, it depends on person to person. Some people have been exposed and as you said, they are very, very susceptible. Unfortunately, the problem is that we only have one detox system. All of these toxins are going to that same funnel. So, if a person has high mercury, has high mold toxins plus has a lot of environmental toxins like organophosphates, then those people are very very sensitive. So, a small amount of mold in their system can trigger a big reaction.

Unfortunately, mold and mycotoxins lead to something what we call as CIRS, which is C-I-R-S chronic inflammatory response syndrome. So, the mold toxins create more inflammation. Your body already has inflammation with Hashimoto’s creates more inflammation, which starts destroying your mitochondria. And that again is a very, very important reason of with mold patients having brain fog or feeling tired or having chronic pain because the mitochondria is not functioning.

So, for these females, yes, removing from the environment is necessary and important, but unfortunately, just removing from the environment alone is not enough because that damage which mold has done in the body also has to be remediated. And that’s what a lot of people, when they’re reading on Internet, they said, “Oh, I’ve been exposed to mold, let me take these couple of supplements to detoxify my body.” But they don’t feel better. The reason is that they’re not doing anything to remediate the damage which mold toxins have already done in their body, especially mitochondria. The mitochondria has to be fixed and other inflammatory markers needs to come down. Then only people will start feeling better.

Cynthia Thurlow: I think that’s such an important point. I did a really great podcast earlier this year with Dr. Aaron Hartman, who’s a CIRS and mycotoxins expert. So, we’ll make sure we link that in the show notes for people to listen to that, there’s a lot to learn and I agree with you that it cannot just be taking, like peeling back one layer of the onion. It is multiple layers. We will talk about detoxification because I’m sure people are wondering, like, what are we going to talk about surrounding that? But that is very important.

But let’s talk about Epstein-Barr and latent viruses and parasitic infections that can provoke exacerbate Hashimoto’s. I always say, what came first, the chicken or the egg? I have had so many female patients that did really well for many years with latent Epstein–Barr, and they know when it gets reactivated, they’re exhausted, they can’t even leave their homes to go to work, and so how does the Epstein-Barr virus, how does that interact with the thyroid to make us more susceptible to Hashimoto’s? 

Anshul Gupta: Epstein-Barr virus are a majority of the viruses, once we get them, it’s very important, this concept for people to understand that they basically live in our body. We unfortunately cannot eliminate them. A lot of people have thought, okay, well, if I take this antiviral or if I take this particular supplement, that I will be able to completely eliminate Epstein-Barr. It is not a possibility. It is going to stay in our body. But what research has shown is that the Epstein-Barr virus can get reactivated in your body.

Now, the classical test, if you go to your doctor about getting that Monospot test that will be negative because it is looking for an acute Epstein-Barr infection or infectious mononucleosis, it is not looking for reactivation. So special testing needs to be done to know whether your Epstein-Barr is reactivated. Now, whenever the Epstein-Barr is reactivated, what it does is it starts changing your immunity in the background. We have this immune process, which is the Th1 and the Th2 response. One is anti-inflammatory and one is inflammatory. So, Epstein-Barr basically changes this response in the background and it starts making your own body attack these different parts of your body, which in Hashimoto’s is a thyroid gland.

So that’s the reason when the Epstein-Barr gets reactivated, body starts attacking your thyroid gland and obviously, they have more symptoms at the time, but then eventually, hopefully in some people, the immunity takes over and then they can keep the Epstein-Barr at bay. But for some people that never happens because their immunity is so poor that they cannot keep that Epstein-Barr at bay. So, they keep on having these symptoms again and again. And unfortunately, sometimes we can have multiple viruses or multiple parasites or other infections which are hijacking our immune system. So, for those people, unfortunately, there is no way to kind of keeping this bay at the time.

Cynthia Thurlow: And really to think about it as a long game, meaning it’s not going to be fixed overnight. It is going to take months and months, and months of not just careful attention with a functional or integrative medicine provider, but also supplements, lifestyle and really understanding, especially for a lot of the women listening to this podcast, are high charging type A, sympathetic dominant women and it’s very, very hard to convince someone like that they have to slow down in order to support their immune function so that they will be able to heal. As you stated, Epstein-Barr just lies dormant or it gets reactivated. It’s not as if you get rid of it. It will stay with you forever, but we want it to be in a dormant state and not to be in an acute phase reaction.

Anshul Gupta: Absolutely. And that’s very important that as you mentioned, women these days, unfortunately, the society we live in, women have to wear all these different hats, they have to be a wife, they have to be a mother, they have to take care of their parents, sometimes in-laws, and they have to go and work so many different hats. So, I feel a lot of women even at very early ages are becoming the type A personality they have– Everything should be perfect. I’m that person who is going to take care of everybody.

But what is actually happening is that they are putting all this stress on their body. They are not taking a pause, right. This pause is very important for your body to function. We all know that whenever our body is stressed out, our body’s immunity go low for several reasons. There are hormonal changes again, everything changes in your body when you get exposed to stress, especially chronic stress over the course of long-term basis decreases your immunity and then when your immunity goes low, all of these infections can get triggered or reactivated and obviously you’re going to feel worse.

So, very important for each and every person, especially high-performing women, to take a pause, cultivate these habits. Just few minutes of meditation, just few minutes of relaxation or deep breathing, those are more than enough to take a break and can reset that whole stress response. But until that is done, if you’re that person, I just want to keep going, go, go, go, your body’s immunity is going to get compromised sometime or the other.

Cynthia Thurlow: Yeah, I think it’s a really important conversation because I’m just as guilty as the next person. But I know I’ve had to work very diligently over the last several years to integrate things into my personal life that I do prior to coming into my entrepreneurial life in order to keep that balance between the autonomic nervous system, the parasympathetic and the sympathetic because think about it, if you’ve had a very demanding, I mean, for me, I was ER med cardiology, ICU. I love the sicker patients. I’m a bit of an adrenaline junkie. I’ve had to really rework my mindset around that.

And I know many women, irrespective of what environment they’re working in at the home or in an office setting or hospital setting, we’re all actively working on those things. And it’s interesting, I was looking at a study and it mentioned that 75% of Americans have moderate to severe stress, so that’s nearly everyone. And add in the pandemic and it’s probably higher. And that 25% admitted to severe stress. I would imagine that’s probably worse now. What’s interesting is that 43% of those that experienced that degree of stress, they had adverse health effects. So, again, I think it’s underreported. I think there are more people experiencing these things, but they perhaps either are not making the connections or there’s a degree of cognitive dissonance. They don’t want to believe that their lifestyle is mediating a lot of what’s going on with their health.

Anshul Gupta: And that’s the corporate language that we are using because if you feel that you are stressed out, that means you are weak. That’s the message each and every corporate does. Oh, stress is good for you. Just keep pushing more and more, you know more means you are actually a strong person. You are a high performer person. So, that’s a language that we are learning. But in reality, we know that that is not true. You being stressed out doesn’t mean that you are weak. You’re just recognizing what your body is telling you. I always tell my clients is that your body has been giving you these red signs or signals for a long time. We just keep ignoring them. Like feeling stressed out, feeling brain foggy, feeling tired here and there, feeling those mood changes.

Those are all red signs. That okay, something is going inside your body. You need to look right. And that can be very relatable to stress. That’s okay, well, if you’re feeling stressed out, if you’re having these symptoms, stress is playing a role. So, please look under the hood. Look at your priorities, set your priorities. And again, whenever we talk about stress management, people think, oh, I don’t have an hour to dedicate to that. I always tell them you don’t have to give an hour. Do you have 10 minutes? In 24 hours, do you have 10 minutes to your life? And they said, well, that is doable. Just 10 minutes or 15 minutes is what your body needs. If you do that, then phenomenal results happen.

Cynthia Thurlow: Yeah, I think that reframe is so important, and what I think is particularly helpful in the context of this conversation is to talk about what specifically happens to our thyroid. As an example, in relation to a lot of chronic stress as we know it depletes those cofactors. You mentioned magnesium, selenium, iodine, iron, zinc, all of which are very important for making healthy thyroid hormone. And we know it impacts the ability for our body to take inactive form of thyroid hormone called T4 and create T3, which is the active form of thyroid hormone.

And we know it also contributes to making the interaction between cortisol, which is that stress hormone, which isn’t all bad. It makes our cells less resilient or makes our cells not communicate properly with thyroid hormone, it’s almost like the thyroid is kind of knocking or the thyroid hormone is knocking on the cell wall and the cell is like, sorry, I can’t hear you. I’m having a party with cortisol. So, I think it’s important to kind of make those connections so that people understand when we talk about managing your stress, it’s to really optimize hormone communication in the body and that’s really what it all comes down to.

Anshul Gupta: Absolutely. Again, I tell people is that whenever I’m talking about stress, I’m not saying that you are creating stress and it is your responsibility to kind of, “Okay, well, my stress is causing my thyroid issue.” No, that’s not the situation. The problem is that the stress is actually doing physical changes to your body. Very important to understand. So, like, as you mentioned, stress causes high cortisol level. High cortisol level doesn’t let your thyroid to function. It doesn’t matter how much medicine you’re taking, if that medicine is not working, your body is not going to be optimized with it.

High stress causes your hormonal shifts, which lot of female hormones, estrogen-progesterone changes. We see estrogen dominance, which is happening again because of all that stress hormone, which is doing it to you. As you said, whenever you are stressed out, your body’s digestive system shuts down. You’re not digesting that food properly. If you’re not digesting it, you’re not absorbing it. So, even though you’re eating the healthiest diet, you’re not digesting or you’re not absorbing those nutrients needed by your thyroid gland.

So, at multiple levels stress is causing so many changes in your body. So, these are physical changes. It’s not just mental or emotional aspect of the stress, it is actually the physical changes that are happening to your body, which are leading to this Hashimoto’s.

Cynthia Thurlow: Now, and you mentioned earlier the role of detoxification and how sometimes your patients are like, just give me a couple of supplements, I’m going to support detoxification in the body and that’s going to fix everything. But from the context of Hashimoto’s or from the context of thyroid issues in terms of detoxification. Let’s kind of from broad concepts talk about where that predominantly occurs in the body and the things that you start thinking about requiring additional support prior to even getting to the point where we’re doing lots of testing and we’re starting supplements and we’re talking about peptides and medications, etc.

Anshul Gupta: Absolutely. So, there are different kinds of toxins, but all these toxins go through some of the detoxification system. The master detoxifier of our body is liver. That’s where a majority of your detoxification is happening. All the toxins have to go through the liver and then liver has to work hard to remove those toxins. We have other minor places where the toxins are being eliminated. The other one is gut. Each and every bowel movement that is happening, especially the bile that you are producing, is what we call as a detergent, which binds to the toxins and help them eliminate through your bowel movements.

Lot of people with Hashimoto’s do have constipation, so they are not removing those toxins. Very important is optimizing the gut. The third place is kidneys. Kidneys are an important role in detoxification, but they need water. A lot of people are not drinking enough water. So, that’s again that place. And the last place is the lymphatic channels. The lymphatic channels are most underappreciated systems in our body, which almost everybody has forgotten. But the lymphatic channels play an important role in detoxification.

The last one you forgot is actually sweating. Skin is a very important organ that helps with detoxification. Sweating can be very, very important that can help with detoxification. Before we even jump to any supplements or things, I always say why don’t we use the natural ways of detoxification, which generally doesn’t have any side effects or anybody can use them. So, saunas are wonderful for that because they help your body to release those toxins, especially infrared saunas, which have deeper penetration in your body. Very, very helpful for removing all these different kinds of toxins. There have been research studies done that whenever people are sweating, we do see that their bodies do eliminate toxins through that method. So, very easy that anybody can use that.

The second, as I said, through kidneys. Make sure you’re drinking lots and lots of water. Other drinks, coffees, teas, and things do not count. So, make sure you are drinking a lot of water to especially flushing those toxins from your kidneys. The third thing is making sure that you are having regular bowel movements. For some people that means that, okay, well, if I’m having bowel movements every two or three days that is regular because that has been my regular since childhood. But that is not regular. Everybody should have at least one bowel movement every day. Two is ideal, but at least one bowel movement so that you can remove these toxins. So, if you’re having issues with constipation, drinking a lot of water, changing your diet, eating all those vegetables, introducing fiber, all of those can be easy fix to have regular bowel movements.

Anshul Gupta: And then comes the liver. If you eat a healthy diet, liver can function very well. In that aspect, low carbohydrate diet is great because all that excess sugar goes to your liver. Sugar is another toxin which liver has to process. So, you need to eliminate that. Colorful diet, each and every color has special antioxidants which supports the liver. Natural things you can eat, like turmeric has wonderful detox potential, supports your liver for doing it.

All these cruciferous vegetables have sulforaphanes, which supports your liver to do it. Deep color full vegetables like beets, like your blueberries, all of those things are wonderful to support your liver. So, these are like natural things which you can do each and every day. It doesn’t have much side effects, which will help to optimize these detox channels for you.

Cynthia Thurlow: I think that’s really helpful. I mean, one thing that I started taking seriously this year, although I hadn’t before, was dry brushing. In terms of getting circulation going, I do it before I get in the shower. I also think about kind of a graduated approach, because if I bring up coffee enemas and I got lots of questions about that, I always think of that as a more advanced strategy. Some people are not particularly interested in going down that route. But I will share with the community that when I had such high mercury levels and I was being threatened with doing chelation.

I had read that actually doing coffee enemas can be very beneficial for upregulating glutathione and detoxification in the body. And I did them for six months and my mercury levels came back to normal. My functional medicine provider was kind of humored about that. And since then, I don’t do them ever very often. But the point I’m trying to share is I got a lot of questions about coffee enemas, dry brushing, all those things that are supporting detoxification, lymphatic drainage, etc. Are you a fan of coffee enemas?

Anshul Gupta: Well, anything which is like [Cynthia laughs] more vigorous for me is like, okay, comes the last. Coffee enemas are great, obviously they work, everybody knows that. But if we can achieve other things by doing it, why to kind of have anybody go through that process because if I don’t enjoy something, then most likely other people also don’t enjoy doing those, right. But yes, coffee enemas work great, obviously they optimize your glutathione levels, they optimize your liver functioning, they also stimulate your gallbladder to produce more bile acids. When more bile acids are there, more toxins are removed. All of those great things which are done with coffee enemas.

But if we can do other things by kind of making sure that your gut is in good shape, your liver is all supported, your gallbladder is good supported, we can actually give bile acids through supplement forms. We can kind of mimic very similar things which coffee enemas do. Sometimes after doing it for several months if that doesn’t work, then we go to the next step of recommending coffee enemas or doing IV chelation or IV drips with glutathione. But I will say in my whole career, probably a handful of patients are one, which I have to go to that step two approach. Most of the time with supplements and diet and other lifestyle changes, we are able to achieve most of the detox.

Cynthia Thurlow: And I think that’s a beautiful thing. I think it’s very reassuring to know that these more kind of stepwise approach isn’t always necessary in terms of supporting detoxification. We can really lean into things that are fairly easy to have access to integrate into our lifestyles. Now, I got a ton of questions about lab work. Some of this is specific to thyroid labs, but I thought it would be helpful when you’re sitting down with a new patient who has Hashimoto’s, what is some of the lab testing that is part of that? In terms of thyroid testing, do you like your patients to do it in a fasted state prior to taking their medication? Do you have any specifications around a woman’s menstrual cycle?

Anshul Gupta: So, first of all, let’s talk about the testing, because that’s very confusing for a lot of people. A lot of people actually do not even know that there are blood tests available to check for Hashimoto’s. Interesting piece is that this morning itself, I was having this conversation with my wife and she knows that I’m a Hashimoto’s expert and we’re having a discussion like this relative of ours has this thyroid issue, and she said, “How will she know that she Hashimoto’s? Isn’t just based on symptoms?” I was like, “No. There are actually blood tests available to check for Hashimoto’s.” And she was like, “Really? There are blood tests available to check for Hashimoto’s? And I had no idea about.” I was like, “Really? Don’t even know, did you not know?”

[laughter]

So, yes. So, very important thing to know if you don’t know your Hashimoto’s, there are blood tests available. So, first category of test to actually check your thyroid hormone levels, most commonly the only test which is ordered is TSH, which is not giving us a complete picture. Yes, TSH is needed, but you need other thyroid hormones to be checked. Free T4, free T3 and reverse T3. So, those are the thyroid panels that you need to check so that you can know how your thyroid is functioning, how much your thyroid is functioning, and is your thyroid converting from T4 to T3 because T3 is an actual active hormone that your body needs.

Then comes Hashimoto’s testing, which is the antibodies. As we discuss, Hashimoto’s is an autoimmune process, so your body is producing antibodies. Now, we have easy blood tests. Each and every lab around you can do these testing. So, the two thyroid antibody tests, one is what we call as TPO antibodies, which is the thyroid peroxidase antibodies. The second one is thyroglobulin antibodies. Both of these antibodies need to be checked. If any of these antibodies are higher than the limit which your lab checks it, then you do have Hashimoto’s.

You don’t need an ultrasound, you don’t need any biopsies or anything to prove that you have Hashimoto’s. These thyroid antibodies are diagnostic enough for it. So, these are the basic tests that each and every person should get. It. The other problem what happens is that persons do get diagnosed with Hashimoto’s with antibodies, but their doctors do not follow those antibodies because obviously for them, well, these antibodies are going to keep increasing. Once they finally destroy your thyroid gland, they are going to come down. So why to you check them?

But for us in our clinic, we want to make sure that we are checking these antibodies because these antibodies do come down with our protocols. So, very important to know where your antibodies are, especially once you’re not feeling good or once you’re feeling good, so what is working and what is not working for your body. So, these are the basic tests. Then I also like to order tests to check for inflammation in people’s body. The most common test is hsCRP and ESR test. Out of those, hsCRP is a wonderful test, highly sensitive CRP, which tells us how much inflammation is present in your body because as I said, it is an autoimmune process. Your inflammation levels could be high and you are not even aware of it.

So, very important thing that each and every person should be checked about it. Then we also want to check like homocysteine levels as well as the B vitamin levels. Now, a lot of people go to their doctors, they check their vitamin B12 levels, which is always normal. If you’re taking a supplement, it is always going to be higher side, everybody gets scared. “Oh, my B12 levels is very high. My doctor said don’t take the supplement.” I said did you check your homocysteine or your MMA level? and they said no.

Homocysteine levels are actually going to tell you whether you have a methylation problem or not, whether you are utilizing those B vitamins or not. Easy tests that all of the labs do it. So, you can easily know whether you have this problem or not because otherwise you have to get a methylation panel separately from a functional lab or you have to get MTHFR testing, while homocysteine can directly tell you how much inflammation is present over there. Then after that making sure that you’re getting your liver checked, getting your hemoglobin A1c checked, and also fasting insulin level checked. Again, fasting insulin is a very, very important reason for inflammation in a lot of Hashimoto’s patients because all of us have high insulin levels.

Chronic high insulin levels will lead to inflammation, which leads to Hashimoto’s. Now, your A1c will take a long time to change and for a lot of people they are sitting in that prediabetic range, but they are not getting their insulin level checked. So, if you check your insulin levels, they are high side that is telling you that you need to do something about it and that is indirect marker of inflammation in your body that you need to work at.

So, these are the basic tests I think, which each and every person can get from their regular doctors. All of the labs do it. Before they jump into more advanced functional medicine tests, check their omega levels, to check their vitamin levels, to check their gut, to check the toxin levels. All of those things definitely comes after you have done these basic testing.

Cynthia Thurlow: I think that’s really helpful and that was one of the most common questions I received. People wanting to know what is reasonable to have a regular allopathic doctor or nurse practitioner check. Now, I think it’s helpful to know for you personally in your clinical practice, do you like your patients to do their thyroid function labs fasted? Do you like them to take their medication before they have their labs drawn or do you recommend, they hold their medication until after their labs are drawn?

Anshul Gupta: So, I want it fasted. I don’t want them to be fasting for 24 or 48 hours, but overnight fasting is what I need because I want to know what their actual functioning is. I generally don’t like to have them take the medicine because a lot of times, some of these thyroid labs can be altered based on that. Now, if somebody is on a higher dose of the medicine, then they have to take the medicine because, unfortunately, then it will show that you need even a higher dosage. For me, whether to take the medicine or not depends on person to person. Fasting, for sure, everybody should get a fasted panel, but whether to do it with medicine or without medicine, I think I recommend it based on person to person on that.

Cynthia Thurlow: And that makes sense. Do you have any differentiators about where a woman is in her menstrual cycle? That question came up three or four times in one of my groups and I was like yes, I will ask, but I’m curious if you have any differentiators depending on whether they’re follicular phase or luteal phase. Are you at all concerned about optimizing when to have that lab drawn?

Anshul Gupta: Not really. Actually, when you are in your menstrual cycle, your thyroid levels should not be affected so much. We are more so concerned about your estrogen and progesterone levels where you check them in your menstrual cycle, but not so much for the thyroid levels. They should be fairly consistent, like over the course of the whole menstrual cycle.

Cynthia Thurlow: That’s what I had read. But I thought to myself, certainly having a thyroid expert on, I would ask that. Now we touched on mitochondria and one of the more common questions that comes up is “I have a thyroid problem, can I fast?” I know we talked about this when I was part of your documentary and so I think it’s important to kind of reiterate the fact that fasting if used properly can be very beneficial for mitochondrial health and especially for those of us that have thyroid issues.

Anshul Gupta: Absolutely, yes. Again, fasting is such a boon that has to be a part of everybody’s healing journey, especially for autoimmune conditions, because we know that majority of the autoimmune conditions do get started in mitochondria. New research is very promising saying that the first organelle or organ to get destroyed in an autoimmune condition is the mitochondria. And fasting definitely helps to regenerate the mitochondria. Now, as we discussed before when you came to our docuseries is that there are some caveats, especially for thyroid patients that they have to be careful about.

So intermittent fasting is wonderful. What we are concerned about is longer fasts. If you’re doing multiple-day fasts, those are the ones which are not so great for the thyroid patients because whenever you fast, that does kind of sends a signal to the body to suppress your thyroid hormone, kind of as a defense mechanism so that you don’t starve to death. So, longer fast impacts the thyroid negatively, especially if you are on medications because that can basically kind of fluctuate your thyroid levels. Now, once you start eating, those thyroid levels normalize. But for those days of longer fast, you might not feel the best.

But intermittent fasting is wonderful. Especially if you’re doing between 14 to 16 hours, you still get the benefit of intermittent fasting. Perfectly safe for the thyroid patients. Again, very, very grateful for your mitochondrial regeneration, helps with a lot of your symptoms, especially your energy levels will better, your brain, your mood, and you’ll lose weight, all of those things which are associated with Hashimoto’s, intermittent fasting can provide you that. Just don’t go on the longer fast. That’s what I feel is detrimental.

Cynthia Thurlow: Yeah, it’s finding that happy medium with hormesis or hormetic stress, the right amount of stress in the right amount at the right time. Now, let’s talk about medication options. Let’s talk about peptides because I know this is an area of expertise of yours and one thing, I want to make sure we touch on is LDN because this is something that having trained in inner-city Baltimore, LDN is used in different ways. But now we’re using very, very small doses for many people that have Hashimoto’s to their benefit.

Anshul Gupta: Absolutely. So, let’s start with the medications first. So, in medications, the most common medication everybody gets prescribed is levothyroxine, which is technically T4. Okay? Now, as we discussed, we will just quickly go through how these hormones are produced so people have an idea. So, the master gland in your brain is what we call as a pituitary gland, which produces this hormone called TSH. This TSH is basically a signaling hormone which goes to your thyroid gland to start producing the thyroid hormone, which is produced in the T4 form. This T4 form actually goes into your body parts and then in the cells it has to be converted into T3, which is the actual active hormone. Now, whenever you’re getting levothyroxine, you are just getting plain T4 hormone. Now, this T4 hormone still needs to be converted to T3.

What we are seeing is that in some people this conversion doesn’t happen. So, even though people are taking the right dosage according to them, the blood work shows that they’re taking the right dosage, but people do not feel better. So, very important to kind of understand that concept. Sometimes a generic form of levothyroxine doesn’t work for people because sometimes you feel that they have fillers. Those fillers especially for people with Hashimoto’s, they are very sensitive to it. So, some people if they’re feeling worse on levothyroxine, that might be the reason. In that aspect sometimes changing, going to the branded Armour Thyroid might be an option for them.

The second option is taking the combination of T4 and T3. The two combinations available in the United States are Armour and NP-Thyroid. Both are natural version of things. They have main T4, but they have some T3 mixed into it. So, you get best of the both worlds, so that’s an option. Sometimes people are already on levothyroxine, they can add external T3, which is like the liothyronine, which some people can put you on. And that gives you some kind of leverage in terms of if you need too high of T3, then you can use that combination of going on both T4 and T3 medicine.

So, they said there are synthetic medications, which is levothyroxine, Synthroid. Then there are natural versions, Armour and NP-Thyroid. But then on top of that, then there is natural desiccated thyroid too. I use that in a lot of my clients because we again see a lot of good benefits with T4 and T3. But this only works for people who are on a low dosage of thyroid medicine. If you are going at 75, 100 or 125, then I feel the natural desiccated thyroid glands do not do justice in giving you the adequate amount. But if you’re just starting off or you’re in lower doses, that can be an option. So, this is a big category of medications which are available to people. Depending on what your insurance is and what your provider can provide to you, you can adjust and get these medicines.

Now the next stop is LDN, low-dose naltrexone. As you said, naltrexone was initially used for issues with opioids and other things. Now we realize that low-dose naltrexone, very small dosage of that naltrexone actually has a lot of beneficial things. Research studies prove that especially with autoimmune disease patients, it can the reduce autoimmunity and can help people reduce their antibodies. No side effects to the medicine so that’s a good thing about the low-dose naltrexone. We are literally not seeing any issues with it. Research studies are promising, so it can be a beneficial thing to add to a lot of clients.

I was using it a lot initially when it came out probably like 10 years or five years ago. I’ve not seen same dramatic improvement in the numbers. That’s the reason a lot of people use it, but then they stop using it because they’re not seeing great benefits. But for me, if you get a provider who can prescribe it, if you do see a benefit with it, this is one more modality that can definitely be tried because for me, if it is safe, why not give it a try? And it is absolutely safe to try LDN.

Then comes the peptides. So, let’s talk about what are peptides. So, peptides are basically natural compounds which are made by your body. Those are a collection of amino acids. Now, proteins are also a collection of amino acids that everybody would have heard, but proteins are long-chain amino acids, while peptides are small-chain amino acids with only a few amino acids. The most common peptide everybody knows about is insulin. Decades ago, when diabetes came in, like pharmaceutical industry identified insulin, they made as a medicine and we are using it.

Now, since the time through research, we have identified several other peptides that actually play an important role in our body. Several of those now can be produced in a lab to kind of help you out in the disease process. So, at least 40 plus peptides that we use for different diseases, most commonly for autoimmune conditions like Hashimoto’s. The two favorite peptides that I use, one is called thymosin alpha 1, which is called Ta1. Thymosin alpha 1 is naturally produced by a thymus gland. Now, thymus gland is actually our gland, which when we are growing up plays an important role in training our immune system to fight off infections or also to keep inflammation down in our body. As we age, the thymus glands actually deteriorate. It is not there. So, your Ta1 levels goes down.

What research has seen is that Ta1 has amazing benefits for autoimmune conditions. It reduces inflammation. It helps your body to produce those chemical mediators like specific cytokines, which fight off the inflammation. It rebalances your immunity. The Th1 and the Th2 response that is imbalanced in Hashimoto’s, it helps it to rebalance it. It actually improves your immunity to fight off infections. People do not know that actually Ta1 is a medicine which is approved in US to be used for treatment of some of the chronic hepatitis infections as well as in some specific melanomas.

So, Ta1 is one of those magical things which I think a lot of Hashimoto’s patients can use. There was a research study done in mice where Ta1 was injected and after a couple of weeks, when they checked their antibody levels, the antibody levels were lower than what they originally started off with. And we do not know any side effects to it. So, one of those safer options that people can use.

The second is what we call is BPC-157. Now, BPC is a natural compound made by our stomach linings, basically safeguards our stomachs. Now, the BPC, a lot of research is with healing. It helps with muscle injuries, ligamentous injuries, but what we also know is that BPC helps with stomach healing as well as gut lining. A lot of people with Hashimoto’s there is a concept called leaky gut, which is an important concept that leads to Hashimoto’s. And BPC can be very, very beneficial with fighting off this leaky gut and can be one of those modalities which can be added to replenish your leaky gut and help it to heal it.

It’s very important supplement, especially if you have SIBO, if you have candida issues, lot of inflammation in the gut, BPC can take care of all of those things. And, no side effects of BPC that we know of. People can easily take it because, again, natural compound made by our body, so it doesn’t even hurt it. So, these are the top two peptides that we use in our practice because they don’t have any side effects and see phenomenal results that we use, then obviously we have other peptides based on the situation that can be added on top of it.

Cynthia Thurlow: What is the typical route of administration for BPC-157?

Anshul Gupta: So, initially it was a subcut route, like how people give insulin shots. That’s the same way BPC was given as a subcut injection. Now actually people have developed capsules of BPC. In the capsule form of also we can use it. The difference is that if you do have a lot of gut-related problems, then the capsules work great. Personally, if I feel that if you have a lot of muscular issues or ligamentous injuries or body pains like fibromyalgia, then the subcut injection works a little bit better in that direction. But if you just want to do it for your thyroid, then I think the capsules work equally great.

Cynthia Thurlow: That’s really interesting. I guess one of the other questions I have because there’s probably someone listening who’s like, I’m going to go try to find a BPC-157 because I want to work on my gut health. I would imagine that you need to go through a licensed healthcare provider to get the pharmaceutical grade or compounded options that you’re probably using in your practice.

Anshul Gupta: Yes, obviously peptides, if you go on Internet, each and every person is selling a peptide, but again, because these are not FDA regulated, so nobody’s checking the quality of it. A lot of these peptides are produced outside the United States in poor lab conditions, so actually can be detrimental. So, the source is very important. Although these are safe, but I still do not recommend using it on your own because there can be conditions which these peptides might not be the best choice for your own body. So, before using them, please consult any healthcare professionals, obviously any functional doctors or any providers who specialize into peptides, so make sure that they are right for you. And they will recommend to you the right places to get these peptides.

Cynthia Thurlow: I think that’s really important because I know that the curiosity seekers that are out there, I always say, well, time out, let’s just make sure that we’re getting a high-quality product. Last question of the day, what are your thoughts on iodine? Because iodine supplementation, I feel like in the thyroid community is very polarizing. There are people that think iodine supplementation takes care of everything. I have other people who feel like too much iodine is what’s driving thyroid issues. What are your thoughts? 

Anshul Gupta: One of the most controversial topics in Hashimoto’s, because the research is out there which tells us low iodine levels will cause Hashimoto’s. But on the other hand, high iodine levels will also cause Hashimoto’s. The problem we get into is that we do not have a perfect test to check for iodine levels in the body. We have not been convinced that the blood levels of iodine are enough, even 24-hour urine collection, which is definitely very difficult to do and is not easy to do, is not perfect in checking that iodine level.

So, we all have to go with our gut feeling of what we feel about iodine. What I have taken is kind of a middle route. I feel high iodine supplements should not be used for sure because we know that high iodine can cause Hashimoto’s. On the other hand, I do feel that people should have iodine in a regular supplementation form in whatever way. Because I’m a natural person, I always encourage to get it through the food.

If people can eat food which are high in iodine on the regular basis, which is generally coming from all these seaweeds or sea vegetables, if they’re eating it, then I think they’re getting enough iodine on the regular basis, which will supplement it. If they’re not doing it, then adding a supplement with at least like 100 micrograms or 150 micrograms of iodine I think is generally good enough for people to do it. High doses, definitely, I don’t recommend with my Hashimoto’s clients because certainly we do have good data that high iodine can lead to Hashimoto’s.

Cynthia Thurlow: This has been such a delightful conversation. Please let my listeners know how to connect with you, how to get access to your website, and more importantly if they would like to work with you directly.

Anshul Gupta: Absolutely. I do have this virtual functional medicine practice. Wherever you are in the country, if you want to work on Hashimoto’s, you can work with us virtually. The best way to connect with us is going on my website. It’s called anshulguptamd.com. There you’ll find– I have this vigorous blog where we share a lot of research-based information regarding it. I even have a YouTube channel and a podcast. Our handle is Anshul Gupta, MD, you can follow us over there. A lot of good information that we are sharing. If you go on our website, there is a form that you can fill up if you want to work with us. So, that’s a great opportunity to connect with us over there.

Cynthia Thurlow: Awesome. Well, this has been such a wonderful conversation and thank you for helping to fill in our gaps on Hashimoto’s.

Anshul Gupta: It’s a pleasure. Thank you for having me over here. Delightful work you are doing. It was a pleasure sharing all this information.

Cynthia Thurlow: Thank you.

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