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Katie: Hello, and welcome to “The Wellness Mama Podcast.” I’m Katie from wellnessmama.com and wellnesse.com. It’s my new personal care line, wellness with an E on the end.
I am here today with the first person who really helped me on my road to recovery from thyroid disease. And I can now say I am in full remission from Hashimoto’s. I’m here with Dr. Alan Christianson, who is most recently the author of “The Thyroid Reset Diet,” which we talk about today, and especially some very specific things that are extremely vital for getting the thyroid to actually heal itself. He makes a very strong case for the fact that thyroid disease often does not have to be lifelong, but that much of the conventional advice that we are given about thyroid disease can actually be counterproductive to long-term healing.
If you aren’t familiar with Dr. Christianson, he is a naturopathic endocrinologist who specializes in thyroid disease, specifically Hashimoto’s, hypothyroidism, and Graves’ disease. He’s also my specialist when it comes to thyroid-specific problems, although I don’t have any current thyroid-specific problems. And he was the first one who was able to accurately diagnose Hashimoto’s and help me figure out what my path to recovery would look like. I’m always so happy to share him with you guys. And I think a lot of the new information he presents in this episode is really, really helpful for anyone with thyroid struggles. And his new book, “The Thyroid Reset Diet” is also very important. So if you have any kind of thyroid-related issues, I highly recommend it. The link to it will be in the show notes along with links to many of the things we talk about in this episode. I think you will learn a lot and especially like I said, some very important points that are often presented incorrectly even by other thyroid experts. So I know that you’ll learn a lot. And without further ado, let’s jump in. Dr. Christianson, welcome back.
Dr. Christianson: Hey, Katie, happy to be with you here.
Katie: It is always such a pleasure to talk to you. I have so much personal gratitude for you. You helped me in my own journey with overcoming thyroid disease. You were the first one who really, first of all, recognized it, helped me get a diagnosis, and then start on recovery. So I will be forever grateful to you for that. And I know that you’ve helped many thousands of people do the same thing. And I love to have you back on. A substantial amount of listeners have some form of thyroid disease, Hashimoto’s being a very common one. And I know that you are one of the foremost experts in the world on this. And so it’s always such a joy to get to share you on this podcast. I know that you have been working on a really comprehensive new book that I think is really, really important for anybody with any kind of thyroid struggles, but especially Hashimoto’s. And I wanna go deep on some of the things you talk about today. But to start broad, I think it’s also important to make sure we have kind of a definition of terms and also an understanding of where we’re going when we have conversations like this. Because thankfully, I didn’t have this experience, because I worked with you, but I’ve heard from many listeners when they’re diagnosed, told that their condition will not improve. It will likely get worse and that it’s lifelong. So I’d love to kind of start there and talk about thyroid disease from the perspective of what is going on in the body and can we support the body in undoing that?
Dr. Christianson: Yeah. Yeah, thank you so much. And great points to frame this. Generally, there’s two big things. There’s the thyroid glands’ inability to make enough hormone and the body not properly responding to that hormone. So those things go together. And up until the recent past, medicine did think that this was progressive, this was persistent, and this was just not reversible. But the new evidence that I’m sharing is that this can get better. For many people, that means that they will respond differently to thyroid hormones. They can have their symptoms clear up in ways that they had not before. And for some, it will mean that they will no longer need ongoing thyroid treatment. You know, their gland can literally grow back new cells and start to produce hormone more effectively, again. So that’s the exciting part.
Katie: That is really encouraging, especially because like I said, that’s not necessarily presented as common information. Why do you think that isn’t really known in the standard of care right now? Are there parts of the approach that we’re missing or that just the conventional treatment would maybe miss that makes that not possible?
Dr. Christianson: Yeah. So the thing that has come out that’s made that perspective apparent is new information. It’s from the last, last several years. And there’s always just a big lag between data being made and then data being delivered, you know, being used and influencing practice. So, this is just the time for that to start coming out but these are new discoveries that weren’t available to any doctors, even just several years ago.
Katie: Wow. Okay. So, walk us through some of those because I know from working with you, that things like thyroid hormone can be helpful and even necessary, especially in the early part of it. But what does that kind of arc of recovery look like and how would someone know, for instance, if that was gonna be possible for them?
Dr. Christianson: Well, that’s a good question. And it’s not always clear in terms of whether someone will grow back their own cells. But anyone can predict that they can do better in terms of responding to the hormone. So, arc of recovery being that people typically can have diagnosis at the early years or some, it can be delayed, some, it can be a decade or more out. And some are not yet on their medication and there’s those that are still stuffering and still symptomatic. And so, with this new approach, they can have their system take up the hormones better. When you take a hormone, it still has to be metabolized and absorbed by the cells and responded to properly by the mitochondria. And those are all parts that can be weak links in the chain and reasons why those who are on treatment don’t feel like they are. They’re still having the same symptoms they had going into it. But those things can change, and they can change an order of between one to three months. For those who are diagnosed and have had the disease for four years or fewer, and are not yet on treatment, they’ve got a pretty good chance of having their cells just be normal again, and take over their own function by themselves, and not needed to go on treatment. And that change can take between about three to six months.
Katie: It’s so fascinating and so against what a lot of the recommendations are. What’s going on physiologically with that happening? Because certainly, the advice that I got early on with a thyroid diagnosis was obviously not from you, but before that was that if you have low thyroid, you need to take more iodine.
Dr. Christianson: Yeah. And that’s something that’s tricky. You know, at a really superficial level of understanding, it could seem logical. The thyroid needs iodine to work. So you can think, “Well, if it’s not working, it must need more.” And I’ve thought about the way the nutrients can work, like the way that keys can work to a car. You know, if you don’t have your keys, the car won’t budge. But there’s countless problems with the car that won’t be remedied by more keys. And you could even imagine that if you poured, you know, 20,000 keys inside of the passenger compartment in the driver’s seat, you couldn’t even drive properly. So, this is how it works. Iodine is something to where the thyroid needs the tiniest amounts. And there’s only small amounts normally in circulation. So, what it does is that it pumps it and it concentrates it inside of itself. The thyroid pumps in iodine. Now, because the amounts needed are so small, if you ever get too much, the thyroid shuts itself off. And it does that because thyroid hormones, they’re dangerous when there’s too much of them. They can damage the heart. They can cause bone thinning. They can cause brain damage. And our bodies have a sense about this. So, rather than make too much hormone, they simply shut off a thyroid. So, too little iodine can be a problem, but then so can too much. And part of the big new insight is that the gap between too little and too much is much narrower than we thought before, especially for some people.
Katie: And so it sounds like there’s a lot of variation and individuality when it comes to the amount maybe a person needs?
Dr. Christianson: Well, to be really precise, there’s not a lot of variation in terms of nutritional requirements for iodine. We’ve not found variations, which some people need much higher amounts than others for their thyroid function. What we do find is that there’s a lot of variance in toleration of iodine. So, the World Health Organization has looked at thousands of situations in which areas have fortified water with iodine, and then seen how that plays out on improving and worsening thyroid disease. And you can talk a lot about just population outcomes and population ranges. And what we found is that almost any individual can safely tolerate up to about 1,100 micrograms of iodine for short-term purposes. But those who are prone to thyroid disease and vulnerable to it, that upper limit is probably more like 200 micrograms. So, the lower limit for almost anyone is somewhere around 50 micrograms. If anyone gets less than that long-term, they can get complications. It’s a little different per age group. That’s really for adults and for non-pregnant women. But yeah, adults pretty consistently are about 50 micrograms for their low end. But those vulnerable to thyroid disease, the further they get above 200 micrograms, even for a short period of time, the more it can cause harm to them.
Katie: And this would include food sources of iodine as well, obviously, not just supplements, right?
Dr. Christianson: Yeah, that brings up a great point. So we get it from supplements. We get it from food. We can absorb some from cosmetics. And it’s the sum total of all those sources that we have to be bearing in mind.
Katie: How can we gauge how much we’re getting from food or what are some foods that we’d wanna be cautious about if we’re worried about consuming too much iodine?
Dr. Christianson: Yeah, so two good questions, how can we gauge how much we’re getting? And the best thing is to think about having a sense of avoiding the biggest outliers. There’s no perfect tools for measuring iodine. We can talk more about that. But thinking about some of the by far the highest in quantity, in the U.S. population, they’re not as common foods, Kelp, Nori, Duelz. Those who do eat them, they contribute a lot, but they’re not as common in a population level like ours. Then we think about dairy foods and processed grains. So, these turned out to be the biggest sources for most people, most people on a typical American diet. They both have a lot of iodine, more so as a contaminant than as a natural extension of food itself. And then third-up after those two would be salt. Many types of salt have iodine added. Many other types, it’s not added, but naturally occurring, it can still have quite a bit.
Katie: That’s interesting. So, I think that might be new information for a lot of people is that processed dairy and grains can be a relatively substantial source of iodine. Is it added or is it in like an iodized salt that’s added processed grains or where’s that coming from?
Dr. Christianson: Well, so the grain specifically, there’s something along the way of processing and manufacturing that’s not totally clear. And it’s changed and it’s fluctuated. So there have been a lot of market basket analysis studies done. The USDA goes into four regions of the country, and they buy things from supermarkets, and they analyze hundreds of different foods for their nutrient content. And this is done annually. And what they found is that when they’re comparing the findings from the early 90s to the 2010s, that iodine content has gone up two or three-fold for a lot of popular grain-based foods. And there’s some things you can buy on the shelf that’ll say, you know, bread that has iodized dough conditioner. And it would seem logical to think that the ones that didn’t say that would be okay. But that’s not really borne out. So, anything that has iodized-based conditioners typically has a fair amount of iodine, but some things that don’t label that still have higher quantities. So, somewhere along the way, in the production of commercial products, bread, bagels, biscuits, muffins, there are various iodine compounds that are used. And something… You know, I love how much emphasis you’ve trained people about the importance of unprocessed foods. You know, processed foods don’t have to label everything that goes in the package. There are many things that are used along the way that are not considered formula recipe ingredients that are still present. And this is one clear example of that.
Katie: That’s so interesting. And it makes sense that obviously iodized salt contains iodine, but other forms of salt could as well just because of the mineral content that they would naturally have. How can we know…? Like, are there safer forms of salt that are better to choose?
Dr. Christianson: There are. And thankfully, this is an example of a really easy parallel substitution. So, you know, one can still be deliberate about their salt intake for various reasons. But it doesn’t have to be avoided across the board because of iodine. You know, simple rule, Kosher salts are generally iodine-free. The most two common brands you’ll see in stores are Morton’s and Diamond Brand Kosher salt. And those are both free of iodine. And there’s a couple of types of sea salt too that I’ve spotted that are also relatively devoid of iodine. You know, one is Maldon’s brand of sea salt. And then Celtic brand has a subtype called their Light Grey salt, which is both fine and coarse ground. And that’s also relatively low in iodine. Pink Himalayan salt can be higher in it. And sea salts besides those two, they can vary just tremendously in their iodine content.
Katie: Got it. I’m a huge fan of the Maldon Sea Salt. So, I’ll put a link to that one, as well. Another thing when it comes to iodine, and I think there’s some misinformation here, I wanna make sure we tackle, a lot of sources recommend doing an iodine patch test on your skin as a way to figure out how much iodine you need. And if the patch test tells you you need more iodine, you should take more. Can you explain, A, kind of what a patch test is and, B, if that’s accurate in knowing how much iodine we need?
Dr. Christianson: Yeah. So, so many things that iodine come down to its volatile nature as a chemical. And it’s highly reactive. It oxidizes quickly. You know, you can think of it kind of like bleach. And it’s similar in a lot of ways. Chemically, it’s the same place as chlorine on the periodic table, the same row. And so because of that, it’s random and it’s hard to pin it down, so to speak. So the logic behind the patch test, the logic makes sense, the logic is that, you know, your body can absorb some things preferentially based upon your requirements. And that’s totally true for like iron. We’ve got a big range in how active our iron-binding proteins are in our intestinal tract. And they fluctuate reflective of our iron need. If we’re low, we absorb more. If we have plenty, we’ll absorb less. Now, that idea is then assumed to hold true for how iodine works on the skin. We do know that iodine does absorb across the skin. The numbers vary, but somewhere around 4.5% of iodine will go across your skin and end up into your bloodstream. So the patch test assumes that how quickly you absorb it is a function of what your need is. And it also assumes that the color change… So, iodine compounds like Betadine, they’re a dark amber, like a dark brownish color, and you paint them on your skin, they’re quite visible. And over time, that fades. And so the assumption is twofold. The assumption is that the fading of the color is proportionate to the absorption of iodine. And the second assumption is that if you are absorbing it, you’re gonna absorb it based upon what your requirements are. So you put that together and they basically assume that if you paint iodine on your skin and it goes away rapidly, you must have needed a bunch. And if it doesn’t, you didn’t need it. So, to break down those two assumptions, the first one is just that there are no known examples of that being regulated to where the body can choose how much absorbs across the skin.
You know, we expect to take in nutrients from our gut, so we can adjust some things there. But our body’s not really geared up to intentionally take things across the skin. I mean, we can, but it’s not so much part of our design or adaptations. We have no means of adjusting our absorption. Now the other problem with the idea is that the color change, so the color change doesn’t mean that it’s gone. The color change is just the oxidization of iodine to iodide. So, the colored iodine compounds like Betadine, they have a mixture of iodide and iodine. And the color is solely from the iodine. Iodide is colorless. So, when it’s exposed to air, it converts from iodine to iodide, and it becomes transparent. So you can have a massive amount of iodine on your skin and the color change is just iodine itself chemically changing. It’s not so much absorbing. And then if that’s not enough, there were some big studies done on this test. And they were done in the early 30s. And they took people that had normal iodine status. They took those that right on deficient and they also took skin from dead people. They took cadaver skin, and they painted on iodine and watched absorption timeframes. And they saw that, yes, most iodine does just oxidize and absorb into the air. Some would cross the skin barriers, but there was no consistent difference whether someone had enough iodine, too little, or whether even if he were living or dead. So yeah, just not an accurate tool, unfortunately.
Katie: That’s really, really good to know because I feel like that information is so commonly used. I come across that in a lot of thyroid forums and just thyroid advice online. And it makes sense that there’s so much variation between individuals, and that skin would respond differently than something taken internally. But especially with the information you present in this book about how careful we need to be with that iodine level, it seems like it certainly wouldn’t be an accurate enough measure to be able to use that as a gauge. I’d also love to go deeper on some the other tenants you go into in the book about, obviously, iodine is a huge key here, but there’s a lot of other factors that go into recovery from thyroid disease as well. And I know, for me, it required a long time of personal experimentation, and trying things, and getting a whole lot of stuff dialed in from gut health, to diet, to light, and a bunch of other factors in between. So walk us through some of those pillars of where someone would need to start, obviously, iodine being a big key. But other places we need to look if someone has thyroid disease, especially Hashimoto’s and wants to start moving toward recovery.
Dr. Christianson: Yeah, so there’s a couple of phases of this. And I think, that’s in three main steps. You know, the first one is, what are the things you can do to help your thyroid heal and repair. And of those, iodine is non-prior. It’s really just like in a category by itself. So, regulating it is central. And that comes down to the diet and the other sources. Then the other things are along the way, which thyroid levels are most likely to benefit your symptoms, you know, give you better health long-term, and then also add to the chance of the thyroid recovering. And this is especially relevant for those who are already on thyroid medication. Even if they weren’t, you know, even though a high goal of theirs was to not take the medication long-term, there’s still a thought about which levels are most likely to make that happen. So, that’s part of it. And referencing labs give a normal range, which is a good orienting starting place. But there’s a lot of ways that can be individualized and a lot of ways that can better reflect optimal function. So you have the first step getting iodine regulated. The second step is those who are on treatment, how can they know when a treatment is doing its very best? And thankfully, those goals of having people feel better, you know, reducing their symptoms, the goal of helping the thyroid regrow and the goal of being healthy in the long-term, they all sync up. And they all align. As a generalization, the TSH level, you know, thyroid-stimulating hormone, it’s the brain telling the thyroid to work and it’s a backward number. It’s the one that has the most variation between normal ranges and what optimal levels are.
So, the closer that can be between somewhere around half and two, especially close to one that’s more likely to resolve symptoms, give the thyroid a chance to heal, and also really set someone up for good long-term health. So yes, the second of those three steps would be getting the best thyroid levels. And then the third part are the other conditions. So, this is a big thing that I’m excited to talk more about too. People with thyroid disease, they often have something else going on as well. And I’ve seen so many examples to where they’ve tried really hard and done all the right things to help their thyroid work better to get their levels right. You know, they’ve done different medications. They’ve changed their diets, but they’re just completely struggling because, say, they’re anemic, or because they have hyperparathyroid disease, or they’ve got apnea. So, I’ve identified 15 conditions, each one of which affects 5% or more of people with thyroid disease. And any given person with thyroid disease, there’s about an 84% chance that they have one or more of these conditions that’s affecting them. And they’re often just not identified and taken care of.
Katie: Wow. Okay, So how can someone go about… I think that’s a really important point that there’s something else going on usually. How can someone go about trying to pinpoint that? Because I feel like this was a thing that… It was so helpful to have you guide me in this journey myself, but it just seemed like there’s so many potential root causes and options and things that can be happening. How can someone start trying to figure that out themselves when it seems kind of overwhelming at the beginning?
Dr. Christianson: Yeah. And that does take a good relationship with a trusted healthcare provider, ideally, someone that gets this concept in the thyroid world. You know, one classic problem that can come up a lot is digestive symptoms, you know, those with thyroid disease there. They’ve got irritable bowel syndrome type symptoms. They know they malabsorb nutrients or protein, and they struggle with that. Well, there’s a thing called atrophic autoimmune gastritis, which has also been called thyroid gastric syndrome. And that affects 30% to 40% of people with autoimmune thyroid disease. And it’s most commonly diagnosed after it’s been present for 20 to 30 years. So it’s a huge, huge problem. It’s not at all esoteric, and it causes significant symptoms for people. So things like this is keeping those in mind. And I guess just having a mindset to of knowing that the pitfall can be that people and also the practitioner can often get focused on just the thyroid. And it’s important. It’s gotta be taken care of. It’s gotta be dealt in. But there can come a point in the journey to where it really has been, but someone can still be not feeling well. And all too often, people think, “Well, maybe even though the levels are okay, maybe I need to take more thyroid or maybe I’ve gotta change a medication, maybe I’ve gotta cut out more foods, become more restrictive.” And, you know, sometimes those things may seem to be helpful at first or maybe they’re not at all, but it can be dangerous, and then just losing away from the capacity to heal, to spend too much time on the wrong directions. So yeah, it’s understanding when that part is done, what it can do, and what could be the other real causes behind the symptoms.
Katie: That makes sense. And with that very specific gut condition. I know, in general, it seems like there’s a very high incidence of something going on in the gut, that’s not helpful when someone has thyroid condition. I know that was the case for me, and I had to do a lot to address gut health. Is that a pretty much, like, universal good thing to start with too if people have thyroid disease is to look at the gut and make changes that are supportive of the gut? And if so, what would some of those changes be that would be beneficial to the gut?
Dr. Christianson: Yeah, for sure. It can be very important for some people, and it’s especially relevant for those that know they have gastrointestinal symptoms, that the gas, the bloating, the irregularity, and then also quite relevant for those that have recurrent malabsorption of nutrients, they keep turning up anemic. They have a hard time processing certain foods. They get narrow range of foods they can do without getting symptoms. Those are all big signs that something is off there. And things to do about that, in terms of just general self-care, a simple step that’s hugely powerful is meal timing. So, being rather consistent and regular about mealtimes. There’s this real complex interaction between the nervous system of the brain and that of the gut. You know, we call this the enteric nervous system in the intestinal tract. And if we look way back on human development over the arc of history, the organisms that preceded us were basically just a gut. Like, the earliest versions of complex life, past individual cells, the first structural form is basically a tube. And if we move forward throughout adaptations and changes, everything was just stacked around or on top of the tube to help it move around and find food, and get food and, you know, not become food. So, that’s our real core part of our identity. And we think so much about the ways that it affects symptoms and also we talk about our emotions, about the things we feel in our guts. So, generalized action steps, as much food variety as possible is useful and variety within categories, like many types of vegetables, but also a variety of categories, the pitfall is that if the diets get too restrictive, we lose on types of fibers.
And what we’re seeing as a general trend is that, of course, the flora is important but the answer to a good flora is not just higher numbers of organisms and a probiotic supplement, but really more diversity and healthy strain of many kinds of flora that are well adapted and well in balance. And to do that, we’ve identified 16 different categories of fibers in the diet. And the more categories of foods someone cuts out, the more difficulties they have covering the bases on those categories of fibers. So, yeah, as much as one can eat broadly more food categories, the better their flora will be. But if they are having symptoms of poor digestion, if they do malabsorb nutrients, then it does take really troubleshooting to see if someone has atrophic gastritis, if they have some neurologic peristaltic abnormalities, if they’re carrying chronic infections. But yeah, really troubleshooting the intestinal tract.
Katie: And if the fiber variety is important with this, I would guess at least extrapolate that a really hardcore keto diet that doesn’t have a lot of fiber or like carnivore probably would not be a good option for thyroid patients. Is that a good assumption or is there more to it than that?
Dr. Christianson: Well, so whenever we try to answer questions, we think about, first and foremost, what do we know from human studies? Like, has there actually been interventional studies done? And then if we don’t have that data and then we think about, “Well, what’s most likely given our models of understanding that we do have?” And so, the keto diets, they have been studied most extensively in pediatric populations. Kids are given ketogenic diets for purposes of epilepsy that’s resistant to medications. And today, they have found that ketogenic diets can be better than seizures for kids that don’t tolerate medications. Generally, when medications are effective, they are lower in side effects for children than the diet can be. But some kids are not responsive. Kids don’t get a lot of thyroid disease. It can be a case per 1,000, a case per 1,200. It’s quite rare that children get autoimmune spontaneous thyroid disease. But in the trials on ketogenic diets, about 20% of children do develop thyroid disease. And for some, that can be lasting. So, we do know that context can be counterproductive. In terms of the carnivore diet, yeah, it’s a diet that we have just no data on and no real tracking on. But we do know that diets that yield the best health outcomes long-term are diets that are rich in a variety of healthy plant foods. They’re generally not… They’re not diets that are devoid of animal foods per se, but they certainly show an abundance of food categories. So yes, given what we know about the importance of the bowel flora and given that we know that the flora is only fed on residues we find from plant foods, there’s every reason to think that that would be counterproductive.
Katie: Got it. Okay. So then on the flip side of that, are there foods that in general… I know there’s always an individuality aspect of this, but in general, they seem supportive of both gut health and thyroid health that are good to focus on trying to include?
Dr. Christianson: Well, there’s actually one study on food categories and thyroid health. There’s been very little data on this. A funny thing, Katie, but if we look at studies on food and thyroid function, and we leave out iodine, and we leave out celiac disease, we’ve got about six studies. If we pull in celiac disease, we’ve got about 30 studies showing that people with celiac disease get more thyroid disease. And if we pull in iodine, we’ve got about 40,000 studies. So that’s kind of the magnitude of our data. But leaving it aside, there was a fascinating study done called the 1001 Dalmatian study. I don’t think I told you about this one before, maybe I did. But so Dalmatians are also humans. There’s an ethnic group of Croatians where the name came from, apparently. And this study looked at a group of them. They are somewhat prone to thyroid disease. And it contrasted their rate of developing thyroid disease, and it compared that against their intake of different food by category. And what they saw is that the food categories most preventative for thyroid disease were Omega-3 rich foods, you know, some types of seafood, especially lower iodine seafood, and then also vegetables, in general, fruits, in general, and legumes came up as well. And so, those the biggest categories that had a negative correlation with thyroid disease. The more they included those foods, the less they developed thyroid disease. And the food categories that were most related to thyroid disease. The singular one was foods that were dense sources of saturated fat. So, butter did come up in that category as did animal fats in general. That was the main thing that was known to elevate it but the risk was most decreased by really just plant foods and then Omega-3 fat foods.
Katie: Any tips on sourcing Omega-3s? Because I know this has been an area of somewhat controversy in the health world the last few years and about the potential of those fats going rancid very easily. Like, what you personally do on this and any tips for sourcing either from food or from supplements?
Dr. Christianson: Yeah, great question. Supplements, I do also think about iodine content. We ask they are stuff that way. And that’s the pitfall about animal Omega-3s is that many of them are dense in iodine. And we think also about plant Omega-3s. And I put a lot of thought into this. So there’s only two essential fatty acids. Those are fats that we cannot manufacture internally. And that’s alpha-linoleic acid and linolenic acid. So these are two that we depend upon. And we make alpha-linoleic acid into EPA and DHA. Those are then secondary metabolize fats. So we can make those given the right circumstances. And what are those right circumstances? Well, there’s an enzyme called Delta-5 desaturase that’s involved in making this vegetable Omega fat into the active EPA and DHA. Kind of a funny paradox is that on very high-fat diets like ketogenic diets, that Delta-5 desaturase is overloaded because it’s gotta desaturates every single fat that’s consumed. So, on the extremes of high-fat diets, paradoxically, there’s the greatest risk of being low in those essential fatty metabolites, EPA and DHA. But when total fat intake is more reasonable, people can consume vegetable omega-3 fats, and be more likely to get what they need from those. So, we see those from things like flax, most abundantly, walnut, hemp seeds, chia seeds. And yeah, without there being super high amounts of dietary fat, people can readily convert those into EPA and DHA. And there are pathways that do that. They are not perfect. They don’t convert all of it. But when you run the numbers, it’s actually not too tough to get enough to get through and make good quantities.
Katie: That’s fascinating and good to know. Yeah, I feel like this is an area that’s been argued about quite a bit recently, and especially with the idea of like fermented fish oils, and if those are beneficial or not. So much to consider on that.
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What about are there other foods that are kind of almost universally good to avoid? You touched on a few and also, like, processed dairy and processed grains? Are there any others that would be problematic, just from a thyroid-specific perspective?
Dr. Christianson: Well, one thing has been talked about quite a bit is gluten. And in almost all cases, when someone avoids gluten, they’re avoiding a whole pile of processed foods. And that’s probably useful. We do know that many people have celiac disease. We know that there’s overlap between thyroid disease and celiac. In the general population, about 1% of people have an autoimmune reaction against a protein that’s found in wheat. And the funny thing is, if you think this through, why would we call that autoimmune if it’s something that’s only from the diet? You know, we don’t call peanut allergies, autoimmune allergies, but celiac is. And that’s because we’re really attacking an enzyme, and that’s anti-glutaminase. And that enzyme itself is a normal part of our bodies. And it’s what we use to form a lot of connective tissues. So celiac disease, it’s categorized as autoimmune because we’re attacking a normal part of humans. It happens by just overlap of biochemistry, that gluten itself is related to anti-glutaminase. So whether we consume gluten or not, we still have anti-glutaminase. And those with celiac or gluten-free, are much better off and they need to do that. But there still are health challenges because glutaminase is part of humans. So we see that general populations have this at about 1%. And those with thyroid disease have this at about 2.8%. So for many, that can be more common. And then we have those with wheat allergy. There’s been a question about whether those that don’t have celiac disease, whether it’s important for them, but have thyroid disease, whether it’s important for them to avoid gluten.
And if someone by avoiding gluten is just cutting out processed foods, they’re probably healthier for that. But there was one big study done in which they took people with celiac disease. And first what they did… They were newly diagnosed. And first, they identified those that were known to have thyroid disease and they pulled them aside. And of the remaining of that group, they watched to see over the course of the coming year, who developed thyroid disease. And they could also watch to see who was compliant with their new recommendations to go gluten-free and who was not. There’s actually blood markers that can show that. And so, the expectation was that if gluten were causative for those with celiac disease, if it caused thyroid disease, that those who avoided gluten, fewer of them should develop thyroid disease than those who did not. It was actually the opposite, not buy a big degree. But there was actually a few more people that got thyroid disease that went gluten-free than those that did not, which was surprising for many. So yeah, there’s certainly no harm in cutting out a lot of processed foods. But it doesn’t seem that that gluten causes thyroid disease for those with or without celiac disease. It turns out that there’s some propensity towards autoimmunity, that if you get one, you’re more apt to get the other, but one doesn’t so much cause the other.
Katie: Okay. That’s a really important distinction, I feel like. Another thing I wanna touch on, I feel like is very related to thyroid disease and another area that you know a lot about, although it’s a little bit less of a direct connection, but is the idea of the factors like light, and sleep, and stress, and how those relate to recovery from, I think, really anything but especially from a thyroid perspective. And I know you’ve written about how we can use light to our advantage for a lot of these health problems. And even we’ve talked about that before on this podcast. I don’t know if we have time to go all the way into that today, but can you give us a high level from a thyroid perspective of how we can use those factors to our advantage?
Dr. Christianson: You know, kind of like I was saying about food, being regular on our rhythms is important. You know this as well as anyone that how critical is having the right schedule for babies to be, you know, and to function well, and to feel good, and we don’t lose that need as adults. We still have a need to be on regular rhythms. And yeah, light exposure sets those rhythms in big ways. Since we would have spoken in the past about that, Katie, there have been a few updates. So, nothing has really changed with the importance about bright light in the morning. You know, one of the biggest things you can do is when you wake up, your first hour being awake, spend some time outside. The light intensity and the light properties outdoors, even on the cloudiest days are completely different than anything found indoors, even in, like, really brightly lit rooms. So, yeah, get outside in the morning. It can be that simple. But yeah, your first hour of being awake, about a half an hour of daylight type light is magical. The one update is that we’ve wondered if blue light was harmful at night because it’s blue light or was it the context of blue light, meaning that your brain was stimulated by looking at a computer or looking at a television? Was it the stimulation or was it the blue light part? And the emerging data is that if you could be reading a book with some blue light or looking at a computer without the blue light, you’re probably better off reading the book with blue light, so that we think now it’s more about just the mental stimulation than just about the nature of light by itself. So yeah, at the end of the day, the total quantity of light matters, even it’s more dim environments, but also avoiding things that are highly mentally stimulating.
Katie: That’s fascinating. And I did not know about that. That’s new information on the blue light and a good reason to, I guess, re-evaluate because I think a lot of people are using things like flux or using apps on their phone or blue blockers, but still watching, like, adventure movies at night.
Dr. Christianson: Right. And it may not be as helpful. You’re probably better off, you know, dimming the lights. The glasses are certainly harmless and they may be of some benefit. But probably the big thing is just not doing things that are rubbing up your brain right before you go to bed.
Katie: Yeah, and from a parent’s perspective, probably also really good advice with kids is to keep them away from stimulating inputs at night as well. Another thing I think about pretty often since having been through Hashimoto’s, myself, and now being in remission, is how can I hopefully keep my kids from ever having to go through this? And I think any parent who’s been through a health problem thinks about that, from the perspective of how can I help my kids not have to go through the same thing that I did? And certainly, I think we can pull a lot from the things we’ve already talked about of things to avoid that can help really improve their chances by improving their gut health, making sure that they are getting nutrient-dense foods and some of those things. Specifically, we talked about making sure we’re not giving them too much iodine. But are there any other things we can do, from a parent perspective, when we’re talking about our children or our spouses maybe who don’t have thyroid problems, to help, hopefully, reduce their chances of ever encountering that?
Dr. Christianson: For sure. The simplest thing you can do is maintain good Selenium status. And the exciting thing is that I was wary about talking too much about Brazil nuts as a food source for kids. They’ve got a lot of Selenium, and we’ve known that the amounts they contain are generally safe for adults, but it is possible for some forms of Selenium to become toxic. So I was wary about encouraging that for kids. But a study was done not too long ago in South America. And, you know, if they would have asked me about this study, I would have told them that probably not a good idea because it was pretty extreme. They had malnourished children that were toddlers and they gave them pretty massive amounts of Brazil nuts, it was like a quarter of their total food intake. And they measured Selenium in a lot of different ways. And what it came down to is that we now know the chemical forms of Selenium in Brazil nuts are ones that kids can make good use of, and they can very safely eliminate if there is any excess. So it really doesn’t bioaccumulate. And that’s not true for all versions of Selenium. So, yeah, Brazil nuts for good snacks for family purposes.
All the bad things I was saying about iodine are amplified when someone is below their targets for Selenium. And that’s not hard to do. It’s rather easy to fall behind in Selenium. But for kids to add in even half of Brazil nut to a Brazil nut a day, for adults, two to four per day. It’s such an easy thing, and your odds of being Selenium deficient when you’re doing that are just about nil.
Katie: Yeah, I heard that tip from you. And I’ve done that since you mentioned it to me years and years ago, along with broccoli sprouts being a big part of my life ever since that first conversation. For anybody who didn’t hear that first episode, can you also just talk briefly about broccoli sprouts and how they can be beneficial?
Dr. Christianson: Yeah, they’re a great thing. So they are dense sources of sulforaphane. And thyroid hormones, there’s what we have that comes into our body from making it or from taking in pills. And then there’s just tons of ways throughout our bodies that we fine-tune, regulate, convert, eliminate. And sulforaphane does a good job helping all those peripheral mechanisms work better. So all the ways your body would want to fine-tune thyroid levels can work much better if sulforaphane is helping your liver. And broccoli sprouts is one of the densest sources of that.
Katie: Awesome. I’ll put the links. I know you have resources about that. And I have a post about it as well. I’ll make sure that those are linked in the show notes at wellnessmama.fm, for all of you guys listening. Dr. Christianson, obviously, I consider you my top resource on all things thyroid health. And I think you are one of the most knowledgeable people in the world on this topic. For people who are working through this on their own and trying to figure out their own path to healing, how can they connect with you and keep learning from you and find more resources?
Dr. Christianson: Yeah, my main hub of information is drchristianson.com, drchristianson.com. And that’s where we just keep all things coming out.
Katie: Perfect. And I know that there are some special links related to the book, which I highly recommend for any of you guys who are working through thyroid issues. That link will be in the show notes as well, at wellnessmama.fm. And I believe there are some special things that go along with this around now for lunchtime. Is that right?
Dr. Christianson: Yes, there’s a docu-series called “Invisible Iodine.” And this just kind of portrays the story of this change that’s occurred because thyroid disease has gone on forever. But the last couple of decades, specifically 90s through the 2010s, its rates have doubled and tripled. So, it’s really on the rise. It’s not a coincidence we’re seeing more about it and talking more about it. And this docu-series explains that rise, and what are the big reasons behind that, and what are some easy things you can do to help prevent it?
Katie: Awesome. I’ll make sure all of those links are in the show notes so people can find them and keep learning, as well as, of course, the link to your book. And Dr. Christianson, I know how busy you are and how many people you help on a daily and weekly basis. Very grateful for your time and for sharing today.
Dr. Christianson: I’m always happy to be with you, Katie. Thanks so much for having me.
Katie: And thanks to you guys, as always for listening, for sharing your most valuable resource, your time, with both of us today. We don’t take that lightly and we’re so grateful that you did. And I hope that you will join me again on the next episode of the “Wellness Mama Podcast.”
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