How to Heal Your Thyroid Naturally

How to Heal Your Thyroid Naturally Interview with Datis Kharrazian Hosted by Neely Quinn Paleohacks, LLC http://paleohacks.com Have a health question? Join our community at: http://paleo.co/joinpaleohackscommunity To hear more from Neely, find her at her website: paleo.co/neelyquinn All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed in whole or in part without the express written permission of Paleohacks, LLC. " 1

Hey there I'm your host, Neely Quinn, and today we're talking about women's weight loss with Datis Kharrazian. I was extremely honored to have interviewed Datis. He's been one of my gurus, I guess you could say, for at least ten years. He's very well-educated and he especially knows a lot about autoimmunity and thyroid. So today, we're actually talking about thyroid and how to be your best practitioner since so many conventional docs don't really know how to treat thyroid issues. We're going to talk especially about gluten. I thought I knew a lot about gluten, but he blew my mind in this talk, so I really hope that you enjoy this talk. It is little sciencey, but again, he's really good at breaking things down into layman's terms, too, so enjoy. Okay. Welcome, Datis. Thank you. Thank you so much for being with me today. It's quite an honor. Thank you. So why don't you introduce yourself to anybody who doesn't know who you are? What do you do? Just A little bit about you. My name is Datis Kharrazian and for me, I started my professional healthcare -- I started going to chiropractic school. When I was in chiropractic school, I realized that I needed to do more with nutrition, so when I finished school, I went and got my masters degree in Human Nutrition. And then I started to realize I really needed to understand research, so then I went and got my doctorate in Health Science degree from Nova Southeastern University. It's a medical school in Florida. At this point in my career, I'm realizing I've done a lot of researches, but I really need to do my own research, so I'm in the final phase of my PhD at Nova Southeastern University. I'm on a clinical scholar program in Harvard Medical School for the past year learning how to do research. We're publishing research in autoimmune disease right now, so I'm partly transitioning from a career of half-practitioner into half-researcher now and really trying to get on the lab and doing a lot of autoimmunity and immunology research and trying to get some of that information out with books to the public and then research paper to the scientific community. Do you see clients as well or not at this point? What I do is I see patients every other week and then I do writing and research every other week, so one week I'm with research and writing 2

and the other week I'm with patients. I have to have a mixture of both to have some perspective on what's real and what's not real. The research questions I have are directly from my clinical practice, so I really need to figure out some things. In the past year, we've done some really exciting research. We have enough data to actually publish 20 papers this year. We've published three so far, so we're really diving into the world of autoimmunity, intestinal permeability, chemical immune tolerances, inflammation, and we're answering questions we've had in the lab. It's just a really fantastic, fun time. Yeah. So you said that you realized that at some point, you needed to do your own research. Is that because it wasn't out there for you already? Right. There's a point where you can only review the literature and get so much information, right? I've been teaching seminars specifically to areas of autoimmunity and endocrinology for 15 years. I've read the literature. I constantly read literature. There's a point where you go, "Wow" We just don't have information on this and we need to know this next step because we have a group of patients that we can't take to the next level and we really need to help them. So we're seeing an explosion of autoimmunity and I think a lot of people that are on Paleo diets are autoimmune. It's probably the first time in their life they've actually felt better and they've actually had some changes in their health. We know that there are several inflammatory proteins like earlier this year, myself and Dr. Vojdani, we published a paper and we found milk and wheat proteins cause neurological autoimmunity. In the literature, only 1% of people are supposed to have celiac disease, but with our study that was publishing nutrients, we found about 20% of the people have those reactions, and of those 20%, half have antibodies to the brain, but these people don't have MS yet, and the population sample we used was 400 healthy population people -- 400 people that have no health problems that think everything's cool. We checked them and we see there are some reactions there. We have this subtle inflammatory autoimmune epidemic going on throughout the world, very, very high rates, I think more in the US and industrialized countries than anywhere else. We've played with our food more in the US through hybridization, through chemicals, through hormones than anywhere else and we're finding some really fascinating information about how chemicals bind to food and chemicals cause reactions. 3

Earlier this year, just actually two months ago, another paper we did got published in the Journal of Applied Toxicology, which the reviewers of the research paper called "breakthrough". This changes everything. What we did is we took chemicals and we found that chemicals like fire retardants, BPA from plastic, benzene rings from cigarette smoke, gas fumes and a series of other chemicals actually combine to human albumin. And when these chemicals bind to human albumin, they become a new antigen for the immune system to react to. What we've also done as research this year, we checked just recently 200 foods, purified protein foods, processed and natural, cooked and uncooked foods to thyroid antibodies, to brain antibodies, and to pancreatic islet cell antibodies for type 1 diabetes. What we're finding is that many of the foods on the Paleo diet are very immunoreactive to people still and specific to the tissue disease they have. For example, we found tuna reacts with T3. If you have antibodies to tuna -- not everyone does, but if you're sensitive to tuna and you make antibodies against it, the antibodies you make to tuna are so structurally similar to T3 thyroid hormone that can actually cross-react and destroy it. So that's similar to all autoimmunity reactions. That's what I always tell people, is that sometimes the food gets into your bloodstream because of leaky gut -- and tell me if I'm wrong -- and then those food particles can look like parts of your body. Is that basically what's happening with autoimmunity in general? Well, there are probably 30 different mechanisms of autoimmunity. Intestinal permeability is one model of autoimmunity and there are many others. The model we're talking about is unrelated to intestinal permeability. Now, intestinal permeability can be a contributing factor and be part of the picture, but it doesn't have to be. There are basically chemicals we've been exposed to. Now, unrelated to leaky gut, some of these chemicals actually bind to our own human albumin. Albumin is found only in tissues. You have albumin in your kidneys. You have albumin all over your body, your liver, your skin. All throughout your body, you have albumin. If a chemical binds to this, you have a completely new -- what they call a hapten, something your immune system thinks is foreign. Let's say you have adrenal tissue albumin bind to benzene ring. Now, you have a completely new antigen, so now you start to make antibodies against it, but the antibodies made against this now are so structurally 4

similar to adrenal antibodies. Now, you start to have adrenal autoimmunity as unrelated to intestinal permeability, just a different model, so we're trying to figure things out. Clinically, we can test these through Cyrex Labs. They have a panel called Array 11. It's a chemical antibody panel and they check for the major chemicals bound to human albumin. It's very interesting that we could start to evaluate this and look at this clinically, and what this tells us is the chemicals that we're checking for are unavoidable. There's no way you cannot be exposed to benzene. There is no way you cannot be exposed to formaldehyde. It's in carpets. It's in tapes. It's throughout your house. It's in buildings. This leads to the question of what they call chemical tolerance. You should not react to certain chemicals. Some people are very sensitive to gasoline fumes, some people are not. It's not necessarily detox issues. There's a cell called the Treg cell, regulatory T-cell, and that really is the key player in this chemical tolerance issue and autoimmunity. What we're finding is that when people lose their chemical tolerance and they start to react against this and the body gets higher levels of antibodies found in the tissue, that's one mechanism where people could set the stage for autoimmunity, but the point I was trying to make with this is that many of the foods we found are within the Paleo diet, meaning that what we're realizing right now is that a Paleo diet is not enough for some autoimmune disease. What we're doing in our lab is we're linking which foods in the Paleo diet or just overall are specific to which tissue autoimmunities. We've done the thyroid right now. We've dissected the whole thing. We're going to publish that paper soon. We've done it with type 1 diabetes since they are the two major ones. We've done it with the cerebellum, which is a big player in gluten ataxia and gluten-sensitive brain disorders, and a major factor in autistic kids. Those are the main ones we tackled so far. For most of us that have been practicing and working with chronic autoimmune patients for a long time, what we always see is when people get really, really sick and they get chronic autoimmunity, they usually can't tolerate many foods and they have never even heard of the Paleo diet, most of these chronic patients. What you'll see is they'll come in and they'll have their own Tupperware of food and then they'll have basically Paleo diet. They're basically stuck eating some fruit, some vegetables, some meat and nothing else, and they still can't handle vegetables and all meat. 5

For us, before the Paleo diet really became popular and trendy, working with chronic patients, we just saw this so-called caveman diet. Patients, when they got really, really immunoreactive and sick, can only eat proteins that are like that. What we're finding now is some people eat that way, but they can't still calm down their autoimmunity and they still can't calm down their inflammation. It's better than eating processed foods, but there's still a dietary food component. We're trying to research now specifically why and which ones and what we're finding is that chemicals bind to these foods. For example, peanutsensitivity and peanut allergy have gone up in recent years and there's some early evidence that they're actually binding to aflatoxin, that is not so much to peanut. A protein is binding to aflatoxin -- Which is? Which is a mold-based yeast growing toxin, natural toxin, and it's the reaction to aflatoxin people are actually having, so we have to realize that our foods are being bound to chemicals all the time. I also work part-time consulting with Cyrex and I work part-time working with a nutrition company. With the nutrition company, we always check for pure ingredients and clean ingredients. Right now, it's very difficult to find rice that isn't bound to lead throughout the world. It isn't a matter of if it's organic. This thing's almost irrelevant at this point. We obviously want organic and we don't want pesticides, but rainwater itself and the soil we live now it's just infested with chemicals. We had a bigger question, so the question is, "Is Paleo enough for autoimmunity?" Being in practice, we go for a lot of people, it dramatically improves their autoimmunity; for some people, it doesn't do anything. Why is that? What's the other component to autoimmunity that's food-based? This is where we're focusing a lot of our research into right now. So backing up a little bit, since this whole thing is about weight loss, how can you relate all this autoimmunity to weight loss and fat gain? What does it all mean? Let me explain this and this is really, really core. For the most part, when people think of weight loss, the rule of endocrinology has always taken center stage where if you're not losing weight, it's got to be your thyroid. If you're not losing weight, you have too much cortisol or you have too much stress. That's why you can't lose weight. If you're not losing weight, you have insulin resistance and this insulin doesn't allow you to burn your fat properly and that's all true. 6

But in recent years, there's been a whole new field and it's called immunometabolics or immunometabolism is another name for it. Now, there's a journal on immunometabolism and this is the world of immunologists trying to explain the obesity epidemic. What these immunologists say about obesity is it's all about inflammation. This is an inflammatory game. If you have inflammation, your insulin receptor sites don't respond well. It doesn't matter what your circulating insulin levels are. If you have chronic inflammation, your hypothalamic feedback loops don't work well. If you have inflammation, your thyroid receptors don't respond to thyroid hormones. Really what we're seeing is that we have this underlying inflammatory cascade. They're also finding different changes in gut species between Firmicutes and Bacteroidetes in our bacterial population, our gut microbiome. It has an impact on how many crosses calories and how we use these things. There's literature on intestinal permeability inflammation leading to obesity and these are due to inflammation and things called lipopolysaccharides that create a systemic immunedysregulating event. So immunologists are now jumping in the game and going, "Obesity is beyond just insulin and hormone and all these things." This is part of the reason I think why a lot of people that go on a Paleo lose weight. It's not just that they stop their insulin surges because when you go on the Paleo diet and you research your grains and other types of foods, you obviously decrease how much insulin you secrete, but it's also anti-inflammatory, that it's sometimes the anti-inflammatory effect of the diet that makes it change. Here's another way to put it. If you have someone who has slow metabolism and they go on a Paleo diet, they should lose weight; it's the most common thing if they're overweight. Now, if they don't lose weight, the next question is, "Is there an underlying endocrine issue or is there an underlying inflammatory issue?" If there is an underlying endocrine issue, you should see other endocrine types of symptoms, thyroid symptoms, insulin symptoms, blood sugar dysregulation symptoms, and the most common one if it's endocrine is blood sugar dysregulation symptoms. If that's the case, then we know they get tired after they eat. They may just have a salad with a piece of salmon on it and just pass out, which is still too much. Technically that's a low glycemic type of meal and they 7

shouldn't have an insulin surge and get tired, but if they do, then we know there's still an insulin component to it. We should also look to see if there is an inflammatory component to it. Do they have chronic muscle aches and pains? Can they recover from workouts? Does the body hurt? Are they swollen? If there is, there's an immune component to it. For people that go on a Paleo diet and still can't lose weight, they're dealing with both and they both interlap between each other because insulin surges -- it's when you eat a meal and get tired and fatigued. That's an insulin surge. Insulin surges stimulate the immune system. The immune system creates exaggerated immune response. What they found is that our body fat had cells, adipocytes, and the insulin stimulates the adipocytes to create more inflammation. They used to think body fat is just storage cells. Now, they think of body fat as severely or highly metabolic active cells. What insulin does is it stimulates fat to then create inflammation then the inflammation activates pre-existing inflammatory responses that are there. It's like adding fuel to the fire. Then the inflammation itself causes the insulin receptor to not respond to insulin, so now we got a vicious cycle. Here's the deal. You may be on the Paleo diet, but if you can't calm down your autoimmune inflammation, you're not going to change much. One of the things is it's diagnostic. It's clinically diagnostic if someone goes on a Paleo diet and is not able to lose weight. There are mechanisms that we know about that have been published that really explain them, so we have to do it as clinicians and we have to do it as patients suffering from it because honestly, if you're a patient suffering from it, there's only a handful of people that know what to do with it, so you have to teach yourself. Here's the deal. Do you want me to tell people what the deal is? Yes. Here's the deal. If you go on a Paleo diet and you still have reactions, there are several possibilities here, meaning you can't lose weight. One of the possibilities is first of all, you have some insulin resistance issues especially if you get tired and get shaky, get lightheaded in the middle of the day, if you're fatigued after your meals. If you eat a meal and you get tired, you can pretty much bet you've got some insulin surge issues even though your labs may be normal. If you do a glucose tolerance test for four hours, you might see some shifts. 8

Also, what we're finding is some of this insulin resistance is at the insulin receptor and it may not have anything to do with circulating levels, so don't be fooled to think, "Hey, my glucose was fine on my lab test. My lab test insulin was fine," because it doesn't always show up on that. The point is if you feel fatigued and crave sugars after meals, you've got some insulin issues going on especially if you're on the Paleo diet. If you have that, you have to decrease the amount of food you eat per meal. It's just very simple. Even though it's Paleo, like if you had a salad that was this big and you get tired, you literally have to cut it in half. Why is that? Because the inflammation is causing insulin surge that even though it's low glycemic, it's still glycemic. So when people eat a food and they can't get their glucose from their food into their cells -- whether they eat vegetables or protein, eventually it all becomes glucose. If they cannot get that glucose into their cells, their glucose has to go into triglycerides and that's an energy-demanding process, so now they get really tired after they eat. You have to figure out what your own potential load can be, how much can you personally handle without getting tired. That has to happen and this is one of the things -- because people go, "Well, I'm eating lowglycemic foods. I'm in Paleo so it should all be cool." No. There's still a load issue with people that have this vicious cycle of inflammation causing their ongoing Paleo diet's non-responsiveness. Two questions real quick before you go on. What about eating a lot of fat? Well, fat seems to be a stabilizing issue, so that can be an option for them. Again, there could be a point where too much fat is an issue, but fat and ketogenic diet seem to be the easiest way to handle some of these things, but you also want people to have some fiber. You want some people to have some veggies. I'm a big proponent of you need to have vegetables and meats in your diet. Totally agree, totally with you. You're not saying that you need to cut down your salad in half and that's it. You're saying that you need to cut it in half and then eat the other half later, right? Right, it's just that meal. What then you have to do is you have to then time yourself of when you could eat without getting tired and craving sugars. 9

There's no cookbook number here. This is so highly individualized. If you go on a Paleo diet, which is a low-glycemic diet for the most part -- all the foods on the Paleo diet for the most part, most of them wants their juice, stick to carrot juice or something like that; it's a low-glycemic diet. If they're on a low-glycemic diet and they still get tired, then they have to cut down on the quantity of their food at their consumption, but then they have to figure out when they can eat again. Usually, we don't want to get anyone to starve. We usually want to get people to go, "Hey, I can eat again in an hour-and-a-half" or "I can eat again in two hours" and then they start to figure out what they can do, but the key thing is that they're looking for fatigue and sugar cravings after meals, and here's an excellent point to it. Another dramatic way to calm down your insulin is obviously through exercise. What we're finding about exercise and what the literature is showing is that there are all these studies that show if you go out for a walk, a casual walk three times a week, you can control your blood sugar. So what? What really is what they're finding is the more intense your workout is, the biggest impact you have on your insulin control throughout the day and it doesn't have to be for a long period of time. A lot of research is now showing that when you work out with a maximum heart range -- maximum heart range is 70% of your maximum heart rate. The easiest way to know it is you're working out and you can't talk doing it, so you're really pushing yourself. If you do that just for four minutes a day -- and it doesn't have to be four continuous minutes. It could be a 30-second burst, take a minute rest, do another 30-second burst. If you get enough bursts where it equals about four minutes, you have dramatic change in growth hormone, insulin-signaling, changes in brain, growth factors and all these things. What we find is that someone who's got insulin issues, they go to the gym and watch a show, walk on a treadmill, talking to the friend the whole time, that doesn't really impact the insulin receptors very much. It has some effect, but it's not really dramatic. The dramatic is they get up and they start doing burpees for 30 seconds, doing squats, pushing their selves to exhaustion for 30 seconds and then taking a break and then doing it a couple more times. That's when they get much more dramatic blood sugar control. So what we see is even if they were able to only handle, let's say, a small size salad and they have to eat every two hours, as they get their insulin control through exercise, they can eat more of a normal size portion and then not have to be so dependent upon fatigue if they eat too quickly. 10

They can go longer and have sustained energy and not crack and those things. This leads us to a very important point because I'm going back to what I'm trying to describe here. I'm trying to describe a person who is on a Paleo diet, but isn't losing weight and that may have some underlying autoimmunity or inflammation going on. One part is you have to control the insulin because the insulin stimulates fat cells that release more inflammation, so you have to control the insulin, but if you over-train, you create more inflammation. This is why some of these people that don't respond to Paleo, they also notice when they work out too hard, they gain weight. Yeah, that's me. There you go. You're inflamed -- maybe. Clinically, we've got to rule that out. Listen, you may not be complaining from anything or you may be inflamed through an underlying autoimmunity, maybe inflamed through things that you don't even know about. Does that make sense? That's one of the key things. In this department of autoimmunity, if you have autoimmunity, sometimes you're like, "Man, my diet is impeccable. I do everything right, but I can't handle overworking." Knowing what I know about you, I'm sure you have an impeccable diet and are doing all the right things, so I would suspect underlying autoimmunity if I heard your history. It doesn't really matter, but I'm just telling you how clinically we think, okay? If someone has underlying autoimmunity, they may have a single complaint that you just talked about that if they work out too hard, they gain weight. That is very diagnostic to us. What that means is as you increase past the level of your metabolic capacity, you make much more inflammatory reactions, inflammatory responses. If you look at research in the sports medicine world, as a person trains for duration, the longer they go, they increase more and more cytokines and more inflammatory markers. What they're finding is that these become the diagnostic biomarkers for over-training athletes that when they look at people that over-train, they just see different inflammatory proteins. The one that's most published right now is something called Interleukin 6. It's like the key marker right now that they see in people who over-train. Interleukin 6 goes up with exercise. Interleukin 6 goes up with physical stress and anything that triggers the inflammatory immune response. 11

The point is this. If a person over-trains and gains weight, it is definitely the wrong thing. They need to decrease their workout. What they find is usually if they can hit that four-minute window without overtraining, it works perfectly. Four minutes every day? Four minutes total. This is what some papers have shown, four minutes. There could be a different research that might be three minutes or two minutes, maybe it's five minutes. The point is that it's probably just not 30 seconds. It's probably more than just one burst, but it's repeated bursts done for at least around four minutes and at a level where it's really intense where if someone can be doing push-ups to exhaustion then jumping up and touching their knees and then whatever they're doing, sprinting as fast as they can for 30 seconds, jump roping as far as they can for as long as they can for 30 seconds or a minute, as long as they can get to that point, then there is control in insulin. What happens to a lot of people is they feel so good doing that after the third or fourth minute that they want to continue, but if they do and their inflammation can't handle it, then they'll crash and they probably won't recover well in the next couple of days, and probably if they had this vicious cycle, they'll maybe gain weight. Right. Did it make sense? Okay. That's the insulin part of this, meaning that if someone is stuck in his autoimmune -- can't respond to Paleo diet and from weight loss' vicious cycle, insulin has to be controlled. If insulin isn't controlled, you can't break out of this vicious cycle. That's our clinical observation. The way you know is if the person stops fatiguing and craving sugar after meals or even craving sugar throughout the day. Also, we have a lot of Paleo people that become fruitaholics. That doesn't work if you have insulin symptoms. You can't just go around eating fruit because it's on the Paleo list. Those people also can't break out of this insulin surge and for some of them, they have to avoid fruit for a period of time if they continue to have sugar cravings throughout the day and crash after meals. Now, at some point as they get better, they can usually tolerate fruit and all these things start to change, but that symptom of fatiguing after meals and craving sugar has to change to break out of the cycle. This is the most important thing because we know that randomly giving chronic 12

patients diets to follow without any observation what they should be realizing from their own physiology doesn't work well, so we want to really make sure that we teach our patients that, and that if you're a patient that you really understand that; if you're a listener, you really understand that, if you're stuck in this web. You have to stop your fatigue after meals, so that's part of it. Now, the next part of this is you have to control your inflammation. You have to control your inflammation. Most people think of inflammation like, "Well, if you're inflamed, it's got to be the foods you're eating." Well, yeah, but no because when you start to go Paleo, you're pretty much on an anti-inflammatory diet and it could be just subtle autoimmunity that triggers it. Now, let's just say a person has autoimmunity -- in this case, let's say, thyroid autoimmunity. Autoimmunity can be triggered from lack of sleep. Autoimmunity can be triggered from stress. Remember Interleukin 6 I was telling you about that they find that goes up with people that overtrain? A fight with your spouse raises Interleukin 6 for three full days. Stress can trigger an autoimmune response. Lack of sleep can trigger an autoimmune response. Any kind of emotional stress you have can trigger it, so you can be more inflamed just because of the environment you're in. Maybe you hate your job or maybe you hate the person you live with, I don't know, but you may not be able to break out of this web if you can't control the inflammation, but the inflammation -- if you have autoimmunity -- isn't just dietary. It could be triggered from other things and then the X factor is it's chemical. At a very complicated level, you want to work with someone who knows how to do autoimmune approaches. We cover a lot of them in my thyroid book, "Why Do I Still Have Thyroid Symptoms?" which we'll get into, but to make it very simple, get some sleep. Really recognize your stressful events. If you're in an environment that's stressful for you, you will not break out of this. If you have ongoing stress and your heart rate's going up and you're upset throughout the day and you're spending a significant part of your day thinking about how you feel because someone or something really stressed you out or made you feel bad, you're going to be inflamed if you have autoimmunity. It's the way it is. It's one of the areas that's most neglected with autoimmunity. A lot of patients go, "Well, I've changed my diet. I'm taking my supplements, so I should get better." Well, not necessarily because there are other contributing factors, so if you're not getting better, let's look 13

at them. For a lot of people, changing their diet, taking some dietary supplements that support them, these could be helpful. Now, without getting too complex into what to do for autoimmunity, let's talk about what everyone can do that's listening and doesn't have someone to work with that they can calm down their inflammation with. What we like to use is high amounts of turmeric to calm down the inflammatory pathway. The reason we like turmeric so much is because turmeric specifically dampens something called nuclear factor kappa B, NF-kB for short, and NF-kB is the vicious cycle of this fat cell to insulin to autoimmunity. There's a lot of research on it and we see that it has a clinical effect. When we say turmeric, which is the same thing as cumin, we don't mean you have curry chicken. We mean you take high amounts of this stuff. What do you mean by high amounts? Five thousand milligrams a day. Oh, my gosh Those things come in 200-milligram capsules, right? How do you get a hold of that much? Well, there are two options you have. You can go to your tolerance. You can sometimes go to 2000 three times a day, which is like ten capsules, if you use capsules. We prefer to use an emulsified liquid. If you use an emulsified liquid, you'd get ten times more absorption. It's one of the options for it. Resveratrol is also another TNF-alpha blocker. There are actually papers published on taking turmeric at high amounts and taking resveratrol at high amounts and losing weight. The researchers conclude that this is probably due to the anti-inflammatory effect of obesity. Is there anybody who should not do this? We know that some anti-inflammatory, especially botanicals, can stimulate the autoimmune system, but resveratrol is what we understand neutral at this point, that there is no trigger one way or the other, and same with turmeric. The only major thing is expense. It's very rare to see, clinically, side effects with people, but people that are autoimmune can literally react to anything. For the most part, it's pretty rare to ever see any type of reactions. The other key thing is Vitamin D. Vitamin D is a regulatory T-cell supporter, so we want to do things to support their Treg function, so we 14

want Vitamin D 10,000 IUs to be a basic level; people can take more. With Vitamin D, you definitely don't want to use high does. It's known as kidney disease. Other than that, you can use high doses. If you go past 10,000, 20,000, 30,000, you definitely should have someone monitor your levels, but for the most part, it's very hard to overload with 10,000 IUs a day. If someone is on a Paleo diet and they can't lose weight, here's the big deal. Let me recap it. They may have this underlying autoimmunity inflammatory cascade. The inflammatory autoimmune cascade stimulates insulin resistance so the inflammation doesn't allow insulin to respond, so insulin memories, which you release to carry glucose into your cell -- but if you can't carry your glucose into your cell, it goes into fat so you get tired after you eat because that demands energy and you also get a hard time losing weight or having weight loss. As they get into this inflammatory cascade and get this insulin-signaling response at the receptor and your body secretes more insulin. Insulin then stimulates fat cells, adipocytes, to release inflammatory cytokines. The inflammatory cytokines feed the underlying inflammation that's there. If it's autoimmunity, it feeds the autoimmunity itself. That's also why these people that has autoimmunity, when they crave sugar after meals and pass out, their autoimmunity flares up, so we have to get that vicious cycle under control. So we get the insulin under control by looking to see if the patient has insulin receptor sites symptoms. If they do, they're fatiguish and have sugar cravings after meals. If they have that, they have to decrease their portion size not for the rest of the day, but for that meal, then they have to see when they can eat again without getting tired. That's what they have to figure out throughout the day. The other thing we want to do is we want them to exercise, but we don't want them to over-train because it causes more inflammation and the biggest impact on insulin receptor responses right now as what we're understanding isn't how long you work out, it's how intensely you work out and just hitting a four-minute total window at various levels of burst and rest, burst and rest, so to have four minutes of high intensity exercise can start to make an insulin receptor respond pretty well. You have to be very careful not to get past that. If they do these two things, control their meal portion size so they don't crave sugar and get tired and then they can exercise at a point where they don't over-train and then they start loading up on things like turmeric and resveratrol and Vitamin D, they may have a chance to 15

unwind. The X factor is how well they can control their autoimmunity. The X factor is chemicals and environmental things that can do it. Let me get straight to the point. Whenever I say environment or chemicals, most people think, "I have heavy metals and I need to chelate them out." That is not what we're talking about. We're talking about loss of chemical tolerance. You're not going to chelate out some of these things out of your body. They're not chelating substances like formaldehyde or these other things. There is another part of this, which is, you have to have healthy detoxification pathways. Your liver has to detoxify some of these chemicals out of your body. What we typically find is when people have lab tests that show they have chemical antibodies, they have antibodies bound to human albumin, to mercury, and antibodies bound to formaldehyde, isocyanate or whatever. If they do chelation, they get worse because they don't have any chemical tolerance. When you do chelation, you get more chemicals in your bloodstream and you'll completely flare up. Next month in my newsletter, Dr. K News, I'm going to write a whole article about this and talk about some of the research we have in our lab and talk about the clinical correlations and also show some of the reviews of papers published that show many people that chelation have worsening of the reactions and more symptoms. These heavy metals were distributed to other tissues and it's actually really contraindicative for moderate to chronic people, so it's not just about chelation. I just want to put it out there. Anyways, that's one of the key vicious cycles we see with people that go on a Paleo diet and don't respond. So who can these people work with? I know that you just laid out some really awesome steps that people can take, but if they want more help and support, where do they find people like you? I'm sure your practice is extremely busy. Yeah, our practice is busy, but here's the deal. Anyone who's really good at what they do will have a busy practice, so if you really find someone that's good, you probably have to first be okay that it's going to take you some time. And also, if the person may be clinically good at what they do, they just may not work with you personality-wise. You just may not get along with them. If you don't get along with your healthcare practitioner, there's no 16

point, if they don't listen to you and you don't feel like you're onboard and click with them, so there are two issues here. Quite honestly, there's this trial and error. You have to find people and talk to them and see what they are. But if you are a person who's chronic and if you're doing the Paleo diet and you can't lose weight, you've got to assume that this is more than a chronic issue even though you may not have a disease. You're in a chronic physiological alteration and you're probably not going to just take chromium and fix this. You're probably not going to be just like, "I'll obviously eat the Paleo way and start losing weight." If you have a chronic pattern like that, there's a part of this where you cannot be a passive participant. You can't just find someone to help you. You have to basically help yourself. You have to really know these key things and start to read about them and understand them. You have to almost, in a sense, be your own practitioner. One of the key things that we see that's a difference between a chronic person getting better or not getting better is how active they are themselves. Passive chronic patients don't do it, so you want to be aggressive. You want to ask questions. Quite honestly, word of mouth is a really big thing. Just you can look for people through friends and forums and different networks. From my thyroidbook.com webpage, I have a list of some healthcare practitioners that have come to my seminars. Some of those people are good and some of them aren't. We have a disclosure saying all we know is they've attended some education, but we have no idea what they know or what they do and how they practice or even if they're a nice person or any of those things, so that's one way. Functional Medicine has a webpage, has a search engine to find practitioners. More than likely, the stuff we've been talking about, you're going to find with a Functional Medicine practitioner. They're called Functional Medicine practitioner and not a typical conventional physician who's handing out blood pressure and cholesterol medications and antidepressants all day. They're not going to really be the one to serve you for this kind of model. You can go to the Institute for Functional Medicine webpage and have a search engine. You can find practitioners that way, but again, you have to interview them. You have to call them. You've got to see what they're about. Quite honestly, you may have to drive. You may have to put some effort into doing it. They may not be around the corner next to you. 17

Yeah. They may be more expensive because they're not going to be in your network probably. Yeah, and that's the other factor. This is the unfortunate thing, is that the current healthcare model doesn't really appreciate diet lifestyle intervention and laboratory evaluations for physiological conditions. It's very much based on you have to have a disease, you have to be endstate sick, have a disease and then you have an approved drug for that disease that's been FDA-approved and that's all they will cover. If you are not losing weight to the Paleo diet, you do not have a medical diagnosis for this. At the very least, you should have your thyroid checked out and make sure you don't have any underlying pathology. It's not to say you shouldn't have a regular routine medical exam, you should, but if you're really trying to change your diet and change your lifestyle, you need to go to someone who's actually trained in that, and conventional physicians don't. Yeah, which is really unfortunate. Speaking of thyroid, I started following you a long time ago because of your book about the thyroid and I know that you focus a lot on autoimmunity, so if we could bring those two together and talk a little bit more about Hashimoto's because so many people suffer from it, as you know. Can you actually tell me how many people you think are misdiagnosed or do have Hashimoto's? Well, here's what we do know. According to the American Autoimmune- Related-Diseases Association, which is the leading platform for researchers and physicians and patient advocacy, their estimates right now are 1 in 12 women have an autoimmune disease. Their estimates are that there's more autoimmune disease than cancer and there's more autoimmune disease than cardiovascular disease. It's an epidemic. Here's the thing they use. They use the word "autoimmune disease", which is end-stage, progressed tissues totally destroyed. Many people, before they get to autoimmune disease, have chronic autoimmune reactivity. So in autoimmune disease, your immune system starts to attack your own tissue and destroy it and that can happen for 10, 15, 20- somewhat years. As it happens, you'll have symptoms and you'll be inflamed, but the current model doesn't diagnose a person until that tissue is totally gone. For example, some papers show that people that have thyroid antibodies sometimes have no symptoms and then they find that for sure in their 18

lifespan, they will develop autoimmune thyroid Hashimoto's and be hypothyroid. There are papers like that in the literature, these perspective studies once they find someone has antibody elevations. So it's just a matter of time? Exactly. A lot of people have it. The most common autoimmune disease of all is Hashimoto's, which is really -- what most people have is hypothyroidism. That's Hashimoto's-based, but they don't know they have an autoimmune disease because when they get diagnosed hypothyroid, they never get told what the cause of it is. They just say, "Well, you have it. Your mom probably had it. You have it," but the actual mechanism is that it's an autoimmune disease and 90% of all hypothyroid people have Hashimoto's based on textbooks at this point and just understanding conventional endocrinology basics, nothing new. It's been known forever. What people don't know is if someone gets diagnosed hypothyroid, the model is you get thyroid hormones and then you come back every year and get your measurements done again and see if they need to increase it. The underlying reason that was put together is because they know that the underlying mechanism is autoimmune, so what they expect is from one year to the next, more of the thyroid gland will be destroyed and that's why you probably should be checked and see if you need to raise your hormone. That model is always put together assuming pretty much everyone that has hypothyroid has Hashimoto's. Hashimoto's is an autoimmune disease, which is an incurable disease. It's a progressive disease and that's why they are on thyroid hormones forever, but no one gets told that and no one gets diagnosed because once you get diagnosed hypothyroid because your thyroid levels are abnormal, the next level of test to confirm it will be if someone ran thyroid antibodies against your blood and they wanted to see if you actually have something attacking your thyroid. Well, no one does the thyroid antibody test in insurance coverage models because it doesn't change the treatment, so why would they spend an extra $200 to $400 for a lab test that will not change treatment? So no one knows they actually have an autoimmune issue. Here's the deal. If you're hypothyroid, you probably have Hashimoto's, which is an autoimmunity. If you're going on a Paleo diet and probably if you have Hashimoto's, it probably helps you feel dramatically better especially being off gluten because it's very reactive against thyroid, but you may be stuck at a plateau. 19

Half the Hashimoto's people we see, hypothyroid people we see, have low or normal body weight and the other half are overweight. They don't fit the classic picture and they are a little bit confused because everything they've read about hypothyroid is that they should be overweight and half the normal weight, so we have this mixed pattern here. And then they're very frustrated because when they go on thyroid hormones, they're expecting what? They're expecting all the weight to go away. This is thyroid and it doesn't change because there's underlying vicious cycles like we just talked about, that the insulin and blood sugar in most autoimmune and thyroid patients, when they go on a Paleo, will probably usually feel a lot better, but they still may not be able to lose weight. Can we talk a little bit more about gluten? I just read one of your articles or something where you were like if you're not eating 100% gluten-free, you're not gluten-free and it's going to affect you. Can you tell us about that? Sure. The second book I wrote is "Why Isn't My Brain Working?" In this book, I spent a whole chapter really explaining gluten in great detail and laboratory testing and all that. If you have an interest, I would suggest you look at that book. Going through your question here when you look at gluten, we know that gluten itself is first of all a very reactive protein and there are different parts of the protein that have different effects on people. Think of gluten as a protein with different branches. There's an alpha branch and there's a gamma branch and there's gluten in there, wheat germ agglutinin that's part of it, and then there are all these different components to gluten. Most of the time, people test for alpha gliadin, which is only a part of it, and they don't test for the whole reaction. Now, they're finding that people who have gamma gliadin reactions get exercised-induced asthma, but not if they have alpha gliadin reactions. So they're studying gluten and this reaction is based on which branch the immune reactivity is of this protein tree to be very diagnostic, and as time goes on, we'll find out more. Transglutaminase is a lab marker that you have in your body, the enzyme that digests gluten. Transglutaminases found in your intestines is 2 that causes intestinal disruption; transglutaminase 3 is found in the skin that comes with skin reaction; transglutaminase 6 is found in the brain. They're finding some people only have transglutaminase 3 and that's why 20

they have skin breakouts and they have no intestinal complaints. Some people only have transglutaminase 6 and their brain gets destroyed from gluten, but they had no intestinal symptoms, and some have all three. The whole world of gluten is exploding and there are major things happening in this world. The key thing though is that it's not a trend. Researches have clearly shown that when they do regression studies or they do studies where they go look at subjects years before, retrospective studies of soldiers who were in an Air Force base in the '50s and they compare the blood samples now, there's been 50 times explosion to gluten sensitivity, and many people think it's modern wheat that's hybridized that causes some of these reactions. We know that this is a really, really big issue. Now, we also know that some papers have shown with the celiac genotype, which is HLA-DQ2 and DQ8, one exposure can cause immune response for six months. Oh wow, six months. Six months of inflammation. And people sometimes think, "Well, it's my birthday. I can make a little exception," but you can't. These little trace exposures can be a major reason why a person can't improve. This brings us back to someone's on Paleo and they can't lose weight. Well, maybe they're not really completely gluten-free. Maybe they're still getting exposed and they can't break that web of inflammation. Since they can't break that web of inflammation, they can't get their insulin under control. So if they can't get their insulin under control, they're stuck not having the effects of being on the Paleo diet where it should support their metabolism and so forth. That's actually a really common thing. You see many people that go Paleo, but they're still getting gluten exposures whether it's cosmetics, whether it's their shampoos. Those are all other possibilities. How does that exactly relate with the thyroid? How does that directly affect the thyroid? Maybe you already said that, but -- Well, gluten is one of these things where it has molecular mimicry. The theory is that it has molecular mimicry with the thyroid, that as you eat gluten, you make antibodies to gluten. Here's how this works. If you eat a protein, you make some antibodies against it to some amount and that's normal, but people that have food sensitivity have really high amounts of antibodies. These high amounts of antibodies then cause inflammation and reactions throughout the body. 21