Dr. Bryan Walsh is an “answers doctor” who helps people deal with the particular questions that come up during their daily lives. He is the author of ” Doctor Detective: The Life and Times of a Medical Maverick ” and ” The Drunken Botanist: How Plants Talk to Us and Other Tales of Idiolepsy “, and he is also the co-host of the radio show ” Doctor Detective “.
From exploring ancient viral mutations to super-powered bacteria to medical mysteries on the verge of a breakthrough, we are here to investigate the surprising causes of disease, the unexplored consequences of our technologies, and the groundbreaking cures that are just beyond our grasp.
We live in a world where doctors and scientists are joining forces to find a cure for cancer. And the potential just keeps on growing. The genomic era—the ability to sequence DNA, determine the genetic characteristics of diseases, and isolate the causes of diseases—will speed up the pace of discovery. In the near future, the tools we need to fight disease will be in the hands of more people than ever before.
Doctor Detective meets a lady with thyroid problems in this week’s case study. Low thyroid may impact individuals of various shapes, sizes, ages, and phases of life, particularly women. There are many symptoms, and therapy is difficult. Doctor Detective, on the other hand, knows exactly what to do. Learn why addressing the underlying cause of a thyroid issue is frequently more effective than just taking thyroid medication.
Eat less calories and exercise more. It’s a fantastic prescription for boosting health and body composition in general. It does not, however, always work.
Even with a great workout routine and a well-balanced diet, some individuals have strange symptoms and complaints, especially considering how much effort they put into their fitness and health.
We know there are just a few specialists on the world to turn to when we encounter customers who have issues that exercise and diet — not to mention their own physicians — can’t seem to cure. Bryan Walsh is one of them.
Dr. Walsh has a keen intellect, a fitness background, a naturopathic medical degree, and a long list of extra training and certifications. His wife, too, is a naturopath. (We’re willing to wager that his children are the healthiest on the world.)
Dr. Walsh transforms from mild-mannered parent and husband to forensic physiologist when clients have nowhere else to turn. He takes out his microscope and examines blood, saliva, urine, lifestyle, and everything else he can think of. He also breaks the physiological impasse.
That’s why we leapt at the opportunity to collaborate with Dr. Walsh on a monthly case study segment. You’ll learn how to enhance your own health and discover how a skilled practitioner thinks by following along with these interesting instances.
In today’s case, we’ll meet a patient who presented to Dr. Walsh with a slew of symptoms, including elevated cholesterol, unwelcome hair growth, persistent weight gain, and severe gas and bloating.
Learn how “Doctor Detective” Walsh solved the puzzle and assisted this customer in achieving unexpected outcomes.
We met Jill, a young lady suffering from acne and hormone problems, in our first Doctor Detective episode last month. Jill no longer had the symptoms that led her to our clinic after a successful dietary intervention. Not only that, but she also became pregnant, a long-held ambition of hers that she had almost forgotten about after years of failed efforts.
Jill contacted us again six months after giving birth to a healthy baby girl. She hadn’t recovered from her pregnancy. She felt weary, a little sad, and just plain lousy. Her physicians diagnosed her with postpartum depression. We had a feeling it was something completely different.
But before we continue with Jill’s tale, we must first tell you about someone else.
Mary, the mother of a 19-year-old lady, approached us for assistance. Mary had been experiencing issues for a long, and many health care professionals had been baffled.
High cholesterol: Despite using numerous medicines, Mary’s high cholesterol was not improving. Mary’s physicians, as well as her mother, were worried.
Mary was under pressure to be slim as a first-year college student due to PCOS and persistent weight gain. Unfortunately, Mary had been diagnosed with polycystic ovarian syndrome (PCOS), a condition that makes losing weight difficult for women.
Mary was on a variety of medicines, including Synthroid (thyroid hormone), Yasmin (birth control given for her PCOS symptoms), statins (cholesterol-lowering meds), and spironolactone (spironolactone is a kind of spironolactone) (typically a high blood pressure medication, but is used off-label for acne). No 19-year-old should be taking so many medicines and enduring so much pain.
Mary was depressed due to her high cholesterol, PCOS, intractable weight loss, and a slew of pharmaceuticals. It was a riddle, to be sure.
Mary and her mother arrived at our office with piles of test results from her physicians at Johns Hopkins Medical Center. It was time for the Dr. Detectives to get down to business.
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Symptoms and indications of the client
Unwanted facial hair development, irregular periods, mood swings, and trouble reducing weight were Mary’s main concerns. She said, “Diet and exercise don’t work for me.” She tried a variety of diets and followed them faithfully, but her weight remained unchanged.
Here are her indications and symptoms, as well as our first thoughts:
|Symptoms / Signs||My views on the subject – possible problems|
|Swings in mood||Blood sugar balance, neurotransmitters, sex hormones, thyroid hormone|
|Weight reduction that is difficult||Thyroid hormone, sex hormones|
|Bloating and excessive gas||Inflammation of the stomach and intestines, as well as impaired digestion and absorption|
|Hair growth that isn’t desired||Hormones of sex|
|Sweating excessively||This is most likely a spironolactone adverse effect.|
|Cholesterol levels are high.||Thyroid hormone, uncontrolled blood sugar, and diet|
Mary’s indications and symptoms all point to a few common threads: thyroid problems and sex hormone abnormalities, as well as potential blood sugar problems and intestinal difficulties. We certainly have some significant indications at this time.
The exams and evaluations
Mary is on thyroid hormone, indicating that she has been diagnosed with hypothyroidism. The issue remains, however: why? Why is her thyroid gland already malfunctioning at the age of 19?
More diagnostic testing were explored. We didn’t need to conduct a full blood chemistry panel since Mary already had a stack of blood test results. We did, however, order a thyroid antibody test to determine whether her thyroid problems were caused by her immune system.
We also knew she had sex hormone abnormalities because of her PCOS diagnosis, but we wanted to check them out for ourselves, so we performed a salivary hormone panel.
The results of the tests
Panel of blood chemistry
Mary’s prior blood chemistry tests revealed the following:
|Marker||Result||Reference Range in the Laboratory||Thoughts|
|glucose levels after a fast||79 mg/dL||65-99||Borderline low – reactive hypoglycemia is a possibility, but early insulin resistance is more probable.|
|Albumin||3.9 g/dL||3.5-5.5||Low – presumably due to impaired liver function, which includes the capacity to digest and eliminate sex hormones.|
|Lactate dehydrogenase is a kind of enzyme that breaks down lactate (LDH)||129 IU/L||100-250||The difficulty to get glucose into cells is confirmed by the fact that it is borderline low (i.e., early insulin resistance)|
|White blood cells are the cells that make up the blood (WBC)||4.5 x 103 mL/uL||4.0-10.5||Immune suppression is a possibility since the level is borderline low.|
|The volume of the average corpuscle (MCV)||95 lF||80-98||B12/folic acid insufficiency is borderline high (common with digestive issues)|
|Red blood cells are the cells that make up blood (RBC)||4.95 x106 per uL||3.80-5.5||Dehydration, increased testosterone, or both may be the cause of the borderline high.|
|Thyroid-stimulating hormone (TSH) is a hormone that stimulates the thyroid gland (TSH)||10.8 micrograms per milliliter (uIU/mL)||0.45-4.50||TSH is elevated, despite the fact that I’m taking Synthroid, which is supposed to decrease it.|
|T4 is a four-letter word (thyroxine)||6.0 ug/dL||4.5-12||Synthroid may be to blame for the low levels.|
|T3 (Third) (triiodothyronine)||59 ng/dL||71-180||Low – inert T4 is not converted into active thyroid hormone.|
|Cholesterol total||259 mg/dL||100-169||Elevated – perhaps owing to a lack of thyroid hormone or a blood sugar imbalance.|
|HDL cholesterol (high-density lipoprotein)||89 mg/dL||>39||Elevated – inflammation is most likely.|
|Vitamin D||18 ng/mL||32-100||Low – unclear cause|
According to the results above, Mary has a problem with blood sugar management and getting glucose into cells to be utilized as energy (which is insulin’s function). This is unsurprising, given that blood sugar and insulin problems are often associated with PCOS.
Also, her liver does not seem to be functioning as well as we would like, and she may be suffering from B12/folic acid insufficiency, resulting in sub-clinical anemia, but this is difficult to determine because to the increased red blood cells.
Thyroid: The Link That Isn’t There
But it wasn’t the most important result in her blood tests. Our thyroid antibody panel revealed the following “smoking gun”:
Mary’s thyroid antibodies, both thyroid peroxidase and antithyroglobulin antibodies, have substantially risen. This indicates that she has Hashimoto’s syndrome, an autoimmune thyroid disease in which the thyroid gland is attacked by the immune system.
Thyroid production declines and thyroid antibodies rise as a result, as shown by Mary’s test results. The thyroid is inflamed, and it is unable to perform its function of assisting metabolism. People gain weight, get chilly and irritable, have slow digestion, fluctuating blood sugar levels… and have high cholesterol.
The symptoms are consistent, and the lab findings round out the picture. We were getting closer to solving the issue.
Mary was placed on Synthroid around five years ago because her thyroid gland was not producing enough thyroid hormone. Her thyroid wasn’t being sluggish, as it turned out: her immune system had attacked her thyroid gland. Her body wasn’t converting thyroid hormones either: inactive T4 wasn’t being converted to active T3, and vice versa. We believe this is due to her immune system’s instability once again.
This result is crucial since she is likely to have more than one autoimmune disease. When the immune system is out of whack, it attacks a variety of tissues and glands throughout the body. Our initial objective, based on her increased thyroid antibodies, is to restore balance to her immune system.
Panel of hormones
Surprisingly, Mary’s salivary hormone panel showed that she was in excellent health. Her cortisol levels were normal, and her rhythm was normal. Her testosterone, androstendione, and estradiol levels were all within normal ranges, but her progesterone was low.
We’re still interested in her hormones, and we’ll probably do a month-long salivary hormone test to monitor them over time, but for now, the immune system is our main concern.
It’s natural to desire to tackle a number of tasks at once. However, it is preferable to accomplish one item at a time.
The treatment plan
Mary had a number of apparently unconnected problems, including high cholesterol, mood swings, difficulty losing weight, gas and bloating, and irregular menstrual cycles, but we discovered one potential link between them all: her immune system.
The immune system is a mechanism that protects the body against
One of the most common systems in the human body is the immune system. The immune system, unlike other systems, has no home; its chemicals are produced by nearly every cell in the body, and every cell reacts to immune system chemicals.
The first task is to activate the immune system.
The first problem is blood sugar abnormalities.
Insulin and hormone changes result from blood sugar abnormalities. This has a negative impact on the immune system.
We advised Mary to consume frequent, protein-based meals and to not go more than 3 hours without eating. Mary acknowledges that eating this way at college is challenging, but we advised her on how to bring nutritious snacks to class, which she agreed to do. Fans of will know that eating regular meals with lean protein is one of the most important habits for becoming slim and healthy, particularly for those with blood sugar issues like Mary.
The Digestive System (Issue #2)
The digestive system is a surprise power player in maintaining the health of your immune system. According to some estimates, the gastrointestinal tract contains as much as 80% of the body’s immune system. Any digestive disorder indicates an issue with the immune system.
We didn’t want to have to wait three weeks for test findings. We wanted to get to the bottom of the stomach issues as soon as possible. This includes the following:
- Mary is allergic to inflammatory foods, therefore she’s on an elimination diet. Because she has positive thyroid antibodies, she must avoid gluten, dairy, and soy for the rest of her life. Eggs, maize, nightshades (tomatoes, peppers, eggplant, potatoes), and most grains (save rice) were among the things we advised her to avoid.
- Digestive support — This includes 2-3 capsules each meal of a digestive enzyme supplement (Digestzyme by Designs for Health) to aid in the breakdown of meals for better absorption.
- Gut nutrition – Several substances have been demonstrated to aid in the improvement of digestive tract health. 1-2 scoops of Designs for Health GI Revive were given to her.
- Probiotics – We don’t often suggest probiotics, but Mary had a history of antibiotic usage, so we chose to include them in her treatment plan. For thirty days, we took two capsules twice a day, ideally on an empty stomach, of Klarie laboratories’ Therabiotic Complete, then reduced the dosage for the following 60 days.
Support for the Liver (Issue #3)
From a clinical standpoint, poor liver function does not have the same impact on immune system function as it does on other systems. However, if her liver isn’t functioning properly, we’d want to obtain a more precise picture of our progress. Antibodies are processed in part by the liver.
In other words, if Mary’s liver isn’t functioning properly, she may be unable to remove her antibodies. Thyroid antibodies may still be high if we repeat a thyroid antibody panel — this time, not because of her immune system, but because she is unable to eliminate antibodies. So we added two Amino-D-Tox (Designs for Health) pills to her regimen.
Immune Support (Issue #4)
We aren’t presently on board with the Vitamin D craze that has been sweeping the medical world for the last several years, although there is some convincing evidence linking vitamin D levels to autoimmune diseases.
We recommended 6,000 IU of vitamin D, along with other fat-soluble vitamins, for 30 days, then dropped to 4,000 IU and retested in 90 days, based on this study and Mary’s low levels. In addition, we added 1 gram of fish oil per day for its anti-inflammatory and immune system advantages in autoimmune diseases.
Issue #5 – Miscellaneous
We suspected Mary had vitamin B12 deficiency, which may lead to a sub-clinical anemia, therefore we gave her 1 mg of sublingual B12 three times a day.
We want to do a lot more with Mary, but first and foremost, we need to quiet down her immune system before moving ahead with other choices.
The end result
Mary contacted us a few weeks into the program to report that the gas and bloating had vanished, she was no longer experiencing mood swings, and she was feeling better and more energetic than she had in a long time. She also said that she had dropped 10 pounds in three weeks and that her clothing were fitting better.
We usually rerun blood chemistries every three months, cortisol every 30 days, and other sex hormones every six weeks when dealing with a patient. We opted to keep her on the exclusion diet and supplement regimen for three more weeks since she wasn’t due for any of them and antibodies may take a long time to remove out of the body.
We re-ran her blood chemistry, including a thyroid panel, at the conclusion of the six-week period. Among the important results were:
- Her thyroid antibodies were half as high as they had been. This indicates her immune system is calming down and reducing the amount of time it spends attacking her thyroid.
- Her total cholesterol fell 45 points as a result of better thyroid hormone conversion and blood sugar control.
- Her total T3 level rose from 59 to 84, which is still low but significant improvement. This indicates that her immune system is balancing out. And it’s most likely why she’s gaining energy and losing weight.
- Her RBC level decreased somewhat, suggesting that she was keeping hydrated better.
- Other issues remained: her albumin was still low, her glucose and LDH were still low, and her MCV was still high.
We haven’t “fixed” autoimmunity yet, but we’re making progress. Which brings us back to Jill, who was the focus of our first case study…
What happened to Jill, then?
We performed a blood chemistry test on Jill after she contacted us after delivering her baby. The results of her thyroid panel were as follows.
Given that Hashimoto’s is now the most common cause of hypothyroidism, we tested her antibodies, which came out as follows:
Thyroid antibodies are high and TSH is high. Does this seem familiar to you?
Both ladies have Hashimoto’s disease, which is sadly more prevalent than most people know nowadays. We don’t know what caused it in Mary, but it was most likely her pregnancy that triggered it in Jill.
Fortunately, the testing revealed what we needed to do to make Jill feel better. She now lives a gluten- and dairy-free diet, manages her hormones and blood sugar, maintains her energy levels, and spends quality time with her now 2-year-old kid. She’s also expecting her second child.
Low thyroid may impact individuals of various shapes, sizes, ages, and phases of life, particularly women.
What can we learn from Mary’s (and Jill’s) experiences?
- Symptoms may arise from a variety of physiological abnormalities, but most of the time there is a single underlying cause. Mary’s immune system most likely caused harm to numerous tissues in her body, including her thyroid gland.
- Hypothyroidism (poor thyroid function) is a prevalent condition nowadays. Synthroid is one of the top four most often prescribed drugs in the United States. While there are many potential reasons for hypothyroidism, Hashimoto’s disease is at the top of the list. When an autoimmune illness develops, it is no longer simply a “thyroid problem,” but rather a condition affecting the whole immune system.
- Eliminate anything that may aggravate immune system imbalances, such as autoimmune diseases, to start repairing immune system imbalances. This involves controlling blood sugar levels with frequent, well-balanced meals, avoiding foods that stimulate immunological reactions (such as wheat and dairy), and optimizing digestive system performance.
- We can assist the immune system balance out even more after we’ve covered the fundamentals… but only after we’ve removed the main triggers.
- The basic behaviors of style eating may be included into a treatment plan. Two of the cornerstone behaviors of effective body transformation, athletic performance, and overall wellbeing include eating every 3-4 hours and consuming lean protein with each meal. We had to make some changes to Mary’s meal composition to accommodate her elimination diet, but eating PN-style is a wonderful strategy for most health issues.
If you’re a coach or wish to be one…
It’s both an art and a science to guide clients, patients, friends, or family members through healthy food and lifestyle adjustments in a manner that’s tailored to their individual body, tastes, and circumstances.
Consider the Level 1 Certification if you want to learn more about both.
The latest episode of Doctor Detective with Bryan Walsh was a double feature, with two stories. The first was about a medical mystery: a man in a coma who is being kept alive with a feeding tube. The second was about a medical mystery: a man who is on a suicide watch in a mental hospital. Both of these mysteries are about medical science.. Read more about the good detective and let us know what you think.
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