Transcription
Hey guys, Dr. Child's here. Today, we're going to be talking about how to lower TPO antibodies if you have Hashimoto's thyroiditis. I've done videos on this topic in the past, but again, a lot of my opinions have changed, and I've learned about new therapies that I think are more effective than the previous ones I talked about. So, we're exploring this topic again.
Now, before we talk about the six treatments that we're going to be discussing here, I want to tell you two things that I want you to keep in mind as we have this discussion. Now, number one is, I want you to, as a thyroid patient, I think the best route is to shoot for zero thyroid antibodies. But, and this is a big but and a big caveat, if you can't get to zero thyroid antibodies, I don't want you to stress about it. Right? So, here's why: elevated thyroid antibodies increase your risk of developing hypothyroidism, however, they do not guarantee that you will develop it. Now, that's number one.
Number two is that thyroid antibodies are never normal under any condition. So, their presence alone indicates that something is off. Off, right? So, that's a good enough reason, in my opinion, to shoot for a low level. But again, don't stress if you can't get there. Instead, focus on a combination of your symptoms as well as that absolute thyroid antibody level. If your symptoms are improving and your antibodies are staying stable, that's usually not a big deal.
Number two is, I want you to know that these treatments are effective. However, they're not necessarily proven to work in every situation. So, as we talk about these, you'll see that there are some studies which actually show that they can be effective. But as I've learned this and as I've treated patients in the past, I've taken therapies which have been quote unquote proven to be effective and I've given the patients for the condition that they're proven to be effective in, only to find out they have no benefit at all. Right? And so, that, that's just the way it is. Right? Not every single patient is going to respond the exact same to the same therapy. So, we're going to talk about six here, which means that if one doesn't work, you can try the others. But no matter what, it's going to take some element of trial and error on your part to figure out what works best for you.
So, with that in mind, let's talk about how to lower TPO antibodies, and we'll be going down here so that you can follow what I'm doing. So, the first one is Nigella sativa. Now, if you haven't heard about this, don't worry, I'll explain it to you. Nigella sativa is a plant that produces black seeds, and from black seeds, we cold press them and we extract black seed oil. Now, the reason we're talking about this first is because it has a double-blind placebo-controlled trial showing that it has effectiveness in treating Hashimoto's, which makes it unusual among many of the other treatments that we're going to be talking about today or going on here as we proceed.
Now, again, what I want, I'm hearkening back to what I said previously, which is just because it's been shown in some clinical studies to be effective, even in a double-blind placebo-controlled trial, doesn't guarantee that's going to work for you. However, when we have an ingredient, especially a botanical or a plant or a natural treatment that has that kind of study, it's definitely worth looking into. So, what did this study show? And it was a relatively small study, by the way. So, it's like, I think it was in the mid-40s or or 50s or so. And this is what it showed: it showed that patients who took it saw a decrease in thyroid gland, we'll abbreviate that, size, which is a really good thing because in Hashimoto's thyroiditis, we usually have some inflammation which increases the size of the thyroid gland. We also saw a decrease in vascularity, which is really just the blood vessels coming inside of the thyroid gland. The more blood vessels that you have in the setting of Hashimoto's, the worse off the condition generally tends to be. Okay? Then, in addition, we saw a pro-thyroid benefit. So, patients who took, um, Nigella sativa saw an increase in thyroid lab tests, so an improvement in their thyroid lab tests. And this did include a decrease in thyroid antibodies. And then finally, we saw an increase in weight loss. It actually wasn't weight loss, it was a decrease in the circumference of the weight of the waist. However, that does is associated with fat loss. So, I'm going to call it weight loss, even though technically speaking, it wasn't weight that was lost, it was fat that was lost.
Now, these four things, right? We have four benefits here, are pretty significant. And again, they come from a double-blind placebo-controlled trial of people taking Nigella sativa, which is the plant powder. Now, I don't think you have to necessarily focus on that because remember what I said in the beginning: Nigella sativa is the plant that produces black seeds, and you can actually take black seeds and create black seed oil. So, I think that you can get, my experience suggests that you can get the benefits not using the plant powder necessarily, but also using the black seed oil. So, if you're going to do that, you can look for BSO, and usually, you're looking for a three percent thymoquinone solution. And thymoquinone is the active ingredient inside of black seed oil. So, if you're going to use that, that's what I recommend looking at. And if you can, it's best to standardize for the other ingredients, which include carvacrol, P-thymine, and free fatty acids. So, this one is definitely worth looking into. It is an over-the-counter supplement and it can be used and can be effective, at least in my experience. Okay, so number two. That's number one.
Number two, we have low-dose Naltrexone, which is sometimes abbreviated as LDN. Now, many patients with Hashimoto's are already familiar with LDN because, well, it's just talked about a lot in circles. Now, the problem with LDN is not necessarily that it, that it doesn't work, because it does in some cases, and we'll talk about that in just a second. The problem is, it can be pretty difficult to get because you need to have a doctor who's willing to prescribe it for an off-label purpose. Now, an off-label, LDN is used off-label, and all that means is that it wasn't intended originally to treat the condition we're recommending that it be used to treat. Okay? So, in the beginning, it was used to treat alcohol dependence. That's really why it was designed to do. Now, later on, doctors found that, whoa, it actually had a positive benefit on the immune system. So, now we're seeing it used in a lot of autoimmune conditions: Hashimoto's thyroiditis, rheumatoid arthritis, chronic pain conditions, and even weight loss. Right? So, it has a lot of benefits outside of just the use in autoimmune disease. But again, as I said, it is a prescription medication. Normally, what happens is your doctor prescribes Naltrexone in a high dose, at 50 milligrams. Now, that's not the dose we need. The reason we call it low-dose Naltrexone is because the dose is much lower than that. So, the dose for that you're looking for, if you're using it for therapeutic purposes, purposes, is 1.5 to 4.5 milligrams per day. That's really the dose that you want to look at if you're a patient with Hashimoto's thyroiditis.
Now, in terms of effectiveness, um, let's talk about that because we've talked about that with black seed oil, we talked about that with some of the other ones, and it's not quite as effective as you might think. So, a lot of people will tout this as a really, as honestly, a miracle prescription medication. And it is true that some people obtain a lot of benefit when they use it. But if you actually look at the numbers, it's only about 50% of people see some improvement, whereas 50% of people who take it see no improvement. Okay? So, automatically, there's a 50% chance that you'll, that it will have zero benefit on you. Now, of the 50% that it works, 25% see pretty good, pretty good, a significant improvement, and about 25% have what we'll say mild improvement. So, there's really a one in four chance that it will be significantly beneficial to you. Whoops, I have the wrong thing there. A one in five chance that it will be significantly beneficial to you, and about a one in two chance that it will have no benefit for you, and then a 25% chance that you might notice, you know, some minor change. Now, when you look at that, um, that's still actually not that bad, considering that there really aren't any good treatments for lowering thyroid antibodies in Hashimoto's. So, I still think it's worthwhile using and giving it a try. But you should have that expectation going into it that it's probably not going to be this miracle drug or this miracle prescription that you've heard about. Right? So, that's just kind of the way that it is.
Next, I want to talk about diet. So, I'm going to talk about two diets here in particular, but there are many different diets that you can use. Now, yes, I will say this: when we talk about diet, diets can be effective and should always be done if you have Hashimoto's thyroiditis or really any thyroid condition at all. No matter what, you should be doing something with your diet. Now, generally speaking, just changing your diet is not usually sufficient to elicit a huge beneficial impact all by itself. Right? So, what that means is, in addition to diet, no matter what you do here, you should be changing your diet. But in addition to changing your diet, you should probably also consider LDN and Nigella sativa or black seed oil and some of the other ones that we will be talking about in just a minute here, because combining these things together is really what's going to give you the best benefit.
Now, in terms of diet, I've talked about many of the diets that can be used to treat Hashimoto's. I'll talk about just two of my favorites here because these are the ones that I think most thyroid patients should start with. And we have the gluten-free diet, the dairy-free diet, and the soy-free diet. That's what this abbreviation means. So, I think this one is the best one to start with because I think it allows a lot more flexibility in terms of the foods that you eat. However, one of the problems with this diet is you have to spend a lot of time learning about it. Right? You have to learn where, you have to learn to read nutrition facts panels and supplement fact panels, or not supplement facts, but nutrition labels, ingredient lists. You have to learn allergen information. So, it does take a little bit of effort on your own to learn that stuff. But I will say, no matter what you do, that information that you learn is going to be beneficial. But if you're, if you're strapped for time or it's going to be too difficult, then what I'm going to say that is probably a really good alternative is Whole30. And the reason I pick Whole30 is because that has a lot more structure to it. It's laid out, there's recipes, there's a community, it's really easy to get into, and it's really good to, to get you in, to dip your toe into the water of healthy eating, learning how to cook, and evaluating that sort of thing.
Now, there are many other diets: keto, carnivore, food, or any sort, any sort of whole food elimination, low FODMAPs, I mean, we, AIP, we have so many different diets that I have used successfully in patients with Hashimoto's. But I think starting here is probably the easiest thing that you can do, and it'll give you the biggest bang for your butt, buck. And if you can't, or if these are looking too intimidating, at least try going gluten-free and dairy-free. I see the most benefit just getting these, uh, just removing those two things out of your diet if you have Hashimoto's. So, that's diet.
Next, we have vitamin D. So, vitamin D is kind of another funny one, um, because there has been, let me explain to you why it's important, and we'll talk about sort of what happens if you take vitamin D. So, we know that low vitamin D levels, any patients who have these, a deficiency in vitamin D, are at increased risk for developing autoimmune disease just in general, as well as even thyroid cancer, by the way. So, there's lots of reasons to increase your vitamin D. Now, some people have done studies and they've tested people and they've given them vitamin D and they've assessed their, their thyroid antibody and the inflammation in their, in their thyroid, and they found that yes, there is a benefit to using vitamin D. Now, I will tell you, in the real world, in clinical practice, giving vitamin D to hundreds, and honestly, probably thousands of people at this point, but lots and lots and lots of people, it's rarely ever the case that taking vitamin D is sufficient all by itself to reduce thyroid antibodies. Right? So, in other words, if you're listening to this and you're thinking, "Oh, well, vitamin D, it's, you know, $10, $15, $20 to buy on Amazon, let me just go buy some vitamin D and that'll help my antibodies," that's probably not the case. However, even though it may not lower your thyroid antibodies, it's still going to be beneficial because you don't want that vitamin D level low. So, it's still worth using. But just don't, just don't expect a dramatic change just by using vitamin D alone. But in addition to all the things we talked about, change your diet, take some other supplements, consider looking at LDN, look at some of the other things we're going to talk about in just a second here, like your testosterone level. That's how you're going to get the most out of it, out of vitamin D.
So, if you're going to be using vitamin D, my recommendation would be not necessarily to use a supplement first, but instead, try getting your vitamin D naturally through the sun. And if you're unable to do that because of the latitude that you live at or the location or whatever, if you're just unable to do that because of your work, or maybe you work nights or something like that, then you can consider supplementation with vitamin D3. Now, the dose is going to be different for each person. Generally speaking, that's somewhere between 2000 IU to all the way up to 10,000. Honestly, see if we can fit that on there. All the way up to 10,000 IU. So, you're going to have to experiment to see what works best for you. Do not increase your vitamin D above the threshold to put you into the high range. I don't think you'll get any benefit there. That's usually about 60. I forget about the, I'm, I don't have the units off the top of my head, but usually, you don't want to go above 60 on the range that's provided with the vitamin or the vitamin D hydroxy test. So, look into that. Don't go above that.
Number five, we have selenium. Now, this is another really beneficial one because of the impact that selenium has on protecting your thyroid gland. So, if we were to think about Hashimoto's thyroiditis, we would, we would have to realize that the majority of the damage done inside of your thyroid gland occurs because your own immune system is attacking itself. Now, that's generally what happens, yes, but there's also an inflammatory component that's occurring, right? Because there's sort of like casualties around the inflammation that's occurring. Now, part of that is because your thyroid gland, when it produces thyroid hormone, it's a little bit of it creates free radicals that can cause damage. Now, normally, glutathione comes and it cleans that up. But we have found in patients who have Hashimoto's that they have a decrease in glutathione levels, and part of that comes because they have a decrease in selenium. So, taking selenium allows you to increase glutathione naturally, and then therefore, it protects your thyroid gland. So, taking selenium is actually really beneficial if you have Hashimoto's thyroiditis, and something that I think every single patient should consider. I actually recommend that you take it. You, you definitely need to be getting it. Now, you don't necessarily have to get it from supplement form, but you should be getting at least about 100 to 200 micrograms per day of selenium. That's generally the dose that I think works best for patients who have Hashimoto's. Now, there is some argument to make for going up to 400 micrograms per day. So, if you, this is called supraphysiological dosing, meaning you're taking a higher than normal dose because you're trying to elicit a more beneficial reaction. So, you can do that if you're somebody who thinks will benefit from that. But in general, the majority of people, I think, do better in this range here, 100 to 200 micrograms per day.
Now, if you are taking iodine, one of the, one of the reasons that a lot of people have negative reactions to iodine supplementation is because they have decreased selenium. So, taking selenium in conjunction with iodine will actually protect your thyroid gland. And there have been many studies which have shown that taking selenium has a decrease or has a beneficial effect and it will decrease Hashimoto's antibodies, we'll call it HAB. Now, there have been some studies which show that there is no benefit. When I look at all the data, the common thread that I see is that the people who gain the most benefit from using selenium are those people who are already deficient before they start taking it. So, that's something to consider there. Then the last one, but by the way, I still recommend for most patients with Hashimoto's using selenium. I just think that that's something that I find a lot of benefit in and I do think it's worth it.
Now, number six is maybe one that you haven't heard of, and that is the use of testosterone. But really, what we're talking about are really any androgens, which would include DHEA. Well, if I could spell that right, DHEA, which is a weaker androgen, but it still is an androgen. So, testosterone or androgens in general seem to have a beneficial effect on the immune system. They have a calming effect on the immune system. And the reason we know this is because there are men and women who both get Hashimoto's thyroiditis. But when you look at the difference in terms of who gets it more frequently, women get it anywhere from, depending on the study you look at, six to ten times more, more frequently than men do. So, for every six women that have Hashimoto's, or six to ten, there's one man who has it. In other words, it's way more common in women. And part of that reason is because women at baseline have a lower T level, they have a lower testosterone level. But in addition to that, having hypothyroidism reduces that testosterone level further. So, you have a double whammy here.
Now, what you can do is you can check your total testosterone, total T, and free T. And if that testosterone level is low, you can actually supplement with physiologic, which just means normal testosterone levels, to improve it. So, we're not talking about giving a woman a man's dose of testosterone. We're not talking about that. We're talking about just replacing that testosterone to an optimal level for which is normal for women. And doing that, I have seen a positive benefit in a lot of areas. And in fact, not only does it improve your, um, thyroid status and your autoimmunity for your thyroid gland, it also has an impact on building muscle mass, which will help with weight loss, and it also has a positive effect on mood, as well as libido. So, I think testosterone, really, if there were any here that were secret therapies, testosterone would be the one that I want you to look at. As well as, well, honestly, all of these. But Nigella sativa is one that not a lot of people know about. LDN, most people know about. Diet, you should be doing. Vitamin D, no matter what you want to do. Selenium is really easy to take. And then testosterone, make sure you check before you use it.
Now, in my opinion, you'll probably get a pretty significant reduction in thyroid antibodies for most people. I'd say about 70, 80% of people who seriously look into these options and try them. And for the rest who don't, they will still have done a lot of good along the way. They'll still see a reduction in their, or an improvement, I should say, in their symptoms. So, that's all I have for you guys today on how to lower thyroid antibodies. If there are lots more, by the way, these are just the ones that I think are some of the most effective. But if you have any questions about these, uh, please feel free to leave your comments below. I'll do my best to answer those questions. If you haven't already, make sure that you download my free thyroid PDF resources. I have tons of information all designed to help thyroid patients like you. So, if you found this information helpful, I think you'll like that as well. So, that's all I have. And otherwise, I'll see you guys in the next one.