FHP – Ep. 13 – “All About Functional Gut Health” feat. Dr. Michael Ruscio, DC

FHP - Ep. 13 - "All About Functional Gut Health" feat. Dr. Michael Ruscio, DC

Dr. Barter talks with Dr. Michael Ruscio all about the importance of functional gut health.


Dr. Ann-Marie [00:00:00] Today, we have the opportunity to interview Dr. Michael Ruscio. We’re going to talk about important topics today, like diets for gut health, how an individual diet recommendation is better than an overall broad diet, how foods that seemingly are healthy can be causing your bloating like broccoli. How hygiene practices could be affecting the diets. These stress gut connection and what you can do about that and how the thyroid and the gut are so closely related and how if you’ve been on thyroid medication, how you’re not feeling any better, how it might be important to take a look at your gut.


Intro [00:00:46] Welcome to the Fearless Health podcast with host Dr. Ann-Marie Barter. Dr. Barter is on a mission to help people achieve their health and wellness goals and help men and women live their best lives fearlessly. Dr. Barter is the founder of Alternative Family Medicine and Chiropractic in Denver and Longmont, Colorado.


Dr. Ann-Marie [00:01:07] Thank you so much for joining us here on Fearless Health podcast. I am your host doctor and your father. And today I am so excited because I have Doctor Dr. Michael Roscoe here today. He is a doctor, a clinical researcher and a bestselling author whose practical ideas on healing chronic illness have made him an influential voice in functional and alternative medicine. I’d love for you to introduce yourself.


Dr. Michael Ruscio [00:01:38] Sure. Well, thank you for having me. And I’m a clinician, a researcher and author. I had a number of gut health challenges myself in college, which diverted my path into more of the alternative medicine camp, and it’s been a great field to be in. There’s a lot of great information, especially regarding gut health and how gut health can or lack thereof can be the cause of things like insomnia, brain fog, joint pain, skin issues, depression, not just gas and bloating and reflux, which is oftentimes overlooked. And so it’s been a real honor and privilege to work in this space. That being said, there’s also quite a bit of overzealousness in the space, and I’ve tried to really bring a progressive but cautious mentality to how I look at information and run everything through a pretty strict scientific filter. And by doing this, we really help people get recommendations that are going to help them. And that’s what’s so nice about using science as science will help you take the guesswork out of what to do. So that’s kind of the short synopsis in terms of me and the few things that I’m involved in relative to gut health.


Dr. Ann-Marie [00:02:50] Well, your book is awesome. So that was fantastic. And the one thing that I really love about your book and just being in practice is you don’t prescribe a specific diet. And I’d like for you to go into that because I think the number one question. People come in with is what should I eat or. I heard about this keto diet or this paleo diet or this, and so I think that I should eat that because of X, Y and Z. And I love that you’ve taken an individualized approach to diet because we see certain people be sensitive to this and other people be sensitive to that. So I’d like to get your perspective on that.


Dr. Michael Ruscio [00:03:36] Yeah, it’s a great question, and I think we’re all amenable to bias. And you know, if you gravitate toward a low carb diet and it’s worked well for you and you’re a doctor or a researcher, you have a tendency to bring that bias into your clinic or into your research. There’s nothing necessarily wrong with that. But when we’re giving recommendations to other people, it’s very helpful if we can broaden our our lens and make sure that we don’t only focus on the evidence showcasing how what we gravitate toward works, but how there are other types of dietary approaches for other people. And so we can have our perhaps personal preference, if you will, fine but also be aware of what the signs and indicators are that someone may do well on a different approach so as to be able to navigate someone through the maze of available diets to the one that’s going to work best for them. So there are a number of diets that can be helpful for gut health or just for overall health, because really there’s not a line in between and separating gut health from overall health. Usually, what’s best for the gut is best for the individual and vice versa. And there’s a few broad strokes, but to say it’s simply the first step is really food quality, and we all probably get that. You don’t want to be drinking sugar sweetened sodas and processed foods and trans fats and things that are deep fried and things like this and focusing on whole fresh, unprocessed foods that that’s really your step one. And then from there, there’s a few nuances from a gut health perspective. The two main nuances would be identifying, said loosely food allergens or foods that are inflammatory to your system. This can include things like withdrawing from the diet, gluten, dairy, soy, just to name a couple. And then there’s a different nuance that’s a bit more contemporary, but also very promising. And this is a low FODMAP diet, and this diet restricts foods that have a tendency to feed bacteria in the gut, which isn’t good or bad. But the context matters where if someone has a preexisting overgrowth of bacteria and then you eat a diet that really feeds those bacteria, you can encourage a excessive overgrowth, which can be quite problematic. And this time, it’s also a bit counterintuitive because you cut out things like broccoli, Brussels sprouts, cauliflower, and these are seemingly healthy foods so I can throw people. But for some people, a period of decreasing the amount of bees in the diet can be quite helpful in hearing their gut. So that’s kind of the really short primer on diet and in the couple of directions one may want to go initially.


Dr. Ann-Marie [00:06:23] Mm hmm. And I think you mentioned the low FODMAP diet. So we’ll just start there because I think that that’s really important. And in the low-FODMAP diet, you actually have seen a lot of help with IBS, with constipation in that particular space because it stops to feed that. Do you want to go into that a little bit and see that as well?


Dr. Michael Ruscio [00:06:47] Sure. Sure. So there’s been to date, I believe, 1:1 clinical trials using the low-FODMAP diet. There may be more than that, but essentially that’s that’s where we are from a research perspective. So I think there’s there’s one just an important footnote here for for the audience to make, which is having more than 10 clinical trials is a pretty impressive amount of research to have. Now what about if you go to your gastroenterologist and they kind of scoff at the idea, which it seems to be somewhat divided? Some gastroenterologists are recommending the low-FODMAP diet. Others aren’t. It just depends on how persnickety you are regarding science, and this is something I think is really important for patients to be aware of. You know, there’s this isn’t actually this this pyramid in our minds. This is known as the evidence based pyramid or the science based pyramid. And we always want to be trying to have evidence from the pinnacle, the very top. But sometimes we don’t have that information yet. You know, we’re working towards it in the scientific research community is publishing more data, trying to get to a point where we’re at the pinnacle. Why this all matters is because your doctor may be telling you, Oh, there’s no evidence for that. And what they’re actually saying is that there’s not yet the pinnacle level of scientific evidence. So you shouldn’t do that. And that’s understandable if the only evidence is we did X with. IV rats, sure, I wouldn’t say that’s make their way home about, but if we have now over 10 clinical trials, then certainly a cautious trial would be warranted. So we get that kind of boring scientific stuff out of the way. Now, now that we’ve qualified that it’s at least worth a trial, the low FODMAP diet is probably the best way. I know this would be just to search on the internet for a low-FODMAP diet, and you can locate a printout that will give you a column of food to focus on and a column of foods to avoid. You will see disagreement among different food lists. So I would either use the one that we’ve developed, and if you just search my name, Michael, you shall low-FODMAP diet. You should be able to locate that fairly easily. Or the University of Monash, which is where a lot of this research is coming from. This can confuse patients in instances because they’ll go online and we go, Oh my God, there’s this one list and that food’s as good on this list, but down on that list and people get confused. And this is because some lists aren’t updating as the research is evolving. Also, what other lists will do is they will impose again their personal bias onto the list, and this is why we’ve clarified on our website. There’s your standard low-FODMAP diet. There’s your paleo low-FODMAP diet, which the paleo community combines what they like to do combined with the low-FODMAP. That’s a major source of the confusion because as oftentimes isn’t disclosed on the food list. And then we’ve also developed a vegetarian low-FODMAP diet just for those who are looking for a focus on non-meat sources of high and low FODMAP foods. But in terms of the diet itself, this is maybe the excuse you’ve been waiting for since you were a kid where you didn’t want eat your broccoli because broccoli is broccoli and asparagus. A lot of these foods that are stereotyped as being healthy are high in FODMAPs. And so for for some people who have maybe perhaps improved their diet but feel like they’re feeling worse, it could be because you started eating all your vegetables good. But inadvertently you went on a higher FODMAP diet, and that wasn’t the right move for your gut health. By making a few changes in terms of trying to eat more of the low FODMAP fruits and vegetables that may lead to a substantial improvement in how you’re feeling. Just a few low-FODMAP fruits and vegetables would be things like a spring mixed salad or spinach. You know, those those are just a couple. Kale would be another. But yeah, it would be worth a two week experiment on the low-FODMAP diet to see if you notice improvements in your gut health. And that’s really all you need is about two weeks to be able to say Yes, this seems to be working or I feel no different at all. And if you feel no different at all, then you can move to a different type of dietary approach or potentially move out of the realm of diet altogether. And we want to give diet a trial, but also be sensitive not to try to force a dietary solution to a non dietary problem.


Dr. Ann-Marie [00:11:12] And I don’t know what you’ve seen in practice. I see that in order to get rid of Steve-O, I actually have to do supplements in order to clean it out. I’ve I’ve met patients that have come in. You know, years and months after doing a low FODMAP diet and said, as long as I stick to this diet, I’m fine, but any time I diverge from that, I have problems. So in my experience, I find that supplements are necessary. What has your experience then?


Dr. Michael Ruscio [00:11:45] Yeah, I would agree with that and that that’s why I say we want to be careful not to try to force a dietary solution to a non dietary problem. And that’s unfortunate when a motivated patient is willing to go to great lengths with their diet. But they don’t realize the reason why in the long term they have to be really strict is because they’re eating around another imbalance that diet can’t totally fix. So yes, that’s the foundation that’s never going to. We’re never going to throw out the diet and say, just eat whatever you want. We always want to have a healthy diet. But if in the long term, you’re having to be very restrictive. There’s a good chance and I actually experience this very thing myself. My diet was perfect, but I was still having symptoms, and that was because there was an active inflammatory issue in the gut make me need to eat so restrictive. And even when doing that, I wasn’t feeling fully well. So yes, layering and various types of supplements or herbs or probiotics can be quite helpful in dislodging imbalances, allowing healing to occur and then hopefully allowing one to eat a broader diet and not have to be so worried about, you know, is there dairy in here? Is there a FODMAP in here? Is there a nitrate in here or whatever the particular individual sensitivities might be?


Dr. Ann-Marie [00:12:59] I think it gets to be too much for a long period of time on these restrictive diets. I know people can’t socialize, they can’t do other things. And so unless you’ve got I mean, the more you can get to the root of the problem, the more their diet opens up. And granted, there’s certain foods can be sensitive to certain people, but no diet is for everybody across the board. There’s not this across the board diet that is great for everybody. I think we we get into that mindset too much about eat like this. This is going to fix all my problems. In a lot of times you’re going to see some sort of dysbiosis in the gut or improper gut flora, a stable infection, a bacteria infection and the other infection. You speak about a lot, which I also see. I really resonate with this yeast overgrowth in the small intestine. Is that correct?


Dr. Michael Ruscio [00:13:53] Well, it’s presumed. The reason why I say it’s presumed is because there is testing available, but this involves essentially what’s known as a vaginal aspirate or taking a tube is taking it down the throat through the stomach, into the small intestine, taking a sample of fluid and then biopsy doing that. So it’s quite an invasive test. And Dr Satish Rao has really pioneered some of that work. However, it’s not something that’s routinely available to be done in clinical practice. There’s not a simple stool test or a breath test or a blood test for this. So when we see a number of symptoms in the absence of any other test being positive, oftentimes we’ll presume that a small intestinal fungal overgrowth can be present.


Dr. Ann-Marie [00:14:40] And how much do you see that in? Or do you suspect that in most of your patients with gut issues, because Candida can be, it’s more opportunistic in a lot of situations?


Dr. Michael Ruscio [00:14:55] Yeah, it’s a good question. Now, some of Dr Round’s research, I believe, found about 25 percent of patients who had IBS symptoms your gas, your constipation, diarrhea, perhaps abdominal pain, who did not have a cibo breath test positive. So they tested for small intestinal bacterial overgrowth that was negative. I believe the estimation of the finding there was about twenty five percent of those patients had small intestinal fungal overgrowth, so it could be a quarter. And I also believe another 25 percent of patients had both bacterial and fungal overgrowth. So I guess depending on how you look at this, it could affect in an IBS subset of patients anywhere from a quarter to maybe a half of those people. So I mean, certainly it is something to be to be considerate of. The good news here is we know that some simple interventions like probiotics are actually quite powerful, antibacterial and antifungal. So in some cases, patients struggle to obtain a very thorough diagnosis, and they get frustrated because they think they need a diagnosis specifically to undergo a given treatment. But the beauty of many of these natural medicines, we don’t need to do an expensive lab workup to say, OK, we’re going to do 30 days in the probiotic and see if there’s an appreciable improvement in your symptoms. So the good news is many of the natural therapies we don’t necessarily need highly specific lab findings to justify it.


Dr. Ann-Marie [00:16:28] And so with I’m assuming you you’ve probably seen a lot of dysbiosis in practice or, you know, improper balance of gut flora, which is pretty much what you’re talking about with the probiotics. So what do you think is the root cause of that issue? Because I think it’s an epidemic.


Dr. Michael Ruscio [00:16:49] Well, that’s really the million dollar question. And I think it’s multifactorial, really. Our upbringing is almost certainly not helping us. And there’s a constellation of factors that seem to perhaps contribute to reduced infant mortality and prolonged life expectancy. On the one hand. But, on the other hand, may increase inflammatory disorders, and these set really center around a theme of increased hygiene practices. So the early use of antibiotics can be helpful on the one hand, but can potentially have damaging effects on the other, especially if they’re used indiscriminately. Lack of breastfeeding or short term breastfeeding caesarean section birds our environment. Also, the fact that mothers have less contact while pregnant with dirt, germs, animals. One study, for instance, found that the more farm animals a mother had exposure to while pregnant, the more animals correlated with the more protection against inflammatory and immune mediated diseases later in life in the child. And then when the child is born, oftentimes they are less in contact with dirt, with animals, with bacteria. And all these factors together help to tone and train the immune system. The immune system is really an imperfect system. It requires practice to function optimally. Your cardiovascular system as a parallel will do okay without any practice per se. I mean, obviously, if you exercise, you’ll have better cardiovascular function. But the cardiovascular system won’t be prone to dysfunction if you’re not exercising quite the way the immune system will be if it doesn’t have the training of exposure to these various bacteria and other microbes in the environment. So all these things together set a negative stage. And then, of course, if we’re stressed, if we’re not sleeping enough, if as adults we’re using antibiotics indiscriminately and if we’re using an unhealthy diet especially that’s high in processed sugar or lower in fiber, then we have a continuation of this theme where we’re not really doing a good service to our gut. So it’s multifactorial, starting all the way in utero up through the day.


Dr. Ann-Marie [00:19:12] And you mentioned stress and you use the term this stress gut connection. Can you go into that a little bit? Because I think it’s really quite interesting.


Dr. Michael Ruscio [00:19:25] Absolutely. We’ve known for a while that IBS patients tend to see a worsening or a flaring of their symptoms during times of stress. Some very elegant research has shown looking at college students pre and post exam that during pre exam stress, they will experience a dwindling of certain healthy bacterial populations in their gut. And this might be mediated by stress hormones in this cascade, as more potential stress hormones affect circulation. If there’s more stress hormones, there’s less regulation to the gut. That circulation may not be healthy for the gut bacterial population, so you may see a dwindling of the healthy bacterial populations. It can also be the effect of the stress hormones directly on the immune system. But, you know, irrespective of the multitude of pathways involved, there does seem to be this connection with stress on the one hand and negative changes both in gut symptoms and gut bacterial populations on the other.


Dr. Ann-Marie [00:20:22] So basically, your body thinks you’re running from there when during finals time, it is like the upshot.


Dr. Michael Ruscio [00:20:29] And if that’s prolonged and it’s unrecoverable and that’s that’s I think the real important thing to keep in mind where we’re not trying to have no stress. One of my mentors knew when I was a college student said stress to life is as tension is to the strings on a violin need to have the right amount of tension for the strings to be in tune and play too much. They snap not enough. The instrument won’t play, but most of us are probably a bit too tight to too much at the time. Yeah, totally.


Dr. Ann-Marie [00:20:59] I think the other interesting piece of IBS you have, the literature has stated that there’s a lot of times a trauma component that came from early on in those ideas cases. And I wonder if I didn’t know about the study of the college students, but I wonder if they are struggling a little bit more because of that old school trauma. It’s almost fight-or-flight again and repeated.


Dr. Michael Ruscio [00:21:25] So you’re referring to an earlier life emotional or trauma trauma? Yeah. And there’s also evidence showing that just like those things may, just like a prior knee injury, may leave some knee aching in the future that require some and stretching similar thing can happen once again. But I think it’s important for patients to keep in mind that those things can be supported, but it’s probably a very good exercise to both go through therapies to address that episode and deal with an episode from emotional perspective. And then also support your gut to recover from any imbalances in the wake of that.


Dr. Ann-Marie [00:22:02] Mm hmm. You know, it was it was interesting. I interviewed a urologist on on the show, and he believes that bedwetting is actually related to constipation or early IBS symptoms. And then that will basically as we become adults, then we’ll have much more severe IBS symptoms, primarily with constipation. But you see that starting at a very young age. I mean, I think bedwetting is one of those triggers that initially is showing that most kids are constipated and showing early IBS symptoms, which is super fascinating. I think we always know that that’s gone back to the gut. But wow, it’s actually in literature now,


Dr. Michael Ruscio [00:22:51] and there’s often this very interesting, bidirectional relationship between the gut in the brain. And as we’re discussing here, there’s kind of this brain or emotional trauma to the gut pathway. Then there’s also a pathway from gut imbalances to the brain where we see gut imbalances like IBS being associated with things like depression and anxiety. And it’s actually gut treatments now are showing the ability to improve things like depression and anxiety. Most namely, there’s there’s been a number of clinical trials showing that probiotics can actually improve depressive and anxiety symptoms.


Dr. Ann-Marie [00:23:24] Absolutely. Absolutely. And you I mean, all of the, you know, 90 percent of the neurotransmitters that make you feel good are made there. So it makes it makes sense if you have the proper balance of gut flora that you’re going to make those neurotransmitters that actually are going to help your brain function so much better.


Dr. Michael Ruscio [00:23:44] Right, right. And nothing surprising to you. And I just I’m hoping that this further permeates into the medical and health community so that patients who are suffering with with brain fog or a poor word recall or anxiety or depression will start to have rather than an antidepressant or anti-anxiety medication given to them, at least consideration of improving one’s gut health first, because that can clearly lead to some nice improvements in how someone’s feeling.


Dr. Ann-Marie [00:24:14] Yeah, and I think that that’s an important point because antidepressants are prescribed, so much anti-anxiety is are prescribed so much. You know, I see it all the time coming in here. And so maybe. Would you mind just dabbling on? How there’s a better way to do that, because I guess where the question is going, you know, the antidepressants don’t boost your heart. They’re not really doing anything. You have to be on a long term, but maybe you can speak to that a little bit.


Dr. Michael Ruscio [00:24:48] Well, I mean, I guess the simple take home there would be there’s a powerful connection between the gut and the brain. I myself suffered with brain fog, which was, you know, if you’ve never experienced brain fog, you feel like you can’t think you feel cloudy and you’re having a conversation with someone and you just feel like everything in your brain is running really slow. Or if you’re reading or writing, you feel like you’re having a hard time connecting with and absorbing what you’re reading or writing. It’s a terrible feeling. And there’s a number of studies showing, most namely with with probiotics, that we can see improvement in neurological outcomes. Now, we don’t want to oversell the case. It’s not to say that Alzheimer’s disease can be irrevocably reversed by probiotics. There are limitations with how much they can do, but certainly for these functional symptoms of brain fog, impaired cognition, anxiety and depression, the gut has a powerful impact diet. It would definitely be your best place to start. There’s you. There’s certainly evidence showing that we’ll see improvements in mood as someone improves their diet, and that’s not really surprising. If you’re eating bad food, how many times have you? Let’s say you got roped in eating fast food at McDonald’s or something like that, and you afterwards say, Oh, I’m not feeling good. Part of how you’re feeling is tired and maybe a little bit fine, or people who, as another example, have gluten intolerance. It’s been documented in a number of papers. One very, very elegant by Volta at the University of Bologna showed that people can have only neurological symptoms secondary to gluten and have no digestive symptoms. I also want to be careful not to say that gluten is a problem of every problem under the Sun, because I think that’s an overstatement of the case that occurs in many articles on the internet. But for some people, that can be quite helpful just as simple withdrawing of gluten from the diet. And then also parallels to there could be other imbalances in the gut that are causing a non responsiveness to diet like we touched on earlier. One study looked at patients with celiac disease, so we know that they have a very, very negative aversion to gluten. They went gluten free and they still had symptoms. And so the researchers said what could be causing this lack of response in the celiac patients? We’re supposed to feel way better when they go off gluten. Why did these patients felt they worked up these patients and short story? They essentially found 10 of these patients had cibo. Two of them had blastocysts hominins and one had a one, and they were all treated with various antibacterial or anti warming protocol agents, and they all saw improvements in their symptoms. So, you know, no matter how you look at it, could it be dietary? Could it be some sort of imbalance in the bacteria, fungus or other organisms? And we can’t see this responsiveness and symptoms, including our other symptoms that finally occurs once we get things straight in the gut. So if you are suffering with anxiety, depression, brain fog, please understand there’s a lot of hope. If you can improve your health, it’s not a cure all. Not a guarantee, but certainly a great place to start.


Dr. Ann-Marie [00:27:57] For some people, it’s such a huge jump from the gut to the brain or the gut to anxiety and depression. The gut regulates so much. I think we’re going to blow their minds when we talk about the gut and some autoimmune conditions. But let’s specifically talk about thyroid Hashimoto’s and how how that’s linked to the gut. And I go back to this because so will come in and they’ll say, I have autoimmune thyroid or I have Hashimoto’s or whatever it is. And I said, we need to look and figure out what caused this and what my thyroid is off. Well, yeah, but what’s the underlying cause to potentially why your thyroid is off? There could be reasons for that. And that is a hard jump for people to make that their gut could be causing anxiety, depression or causing their autoimmune Hashimoto’s, etc. So would you mind speaking to that a little bit?


Dr. Michael Ruscio [00:29:00] Absolutely. And this is a critical point for patients. Understand. Thyroid imbalances are too often blamed for symptoms when in many cases, the thyroid is not the culprit. Now, yes, there are clearly, obviously patients who are hypothyroidism. But what I see routinely and even the doctors who follow my newsletter are now looking at this in their practices. Finding the same problem and writing up case studies is that you will see a number of cases who were diagnosed hypothyroidism one on medication, and they’re still not feeling fully well, and they want to try to tinker with their dose or the type of medication. And they’ve overlooked the gut. And it’s not until the gut is addressed that they will actually see a resolution of this symptoms. Dr. Jill Mather, one of the clinicians in our group, detailed a beautiful case study recently where this patient came in on Levothyroxine. So your standard T4 and she wasn’t feeling well and they thought, Well, maybe you need to be on tea for that. We’ve got our action plus T3. So I believe they then switched her to something like nature, thyroid or thyroid or, you know, whatever it is. And she felt worse. And so then that changed again to back on the water Iraqis. And they added inside mouse and now T-Force medication as a T3 medication. So it works again. And they kept going through these maneuvers trying to figure out, OK, how can we get everything just right? We ran some lab work your T3 with a little bit low, so we give you more T3 or your T4 was too high and will decrease your T4. And he chronicles about six or eight months of this, and the patient never really feels appreciably better. So he says, OK, we’re going to go back to just T4 and we’re going to look at your gut health essentially within two months of using therapies for her gut. Simple therapies like probiotics, not only probiotics, but essentially gut support. All of her symptoms are not humans. So it’s very important patients understand that the symptoms that you’re attributing to your thyroid may actually be coming from your gut. And we know that symptoms like depression and fatigue can come from your gut, and we know that gut treatments can alleviate these symptoms like depression and fatigue. We also know that one of the reasons for inconsistent, I guess, symptomatic benefit from a thyroid hormone replacement or levels of your lab work that are going up and down can be inconsistent. Absorption through the gut is most thyroid hormone is absorbed in the small intestine. And studies have shown that namely patients who have a bacteria or H. Pylori in their gut will actually malabsorption thyroid hormone medication. And when the H. Pylori in the gut is addressed, patients will have improved symptoms and they will actually need less thyroid medication because they’re now more consistently absorbing their medication. There’s also evidence connecting problems in the gut to thyroid autoimmunity. The data there are still a little bit early, and in terms of we can’t quite say if it’s causal or not, but we know that if people have small intestinal bacterial overgrowth, they’re more prone to have hypothyroidism and not to get, I guess, too into the weeds here. But how these may connect is in a two-fold way. A problem in the gut may set the stage for thyroid autoimmunity. However, it may work the other way. Also, those who have thyroid autoimmunity are more prone to have low levels of stomach acid, which opens the door for a litany of bacterial imbalances in the gut. So there is this powerful, bidirectional relationship between the two, but the main take home is if you’re on medication and you’re not feeling well, it would really behoove you to consider looking into improving your gut health because it might be causing the symptoms. Alternatively, if you’re not feeling well and you’ve been worked up by a doctor and they told you, you’re not hypothyroid, I wouldn’t keep pressing to get the hypothyroid diagnosis. I would do some work to improve your gut health because overdiagnosis of hypothyroidism is another problem, and this is something that’s been decried in a number of research papers, one by a researcher named Levada who found that about 60 percent of patients were given an incorrect thyroid diagnosis. And the problem here is patients are pushing doctors. Doctors are trying to help. So often times they will just entertain them with a prescription. But if that’s not getting to the root cause of the problem, you’re not going to heal. So hypothyroidism does exist. We want to identify and treat it, but we don’t want to make it out to be the problem. And it’s not. We don’t want to overlook a problem. The gut has what might be the cause of the thyroid symptoms that haven’t yet been relieved.


Dr. Ann-Marie [00:34:03] So have you seen? You know, I think. It’s pretty common practice in the medical community to talk to not rerun antibodies for autoimmune, thyroid, common practice, maybe run, and once they say that they’re irrelevant and never to run again. What’s your take on that? Because I personally have seen those just shoot down and drop when you start to treat the rest of the person? I’m curious what your your take is on that


Dr. Michael Ruscio [00:34:35] as a fantastic question. Do you mind if I if we pause for one second, I’m going to shut my the sun’s about to start coming right through here? Do you mind if we? Now, antibodies are certainly an important part of the fiber picture, essentially, what antibodies will tell you is do you have the most common cause of thyroid autoimmunity present on site? Do you have the most common cause of hypothyroidism present, which is thyroid autoimmunity? That’s important to know because there are some therapies that can decrease antibody levels. Diet has been shown to improve antibody levels. Selenium, magnesium, CoQ10 and vitamin D have also been shown. There’s a few other natural agents that have also had a study here or there, but the best evidence? Vitamin D selenium and diet for lowering thyroid antibodies. But there’s also an important piece of this which I think is is over focused on in health care, especially in kind of alternative and integrative health care. Now what? Yes. On the one hand, these antibodies can be helpful because we do know that if antibodies are very high, they do increase your risk of becoming truly hypothyroid in the future. If you’re not currently hypothyroid and they may tell us if they’re chronically high that you will need more medication over time. So there is this correlation between how much healthy thyroid gland you have and how how higher antibodies are, the longer the antibodies are accessible behind the more of your thyroid tissue gets damaged and eroded. And if you have less healthy thyroid tissue, you have less output of thyroid hormones, so you progressively become hypothyroidism. So that’s how these two connect. But the inaccurate, I think an overstated aspect is when we are overzealous in trying to drive antibodies down into the normal range. And this doesn’t seem to happen probably in the majority of patients. But what they will see is they will go from very high, let’s say, above 1000, and they start making some interventions and they drop down to 100, 200, 300, 400. The cutoff is usually 35. You’re above 35, you’re positive. If you’re below 35, you’re negative. And one study looked at the long term fashion. What level of antibodies should we be considering a clinical win? Because there’s the lab, which gives you positive or negative. Then within that realm of positive above 35, all the way up to a few thousand to three four five thousand. Is there some nuance here? All right. There’s thirty six, the same risk as three thousand. Well, it turns out that at least available, at least according to the best available evidence, it seems that five hundred might be the cutoff point. If you’re above five hundred, you are at risk a moderate risk for not even a severe risk, but a moderate risk, according to the researchers. For progression of your hypothyroidism, if you’re below five hundred. You’re a minimal risk. Why that’s important is unfortunately will happen with some patients. They’ll be diagnosed with hypothyroidism with Hashimoto’s this autoimmunity and they’ll make some great steps there will improve their diet and will use vitamin D that we use when they’ll start feeling better. And then they’ll have their repeat bloodwork and they will have gone, let’s say, from thirteen hundred down to 300 hundred. And then they’re told, Well, you’ve got a diet harder, you’ve got to take more supplements. And that doesn’t seem to be what the evidence supports. And why that’s problematic is if that causes the patient to have a more difficult diet and take more supplements and kind of stresses them out, then that stress might be more counterproductive to their health than the level of the 300 on their antibodies.


Dr. Ann-Marie [00:38:29] Absolutely. I absolutely agree. I agree with you. So what do you really? What do you do every day to keep yourself healthy? What are tips that you have to stay healthy, not sleep?


Dr. Michael Ruscio [00:38:44] That’s probably the end of all the things that I do. I will notice the most profound change with a good night’s sleep or a bad night’s sleep. Sleep is probably the most impactful, so if people aren’t giving a lot of attention to their sleep and I think what one should be able to do is go to bed early enough so that you wake up before your alarm clock. This will give your body a chance to obtain enough rest. If your body always wants to sleep, let’s say an hour or more, but you’re never giving it enough time. That’s an opportunity for you. I know it’s easier said than done. I get that, but that’s an opportunity for you, for saying my, you know, I get brain fog or kind of tired midday, or I don’t have the energy later in the day to go to the gym. Or, you know, I come home for the end of my day and just sit on the couch and watch TV because I’m tired enough. Sleep may really improve that situation. Systems, a foundation diet. Also important, I’m always trying to improve my food quality and eat the broadest array of healthy meats and fats and fruits and vegetables, and really not just focus on a handful of healthy things, I typically but rather broaden the diet to be as healthy, as colorful and as the first as I can exercise another huge one. You know, when I am pushing myself with exercise, I really do not, and I feel quite a bit better. There’s a line where you don’t want to overeat exercise, but I think most people are probably on the other end where they’re a little bit south of where they should be with exercise, and so increasing their size could benefit them. And then I think a stress management or reduction technique of some sort where you’re just getting your mind away from cell phones, computers and kind of that dopaminergic hamster wheel of stimulation. And you can just decompress, unplug, preferably at some time in nature where you’re not thinking, you’re not doing, you’re not on a schedule, you’re not in the timetable, you don’t have a goal. A little bit of that, even as little as 10 minutes per day, actually. One study found that 20 minutes of meditation per day led to, I believe, is a 48 percent reduction in use of the medical system. So it’s getting 22 10, but certainly a worthwhile. And then for gut health, I use three probiotics and and I got nutrient cocktail every morning and not after I did the heavy lifting to get rid of the major imbalances. That’s kind of a good long term means protocol for me and all those things together, and I generally hum along pretty well and, you know, do do pretty good.


Dr. Ann-Marie [00:41:27] That’s right. That’s really great. Where can people find you if they want to get in touch with you?


Dr. Michael Ruscio [00:41:33] Yeah, my website is Dr. Drew Show Dot Com, which is D.R., our U.S. CIO Gqom. They can find out on my book there. I just had a paper published in the Journal of Alternative Therapies and Health and Medicine, and we’ll have that on the homepage soon. They can look at some of the dietary supplements they recommend. Look at our blog, some other videos, but really, that’s kind of a plug in to pretty much everything.


Dr. Ann-Marie [00:41:59] That’s great. Congratulations on your published paper. That’s incredible.


Dr. Michael Ruscio [00:42:03] Thank you. Yes, it was a lot of hard work.


Dr. Ann-Marie [00:42:05] That’s were the big deal. Yeah. Well, thank you so much for being here today for joining us here on the Girl’s Health podcast. If you like what we’re doing here. Please go below us five stars and comments. Thank you so much for being here. Thank you so much for listening. If you enjoyed learning with us today, please give us a five star review. Comment like and share our podcast with your friends and family. As always, if you’d like to learn more information about today’s guest, please head over to FearlessHealthPodcast.com for links to their site and other educational resources.

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