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Ask Me Anything With Mary Shomon

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In this video, Thyroid Health Coach Mary Shomon joins Paloma Health for an "ask me anything" live event.


Mary answers—

Ask Me Anything With Mary Shomon

We are doing a live Q and A today with Mary Shoman, a thyroid and hormonal health coach and advocate.

She's an advisor to Paloma Health. She's a New York Times bestselling author. Mary, you've written 15 books on thyroid health and hormone health.

And you've been a long-time player in this game. And so this is an ask me anything with Mary Shoman, which is a unique opportunity for you to ask any questions you want to Mary.

There's a chat feature. You'll see, on the side of your screen there, and you can start putting questions in there.

We've got this set for 30 minutes. So we will get to as many questions as possible, and a replay will be available afterward.

So Mary, um, I'll hand it over to you. We've got the chat feature here, and I also know you have some questions that came in in advance, so I'll let you take it away.

Absolutely. Thank you, Katie. And this is a lot of fun because Katie and I are the regular co-hosts of the Paloma speaker series, where we get experts, doctors, practitioners, healthcare providers and talk about a specific focus area. Our next one's coming up shortly.

And it's frankly about the liver toxicity and toxins and the practice of fibroids. But I love the idea today that said, it's an ask me anything because I am on Facebook all the time, and I even posted last week that I'm going to be doing this.

Anybody have any questions if you want to gain from taking them out. Some of the things that we haven't had, a lot of questions here over a hundred questions.

So I'm excited to see some of you here. I recognize your names and, uh, some of you already questions, and those are at the top of my list so that you know.

Uh, so, uh, let's go ahead and get started. And, um, I will begin with a question for one of our participants who's already online, Laura and Laura had posted this in our community, and I thought it was a really good question.

How to decrease TPO antibodies?

And so I think it's a good one to start with. So we're asked I have Hashimoto's disease with going gluten-free and DF, assuming dairy free for the past six months.

I've seen a decrease in my TV out my thyroid, for example, I collect test. I took my, um, I'm taking the right supplements and exercise.

What else can I be doing my TPO as a ministry to their levels increasing? And should I get sex, hormone testing, and EDD.

I've seen bar virus testing through loud other issues. So this is a great question. And it's a question that many people have: why do my antibody levels go up and down?

And it's helpful to think about a couple of different factors, but you did some really useful things, uh, cutting out things that make your body for your state in your cases theory.

Those are some of the guidelines that we have in the Paloma app. And you've got the dietary guidelines for the autoimmune protocol diet, but sometimes the antibodies are not necessarily going to only be money to your dietary inputs.

One of the things that I've seen in, in many situations, antibodies will go up when you are exposed to other types of infections.

So let's say you're a mom with little kids, and they're coming home from school with every flu, cold, and sniffles that are going around.

You may see a bump in your antibodies. Your main system gets over-activated by exposure to other viruses, bacteria, and various types of pathogens.

And it starts to attack the thyroid. So you'll see an increase in those antibodies. It also may be that in the period of post-vaccine, we have seen some people who've got COVID vaccines report they had temporary bumps in their antibodies. Usually, they resolve back to normal, but they had a bump for weeks. So it may be a period when we were a year, and he was supposed to be exposed to the vaccine, which caused a temporary bump in your hair and body.

It also can mean that there's another stealth infection going on in your body. And it, again, may not have anything to do with your food.

So you may have gingivitis in your gums. You may have a urinary tract infection, respiratory infection, or some other type of infection that is bubbling below the level that can also be for your antibodies to go up.

So of the things that I would be looking at would be number one, um, making sure that there are no infections that, that there weren't any exposure to things that might've triggered that thought in your hands, body levels.

Number one, number two, I would want to make sure that I'm taking a good supplement that supports my, uh, my immune system and my thyroid in particular.

And that would be one that would be selenium. So, uh, the thyroid daily care supplement from Paloma is a great choice, or maybe have another that you prefer, but okay.

Um, and you also want just to look at your diet if you need any changes during that period where there aren't any spills and might include fearing for photography.

So that would be a good starting point if you have any funny. And, um, I know anybody have now or not, not getting along to some of the questions that have already been submitted.

And Katie is so helpful that she will be providing lots of resources where she just gave us daily thyroid care supplements for them to be interested in that.

I take that every day, and I love it because it just covers everything and keeps me with everything, five different supplements.

So I take that vitamin, and I think that covers everything I want to get, uh, especially, um, okay.

I'm going to go on to another question. And again, remember the chatbox, which is the little, um, block bubble down at the bottom of your page, like on that and enter your, uh, request for anything that you have to say right here.

Uh, Katie, how do people enter their information in the chat? I'm looking, I can see the track reading, but I can't, I can't see a place for. There should be a send button to the right at the bottom of the chat.

Um, So you type it in the open. I think there's a little box down at the bottom.

It's where you find your information. And then since then, just through you sent me a Suzanne, is your microphone on? Make sure you don't have an X over it; we'll check that. And maybe someone else can let us know if they're also having issues hearing you or if they can hear you.

What supplements help your thyroid if your thyroid doesn't work?

So Nikki wants to know about supplements that help the thyroid if your thyroid doesn't work? Maybe that's a good question. There is no supplement that's going to replace the hormone that we absolutely need to survive. But what the supplements can do is help with conversion, help lower our antibodies in the case of selenium.

And it helps to do those things. Um, it can help reduce inflammation, support our hormone balance in the case of vitamin D, and provide raw materials or support thyroid hormone production, such as the case with iodine or tyrosine.

So there are many ways that supplements can support and improve thyroid function, but you have to have a thyroid that is actually producing something to do that. And in many cases, you have to be supplementing in addition to taking thyroid hormone medication. But that doesn't mean that supplements can't make your treatment better, more effective, and will leave you feeling better.

Um, okay. Mandy said she left, came back in, and now she's got the volume.

Does quercetin affect our thyroid medication? If so, how can we take it without this happening?

All right, Katie wants to know  Does quercetin affect our thyroid medication? If so, how can we take it without this happening? You know, that's a good question; I've taken quercetin at various points but always taking the normal daily recommended amount. Now I've not taken it in any sort of megabyte doses of therapy.

So I don't know about large doses of quercetin, and it's something that I want to look up and get back to you, maybe in another call or another Ask Me Anything type of event and possibly send the follow-up out with a patient information.

Um, but I tend myself at times, especially during the spring and I want to have some allergies. I have never had a problem with him having a 50 effect my library, but I want to research that further on it.

When should I take my proton pump inhibitor? Should I take it an hour after thyroid meds or take it at night? How will it affect my PH and my stomach?

I'm going to jump over to one of my questions from all the people who were going to try to make it or couldn't make it but wanted their questions answered. So we have Kimberly. She's taking a proton pump inhibitor drug for ulcers, irritable bowel, Suffolk jail Lux, those types of things. She's wondering when she should be taking for proton pump inhibitor and, can I take it anytime an hour after her thyroid meds or take it at night, and how will it affect my PA and my stomach?

So it's a really good question because there are a lot of people that are taking Prevacid and other types of proton pump inhibitors for ulcers, GERD, etc. Here's the kicker. These drugs have real heavy interference with thyroid medication. So much so that most of the top gastroenterologists that I know and many of the endocrinologists who are savvy about GI issues will tell its best to bypass the tablet form of levothyroxine entirely and go to Tirosint, which is the capsule form because it has the least amount of interference with proton pump inhibitors.

So that said, I think Kimberley's endocrinologist probably gave her better advice than her gastroenterologist. I'd err on the side of caution to take them as far apart as I can. 

Let's see, I'm going to take a look here. Definitely questions here. This is a new platform for us, so we're just getting used to it and, um, trying to figure out how it's all working.

Does low-dose naltrexone work to lower TPO? If so, how long does it take to see results?

Low dose naltrexone for those who don't know, is a really unique treatment that is considered an off-label treatment. High dose inhaled naltrexone is an opioid receptor blocker for people coming off drugs or alcohol as part of a rehabilitation program. But years ago, this really smart doctor, Dr. Bernard Bihari discovered how low of a dose can I go down to and it still is beneficial?

He found that at a very low, therapeutic dose they could still see some benefits like antibodies were lower, even sometimes dropping below the normal range and being considered in remission. And that in some cases, people could lower their dose of autoimmune treatment medications.

The problem with LDN is that you have to find a doctor who is willing to prescribe it but as Laura found, some of our Paloma doctors are really on board with the use of low-dose naltrexone. It's very inexpensive. The main thing with naltrexone is there are very few side effects at low doses. Some patients find that it doesn't do anything for them, but it doesn't cause any negative side effects and it's not expensive so it can be worth a try. Usually, most of the doctors that I know and most of the Paloma doctors will say you have to give it three, four, even six months to see results. Most people who do LDN will tell you that as far as they can tell, they do feel better. For those who didn't have any response or results, sometimes they'll go off of it and say,  "Well it was worth a try."


I was on Euthrox medication for a month or so at too high a dose. I had labs showing extremely high LDL cholesterol but had never had a problem before. Have you come across this before with that kind of medication or it is more likely diet or something else?

You know, Claire, I don't know. That's a sort of question that has too many moving parts to understand what's going on. Usually, when you're overmedicated on thyroid medication, it's going to make your cholesterol levels go down. So I'm not quite sure why yours would go up. It would suggest to me that it's something with your diet, something else entirely, or maybe something going on with your current thyroid medication. I'm not sure. I think this is a question to bring to your doctor. I'm sorry, I'm not a doctor. I'm an educator. But I can tell you that high cholesterol is usually associated with someone being very hypo and undermedicated, not the opposite. 

I've had my blood tested twice in the past six months. Both show high antibodies with otherwise normal thyroid markers. Meanwhile, many of my symptoms align with hypothyroidism. Do I actually have a thyroid problem that could cause symptoms? Should I push for another endocrinologist referral or see a Paloma doc?

A lot of good questions here. You've got your situation. You've got the antibodies, but thyroid levels are normal. 

There's a doctor I love. He's a known expert on thyroid and fibromyalgia. He says, if I take a poll of shoe sizes, you're going to have shoe sizes ranging from five and a half to 10. And so that's our reference range. If I'm going to have to give a woman that's a five and a half a size ten shoe, it's going to be swimming on her.

Similarly, if I give this size ten woman a size five shoe, she can't get her foot in it. So the reference rate is just that. It's a collection of a general range; it's not a hard and fast rule that says everyone in the range will feel great.

So one of the things you need to look at is where in the range you are because there's the range, and then there's the optimal range. That typically means that the TSH will be on the lower end of the range and free T3 and free T4 on the higher so you'll have enough thyroid hormone circulating, which would be reflected in a lower TSH.

So that would be step number one. What's your number, where is that number, and is that consistent with how you're feeling based on the fact that you also have the antibodies for Hashimoto's?

Um, the other thing would be, yes. Should you look for another practitioner consult? Yes, and honestly, I would suggest that you push for a Paloma doctor primarily because Palom doctors are working with thyroid patients constantly every day as their primary focus o they understand that even slight variations in the TSH.

It's not expensive. It's actually really affordable. Paloma Doctors are even less expensive than my co-pay for my doctor. So it's a, it's an extremely affordable option. And I would invite you to check it out and see if you get something because it deserves to be taken seriously.

Hashimoto's is a disease unto itself. And it can cause symptoms. And hypothyroidism is the result of Hashimoto's. It's a separate thing. Taken together, they can create all sorts of havoc. That's why you want to address, diagnose, and treat effectively. 

I have been with a new compounding pharmacy for about three months. I thought things we going well but now my hair is falling out (over 50 hairs a day). Is it stress or could it be something in the new T3/T4 medication? What test should I take to determine what to do? I thought I was doing so much better. Actually, my thyroid levels were much better than before. I am concerned I am regressing from all the progress I made in the last year.

Your levels are better on this new compounded T3/T4 medication. Here's the thing; many people are very sensitive to fillers. [Inaudible.] 50 hairs is a normal amount of hair loss, even though 50 seems like a lot. But it may not be normal for you. But generally, it's not considered dramatic hair loss.

The other thing that I would look at is, yes, I would ask the compounding pharmacy exactly what fillers, binders, etc. are you using in the thyroid medication?

And what is the API (active pharmaceutical ingredient)? Where are you sourcing T4/T3? Cause in some cases, some of the APIs are very heavy on lactose, or starch, or acacia, or other types of ingredients. Others are not. So I would start doing a little bit of dig work. What are the fillers that the compounders are putting in the capsule? And what are the actual sources of the API? And where are they getting them from so that we can backtrack.

As far as your hair is concerned, I wouldn't worry. Because the other thing is sometimes, we shed during the seasons. And hair is cyclical. Sometimes it'll shed for a couple of weeks or a couple of months. Then it starts to grow for a couple of months. Then it stops and is steady for a while. And then it sheds again. It goes through this up and down pattern. It may have been a coincidental shedding period or related to dosage change or changing pharmacy. So those are things id be looking at to start.

And just an FYI, when my hair starts to shed, and I've gone through hair stuff pretty bad--a couple years into my thyroid diagnosis, I lost so much hair. I was down to a ponytail the size of a pencil. Seriously, I had about this much hair. I was frantic. It took me about two years, but I got on the right, optimal dose of T3. I also added a hair vitamin, and I added some collagen supplementation. And a combination of those things, really... and I added some keratin or some iron. Once I got all those things in balance, my hair came back. Now occasionally, I go through shed mode, and I'll get out the hair vitamins and get back on it.

Is there a thyroid diet you recommend? I know AIP and thyroid-healing seem to come up often. Some are very restricting.

When it comes to thyroid diet, there's no one size fits all. One size fits all doesn't work. Some people will lose weight simply by restricting foods and calories. For some, the AIP could be super helpful. There are so many ways to go about it, and I can't say that there's anyone better than another. That said, the autoimmune protocol is a good starting point because it tends to be a comprehensive elimination diet and helps rule out some common problems like gluten, dairy, or sugar. That's part of the problem. AIP is a good starting point but if it's too restrictive for you, start by eliminating SOME of the foods on the AIP. They all have pros and benefits, and it really is a trial and error process to find out what the best approach is for you.

Making sure your thyroid is optimal since it's possible that your thyroid is not where it needs to be.

You can also do something like [inaudible] that assesses our DNA, so you know what to focus on. Are you a protein person? Are you a carb person? Do you need a higher level of fat than other people? They'll give you a detailed report. If you have 23&Me, you can send it in to them, and they'll send you back a report for like $30. If you have never had a DNA test, we can order the whole thing from them. I think it's less than a hundred dollars. And it's amazing information. It really helped me with nutrition.

Can starch and rice be a problem for thyroid patients?

Um, it depends, Cathy. It depends on if somebody is sensitive to starch and sugar and rice. If they are somebody who, if these substances are aggravating them. I mean, some people are allergic to rice.

Those types of things depend. I've heard from one of my favorite nutritionists, "There's no bad food. There's just too much of it. Or, you know, not preparing it properly." So there's nothing wrong with starch and rice unless you have major medical reasons. But for most of us, most foods are okay. How are we preparing them? What's the quality of food? Is it laden with pesticides? And covered in junk? Are you eating it in an appropriate quantity? 

That even goes for things that are supposedly healthy, like soy. A little bit of soy is fine. Some people say, "Oh, if a little bit is good, then a lot must be better." And then they get into quantities of food that can affect your medication, and then it can backfire. 

We don't want to overdo it with soy. We don't want to overdo the raw goitrogenic, cruciferous vegetables. We want to be moderate. Because they can have negative effects on hormones in your thyroid.

Um, okay. Let's see. We'll take one or two more questions off the list, and then we'll probably wrap it up because I think our initial plan was to go for about 30 minutes today.

Um, let's see. All right. A couple of very simple questions that people ask them are really important to answer. 

Can your thyroid grow back after removal?

Susan wants to know behind your thyroid grow back after removal. And it's an interesting question. So the thyroid can't grow back; you can't like regenerate a thyroid, though I wish we could. If you've had your thyroid removed--whether you had thyroid cancer or surgery or Graves' disease or goiter or nodules. In some cases, there will be little bits of tissue of your thyroid left behind. If you don't have cancer, you just have nodules or something, this is not a problem. With thyroid cancer, however, those little bits can become activated and become cancerous again, which is part of the reason thyroid cancer patients take care of all the thyroid tissue. The remaining bits of thyroid tissue can grow in size, not to generate a full functioning thyroid, but they can grow and produce thyroid hormones. So it's a kind of interesting concept.

Are thyroid glands transplantable?

We have another question. They want to know if you can transplant thyroids. And right now, they are doing animal tests. Like I think they're transplanting rabbit thyroids. We are probably not that far down the road from thyroid transplants. I've actually seen they can transplant parathyroids, the gland behind the thyroid. And they actually put it in your arm so they can put a certain amount of calcium when they need it. 

I think we're close to it, but it's not something I'm going to count on for the next five to ten years. But I think they're on their way to that. So thyroids can't grow back, but they can leave pieces behind that can still produce thyroid hormones.

Do you see advances to check thyroid levels at home like blood sugar?

This is a really good question. There are sort of two different answers. You can already check your thyroid at home with the Paloma test kit. You order your Paloma test kit. It tests TSH, free t3, free t4, and TPO antibodies, and you can upgrade to add on Reverse T3 and Vitamin D. That's one option to test your thyroid from home. You order your test online, the test comes in, you put the blood on the card, you mail it back, and then your results are available online.

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But I think what Kim was asking about is more like, "Can I prick my finger and have it say, "Your TSH is X?" What they have right now is there are rapid TSH tests. They prick your finger for blood, and within a few minutes, like a pregnancy test, you'll get an up or down. Are you hypo or hyper? It's not going to give you a specific number. We haven't gotten quite there yet. does the technology exist to be able to do it? Probably. But is it something they've been able to mass market and make available to the average person? Not quite yet. The next best thing is the Paloma test kit. Get it by mail, mail it back in; it's so convenient, especially with COVID and everything going on. We don't want to be standing in lines, sitting in labs, or driving all over the place to get our lab work done. This makes it so much simpler. They use certified scientific labs. No different from tests you'd get at your doctor.

Why aren't doctors taking thyroid testing more seriously?

It's probably a really appropriate question cause this is Thyroid Awareness Month in January. Patients get really fired up about it, and I don't know that the doctors do as much. 

And there's a question and I wish that I had an answer. I guess I have some theories. I think in part because it's a female-dominated condition; women are eight to ten times more affected than men.

I also think because the symptoms are often attributed to emotional rather than physical problems. Tired, depressed, foggy-brained, feeling down, you're sleeping. These can all be symptoms of depression or PMS or menopause or postpartum. It's sort of shuffled off to emotional symptoms rather than physical symptoms. So I think to some extent that women are most often affected by it and it doesn't take so seriously.

Honestly, I'm going to sound like a raging feminist. If men were hypothyroid at the same numbers that women were, there would be clinics all over the country. There would be hypothyroidism programs on television and everything else. The good news is we've made real progress in the last fifteen to twenty years with patients being able to get information and advocate for themselves has incredible power and has improved thyroid care. 

Twenty years ago, doctors would not use t3, not use naturally desiccated thyroid drugs. and surveys show that the numbers have increasingly gone up until I think it's like half the doctors now are willing to prescribe t3 and naturally desiccated thyroid drugs because patients are saying this is what we want. 

It's also exciting because we now have practices like Paloma. Paloma is a hypothyroidism-dedicated practice. You could not get more than what you want from them. They've moved to a medical practice in a virtual environment where everybody understands exactly what is required. They know all the medications. You don't have to educate them, convince them, and convert them to your way of thinking. They already know and they get it. And that's a new development. When I first heard about Paloma, I thought, this is what I wish we had forever. 

I really really believe in this concept. There are a lot of doctors who can do a wonderful job with thyroid out there, but this is almost a guarantee that you're gonna hit it right out of the park [with Paloma] because there's no separating the guys who know from those who don't.

I think we're gonna wrap it up because I've been talking for like 30 minutes left and I still have a gazillion questions left. 

 Katie, what do you think, how are we going to tackle all these extra questions? And I've got from people that want to hear?

Sure. Well, I don't want to sign you up for anything that you haven't committed to yet, but it would be great to do these regularly. Obviously, you got a lot of questions, and we got a lot in the chat, so it'd be nice to do more of these, you know, ask me anything or office hours with Mary Shomon moving forward.

So we'll figure out how to get all the questions answered. 

Yeah, I would, I would love to. People take the time to ask the questions and I wouldn't be, uh, the answer that they want, you know, for those of you who maybe haven't explored the full Paloma side, I also encourage you to go take out, pick out the flop article because I'm just one of them.

Perfect, wonderful, um, blog, posts, articles, informational thing. I mean, I go in there and, you know, I, I hear a couple of things every month when I go in there and I feel like I find all these amazing articles, but there are so many different ways to do experts and find out there's RS series.

Uh, there's advanced like this. And then of course there are, uh, connecting with the, um, providers. And so, you know, I feel like we're trying to just kind of get everybody in a .

That's our goal. We're trying to make it easy for people to take back control of their thyroid health and have everything they need in one space.

So Mary, thank you so much for your time and answering all these questions. And thank you to everyone who joined us live.

Again, thank you so much and we'll see you soon. Happy new year. Bye.

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