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How To Better Manage Stress To Protect Your Thyroid

Hear from Paloma Health's Dr. Sean Zager, MD, and WTHN's Dr. Shari Auth, DACM, about the impact of stress on hypothyroidism and Hashimoto's, and how to manage it.

How To Better Manage Stress To Protect Your Thyroid

Hi, everyone. Welcome. Welcome to April's speaker series. This is hosted by Paloma Health and every month we do a deep dive into a topic related to hypothyroidism. This month, we're talking about how stress impacts your thyroid and how you can manage it. We have two experts with us today. We've got Dr.

[00:00:26] Shari Auth of WTHN and Dr. Sean Zager of Paloma Health and Mary Shomon a patient advocate is also here co-hosting with me. So quickly, a little bit about Paloma Health. We are an online medical practice that focuses exclusively on testing and treating hypothyroidism. We offer at home thyroid  test kits.

[00:00:45] We offer a virtual consultations with thyroid doctors and nutritionists. We have a vitamin supplement, a mobile app that helps you with diet and lifestyle modifications. And we just recently launched a membership that helps you with end to end, really personalized, highly tailored care for hypothyroidism.

[00:01:02] So that's a bit about who we are and what we do. Today's event will be about 60 minutes. We're going to start with intros from both of our speakers. Then we'll go into some panel discussion and then we're going to open it up to live Q and A for all of you to ask questions. So as the speakers are talking, go ahead and drop your questions into the chat feature at the bottom of the screen.

[00:01:23] And we will get to as many of them as possible. I'm going to pass it over now to Mary Shomon. Mary is a patient advocate for those living with thyroid and hormonal issues. She is a New York times bestselling author. She's written 15 books on living with thyroid conditions and managing symptoms. And she really is a wealth of knowledge.

[00:01:42] So Mary, I'm going to pass it over to you to tell us a bit about who you are and then introduce our speakers. Hi everyone. I'm Mary Shomon and as Katie said, I am a patient advocate writer, educator in the hormone auto-immune and thyroid health space. And  today, we are really diving into a topic that is near and dear to my heart because

[00:02:08] stress and thyroid, they can't really be separated because if you have a thyroid condition, there are times that it is going to stress you out. And if you have stress, how is that contributing to, or possibly worsening your thyroid condition? So it's almost impossible in some ways to separate the two, because we really do need to look at the feedback, the impact that thyroid has on stress and that stress has

[00:02:34] on our thyroid. And that is exactly what we're going to be doing today with Dr. Sean Zager who is one of our Paloma doctors  and Dr. Shari Auth, who is a Doctor of Chinese medicine and an acupuncturist, and has a whole lot of great holistic credentials. And so we are so excited to have both doctors here today with us.

[00:02:59] So thank you both for joining us today. And we're going to go ahead and start out with just a brief statement from Dr. Zager. But I'm going to give you a little bit of background on him first. So we can toot his horn for him. So Dr. Zager is a board certified family physician whose passion really focuses in on the holistic approaches to patient care.

[00:03:21]He's a graduate of the University of Michigan Medical  school, where he also completed a fellowship in integrative medicine. His residency training was in family medicine with UCSFs Sutter health in Santa Rosa, California. And one of the reasons that Dr. Zager is one of our key people that we've featured in our speaker series is that he really exemplifies the Paloma approach, which is that we don't believe that hypothyroid care is a one size fits all

[00:03:48] operation. And that has always been one of the hallmarks of Dr. Zager's care. He draws from both conventional and evidence-based alternative methods of diagnosis and treatment for thyroid and other conditions, and really focuses in on the idea that effective approaches are coming from an understanding of your

[00:04:07] narrative, your health. So Dr. Zager also looks at thyroid related to the other hormonal systems. So the adrenal, the immune system, gastrointestinal health, sex hormones, all of those factors that  take part in this. It's entire picture and play a role. So I'd like to welcome Dr. Zager first to us.

[00:04:28] And why don't you tell us a little bit about your overall approach to the focus on thyroid and stress and how they connect. Hello to everybody. I'm going to take just a few minutes here to just introduce myself a little bit further and just talk about a few key takeaways as we get this conversation going.

[00:04:49]Yeah, I'm Dr. Sean Zager. I live and work out of Ann Arbor, Michigan, where it is currently snowing, believe it or not. And yeah, I'm a family doctor. I am well-acquainted with bread and butter, primary care. Practice it regularly. But I think that for chronic conditions like Hashimoto's, or just hypothyroidism, it's really important to have a, more of a holistic approach where we get to know each patient's individual needs and also can consider all the interrelated factors that go into a disease process or a disorder in the body.

[00:05:23] Cause it's really multivariable. Okay. Now, I just think it's important at the outset here to just take a second. And we're talking about the impact of stress on our health and certainly on our thyroid health. I think it's really important for all of us   in this meeting here for all of us around the globe to, to realize that we're in the second year of a pandemic, it is a stressful time.

[00:05:51] And I just think it's, it is meaningful to acknowledge that for just a second and just take a deep breath and know that we're all in this together, but it's a stressful time. And so it's all the more important that we prioritize our own self-care and certainly our thyroid care to be able to get through this in a way that we can come out better in the end.

[00:06:12]Yes, certainly we need to optimize our thyroid care. If you are a person with an under-functioning thyroid or with Hashimoto's, please connect with your Paloma healthcare provider and make sure that your thyroid is well understood and appropriately  treated.  That is central. But I want to say just as a key takeaway here, that I want to bring it back to the basics.

[00:06:36] I think that in addition to making sure that your thyroid is well taken care of your own self care and what I always call it, the pillars of our health care deserves special attention, especially at this time. So that is diet, and I could spend an hour talking about diet. I'm going to spend just half less than a half a second or half a minute here

[00:06:57] and just say that, some buzzwords,  obviously there's different dietary needs for everybody. And so there's not one diet that fits all, but some buzzwords that are important that may deserve a little bit of a deeper dive to follow an anti-inflammatory, low-glycemic index, low-glycemic load, Mediterranean style diet, and maybe especially those with auto-immune conditions

[00:07:19] like Hashimoto's, something along the lines of an auto immune protocol diet. Those are all good buzzwords to, to lay out there. But there's no doubt that if we eat well, we handle stress better. And if we eat poorly, we don't. Okay. And we'll, we're gonna talk more about that later, even as it relates to the gut regular exercise, good sleep hygiene, these affect each, the other one positively.

[00:07:41] And in and of themselves, they both support our thyroid health and our stress management to great degrees. And lastly, quieting or relaxation practices. It could be whatever it is for you being outside in nature, deep breathing exercises, meditation, guided imagery, yoga, listening to relaxing music, Tai Chi, prayer.

[00:08:00] These go such a long way to supporting our sense of quiet and our sense of relaxation and supporting our adrenal function, which is intimately related with our thyroid function, which we will also be talking about later. And so I'll just leave it there but those pillars of health care of our own healthcare: diet, exercise, sleep, quieting practices, we will always talk about those.

[00:08:27] I always talk about those things with my patients, every step of the way. Thank you, Dr. Zager. A very good overview of the things that we need to keep in mind. Now I want to welcome Dr. Shari Auth. Shari is     a licensed doctor of acupuncture in Chinese medicine. She has a master's in herbalogy  and is a board certified Chinese herbalist with extensive training in

[00:08:53] vedic and Western herbs. She's also a licensed massage therapist and   she's Guild certified in the Rolf method of structural integration, and a faculty member of the Swedish Institute in New York City. She is co-founder of WTHN, a New York based acupuncture studio where ancient wisdom meets modern science to deliver holistic treatments with a deeply healing powers.

[00:09:19] So Dr. Auth has  studied the healing arts globally focusing on various ancient healing practices that she has brought into her practice today. She's also the founder of the Auth method of therapeutic massage and has trained thousands of practitioners in her specific method. Dr. Auth, would you like to share with us some of your thoughts about the relationship between thyroid

[00:09:46] and stress tests and the importance of some of the focus that we're putting in on that topic today. Absolutely. First off, thank you, Dr. Zager, for your words.  I wish there was more holistic physicians like you. I'm so aligned with everything you said. It was just beautiful. And just a little bit about WTHN first. We're in New York city and we're making acupuncture and Chinese medicine more accessible.

[00:10:11]We have a beautiful ground floor space in the flat iron. We're making it more accessible through education but also through convenience and price point. We cut the price of acupuncture in half for New York City. Did that for numerous reasons including allowing people to really use Chinese medicine the way it's meant to be used, which is preventatively to keep your body in good health.

[00:10:36]And not just reactionary. I've been in private practice for a couple of decades. And what I found was that, people would come to me because maybe they were in pain or something like this. And once they felt better, they were gone and then they come back six months later cause they're in pain again.

[00:10:51] And I just thought, that's not really what Chinese medicine is about. In ancient China, you saw your doctor when you were well and your doctor kept you well. And if you got sick you went for free cause your doctor had failed you. So it's really the reverse of Western medicine. I love that this opening question is how does stress affect the thyroid?

[00:11:12]I think diet is totally important as Dr. Zager suggested, and I actually love the Mediterranean diet myself. But I treat New Yorkers. I find a lot of them, it's not their diet. Their diet is fine. They've spent so much time being wired and tired. They've spent so much time pushing and being in their fight or flight nervous system called the sympathetic nervous system.

[00:11:38]And even eating, when they're in that fight or flight mode, where the body can't even really digest properly because the blood is going to the muscles in the brain instead of the stomach, and they've said so much time there that they've really exhausted themselves. And there's a tipping point where you're no longer wired and tired.

[00:11:56] You're just tired. And that's when the hypothyroidism sets in and then it's really about rebalancing and retraining because the thyroid is like the Canary in the cage. And it's really about balance. So it's really hard because even though you're tired, you have to take away the external stimulants.

[00:12:18] Because in the end, they're only depleting you further and really starting on what is your, where is your true energy level and just accepting that and just doing things that are nourishing. And I find one of the things that's hard about really managing hypothyroidism and really healing it is that it takes patience.

[00:12:42] It takes patience to really fill your body back up and get what is true energy. Especially when we, as Americans, spend so much time with these artificial stimulants of coffee and sugar and things like that. It's like, what is the energy of a carrot? And it's so hard to feel the energy of a carrot when you're used to

[00:13:04]a latte or a red bull or whatever, but that's really what it takes is getting down to the basics and feeling the natural energy that you get from doing a yin yoga or a lighter workout. Like stretching and instead of the high that you get from doing a high energy workout, which if you're really truly tired and deficient, as we call it in Chinese medicine only really make you more deficient.

[00:13:30]Really important to do these more gentle form of exercise that will really help you fill your tank back up. And Dr. Zager said, and I found this so lovely. It's in Chinese medicine there, isn't just one headache. There's dozens of headaches. So every patient, when they come in, we, we really, it's a customized treatment.

[00:13:56]There's something unique about your hypothyroidism, which is why Paloma Health is so beautiful to recognize that. And so because of that uniqueness, there isn't one right answer. Which is so great that Paloma Health has this concierge service to really seek that out. And what it is that you truly need.

[00:14:16]One of the ways that acupuncture and Chinese or acupuncture let's start with that helps with stress is that it lowers your cortisol levels. So it lowers your primary stress hormone, and it helps to shift you out of the sympathetic nervous system in that flight or fight, fight, or flight response and into your parasympathetic nervous system, your rest and digest response.

[00:14:43] So it's really common when people go to get acupuncture that they might fall asleep on the table. The needles aren't painful. They're the size of a human hair. It's quite relaxing, like a massage. It's hard to imagine that if you've never had it, because chances are your only experience with needles or hypodermic needles, which are these big, thick, hollow needles that are used to inject something or remove something like blood, you can actually fit 40 acupuncture needles into one hypodermic needle. That's how small these needles are. And acupuncturist train for three to five years to know exactly how to insert these needles. So it's a very relaxing experience. And people often leave talking about the Accu high, you leave and you just, you feel fantastic, and there's no negative side effects. In fact, there's just, there's positive side benefits. People will go to acupuncture for one thing and leave and say, Oh, I slept so great. And Oh my shoulder feels better. I don't mind my digestion's better, or I'm not getting sick as much

[00:15:51] cause my immune system stronger and such. That's a great overview. And just so you know, people who have not had acupuncture the first time I had it, Dr. Auth I have a complete endorphin high. I was getting it just for some pain in my back. And the next thing I knew I was just flying high, like laughing my head off felt like I was on top of the world and I said to my doctor, what's going on?

[00:16:19] And he said, Oh, you're having an endorphin rush from your, from the acupuncture. And it was absolutely amazing. And since then I have done exactly what you said. I have fallen asleep on the table. I have left feeling like I didn't go in. I went in for my elbow, but how come everything else feels good to do?

[00:16:37] And so I'm I'm a strong and firm believer in the power of acupuncture and Chinese medicine to help get back in balance and to support our stress response. So thank you for that introduction. And let's go ahead and go to Dr. Zager to for our, really our first key question. And I'm wondering Dr.

[00:16:59] Z, if you can tell us a little bit more about. How chronic stress specifically can impact thyroid function? And also if you could explain to our viewers that stress is not just, Oh, I'm stressed out because I have too much to do, but that it's also, there's also physical stress and life and emotional and mental stress.

[00:17:23] So maybe you can give us a little overview of that and then tell us what it's doing to our thyroid. Wow. Yeah. I guess that's good to clarify first stress. First of all, stress is not always bad. We, there's something called you stress that this there's studies out there that show that we perform at our best with a little bit of stress.

[00:17:44]And that's okay. That's motivation to reach the finish line. Put out, put our good efforts in and be attentive in the process and and clear thinking. So stress in itself is not a bad thing. It's when the stress reaches high levels for too long a time, and it can certainly be mental or psycho-emotional or

[00:18:09] physical. And it's hard sometimes even to extricate those things, they go so hand in hand. But when it, when that happens, then we start to see it become inflammatory to the body and the mind and throw us off balance. And in almost it can be any way. I would just say, and I was going to say this a little later in this question about this go right to it.

[00:18:29]Let me stick with my order because I want to clarify a couple things first. So chronic stress negatively affects our thyroid function in more ways than one. Okay. First of all, when there's chronic stress, it creates a chronic increase in our cortisol production. And so I just want to clarify those terms.

[00:18:47]Cortisol is a hormone that's produced in our adrenal glands. They are another hormone secreting gland separate from the thyroid gland that is very intimately connected with the thyroid gland and thyroid function. The adrenal glands are walnut size glands. It's an on top of the kidneys. They produce several different hormones.

[00:19:05]But the one that I'll talk about today is cortisol. Which is our stress hormone. It's actually very adaptive. All animals create cortisol in response to stress, essentially to mobilize the energy, to combat that stress or, confront that stress and hopefully overcome it. So if you're a zebra on it, this is, the classic.

[00:19:25] If you're a zebra, on the Savanna and you're running from a lion, you, you secrete cortisol and it helps you run. And the quarter is a level will eventually go down because you escaped the lion and you're resting somewhere in the grass or because you're dead. And humans are the only creatures who experienced chronic stress, because of our consciousness, because of the way that our minds can work. So when there's chronic increases in stress and chronic increases in cortisol, What we see as a disruption. I don't want to get to o medical here, but I'll just say we get a disruption in the hypo thalamic pituitary pathway, which is a pathway in the brain that controls lots of our various hormones in the body, including our thyroid hormone.

[00:20:12]So when we have increased chronic stress, increased chronic secretion of cortisol, it tends over time to then decrease our hormones, thyroid hormone production. Which then leads to hypothyroidism sometimes. Hashimoto's and that's when you need support for your thyroid. Chronic stress also increases inflammation in the body directly, as we were saying before and this, and I think that's Dr. Auth's going to talk about this in the next question, but so I won't go into it too much but this creates immune dysregulation and can worsen autoimmune conditions like Hashimoto's.

[00:20:44]And finally, chronic stress can impair thyroid function by way of its negative impacts on the gut. Which I going to touch on in a later question. So I'll leave it there. Those are a few, I think, central ways that chronic stress negatively impacts the thyroid. Great. Thank you for explaining that.

[00:21:03] And I think so I think the take home message here is that chronic stress, whether it's physical stress, emotional stress life stress is going to have an impact on our thyroid gland. And as Dr. Zager, as you said, it also is increasing inflammation and disregulating the immune system, which leads us to a question for Dr.

[00:21:25] Auth. Can you tell us a little bit more about how chronic stress has an impact on the immune system and what it means for auto-immune conditions? And in particular, the one that many of our viewers have, which has Hashimoto's thyroiditis or Hashimoto's disease. Yeah. I love this question because it was one of the things that, that really started my career in holistic health.

[00:21:51]When I was in college in the early nineties I started studying psychoneuroimmunology, which was the study of how our emotions affect our immune system. And now this is just highly documented, there's hundreds of scientific studies that show the connection between stress and immunity in different quarter core corticosteroids that suppress the effectiveness of the immune system, both cellular and humoral immunity and lower lymphocytes.

[00:22:20] And this sort of thing. So very well-documented the negative impact that stress has on the immune system. Fortunately also very well-documented is how things like acupuncture helps boost immunity, and really from all aspects of immunity. And at the same time is going to lower your stress levels.

[00:22:42]And then and then how that can then in  turn, turn into an auto-immune disease is just the more prolonged and advanced stages of that stress wearing down the body. So really any time we're dealing with chronic stress we're looking at it having specific effects on the thyroid and on the immune system and on the inflammatory process.

[00:23:06] And as a result, it can aggravate or become a trigger factor for auto-immune conditions or even the worsening of auto-immune symptoms because of that, a dysregulation of the hormones and dysregulation of the immune system. So we definitely want to look at stress as one important piece of our overall package of things we're doing to try to tackle our thyroid condition from a multifactorial approach which leads us to another question.

[00:23:35]Dr. Zager, we know that the gut, as you were talking about and what we eat is so important for our thyroid health and they're intricate intricately related, but how does stress affect the gut? Because if we get our gut messed up, that's going to affect our thyroid. If we have stress, it's going to affect our thyroid, but it sounds like there's an extra layer of issue here because stress can actually affect the gut health as well.

[00:24:04] So can you tell us a little more about that? Absolutely. Yeah. Thanks for the question. I could spend an hour talking about  how stress affects the gut. I'm going to spend two minutes talking about it, so I'll just break it down. So the gut is our biggest, most important window between the external world and our internal world, right?

[00:24:25] When the gut is healthy, when the GI tract is healthy, it is meant to act as a very intricately refined semipermeable membrane that helps us absorb nutrients and helps us keep out food particles and toxins and eliminate them. And that's the job, the primary job of our GI tract. We now know pretty clearly that when that chronic stress in and of itself can cause inflammation, many parts of the body, but certainly in the gut.

[00:24:58]And this can lead to what a lot of viewers may have. At this point, 20 years ago, this was something that people didn't know about, but the idea of leaky gut phenomenon, I feel like it's come a little more front and center, mostly through the functional medicine movement. And so when people have leaky gut from inflammation, a lot of things happen most notably decreased, inability to absorb nutrients, increase absorption of things that we shouldn't be absorbing like food particles or toxins into the blood.

[00:25:21]And then an increased risk for what I would call dysbiosis, which essentially means that the ecology or the flora of the gut becomes imbalanced and it could translate.     You could see it as increased overgrowth of bacteria, overgrowth of yeast,  parasites, not enough good bacteria.

[00:25:38] This is, these are examples of dysbiosis. So just to say specifically how these can affect the thyroid Because each one of these has direct impact on the thyroid function. Number one, of course, we need nutrients some more than others, but many nutrients for, to create active thyroid hormone. Just to name a few: iron and copper and selenium and zinc. We need these and when we're not absorbing these through the gut, the way that we need to our thyroid function suffers. Secondly, when we are, when that leaky gut phenomenon happens in response to stress, we're absorbing things that we shouldn't be into the bloodstream.

[00:26:13]It, as you would imagine, when there's things in the bloodstream, it then triggers our immune system to say, Hey, what's that? What do I do with that? I'm going to create more inflammation in the body to try to take care of those, or, find other ways of mobilizing and eliminating those new toxins or things in the blood that shouldn't be there because of that leaky gut phenomenon.

[00:26:31] And that worsens auto-immune disease like Hashimoto's. And that dysbiosis, thirdly, that I talked about, it's interesting. There was actually  a recent study. I think it was 2000. It was June of last year, last summer that it was very interesting. They showed, there was two groups of mice.

[00:26:48]One healthy and one that was hypothyroid. They conducted FMT, which is the fecal microbiota transplantation, that something might sound gross to some or some have heard of this, but where they take fecal samples and from the hypo thyroid mice and put them into the normal, healthy mice.

[00:27:07] And they found that just by, by doing that. And I should say that the fecal samples from the hypothyroid mice were dysbiotic, they didn't have the same, the healthy microbiome that the healthy mice had. By transplanting them and creating that dysbiosis in these previously healthy mice, they induced hypothyroidism in these previously healthy mice.

[00:27:29] So just that dysbiosis was enough to affect the thyroid negatively per this study that was done just less than a year ago. And I just I'll round it out by saying that of course chronic stress can lead to poor decisions for food choices. Which again can, in just as a different pathway by which we get less nutrients for our thyroid, increased inflammation in the gut and in the body that increased risk for that leaky gut phenomenon that I'm talking about here and then immune dysregulation.

[00:28:01] Terrific. Thank you. That's a really good overview of the different effects that we're looking at. Dr. Auth. We have people that are going into stress responses, whether they're stressed out about particular things in life. Everything from sitting in traffic and road rage to anxiety about money, or, not getting enough

[00:28:24] Sleep and being exhausted and pushing. And I have heard on the grapevine that you actually have some tips that you can share with us about how to switch to a relaxation response from that high stress fight or flight kind of mode, including even something we can learn how to do today on

[00:28:45] our session. So can you tell us a little bit about what we can do to go from fight or flight into that more relaxation response mode and into a better place from a health standpoint? Sure. That'd be great. I'd love to do a breathing meditation and one thing I'd like to say about that is the more often you meditate, the easier meditation becomes.

[00:29:11]And one of the things I love about meditation is how portable it is. I find, my favorite place to meditate is when I'm waiting for the subway, or maybe sitting in traffic or that sort of thing though, with the pandemic, I feel like there isn't traffic anymore, but I'm sure it's coming back.

[00:29:25]But just to actually calm your mind in those situations I also find that it really helps to become aware of what triggers you. Sure those triggers like, like traffic, which we can all relate to. But a lot of times our stress triggers have more to do with emotional interactions or just daily interactions that we're having with somebody else, our spouse, a coworker, this sort of thing.

[00:29:50]I know for me I can take things personally. Maybe something happens at work or when my family and I misread something and I suddenly feel angry or stressed or this sort of thing and learning how to dial it back and look at the trigger objectively and realize what's underneath it.

[00:30:12]And as much as you can detonate those triggers so that they're not constantly appearing in your life, helps you to really go with the flow. I really love, we have a stress formula called "Run the world" and it's made with herbal adaptogens. And one of the things I love about herbal adaptogens is that they really help to make you less reactionary in the moment.

[00:30:38] So you can find that pause easier between when something happens and then you go and get triggered and your stress hormones start flying the adaptogens help to create a little bit of a buffer so that you can breathe through the situation. And then, do the deeper work later to figure out what was really going on there.

[00:31:03]But having less of a physiological response. And less of a behavioral response in the moment, which can often get your body in trouble, but can also just get you in trouble and create fights or behavior that you're not proud of. Great. We have a minute or two to just do a little sample, a taste  of a breath meditation, if you want to take us through that.

[00:31:29] And cause we want to also leave some time at the end for  folks to have questions. Okay. I'll hurry  along. So I'm going to teach you a point. It's called pericardium six. So if you find the center of your wrist crease, I can teach you an accu puncture points. You can do an acupressure on yourself and then we'll close your eyes and we'll work this point on ourselves.

[00:31:48] So I'm going to have you slide towards the elbow about two inches from the wrist crease. You'll feel some little ropey tendons right there. And then I want you to just put your thumb right on those tendons. And then I'm going to hold my arms up, but you can just relax your arms in your lap, and you're going to take your thumb.

[00:32:06] And make little tiny circles and just drop a little bit of pressure into this point. You want to have enough pressure that you feel like you're activating this point, but not so much pressure that it, that you're overwhelming it. And it certainly should not be painful. Feet on the ground. Close your eyes, take a big inhale through your nose, fill up all the way.

[00:32:36] And exhaling through your mouth, pushing the air out, making little tiny circles on this point called pericardium six, slow, deep inhalations through the nose

[00:32:59] and exhaling through the mouth.

[00:33:05] And imagine that you're activating this point.

[00:33:10] This point is great for calming the mind, and it's also really good for digestion.

[00:33:21] So it's good for any kind of digestive upset and let's take one last deep breath here.

[00:33:33] And on the exhale. Let your thoughts go, let your head empty

[00:33:44] and just get present.

[00:33:50] Dr. Zager said something really nice about, how animals don't really have stress. And I thought that's cause they're only in the moment, our stress comes because we're in yesterday or we're in tomorrow, but if you can just be here right now, chances are, you're not running from a tiger.

[00:34:09] That was wonderful. I don't know about all of you, but I already felt more relaxed and that's a great spot. Katie, did you feel it? I could see Katie was looking like she was enjoying it too. Wonderful. Thank you for that. That's terrific tip. And we can all try using that. I have a 16 year old son, so I think I'll be using it quite a lot to keep me calm.

[00:34:31]I want to switch over to one last question, and then we're going to touch upon questions from those of you who are watching today. So if you have any questions,

[00:34:41] now is the time to get them into the chat box. We have a couple of folks that have asked questions, and if you have any others, we'll be taking those after this. But Dr. Zager;

[00:34:53] you mentioned a little bit earlier that you were going to touch upon the relationship between the adrenals and the thyroid and the adrenals being our glands that handle the stress hormones.

[00:35:03] And so the adrenal- thyroid relationship, is that right? Stress hormone, thyroid connection. So can you give us some of your favorite tips for how to heal, support and balance that adrenal thyroid connection to help manage and reduce the stress response? Absolutely. Yeah. Thanks Dr. Auth for that exercise.

[00:35:25] That was cool. Appreciate it. I feel that was really helpful. All right, yeah. So talking about how to support the adrenal thyroid connection, and just try to support the health of our adrenal glands and thyroid glands together. First of all, of course, getting really good quality thyroid care goes a long way.

[00:35:48]Connecting with your thyroid health care practitioner to make sure that your thyroid, if it's under functioning or if you have Hashimoto's is well supported, goes a long way to help optimize your adrenal health. Because if you have chronically undiagnosed or undertreated hypothyroidism, it ultimately will start to cause an increase in cortisol production from the adrenal glands, because it creates a chronic stress in itself.

[00:36:16] So that, that good quality thyroid care is so important. I would say too, let me say also that when there is that imbalance with low thyroid chronically low thyroid and chronically high cortisol, things like sleep disturbance, fatigue, weight gain, increased blood pressure, decreased ability to control blood sugar, decreased neurocognitive, clarity, more mood swings, more anxiety,

[00:36:38] this is some of the things that people experience when that thyroid is under-functioning causing the overfunctioning of the adrenal glands and cortisol production. It can often lead to that wired and tired kind of space that Dr. Auth was talking about in the beginning. Secondly, again, I'm going to bring it back to where I started with those pillars of healthcare.

[00:36:59]If we're talking about supporting the thyroid and the adrenal gland, it's gotta always, the combination is always got to include good, healthy diet. Regular exercise, good sleep hygiene, good sleep quality, quieting practices also connecting with friends and fulfilling yourself socially and spiritually.

[00:37:17]And one last thing that I love and I was happy that Dr. Auth just mentioned this too is probably my favorite class of botanicals out there is adaptogenic herbs. I just love adaptogens. For the viewers out there that don't know, adaptogenic herbs and Dr. Auth, of course, feel free to chime in, but adaptogenic herbs are, many of them are really ancient tonics that have been around from various parts of the world for millennia.

[00:37:46] And a lot of them are ones that people have heard of them. Some maybe not, but they've been used around the world to increase our capacity to manage stress, to increase our neurocognitive clarity, to increase our energy, and to decrease tendencies towards anxiety or reactiveness like Dr.

[00:38:04] Auth mentioned, and it also to decrease inflammation in the body altogether.   There are some adoptogenic herbs that are more stimulating things like ginseng  which can be Asian or American ginseng or Siberian ginseng. Schisandra,  Rhodiola, there's various mushrooms that are adaptogenic like reishi or cordyceps. Maca roots often use also for sexual energy support. Licorice, tumeric, ginger, stuff that we eat all the time.

[00:38:33] And then other adaptogenic herbs are a little bit more quieting. And calming like ashwagandha from the Indian sub-continent. Holy basal, milky oats seed. These are so then there are many others out there. So there, there are nuances in how these are used and blended together. And I encourage yeah, people out there to talk to their healthcare providers about adaptogenic herbs to support their adrenal and thyroid function.

[00:38:59] Terrific. Thank you. Some good advice there. Dr. Auth, we have a question from one of our viewers. How often do you recommend that someone get acupuncture? Or practice acupressure self care techniques in order to really reap overall benefits. And is this a lifelong thing or do we go for just a short period of time or a couple of weeks or a couple months?

[00:39:28] What's your recommendation there? These are lifestyle recommendations. So they're really things that you integrate into your health care routine or your wellness routine? I would say with acupressure, every day is great. But I don't want to discourage people with, if that sounds overwhelming to them.

[00:39:50]But acupressure is so good at stimulating circulation in the body and reducing inflammation at the same time, it's really something you can do every day. Just like exercise and eating. With acupuncture, what I like to say, because granted, it's a custom response to what's going on with the patient in front of me.

[00:40:11]If somebody comes in with chronic migraines that they've had for five years, I'm going to say, come every week for eight to 12 weeks and let's get ahead of this. So we can just use the acupuncture to prevent the migraines, so it's really a customized response, but I would say a blanket response, not knowing who we're talking about.

[00:40:30] I would say acupuncture every week is wonderful. Acupuncture once a month is minimum. And somewhere in between is reality. There's always going to be a week you can't make it, you're traveling this sort of thing. But it's really good for optimizing the every day. So it's going to balance your hormone levels.

[00:40:51] It's going to increase your immunity, optimize your digestion, help you sleep, manage your stress. It's great for tackling aches and pains before they turn into something that is debilitating or   keeps you in bed or this sort of thing. Acupressure, we have an acupressure mat. We also have ear seeds, which are a little bead on a clear plastic sticker that you can put on a point on the ear.

[00:41:16]There's dozens of points on the ear that do everything from, relieve neck pain, to balance hormone levels, to calming the mind. These are really practices you can do regularly on your own. And we really tried to come out with more home solutions like this in the last year with the pandemic so that people could really learn to treat themselves knowing that a lot of people just aren't getting out for things like acupuncture or massage or even yoga classes.

[00:41:41] Terrific. That's great to know, because as you said, it is harder to get out these days, but hopefully  things start to reopen. We'll be able to get back out there and get our acupuncture, go to our yoga classes, go see our integrative doctors in person, and start doing some of the, some of these things that are gonna really help us get back on track.

[00:42:00]Doctor. Dr Zager, we have a question that's actually really relate to the whole issue of stress and a thyroid. And one of our viewers wants to know if you can talk about the issue of reverse T3 and what it has to do with stress and what it has to do with the thyroid. Absolutely. Okay. So reverse T3 is essentially,

[00:42:27] it represents the movement. Okay. Let me take a step back. So in our bodies T4 is converted into T3, which is the active thyroid hormone. Most of the the most commonly prescribed thyroid medications like levothyroxine and Synthroid are T4 that need to be converted into T3 in the body.

[00:42:46] Reverse T3, represents the movement away from active thyroid hormone back into its precursors. And there's been some study. The study is certainly mixed. But there's been some study to show that this can represent inflammation in the body. As can low total T3 levels. Gosh, I don't want to get too in the weeds, but in my practice, what I often do is I look at ratios between total T3 and reverse T3.

[00:43:11] And when you see that total T3 low, or that reverse T3 high, I wonder about if there are other inflammatory processes going on in the body. And if that patient might need to bypass the conversion from T4 into T3 and just get straight T3, which isn't a therapeutic option. It's, there's a lot of things that can cause that process to occur stress and inflammation being, being, a large generalization of what can cause it, and there are many specific conditions that can cause it.

[00:43:42] I dunno. I think I'll, I'm happy to expound, but that's essentially the way that I look at it from a birdseye. Okay. I think it, would you agree that one of the things that we often see hand in hand is that elevated, reverse T3 may also be accompanying elevated thyroid antibodies because both are going to be reflective of greater inflammation or greater stress.

[00:44:05] And so we have one question from one of our viewers regarding how to bring the antibodies down, because obviously if the antibodies are high, their body's under more stress and inflammation and the lower we can get the antibodies, the better off we're going to be from an overall health perspective.

[00:44:22] So what particular approaches do you have to getting antibodies down? Absolutely. So again, there, there are so many more markers in the body to fault that, that change with inflammation. And certainly thyroid antibodies are one of those and reverse T3 is one of those and increased cortisol production is one of those.

[00:44:41] And the list goes on. We touched on this in the body of the talk here that. To bring down thyroid antibodies. The first thing you want to do is if there is evidence of thyroid dysfunction, specifically, seeing any other thyroid function tests like TSH, you want to address that first.

[00:45:01] If someone's walking around in a hypothyroid,   in an unaddressed or untreated hypothyroid  state, and they have elevated thyroid antibodies, the first thing you need to do is treat their thyroid and make sure their thyroid is well supported. So it has a chance to heal, right? So that's the first thing.

[00:45:15]Once you've optimized thyroid function and the antibodies are still elevated, then you do what you can do to decrease inflammation in the body. And there's a lot of ways to do that. Again, the main, there's more and more scientific study into this. Looking at those pillars of healthcare, this is why people talk about the autoimmune protocol diet helping to support Hashimoto's and pull those antibodies down.

[00:45:41] I would say other good self-care practices, like good exercise and good sleep and stress management, all go a long way to helping to pull those antibodies down. And I'd say that there are other medications and supplements that can be used from anti-inflammatory supplements, good quality omega-3 fish oil, to anti-inflammatory herbs, like tumeric or ginger too.

[00:46:05] It's off label, use of low dose naltrexone, which is probably a whole 'nother talk but certainly I use that in my practice as well. Terrific. Thank you. Dr. Auth, we've heard from Dr. Zager about some of his thoughts about the nutrition and food element to all of this picture. And I'm wondering if you have any thoughts about,

[00:46:28] your feelings on dietary recommendations or foods that are good for reducing stress or a particular dietary approach that's reducing stress. Because I know in Chinese medicine, we have very different ways of characterizing certain kinds of foods and looking at their health effects. So I'm wondering if you can give us some of your thoughts to add to what we've already heard as far as the anti-inflammatory.

[00:46:55] Approach of eating that might be helpful for stress and overall health. I'm going to segue a little bit and say that herbs are food. So herbalism is the oldest form of medicine on the planet. And every culture from around the world had their own system of plant medicine. So they look to the plants around them.

[00:47:19] They tried things and they figured out what the effects were. They noticed if something made them tired, they noticed if something gave him energy, they noticed if something was poisonous and don't eat that one. And all of this wisdom was passed down from generation to generation. The largest body of which is Chinese herbs, enormous body of plant wisdom and very complex system in which to use herbs, to treat the body.

[00:47:50]And herbs are really just food. Like you I look at some Chinese herbs, like goji berries, that you can now just buy in a snack bag. This is a, an herb that's been used in Chinese medicine for centuries. It tonifies the yin and a tonifies   the essence in the blood, so herbs are really just part of a healthy diet.

[00:48:09] I take herbs every day and I've taken herbs every day for 30 years. And I'm either treating whatever's going on with me or I'm optimizing every day. If I wake up feeling stressed, if I wake up feeling tired, if I need to focus, if I need to boost my digestion, I'll take an herbal formula that has a lot of herbs that boost digestive, enzymes, this sort of thing or herbs that are sedatives to help you go to sleep.

[00:48:34]We have a formula, that's an herbal formula. It's great for hypothyroidism called "Fully Charged," and it has different herbs that really help to support the thyroid. Particularly hypo thyroid, not hyperthyroid. So that would be my encouragement is to explore herbs and herbal medicine and how it can help you with your every day whether it's fatigue or a slow metabolism or need any, take something.

[00:48:59] We have another formula called "Gut Check," and it's based on a very famous Chinese herbal formula. Almost all of our formulas are based on famous Chinese herbal formulas. We're just the first people doing these formulas, organic. This was very important to me. I've been prescribing herbs for 20 years.

[00:49:16] I know where all of us acupuncturists are getting our herbs and they're not. They're not organic. They're not tested for metals, this sort of thing. So it was really important to me to come out with a product that was really high quality and do it in a way where it's  really user friendly. We're going to offer a discount code, so you can go to our website and you'll find that all the information you need is there for the formulas.

[00:49:37]And they're really just. We have nine formulas and we're coming out with a couple more really soon. And they're just for really, everyday complaints  that we all share. The only one that isn't for you guys is "Can't Touch This" because it's an immune booster, so it's not great for auto immune, but everything else.

[00:49:55] Okay. So if you don't have auto-immune thyroid you can't touch this is okay. But if you do have Hashimoto's or another auto-immune disease, that would be one to to not deal with, but all of the other formulations are appropriate for thyroid patients, correct? Terrific. All right. I think we're coming up on the end of our hour.

[00:50:16] And I want to go ahead and thank Dr. Shari Auth who has given us some amazing information about her approach to stress reduction and all of the traditional Chinese medicine and acupuncture and herbal approach to things. And Paloma's own Dr. Sean Zager, who always has so much to share.

[00:50:36]I think we could probably do a couple of hours with each one of you experts, because you had so much incredibly good information. You'll find Dr. Zager on Paloma and he's one of our, one of our premier doctors and we love having him here for our speaker series. And thank you both for joining us, and I'm going to turn it back over to Katie to wrap things up for the final a minute here.

[00:51:00] Awesome. Thank you, Mary. And to both of our speakers for spending time with us this afternoon where I am, it's evening where most of you are. I think so. Thanks for spending time with us today. I just want to touch on one question. Pauline asked, Hashimoto's   patients can not take the "Can't Touch This?" That's right.

[00:51:16] And we will send out a replay of this event in the next 24 to 48 hours. We will include a discount code in there for an at home thyroid test kit. And also off of WTHN's online shop or your first acupuncture treatment, I think that's right. But check your email. Our next speaker series will be announced soon.

[00:51:34] You will get an email about that happening sometime in May. I've learned a lot. I hope all of you have learned a lot too, and we will see you soon. Thanks so much everyone. Thanks everyone. Thank you.


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