A Fresh Take On Hypothyroidism
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The Three Rs To Boost Thyroid-Related Energy Levels
This is Dr. Izabella Wentz. She’s a doctor of pharmacology, and after her own diagnosis with Hashimoto’s thyroiditis, she has taken it up as her personal goal to educate others on managing hypothyroidism.
Dr. Wentz is also trained in functional medicine through The Institute for Functional Medicine, Kalish Functional Medicine, and the American Academy of Anti-Aging Medicine. She is a Fellow of the American Society of Consultant Pharmacists, and holds certifications in Medication Therapy Management as well as Advanced Diabetes Care through the American Pharmacists Association. In 2013, she received the Excellence in Innovation Award from the Illinois Pharmacists Association.
Dr. Wentz’s mission
Dr. Wentz was disenchanted by the general medical response to hypothyroidism in three main ways. She tells us:
- Thyroid patients are not diagnosed appropriately.
- For this, she criticises over-reliance on TSH tests that aren’t a reliable marker of thyroid function, especially if you have Hashimoto’s.
- Patients should be better optimized on their medications.
- For this, she criticizes many prescribed drugs that are actually pro-drugs*, that don’t get converted adequately if you have an underactive thyroid.
- Lifestyle interventions are often ignored by mainstream medicine.
- Medicines are great; they truly are. But medicating without adjusting lifestyle can be like painting over the cracks in a crumbling building.
*a “pro-drug” is what it’s called when the drug we take is not the actual drug the body needs, but is a precursor that will get converted to that actual drug we need, inside our body—usually by the liver, but not always. An example in this case is T4, which by definition is a pro-drug and won’t always get correctly converted to the T3 that a thyroid patient needs.
Well that does indeed sound worthy of criticism. But what does she advise instead?
First, she recommends a different diagnostic tool
Instead of (or at least, in addition to) TSH tests, she advises to ask for TPO tests (thyroid peroxidase), and a test for Tg antibodies (thyroglobulin). She says these are elevated for many years before a change in TSH is seen.
Next, identify the root cause and triggers
These can differ from person to person, but in countries that add iodine to salt, that’s often a big factor. And while gluten may or may not be a factor, there’s a strong correlation between celiac disease and Hashimoto’s disease, so it is worth checking too. Same goes for lactose.
By “checking”, here we mean testing eliminating it and seeing whether it makes a difference to energy levels—this can be slow, though, so give it time! It is best to do this under the guidance of a specialist if you can, of course.
Next, get to work on repairing your insides.
Remember we said “this can be slow”? It’s because your insides won’t necessarily bounce back immediately from whatever they’ve been suffering from for what’s likely many years. But, better late than never, and the time will pass anyway, so might as well get going on it.
For this, she recommends a gut-healthy diet with specific dietary interventions for hypothyroidism. Rather than repeat ourselves unduly here, we’ll link to a couple of previous articles of ours, as her recommendations match these:
She also recommends regular blood testing to see if you need supplementary TSH, TPO antibodies, and T3 and T4 hormones—as well as vitamin B12.
Short version
After diagnosis, she recommends the three Rs:
- Remove the causes and triggers of your hypothyroidism, so far as possible
- Repair the damage caused to your body, especially your gut
- Replace the thyroid hormones and related things in which your body has become deficient
Learn more
If you’d like to learn more about this, she offers a resource page, with resources ranging from on-screen information, to books you can get, to links to hook you up with blood tests if you need them, as well as recommended supplements to consider.
She also has a blog, which has an interesting relevant article added weekly.
Enjoy, and take care of yourself!
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Apricot vs Avocado – Which is Healthier?
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Our Verdict
When comparing apricot to avocado, we picked the avocado.
Why?
Both are great, but…
In terms of macros,apricot has slightly more carbs, while avocado has more than 30x the fat (famously healthy fats, including a good ratio of omega-3 and omega-6), and more than 3x the fiber. So, an easy win for avocado here.
In the category of vitamins, apricot has 13x the vitamin A, while avocado has several times more of vitamins B1, B2, B3, B5, B6, B7, B9, E, K, and choline, winning.
Looking at minerals, apricot is not higher in any minerals, while avocado has more copper, iron, magnesium, manganese, phosphorus, selenium, and zinc; another clear win for avocado.
In other matters, apricot has some specific anticancer properties that avocado can’t boast, so apricot does win one point here.
Adding up the sections makes for an overwhelming overall win for avocado, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
Top 8 Fruits That Prevent & Kill Cancer
Enjoy!
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Green Tea Can Benefit You (But Watch Out!)
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It’s not breaking news that green tea is healthy in moderation. But there’s a lot that many people don’t know, too.
A timeless classic, unless…
Of the various true teas, there are different possible metrics we may go by and different ways we could weight them, but the popular consensus is that green tea offers the strongest and most consistent health benefits, while traditionally brewed tea of any type is broadly safe and beneficial.
In terms of polyphenols, green tea retains high catechin levels due to minimal fermentation, while black tea contains theaflavins and thearubigins from oxidation; theanine and of course caffeine also contribute to physiological effects, and we’ve written about those in fair detail here:
- L-Theanine: What’s The Tea?
- Neuropsychologist Explains What She’s Got Out Of 6 Years Taking L-Theanine
- Caffeine: Cognitive Enhancer Or Brain-Wrecker?
As for the rest of the benefits, they are manifold, including:
- Cardiovascular protection: regular green tea intake—e.g. 2–3 cups per day—is linked to lower cardiovascular and all-cause mortality; polyphenols reduce LDL cholesterol, improve endothelial function, lower blood pressure, and reduce oxidative stress.
- Anticancer potential: findings in humans are mixed, but meta-analyses support reduced risks of oral, lung (in women), and colon cancers with regular green tea consumption.
- Weight and metabolic effects: green tea and catechin-rich preparations show modest, consistent reductions in body weight, fat mass, LDL cholesterol, and oxidative stress; cohort studies suggest lower diabetes risk, though other studies have not shown benefits, so in other words, the science is still a work-in-progress on this one.
- Neuroprotective effects: habitual tea drinking is associated with reduced cognitive decline, better cognitive performance, and lower Alzheimer’s-related biomarkers, with strongest benefits in adults aged 50 to 69. It’s also generally found to be beneficial for stress management.
- Muscle health benefits in aging: a surprising and much less well-known one, but catechin-rich green tea can help maintain or increase muscle mass and improve grip strength in older adults or those with sarcopenia in general.
- Inflammation and immunity: tea polyphenols lower inflammatory markers and oxidative stress, help reduce uric acid levels, and show antibacterial and antiviral activity (including against influenza, HPV, and SARS-CoV-2), though most antiviral data come from in vitro studies.
Rather than bombard you with sources for all of the above, we’ll drop a link to one excellent paper that covers them all:
Beneficial health effects and possible health concerns of tea consumption: a review
Wait, what’s that about “and possible health concerns”?
The problems highlighted by the above-linked studies are threefold, but the good news is that they can all be avoided, so long as you’re aware of them:
- Brew it yourself: bottled and bubble teas often contain sugars, artificial sweeteners, or preservatives that negate benefits, and to make things worse, processing and storage markedly reduce catechin content. So, just buy tea leaves and brew your own.
- Check safety/quality certifications: some teas contain pesticide residues, heavy metals, or microplastics; typical exposure is low risk, but long-term heavy consumption could run into problems if the supplier isn’t good.
- Timing matters for nutrient absorption: generous tea intake can inhibit non-heme iron and calcium absorption, so it’s best to avoid drinking your greens at the same time as eating your greens (leafy greens being good sources of non-heme iron and calcium).
Some people can also run into other problems that are more person-specific; we touched on that briefly here a few years ago: Green Tea Allergies and Capsules
Want to learn more?
As we mentioned up top, the other kinds of teas have their benefits too.
You can see which is best for what, here: Which Tea Is Best For The Health, By Science?
Enjoy!
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The Sucralose News: Scaremongering Or Serious?
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What’s the news on sucralose?
These past days the press has been abuzz with frightening tales:
- This Common Artificial Sweetener Can Break Down DNA, Scientists Warn
- Sucralose Damages DNA, Linked to Leaky Gut
- Chemical found in common sweetener damages DNA
- Chemical found in widely used sweetener breaks up DNA
- Chemical from Splenda breaks up DNA
How true and/or serious is this?
Firstly, let’s manage expectations. Pineapple juice also breaks down DNA, but is not generally considered a health risk. So let’s keep that in mind, while we look into the science.
Is sucralose as scary as pineapple juice, or is it something actually dangerous?
The new study (that sparked off these headlines)
The much-referenced study is publicly available to read in full—here it is:
You may notice that this doesn’t have quite the snappy punchiness of some of the headlines, but let’s break this down, if you’ll pardon the turn of phrase:
- Toxicological: pertaining to whether or not it has toxic qualities
- Pharmacokinetic: the science of asking, of chemicals in bodies, “where did it come from; where did it go; what could it do there; what can we know?” ← try not to read it to the tune of “Cotton-eye Joe”
- Sucralose-6-acetate: an impurity that can be found in sucralose. For perspective, the study found that the sucralose in Splenda contained “up to” 0.67% sucralose-6-acetate.
- Sucralose: a modified form of sucrose, that makes it hundreds of times sweeter, and non-caloric because the body cannot break it down so it’s treated as a dietary fiber and just passes through
- In vitro: things are happening in petri dishes, not in animals (human or otherwise), which would be called “in vivo”
- Screening assays: “we set up a very closed-parameters chemical test, to see what happens when we add this to this” ⇽ oversimplification, but this is the basic format of a screening assay—not to be mistaken for a “screaming essay”, which is what happens when a student’s final thesis is due tomorrow
Great, now we understand the title, but what about the study?
Researchers looked primarily at the effects of sucralose-6-acetate and sucralose (together and separately) on epithelial cells (these are very simple cells that are easy to study; conveniently, they are also most of what makes up our intestinal walls). For this, they used a fancy way of replicating human intestinal walls, that’s actually quite fascinating but beyond the scope of today’s newsletter. Suffice it to say: it’s quite good, and/but has its limitations too. They also looked at some in vivo rat studies.
What they found was…
Based on samples from the rat feces (somehow this didn’t make it into the headlines), it appears that sucralose may be acetylated in the intestines. What that means is that we, if we are like the rats (definitely not a given, but a reasonable hypothesis), might convert up to 10% of sucralose into sucralose-6-acetate inside us. Iff we do, the next part of the findings become more serious.
Based on the in vitro simulations, both sucralose and sucralose-6-acetate reduced intestinal barrier integrity at least a little, but sucralose-6-acetate was the kicker when it came to most of the effects—at least, so we (reasonably!) suppose.
Basically, there’s a lot of supposition going on here but the suppositions are reasonable. That’s how science works; there’s usually little we can know for sure from a single study; it’s when more studies roll in that we start to get a more complete picture.
What was sucralose-6-acetate found to do? It increased the expression of genes associated with inflammation, oxidative stress, and cancer (granted those three things generally go together). So that’s a “this probably has this end result” supposition.
More concretely, and which most of the headlines latched onto, it was found (in vitro) to induce cytogenic damage, specifically, of the clastogenic variety (produces DNA strand breaks—so this is different than pineapple’s bromelain and DNA-helicase’s relatively harmless unzipping of genes).
The dose makes the poison
So, how much is too much and is that 0.67% something to worry about?
- Remembering the rat study, it may be more like 10% once our intestines have done their thing. Iff we’re like rats.
- But, even if it’s only 0.67%, this will still be above the “threshold of toxicological concern for genotoxicity”, of 0.15µg/person/day.
- On the other hand, the fact that these were in vitro studies is a serious limitation.
- Sometimes something is very dangerous in vitro, because it’s being put directly onto cells, whereas in vivo we may have mechanisms for dealing with that.
We won’t know for sure until we get in vivo studies in human subjects, and that may not happen any time soon, if ever, depending on the technical limitations and ethical considerations that sometimes preclude doing certain studies in humans.
Bottom line:
- The headlines are written to be scary, but aren’t wrong; their claims are fundamentally true
- What that means for us as actual humans may not be the same, however; we don’t know yet
- For now, it is probably reasonable to avoid sucralose just in case
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Mango vs Pineapple – Which is Healthier?
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Our Verdict
When comparing mango to pineapple, we picked the pineapple.
Why?
It was close! Both of these tropical fruits have almost identical macros, and when it comes to vitamins and minerals, mango has slightly more vitamins while pineapple has slightly more minerals, so that balances out too. Their glycemic loads are 11 and 13 respectively, so: very low, and very similar.
See also: Which Sugars Are Healthier, And Which Are Just The Same?
In terms of what sets them apart:
Mango has a lot of vitamin A, to the point that it can interfere with blood-thinners if you take those.
Pineapple has bromelain, an enzyme with unique anti-inflammatory properties that we must devote a Research Review Monday to one of these days, because there’s a lot to say, but the short version is, it’s very powerful.
Since bromelain is found only in pineapples, whereas vitamin A is easy to find in abundance in many foods, we went with the pineapple.
Enjoy!
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How To Rebuild Your Neurons’ Myelin Sheaths
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PS: We Love You
Phosphatidylserine, or “PS” for short, is a phospholipid found in the brain. In other words, a kind of fatty compound that is such stuff as our brains are made of.
In particular, it’s required for healthy nerve cell membranes and myelin (the protective sheath that neurons live in—basically, myelin sheaths do for neurons what telomere caps do for DNA).
For an overview that’s more comprehensive than we have room for here, check out:
Phosphatidylserine and the human brain
Many people take it as a supplement.
Does taking it as a supplement work?
This is a valid question, as a lot of supplements can’t be absorbed well, and/or can’t pass the blood-brain barrier. But, as the above-linked study notes:
❝Exogenous PS (300-800 mg/d) is absorbed efficiently in humans, crosses the blood-brain barrier, and safely slows, halts, or reverses biochemical alterations and structural deterioration in nerve cells. It supports human cognitive functions, including the formation of short-term memory, the consolidation of long-term memory, the ability to create new memories, the ability to retrieve memories, the ability to learn and recall information, the ability to focus attention and concentrate, the ability to reason and solve problems, language skills, and the ability to communicate. It also supports locomotor functions, especially rapid reactions and reflexes.❞
(“Exogenous” means “coming from outside of the body”, as opposed to “endogenous”, meaning “made inside the body”. Effectively, in this context “exogenous” means “taken as a supplement”.)
Why do people take it?
The health claims for phosphatidylserine fall into two main categories:
- Neuroprotection (helping your brain to avoid age-related decline in the long term)
- Cognitive enhancement (helping your brain work better in the short term)
What does the science say?
There’s a lot of science that’s been done on the neuroprotective properties of PS, and there are thousands of studies we could draw from here. The upshot is that regular phosphatidylserine supplementation (most often 300mg/day, but studies are also found for 100–500mg/day) is strongly associated with a reduction in cognitive decline over the course of 12 weeks (a common study duration). Here are a some spotlight studies showing this:
- Effects of phosphatidylserine in Alzheimer’s disease
- Double-blind cross-over study of phosphatidylserine vs. placebo in patients with early dementia of the Alzheimer type
- Effect of Phosphatidylserine on Cerebral Glucose Metabolism in Alzheimer’s Disease
- The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints
Note: PS can be derived from various sources, with the two most common forms being bovine (i.e., from cow brains) or soy-derived.
There is no established difference in the efficacy of these.
There have been some concerns raised about the risk of CJD (the human form of BSE, as in “mad cow disease”) from consuming brain matter from cows, but studies have not found any evidence of this actually happening.
There is also some evidence that phosphatidyserine significantly boosts cognitive performance, even in young people with no extant cognitive decline, for example:
(as the title suggests, they did also test for its effect on mood and endocrine response, but found it made no difference to those, just the cognitive function—which enjoyed a boost before exercise, as well as after it, meaning that the boost wasn’t dependent on the exercise)
PS for cognitive enhancement in the young and healthy is not nearly so well-explored as its use as a later-life guard against age-related cognitive decline. However, just because the studies in younger people are dwarfed in number by the studies in older people, doesn’t detract from the validity of the studies in younger people.
Basically: its use in older people has been studied the most, but all available evidence points to it being beneficial to brain health at all ages.
Where can we get it?
We don’t sell it (or anything else), but for your convenience, here’s an example product on Amazon.
Enjoy!
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Chai-Spiced Rice Pudding
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Sweet enough for dessert, and healthy enough for breakfast! Yes, “chai tea” is “tea tea”, just as “naan bread” is “bread bread”. But today, we’re going to be using the “tea tea” spices to make this already delicious and healthy dish more delicious and more healthy:
You will need
- 1 cup wholegrain rice (a medium-length grain is best for the optimal amount of starch to make this creamy but not sticky)
- 1½ cups milk (we recommend almond milk, but any milk will work)
- 1 cup full fat coconut milk
- 1 cup water
- 4 Medjool dates, soaked in hot water for 5 minutes, drained, and chopped
- 2 tbsp almond butter
- 1 tbsp maple syrup (omit if you prefer less sweetness)
- 1 tbsp chia seeds
- 2 tsp ground sweet cinnamon
- 1 tsp ground ginger
- 1 tsp vanilla extract
- ½ tsp ground cardamom
- ½ tsp ground nutmeg
- ½ ground cloves
- Optional garnish: berries (your preference what kind)
Method
(we suggest you read everything at least once before doing anything)
1) Add all of the ingredients except the berries into the cooking vessel* you’re going to use, and stir thoroughly.
*There are several options here and they will take different durations:
- Pressure cooker: 10 minutes at high pressure (we recommend, if available)
- Rice cooker: 25 minutes or thereabouts (we recommend only if the above or below aren’t viable options for you)
- Slow cooker: 3 hours or thereabouts, but you can leave it for 4 if you’re busy (we recommend if you want to “set it and forget it” and have the time; it’s very hard to mess this one up unless you go to extremes)
Options that we don’t recommend:
- Saucepan: highly variable and you’re going to have to watch and stir it (we don’t recommend this unless the other options aren’t available)
- Oven: highly variable and you’re going to have to check it frequently (we don’t recommend this unless the other options aren’t available)
2) Cook, using the method you selected from the list.
3) Get ready to serve. Depending on the method, they may be some extra liquid at the top; this can just be stirred into the rest and it will take on the same consistency.
4) Serve in bowls, with a berry garnish if desired:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Grains: Bread Of Life, Or Cereal Killer?
- Which Plant Milk?
- If You’re Not Taking Chia, You’re Missing Out
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Sweet Cinnamon vs Regular Cinnamon – Which is Healthier?
Take care!
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