The SIBO Doctor - Episode 12 - Gut-Thyroid and SIBO

Today, Dr Nirala Jacobi is in conversation with Dr Michael Ruscio about the gut-thyroid connection and how it relates to SIBO.

Dr Ruscio is a functional medicine practitioner, chiropractor, clinical researcher, and host of the Dr Ruscio Radio Podcast.  Dr Ruscio and Dr Jacobi both recently presented and connected at the Integrative SIBO Conference 2017 in Chicago. 

Topics discussed in this episode include:

• How Dr Ruscio became interested in SIBO.
• What is the gut-thyroid connection? Discussion of 4 main areas:
  1. The way the gut affects thyroid autoimmunity
  2. The way the gut affects thyroid hormone absorption.
  3. The way the gut can cause hypothyroid-like symptoms, even when thyroid hormone levels are normal.
  4. Those on thyroid medication and/or have hypothyroidism, are at increased risk of SIBO.
• Being hypothyroid, or being on Levothyroxine as presenting an increased risk for SIBO, and why this may be.
• The SIBO-H.Pylori relationship and the increased risk of SIBO after conventional H.Pylori treatment.
• The relationship between H.Pylori and thyroid autoimmunity.
• Does Dr Ruscio treat H.Pylori even if the patient is asymptomatic?
  1. Pylori as an indicator of overall gut health.
• Pylori pathogenesis v.s. commensalism with the host.
• Recalibrating the gut microbiota in light of H.Pylori, with natural treatments such as:
  1. Probiotics
  2. Herbal antimicrobials
  3. N-acetylcysteine
• Testing for hypothyroidism
• What is true hypothyroid?
• What is subclinical hypothyroidism?
  1. TSH high
  2. T4 normal according to the reference ranges.
• When to treat hypothyroidism, and when not to.
• The relationship of gut inflammation to thyroid autoimmunity.
• Switching focus from treating the lab values, to treating the person and the underlying causes of disease.
• What testing does Dr Ruscio use diagnose thyroid issues?
• Thyroid antibodies and the response to diet and lifestyle adjustment.
  1. TPO antibodies between 100-300 and Dr Ruscio’s interpretation of this and patient care suggestions.
  2. TPO antibodies over 500 and the correlation to thyroid autoimmunity.
• Intestinal permeability and the link to autoimmunity.
• What are the other links between Hashimoto’s and SIBO? Implicated elements include:
  1. Impaired bile production.
  2. Impaired phase 3 detoxification.
• What are Dr Ruscio’s preferred treatments for Hashimoto’s Thyroiditis?
  1. Vitamin D.
  2. Combined selenium, CoQ10, and magnesium.
     • Best therapeutic duration for selenium supplementation discussed.

• How exogenous thyroid hormone facilitates thyroid repair.
• Dr Ruscio’s thyroid medications and whether to use a T3, T4 combination, or a liquid thyroid medication, and which medication to consider in light of chronic digestive conditions. Examples of thyroid medications include:
  1. Nature-throid
  2. Armour
  3. Westthroid
• Dr Ruscio’s favourite thyroid tests
  1. TPO Antibodies
  2. Thyroglobulin Antibodies
  3. TSH
  4. Free T4
  5. Total T4
  6. Free T3
• Dr Ruscio’s gut tests:
  1. SIBO breath testing
  2. Pylori - blood samples for 3 different fractions of the antibodies - G, A, and M.
  3. Pylori stool test for stool antigen.
  4. Pylori breath test.
  5. Complete stool test.
  6. Blood or serum antibody testing for amoebas and candida antibodies.
• Dr Ruscio’s clinical newsletter for practitioners, launched January 2017, outlining real case studies, clinical research studies, practitioner questions of the month, and a monthly practice tip from Dr Ruscio for each month.

Resources

• Dr Michael Ruscio
  • Dr Ruscio Radio Podcast
• Dr Ruscio’s practitioner-only newsletter.
• Metagenics International Congress, 2017 featuring Dr Michael Ruscio as a speaker.
• Book recommendation:
  • Martin Blazer - Missing Microbes
• Examples of thyroid medications:
  • Nature-throid
  • Armour
  • Westthroid
• Dr Ruscio’s favourite thyroid tests
  • TPO Antibodies
  • Thyroglobulin Antibodies
  • TSH
  • Free T4
  • Total T4
  • Free T3