Alan Christianson, ND
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ROBYN: Hello everyone and welcome to month seven of the Self-care Revolution. My name is Robyn Benson. I'm a doctor of [inaudible 00:38], and I'm the founder of Santa Fe Soul Health & Healing Center.
KEVIN: And I'm an intuitive counselor, and we're having a great old time this morning.
ROBYN: That's a first huh?
KEVIN: Yeah, it's a revolution. Yes.
ROBYN: It must be this amazing doctor we've got on. I'm kind of breathless, reading his amazing bio. I have to take from both the short and the long. We're so excited to have you, Dr. Christianson, with us here today.
ALAN:Thank you very much. I’m honored to be here.
ROBYN: As all of you know, so the seventh month, this is about exercise as medicine. We’ve been on quite a long journey where we started in our first month with food as medicine. The second month we talked about rest and heart matters. The third month was all about releasing trauma. So here we are, and as you can see, we have an amazing group of speakers. What’s exciting Dr. Alan Christianson, he’s not only an exercise enthusiast himself, but he has quite an extraordinary background as a Doctor. He’s written a book about Thyroid Disease and without further ado, let me give you his extraordinary bio here.
So Alan Christianson is a Phoenix, Arizona, based naturopathic doctor who specializes in pain management and endocrinology in pain management with a focus on thyroid disorders. He founded Integrated Health, a group of physicians who focus on optimal wellness rather than disease. Accolades include Top Doc recipient in Phoenix Magazine. Alan coauthors the Complete Idiots Guide to Thyroid Disease and Healing Hashimoto's. His numerous media appearances include The Today Show and Shape Magazine. Because I have met Dr. Alan, I'm gonna give you a little bit more here. Alan, this is an important piece. As a child, growing up in royal Minnesota, Alan had a superior intellect. In fact, he read the Encyclopedia from cover to cover before Kindergarten. His body, however, told a different story. Alan struggled with health problems, such as epilepsy, poor coordination, and obesity. Alan gave up sugar and developed a rigorous exercise routine. A year and a half later, the former overweight, uncoordinated adolescent was involved in competitive sports and became the class's fastest runner. He turned that passion into a lifelong endeavor and completed his premedical in Nursing Studies at the University of North Dakota. He went on to earn his MD with the first graduating class of the Southwest College of Naturopathic Medicine in Tempe, Arizona. Over time, Alan discovered that medicine didn't have all the answers. Instead, he combined his expertise and insatiable knowledge to teach others how to use food and nutrients for optimal health. When he's not maintaining a busy practice, Alan's many hobbies include unicycling, marathons, off-road motorcycling, technical rock climbing, and martial arts. He's also a licensed pilot. Alan resides in Scottsdale, Arizona, with his wife, their two children, and his six unicycles. I love it. Once again, welcome. We're so happy to have you here.
ALAN: Thanks again for having me. This should be a blast!
ROBYN: Oh, we’re ready. So, Kevin... Kevin’s very anxious. He’s got like a list of questions.
KEVIN: I’m very interested in this topic of the thyroid and how we can increase the functioning of that. You’re mentioning different kinds of thyroid disease, in particular, Hashimoto’s? Maybe we can just start there and then we’ll work into other topics. What is that, first of all, and how common is it?
ALAN: It’s quite common actually. The thyroid gland itself is a little thing about the size, the shape, the location, and the mass, of a bow tie. So it’s about the place where a bow tie would occupy the position on your neck. It makes infinitesimal amounts of hormones that govern every single reaction in the body, all types of metabolic rates, protein synthesis, cell repair, detox; they’re all governed by thyroid function. Globally, there are over a billion people on the planet that never got proper development of their brain because their thyroids didn’t work right. The most common global cause of thyroid disease is from lack of iodine. In the modern world, it’s quite different. Thyroid disease is rather common, not so much from lack of iodine. The most common reason for developing thyroid disease in the modern world is an immune response called Hashimoto’s Hereditist. For any given woman, there’s about a 25 percent chance of developing some sort of thyroid diseases over the course of their life span in the modern world. And the autoimmuneHashimoto’s disease is by far the most common manifestation of that.
ROBYN: Can you talk about really what an autoimmune disease is and what it’s becoming more… Why we’re seeing more and more Hashimoto’s in all types of thyroid disease?
ALAN: Yeah. An autoimmune in general, it’s getting more problem, is when you think about your immune system as a home security guard. A home security guard should leave alone your family members and pets, but it somebody is trying to break in your window, the security guard should shoot them. That’s how it’s supposed to work. Immunity can make mistakes, and the mistakes can happen just by nature. Your immune system does you better service by attacking things unnecessarily than it does by ignoring things. So it’s more apt to attack if not sure. In the modern world, there are so many ways we’re exposed to that get deeply entrenched in our tissues, so our thyroid, our brain, our liver, our connective tissues, are areas where things from the environment like lead, mercury, or pesticides can really build up. If they’re there from a length of time, they can create some local chemical irritation that alerts the immune response. So with an autoimmune disease, your home security guard shoots your dog. Now you’ve got something that should be inside of you and is meant to be there and it stays, but because of the chemical change from environmental wastes, your immune system goes after them by mistake. Once that starts, it keeps on doing it and doing it. Autoimmune diseases of all types are on the rise.
KEVIN: In relation to our exercise, this is one of the things that’s creating the fatigue that is not allowing people to really have the energy or health that they need to be able to exercise. Is that correct?
ALAN: It sure is. The paradox about that, your energy levels are coming from your body taking your fuel, basically your food broken down into glucose, some kind of a substrate, some kind of a small piece, and that fuel being converted into energy. If the thyroid hormones aren’t being made properly, not only is there a lack of energy formed, but the stuff that wasn’t burned, that builds up and that’s fat growth. So the two sides of that same coin are, easier weight gain and harder time maintaining a good body weight, and then fatigue for all the stuff that should be generating fuel for the body, just makes fat. Think about you’re throwing logs into the fire. If you keep missing, you will have this big mess of logs all over and the fire is going to go out. That’s what happens with thyroid disease. We get tired and it’s harder to manage our weight.
ROBYN: Can we just back up a little bit. Can we talk about hypo- and hyperthyroidism?
ALAN: For sure. The big three kinds of thyroid disease are basically the gland putting out excessive hormones, deficient hormones, or the gland becoming cancerous. So the excess hormones we call hyperthyroidism, and the lack of hormone we call hypothyroidism. Think of a hypodermic syringe that goes under the skin or think about a hyperactive person, they’re overactive. Hyperthyroidism is when the gland makes excessive hormones. In those cases, we can have the heart rate; we can feel very anxious or fearful for no external cause. There can be a lot of breakdown of the body’s muscles and bones. It’s a horrible thing. The ironic thing is what leads to hypothyroidism or low thyroid activity; especially Hashimoto’s is the tiniest difference of what leads to hyperthyroid. Those same steps about environmental treasures and immune responses they’ve gone to the difference of what your home security guard shoots, the dog or the cat. That determines if your glad is over active or under active. The general relationship is that hypothyroid disease is about 15 times more common than hyperthyroid disease. There is a little overlap too, so Hashimoto’s for example, when the body’s attacking the gland and it’s overflowing, at earlier stages, there may be an excessive amount of hormones released. At later stages, though, the gland tends to be more clearly slowed. Hyperthyroidism is a very real thing as well, and it does affect many people.
KEVIN: So who gets this? Is this something, is this a lifestyle or is this something that you’re born with?
ALAN: There’s a constellation of events, kind of like a perfect storm that gives rise to it. As it manifests, it is more common in women than men, and it is more common with age. Having said that, it’s something that affects enough people to where there are plenty of young males who have it as well as the more common menopausal women. The events come together, one of which is some kind of genetics susceptibility. There may be a family member who has had some kind of thyroid disease. But there’s some kind of genetics susceptibility, and with thatthere’s some kind of exposure to chemicals such as mercury or lead or fluoride above certain quantities. So you’re susceptible, you’ve got toxins in the thyroid, and then there’s usually the potential for immune dysfunction. One common reason for that is Vitamin D not being optimal. You probably know that most people don’t have optimal amounts of Vitamin D. And the final step is some kind of trigger to the immune system, like an infection, or moving into or out of pregnancy, some kind of immune stress. So, you’re susceptible, you’ve got toxins in your thyroid, your immunity may not be working perfectly, and something jolts the immune response. All that together creates this reaction which your body starts to attack your thyroid.
ROBYN: Could you explain to our listeners how it goes undiagnosed and how it is normally treated?
ALAN: That became such a passion of mine. Early on in my medical residency, I saw that there were very different ideas on treating this, how to diagnose it, how to treat it, and it was my impression that there’s really no one theory that I was exposed to that did a great job in a high enough percentage of cases to satisfy me. The problem is that we only diagnose it at later stages. We use normal values and we put a lot of weight in our blood test nowadays. The tests are good; technology is good, but there are some situations where it needs a bit more perspective. The shortcoming about normal values in this context is that it’s normal for who? The numbers we use are mostly numbers from people who had thyroid test. By default, the people that get the most thyroid tests, not only have thyroid disease, but have the most unstable thyroid disease. So people have very good thyroid function or even those who have thyroid problems but they’re well treated and stable, they’re not getting very frequent tests done. The most frequent population having the tests done are those who have the most amount of dysfunction. The way it works in terms of establishing our ranges, that’s who ends up setting the guidelines. So we’ve got this crazy system in which you’reonly flagged at having a problem when you’re obviously way worse than most people who already have the problem.
ROBYN: So you believe that your thyroid fluctuates a lot and as you get older, and we’ve already had people asking questions. What’s the best way to get this tested and what exactly do you order? What’s the best blood test to have your doctor order for you? It seems doctors don’t really know. They’re not as knowledgeable as you are, Alan, and certainly those of us in complimentary medicine are much more thorough.
ALAN: For sure. Part of it does involve more thorough testing. The most common thing that’s done is the TSH, and that’s the marker that shows how much the pituitary gland is trying to make the thyroid work. It’s a good general reflection of thyroid status. It doesn’t always change it during the early stages of disease. There are many in alternative medicine who would like to dismiss it altogether. That’s not my perspective. But the ranges that are commonly used are far too broad, so it is good to have a TSH tested. Ideally someone can look at that from the perspective of optimal as opposed to just average. The other big thing that’s helpful is screening for the immune response, you know, screening for thyroidantibodies. The shortcoming about that is it can be falsely negative. A third of the time, someone may have an immune response but they may not have measurable antibodies. Something that I do when I suspect thyroid disease is a fair amount of ultrasounds. That’s one of the better ways to evaluate if there is an immune response on the gland and also thyroid cancer is the fastest increasing type of cancer, so I like to have people well screened for that. We’ve had many; thankfully, people we’ve diagnosed at earlier stages hat wouldn’t have been otherwise.
ROBYN: Can you explain also the nodules that are often found on thyroids and what that means?
ALAN: With thyroid we’ve got problems with function and problems with structure. Problems of function mean that the wrong amount of hormones is being made. There might be too much or too little hormone. Problems of structure mean that the actual structure of the gland is not right. The gland could have lumps or bumps or calcifications. And the main thing we’re always thinking about with structural problems is a possible cancer being present. So, nodules are areas that don’t have the same texture and density that healthy thyroid tissues have. Some studies have shown that if you just grabpeople and do thorough ultrasounds on people, you may see nodules on up to 10 to 20 percent of a population. They’re quite common. When they’re present, they change what’s acceptable for thyroid hormone blood levels. When they’re present we want very narrow range of levels to make sure they don’t progress and become cancers. So managing thyroid disease, some of it is thinking about short-term goals and health which is important, but part of it is also being a good steward to that person’s long-term disease potential.
ROBYN: Okay, I know this is getting a little more detailed, but can you also talk more about the T3 and T4 conversion and how important that is.
ALAN: Along with thorough testing along with TSH looking at antibodies, there are the three hormones. This is a funny thing, and again, this may be a more level of detail, but the three hormones, they reflect more how the body’s using thyroid than what the thyroid is doing. They can be helpful in terms of really fine tuning someone’s health in terms of liver function and kidneys, whether they’re carrying toxins or have infections, but many in alternative medicine think of them as separate markets showing thyroid status, and they’re really more reflective of what the rest of the body is doing with thyroid hormones. They are good to be aware of, but if someone has an optimal TSH, if they have abnormalities with T3 and T4, it’s not so much of the fault of the thyroid at that point, it’s more of an issue of what the body is doing with the hormones.
KEVIN: I’m wondering, for somebody with a basic understanding, like myself and some of our listeners as well, we’re getting into the very nitty gritty of this, but maybe we could back up just a little bit. I know that you mentioned how the pituitary affects the thyroid. Maybe you could explain, just basically how this endocrine system works and cascades.
ALAN: I think about it like a corporation. You’ve got a CEO, you’ve got a manger, and you’ve got various workers. In this scenario, think about the workers being lazy workers. They only work when they’re told to work. If someone’s not riding them any given moment, they’re gonna jump on Face Book, they’re gonna goof off. So that’s kind of the stage we’ve setup. In the body, that’s the endocrine system. The CEO would be [inaudible 18:46], a little tiny thing, the size of a be-be, and this doesn’t get involved in micromanaging the workers, but it does sense the big movement of the company, the big changes, the big direction, the overall strategies. The CEO manages the works via the manager, the main manager. In this scenario, that’s the pituitary gland. The pituitary is more hands on with the workers. The CEO is giving the pituitary, the broad overriding direction, like, “Hey, this worker needs to pick it up and this worker needs to slow it down,” and then the pituitary relays that information to the specific workers. In this scenario, it’s the thyroid. And that could also include the adrenal gland, the ovaries, the testicles. So when one of the glands is putting out too little work, the pituitary has to push it harder, has to stimulate it further. Once it does that, the gland works harder. If the glad ever becomes overactive, allthe pituitary has to do is stop riding it and stop yelling at it and it will slow down. In this case, the thyroid stimulating hormone is made by the pituitary and that makes the thyroid work. It’s a good marker of thyroid function, but it’s a backwards marker. If the pituitary is sending a high signal, it means the gland is underactive and it needs to be stimulated. If it’s really lowering its signal, it means the gland is overdoing it and the pituitary is trying to let it go back to Face Bookor let it slow down in some way.