The Other Way

043: Dr. Heidi Lovie on combating Hashimoto's: Insights from Western Medicine & Chinese Medicine

June 27, 2023 Kasia, Dr. Heidi Lovie Season 1 Episode 43
The Other Way
043: Dr. Heidi Lovie on combating Hashimoto's: Insights from Western Medicine & Chinese Medicine
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Are you struggling with Hashimoto's thyroid disease? This episode is a must-listen, as I had the pleasure of speaking with Dr. Heidi Lovie, a renowned expert in Hashimoto's and Chinese medicine practitioner with over 20 years of clinical experience. As someone who personally suffers from this condition, Dr. Lovie provides invaluable insights on managing Hashimoto's from both Western and Chinese medicine perspectives.

We cover a wide range of topics, including the connection between the immune system and Hashimoto's, potential causes of this autoimmune disease, and how it may evolve over time. Dr. Lovie also shares her personal experience with Hashimoto's, her journey through perimenopause, and the challenges faced by many individuals with this condition, such as traditional gender roles and societal expectations.

Join us as we delve into the world of thyroid health, and discuss the importance of finding the right medication, healthcare practitioner, and lifestyle changes to manage Hashimoto's effectively. Whether you've just be diagnosed or are seeking further insights, this episode will provide valuable information and guidance on your journey to better thyroid health.

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To connect with Kasia

Kasia Stiggelbout:

Hello and welcome to Nourish. My name is Kasha and I'm an entrepreneur, a longtime meditator and a student of Chinese medicine. My mission with this podcast is to share the tools and practices to help you integrate your whole self into every aspect of your world. As someone who is both a Taipei high achiever and a deeply spiritual, vulnerable and empathetic being, i know firsthand how it feels to be living a double life showing up one way at work a different way alone and struggling to reconcile the two.

Kasia Stiggelbout:

This disintegration of authenticity is one of the biggest causes of burnout, health flares and anxiety. For me, understanding how the mind-body connection is crucial to health and success, cultivating a strong sense of inner self and applying the healing philosophies of Chinese medicine and Zen Buddhism to my life has allowed me to lead from a completely heart-powered place, letting go of other people's judgments and finding peace in allowing my multi-dimensional being to shine. My hope is that this podcast may inspire you to do the same. I want to call out. it is a practice, it is a journey, but I believe it is the most important thing that we can do for our bodies, minds and our ultimate potential. Enjoy.

Kasia Stiggelbout:

Hello, hello and welcome back to the show. I'm your host, kasha Still congested, y'all, i swear allergy season is never ending. But I am so thrilled to be back and share with you my next conversation. This one is actually a very much requested episode and we are diving into thyroid health and, more specifically, hashimoto's. Hashimoto's affects one to two percent of people in the United States and today I am so honored, so thrilled to be speaking with a internationally renowned expert in Dr. Heidi Lovie field, .

Kasia Stiggelbout:

Dr. Lovie is a Chinese medicine practitioner in Manhattan with over 20 years of clinical experience and although she considers herself a general practitioner and of course she regularly works with all types of patients a lot of gynecological health her specialty is truly autoimmune disorders, with a focus on Hashimoto's thyroid disease. Y'all this is such a juicy episode. I feel so excited to be sharing this because a lot of the topics that we cover are listener requested topics. So we dive into, you know, the bare bones of defining Hashimoto's disease from both a Western medicine point of view and Chinese medicine point of view. We dive into how the thyroid works, what treatment might look like, is remission possible, what drug therapy looks like and is it good, is it bad debunking some of that stuff, but also about the connection between the immune system and Hashimoto's, which this one, i think, will floor a lot of people, because there is this misconception out there, and Dr Lovie really gets into this around what is the cause of Hashimoto's and how should we be treating it?

Kasia Stiggelbout:

We are going to talk about the diagnosis and the many diagnoses of Hashimoto's, which is something that I think is a little bit controversial. We dive into it and also what might it look like over time, and so how can your Hashimoto's evolve and what are some of the things that you can do to have an impact on some of the outcomes? Y'all, Dr Heidi Lovie is remarkable. She is not just an incredible practitioner. Not only is she entertaining, but she is also someone who knows firsthand what it is like to cope and manage and treat this disease, because she suffers from it herself. This is such a juicy episode. We cover a ton and, without further ado, let's welcome this superstar to the podcast. Dr. Lovie, welcome to the show, hello hello, thank you.

Dr. Heidi Lovie:

This is fun, this is exciting. I'm happy to be here.

Kasia Stiggelbout:

I am so excited to have you here. I am just so pumped to get into all things thyroid, hashimoto's, chinese medicine. The intersection of all of this and the content you put out there is fantastic. I am particularly pumped because this is an episode where, as I mentioned to you, have gotten a lot of requests from the audience. This is going to be really, really juicy.

Dr. Heidi Lovie:

Good. Hopefully we'll get to most of these questions, because I think there's a lot of misinformation out there. You and I were talking before a little bit. There's so much information out there. A good question is where to start? You always start at the basics, you always start at the beginning. This is a good beginning 100%.

Kasia Stiggelbout:

You are really good at explaining all of that. Before we dive into all the juicy stuff, I'm going to start with a very basic and personal question, which is one that I ask every guest. That is, what are three words that you would use to describe yourself?

Dr. Heidi Lovie:

I had a good think about this. I think three words non-work-related, the three words would be curious. Curiosity killed the cat. I don't know that that's necessarily a good thing. I'm very curious about how things work, taking them apart, putting them back together, i think kind of. As long as you're curious, you're young.

Dr. Heidi Lovie:

I think resilient That's not a word I love to use, because nobody wants to be resilient, nobody wants to be able to take a punch and get back up, but we're going to talk about that as it relates to thyroid, as it relates to health, as it relates to everything. Resiliency often comes from experience. That kind of experience can be hard, but definitely I'm resilient. I don't think when the world ends it's going to be only me and the cockroaches, but it might. Who knows That kind of resiliency. I think I'm very creative. That feeds into the curiosity, constantly doing new things, constantly looking at things and creatively thinking what's the next step, what's always the next step? Not fighting back but fighting forward is one way that I think about things a lot. How do I fight forward, how do I move forward? I guess those would be the three words.

Kasia Stiggelbout:

I love those. Frankly, i don't know you very well personally, since we have just met right now face-to-face or face-to-zoom, but I will say that all of those definitely resonate with how you came across on some of the other podcasts that I've heard you speak. It'll be you, the cockroaches and all the patients that you treat, that will be resilient when the world ends. I'm very confident in that.

Dr. Heidi Lovie:

It's going to be quite the party. It's going to be quite the party.

Kasia Stiggelbout:

Hopefully we don't have to go there Definitely not in this hour. I want to dive into the list of questions that I shared with you. They're, as you mentioned are, quite a bit. You are a Chinese medicine practitioner, You're based in Manhattan and you have 20 years of clinical experience, Although you are a general practitioner. I have heard from other practitioners that I have seen from podcasts that you've been on that you are truly internationally renowned for your focus on autoimmune disorders, especially Hashimoto's thyroid disease.

Dr. Heidi Lovie:

Well, like I'll tell you, Hashimoto's isn't what I started out with in private practice. When I was an intern here in New York City we had St Vincent's Hospital. With St Vincent's Hospital they had the HIV unit. This was mid-auts. This was just as we were really coming out of the HIV AIDS epidemic. New York and San Francisco were two places where those events really took a toll on the city. We really were looking at pandemic and epidemic medicine. At the time. I did a rotation at the St Vincent's HIV Center. It was formative for me. It was life-changing for me. Working with patients who have gone into AIDS which a lot of practitioners we don't face-to-face see what actual AIDS looks like That started to be forgotten in the collective memory quite a bit. I was going to be the HIV queen of New York. That's what I wanted to do. I went into private practice. Now I have Hashimoto's. It's.

Dr. Heidi Lovie:

What brought me into Chinese medicine was to figure out my own health issues, my own health concerns. When I went into private practice I was like, yes, i'm going to get like drag queens, i'm going to do trans, we're going to do LGBTQ, it's going to be awesome. I got Hashimoto patients on the table. I was just like, yeah, i know what to do with this. I had success with patients who told other patients who told other patients. Suddenly I had a waiting list of people with autoimmune. Then autoimmune not always, but it happens to be mostly women like 80 to 85% women. All my autoimmune patients suddenly wanted to get pregnant. I was just like, oh my god, we have to figure out how to get my crew pregnant. Then I went into women's health pretty deeply. Women's health. I wound up teaching women's health at Pacific College for over a decade, then everything that comes with fertility and autoimmune, and then that just kept going deeper and deeper.

Dr. Heidi Lovie:

As more information and more research started coming out about Hashis, i started putting pieces together. I was just like Chinese medicine has such incredible value. Add to this because we look for patterns. Again, it's the curiosity and the creativity. How do we take this apart and put it back together in a way that meaningful? The same way that, as women, we experience menstruation at 14, 24, 34, 44, it changes, autoimmune changes. The way you experience autoimmune at 14, 24, 34, 44 is going to be different. Now all my autoimmune patients are in menopause or they're perimenopause. I'm like, oh great, we get to take this on With the Hashis as I started to get a little bit of an underground reputation with it. I started teaching it because people were referring to me so often. It got to a point where she's like I don't need to be treating all of this. The community needs to be treating this and we need to be treating this within ourselves. It's kind of how that trajectory went. I'm still learning, i'm still uncovering pieces with it.

Kasia Stiggelbout:

Oh, i love how much you mentioned how the community needs to be treating it. I do feel like that is the case with a lot of autoimmune conditions. It's just so important to get awareness about autoimmune conditions out there and some of the things that can trigger it. There is, as you mentioned, so much misinformation that it can be hard to incorporate or feel empowered, as a patient who suffers from an autoimmune condition, to do something about that.

Dr. Heidi Lovie:

I feel like a lot of doctors are not fully educated about it either, right? And so there's a lot of medical gas lighting that happens with it And you're the only one living in your body. Hopefully I don't know, you might have other squirrels in there, but, like usually with patients, they're the only one residing in their body, right. So I trust their experience with things and I trust their subjective experience of what they're going through, and a big piece of that is, as a healthcare practitioner, listening to someone and understanding that you know, especially with autoimmune, we're in a place right now where it's very much like an art form and a science.

Dr. Heidi Lovie:

And so just because, like you don't have the numbers to back up the experience, doesn't mean that patient isn't having you know, like suddenly it's just like well, your numbers, your lab values look fine. I don't know why you're depressed and have high cholesterol and your hair is falling out. So take some B vitamins, go on some Zoloft and like go for a run, get off the couch, and it's like no wrong answer, like literally wrong answer. And so then we start to doubt ourselves, we start to doubt the own experience of our health journey And then we just we kind of get stuck, and I think that's why a lot of times people are like I don't know where to start because they might have had gaslighting along the way, like they might've had those those kind of experiences where they doubt. They actually doubt, like the truth of what they've gone through.

Kasia Stiggelbout:

Ah, that is so powerful. So before we dive into all of the questions, i have to go along with that. I want to actually backtrack for a second, because you and I both talked about how in my outline of questions there were a lot of basic ones in there And these are actually coming from Hashimoto's patients who have been diagnosed with Hashimoto's, and so I would love to actually start at the beginning and get a clear definition for what is Hashimoto's as we perceive it from like a Western medicine diagnosis, and how does Chinese medicine view Hashimoto's? And is it like one pattern, more patterns? So, if you can kind of just level set for us for a minute Sure.

Dr. Heidi Lovie:

So you know I'm going to say something a little controversial. That's gotten me in hot water before, but, like it's something I like to say that needs to be said is that I don't think it's a bad thing to divorce your endocrinologist, and what I mean by that. What I mean by that now hear me out, i know it's like it's very like scandalous to say So endocrinologists are fabulous for things like diabetes. They're fabulous for things like Cushing's disease, addison's disease. They're endocrine diseases. That's what an endocrinologist does.

Dr. Heidi Lovie:

The issue with Hashimoto's is Hashis is an immune disease, first, and endocrine disease second. The endocrine system is a byproduct, it's collateral damage, of an overactive immune system, so what Hashimoto's is is there's two types of antibodies, right that? so we have thyroid perioxidase and thyroid globulin, so we would say TPO and TGAB. So one is a protein and one is an enzyme, and so think about these things like if you're baking a cake, right, and you need all these different ingredients in a cake, you know, to actually get that like yummy, juicy cake. These are just two ingredients in the cake. So what winds up happening, though, is the immune system, for a variety of reasons, will produce antibodies again, one the other or both of these things in the thyroid in our cake analogy here, right? And so now what's gonna happen then is we can start to, as the immune system starts to attack these enzymes and the proteins, the thyroid gland is secondary to that attack, and so it starts creating scar tissue, it starts creating inflammation, it starts creating swelling, and so in Hashimoto's, i think, there's actually about 16 different types of Hashis, because and this is something that's not said often either, right So because with this TPO and TGAB you can be high in one, the other or both of them, and then so already we have about six different types of Hashis right there, and you can start layering in other scenarios about what could be driving this immune response.

Dr. Heidi Lovie:

And so from a Western standpoint, especially from an endocrinologist standpoint, their training is gonna be hormone replacement therapy. So the idea is that if the thyroid is under attack and the thyroid is not able to produce the hormones that we need, then just replace them Synthroid, levothyroxine, cytomyl, i mean, like I could go down, like the whole list, right, of all the drugs. And so what will start to happen is, for some people it can be life changing, right? I'm not anti-medication by any stretch of the imagination And I'll tell you with my own Hashis I take medication I have to right, like it's just kind of where I'm at in the journey. So they do a lot of the hormone replacement, but they're not addressing the core issue, which is a hyperactive immune system. And so then they'll say like okay well, oh, your joints hurt too, we're sending you to rheumatologist. Oh, you have high cholesterol, so we're gonna put you on Lipitor. And then, all of a sudden, these patients are on a myriad of drugs And Synthroid.

Dr. Heidi Lovie:

I can go through charts that I'm happy to share, like offline, with you, like going back to at least 20, 2013. Synthroid and its cousins in terms of, like the generics, make it in the top three most prescribed drugs. In the US, metformin just broke into that top three. So historically it's like Synthroid, usually like some sort of statin and antidepressant, like we'll wind up in this top three. So the kind of knowledge around Hashimoto's is just like we'll just take a pill and we'll fix it, and what it might fix is the feedback loop, the pituitary endocrine feedback loop, and so what's happening is there's under testing, there's over prescribing of other medications, and then nobody's really talking about kind of the ancillary, like side things you can be doing to help yourself with it. So that's what I mean by, like divorce, the endocrinologist. I have found that a lot of general practitioners, a lot of natural paths, a lot of functional medicine practitioners, even nurse practitioners, are much more open to looking at holistically what are the other things that are in play here and actually helping people.

Dr. Heidi Lovie:

But a lot of people get stuck in that cycle of like, well, i'm on 125 of synthroid and my TSH is good. I mean, my hair is still falling out, i can't lose weight and I can't get out of bed in the morning, but like the blood work's normal. And so patients all the time I can't kind of see your blood work And they're like it's normal. I'm like, is it, though? And like did you actually get a full panel? And so I kick people back to the doctors all the time And I'm like, no, this is not a full panel, they only tested TSH, t4, t3. Like they didn't actually look at what Hashis is.

Dr. Heidi Lovie:

And so if you have an antibody level, like just throwing numbers out there, but like thyroid perioxidase, right Generally, depending on the lab, because it's lab that determines, like what's normal. But depending on the lab, your TPO is gonna be under nine or it's gonna be under 34. Now, regardless of that, it doesn't even matter, a level of 80 versus 800, versus 8,000 are three totally different health scenarios. They're totally different And your experience of that kind of inflammation and that immune attack are gonna be incredibly different. But a lot of endos are like well, you tested once for it, like back in the 90s, that's all we need to know. And in Chinese medicine, kind of the name of the game, i try to flip the script a little bit to be like, okay, like that's all great, but let's actually work with the immune system, let's watch the antibodies, let's see if we can get it down, because that's what remission is. So I don't know does that answer the question.

Kasia Stiggelbout:

Oh my gosh. well, yes, but it also just like opens a whole can of worms, and I'm so glad you jumped right into this because that was one of the questions that kept coming up. It's even difficult to phrase. It's like, well, I feel good, or my tests are good, but I feel bad, i don't get what's going on, and that seemed to be like a common question that I didn't even include here because I was like I don't even know how to ask that. right, because how do you view that?

Dr. Heidi Lovie:

right. So I think you know, like another, one of the questions that, like I see here is what exactly is the role of the thyroid? Why is it important? What's its function and what other organs does it control? The thing about thyroid hormone is it touches every single cell of the body. There's not a single cell of the body that thyroid hormone doesn't touch. It touches heart muscle, it affects hair, it affects metabolism, it affects everything. It affects peristalsis, which is like the movement of the intestines. It affects skin, it affects hair, it affects nails. So this is a multi-system disease. I want to say disease, i mean out of ease. This is a multi-system disease And so there's not a single organ structure that it doesn't affect.

Dr. Heidi Lovie:

And so now I think the other confusing thing about it is when you know I'm Gen X and old enough to like joke calling at the interwebs, but like when you, when you get onto the information highway and the interwebs, the issue is when people are publishing information, they're going to be publishing either the best of the best or the worst of the worst And, like I said, there's already different types of Hashis. I just haven't seen that in the literature, but it is. There's grumblings around this, right, somebody's going to publish something about this soon. But so if, if I have the type of Hashis where I have no TGAB and I have a high TPO and I get onto a blog about somebody that says they cured their Hashis by simply going gluten free And I'm like, okay, i'm simply going to go gluten free and it makes a dent but it doesn't change it, i feel like I've failed versus saying that like, oh, that was advice for one type of Hashis, you know. And so I think we start to get confused with this, because everybody's now everyone has a platform and everybody's putting out information And it's just like where do I even start with like the information? There's so many now, like online courses and books and blah, and like everyone trying to sell you something, and I think, like when people first get diagnosed, they're willing to buy anything. Right, because they're just like I just want to feel better and I just want to like understand what's happening, and so I think there needs to be like some critical thinking around how we're digesting the information around it And, kind of the best place to start is understanding how does the thyroid work. You know what's banging me up And what do I do. What do I do next?

Dr. Heidi Lovie:

And like with the functional medicine piece, i'm going to say something controversial, but I love the way that they do it again. I'll do it again. Here we go. I love the way that they test. I don't always like the way that they treat, so they do. Like the holistic testing You can get like a better picture, but suddenly you're like on a $400 a month vitamin regimen And a lot of times the last patients like to actually feel better and they're like I don't know, not really.

Dr. Heidi Lovie:

And so the thing about Hashis too is like I like to say that it's plastic, not static, so meaning it can actually kind of change over time. It'll change slowly, but it can change over time, and so it's one of those things where you know it's kind of with you, it's always with you, but it keeps you honest, right, keeps you honest with what you're eating, how you're moving, how you're taking care of yourself, as long as you have some guidance And I always think of Chinese medicine as kind of a manual on how to human right, and so you're not going to open up like the Huangdian aging, like one of our classic texts, and it's like Hashimoto's do this right, but it is like all right, like if you want to live in your body and be of your body and feel good and live to 100 years, and live to 100 happy years, healthy years, where you're moving, you're pooping, you're communicating. Here are some ideas how to do that. I think, in the modern age, though, you know, we're living with a lot of chemical exposure. We're living with a lot of, like, plastic exposure.

Dr. Heidi Lovie:

There's a lot of corn, there's a lot of things that are kind of working against us and working against our biology, and instead of thinking like, okay, this is working against me, you kind of got to work with what you have right, and so a big piece of that is also you know, how antiseptic are you going to get right? Like health is. If I tell you to go lick Broadway at Times Square, yeah, it'll be gross, but can you do it? That's health. If you can't do it, you know, and you're suddenly on all these FODMAP diets and you know you can't even look at the cat cross-eye. You know that's not a modicum of health.

Dr. Heidi Lovie:

So I think that's also where we're struggling, and that's why we're seeing this explosion of autoimmune, even outside of Hashimoto's, because the one thing in common that they all have is inflammation, and some of them like to run in packs. So Hashis tends to run in packs with vitiligo and PCOS, like that's kind of like a common thing. You see those together, but why does it go? Hashis in one person, graves in another, ms in another? you know, that's something that we could debate and talk about all day.

Kasia Stiggelbout:

So one of the things that I love that you mentioned is this notion of kind of viewing it as plastic as opposed to something that is like static and kind of the same throughout your life. And one of the questions that has come up and I'm really curious to get your point of view on this from maybe both the Western lens and the TCM lens, especially if they're different But can you be born with Hashimoto's or is it something that is a result of you know, lifestyle, emotions, kind of all of that collectively Like as a overactive immune system reaction to what's happening? Yes, to all of that.

Dr. Heidi Lovie:

Okay, great. So you know, like once upon a time, hashimoto's thyroiditis you used to be considered a middle aged ladies disease, like, okay, you're in your 40s, that's what it. That was kind of the stereotype, right? Yep, there's only one study I've seen done to date which is cross sectional for gender and ethnicity, and it was a study done where they reviewed the records of US Army people, right, that had, like, gender ethnicity is closed, and so, because they're trying to figure out, like, who really does get Hashis, what's the sectionality of this? And so what we saw in that study is it happens to be mostly white women, and then next would be black women And then last is Asian Pacific women, so black women tend to get much more graves disease We don't see, like either of these, so much I mean, does show up in like Asia Pacific Islanders, and then men are a minority in that, but it still follows the same like ethnicity trend, right. What we are seeing is I used to joke like in kind of earlier in my practice I've treated thousands of cases of Hashis at this point, and I used to joke yeah, i can count the number of men that have come in on one hand. I will tell you, though, that since the pandemic I've taken that back. There's something that started happening around like 2019, where I've actually had more men showing up in the practice with it, so we're seeing it move into like cross, that gender and sex piece to it. I've seen patients as young as eight years old turn up with it. We're starting to see it in children, and that's all becoming more and more common, unfortunately.

Dr. Heidi Lovie:

I had a conversation with my aunt the other day. She had a call and she was telling me about, like, some health issues, and you know, we didn't like I don't know, like we don't really talk about like health issues in the family so much. And she's like I have a Hashis. I'm like, of course you do. She's like, and so does your male cousin and your female cousin. I'm like okay, that's on brand, i guess. And she's like your grandma had it. I'm like grandma had it And she goes yeah, and her mother had it, but they called it tuberculosis of the thyroid at the turn of the century because Hashimoto's it's named after a Japanese doctor who he had the disease And he was trying to understand his own disease process and it wound up killing him in the end, like the disease process actually wound up causing enough damage that he died from it. So you know, this is something where it's not new. It's been around for a while, it's had many different names but it's definitely gotten worse and worse and worse. And we are seeing it younger And are there different factors to it? Totally, totally.

Dr. Heidi Lovie:

You know, biology is not always biography, but there's a lot of things that can kind of kick it off right, and so you know there's often in autoimmune circles that they call it a catalyst event. And a catalyst event is I have never felt the same since X. I have never felt the same since I got the flu. I have never felt the same since that food poisoning. I have never felt the same since my divorce. I have never felt the same since financial stress, when I got fired. I have never felt the same since blah, blah, blah, right.

Dr. Heidi Lovie:

So those are all things that could be a viral catalyst event, an environmental catalyst event, an emotional catalyst event, but that catalyst event, the spark, was already there, right? So there's a great book. It's a little dated, it's called The Autoimmune Epidemic And Nakazawa is the author, and the way that she describes it is think about if you're filling up a cup of water. Right, you know that game that you played when you were a kid, where you fill the water to the top and the tensile strength of the water you try and get it to sit above the cup right.

Dr. Heidi Lovie:

You know that game that you played And then it's one drop And all of a sudden the cup spills over right Now. Was it that one drop or was it everything that led up to it? Yes, to all of the above. So that's why I'm saying yes to all of the above in your question. Right Is that you can have predisposition for it. There can be an emotional catalyst for it, There can be like genetics, There can be food. There can be a lot of things involved, And that's again why it gets so confusing for people, Because a lot of times people are like I want to know why this happened, And the answer is not so clear.

Kasia Stiggelbout:

Ugh, that actually brings up such a good point. I'm somebody who also suffers from an autoimmune condition. It's not Hashimoto's, it's Eczema. But when I say that I suffer from this like Sydney Malour, who actually is the one who is like you have to talk to Dr Lovey And she has like before and afters, i mean I get covered in it when I have some sort of a flare triggering thing that I cannot figure out, like what triggers it. But for me I think it tends to be emotional And one of the things that I know, i feel, and a lot of the actually primarily women who shared some of these questions have expressed, is that it's like you want to get to the root of what caused it And sometimes you may not really ever know And I'm curious to know does that actually make a difference in treatment from your point of view?

Dr. Heidi Lovie:

No, and that's just a control issue, right, because you feel out of control, like your body's out of control, right? And it's also why we tend to see a lot of disordered eating, more than women with than men, like because we feel like we have control. Like, if we don't have control over our life and we don't have control over the patriarchy, and we don't have control over capitalism and we don't have control over, like, insurrections or medicine, at least we have control over our own body. So when we go through an autoimmune, we feel like it's this massive, gross betrayal, like our body is betrayed us in some deep way that we don't understand. And then it's just like why, why are you doing this to me? And so there's this kind of like because I have to control. So it's a control issue sometimes. And are we going to rewind to that? like? is that going to help in treatment? Not necessarily. One of my first questions when I'm doing coaching with people is what does Manage Hashis look like to you? And that's something that you have to ask yourself. I can't answer that for you, right? And so some people just like I just want to be able to get out of bed in the morning and like be able to play with my kids, because some people is like full remission, that's it. It could be whatever.

Dr. Heidi Lovie:

And I've been working with this long enough And I understand my own body enough that I was in remission for years. I still had to be on medication because of the scar tissue. You know I was diagnosed at about 18, probably been going on since I was 13 or 14, because you know that was the 90s and nobody tested thyroid, no one knew what a thyroid was right. So I didn't really get on. I didn't get my arms around it until my mid to late 20s And by that time there was just like kind of really so much scar tissue in there that I needed help with it. So I take tyrosine it's the one that works for me and you know happy to talk more about medication at some point.

Dr. Heidi Lovie:

But I was in full remission before the pandemic And you know I had this large wellness center here in New York and we lost the wellness center because of the pandemic And I did everything I could to keep it open And I treated through the pandemic Like I treated in New York City through the pandemic, through COVID, losing my wellness center like newly married right. So it was me. Like you know, the stressor of that was was I look back and I'm just like I still don't know how I made it to the other side And you better believe, i came out of remission. I came out of remission And this is the part where I say it's like plastic, not static. So just because you're in remission doesn't mean you're cured and it's going to go away, right.

Dr. Heidi Lovie:

But all those stressors, it was just far too much for my body, right? And then, on the other side of this, i hit perimenopause And so now it changed the flavor of my hashis. And so again now I'm in this place where I'm having to rediscover my body and rediscover, like, what my body needs, and sometimes like, okay, well, what does remission or what does managed hashis look for me. I mean it's a question I asked myself.

Kasia Stiggelbout:

I'm so happy that you mentioned that because I think that, as you kind of spoke to this like need for control, need to know, like why did my body betray me in this way, like I think it's important for you, as somebody who has treated thousands of people at this point with Hashimoto's, to name that the root may not actually change the outcome And and this is like a core thing that really Chinese medicine has kind of like shifted my mind around, which is the fact that you're always changing and evolving And so your conditions may appear, may disappear, may change in form, and I think just accepting that and meeting it where it is is just so crucial And there's like an element of kind of releasing some of that weight, because it's an illusion that you're going to completely control your body and your health fully at any point. Frankly, right.

Dr. Heidi Lovie:

Yeah, and you know, it's even like, if you kind of move into the fertility space, right, like working with people trying to get pregnant. You know, one of the things I always say is, just like it's not up to you, right, like babies have their own timeline, and so, you know, there's so many things with our health, right, that we feel like we should be in control of, but you know, there's kind of I don't know, but, like, one of the things that I have been thinking a lot about lately is, you know, we have this generation of chronically ill women, really, right, and you know, a lot of us were raised with traditional gender roles. You know that's changing now, right, but a lot of us were raised with traditional gender roles while simultaneously being empowered to be independent, build our own careers, and so now we have to do everything, and we feel like we have to do everything. Where, by the way, the 40 hour work week was founded on the concept that there's someone at home who's not working to be doing stuff. So we're not designed for 40 hour, 50 hour, 60 hour, 70 hour work week, right? But you know, one of the things that I see quite a bit and this is not everyone right, like I'm just stereotyping and I'm just like bell curving. So this might speak to some people and other people might just be like I don't know what the hell you're talking about.

Dr. Heidi Lovie:

But one of the things, that kind of a common thread and I'm specifically speaking towards the women in the practice, not the men, but a common thread that I see with the women is that they're really good like project managers. I call them plate spinners, so they're folks that can do a lot of things and a lot of things like really, really, really well and keep everything going. And part of that is because the self-esteem is based on what you do for other people, not who you are. And so there's this big thing that I talk about with my Hashis. People is just like you know, like you have to get to this place where you're standing there with your tits out in the wind hoping you're still going to be loved if you're not doing all the things. And it's almost too scary to put all the things down right, because the other thing that I see again, not everyone, but a lot is that there was often like a narcissist or narcissist adjacent center of primary in the family, so it could be like mother, father, sibling, or there could have been someone mother father, sibling with a serious health issue where the Hashi individual was kind of groomed to caretake, and so very often there's this backburner of self and again putting our best efforts forward, of what we do for other people and not ego and self-esteem are not bad things, but that's not like a sustainable place to garner that from right. And so what winds up happening is you kind of have this blowout of the endocrine system.

Dr. Heidi Lovie:

And from a Chinese medicine standpoint, you know, we talk about Chi, and Chi is not some like ethereal. It can be like we can get into, like the metaphysical Chi, right, but when we're talking about Chi as a medical thing, a medical thing, i'm talking like ATP, krebs cycle, like basic functioning of the cell, like how does that work? And so there are different things that kind of give us energy to get through the day, right. Thyroid Chi, thyroid energy that's the good stuff, right. That's like Prima, like that's what you put into a Lamborghini, like that's what you want, right, that's like Shep's kiss.

Dr. Heidi Lovie:

When we don't have access to that, the next place that we're going to do is we're going to pull from the endocrine system and other places And so it's common, it's really common. Okay, we don't have that. So we're going to lean into blood sugar mismanagement, because we think blood sugar, diabetes but other things like playing to blood sugar right. So we might lean into caffeine, carbs and sugar, right, the unholy triad. That's delicious in all forms, but like that's kind of like putting diesel in the Lamborghini it'll run but it's going to burn out the engine eventually, right, like that's not like the chef's kiss.

Dr. Heidi Lovie:

And then, when we don't have that, we're going to dig deep into the adrenals And then we wind up pulling out the adrenals and we started winding up like blowing up the gonads too. Right, like FSH, lh, we wind up blowing the whole system because it's just like we have to keep going. And so a lot of Hashis folks will hit a brick wall and like it feels like you're jumping into a brick wall. And I tell people you know tired, but you don't know fatigue until you've had autoimmune or you've gone through chemotherapy. You might have an idea of what that is, but you don't understand. Like having to scrape into your marrow to get up, to get the kids to school or to walk the dog or whatever, and then like sleeping for 18 hours because you cannot get up because you've blown out all systems, right.

Dr. Heidi Lovie:

So there's this chi management piece to it which is like also a blood sugar management piece to it. There's a lot of ways to start parsing this right, and so you know, to your question before, what does treatment look like from a Western point of view versus a TCM point of view? Really depends on the practitioner. Really really really depends on the practitioner. But there needs to be some sort of diet intervention, some sort of chi management intervention, some sort of inflammatory intervention, some sort of movement intervention.

Dr. Heidi Lovie:

It's not just like oh, i'm gluten free and I'm fine now. I mean, that's kind of what the thought was in like 2005,. 2006 has changed since then. So you know, i think we have to be careful too, like with the disordered eating, because I've seen disordered eating come from this as well, where things are so antiseptic and so FODMAPI. So the whole thing is really finding the balance, the 80-20 rule, right, and what we find with like Hashi folks is that they're giving like 120% all the time. They're scared not to. And when I tell people I'm like look, if you were to give 80%, no one would know. You would know, but no one. No one else would know, and I'd rather you feel guilty for giving 80% than blowing out your adrenals because you gave 120. And so there's that psychological piece to it too that can't be ignored.

Kasia Stiggelbout:

Ugh, that is so so, so good. So good, because I think that speaks to that was just such a good breakdown of the way that the emotional state can play into our actions or behaviors and how that can trickle down into perhaps like a catalyst event or just kind of a continual cycle of this inflammation. So this actually segues really well to a question that came up quite a bit, which is what are some and I know that there are many and it probably is customized to the individual but what are some general lifestyle and food related adjustments that you would really recommend for people who suffer from Hashimoto's? You mentioned gluten a few times, fodmap a few times Like, i think, bucketing it into food, and then lifestyle practices just a couple of takeaways for folks to just start to like feel a bit more empowered to take some of the onus on themselves as well to do something.

Dr. Heidi Lovie:

Sure. So I think you know this is where some people get like pretty frustrated, right, because some people will go gluten free and like they go into remission, right. Other people go gluten free and they're just like it did jack all, like it did like nothing here. For me, right, the first thing that I tell people is to go gluten free. Like that for not all Hashis, but a lot of Hashis can be the biggest return on an investment that you can do for yourself. Now, i love gluten, yo, i love like a good croissant, like throw me in Italy, i'm going to eat my tits off in pasta. Like we're talking fertile crescent, we're talking like that's the good stuff, right, like nobody wants to give that up And so I never, you know kind of throw it around like cavalierly, right. Like just like I'm going to be fine.

Dr. Heidi Lovie:

But you know, if we're flipping the script on its head and we're saying like let's kind of rewrite the rules to the game, the first thing that we want to do is we want to eliminate insult, we want to make sure that the immune system isn't kind of overreacting. You know there was a I get made fun of for this, but the analogy I always give is that it's kind of like having a drunk sorority girlfriend in a bar who's just like you don't know her, don't look at it, and so she starts throwing punches to try and protect you from like this perceived threat that she's so drunk she winds up vomiting on you and like punching you in the face and giving you a black eye. So we got to get like our sorority sister of an immune system to calm down and reduce insult And so we start looking for well, what are kind of the biggest insults that are kicking it off. Gluten happens to be one of them because it's just the protein chain structure and how the body gets a misread on that, because it's kind of close to what protein structure and thyroid looks like right. So if I were to minority report, kind of write this on the wall and say it's like the protein for thyroid is ABC123 and the protein for gluten is ABC321. It's close enough that in a hyperactive immune state it's not going to bother rereading the sentence. It's just going to read ABC and go after it and continue to produce more antibodies. So the less antibodies we have, the less attack. So we want to try and get those antibodies down.

Dr. Heidi Lovie:

So biggest return on investment again is we go gluten free. And I'm not talking gluten light, i'm not talking like well, you know, like on Saturdays it's like no, you have to go gluten free. And you had to go gluten free, like seriously, for about three to four years, like to really get everything to calm down. Start with 21 days, right, and then after that, right you kind of like with time. So gluten free is a big one.

Dr. Heidi Lovie:

I always tell people eat your colors. So if your plate is too beige tone, if it's too earth, like tan and khaki, right, we want those colors because those are all antioxidants And those are all things that mother nature worked really hard to produce. Those colors And so like, if there's a bright color to something generally is either going to be really poisonous or really good for us one or the other. So I think, if you know you're going to the grocery store, most likely they're not putting like frog toxins and things like, but hopefully not right. And then I really encourage people to think about blood sugar management, right. So, again, like I was saying, like those of us with Hashis, if we don't have access to the good Lamborghini gasoline, like, we have to kind of go for like the more pedestrian gasoline, which means we do have to eat cleaner, you know, and so what that means. Another big thing I tell people is you know, you just try the stuff on and if it doesn't work, throw it away. Right, and this isn't going to work for everyone, but you try it on.

Dr. Heidi Lovie:

So we take a page from the keto playbook for breakfast, only for breakfast. And so for breakfast, what you can try is simply fat and protein in the morning. That's it, right. So nothing carb, nothing sugary, nothing that converts to sugar, nothing. And so the idea behind that it's a metabolic hack that sets the blood sugar and stabilizes the blood sugar a little bit differently. I'm not telling you not to have like the oatmeal and the blueberries and the yogurt or whatever. I'm just telling you to have that two hours later. And so the mark of health, by switching the breakfast, will be that you don't feel like you need a coffee and a brownie at three o'clock in the afternoon. That's the mark of health is that you have like a different sustained energy level throughout the day because we just we use cheat. We use cheat totally different, so we have to interact with it differently, and I tend to find that a lot of Hashii.

Dr. Heidi Lovie:

People don't do well on keto, right, and they don't do well intermittent fasting because the blood sugar isn't stable enough for them. So the other thing you can try is, you know, carbs are still our friends. Like we like carbs, the brain loves carbs. The brain needs carbs, right? So instead, have a small amount of carbs as part of your last meal. You know I'm not saying like go like Mao down on McDonald's fries. I mean you do you, that's between you and God. But like you know how. Like, have a little bit of rice, have a little bit of kanji, have a little bit of some sort of carbs that are gentle and easy to digest and see if those two kind of food things make sense, right? And again, mark of health are you waking up with more energy? Do you have sustained energy throughout the day? So start playing with the blood sugar. You know those would be two places.

Dr. Heidi Lovie:

And you know, I think there's a lot of talk you know about like the what is it? the medical medium and celery juice and like all of that. I don't know, i'm quite opinionated about that from a Chinese medicine standpoint. Some people swear by it. I don't know. I think it just kind of gives you poopy pants, like not.

Dr. Heidi Lovie:

Probably the best thing is we're trying to warm up a system, right. But you do want to see if there are other occult co infections. So you want to talk with the doctor and have them testings, like here in the north, in the northeast, lyme's disease is an epidemic, right. So you want to test for Lyme's, you want to test for Bartonella, you want to test for Epstein bar, you want to be testing for all these kind of other things, because that could again create a hyperactive immune state. That's adding to insult And some of those infections are things that like need to be dealt with. And remember, healing doesn't happen alone. Healing happens in community. So you need to be finding practitioners and kind of creating a team for yourself that can do the testing and kind of help lower some of these insults that are happening in the system.

Kasia Stiggelbout:

I love the term insults because I think that gives people something to look towards. Right, Because you can't control what has happened to your thyroid, but you can control. You could do your best to at least influence. Are you kind of continuing that inflammation or bringing it down? Dr Lovie, I can get chatting with you. We actually did get through quite a bit of this outline, So I'm pretty impressed with us here, Like okay, let's see if there is anything else like fun here. I do have one question that is pretty important that I know has come up a few times, And that is you mentioned remission for folks, And a lot of people are like I will be on medication for the rest of my life, Like my thyroid is 80% damaged. What do you say to that? Like, have you with your patients, witness people get off medication and or kind of go into remission And what can I know? it can probably be different, right?

Dr. Heidi Lovie:

Let's be very clear about this. Like I think we have to remove medication stigma, right, and I think there's a lot of stigma and a lot like like what is managed. Hashimotu's to like I'm off medication. Well, why? Why do you want to be off medication? You know the fact that Dr Hashimotu died was because he didn't have medication right. So I think it's right medication, right person. And you know what happened a couple years ago, so I can tell you my own medication journey.

Dr. Heidi Lovie:

Synthroid makes my joints hurt, gives me the muscle aches. Love with Iroxine like my numbers will look like beautiful, but I have so much brain fog that like I sound like English is my second language. Like I wind up tripping over words so much with it. Nature throw it. A couple years ago got switched to nature throw it and it was like somebody flipped on a light. I'm like Oh there she is, hello, like so nice to meet you. And then they changed the formulation to it and nature throw it quit working for like a whole ton of people. So everybody wanted switching over to armor And they're just like I guess that'll do the job, But like still didn't really kind of work for like a lot of people, right, and so I was on armor And then wound up.

Dr. Heidi Lovie:

I was like, well, you know, i know I send a divorce to endocrinologist, but let's do a call like let's get like second, third, fourth, fifth opinions. And so I went through the medication machine again because they're just like Nope, let's like baseline you at like level And I'm just like God damn it. Okay, fine, but I felt like crap. And so wound up on tyrosine, believe it or not, and because I had fibromyalgia that was so bad at one point I was crawling through the front door after patient days and I couldn't figure out what was happening And we realized there's too much T three in the armor And it was T three that was causing the muscle pain, right. And so you know, when we're talking about medication, like it's really incredibly important to have a healthcare practitioner that is medication fluent and the different types of meds that are out there that are going to work for your system. And so tyrosine like these days it's the, it's the cleanest T four on the market we have available to us here in the United States is what works for me. And what does manage Hashi mean to me? It means the lowest possible antibodies that I can have right, and if I can drop my antibodies below diagnostic criteria, that's good for me. Manage Hashis means can I wake up in the morning, can I have a conversation and sound like my usual intelligent self, you know, and do I have the energy to get through the day, and that's what's important for me, and I can't do that off medication.

Dr. Heidi Lovie:

Now there have been case studies They're very rare where the thyroid can actually regenerate itself, but that is not the norm. That is less than 1% and we don't understand why that happens, right, but kind of one of these things that happened a couple of years ago. And this again is like why I like teaching, right, because like students, that's come with questions and you're just like damn, i never thought about it like that, let me think. And I had this Korean student who approached me and she said oh, i have a copy of this study that was done in South Korea where they had a small group. I think the group was like less than 80 patients, women, who all had tested positive for Hashimoto's, with high TPO's, and they had the women wash off the back of their neck, you know, like that whole like wellness thing that everyone's like doing for their faces looking all young. So they had these women wash off the back of their neck for three months and they tested the TPO's before and they tested the TPO's after and something like 90% of these patients like almost went into remission. So I'm reading the study and I go bullshit, i am calling massive BS on this. There is no way. I was like this is like a bad study, this is a poor study, like this is, and I threw the study away. Right, i'm just like terrible And I throw it away.

Dr. Heidi Lovie:

And then, of course, i'm in the shower the next day. I'm like, yeah, but from a Chinese medicine standpoint, right, the sage acupuncturists uses the left to treat the right, the top to treat the bottom, the front to treat the back, the yin to treat the yang. So if they're scraping the back of the neck for the front of the thyroid, i was like, well, yeah, i guess that kind of checks, okay. And then I started thinking more about it to be like, oh well, when we have this autoimmune attack and the body is attacking the tissue around the thyroid, part of that scar tissue that's happening in there is fascial, and so when we start to happen, i have yet to meet a Hashish patient that doesn't have neck pain.

Dr. Heidi Lovie:

You know, because what starts to happen is is if your sight line is at the horizon and you start to have tissue fascial damage in the neck, your sight line is going to drop because your chin is going to drop, because your head's going to collapse a little bit down into the chest because of that pulling. So now, in order for my eyesight to hit the horizon, i can either like bring just my eyes up and that like looks creepy, like chin down, eyes up, like you can't walk like that, so instead you have to come forward And so now neck and oxyput is out of alignment and you have headaches and in order to compensate, your shoulders now roll in And so now, instead of like hands that side, like karate, chop, karate, kid hands, you have like monkey hands in front of you And so your whole alignment is out because of this frontal autoimmune attack happening in the neck. So I don't know, maybe right. So I had my patients start doing it. I started doing it, started going to a chiropractor to get like a lot of neck work, having him de-adhesive my thyroid because he's like it's so sticky in there And I swear to God, like 90% of us had drop massive drops in antibodies, And so when people again like ask what are other things that I can do, it is like you can actually work on glandular health, you know, and like you can do quash.

Dr. Heidi Lovie:

There's lots of really good videos about like neck wash on, like on the YouTube's right, tons of like great videos out there. There is a practitioner who I'm going to think of her name in a second, but she runs Lanchean L-A-N-S-H-I-N. It's a studio in Brooklyn that's specifically focused on gua sha and she puts out amazing tutorials on facial gua sha and she has the whole series on neck gua sha. So you know, and considering like she's Asian American and so she's coming from a familial tradition, like she's closer to source with it, so like, go check out like her work on how to actually do that properly. But that's not something like that in Endo is going to tell you right, like, that's not something that like is out there.

Dr. Heidi Lovie:

That's really something that I've been trying to kind of push in the Chinese medicine community. Right, like, do the gua sha, do the gua sha, do the gua sha. But you know, we need to continue to look at the studies, we need to continue to look at the cross-sectionality of this and we need to continue looking internationally Like what people are doing in other places, and not always like follow soup, but use like critical thinking and try it on. Just try it on And if it doesn't work for you, throw it away Like it's totally fine, like it's totally fine, absolutely Yeah.

Kasia Stiggelbout:

And I mean, i think the side effects of neck gua sha, unless you're doing it improperly, are what? Minimal, minimal at best right, minimal at best.

Dr. Heidi Lovie:

I mean, if you go too hard, too fast, like on your karate, you might knock yourself out. So that's why, like, watch the videos and don't do that. But if you want it, like, safe for them, sorry, and even only do the neck. That's what came. And, by the way, i've never been able to find that study again. Like I've sent hordes of people out to be like can somebody please find me a copy of this like study that I tore up and threw away And so, like if anybody listening to this like can find that study like free treatment in New York, really, because, like, i really need a copy of this thing.

Kasia Stiggelbout:

And or Dr Lovey, you are going to run this study. Get it funded. There's a shout out for that because I would love, love, love, love, Like a broader study like this. That would be amazing.

Dr. Heidi Lovie:

Yeah, i looked at it, but when I discovered, like, what it would take, i'm like, yeah, so like I'm not going down that NIH route, i'm just going to like, stick with my patients.

Kasia Stiggelbout:

If anyone from the NIH is listening, just saying, throwing it out there, placing it, and, dr Lovey, we are actually over time. but you know, now that you mentioned this free treatment in New York, if somebody finds a study you have to leave us with where can people find you And what do you have going on? And you know one more thing. I guess that was a couple of questions, but where can people find you, what do you have going on And do you offer something for people who are not based in New York? You mentioned coaching. you know any resources that you can put out there. I know people are going to want to know, so please share them with us.

Dr. Heidi Lovie:

Sure. So Lovey acupuncture L-O-V-I-E acupuncturecom You can find me there And because I am licensed in New York, i can only treat people on site In New York. But I actually do international coaching with people. So if somebody wants a coaching session, you can book that online. Like I offer it like a couple of times a week And it starts with the longest intake form you've ever seen in your life And I'm not going to apologize for that, because like we actually need that information. And then we sit down like for an hour, like an hour minimum and just like really dive into what is the flavor of your individual hoshies And a lot of times it's getting people resourced. A lot of times that conversation is one on one education for people And then kind of pointing people in the right direction so that they can feel empowered, and just making this like a little less scary. Like it's hoshi posse, like if you're going to get an autoimmune, like it's the best autoimmune to get, like you're in good company.

Kasia Stiggelbout:

I love that attitude. All right, dr Lovey, this was such a joy. Thank you so much for joining us. Truly Very welcome. Thanks everybody for listening and see y'all next time. Bye.

Kasia Stiggelbout:

Thank you so much for tuning into this episode of Nourish. If you enjoyed this conversation, please leave a review. Five Star Reviews helped the podcast grow And I'm so grateful for that. I publish new episodes twice a month, so hit the subscribe button to be notified And, if you want to stay connected in between episodes, join my community on Instagram and TikTok at nourish underscore podcast. All right, that's all I got for you today. See you next time.

Thyroid Health and Hashimoto's Disease
Hashimoto's and Western Medicine
Autoimmune Conditions and Catalyst Events
Navigating Hashimoto's and Changing Health Conditions
Managing Hashimoto's
Managing Hashimoto's
Managing Medication for Hashimoto's
Gua Sha for Hashimoto's

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