By Lisa Tamati, Science Writer and Host of Pushing the Limits
Thyroid disorders, including hypothyroidism, Hashimoto’s thyroiditis, and Graves’ disease, affect millions worldwide, often with profound impacts on metabolism, energy, and overall health. I
n a recent Pushing the Limits video interview, I had the privilege of speaking with Dr. Eric Osansky, a chiropractor and renowned expert in thyroid health, who shared his personal journey and evidence-based insights into managing these conditions. Dr. Osansky’s expertise, forged through his own battle with Graves’ disease and years of research, offers a holistic perspective on thyroid disorders, emphasizing the interplay of autoimmunity, gut health, stress, and environmental factors. This blog, crafted for an educated audience, delves into the science of thyroid function, diagnostic challenges, and integrative strategies for healing, drawing from our detailed conversation.Dr. Osansky’s Journey: From Graves’ Disease to Thyroid ExpertiseDr. Eric Osansky’s path to becoming a thyroid authority began with a personal health crisis in 2007. As a chiropractor, he was accustomed to addressing musculoskeletal issues, but his focus shifted when he experienced unexplained symptoms: a resting heart rate of 90–110 beats per minute and a 42-pound weight loss, initially attributed to diet and exercise. Basic thyroid testing revealed hyperthyroidism, and further evaluation by an endocrinologist confirmed Graves’ disease, an autoimmune condition characterized by excessive thyroid hormone production.Skeptical of conventional treatments—antithyroid medications, radioactive iodine, or thyroidectomy—Dr. Osansky drew on his functional medicine knowledge from nutritional seminars.
He opted for herbal remedies like bugleweed (an antithyroid herb) and motherwort (a natural beta-blocker) to manage symptoms while addressing underlying causes through diet, stress management, and supplements.
By 2009, he achieved remission, normalizing his thyroid function and autoantibodies, a state he has maintained since. This transformative experience inspired him to help others with thyroid disorders, leading to three books and a thriving practice focused on Graves’ and Hashimoto’s.
The Thyroid Epidemic:
Autoimmunity at the CoreThyroid disorders are alarmingly prevalent, with hypothyroidism and hyperthyroidism often rooted in autoimmunity. Dr. Osansky highlighted that approximately 90% of thyroid conditions are autoimmune:
Hashimoto’s thyroiditis drives most hypothyroidism cases, while Graves’ disease underlies most hyperthyroidism.
These conditions arise when the immune system mistakenly attacks the thyroid, impairing its ability to produce or regulate thyroid hormones.
Hashimoto’s Thyroiditis: The most common autoimmune thyroid disorder, Hashimoto’s involves antibodies (thyroid peroxidase [TPO] and thyroglobulin [TgAb]) attacking thyroid tissue, leading to hypothyroidism. Symptoms include fatigue, weight gain, hair loss, and cold intolerance.
Graves’ Disease: Characterized by thyroid-stimulating immunoglobulin (TSI) antibodies that mimic thyroid-stimulating hormone (TSH), Graves’ triggers hyperthyroidism, causing weight loss, palpitations, heat intolerance, and anxiety.
The autoimmune component is critical, as Dr. Osansky emphasized, because untreated autoimmunity increases the risk of developing additional autoimmune conditions, such as celiac disease or rheumatoid arthritis.
Yet, conventional medicine often overlooks this, focusing solely on hormone replacement or suppression without addressing the immune dysregulation.The Thyroid’s Systemic Role: Beyond MetabolismThe thyroid gland, located in the neck, produces hormones—thyroxine (T4) and triiodothyronine (T3)—that regulate metabolism, energy production, and cellular function. T4, the inactive form, is converted to T3, the active hormone that binds to receptors throughout the body. Thyroid hormone receptors are ubiquitous, influencing virtually every system:
Metabolism: Thyroid hormones control basal metabolic rate, affecting weight, energy levels, and temperature regulation.
Cardiovascular Health: Hyperthyroidism elevates heart rate and risks atrial fibrillation, while hypothyroidism slows heart rate and raises cholesterol levels.
Bone Health: Hypothyroidism impairs bone density, while hyperthyroidism accelerates bone turnover, increasing fracture risk (evident in elevated alkaline phosphatase levels in Graves’).
Neurological Function: Thyroid dysfunction affects cognition, mood, and motivation, with hypothyroidism causing brain fog and hyperthyroidism inducing anxiety.
Cholesterol Metabolism: Hypothyroidism elevates total cholesterol and LDL, while hyperthyroidism lowers them, reflecting metabolic shifts.
Dr. Osansky likened the thyroid to a “gas pedal,” accelerating or decelerating bodily functions. Achieving the “Goldilocks zone”—neither too fast (Graves’) nor too slow (Hashimoto’s)—is essential for optimal health.Diagnostic Challenges: The Need for Comprehensive TestingAccurate diagnosis is a cornerstone of effective thyroid management, yet conventional testing often falls short.
Dr. Osansky criticized the overreliance on TSH, a pituitary hormone that indirectly reflects thyroid function.
While elevated TSH suggests hypothyroidism and low TSH indicates hyperthyroidism, it misses critical nuances. A comprehensive thyroid panel, he argued, should include:
Free T4 and Free T3: These measure unbound, bioactive thyroid hormones. T3 is crucial, as it directly binds to receptors, yet many clinicians test only T4, overlooking conversion issues.
Reverse T3 (rT3): An inactive metabolite of T4, rT3 competes with T3 for receptor binding, acting as a brake on thyroid activity. Elevated rT3, common in hyperthyroidism or chronic stress, signals metabolic dysfunction, though Dr. Osansky noted its limited diagnostic value in Graves’ due to predictable elevation.
Autoantibodies: TPO and TgAb for Hashimoto’s, and TSI for Graves’, confirm autoimmunity. Early antibody detection can precede TSH abnormalities by years, enabling preventive intervention.
Radioactive Iodine Uptake (RAIU): Used in Graves’ to assess iodine uptake, Dr. Osansky avoids this test due to radiation exposure, favoring antibody testing for diagnosis.
Conventional resistance to full panels stems from a focus on symptom management over root causes.
For Hashimoto’s, clinicians argue that TPO/TgAb testing is unnecessary since treatment (levothyroxine) remains unchanged.
However, identifying autoimmunity guides functional interventions to modulate the immune system, potentially halting progression.
Dr. Osansky stressed that subclinical abnormalities—e.g., a TSH of 4 (within lab range but above optimal) or low-normal T3—warrant attention, akin to addressing prediabetes to prevent diabetes.
The Autoimmune Triad: Genetics, Triggers, and Leaky GutAutoimmunity, as Dr. Osansky explained, follows the “triad of autoimmunity”:
Genetic Predisposition: Genes like HLA variants increase susceptibility, but alone are insufficient.
Environmental Triggers: Stress, toxins, infections, and dietary factors (e.g., gluten) initiate immune dysregulation.
Leaky Gut: Increased intestinal permeability allows pathogens, undigested food, and toxins to enter the bloodstream, triggering inflammation and autoimmunity.
The gut-thyroid axis is pivotal, with 70–80% of immune cells residing in the gut-associated lymphoid tissue (GALT). A compromised gut barrier, marked by elevated zonulin or low secretory IgA, fuels systemic inflammation, exacerbating thyroid autoimmunity. Dr. Osansky noted that 60% of T4-to-T3 conversion occurs in the liver and 20% in the gut microbiome, so dysbiosis or liver toxicity impairs thyroid hormone activation.Molecular mimicry further complicates matters.
Gluten, for instance, shares amino acid sequences with thyroid tissue, prompting the immune system to attack both (a theory championed by Dr. Tom O’Bryan). Environmental toxins like fluoride, chlorine, and bromide also bind to thyroid tissue, triggering immune confusion.
A 2015 study confirmed gluten’s role in increasing gut permeability universally, even in asymptomatic individuals, underscoring its potential as a thyroid trigger.
Stress and the HPA-HPT Axis:
A Vicious CycleChronic stress, a near-universal factor in modern life, disrupts the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axes, amplifying thyroid dysfunction.
Dr. Osansky’s Graves’ was partly driven by overtraining, which depleted cortisol and DHEA, creating a pro-inflammatory state. Stress lowers secretory IgA, weakens gut barriers, and impairs T4-to-T3 conversion, as cortisol inhibits deiodinase enzymes.
The HPA-HPT interplay is complex. The hypothalamus signals the pituitary to release TSH, which stimulates thyroid hormone production.
HPA dysregulation, often termed “adrenal fatigue” (now HPA axis dysfunction), disrupts this cascade, promoting autoimmunity.
Studies link stress directly to Graves’, with anecdotal evidence suggesting a similar role in Hashimoto’s.Managing stress is non-negotiable, Dr. Osansky emphasized. Strategies include:
Mind-Body Practices: Daily deep breathing, meditation, or yoga to activate the parasympathetic nervous system.
Sleep Optimization: 7–9 hours of quality sleep to restore adrenal function.
Nature Exposure: Grounding and sunlight to reduce cortisol and boost vitamin D.
For individuals like myself, juggling caregiving and multiple businesses, stress is unavoidable.
Dr. Osansky advocates starting small—e.g., 5-minute breathwork sessions—and building routines to mitigate its impact.Brain Injuries and Thyroid Health: An Overlooked ConnectionA surprising insight from our discussion was the thyroid’s vulnerability in traumatic brain injury (TBI).
I noted that 60% of TBI patients develop leaky gut within hours, often accompanied by blood-brain barrier disruption.
This gut-brain axis perturbation likely affects the pituitary, a fragile structure susceptible to shear forces in TBI.
Dr. Osansky agreed that pituitary damage could disrupt TSH signaling, warranting thyroid evaluation in TBI patients, especially those with persistent post-concussion syndrome.
This connection is understudied, but the endocrine system’s interdependence suggests that TBI-induced pituitary dysfunction could exacerbate thyroid issues, contributing to fatigue, cognitive deficits, and metabolic slowdown.
Routine thyroid panels, including antibodies, should be considered in TBI management, alongside gut health assessments.Integrative Management: Diet, Supplements, and Medications
Dr. Osansky’s approach integrates lifestyle, nutrition, and targeted supplementation, with medications as a bridge when needed.Dietary StrategiesA whole-food, anti-inflammatory diet is foundational:
Eliminate Gluten: Due to its role in leaky gut and molecular mimicry, gluten avoidance is critical, especially in autoimmune thyroid conditions. Non-celiac gluten sensitivity may still trigger symptoms.
Avoid Dairy and Nightshades: Dairy and nightshades (tomatoes, eggplants, peppers, white potatoes) can be inflammatory in susceptible individuals. A temporary elimination diet helps identify triggers.
Healthy Fats: Prioritize coconut, avocado, and olive oils over inflammatory oils (canola, sunflower, safflower).
Minimize Refined Foods: Avoid sugars and processed carbohydrates to stabilize blood sugar and reduce inflammation.
Dr. Osansky noted that wheat in modern diets is often gluten-enriched, exacerbating its inflammatory potential compared to heritage strains used in Europe.SupplementsKey supplements support thyroid and immune health:
Omega-3 Fatty Acids: Fish oils reduce inflammation and support membrane integrity. I highlighted plasmalogens (e.g., from Dr. Dayan Goodenowe’s work), specialized lipids that enhance neuronal repair and may outperform traditional omega-3s.
Probiotics: Support gut microbiome diversity, especially if fermented food intake is low.
Vitamin D: Optimal levels (80–110 nmol/L) bolster immunity and bone health. Most individuals require supplementation, even with sunlight exposure.
Selenium: A cofactor for glutathione synthesis and thyroid hormone conversion, selenium reduces TPO antibodies. Food sources (Brazil nuts, sardines) are ideal in maintenance, but supplements are advised during healing.
N-Acetylcysteine (NAC): A glutathione precursor, NAC supports detoxification and reduces oxidative stress.
Magnesium and B Vitamins: Address common deficiencies that impair energy metabolism and thyroid function.
MedicationsWhile Dr. Osansky prioritizes root-cause resolution, medications have a role:
Levothyroxine (T4): Standard for hypothyroidism, but overprescribed without addressing autoimmunity or T3 conversion.
Liothyronine (T3): Underutilized, T3 is critical for patients with conversion deficits. Desiccated thyroid (containing T4, T3, T1, T2) is an alternative, though T1 and T2’s roles are less understood.
Antithyroid Drugs: For Graves’, methimazole or propylthiouracil lower thyroid hormone levels but don’t address autoimmunity.
Herbal Alternatives: Bugleweed and motherwort manage hyperthyroid symptoms naturally, though efficacy varies.
Dr. Osansky avoids discontinuing medications abruptly, instead guiding patients to balance symptom management with functional interventions.
For example, persistent T3 deficiency despite levothyroxine may necessitate T3 or desiccated thyroid, alongside efforts to fix conversion issues (e.g., gut dysbiosis, liver detox).
Environmental Toxins:
The Fluoride ControversyFluoride, ubiquitous in water supplies and dental products, emerged as a significant thyroid disruptor.
Dr. Osansky and I share concerns about its neurotoxicity and thyroid toxicity, supported by studies showing fluoride’s interference with iodine uptake and thyroid hormone synthesis.
Other halogens—chlorine and bromide—exacerbate this by competing with iodine, a critical thyroid nutrient.To minimize exposure,
Dr. Osansky uses reverse osmosis water filtration and fluoride-free toothpaste, practices I echo. He debunked the myth that fluoride is essential for dental health, noting his cavity-free status despite avoiding it.
Mass fluoridation, we agreed, is an outdated practice that disregards individual health risks, particularly for thyroid patients.
Genetics: Predisposition, Not Destiny
Genetic testing, while not Dr. Osansky’s primary tool, offers insights into thyroid susceptibility. I’m a proponent of DNA testing for its longevity as a health investment, revealing actionable genes like MTHFR (linked to methylation deficits) or GST (detoxification).
Dr. Osansky, who carries homozygous MTHFR C677T, monitors homocysteine as a proxy for methylation issues but doesn’t routinely test HLA markers for celiac or thyroid autoimmunity, as genetic predisposition doesn’t guarantee disease.Paul Robinson, a UK thyroid expert, identified specific genes increasing Hashimoto’s risk, though Dr. Osansky was unfamiliar with these.
Genetic data, I argued, serves as a lens, complementing bloodwork and microbiome testing to tailor interventions, particularly for detoxification and immune modulation.Resources and Next StepsDr. Osansky’s work is a beacon for thyroid patients seeking alternatives to conventional care. His resources include:
Books:
Natural Treatment Solutions for Hyperthyroidism and Graves’ Disease (3rd Edition, 2023): A comprehensive guide to functional approaches.
Hashimoto’s Triggers (2018): A 500+ page tome on identifying and eliminating autoimmune triggers.
The Hyperthyroid Healing Diet (2024): Explores dietary strategies, including oxalates, histamine, and low-FODMAP protocols.
Free Six-Step Guide: Available at naturalendocrinesolutions.com, offering practical steps for thyroid healing.
Podcast: Save My Thyroid, available on all major platforms, featuring expert interviews and patient stories.
Newsletter: “Healthy Gut, Healthy Thyroid” at savemythyroid.com/newsletter.
Dr. Osansky works one-on-one with patients, though availability is limited. Contact his office via his website for inquiries.Conclusion: A Holistic Path to Thyroid HealthThyroid disorders are a complex interplay of autoimmunity, gut health, stress, and environmental exposures, demanding a systems-based approach.
Dr. Osansky’s journey from Graves’ patient to thyroid expert underscores the power of addressing root causes—leaky gut, immune dysregulation, and toxin overload—while judiciously using medications or herbs for symptom control.
Comprehensive testing, anti-inflammatory diets, and targeted supplements like selenium and NAC offer hope for reversing autoimmunity and restoring balance.
For those navigating thyroid issues, or supporting loved ones, Dr. Osansky’s insights are a call to action: advocate for full thyroid panels, eliminate gluten and fluoride, and prioritize stress resilience.
My own experience with mild hypothyroidism, compounded by stress-induced cortisol crashes, reinforces the need for T3 support and gut healing, areas I’m exploring with my Aevum Labs immune formulation, Rejuvenate Pro, designed to combat immunosenescence (aevumlabs.co.nz).
Visit lisatamati.com for more resources, including my Healthspan Hacks course with Dr. Elizabeth Yurth, and join the movement to reclaim thyroid health naturally.
Check out the interview with Dr Eric Osansky on our youtube channel below