My low bone density story, Digestive Enzymes, Intermittent Fasting

Welcome to Healthy Gut Healthy Thyroid!

This is your weekly roundup of the BEST actionable steps for those people with thyroid and autoimmune thyroid conditions who want to restore their health…by healing their gut. Whether you have hyperthyroidism or Hashimoto’s you will benefit from the content in this newsletter.

In today's issue:

• Main Topic: The Thyroid-Gut-Osteoporosis Connection Part 1

• Podcast Review: The Dangerous Chemicals Lurking in Your Food, Water, and Home

• Understand Your Tests: Clostridia Bacterial Markers

• Ask Dr. Eric:
  ✔️When should I take a digestive enzyme?
  ✔️Can intermittent fasting benefit thyroid health?

The Thyroid-Gut-Osteoporosis Connection

Low bone density is common in the general population but is an even greater concern for individuals with thyroid conditions. While osteopenia and osteoporosis are more prevalent in women, men are also affected.

One of the biggest challenges with low bone density is that it typically presents with no symptoms. In fact, many people only become aware of osteoporosis after experiencing a fracture.

My Low Bone Density Story

When I was diagnosed with Graves’ disease, my sole focus was on regaining my health—not sharing my story with others. However, as I progressed toward remission, I realized that my experience could help others struggling with thyroid and autoimmune conditions.

Fifteen years later, I continue to support individuals on their journey to restoring their thyroid health.

Recently, at age 54, I had my first bone density scan, and I was surprised to learn that I had low bone density. Initially, I hesitated to share this with my audience—I honestly felt embarrassed, as I have prioritized my health since achieving remission from Graves' disease in 2009.

I have followed a healthy diet, managed my stress, and exercised regularly. However, I now wonder if certain choices I made after restoring my health may have contributed to my low bone density.

Why Is Low Bone Density Common in Thyroid Patients?

Many individuals with thyroid conditions unknowingly have low bone density. I am not a proponent of excessive scans, which is why I delayed getting a bone density test. However, compared to CT scans and X-rays, bone density scans involve minimal radiation exposure.

Looking back it shouldn't be surprising as to why I have low bone density, and there are several reasons why it's so common in individuals with thyroid conditions:

Reason #1: Thyroid Hormone Imbalances Affect Bone Density. Since I have a history of hyperthyroidism it is possible that excess thyroid hormones contributed to my bone loss, even though my condition wasn’t unmanaged for too long.

Fortunately, I was able to stabilize my hyperthyroidism naturally using bugleweed while addressing the underlying root cause. However, some individuals require antithyroid medication—which, although effective, is not well-tolerated by everyone.

For those with Hashimoto's, research suggests that low thyroid hormone levels impact bone quality more than bone density itself.¹

Reason #2: Inflammation Can Contribute to Bone Loss. In 2019, I wrote an article titled "Can Thyroid Autoimmunity Cause Osteoporosis?", where I explored how chronic inflammation from Graves' disease and Hashimoto's can negatively impact bone density.

At the time, I was surprised to learn that autoimmune-related inflammation alone may accelerate bone loss. While I cannot determine how much this factor contributed to my low bone density, it is worth acknowledging as a potential cause.

Reason #3: Gut Health Plays a Role in Bone Density. A healthy gut is essential for optimal digestion and nutrient absorption, including key nutrients required for bone health.

At the time of my Graves' disease diagnosis, my gut health was far from optimal—a reality for many individuals with thyroid and autoimmune thyroid conditions. If the gut is compromised, the body's ability to absorb calcium, magnesium, and other bone-supporting nutrients may be significantly reduced.

Reason #4: Insufficient Calcium Intake. For years, I relied on non-dairy sources of calcium, such as collard greens and broccoli. While these are excellent nutrient-dense foods, they may not provide sufficient calcium for maintaining optimal bone density.

If I had also included small fish with edible bones (e.g., sardines) in my diet a few times per week, my calcium intake may have been more adequate.

I was also hesitant to supplement with calcium, fearing its potential negative effects on cardiovascular health. However, calcium supplementation—when done correctly and combined with vitamin K2—can be beneficial for individuals who are not getting enough through diet alone.

Reason #5: Lack of Resistance Training. While aerobic exercise (e.g., running, cycling) is great for cardiovascular health, resistance training is crucial for maintaining bone strength and muscle mass.

Although I have been exercising for over 30 years, I admit that I previously focused more on aerobic exercise. I did incorporate weightlifting, but not as consistently as I could have. That has changed over the last few years, as I currently do focus more on resistance exercise.

For those currently healing from a thyroid condition, intense exercise may not be a good idea. However, light resistance training, such as bodyweight exercises or weight-bearing activities, can still provide bone health benefits.

What’s Next?

There is so much more to discuss regarding bone health and thyroid conditions, including:

• My current bone-building routine

• Additional tests to assess bone health

• How to ensure adequate calcium intake

• The role of gut health in supporting bone density

I will be covering these topics in next week’s newsletter because bone health is a concern for nearly everyone.

Final Thoughts

Low bone density is a significant but often overlooked issue in individuals with thyroid conditions. The good news is that bone health can be supported and improved through targeted lifestyle interventions.

I encourage you to prioritize your bone health by:

✅ Balancing thyroid hormones

✅ Do what's necessary to reduce inflammation

✅ Supporting gut health for better nutrient absorption

✅ Ensuring sufficient calcium intake

✅ Incorporating resistance training

If you haven’t had a bone density scan, it may be worth discussing with your healthcare provider—especially if you have a history of thyroid imbalances, which is the case for most people reading this newsletter.

Stay tuned for next week's newsletter, where I’ll dive deeper into practical strategies for improving bone health!

Find Your Hashimoto’s Triggers

If you have Hashimoto’s thyroiditis, visiting an endocrinologist is likely to result in a prescription for thyroid hormone replacement. And while there is a time and place for thyroid hormone replacement, the problem is that it doesn’t do anything for the autoimmune component of Hashimoto’s.

And so what happens is that many people will take thyroid hormone without doing anything to improve the health of their immune system, which means that over time further damage to their thyroid gland will take place.

The good news is that you can do things to reverse the autoimmune component of Hashimoto’s. And the best way to accomplish this is by finding and removing your triggers.

My book “Hashimoto’s Triggers” will show you how to do this. By reading this book you will discover the following:

• More than one dozen triggers of Hashimoto’s thyroiditis

• The different diet options, and how to detect your specific food triggers

• Everything you need to know to heal your gut

• How to reduce fatigue, brain fog, hair loss, lose weight, and address other common symptoms

• Strategies to lower thyroid antibodies when nothing else has worked

• Nutritional supplements and herbs for Hashimoto’s

• A comprehensive list of the blood tests you should get, along with other specific tests that can help detect your triggers

• What you need to do to achieve optimal adrenal health

• Natural treatment options for viruses, pathogenic bacteria, parasites, Candida, and SIBO

Click Here to order the book “Hashimoto’s Triggers”

Save My Thyroid Podcast Review

I have a podcast called "Save My Thyroid", where I discuss how people with hyperthyroidism and Hashimoto's can save their thyroid and regain their health. And during each edition of this newsletter I'll briefly discuss a recent podcast episode.

In a recent podcast episode I discussed the impact of endocrine disruptors on thyroid health. In this episode I discussed the hidden dangers lurking in your kitchen cabinets, bathroom shelves, and even your drinking water, as I exposed the truth about endocrine disruptors.

I talked about how chemicals like BPA, phthalates, and pesticides are disrupting your thyroid function, potentially triggering autoimmune conditions, and wreaking havoc on your overall health.

This is more than just avoiding drinking water out of plastic bottles on a regular basis. While we can't completely eliminate our exposure to these endocrine disruptors, there are a lot of things we can do to reduce our exposure, and at the same time do things to detoxify these toxicants from our body.

To learn more about endocrine disruptors make sure you check out the episode.

Understand Your Tests

Clostridia Bacterial Markers

Clostridia are gram-positive bacteria commonly found in soil and the gastrointestinal tracts of humans. Many Clostridium species are considered commensal, meaning they coexist in the gut without causing harm and may even provide benefits.

However, some Clostridium species can be pathogenic, producing toxic metabolites that negatively impact neurotransmitter metabolism. The Organic Acids Test (OAT) from Mosaic Diagnostics detects the following four key toxic metabolites produced by Clostridia bacteria:

HPHPA (3-(3-hydroxyphenyl)-3-hydroxypropionic acid). Primarily produced by C. botulinum, C. sporogenes, and C. caloritolerans.

4-Hydroxyphenylacetic acid. Elevated levels may be associated with small intestinal bacterial overgrowth (SIBO). Produced by C. difficile, C. stricklandii, C. lituseburense, C. subterminale, C. putrefaciens, and C. propionicum.

3-Indoleacetic acid. A tryptophan byproduct, elevated in urine when overproduced by C. stricklandii, C. lituseburense, C. subterminale, and C. putrefaciens.

4-Cresol. Predominantly produced by C. difficile, a well-known pathogen commonly spread in hospitals and nursing homes.

The Impact of Clostridia on Your Health

Certain Clostridia metabolites can negatively affect the gut, as well as interfere with neurotransmitter metabolism.

For example, some Clostridia species inhibit the conversion of dopamine to norepinephrine, leading to an excess buildup of dopamine. This imbalance may contribute to neurological symptoms and mood disorders.

The Challenge of Treating Clostridia

While herbal antimicrobial protocols can help to eradicate Clostridia, treatment can be challenging because Clostridia bacteria form spores, making them more resistant to eradication.

How I Address Clostridia:

The protocol I use for Clostridia is from Mosaic Diagnostics. I start by recommending daily antimicrobial herbs for the first two weeks.

After two weeks, I have the patient reduce antimicrobial herb intake to every three days., along with incorporating a soil-based probiotic and saccharomyces boulardii.

I have them follow this protocol for two to three months, then ideally they would want to retest the Organic Acids Test (OAT) to ensure Clostridia metabolite levels have returned to normal.

Ask Dr. Eric

During every issue I'll answer a few questions that I think can benefit most people with a thyroid or autoimmune thyroid condition. If you'd like for me to consider your question for a future edition of this newsletter email your question to [email protected].

QUESTION #1: WHEN SHOULD I TAKE DIGESTIVE ENZYMES?

Dr. Eric, when do you recommend taking digestive enzymes?

Thank you for your question! I often recommend digestive enzymes to my thyroid patients as part of their healing process. While I don’t always suggest them immediately after an initial consultation, they are commonly included in my gut support recommendations after reviewing bloodwork and functional medicine test results.

However, I don’t recommend just any digestive enzyme. Since low stomach acid is prevalent among many individuals, I typically suggest a digestive enzyme that contains a small amount of betaine HCl.

While some people may require additional betaine HCl, others may not tolerate even small amounts. Individual responses vary, which is why personalization is key when incorporating digestive support.

Plant-Based vs. Animal-Based Digestive Enzymes

Is it better to take plant-based or animal-based digestive enzymes? Both can be effective, and in the past, I primarily recommended vegetarian-based digestive enzymes. Bromelain (from pineapples) and papain (from papayas) are two of the more well-known plant-based enzymes.

However, the digestive enzyme supplement I currently recommend contains a combination of plant-based enzymes, betaine HCl, and ox bile, making it non-vegetarian.

For individuals who require more comprehensive digestive support, the addition of betaine HCl and ox bile can enhance fat digestion and overall absorption of nutrients.

Do I Take a Digestive Enzyme?

In a previous edition of this newsletter, I mentioned that I take a probiotic supplement regularly for general wellness. However, I do not take a digestive enzyme on an ongoing basis.

While I believe digestive enzymes can be highly beneficial during the healing phase, they are not always necessary for long-term maintenance once gut function has been restored.

Key takeaways:

✅ Digestive enzymes can support gut health while healing but may not be necessary long-term.

✅ Betaine HCl can help those with low stomach acid, but some individuals may not tolerate it.

✅ Both plant-based and animal-based enzymes can be effective, depending on individual needs.

QUESTION #2: INTERMITTENT FASTING AND THYROID HEALTH

Dr. Eric, what are your thoughts on intermittent fasting when dealing with Hashimoto's?

Thank you for your question! While your question was specific to Hashimoto’s, I’ll also address this for those with hyperthyroidism, as both groups often wonder whether intermittent fasting (IF) is safe or beneficial for them.

Over the past few years, intermittent fasting has become increasingly popular. For most individuals with thyroid and autoimmune thyroid conditions, a 12-hour overnight fast is generally well-tolerated. Some people may safely extend this window to 14 or even 16 hours, but not everyone will respond well to longer fasting periods.

Concerns with Intermittent Fasting

Personally, I incorporate intermittent fasting into my routine—typically fasting for 12 to 14 hours between dinner and breakfast, and occasionally following a 16:8 protocol. However, there are a couple of concerns with IF:

1. Inadequate Protein Intake. When following a restricted eating window (especially 8 hours or less), some individuals may struggle to consume enough protein, which is crucial for maintaining muscle mass and supporting immune function.

2. Adrenal Stress. Longer fasting windows can place additional stress on the adrenal glands, especially in individuals with low cortisol levels. While your adrenal function doesn’t need to be “perfect” to begin intermittent fasting, those with significantly depleted cortisol should work on restoring adrenal health before attempting fasts longer than 12 hours.

Intermittent Fasting and Hypothyroidism/Hashimoto’s

Many people with hypothyroidism and Hashimoto’s can safely incorporate intermittent fasting, particularly fasting windows of 12 to 14 hours. However, if you are dealing with hypoglycemia or low cortisol levels, you may want to avoid longer fasts until those issues are addressed.

Intermittent Fasting and Hyperthyroidism / Graves’ Disease

While some individuals with hyperthyroidism gain weight, the majority experience weight loss. When I was diagnosed with Graves' disease, I lost 42 pounds, and I would not have been a good candidate for intermittent fasting at that time.

I also had very low morning cortisol levels, further making longer fasts inadvisable. For individuals with hyperthyroidism who are not underweight and have stable adrenal function, a fasting window of 12 to 14 hours is usually fine, and in some cases even 16 hours is acceptable.

Additional Thyroid-Related Resources

Click Here for How to Reverse Osteopenia and Osteoporosis (episode 124)

Click Here for an interview I did on another podcast related to Hyperthyroidism & Osteoporosis

Click Here for an article I wrote on digestive enzymes

Click Here to see how I reversed Graves’ disease

Click Here to access hundreds of thyroid-related articles and blog posts

Click Here to join the Graves’ disease and Hashimoto’s community

Click Here to purchase one of Dr. Eric’s thyroid-related books

Click Here to work with Dr. Eric and his team

References:

(1) https://pmc.ncbi.nlm.nih.gov/articles/PMC3169869/ 

(2) https://pubmed.ncbi.nlm.nih.gov/36950759/ 

(3) https://pubmed.ncbi.nlm.nih.gov/33842951/ 

(4) https://pubmed.ncbi.nlm.nih.gov/38806467/ 

(5) https://pubmed.ncbi.nlm.nih.gov/33530881/ 

(6) https://pubmed.ncbi.nlm.nih.gov/37705730/

That’s a wrap