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Hormones & Thyroid: Why Lab Work Is Necessary

Coffee With Dr. Stewart. Season 2, Episode 1
Podcast Air Date: August 30, 2015

Listen in as we discuss with Dr. Kendal Stewart hormone differences between men and women, issues that may arise due to poor hormonal regulation, and natural ways to support hormones. Other topics include thyroid issues in women and the importance of lab work for your health.

Kara Stewart-Mullens: Neurobiologix proudly present Season two of Coffee with Dr. Stewart. This show will provide our listeners with up to date medical information from a leading neurotologist and in neuro means specialist. With Dr. Stewart's broad medical knowledge, we will discuss how he helps his patients with issues such as ADHD, migraines, hormones, sleep fatigue, methylation, Autism, genetic mutations, and nutritional protocols. I am your host Kara Stewart-Mullens, and I invite you to sit back, grab your favorite beverage a cup of coffee and let's have Coffee with Dr. Stewart.

Well good afternoon everyone. We are so excited to be starting season two of Coffee with Dr. Stewart. I am your host Kara Stewart Mullens. And of course the man of the half hour Dr. Stewart, Dr. Kendal Stewart. How are you?

Dr. Stewart: I’m doing fine. Kara.

Kara: Again, remember we are brother and sister. He's my older brother, so he gets a little a little sarcastic with me at times. But I think I think it's okay, I can deal with it. I've been dealing with it my whole life. So Dr. Stewart, we did 13 episodes in Season 1. It was awesome. We haven't done a show in eight months.

Dr. Stewart: Wow.

Kara: So fill me in a little bit what you been up to. A lot of people ask that question.

Dr. Stewart: Well, a whole lot actually. We basically have been going through a new project that was very exciting. Basically, make a long story short, back in late 2012 a new genetic project was finished. And that was one where all the researchers, who were gene specialists, decided to put all their data into a single database. And love 1096 of those genes actually turned out to be enzymes that we were very interested in. So basically in the beginning in about 2013 we took the data and I started parsing through it.

Kara: As usual.

Dr. Stewart: And just like a geek biochemist and what happens is we basically have identified between 35 and 40 genes that are very, very important to understanding all the chemistry that we've been talking about.

Kara: And you're talking about if they have a mutation on them, correct.

Dr. Stewart: Yeah, these are called single nucleotide polymorphisms, which are SNIPS for short. And what that means is that there is a wild type which is the normal type of that enzyme. And then we essentially have a group of things where certain differences are found in that enzyme from how they're coded, which can code for either no change in the enzyme function or for significant changes in the enzyme function.

Kara: And we talked about that on Episode 13, the genetic mutation episode of last season. So I know that we're going to get a lot into this. And I know you're going to throw a lot of genetic stuff in as we go. Today, we're going to talk about hormones. But again, I know that has a lot to do with the genetic coding, and if you've got a mutation on this and this. I'm going to give you a real brief recap on Dr. Stewart. He's a neuro means specialist, he's board certified otolaryngology, had a neck surgery. He's an otologist, neurotologist - basically AKA skull-base surgeon. No longer does surgery, he's on a healing path for his patients. So Dr. Stewart I just recapped on season 1, but methylation is something that it's kind of at the core of our show, right?

Dr. Stewart: Right.

Kara: Okay. So give me just a brief recap for the audience, because we will be using this term again and probably every episode. So give us a brief quick overview of what methylation is and why it's important.

Dr. Stewart: So methylation really involves the chemical composition change of any particular chemical.

Kara: In regular people speak.

Dr. Stewart: Correct. So what that means is that we're adding a special chemical group to anything. And that chemical group is called a methyl group, and it stands for one carbon and three hydrogens. And basically what that does is it changes the ability of this molecule, whatever we change whether it's a vitamin, whether it's a neurotransmitter, we change the ability of it to work in different places.

Kara: So basically to get into the body?

Dr. Stewart: Correct. So it's one of the carbon structures that basically allows us to use certain vitamins and different places in the body.

Kara: And you always talk about B12 and folate, because those are like the folic acid that's in our foods and so a lot of supplements. If we have a mutation, a methylation mutation…

Dr. Stewart: Well on the methylation notation there's all kinds of methylation mutations now. And basically we have to take folic acid. And the way the body works is it puts it through a step plus processes, basically several steps, to create the vitamin that we want. Which is the active form of folic acid called 5-methyltetrahydrofolic.

Kara: Okay. And then methyl B12?

Dr. Stewart: And then methyl B12. So we know now that there are actually seven steps that a folic acid has to go through.

Kara: Wow.

Dr. Stewart: And all seven steps create the final end product. So if we have a weakness in any of those steps we don't create as much of the end product.

Kara: And then we become deficient?

Dr. Stewart: Correct.

Kara: Okay. All right. So if everybody got that quick recap of methylation, that is a keyword that we use. The reason why I picked hormones today to talk to Dr. Stewart, he's going to say I'm not officially a hormones specialist. But I know that this is a big part of his practice, because you got to fix the hormones a lot of time to recover the patient. So this was the number one request from our listeners of what they wanted you to talk about. So we're going to start with two things. Okay, we're going to say about boys and men, and we're going to talk about women. But first just tell us what hormones do in general for people. I know it's a big question.

Dr. Stewart: Well hormones essentially are signaling molecules. They basically go from one place and they tell another part of the body to do something. And so there's all types of hormones. You have thyroid. You have steroids of various types. You have transmitting hormones. You have all these different things, but they're basically hormones should this be known as a signaling molecule that goes to a certain place and tells that cell or that structure to do something different.

Kara: Okay. And they're absolutely necessary for health?

Dr. Stewart: Absolutely. All organisms whether you're a plant, whether you're an animal, whether you're a person.

Kara: Oh, interesting.

Dr. Stewart: So hormones really are not just what people think, which is just testosterone and progesterone…

Kara: And estrogen.

Dr. Stewart: That's what everybody talks about and hormone specialist. But what happens is those are all necessary elements to make our bodies function properly.

Kara: Okay. Well then let's start with the men first. Okay. So I've heard you say that there is an epidemic in young men today with like testosterone levels. Okay. So recently a family member of ours, 17, has fallen asleep at the table, was sleeping all the time. We thought oh my gosh he's staying up to like 5:00 am, and he can't stay awake during the day. But we sent him down to you, got this bloodwork, and what did you find that his testosterone levels?

Dr. Stewart: Were just nothing.

Kara: Were nothing in a 17 year old boy?

Dr. Stewart: Correct.

Kara: I find that odd.

Dr. Stewart: Some people would say that he just may be a late bloomer or all that type of stuff. What I'm going to tell you is that in order for you to kind of go through the puberty changes it really doesn't take that much testosterone. Okay. You can actually grow hair in the right places and start to develop. But the long and the short of it is you want to make sure that we have a reasonable amount of the hormone there. So we have these things called normal ranges, which are basically bell curves of the community.

Kara: Okay. That's for bloodwork?

Dr. Stewart: That's for bloodwork. And so we follow this bell curve, which is the 80% with the 10% that are above that the norm, and 10% below the norm, we kind of leave those out as outliers. So basically bloodwork is just a smattering, or a trend, for the entire community. You understand? And so most people who are going to be active and want to do things, you want them at least at the 50th percentile if you can. Now the problem is, what we have noticed as a general trend, is that testosterone insufficiency in men is becoming much, much more common.

Kara: Because I know you see a lot of athletes, professional, non-professional, and a lot of teenagers. And so this is a common thread across the board.

Dr. Stewart: Correct. And we're not really sure why we're seeing this change. I mean I have…

Kara: Yeah, what's your opinion? I think I know what your opinion is, but I like to hear it.

Dr. Stewart: Well what we're learning is that there are lots of chemicals in our environment that have interruptive capabilities. The one that everybody's probably heard of most as BPA.

Kara: In plastic bottles.

Dr. Stewart: Bisphenol A. Bisphenol A is what we call a phthalate. And a phthalate is something that is found in organic molecules like plastics. And basically what happens…

Kara: You mean the hot bottle waters that sit out in a Texas heat?

Dr. Stewart: Exactly. So the problem is, is that plastics are made and stretched by using heat. And then once they get hot again we can release specific chemicals. So lots of people, including myself, believe that we obviously once a bottle gets over 100 degrees in the Texas heat, it will release phthalates into the water. And that's why we have all these different BPA types of plastics out there.

Kara: BPA free, yeah.

Dr. Stewart: That means BPA free, it doesn't mean phthalate free.

Kara: Oh good point there. I did not know that. So what happens if you keep drinking this bottled water with these phthalates that are released or other things.

Dr. Stewart: Phthalates, apparently according to most chemists were actually estrogenizers.

Kara: That leads into my next question then.

Dr. Stewart: Now, we're starting to also notice that there's some interrupters of some sort. And I can't really theorize on those yet, because I really haven't looked at it as closely as I should. But clearly we're having trouble taking cholesterol and making pregnenolone, and pregnenolone to making the progesterone. And that's the pathway along the steroid hormone production.

Kara: OK well I guess that leads then, because this is a common question and a concern by a lot of moms that we talk to you. With the men, and the phthalates, and the BPAs, and then the estrogen dominance that happens in the men, begin – forgive me for my bluntness - but the man boobs. And these are not overweight kids or adults, these are guys that are in good shape but they have man boobs.

Dr. Stewart: I mean, you never know what's going on. The natural chemistry tells us that, especially in northern European man, Eastern European men, we tend to carry a little bit more body fat as a general rule. That does not mean that by any stretch of the imagination we're heavier than other ones. But what we tend to do is, we tend to estrogenize a little bit more. The natural conversion of progesterone to DHEA to testosterone and then onto estrogen is part of the chemical pathway. Believe it or not all women who make estrogen make testosterone and then converted to estrogen, they just convert it very quickly. Whereas men are not supposed to convert so much. So we are seeing men that tend to estrogenize more.

Kara: Does that create that in the chest areas?

Dr. Stewart: Because remember it's always a balance. Remember if you have more estrogen than testosterone, or you have an imbalance to it you're going to have the hormone show some type of side effect.

Kara: Okay. And that side effect, I mean what can you do about it? I mean first of all there's no guessing game, right. You need to get your bloodwork done.

Dr. Stewart: Well you get your blood work done, because the thing is what you got to realize on everything we talk about, and that's something that you're going to run into all kinds of physicians and people who think this is all hogwash. But this is very significant science, it's what we call molecular biology or biochemistry. And basically, if you don't understand it, it does sound like a bunch of hogwash. Okay. But what it really involves is what do we know about how a specific molecule in the body gets formed and about its actions, and how can we manipulate it. Now we do have natural things and also…

Kara: Bioidentical?

Dr. Stewart: Well we have natural things that can block estrogen, so a lot of…

Kara: Like DIM, like what I take DIM.

Dr. Stewart: DIM is very well known to block estrogen conversion. And we also have prescription agents that block estrogen conversion, we use a lot of those and breast cancer and other things like that. But you can clearly interrupt these pathways by different chemical and natural methods. It's just you want to know what you're doing and always want to verify everything

Kara: Okay. Yeah, I mean, all the facts that I read you know on hormones and stuff. I mean everybody, just do not guess you need to go get...

Dr. Stewart: Well you have to.

Kara: Yeah. You can't just put on a testosterone cream because you're tired.

Dr. Stewart: No. Because what you got to understand too is that God makes recipes. And so when you put more of one hormone in, you're going to start using up more of another hormone, such as thyroid, and an anabolic like testosterone, progesterone, estrogen they work together. So if I put more testosterone and I don't have enough thyroid, next thing I know I'll be thyroid deficient.

Kara: I've heard you talk about your professional athletes; they get their testosterone prescription and sometimes they take too much. What is some of the side effects from that?

Dr. Stewart: We have to be careful on pro athletes. I don't want to mess that there.

Kara: Okay, let's just say athletes are men in general. I'm talking about men.

Dr. Stewart: How about ex-athletes?

Kara: Okay, there we go.

Dr. Stewart: So a lot of them just want to have what they had before.

Kara: When they're younger.

Dr. Stewart: Exercise induces steroid production. And so the whole idea is we have to balance everything. So you have to, if you're going to add one thing you've got to make sure that you have the other supporting cast in place. Okay. Which means that if I'm going to have a car this running right I have to have gas, but I also have to have oil and washer fluid and power steering fluid and all this other stuff to make sure it works right.

Kara: Well I know that that 17 year old from our family you put a little sublingual together with like three different things, and it was like a miracle.

Dr. Stewart: Yeah. So we don’t…

Kara: He was a different person in a week.

Dr. Stewart: Yeah. We don't have to put testosterone back in, what we can do now with certain agents like HCG for instance Human Chorionic Gonadotropin. And we can actually tell the testicles to actually make more testosterone. Actually, we're not necessarily synthetically replacing it, we're just giving the body the signal that God is supposed to.

Kara: The natural. All right well we're going to wrap this half, this first portion up, and we will be right back with Coffee with Dr. Stewart.

[Commercial Break]

Kara: All right and we are back with Coffee with Dr. Stewart. I am your host Kara Stewart Mullens. Season two Episode one: Hormones, it sounds so daunting. But Dr. Stewart is trying to help us figured out. I mean myself, I always say this, gosh, I'm just a poster child for every issue that you treat. Ten years ago, when I finally got back in Austin with my brother around, and I'd felt horrible, and I wasn't losing any weight. And he took my words he says you know what? You have the hormones of an 80 year old woman. And I was like well, I feel like an 80 year old woman. So he did his magic nutritionally and natural hormone wise, and I feel pretty darn good, and I got pregnant really quick. So I don't know if that had anything to do with that, but that's another show in itself. But that's my story, and so it is fixable. Dr. Stewart we talked about men in the beginning and that could be a long conversation too. But let's give it to women, because you always think of hormones and usually think of women. Because we're all worried about peri menopausal, menopause, and postmenopausal, and you hear so many things that women are doing naturally, bioidentical. But one of the main concerns is always thyroid. Our family runs deep a thyroid condition. I've been on thyroid medications since I was like 21. Every woman I talk to is on some kind of thyroid medication. So what is going on with thyroid these days or for years?

Dr. Stewart: Clearly, we've known for a long time that women get into thyroid problems probably on the order of 20 times greater than men do. And there's been a lot of theories around that, but basically and then one calls a thyroid problem in women, especially at a younger age, is really what we call Hashimoto's thyroiditis. And that's basically an autoimmune disease where for some reason the immune system decides that the thyroid is some type of foreign structure and decides to attack it.

Kara: So if you have hypo or hyperthyroidism you're going to have Hashimoto's?

Dr. Stewart: No, Hashimoto's a lot of times when the thyroid gets attacked will become hyper for a short period of time, but eventually it will lead to hypo or too low.

Kara: So I've never been diagnosed with that, but would that be something that you would say that I would…

Dr. Stewart: Yeah, you have it.

Kara: Oh, well thank you.

Dr. Stewart: What that means is you've made antibodies that we can find we're called antithyroglobulin antibodies. And other antibodies that basically show us that the thyroid is actually under attack by the immune system.

Kara: And you're saying that most the women out there that have a thyroid… Because I always thought it's hereditary – mom had it, grandma had it.

Dr. Stewart: Hereditary is on the fact that your immune system is overly aggressive.

Kara: Okay and that is hereditary?

Dr. Stewart: Correct. So auto immune diseases tend to run in families. So this type does tends to run in families too.

Kara: So now when people are on like Armour thyroid and all these thyroid prescriptions, I mean is that the right way to go?

Dr. Stewart: Well sure is, because if you don't have enough…. You see, thyroid is really interesting molecule, because what it does is it works with steroids that we've talked about before. And basically, what their purposes to go to a cell and tell the cell to make more energy. So basically they go in and they tell the mitochondria in the nucleus, and this the cell to hey wake up and less work at a nice energetic state. So if we don't have enough being told to the cell and the cell doesn't do what it supposed to. So we want to keep it at a good level in order to keep your cells metabolizing and working well. That's why women who get into low thyroid gain weight. They don't heal very well. They get into all these secondary effects, because the cell is not being told to produce energy and do its thing.

Kara: But you hear a lot of women say that, oh I went to my doctor and said it was fine. But I know I've got dry skin, I'm losing my hair, I'm overweight, this and that.

Dr. Stewart: Here’s the big controversy

Kara: Okay, give it to me.

Dr. Stewart: So we have this normal range, okay, that is a normal range….

Kara: That’s the bloodwork range the labs give us.

Dr. Stewart: That is the normal range over the population. That does not mean it's right for you. I say that it's created for young doctors not to make a mistake. But when you when you really start to treat people, you're treating people. Now there are two factions of people, there are factions of doctors who say you have to stick to the normal range, and if you're in the normal range your normal. But I will tell you clinically that does not work out for most people.

Kara: Well they told me I was in the normal range, and you looked at it and you said no.

Dr. Stewart: Right. Now there's two forms of thyroid there's T4 and that has to be converted to T3, which is 10 times more bio active. And that conversion is actually done by an enzyme called dyanaise.

Kara: And they used to just check one of those, right?

Dr. Stewart: Well there's a whole controversy around it.

Kara: I like to pull this out of you.

Dr. Stewart: I know. So T4 has to be converted T3, many people have trouble converting T4 to T3. Now typical endocrinologists, most of them, and doctors will actually replace with Synthroid which is a prescriptive level.

Kara: For?

Dr. Stewart: For T4. But if you don't convert it to T3, which is called T3 or low T3 syndrome, you really have a very poor activity even though your thyroid looks normal on the T4.

Kara: Yeah because you put me on a combo of a T3 and a T4.

Dr. Stewart: Yeah. Now most endocrinologists do not like that combo. They like synthetics. They'll use things like, oh all pigs are different, and there's no consistency to that medicine, etc., etc. But many, many doctors choose to use these combo formulas because they contain both T4 and T3. Now in prescriptive medicines, we can do the same thing we can put T3 in with cytomel.

Kara: That's what you have me on.

Dr. Stewart: You have two different medications that are doing it, but you have to pay attention to both the T4 level, which is the pool, and the T3 level, which is the more active form. You want a nice combination of both.

Kara: And I think some doctors are, I mean a lot of doctors are, coming around as research is coming out.

Dr. Stewart: Now that conversion, using using dynaise, uses the trace mineral selenium. And so many, many people who have poor T3. if will just put them on a little bit of selenium.

Kara: And that's a mineral.

Dr. Stewart: That's a mental, a trace mineral. And they'll tend to convert it a little bit better.

Kara: So that's like you have to have that mineral to help with thyroid.

Dr. Stewart: Basically there's no one way to do it. Now the bigger issue is, obviously I deal with a population of patients that are skewed, meaning they're sick. And there's another triggering mechanism it's called the TSH or the thyroid stimulating hormone. It's supposed to tell the thyroid to work. So many doctors will just look at that, but they're making a bad assumption that the brain is actually, and the pituitary is actually normal in those people. We found out many of the patients who have methylation deficiencies, who can't make enough dopamine which is what triggers TSH. They're TSH cannot be trusted.

Kara: So when you support the methylation pathway with the right nutraceuticals. then you're also helping the thyroid.

Dr. Stewart: So what... Well, yes, in theory yes. But what I typically tell people is if you're checking the thyroid you need to check TSH, Free T4, free T3. Because you want to know where the whole pathway is, don’t assume that just because one of them looks normal that the pathway is normal.

Kara: Okay, yeah. You always talk about a lot of pathways, because you're going down the glutathione pathway and halfway down it doesn't, something is wrong. And now, is there a mutation for thyroid that you can get on your genetic testing?

Dr. Stewart: There are some specific haplotypes. We call them haplotypes there are specific family groups that have a higher risk of it. So you can see a risk of thyroid, just like mom and you. You have this, you have that haplotype. So there's not one that says yeah, your thyroid is going to be screwed up.

Kara: Okay, I got to.

Dr. Stewart: Now the last thing is, is that some people recently are starting... We've always wondered why do women get it so much more. Some people have long suspected birth control pills as the cause of that. And so there has been some recent studies out on the Mirena IUD and the incidence of Hashimoto's thyroiditis.

Kara: Oh great, that's what I had for five years.

Dr. Stewart: So the answer is, I don't think that research is definitive by any stretch of the imagination. It's been a long speculation, because we see it's so much more in women than men. but I don't think the factions out there. The right answer now is just make sure you check it. And make sure that you have a doctor who also, so if I put more thyroid into you you're going to need more progesterone. You're going to need more pregnenolone. You're going to need more of other things to keep up with the thyroid.

Kara: Well, that leads to my next question. Okay, so you know you fix me 10 years ago. I've been on thyroid medication for a long time. Lately, I haven't been feeling as well. I'm 43, not quite peri menopausal, but recently checked my progesterone levels and it was again very, very low.

Dr. Stewart: Sure.

Kara: You put me on a little compound that I take in the evening. So again, what's going on with progesterone in women? Because it's either estrogen and progesterone that they're always trying to fix.

Dr. Stewart: I didn't put you on it. I had another doctor put you

Kara: Oh, okay. Yeah, you did.

Dr. Stewart: Don’t get me in trouble.

Kara: That was my general practitioner, never mind.

Dr. Stewart: Sorry. I don't treat family.

Kara: Yeah.

Dr. Stewart: Okay. So the whole idea is basically we know that we have to have a nice balance. It's like a recipe. And so if you have a nice recipe, what you do have is you have a specific balance to everything that's in the body. It's just like I tell people, especially husbands, husbands are always wondering why their wives are having to take all this stuff. And I'm like, do you have a favorite recipe that your wife makes. Well, what if she left out a couple of key ingredients, would it taste as good? And the answer is no. So there's no one silver bullet for what you're looking for. There's always a relationship that has to go on. So a lot of times if you put a woman on thyroid, what you're going to have to do as a doctor, is come back in a few months and relook at the other hormones to make sure you haven't created another imbalance.

Kara: Oh, I gotcha, I gotcha. Well that makes a lot of sense. I appreciate… I mean, I had several more questions, but we are running out of time. Young or old you always need bloodwork period with hormones.

Dr. Stewart: You have to, you cannot guess as the one thing that's my genetics and laboratory values. And whether their saliva, or whether their blood, it doesn't really matter you can work off of either one. But you have to have proof of what you're doing, because she got to have objectivity of this or you're going to make a mistake.

Kara: Yep, the main thing I kept saying is not something to play around with. A good doctor needs… You need to seek a solid diagnosis and talk to a doctor who understands it.

Dr. Stewart: Correct.

Kara: All right, everybody. Well, I thank you for joining us, for more videos or product information you can visit And next week we're going to have a special guest, Dr. Emily Gutierrez. She is from Neuro Nutrition, very smart lady from John Hopkins. She's going to talk to us about naturally helping those that are suffering from ADHD, ADHD. So join us next week on Sundays at 5:30. And everybody have a blessed and happy Sunday.



This show is intended for general information and entertainment purposes only. Dr. Stewart serves as the Chief Science Officer and lead formulator neuro biologics and advises you to consult with your own medical professional on any information given during this programming. This information is not intended to diagnose, treat, or cure any disease or medical condition.