The Thyroid Connection to Pain Guest: Suzy Cohen€¦ · conditions, diabetes, headaches, and drug nutrient depletions. She’s the author of seven different books, including Drug

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The Thyroid Connection to Pain Guest: Suzy Cohen The purpose of this presentation is to convey information. It is not intended to diagnose, treat, or cure your condition. Dr. De Koyer: Hello! And welcome to The Pain Relief Project. Today our guest is Suzy Cohen. Suzy is a functional medicine practitioner, and is a licensed pharmacist for twenty-five years. You’ve seen her on The Dr. Oz Show six times, and has appeared on The View, Good Morning America Health, The Doctors, and hundreds of other television networks. Last year she hosted her own summit, TheThyroidSummit.com, which broadcast worldwide. Her major interests include Lyme disease, thyroid conditions, diabetes, headaches, and drug nutrient depletions. She’s the author of seven different books, including Drug Muggers, and her newest number one bestseller entitled Thyroid Healthy: Lose Weight, Look Beautiful, and Live the Life You Imagined. Suzy is the founder of her own brand of dietary supplements sold at ScriptEssentials.com. She’s also a mom to three wonderful children: Samara, Michael, and Rachel. And she resides in Boulder, Colorado with her husband Sam. You can read her free articles and receive your free newsletter and gifts by visiting her website, SuzyCohen.com. Suzy, you’re a pharmacist for twenty-five years, a bestselling author, mother, wife. How do you find time to do everything? And why focus on the thyroid? Suzy: It’s a lot of caffeine, Noah! No, I’m kidding! First of all, thank you for having me on your wonderful Pain Relief Summit. It’s such an honor to be included. As for how I find time to do everything, when your thyroid hormone is optimized, you have a lot of energy. And that’s kind of where I’m at right now. But it wasn’t always the case.


So several years ago, I realized I had low thyroid. But I didn’t know it at that time. All I knew was that I was fatiguing much sooner. I was carrying a little bit more weight than normal. And it was strange. And I went to my doctor. And he prescribed Zoloft. And I didn’t touch it. I mean, I’m a pharmacist. I’ve been one for twenty-five years. So I know what these antidepressants are capable of. I also knew I wasn’t depressed. That wasn’t part of my clinical picture. And so I did some research and I found out what was going on. And I learned all about the thyroid. And that’s what really propels me is that combined with the fact that my husband had dealt with some thyroid issues and has a very low body temperature. So between the two of us, the word “thyroid” and “thyroid gland” and “hypothyroidism” was constantly coming up. And everything I learned I put into my bestselling book Thyroid Healthy: Lose Weight, Look Beautiful, and Live the Life You Imagine. Dr. De Koyer: Could you tell our audience the difference between hypothyroidism and hyperthyroidism? Suzy: Well, hyperthyroidism is excessive thyroid hormone. And hypo would be low levels. And the clinical manifestation of that is quite different. When you have hyperthyroidism, you’re almost hyperactive. You can think of that word “hyper” as you would hyperactive. Everything is on speed. So, you see, your thyroid gland is like your metabolic gas pedal. So when you have too much thyroid hormone, you’re gong to be anxious and exhibit agitation, maybe more irritability. Everything is faster. You’re thinking faster. Your mind is racing. You’re not sleeping well. Everything’s on overdrive or hyperactive. And it’s quite the contrary with hypothyroidism. That’s low levels. Think of slow thinking, brain fog, can’t burn weight. Everything is slower. You just want to sit on the couch and eat Bon Bons and watch reality shows. I did, anyway, at least for me! Dr. De Koyer: Now, I’ve heard and I realize that lab testing is not that great


for thyroid. So please give our listeners the basics on thyroid disease—and you’ve already touched on it a little bit—so that they can recognize if they have it. And what are some of the major signs and symptoms? Suzy: Sure. If you think of your thyroid gland, think of it as a fat-burning switch. So when you burn fat, it helps you with your weight and metabolism. It helps you with appetite. It also helps keep you warm. So think of your thyroid gland that way. The common major signs and symptoms—there’s so many—but the major ones include chronic fatigue, feeling cold. Sometimes you’re the coldest one in the room, cold hands and feet. Depression could be part of that. Weight gain or a stubborn weight loss. It’s like you eat nothing. You could eat like a bird and you’re still holding on to weight or gaining. That’s a sign that your fat-burning switch, your thyroid gland is asleep. Hair loss. Sometimes it’s the outer edges of the eyebrow or on top of the head. Especially for women, this can be very disconcerting if your hair starts to fall out in clumps in the shower. Anxiety is sometimes part of it. And increased pain sensitivity. It’s like things just hurt, whether it’s a joint or muscles or your head. There’s just an increased perception of pain. Now, you would think with symptoms like that, the disorder would be spotted easily. It’s like the pink elephant in the room. It’s right there. It’s huge. It’s obvious. But the testing sucks! It’s inaccurate. Conventional blood tests don’t pick it up. So diagnosis is made based upon your symptoms. At least it should be. It should be based upon your clinical presentation. What do you look like? And increased pain perception is a very prominent feature of high inflammatory cytokines and thyroid disease. It just goes with it. Dr. De Koyer: So what are the most common pain syndromes that are associated with hypothyroidism? Suzy: Well, it could be anything from head to toe. But primarily what we see is muscle pain. And most often this will go on to get diagnosed as


fibromyalgia. Migraines and tension headaches are common. Nerve pain—and when I say nerve pain, I mean peripheral neuropathy. But it could also be a dysautonomia. It could be a disautonomic. It could even affect the bladder where you get interstitial cystitis. Arthritis is a big one, joint pain. And restless leg syndrome. This is a big one, especially if you have thyroid disease that’s upon you because of a nutrient depletion. For example, you’re taking Drug Mugger. That’s what I call a drug that mugs a nutrient from your body. And let’s say you’re taking a Drug Mugger, such as an acid blocker. And it’s wiping out your stash of selenium and magnesium because that’s what that drug will do. And when you run out of selenium and magnesium, you’re more apt to have these symptoms of more hypothyroidism, as well as restless leg syndrome and cramps and more prone to infections. So if you’re dealing with a drug nutrient depletion or what I call a Drug Mugger from a drug that you’re taking, you could have higher pain syndrome and a higher perception of pain, lower pain threshold, anything you want to call it. You’re going to hurt because you’ve run out of nutrients and your thyroid gland is asleep. Dr. De Koyer: That term “fibromyalgia” is kind of mysterious for people. Could you explain that to the audience and what that is and what kind of symptoms that may present? Suzy: Sure. It’s really not mysterious if you break it down. It’s just painful muscles, right? You go to the doctor and you say, “My muscles hurt. It hurts here. It hurts there. I have these tender points.” And he says, “Oh, well, you have fibromyalgia.” Well, that’s just a technical term of what you just told him. And you have to pay for that. And it’s kind of like a bucket. That is another diagnosis that’s made based on your clinical presentation. You can’t test somebody and say definitively, “You have fibromyalgia.” All it is is a technical name for muscle pain. And muscle pain could be the result of a drug nutrient depletion, what I call a Drug Mugger. It could also be the result of


Lyme disease, very common with Lyme disease where people will get diagnosed with fibromyalgia or chronic fatigue syndrome when it’s really infection based. So that’s just one way. But a person with fibromyalgia, to me, it’s definitely a disease in the sense of I know you’re hurting. I’m not discounting that at all. But to me, it’s more of a symptom. And you have to uncover what is driving that fibromyalgia, that muscle pain. You have to figure out what is causing that. And I know being married to a chiropractor—I’m sure you see this in your practice—that people can show up with very mild cases of fibromyalgia. And you fix them with several adjustments or muscle stim and all the things that go with that. You know? And within a few weeks, they’re feeling better. But the hard cases of people with fibromyalgia, that could be driven by an infection such as borrelia burgdorferi or bartonella or other infections. It could be based upon pro-inflammatory cytokines. Cytokines, by the way, is a big word for inflammation chemicals, things that your body naturally produces to help you with an injury, perhaps. And it’s supposed to be temporary. But these inflammation chemicals don’t go away. They start getting churned out and spit out by metabolic pathways in your system, such as NF kappa-B. It’s like a big, bad bulldog that won’t shut up that’s just clawing at you and frothing at the mouth and churning out all of these different cytokines. And it’s making you hurt, where in a normal person, those cytokines would go away after the temporary injury. So in people with fibromyalgia that’s chronic, you’ll see them. They have high pro-inflammatory cytokines, which can be measured with blood tests. And they’ll also have other kinds of pain syndromes, especially leg cramps and twitching and restless legs. Dr. De Koyer: Suzy, why are we seeing an increase in Lyme disease in your professional opinion?


Suzy: Lyme disease is a very close-at-heart subject for me. I don’t know if this is clear to our audience. But my husband has that. He got it from a tick bite in the nineties from a pet. The pets carry the ticks into the house. And we lovingly spray our pets, right? We don’t want them to get fleas or ticks. So they jump off your pet and they can get on you. And if you don’t see that and get bit, you could catch Lyme disease. That’s just one way. Obviously, you can get Lyme disease many other ways. So he didn’t know that. It’s really hard to talk about, quite honestly. It’s difficult because he has suffered so much. And I have learned so much by watching him. And everything I’ve learned I have shared with people. But they didn’t know that. All they knew was, “Suzy Cohen, she’s so smart. She tells us this. She knows how to help us with that and fix this symptom and that.” I’m like a Jack of all trades. I can talk about every weird symptom from head to toe. But much of that comes from my personal study and our personal struggles and a great love that binds us together even though he suffers pretty much every day with something. He’s pretty much better now, much, much better. But Lyme disease doesn’t go away in most people after you discover it eighteen years later. If you catch it right off, it’s okay. But if you’re going to miss it—and our doctors missed it over and over and over because the testing sucks…This wasn’t his fault or our fault. The testing was very, very bad. And until recently, we didn’t have a way to test for Lyme disease. And so there’s people listening right now that might be wondering if they have it. One of the hallmark symptoms of Lyme disease are symptoms that just move around. One day your head hurts. The next day you’re head’s fine. Your joints hurt. This shoulder hurts. Then that knee hurts. Then it’s the bottom of your foot. Then it’s your hips. Then you’re fine, but your stomach hurts. It’s like things just never go away. It’s like a moving target all the time. And sometimes it changes from hour to hour and minute to minute.


And if you have symptoms that are like that, you need to get tested properly. We recommend IGeneX for testing. We think that while they’re not perfect, they are better than conventional tests for Lyme that one might get through Quest or Lab Corp. They’re not testing all the strains. They’re missing upwards of seventy to ninety percent of people with Lyme disease. And these people that get misdiagnosed go on to be heavily medicated. And they suffer. And it could be a tremendous amount of disability for some people. Dr. De Koyer: Wow. That’s incredibly important information. Thanks for sharing that. I know that is a very sensitive topic for you. I appreciate that greatly. Coming back to the thyroid—and you may have already mentioned this—what are the most common pain syndromes that you see associated with hypothyroidism? Suzy: Well, we talked about these briefly. Neuropathy, arthritis, restless leg syndrome, migraines, tension headaches, muscle pain. I think really what I should talk about is the real connection between chronic pain and thyroid disease, like how is it all connected and what the big secret is. I’ll tell you right now. Chronic pain will significantly cause a reduction in tissue levels of T3 without ever altering your TSH. So if your doctor uses the standard method of thyroid testing, which is basically a test—the TSH, it stands for thyroid stimulating hormone. If they test you for the TSH—and ninety percent of them will—it will appear normal. But your thyroid hormone levels are anything but because chronic pain reduces tissue levels of T3. What I’m saying is that your thyroid hormone is not inside the cell if you have chronic pain. So you’re naturally hypothyroid if you live in chronic pain. But your test will not detect it. Your doctor will not see that. You have to test properly. And I


talk about this in my book Thyroid Healthy. And I mentioned all of the different tests that one can do. I’ll throw out two right now. I would measure free T3 and reverse T3. And that’s what I would do. But that’s a big secret because people who are suffering right now, who are living in chronic intractable pain who are living on medications, which I’ll talk about in a second if you want me to— Dr. De Koyer: Yes, please. Suzy: —and they’re taking all these drugs, Hydrocodone, for example. That’s one very popular analgesic that’s available by prescription. A little bit of thyroid hormone along with that Hydrocodone could go a long way because slam dunk. It’s like one plus one equals happy. So, yeah, that’s the real connection that nobody’s talking about. And I really want to hammer that message home today because people who are listening today, they’re hurting. I know they’re hurting. I wrote a book called Headache Free, by the way, for people with migraines and clusters and tension headaches and Lyme-related headaches. So I study pain syndromes a lot. And I can tell you right now, if you get a painkiller—and a lot of people are lucky enough to get a pain killer. Their doctors will be compassionate and prescribe these drugs for them—they’re not usually going to get the thyroid hormone tests. So the point I really want to anchor here is that people who are taking pain medications really need to ask their doctor to also take some thyroid medication because the two can be very synergistic and can be very, very helpful for any chronic pain syndrome. Dr. De Koyer: So, Suzy, what are some common pain medications? And what are their basic side effects? Suzy: Okay, well, when you say common pain medications, there’s basically two main classes. One are the opiate analgesics. And the others are termed


NSAIDs. It stands for non-steroidal anti-inflammatory drugs. So let’s start with the first one, the opiates. These are popular drugs. They’re by prescription. Hydrocodone, it’s sold under the brand name Lortab or Vicodin. Oxycodone, another one sold under the brand Percocet. Percodan is another one. Morphine, Codeine, Dilaudid, Fentanyl, there’s others. These drugs come in oral capsules and tablets and patches and all sorts of things, even injection. Their basic side effects include constipation—can be very severe, actually—dizziness, drowsiness, nausea, and, of course, physical and psychological dependence. You could have one or both. You see tolerance with these kinds of drugs because over time, they don't work as well. You need more and more. And they’re very highly addictive. Now, the NSAIDs, there’s no risk of addiction with those. Those are known very popularly around the world by generic names, such as Ibuprofen. Everyone’s heard of that. Acetaminophen, overseas we call it Paracetemol. And Naproxen. These are sold over the counter. Sometimes you see higher doses by prescription. Now, these drugs, again, they don’t cause any physical dependence or addiction. But they do have the ability to harm the vascular system and the gastrointestinal tract. You see damage possibly to the liver, more associated with Acetaminophen or Paracetemol. And you see more damage associated to the gut lining with the other two, Ibuprofen and Naproxen. So those are the two basic classes. There’s a lot of drugs. There’s a lot of combinations of these drugs. Sometimes they’re combined. But their basic effect is to reduce pain. And their basic side effect varies. There’s hundreds of different ones. I just highlighted the main ones. So you can see why I’m so passionate about thyroid hormone. A little does of thyroid hormone along with one of these medications could make a huge


difference for someone because it might enable them to either completely get off their medicine—it’s possible—or to reduce the dosage over time. How fantastic would that be?! And a side effect of taking thyroid hormone is that you feel great! And you lose weight. And if you recall at the outset, I said that your thyroid gland is kind of like your fat-burning switch. Flip it on and you’re skinny jeans look better! Dr. De Koyer: That’s great. Now, what are some natural options for pain and some natural thyroid supplements? Because I see you make Thyro-Script. Could your supplement help with pain? Suzy: Okay, there’s several questions in there. So the natural options for pain. There’s so many. You can buy California Poppy in a liquid extract over the counter. That can help some people. I like frankincense. It’s known as boswelia. There’s bromelain, which is a pineapple extract. Malic acid, which is derived from green apples. It can be very helpful for someone with fibromyalgia. In fact, malic acid in combination with magnesium supplements would be superb. And we can’t disregard diet. We all want our cheeseburgers, right? But that’s not going to help with someone who’s in pain because it’s going to throw off a lot of those inflammatory cytokines. So I would say a diet that is a high antioxidants and low in inflammatory compounds, something that won’t set you off. And a lot of people—they don’t like to hear it—but they are sensitive to gluten found in bread, pasta. They’re sensitive to dairy and natural cow’s milk and butter, ice cream. And also soy. These things can be problematic for people. And so can the nightshade family: potatoes and eggplant and peppers. I would say avoid those and eat a diet that is high antioxidants. I’m thinking green leafy vegetables. They give you folate. And natural folate helps with your methylation cycle. That’s very important because methylation helps you detoxify and dump poisons. You want to do that. If your methylation cycle is


disturbed, then you’re not going to be clearing your toxins. You’re not going to be detoxifying. And the garbage backs up in your system. What does that look like? Pain. So we have to be mindful of these things. And those would be my top natural options for pain, as well as proteolytic enzymes. I should have mentioned that. Proteolytic enzymes would be fantastic for anyone in pain. And I have to preface all of that with ask your doctor if it’s right for you because I can’t possibly know what’s right for everybody. We’re just chatting here, having a conversation and trying to educate people. So if our audience has listened and heard anything they want to take, I advise you to ask your practitioners if this is okay for you. As for my Thyro-Script, this is a thyroid support formula. It can help with peripheral conversion of T4 to T3. It contains botanicals and minerals that can support thyroid function. And it also has a digestive enzyme in it called DPP-4, Dipeptidyl peptidase, which helps absorb some gluten and casein from the food that you’re eating. So it kind of helps with the hit that your thyroid gland would normally take. It’s not a pain supplement. It’s a thyroid support supplement. Dr. De Koyer: Excellent. Excellent. Now, you mentioned soy. And I’ve seen and heard and read many places that soy is very detrimental to your thyroid. Do you agree with that? Suzy: Well, it depends on the kind of soy. So things like tofu, I think of that as like a plastic food. Plastic cheeses made of these things like tofu and tempeh. I hope I’m saying that right. Nah, I don’t like that. Soymilk, this is heavily refined and processed. And sometimes it’s GMO. Oftentimes it’s GMO. So I avoid it. But I’m one of these people that feels that someone with thyroid disease should be eating their broccoli and their Brussels sprouts and cauliflower.


And these are goitrogens. They’re not at all related to soy. But it comes up quite frequently when you hear, “What foods should I avoid if I have thyroid disease?” And so you’ll see the soy. And then you’ll see comma and you’ll see the cruciferous vegetables, meaning cauliflower, Brussels sprouts, all these. I’m saying avoid the processed soy and enjoy those other “goitrogenic” foods. You’d honestly have to eat bucketfuls of them every day. I know this is going to be rather controversial. But I’ve got to tell you, those crucifers, they have some strong, strong phyto, antioxidants, and other compounds that are anti-cancer. I never want to take your broccoli away. And in my experience, like I said, you have to eat a bucketful of these things every day to have them impact your thyroid gland. Dr. De Koyer: I couldn’t agree more. So you’re saying several cups of those vegetables a day, several cups a week, just constantly having it in your diet in some way, fashion, or form? Suzy: Yeah, I’d say several times a week is fine. Kale is another one. We didn’t mention that, and Swiss chard. A lot of people love this. They want to sauté it in the pan with garlic and some olive oil and some sea salt. I’m getting hungry. And some roasted beets, which give you betaine, which are wonderful for your methylation cycle. Far be it from me to take that away. I think that’s really healthy for a person, even with thyroid disease. And I’m going to make the assumption right now that everybody with chronic pain has some degree of thyroid problem, whether or not your test uncovers this. And the reason I say that is because you’re being told you’re fine. But they’re measuring the wrong test. They’re looking at your TSH, saying, “Yeah, yeah. You’re fine.” They're looking at your T4. “Yeah, yeah. You’re fine.” Well, none of that really honestly matters. It’s your tissue levels of T3, which we’ve already established to be low if you have chronic pain. Dr. De Koyer: So why is there this underlying problem that the general Lyme tests that we give are not that accurate? The general thyroid tests that we give


are not that accurate? Why do we see this theme reoccurring over and over again? Suzy: Well, with Lyme disease, it’s really hard to test because there’s dozens of species of these organisms. And the testing can only test for a couple of different strains. So it’s not going to catch all the other bugs. There’s so many bugs. There are so many pathogens. And it’s not going to be tested correctly. They’re also using different types of tests—Western Blot, for example. So with thyroid disease, I think the standard of practice is to use the TSH test. It’s not a standard of practice to me. It should be dumped as far as I’m concerned. What do I care? What should you care what a brain hormone is doing? We want to know what the thyroid hormone is doing inside the cell, out of your head. Your brain has its own set of enzyme systems. Your brain’s really never going to starve for thyroid hormone. But the rest of you will. This is why you can be the poster child for thyroid disease and walk around with all these different pain syndromes and get smacked with diagnoses that you don’t really technically have. And a little bit of thyroid hormone would help you. You’ve got to optimize your thyroid hormone. And I talk about this in Thyroid Healthy in chapter four, where I talk about the best labs. And I offer ranges for people. And I can tell you right now that if your free T3 is somewhere between 3.5 to 4.3, that’s pretty good. Total T3 should be somewhere between 140 and 175. Your TPO antibodies—these are reflective of autoimmune disturbance—those should be less than twenty. And your RT3 or reverse T3 should be less than fifteen. I don’t want to get deeply into this. It’s all covered in my book Thyroid Healthy. Also, there’s free articles on my website SuzyCohen.com. You can find all those numbers there. I post this publicly. What I really want to say here is if you’re suffering and you’re hurting, you need to look beyond the Vicodin.


Dr. De Koyer: I couldn’t agree more. I couldn't agree more. So, bottom line, what do you recommend as a pharmacist? Are you saying that people should get off their pain medication or not? Suzy: No. If the pain medication helps you, don’t get off. If you decide you want to get off and it’s a low dose, do so with your doctor’s blessing and supervision because you have to wean slowly. What I’m saying is to consider thyroid medication and all the other adjunct therapies, such as chiropractic. I think that is an absolutely remarkable way to help people. I’m personally a fan of the activator method. However, I know there’s dozens of other methods that are wonderful. Remember, I’m married to a chiropractor. So I’m like a brat when it comes to chiropractic. Dr. De Koyer: Right, right. Suzy: I want a little TLC. “Oh, my back hurts!” [Laughs] Suddenly he’s hugging me and helping me and doing all these things to help me. And he’s wonderful. And I know you are, too. And Reiki is another wonderful modality. Massage, fantastic! If people could get a massage that would go a long way in reducing cortisol, which we haven’t even talked about. But cortisol is kind of like acid on your system. Too much cortisol—meaning too much stress—is going to increase every single pain syndrome. Another thing we didn’t talk about that I discussed fully in my book Diabetes Without Drugs is insulin. Insulin is like one of those pro-inflammatory cytokines. The higher your insulin, the heavier you’re going to be and the more pain you will experience and the more neuropathy. Just FYI, thyroid disease is often the driving factor for diabetes. Shocking. And then while we’re on the topic of diabetes, we may as well touch on statin cholesterol drugs because that’s one of the first line agents used to reduce cholesterol so that a diabetic doesn’t have a heart attack, right? So statin cholesterol drugs like Lipitor, Zocor, Pravachol, Crestor, these drugs are very popular. They’re very good at what they do. They know how to reduce that


cholesterol that’s generated and pumped out of your liver cells. But in doing so, they reduce CoQ-10 and vitamin D. Shocker! You know what happens when you run out of CoQ-10 and vitamin D? Your muscles hurt. Your legs cramp. You get back spasms. You can start to lose your memory and get all kinds of liver abnormalities. It’s a problem. Dr. De Koyer: Another one of your Drug Muggers, I would assume? Suzy: Yes! Statins are Drug Muggers for CoQ-10 and vitamin D. So I’m not saying to stop the drug. What I’m saying is to marry that drug with the right nutrition and the right vitamin. And in this case, it would be CoQ-10 and the activated form Ubiquinol, as well as vitamin D. And if that doesn't help, I would bring in a little creatine. Small doses, maybe 500 milligrams. Not a lot or you’re going to cramp with that. Backlash, right? And drink a lot of water. And, of course, ask your doctor if this is right for you. Dr. De Koyer: That is such incredible, valuable information that so many people may not know that could definitely change their pain levels. Incredible, incredible information. So let’s assume somebody wants to stop their pain medication. Is there a right way and a wrong way to do that? Suzy: Yeah. This is a short answer. The right way is to ask your doctor about stopping it and how to wean off because you can’t suddenly stop some of these drugs, like the opiates because you’ll go into withdrawals and it’s very uncomfortable. And it can be dangerous. So the right way is to make sure your doctor knows what you’re doing and somebody is available to help you. And then you can wean off. And there’s drugs that can help you do that. They use LDN. They actually use Naltrexone to help people like heroin addicts and alcoholics and people who are stuck on


opiate drugs to get off those drugs. But there’s this thing called low dose Naltrexone. Naltrexone that I just mentioned that helps you with addiction, comes in a 50 milligram dose. But there’s this lower dose called low dose Naltrexone, which is only like 1.5 milligrams. It’s like one-fiftieth the strength of typical prescription Naltrexone. And this low dose Naltrexone is great for people with pain because what it does is it sits on your cell’s receptors. And it kind of fakes your body into thinking that you don’t have enough endorphins happening. Endorphins are your happy brain chemicals. They’re the happy neurotransmitters that make you feel good. And they’re associated with chocolate and orgasms and shopping for shoes. You make endorphins! So if you can fake your body into thinking that there’s not enough endorphins around because LDN is sitting on the cell’s receptor, your body is going to crank out more. What a beautiful thing! Now, low dose Naltrexone is a prescription drug. It’s something your physician would have to call into a compounding pharmacy because it’s such a teeny, tiny dose. It’s not the real Naltrexone. That’s a big, big dose used for a whole different thing. But the low dose Naltrexone could help somebody get off their drug and their addictive medicine. And that would be done under the advice of your physician, along with supervision for that. Dr. De Koyer: That’s one of the best explanations I’ve ever heard because I’ve heard many people speak of low dose Naltrexone, including Chris Kresser. And it always has confused me. But people are using that to try to treat or to relieve the pain of autoimmune diseases, as well, correct? Suzy: Yes. It can be remarkable, especially for rheumatoid arthritis and multiple sclerosis and Crohn’s, ulcerative colitis, a lot of studies on that. And I’ve heard Chris Kresser speak. He is so awesome!


Dr. De Koyer: He is. He is. He’s so brilliant. But, like I said, that was such incredible information. It was put in such a simple way and just so, so valuable. If somebody wants to try thyroid medication along with their pain medication, should they just ask their doctor to treat them for thyroid disease? Or should they ask for medication without testing? Suzy: Hmm. Well, I have a little impatient gene somewhere in me. It must be a SNP for that. I would say just ask to be treated with a low dose of either compounded T3 or Cytomel. I think that would be great, or even some Armour Thyroid, maybe Nature-Throid. Those are two brand names of T4/T3 drugs. I would just ask for it because if you ask them to test you, you’re kind of wasting your time. Remember, the tests aren’t going to come up. And you’re going to spend all that money. And they’re going to say, “Nah, your thyroid’s fine.” And you’re going to be like, “No. I heard Suzy explain this. I’ve read her book. I understand.” I would just fast forward to the point where you’re like, “Can we just try this? Can I just try this? Look at these symptoms. They’re really pretty classic of thyroid disease. I am kind of tired. I’m not thinking as clearly as maybe I should. I keep losing my keys and forgetting things. I’m cold. Look at my eyebrows,” etcetera. If you have those symptoms, those are clear signs of thyroid disease, as well as other things. But they’re clear signs of thyroid disease, too. And it’s worth just asking for the medication. Dr. De Koyer: Now, I have a ton of patients that are on Levoxyl and Synthroid. But I’ve also heard about Armour Thyroid before. What are the differences between all of those drugs? Suzy: Well, Synthroid is a pure T4 drug. And T4 is thyroxine. And thyroxine is what your gland pumps out. So Synthroid is a clean, pure, bioidentical match to what your gland makes naturally. It’s kind of cool. We’ll come back to that.


I want to circle back to that in a minute. The Armour Thyroid and Nature-Throid are combinations of T4 and T3, which are two hormones. Now, T3 is what you want. So let’s circle back to Synthroid now. I said it was T4, thyroxine. That’s what your gland makes. People don't realize that that’s an inactive hormone. T4 doesn’t wake you up and make you feel good. But it doesn’t reduce pain and it doesn’t turn on that fat-burning switch. T4 has to be converted into T3 in order for you to feel good and get all of those amazing benefits. So if you could convert the Synthroid or Levoxyl or Levothyroxine, great. You’re going to feel good. It’s going to work out for you. But what if you lack something nutritionally and you can’t carry out that conversion and your enzymes don’t work? Or maybe you’re short on iodine, which most people are. Short on selenium. Short on iron or vitamin D. Maybe your cortisol is high. You have a lot of stress. All of these things will affect your ability to convert T4 to T3, whether you take it as a pill or you pump it out of your own thyroid gland. And this is what I refer to in my book as being “thyroid sick” because I think there’s a distinction that should be made between being thyroid sick and hypothyroid. And I’m making this distinction. And I go on about it in my book because if you’re hypothyroid, that implies that your thyroid gland doesn't work. It is not pumping out that T4 or thyroxine, right? You’re hypothyroid. But what if your gland is fine? What if you’re doing that well? Most people are. But what if at the tissue level that T4 isn’t getting converted to T3 inside the cell? Well, you’re not hypothyroid. Your thyroid gland is working fine. It’s pumping out plenty. There’s nothing wrong there. You’re not hypothyroid. You’re what I call thyroid sick. The clinical term for that is thyroid resistance. But it’s just simpler for people. So at the level of the cell, you could be starving for thyroid hormone and be the poster child for thyroid disease and get all of the adjustments in the world


and take every supplement you can put your hands on and you can afford. And you’re still not going to feel good because at the level of the cell and the tissues, you’re still starving for thyroid, even though your thyroid gland works fine. So most people with chronic pain, like I said, they’re low in thyroid. We’ve been saying hypothyroid. But I’ve been really meaning to say thyroid sick. They don't have enough thyroid hormone inside the cell. If you give them Synthroid or Levoxyl or Levothyroxine, they’re probably not going to convert that. So I would not recommend that personally for someone who has a history of chronic pain. I would just give them T3. I would just give them the T3 in the form of either Cytomel, which is a brand of Liothyronine Or you can have it compounded at compounding pharmacies. The doctor just has to phone it in.Or you can use something like Nature-Throid or Armour Thyroid, which contains both T4 and T3. I hope that makes sense. Dr. De Koyer: Makes a hundred percent. So is Synthroid going to work for someone in chronic pain? Or do they need to get that T3 like you just stated? Suzy: Well, my opinion is that it’s not going to work. But don’t listen to me. You can try it. There’s no harm in trying it. It’s a very good drug. It’s a brand name. It comes in generic. It’s affordable. But, remember, it’s T4. I don’t personally think a person with chronic pain syndrome is going to be able to make that conversion of T4 to T3. I don’t think it’s going to happen. I think what’s going to happen is it’s going to go down the other pathway and form reverse T3 and put you into more hibernation. And you can ask your patients who take this drug and say to them, “I know you’ve been suffering for a long time and dealing with such-and-such syndrome. And I know that you started this Levothyroxine last year,” or whatever, several years ago. “How are you feeling?” And if they say, “Well, they keep having to up my dose and increase it, and they keep having to try this


and other pain drugs and I’m just not feeling as good as I should or I’m not feeling as good as I wanted,” you can say to them, “It’s because your T4 drug is going down the wrong pathway and forming more reverse T3, which is inactive.” It blocks the cells from really getting the free T3, the real thyroid hormone. It just sits on there. It sits on the cell and blocks it from absorbing real thyroid hormone. It puts you into hibernation mode. So at that point, I would say, “Well, then you need to speak to your doctor about switching to another drug that contains T3 or one that is pure T3.” You can also recommend that they have their reverse T3 measured. It’s one of those biomarkers I mentioned. And a healthy level would come in under fifteen nanograms per deciliter, or less than 1/50. You see it expressed different ways. Dr. De Koyer: Brilliant. Brilliant. Now, Suzy, speaking to you, interviewing you, it’s like a fire hose of information. Suzy: [Laughs] Ya think?! Dr. De Koyer: I know! I know. So where can we find out more about you? And speak a little bit about the books. I know you’ve written more than just a few books. So speak on that a little bit. Give the audience a little bit about all the different books you’ve written and different programs and information you have for us out there. Suzy: Sure. Well, that could take a while. So I’ll just give you a brief summary of some resources. So the first place people should go is SuzyCohen.com. And if you sign up for my free newsletter, I promise not to spam you. I will send you gifts like downloadable PDFs of information similar to what you’ve heard today. I have a free gift for people. It is the “5 Reasons You Get Misdiagnosed” as it pertains to thyroid. And my other site, if you are interested in unique, innovative supplements that are based on my functional medicine experience, you can visit my other


website called ScriptEssentials.com. Some of my books include a health handbook from head to toe. That is called The 24-Hour Pharmacist. This is available in paperback and Kindle. Drug Muggers is everybody’s favorite because you can look up what medicine you’re taking and find out why it’s causing your problems. Big secret with women who take birth control pills, those pills are drug muggers for magnesium and zinc and indirectly testosterone. So birth control pills can affect your sex drive. And they can leave you feeling depressed and hypothyroid. So if you’re taking a birth control pill pack and now you need something like Synthroid or Armour, that’s what’s happening. You need to put back or restore those nutrients that your birth control pills are stealing. And then hopefully you can get off those drugs. So that’s Drug Muggers. All of my books are available in various languages. I have Diabetes Without Drugs. That is a classic. It’s used in classrooms for the A4M group, the American Academy of Anti-Aging Medicine. So physicians will sometimes see some of my work taught to them in those classrooms prior to board certification. And Headache Free released last year, in fact, about one year ago today. Headache Free is helpful for people who are struggling with all kinds of headaches: tension, cluster, Lyme-related, migraines, even mystery headaches, those that are associated with lightning and thunderstorms, and those that are associated with sex. You can actually get a headache. And my most recent book is Thyroid Healthy, which we’ve been talking about. I do have other eBooks available, one on pancreatitis and pancreatic cancer. And I have one available on eczema. Of course, I’m all over social media, all of them. Just put my name in and I should pop up. Dr. De Koyer: That’s beautiful. Thank you.


Suzy: Yeah, and I also want to throw out a couple of resources. I like the work of Dr. Ben Lynch. He does work on methylation. And I didn’t want to randomly throw out methylation earlier without throwing a shout out to him because if you’re really interested in whether or not you have that genetic SNP or anything related to methylation—it’s a big buzz word nowadays—visit MTHFR.net. That’s Dr. Ben Lynch. He’s a great guy. And my friend Sean Croxton, he’s got a great podcast that people can listen to for natural health information. And there’s much more. I have links to people and friends all over my website. Dr. De Koyer: Those are two great resources that I’m very, very familiar with. Suzy, thank you again for being part of The Pain Relief Project: Natural Solutions that Actually Work. Everybody, have a great day. And be awesome and never un-awesome!

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The Thyroid Connection to Pain Guest: Suzy Cohen€¦ · conditions, diabetes, headaches, and drug nutrient depletions. She’s the author of seven different books, including Drug