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Scott Benner 0:00
Hello friends, and welcome to episode 632 of the Juicebox Podcast.

Welcome back for the fifth installment of the defining thyroid series. Today Jenny Smith and I are going to discuss autoimmune disease. So far in the defining thyroid series, we've tackled hypothyroidism, and Hashimotos thyroiditis. That's an episode 616. In Episode 619, we define pituitary and thyroid glands. In Episode 624, we defined P S H testing, and in Episode 628, we define T four and T three. Again, today we're going to talk about autoimmune and how it impacts your life with thyroid disease. Please remember, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. If you have type one diabetes, or are the caregiver of someone with type one, and are a US resident, please go to T one D exchange.org. Ford slash juicebox. And take the survey

this episode of The Juicebox Podcast is sponsored by Omni pod makers of the Omni pod dash, the Omni pod promise and the upcoming Omni pod five. Learn more about that Omni pod dash and see if you're eligible for a free 30 day trial at Omni pod.com forward slash juicebox. Welcome back, Jenny.

Jennifer Smith, CDE 1:59
Hi, how are you today? Oh, you know how I am? You're always full of energy. So

Scott Benner 2:07
Oh, sure. Sure.

Jennifer Smith, CDE 2:10
I could never tell what happened in the night before. Does he always talk in the morning too, right. So

Scott Benner 2:15
I always do. So I overslept, and was a woken, luckily, by a text from my neighbor wondering if our power was out. It is not by the way, obviously. And then I looked at the clock and realize that it was four minutes before you were going to call.

Unknown Speaker 2:34
And it's time to get up and get going.

Scott Benner 2:36
So I'm just gonna leave it at that and tell you that I may or may not be wearing pants. So today we're going to

Jennifer Smith, CDE 2:45
say good, that's a good thing about you know, stuff like this, or you could have fuzzy

Scott Benner 2:50
slippers, I look perfect. And this these headphones are holding my hair down. So

Jennifer Smith, CDE 2:53
we're all good. Nobody cares.

Scott Benner 2:56
Alright, so we're gonna define, I mean, you know, it goes along with the thyroid terms, but autoimmune disease. I have it here as a disease caused by a defect in the body's immune system. Instead of protecting the body it attacks and destroys a healthy part of the body. Having an autoimmune disease is considered a risk factor for hypothyroidism. Correct? Okay. hypothyroidism, of course, is defined in another episode, but a condition in which the body's immune system mistakes its own healthy tissue as foreign and attacks them. Most autoimmune disease cause inflammation that can affect many parts of the body. Inflammation to the real, is the real bandit in all this, isn't it?

Jennifer Smith, CDE 3:40
For most of the autoimmune diseases, it really is. Yes. I mean, if you look at just the simple ones that are very inflammatory kinds of conditions, it's rheumatoid arthritis and lupus and even, you know, like, the fibromyalgia and all of those types of things, the inflammatory bowel diseases. I mean, it all relates to inflammation.

Scott Benner 4:05
Yeah, I'm gonna, you know, well, I guess the first let's tackle this here, right. So I'll tell you that I think Arden has type one diabetes, because obviously she was born with or developed markers for the first two years of her life. Antibodies, and then she got sick. So for Arden, in my you know, listen, I don't have a crystal ball. I think Arden got coxsackievirus she got coxsackievirus it was this thing that our pediatrician was like, oh, kids get this don't worry, it clears out. This is how long it takes a protracted amount of time passed, which I don't remember how long anymore because I was not a person who tracked the illness back then. And, and then suddenly, Arden had Coxsackie virus again. Hmm. So I took her to the doctor. And I remember him saying this This is weird. I was gonna say that's, that is weird. You're not supposed to get this more than once. It's like chickenpox. I remember saying you get it and you don't get it again. And when I look back now, I wonder if it ever really went away the first time. Like, maybe she got it, and her body just

Jennifer Smith, CDE 5:17
was like, what's what hibernated for a bit and

Scott Benner 5:21
ran her body ran right past the coxsackievirus right into our pancreas is what I'm thinking. And, and so that was kind of how it started. And you know, people who pay attention, you talk to them, they have any number of stories about an illness they had before they were diagnosed with type one or sometimes, right stress, stuff like that. Anyway, you know, in the, in the course of looking into this, if you Google auto immune disease, what is it, you'll get? Here's the top five, here's the top seven, here's the top 10. You know, there are so many lists of things that people like you blew through a couple, one that's more common than then you think once you get involved with people with the type one like I see vitiligo on a lot of Yes. Right? Celiac almost feels like sometimes it goes hand in hand with people with type one. Which one do you think you so you see most frequently?

Jennifer Smith, CDE 6:19
I would say, quite honestly, thyroid and celiac are the primary that I see. In fact, I would say that the majority of kiddos that I work with, or families that I work with, the celiac has already been, like tested at diagnosis. At this point, I'm quite certain that when I was diagnosed, I I would probably guess that when Arden was diagnosed, she probably wasn't tested for celiac. Was she at the same time? Yeah. But those are pretty common. And then it's like a retest, because many markers can actually be higher at a diagnosis where everything is out of order, right? And you've got this high blood sugar level, your body has been kind of attacked, so to speak, and is trying to do, okay. So in terms of celiac, oftentimes, even if there is a positive result, originally, those may, may or may not come back down into what they consider normal. And or they may also do like the biopsy, which is considered the most diagnostic in terms of true positive celiac condition. But thyroid is the other one, definitely. I mean, those three, very much go hand in hand, I would say, you know, along with it, but I don't, I don't see it as frequently is RA or rheumatoid arthritis. So, you know, I think a lot of times too, with rheumatoid arthritis, it takes it takes really digging into the symptoms that you've been having, and finding the right doctor to analyze things, and it helps you figure out what it is, you know, that could be causing some of those, like more telltale signs for RA, because it could certainly be something else to

Scott Benner 8:19
well, you know, I go back and forth on the show, hinting around that Arden has other issues, but I don't talk about them because we haven't figured them out yet. You know, it's years and years of, you know, looking and watching and writing things down and talking to doctors and then to oh, you know what, this all sounds like her thyroid and then we, I mean, Arden's thyroids now managed to with an inch of its life, and it didn't help her for some of the other problems, right. And we just did find a doctor very recently, actually, as I gone to her. So Arden has an endo that manages her thyroid, the woman who's on the thyroid episode, Dr. Benito. And then Dr. BENITO suggested another. Another doctor, which we saw recently actually Arden's getting bloodwork today to check into the things that that this doctor is is wondering about, and it's just important to know that we've gone to the Children's Hospital with these concerns. They do a fairly I don't know what I want to call it, uh, you know, gosh, it was, I'm trying to make a very in depth panel. Well, you would think it would have been in depth, but instead it was like it was blood work. And she they saw her for 20 minutes. They're like, Ah, she doesn't have that. And that was

Jennifer Smith, CDE 9:36
the Oh, yeah, that was the doctor that was not this new doctors do doctors

Scott Benner 9:41
talk we were in there for I think I told Jenny privately, almost three hours to two and a half, three hours in a doctor's appointment, where she was just talking to her and pulling things out that a regular doctor would not and you kind of have to do that because these things so clearly mimic each other all the time. In my heart, it's about the, it's about the inflammation. Yeah, you know, like this, this, the autoimmune diseases and inflammation give you a lot of feedback in your body that's similar. You know, joint pain could be any number of autoimmune, yes. As an example. So I just wanted to bring it up here because I think we've got people's attention on the thyroid thing. I'm getting a ton of nice feedback online, saying thank you for involving thyroid in the in the podcast. We'll definitely do this again. I mean, I imagine we're going to end up doing this with celiac in the future and give giving a little deeper look into that. But you know, I'm looking at a list here, pernicious anemia, alopecia that a Lago type one Graves disease, celiac, rheumatoid arthritis Hashimotos. These are what this one place calls the top 10.

Jennifer Smith, CDE 10:59
Ms. I mean, yeah, you know, I know, there are there is a bigger list than I think, the last time that I looked. So I think things have either been added or they've been clarified a little bit better, which is a good thing. Because sometimes you feel a little bit lost in terms of, well, what's wrong with my body that this is happening? You know, and I think that's the unknown thing about autoimmune disorder is that it really isn't, the trigger isn't really known. Why does one person's body react so well, and not have any problems to whatever this trigger is that then for somebody else, completely gets this ball rolling, of inflammation and immune attack, that's a completely incorrect immune attack on healthy cells that are supposed to be doing what they're, you know, meant to do?

Scott Benner 11:52
Well, what I Google just now, I never would have if I didn't make this podcast, but because of the after dark episodes, I've now been in contact with three and I have one more on the books, people with type one diabetes who want to come on and talk about their bipolar disorder. Ah, I never would have thought of that. But you know, a quick Google search bipolar disorder, autoimmune, just those three words. Bipolar disorder are strongly associated with immune dysfunction. You know, it goes on after that to say replicated. Epidemiologists, epidemiological studies have demonstrated that bipolar has high rates of inflammatory medical comorbidities, including autoimmune disorders, chronic infections, cardiovascular disease, and metabolic disorder.

Jennifer Smith, CDE 12:38
Well, then getting bipolar diagnosed the right way. Again, another whole topic because bipolar one, there's bipolar two, there's from the little that I know about, it's, it's another world of management.

Scott Benner 12:51
Yeah, people can get people can get medic medicated, completely wrong. Wrong, they get close to Okay. And then the doctors accept that as we want. So we can do, I've seen a couple of older adults that have been working with, you know, their bipolar disease for years, almost stand up one day and go, I don't think this is right, and then start over with another doctor, and they completely change their medications around it changes their life. So yeah, yeah, these are just things that I mean, listen, I think I mean,

Jennifer Smith, CDE 13:24
as a as to interrupt, it's kind of a hallmark of a lot of these autoimmune conditions. It's the reason that it's not a cut and dry, open up the textbook, Here's your medicine, take it and everything's going to be great. Autoimmune disorders, they really require individualized management. What works for one person may not be the quote, unquote, cocktail that works for the next person.

Scott Benner 13:53
Well, when I was sick a few years ago, and I had a problem with iron, you know, you know, anemia is on this list, too. And when I was tested, they told me I was celiac sensitive, not they didn't call me they didn't say I had celiac disease. They said, I said, I'm sensitive. You are gluten sensitive, it'll send a little sensitive to some glutens. Right? And, you know, I mean, listen, we've known each other a long time you see me, I'm not a thin or lean person, and I'm not an obese person. But I don't. Let's see how this sounds. My lifestyle doesn't reflect my body. Meaning, right, I don't, I don't eat a ton of food, and my body holds on to weight. And I do wonder sometimes too, if that's even, you know, some sort of inflammation somewhere, maybe I don't know, like, I have no idea but you know, it makes me wonder as I get older, so, you know, if it's all just bad luck, or, or why well

Jennifer Smith, CDE 14:59
I don't think so I think it also speaks somewhat to, I guess what's been hinted at in terms of inflammation, right? A good portion of our immune system lies in our gut, our gut, not like some fancy little gland somewhere like in our digestive system. If we keep our digestive system healthy, that goes a huge way in keeping us immune to our body reacting the incorrect way to something, right. And a lot of study has been done, especially in autoimmune disorder type one and celiac very specifically, in terms of like, the the term has been thrown around so much I hate using it, but like this leaky gut type of potential for somebody who has that type of body that may have the potential to let something sneak through, right, the digestive system, which then causes this reaction in the body, that allows the body to then go the wrong way with how it responds to that, right.

Scott Benner 16:08
Yeah, well, I'm hoping I'm gonna I should, I'm hoping that this. I'm hoping the rheumatologist that aren't seeing now is going to work out. And this is as hopeful as I've ever been after visiting somebody for art and right. Because I'm going to get that person on this podcast too. If this all works out. I'm going to get her because here's how they started with Arden's treatment. It wasn't you know, I mean, there's a blood panel, like, you know, three prescriptions long, like don't get me right there that route. But she looked at her and she's like, Honey, you're a very healthy person, we're going to figure out what's wrong here. And what they started her on was a quality multivitamin. Fish oil, you know, bumping up her vitamin D significantly by giving her oral drops to hold her mouth instead of tablets to take and a couple of probiotics and not like, you know, not like go to the pharmacy and get us a chewable probiotic. Like this stuff smells a little like poo when it comes out of the container here. And it's refrigerated I bet Oh, it's it's something else is what it is. And so, and she's like, for a month, take this cocktail. And then we'll do your blood work in the meantime, and we'll come back and talk again. Right? It's like, but she's like, what makes sense to me is that your gut is unbalanced. And now we were we had we were on to that already. So I've been I've been taking my diabetes brainon appointment at Arden for other reasons for a while. And I'm not a doctor. So it goes a little slow. But we had just gotten Arden about two months ago, a study of her gut, which by the way, comes from pooping in a box. Yes, and sending it away in the mail. Not easy to get a 17 year old girl to do, but we did it, my wife did it, I actually want to give her all the credit. Anyway, at some point, I'm gonna figure this out and then we're gonna add it into this podcast. So for all for today, I appreciate you helping me define autoimmune disease. Of course, if you're tired of injecting your insulin with a pen, or a syringe, or you have a pump with all kinds of crazy tubing attached to it, that you really don't like this next bit is for you.

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if you're wondering what signs and symptoms to look for in hypothyroidism, hyperthyroidism, Graves' disease and Hashimotos I'm going to list them all for you right now. If you already know what they are. Well then thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. But if you're waiting for the signs and symptoms they're gonna happen like right now. symptoms of hypothyroidism Feri the Mayo Clinic list of possible symptoms as fatigue, increased sensitivity to cold constipation, dry skin weight gain, puffy face, hoarseness, muscle weakness, elevated blood cholesterol level, muscle aches, tenderness and stiffness, pain stiffness or swelling in your joints heavier than normal or irregular menstrual periods. thinning hair slow heart rate depression impaired memory enlarged thyroid gland, which could be known as a goiter. If you're looking for this in infants, you might also look for a large protruding tongue difficulty breathing hoarse, crying and umbilical hernia, or yellowing of the skin and whites of the eyes. As the disease progresses and infants You may also notice constipation, poor muscle tone and excessive sleepiness. In teens, you may notice poor growth resulting in short stature, delayed development of permanent teeth, delayed puberty or poor mental development. Let's move on to hyperthyroidism. Still on the Mayo Clinic's website, they say of course, that hyperthyroidism can mimic other health problems. We've been talking about this through all these episodes, you know that unintentional weight loss even when your appetite and food intake stay the same or increase, rapid heartbeat, irregular heartbeat, pounding of your heart, increased appetite, nervousness, anxiety, and irritability. Tremors usually a fine trembling in your hands or fingers, sweating changes in menstrual patterns. increased sensitivity, heat, changes in bowel patterns, especially more frequent bowel movements, and enlarged thyroid gland of course called a goiter, which may appear a swelling at the base of your neck, fatigue, muscle weakness, difficulty sleeping, skin thinning, fine embrittle hair. For Graves disease, you're looking for dry eyes, red or swollen eyes, excessive tearing or discomfort in one or both eyes, light sensitivity, blurred or double vision, inflammation or reduced eye movement, protruding eyeballs. Just quickly Hashimoto Disease, which as we know, is an autoimmune version of hypothyroidism. Hashimotos disease progresses slowly over the years you may not notice signs or symptoms of the disease eventually the decline in thyroid hormone production can result in any the following. There gonna be a lot of duplicates here from hypothyroidism, fatigue and sluggishness, increased sensitivity to cold, increased sleepiness, dry skin, constipation, muscle weakness, muscle aches, tenderness and stiffness, joint pain and stiffness, irregular or excessive menstrual bleeding, depression, problems with memory or concentration, swelling of the thyroid, the goiter of puffy face, brittle nails, hair loss, enlargement of the tongue. I'd like to just finish by saying that if you have any of these, please see a doctor get a simple blood test and get yourself some answers. Don't forget a TSH over two is enough reason to be concerned. Treat your symptoms, not the lab values. Thanks again for listening. I'll be back very soon with another episode of The Juicebox Podcast.