Dr Elena Zinkov is a functional medicine doctor who is an expert in hormones. In this episode of the RecoveryAfterStroke podcast we discuss the link between the brain, the thyroid gland and neurological fatigue as well as what you should know to help recover from fatigue after stroke.
01:04 Dr. Elena Zinkov
03:57 What is Funcional Medicine?
08:48 Is the brain injury causing fatigue or is it something else?
15:08 Knowing when not to rely on lab results.
20:15 Taking time to fully recover.
29:46 Different kind of medical approach.
37:54 How the gut is connected to the brain and body.
50:22 Getting rid of pro inflammatory foods.
56:47 Iodine and Vitamin D
I’m an ex competitive athlete. So for me, I don’t just believe in seeing someone once in their life and then saying, off you go, I believe that there’s a journey. And there are goals that we go after, and that there’s checkpoints right along the way that we need to address. And so even my approach in medicine is that kind of, of an athlete, right and I bring the coach elements into it.
But one of the key questions that I asked my clients is, what is the situation symptom or your state of being? What is it costing you right now? Because sometimes you will say, Oh, I’m just so tired. I’m so tired, I can do anything. And I’m like, tell me, what is it that you can’t do? And I had one patient that broke down on me just a couple of weeks ago. She goes, Oh, my goodness, I’ve been compensating at work so I can be there with my family and then I’ve been compensating with my family so I can be there at work. And she said, and I don’t even know who I am.
This is recovery after stroke with Bill Gasiamis. Helping you go from where you are to where you’d rather be.
Dr. Elena Zinkov
Bill from recoveryafterstroke.com. This is Episode 90 and my guest today is Dr. Elena Zinkov. Dr. Elena is a naturopathic doctor woman’s hormones and health expert and a functional medicine practitioner who support her patients at her clinic in Seattle and via telemedicine nationally in the United States and worldwide. In 2019, Dr. Elena was voted top doctor in naturopathic medicine by the Seattle met.
Just before we get started, you should know that you can now download all the words of any of the recovery after stroke podcast episodes as a PDF. It’s perfect if you prefer to read and take notes or highlight different parts of the interview for future reference. It’s a great way to learn and helps retain new information to memory.
Just go to recoveryafterstroke.com click on the image of the episode you have just listened to and at the very least Beginning of the page, you’ll see a button that says Download transcript. Click the button, enter your email address and the PDF will begin downloading. Also, a few weeks ago, I launched recovery after stroke coaching, the people who have signed up and now being coached by me and are being helped to overcome challenges including fatigue and anxiety amongst other things.
So if you’re a stroke survivor that wants to know how to heal your brain, overcome fatigue and reduce anxiety, recovery after stroke coaching might be for you. If you have fallen in the cracks between hospital and home care and desire to gain momentum in your recovery, but do not know where to start. This is where I can help. I will coach you and help you gain clarity on where you are currently in your recovery journey.
I’ll help you create a picture of where you would like to be your recovery 12 months from now and I will coach you to overcome what’s stopping you from getting to your goal. Want to know more? Just send an email to [email protected] and I will arrange a time to speak with you in person about how recovery after stroke coaching can work for you. And now it’s on the show, Dr. Atlanta. Welcome to the podcast.
Thank you so much for having me. I’m super excited.
Yes, me too. Because I, I always want to get people on who are experts in helping other people heal and recover from things. And that’s really important to get new messages of how to heal and how to recover. And what especially stroke survivors can do to support themselves instead of just relying on the medical world to get them over the line or to help them. So when I came across your Instagram, I became curious about what a functional medicine doctor does. So would you be able to open with telling us a little bit about yourself and what it is that you do as a functional medicine doctor?
What is Funcional Medicine and how it helps with stroke and fatigue.
Yeah, absolutely. Well, Funcional Medicine is kind of a new way of looking at medicine and a new way of looking at how we approach health and how we approach the human body. Because we know that we’re not just a bunch of molecules and atoms and biochemistry, you know, we have things that happen in our personal life and then our life directly affects our physiology.
And so in functional medicine, we really look at the person as a whole we look at not just one system or one symptom, we really look at how those symptoms and systems are working synergistically. And so as a functional medicine provider, for me, personally, I’m a hormone expert. So I look at hormones, I look at the interconnection of different hormones, but I also look at how different systems affect hormone levels.
So somebody could be immunocompromised or somebody could be recovering from stroke, right or maybe someone is going through a dysbiosis of some sorts. And so then I look at well how is that then affecting their every day to day life experience everything from their energy to the relationship to their performance at work.
So as a functional medicine provider, we will look at multiple layers of the human body, how different systems are interconnected. And we also strive to not just go for the symptom, and just prescribe a pill but really see try to approach from a natural perspective and also from a traditional perspective. So really, functional medicine is integrated medicine as I would put it.
Yeah. I’m going to simplify it for myself in that reminds me of a story that I was taught when I was a little kid about the lion with the thorn in its foot. A lot in is usually confident it’s usually able to, you know, command the pride and all sorts of things. And then it has a little thorn in its foot, and it stops the lion from being itself.
The lion then gets looked at differently by the rest of the pride because it’s a limping and it’s in pain, and everything about the lions well being and the way the lion participates in its community gets altered and affected. And it’s similar to how my chiropractor describes, you know, that problem in my toe, which I had, when I discovered that there was a brain injury, like 7 days before I went to the hospital, it was numbness in my toe one toe that was telling me that there was something wrong with my body.
Of course, I ignored it until the numbness, you know, was impacting my entire left side seven days later, but that one little bit of numbness in my toe was telling a much larger story if only I was paying attention. And I never before that would have thought that my toe was connected to my head. And that was the first time I ever realized that this connection such a distance away, the two things are connected. Is that kind of what you’re getting at?
Absolutely, you bring up such a valuable point and I love that story. I’m gonna have to steal it from you. I will share it with also my listeners and viewers and followers because, you know, sometimes one of the most, I would say frequently heard symptoms that I hear about is fatigue, for example, right, people will complain about fatigue and they will sometimes let that fatigue go on for days and months and years.
When in reality that fatigue could be a symptom of a much greater and bigger problem. But to your point into your story, yes, that symptom, right that the numbness in the toe is a sign of something bigger and is connected to something really important like your brain, right? So that’s Yeah, I love that story. And thank you for sharing that.
Yeah, my pleasure. So one of the things I’m trying to do for stroke survivors is paint a bigger picture about what’s wrong with them. It’s not just in your head, it’s the rest of your body. And I had the, and some people will think I’m a bit weird, but I had the benefit of also having a thyroid issue at the same time as my brain issue. Right so.
You just won the lottery on that one?
Is the brain injury causing fatigue or is it something else?
I did, right? And what it gave me was an insight into fatigue is not just caused by brain injury. And I really want to make a point of that say that people listening and learning from these podcasts can go to a place of curiosity about is the fatigue my brain? Or is it something else? Because I asked myself that question, because after brain surgery, my doctor said, technically, you’re healed in that, yes, there’s a process of recovery of your brain.
But two and a half years later, when I was experiencing massive fatigue, and I knew about my thyroid, I had to, I had to be cautious about just continuously blaming, so to speak my brain. So I put a lot of time and effort into working out what it was, and I found an amazing doctor in Australia who was an endocrinologist who said to me, I’m very confident, and it took a long time to get to this guy and to find him.
He said, I’m very confident that the fatigue you’re experiencing, has got to do with your thyroid issue, not your brain and that was such a massive relief because it finally said to me, you’re brain is healing and is on the way to being healed from a you know, from a traumatic experience that it experienced the bleed and then surgery.
And then it was like okay, so what can we do now to support my thyroid, and what I found was the things I was doing to support my brain, also helping support my thyroid, but I needed to dial it in a little bit differently. So you’re gonna, shed some light into the fatigue that’s caused by hormones, or lack of balance in that space.
Right? Well, and I’ll say a few things about that, because we’re talking about kind of functional medicine and approach in functional medicine, and then also fatigue and thyroid and I’ve worked with quite a few people who’ve had brain injury, and I’ve worked with women postpartum who bled severely and that impeded the blood flow to the key glands in the brain, which then caused a lot of hormone disruption and so somebody who’s suffering, the brain injury and a time that there’s a direct impact to the head, for example, due to an accident, or there’s a bleed right? hemorrhaging.
And anytime we deprive the key endocrine glands in the brain, such as the hypothalamus and the pituitary gland, which then send the signal for the thyroid for the adrenal glands for all the other glands to work properly. Then when we don’t have those signal, then we see a hypo function, or like hypothyroid. And of course, that can be to all sorts of other issues. But you know, what can happen is that and this is what my patients are saying is that when they go to a conventional medical provider, is when they complain of things like fatigue.
Most conventional medical providers will say, Well, of course, you’re fatigued, you had a brain injury, right? Give it some time, give it two years, give it five years, you know, if you’re not well by then then maybe we’ll do additional imaging or testing, but your fine or you know, a lot of times for women, it’s like, well, of course you’re perimenopausal, you’re fatigued, it’s normal, you know?
And so everybody looks at these very tight ranges on the labs that saying like, Okay, well, you’re within the range, you’re fine. And what functional medicine does is, it looks like it, you know, medical provider, functional medical prive will say, Okay, let me see here, you had a brain injury, let’s think about the impact that it had on all the internal structures. Let’s think about the impact that just even the stress of going through recovering the stress of going through experience that it had on two very key glands, the thyroid gland and the adrenal gland.
Let’s see, even if you aren’t within the range, is that range appropriate for you? Or do you need to be on the higher end of the range? Right, and how can we support you naturally and how can we support you Maybe with a little bit, of medication, which I’m not opposed to there’s a ton of place for all those things. But what you’re saying is How long it took you to get to the endocrinologist for someone to shed light and say, hey, guess what your fatigue is related to thyroid.
People will wait years and years and will be searching for years and years to finally find a provider who can reassure them that the problem is not only in their head, which a lot of providers will say, Oh, it’s just in your in your head, right. But there’s an actual problem.
Yeah, one of the things that I wasn’t convinced about was what you call labs, what that we call our blood tests. One of them I wasn’t convinced about was that range that they were telling me Yeah, you’re in the normal range. And every time I went and got my blood tested, I was always in the normal range. And somewhere I heard on the podcast, somebody say that those average results of our levels of what’s considered normal, the average results of a sick population because it’s usually sick people that get blood tests, it’s not healthy people that go and get blood tests done.
And therefore, you’re in the normal range of when people are sick. So that was a real eye opener. And to find this other endocrinologist that I was prepared to investigate further into that was a real relief as well, because he was the first person that said, these blood tests do tell a story, but they don’t tell all the story.
Right, exactly. And so one of the things of how can we make this useful for example, for your listeners, right, is that here’s actually I’m going to share something that I do in my practice, and this is actually just even this past week, just from some of the cases and some of the patients that I’ve seen, but for example I I’m work a lot with professional athletes and professional athletes are just naturally are there’s a lot of stress on their bodies and some people are a little bit more resilient, and some people it can take a toll on them. And so again, thyroid and adrenal gland get taxed pretty heavily.
Knowing when not to rely on lab results according to Dr. Elena Zinkov
And one of my patients, you know, her thyroid results, I’ll give an example her 3T3 was 3.3. Beautiful, right in the ranges, we’re talking about it right. But I just was not convinced. I think for her, for example, that was a bit on the low end T3 levels. And so rather than just going straight for the medication, I said, you know, just because I feel like those are your thyroid levels are optimal. I think there’s room for improvements, because we’re taking into consideration not just her labs, but we’ve addressed so many things with her, I’m taking her lifestyle into consideration.
And so we decided to go ahead and try even more of a natural herbal support to give her thyroid a little boost. And you know, what, if that doesn’t really move a needle for her eight to 12 weeks down the road. I’m not afraid to try a little bit of a thyroid medication, you know, just because for me, I’m very goal oriented and very results oriented and so are my patients who want to feel better and who want to perform, but it’s really important to not just look at labs.
And, you know, I’m on this fine line all the time where I believe someone’s labs are optimal, but the person is not feeling optimal. Therefore, I need to bridge that gap between where they are, where they want to be. And sometimes, honestly, labs like you said, they don’t tell the whole story and to go just about the labs is just poor medicine practice, you know, you can train a I joke about this, maybe this is a bad joke. But I just say that, you know, you can train a monkey to look at labs and prescribe, like, if this within this range, prescribe this, if this is within this range, prescribe that.
But really we don’t go into medicine to get a medical degree to just go off of labs. That’s not what you know, that’s not the gift that we’re gifted with. The other thing I was going to say and this is again, to help your listeners is there’s many different ways to test hormones and to test thyroid function. And frequently it’s becoming more mainstream, I would say in media and even just in mainstream media that we don’t just test, let’s say, TSH, or we don’t just test T4, but I also if I feel like the labs are not showing the whole picture, particularly blood tests, then I go for urine testing.
And urine testing is great because we take an active hormone, we pass it through the liver, we pass it through the kidneys, we excrete it. And now we can work backwards to see what the total hormone levels are over 24 hour period trunk right? So not just you go to a lab at eight o’clock in the morning and you test it and you’re like, well, that looks normal. Well, what did the hormones do during the day, right? Because hormones, technically peak in the morning, they decline throughout the day. So whenever I, you know, me personally, my approach is that if labs are showing one thing, the patient’s telling you another look deeper.
Yeah. I love that when I, if we go back a little bit to that time in our conversation when you said, we need to look at the person’s lifestyle nobody ever said to me, how many hours a day are you working? Nobody ever said to me, What time do you go to bed? What time do you wake up? You know, how much time do you give to yourself in the middle of the day in the afternoon. Nobody ever said that.
And it’s really strange because I think, you know, working 16 hours a day is sure to cause stress. And it’s sure to create some kind of dysfunction somewhere and you might not know where that’s happening but if you’re just looking at the blood, you’re so narrow minded in your possibility of supporting that person. There’s not a lot of possibility there. It’s like, let’s try and get the bloods, right? If the Bloods are right, everything’s right, absolutely.
And then a lot of stroke survivors do this strange thing. And I kind of get it because I sort of went down this path. They experienced a stroke, they lose some function, and then they regain it through rehabilitation and many years of recovery. And then they do these amazing feats of endurance, like, run for marathons or, ride a bicycle across a country or something like that.
And the the wiser version of me eight years down the track, reflects on that and says, Would it be a good idea for me to stress out my body to the max Now, just to see if I can do it? What impact is that going to have of my health and well being, and I feel like what it’s going to be doing is just giving those systems that were impacted negatively because of the stroke, more reason to feel overwhelmed and more reason to be struggling and, and not supporting us the way that we need.
Taking time to fully recover
Yeah, yeah, absolutely. You bring up such a great point. And I sometimes give an example of like, you know, when you recover from a really bad flu or cold or, or sickness, and then the second you feel better, you’re like, I’m going to go for a hike and I’m going to go work out, right? Because you get that wave of energy. And I say, well, that’s the worst time to do it. Because then usually people then they’re like, Oh my god, I feel horrible, right? I’m back to kind of where I started.
Because the time that you start feeling better it’s not the time to push it. It’s actually the time to continue and recover. And especially when it comes to something like brain injury and you know, I work with a lot of C suite level executives and Some of them who’ve had brain injury, it’s impossible to, you know, kind of to tell them, you just need to relax.
We need to find painting classes, we need to find pottery like we need to do, we need to channel that energy in other ways, because the tendency for people who have who have struggled who have overcome something and then desire to prove to themselves or to others that now they can do this, can, you know, can really deplete us and can set us backwards many, many years.
And so when it comes to hormones, even because we’re talking about hormones, right, because again, brain injury, hormones, all those things are connected. And stress. So I talked about, since we’re talking about endurance, and the feats of biking and racing, all these things. So stress, there’s good stress, and there’s about stress, but stress is stress. If you laugh for laughter, if you laugh for 12 16 hours. That’s a big stress on your body right? If you laugh for a few seconds if you laugh for an hour with your friends even for a couple of hours, that’s a positive stress.
Exercise if you exercise for an hour let’s say per day or if you I personally like to break out my workouts if you follow me on Instagram I’m like at the gym in the morning and when the gym in the evening I’m doing squats in my office like I like to spread out my workouts throughout the day, because it’s a lot more sustainable for the body and that way you kind of give yourself give your metabolism a little boost throughout the day.
A little sidetrack but if you it when whenever your training and this goes back to you in my professional athletes whenever you’re extensively training 2, 4, 6, 8 hours per day, and maybe you’re one of those people that likes to do things off the couch like I’m going to go climb Rainier, you know in a day and only train for a week. That’s a negative stress, right and if especially if you don’t give your body the right support the right nutrients, the right diet, if you are trying to train and you’re working 16 hours a day, you’re not sleeping a lot, and you’re cutting into that magical sleep time.
So basically, if you’re not supporting your body while you are trying to train and then do the events, and most importantly, if you didn’t recover Well, if you didn’t give yourself the time, the years that it can take sometimes to recover, you’re going to crash, because that’s stress all those seems positive, like I’m going to sign up for an event and I’m going to do this thing. Although they’re positive elements to it over time. It can add up to just being too too negatively impacting and reflecting on your health.
Yeah, it’s interesting, the mind over matter thing you hear people is the body gives up way before the mind does. But there’s a reason for that. Your body’s telling you, you’ve done enough, if you’re going to just override what the body’s telling you and you’re going to use your mind to convince your body to keep going might not be a good outcome.
I don’t and it’s very interesting because, you know, you hear a lot of people even hear a lot of motivational speakers to go past the pain and endure, and you’re bigger than this and you’re stronger than this. And I’m sitting here like with my science brain just kind of thinking about this, like, to a certain point, there are points in your life where changing your perspective about things where, you know, in during, in other aspects of our lives, but when it comes to health, when it comes to training, when it comes to lifestyle when it comes to trying to cut back on our sleep, so we can do more.
That’s where I don’t see that it’s working for us. And you see that starting to work against us and hormones. I frequently talk about threshold. And if you think about kind of a bell curve, and the threshold being kind of that you’re on top of the bell curve, right? You’re doing great, you’re climbing up the bell curve, right? And you’re feeling really awesome.
And then let’s say you decided that you’re going to sign up for an event that your body’s not prepared for. And you fall off that curve, right? It’s harder to get back up on that curve from the opposite end when you’re down and when you’re sick. And so that’s how hormones work. And that’s why it’s important to pay attention kind of looping back to the story about the numb toe is, pay attention to those signs.
Don’t endure the numb toe, don’t endure you know, the thorn in the pod, don’t endure fatigue. Your body’s telling you something, the body actually gives you a lot of yellow and red flags along the way. But if you’re in the mindset of I’m going to endure this, I’m going to get through this. I am smarter than this. You’re going to end up not feeling really good and it’s going to take months and years for you to get back up.
And that’s why I’m a huge proponent of prevention. I’m a huge proponent of doing daily things to support ourselves. And one of the reasons I’m in hormone health is because hormones, they impact all aspects of our health, you get sick, that impacts your hormones, right? You get injured, that impacts your hormones. It impacts your psyche, your mental, physical, emotional well being.
And one of the things that I tell people is that the sooner you address that, the better. But if you decide to wait, let’s say five years to do anything about your thyroid, or your fatigue, or whatever that is, then prepare to that it might take that much time to also get you feeling 100% better, right? And then some.
If you’ve had a stroke, and you’re in recovery, you’ll know what a scary and confusing time it can be. You’re likely to have a lot of questions going through your mind. Like, how long will it take to recover? Will I actually recover? What things should I avoid in case I make matters worse, doctors will explain things, but obviously because you’ve never had a stroke before, you probably don’t know what questions to ask.
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Knowing what I know now and because of all the time and effort I put into learning about my thyroid condition. I know that for a fact my thyroid issues started when I was less than 10 years old. And I know that now because I recognize the symptoms that are in the literature wherever I hear people talk about, you know, people such as yourself, talk about thyroid issues, etc.
And I tell the story about my brain bleed was as a result of an arteriovenous malformation it was something I was born with that bled once twice and then three times, But to get to that point I had to create the perfect storm of things to support bleeding instead of wellness. And that was happening slowly over the years, as a teenager I drank too much I smoke too much as a 20 something I worked too much and had family and that kind of stuff.
And in my 30s I had a massive debt and mortgage and I had to overcome that and find a way. So I created a perfect storm to get to the age of 37 where I became unwell, now I’m 8 years down the track of only just got back to proper fulltime work in my regular place of income, and the cost of what you said getting back up the top of that bell curve has taken 8 years and I’m just starting to climb now and it’s cost me so much money it is not funny its just unbelievable amount of money from not only the money I’ve spent on medical support but also the money that I haven’t been able to earn because I’ve been unwell.
Different kind of medical approach to help with stroke fatigue
Yeah, absolutely. Well, here’s the thing, when I interview my potential clients, because, you know, I also have to make sure that I work with people who I know will be on this journey with me, right? And I’m an ex competitive athlete. So for me, I don’t just believe in seeing someone once in their life and then saying, off you go, I believe that there’s a journey and there are goals that we go after and that there’s checkpoints right along the way that we need to address.
So even my approaching medicine is that kind of an athlete, right? And I bring the coach elements into it. But one of the key questions they asked my clients is, what is the situation symptom or your state of being? What is it costing you right now? Because sometimes you will say, Oh, I’m just so tired. I’m so tired, I can do anything, and I’m like, tell me, what is it that you can’t do?
And I had one patient that broke down on me just a couple of weeks ago, she goes, Oh, my goodness, I’ve been compensating at work so I can be there with my family. And then I’ve been compensating with my family. So it can be their work. And she said, and I don’t even know who I am. Right? And this is what it’s costing you not just like the symptom, right, not just being able to maybe go for a mile run. It’s costing people their values in life, right, how they show up to work, how they show up as bosses, how they show up as spouses, as partners, as mothers, as fathers, that’s a huge cost, right?
And when you’re looking at when you’re 60 70 80 years old, and I have patients coming in who are saying, Look, I don’t want to just live when I’m 90, I want to thrive, right. And I want to thrive along the way, I want to be there. For my children throwing the football, I want to be there for my wife supporting her in her business or, you know, just as the mother of my children, and vice versa.
And so people are starting the language is starting to shift like, you know, sometimes my patient say, I just want to feel more energized for me, it’s important to know, okay, we’ll give you more energy, what are you going to do with it? How is that going to change your quality of life? How’s it going to change the impact that you’re bringing into this world? I call myself a potential junkie.
I’m like, fixed on helping people reach their potential, you know, and so for me, it’s really important to understand, beyond losing weight beyond regaining thyroid function, what is it We’re really going after What’s your goal in life, right? Because we have to understand the core drivers that are in your life. And so But back to your point about even the I think sometimes people don’t realize how much money they’ve already spent on their health along the way, the trickling effects where they could have been better off finding the right person or the right specialist or that program that is proven to give them the results that they want and can save them years and can save relationships and can save the careers and everything else.
Yeah, that’s beautiful. It’s about relationships there at the end. There’s no doubt about it. One of the things that I became motivated about was healing relationships that went really broken. But they weren’t ideal in the way that I would respond to people or behave towards people or think about how they were impacting me.
And that being able to have a chance to heal my relationships made a massive difference in my life after stroke, and then the other thing that you said, which was, what do you want to do with that extra energy? If you’re just gonna get that energy, and then go and run, you know, five marathons in five days? That’s probably not what we want to do.
Yeah, that is, that’s brilliant. Exactly. You know, I think as I just get older and wiser, I just realized how important energy is and where we channel our energy and what we cannot channel our focus. And I think there’s very small percentage of people who can actually off the couch, go train and then run five marathons back to back. Like that’s just takes a very there’s a very small percentage of population.
And I think what happens sometimes is, you know, the herd mentality is that we kind of we see that one person and we all decide that we want to be like Olympic athletes. Like I’m sorry, it just doesn’t work that way. Right? But but you can channel that focus and that energy in other ways. And I think that’s it goes down to understanding. Well, maybe you do want to go run five marathons. But what’s the point of it?
What what’s the why, right? It’s like wasn’t saying like ask five times the why or ask five whys to really get to the bottom of something. It’s like, I want to run five marathons. Why? Right? I want to get more energy. Well, why? And so I think it helps people, not only from like a, not from just even making a mistake, for example, not to say that because I’m all for kind of failing fast and making mistakes, to learn lessons and stuff, but to help better understand our motives behind even being healthy, right, but more importantly, understanding that what we’re not doing today to prove our health is impacting our present and our future.
That’s awesome that’s so true. I want to switch gears a little bit now. One of the challenges that I’ve experienced since about 2016 has been tummy bloating. And all that type of thing. Before my brain surgery in 2014. I was quite slim, not bloated, I wasn’t experiencing gassiness, or any of that kind of stuff. I wasn’t craving any foods or any of that type of thing.
And I went through brain surgery, I really prepared my body and my brain for surgery for a really good outcome. And I got a great result. I was out of rehab a month sooner than they thought I would be. And then I started to go down this path of understanding fatigue and discovering that we needed to deal with a thyroid issue.
And what I had was an enlarged thyroid gland on the right side. And as a result of its size, it was surgically removed. Now, that half that came out was done in around two years after my brain surgery and my belly was never the same after that thyroid surgery, and from then on, it became bloated. It became inflamed, it became irritated, digesting food became an issue.
And just recently, I’ve had, again an opportunity to work with a functional medicine practitioner in Melbourne in Australia who’s going to treat what he for lack of a better term, the bad gut bacteria in the belly and repopulate my belly and my intestines with a good gut bacteria. There’s a there’s a one month program that I’m going to go on, and it also includes a low fodmap diet during that time.
How the gut can help manage stroke fatigue and recovery
Now, that’s the backstory. The question is, with regards to the importance of the gut in healing the brain, how can we, can you explain a little bit how the gut is connected in supporting both the brain and the body and minimizing fatigue and supporting better clarity?
Yeah, absolutely. Yeah, huge topic and a really important topic. In fact, just even this week, I was having conversations with my patients who weren’t responding as well or as quickly as I’d like to our hormone treatments, and then kind of looking deeper realized that there’s possible SIBO or small intestinal bacterial overgrowth happening and whenever there is any sort of gut microbiome imbalance, whether it’s CBOE small intestinal bacterial overgrowth, or there’s something in the colon, so maybe there’s just an imbalance in the microbiome in the colon.
That’s going to prevent proper hormone utilization. So even if you take something internally, whether it’s an herb or supplement, it’s not going to get broken down as efficiently, it’s not going to get as absorbed as efficiently. And frequently, one of the things that people will complain about, especially in regards to, let’s say, brain injury or fatigue, or just general wellness is that I’m doing everything, I’m taking everything, I’m not feeling better.
And then usually My mind goes to two things that it’s either one, there’s something in the gut, that’s preventing the proper utilization or absorption of the hormone, or nutrient or whatever it is that we’re giving the person or its environmental. So especially in a place like Seattle, for example, where there’s a lot of mold growing, there’s a lot of people who are exposed to mold and have higher levels of mold toxicity and so that’s another thing is that sometimes heavy metals and mold and all these other environmental pollutants including plastic byproducts can become endocrine disruptors.
But kind of go back to the gut is absolutely so in your case, when you have part of the thyroid removed because the thyroid, I call it the furnace. And the reason I called the furnace is because it keeps things metabolically more active. So if you think about if you set you know, if you set the thermostat to 80 degrees, things naturally cells, atoms everything starts moving a little bit more rapidly, right, we add more heat so basic chemistry.
If we turn down the furnace, let’s say to 60 degrees, things slow down, right? Or if you’re in Seattle, it’s like 30 degrees and it’s February for March. But anyways, so if you into the thyroid, it keeps things moving, and rather quickly. So when you remove part of the gland in some cases, when people have full thyroid removal, there’s nothing that keeping that’s keeping that metabolism going.
And so one of the classic signs of thyroid dysfunction or hypothyroid is bloating, and also constipation. So those are two very common signs because again, hormones gut connection. If when your thyroid is functioning properly, then the gut is, let’s say, moving more quickly, right? So you’re able to digest food better, you’re able to move the food along with digestive tract faster, and you’re able to eliminate and so a lot of times when people with thyroid issues, they will typically complain of gut disturbance and all sorts of gut issues.
But the other thing there’s a reason why the gut is termed as the second brain and this is kind of where we’re talking about the brain gut connection is that I mean 80% of serotonin is produced in your gut, the happy the feel good hormone neurotransmitter, so only 20% in your brain and so If you do have dysbiosis, or microbiome imbalance when you’re not producing serotonin, then chances are that’s going to contribute to brain fog that’s going to contribute to your inability that’s going to contribute to you wanting more carbohydrates.
Instead of healthy foods, it’s going to make you more trigger happy. And so, you know, the other thing is that if we take a look at kind of a chart of everything that microbiome does, it controls your inflammation, it controls your immunity, and it’s not just that it’s controlling that within the closed gut circuit. It’s, everywhere. It controls inflammation in the whole body and we think about the brain, it can contribute to inflammation or lower levels of inflammation with a healthy gut, in the brain.
Yeah, I love what you said there about inflammation. So one of the key things that I wanted to do and I discovered maybe somebody said it to me when they diagnosed the bleed in my brain maybe they said, as a result of the blood, it’s inflaming the, you know the tissue. In the brain, and as a result of that you’re experiencing the numbness and as it gets larger, more information, more brain cells go quiet and you feel more numbness. I said ok inflammation, inflammation kept coming up inflammation.
So what we’re going to do is we’re going to give you a medication, it’s called dexamethasone, it’s a steroids and it’s going to decrease the inflammation. And I thought, Okay, well awesome. So I started to connect the dots between inflammation and the problem in my head. And the dexamethasone was great in that it supported the brain in the short term not to become too unwell. But it also created some very negative side effects like not being able to sleep at night feeling like things were crawling under my skin, irritability, all these issues, and I put on 8 kilograms which I think in pounds is double that something?
How many? You said eight kilograms? That’s about about 18 pounds.
Yeah. So I put on about 18 pounds in two weeks. And i thought wow okay. I really don’t want to be taking this medication to decrease the inflammation because if it’s doing all this other stuff to me, this is not good. So what can I do to decrease the inflammation in my own brain? And I found that what I could do was influence my inflammation levels by changing some of the foods that I ate.
And when I did that, inflammation everywhere else went away as well, which was massive moment for me it was I couldn’t believe it. And I want to talk about as a result of that, can we talk about food and how food is going to start healing the belly and therefore start supporting the brain and decreasing inflammation in the brain.
Yeah, absolutely. So there’s definitely foods that are more pro inflammatory. And it’s just by the nature of how it’s processed. It’s how food is being treated. And so the common allergens that we see people reacting to is of course, dairy. gluten containing products and gluten grains. Soy is a big one, corn, caffeine, alcohol, processed sugar, and even citrus.
All of those things can be pro inflammatory. And they the other thing is I would add into that mix is the Nightshade family of plants. So tomatoes, bell peppers, white potato, cayenne pepper, so all of those things, those plants have certain constituents in them that are pro inflammatory so it will naturally create more swelling, more irritation in the body. inflammation in the body.
And so naturally when I’m talking to someone about reducing inflammation in the body, those are the key groups that I want to decrease the intake of with dairy and gluten being the top ones and gluten just, it just creates inflammation, from a sense of it can cause gut disturbance like bloating and diarrhea and all those other unpleasant symptoms and dairy can also do the same thing. But dairy can also cause a lot of mucus production in the body and phlegm and can also cause sinus congestion and it just also very pro inflammatory.
And so one of the first things that I do when somebody’s even complaining about the gut and for looking to restore the gut in order to reduce inflammation and positively impact our brain function, is we got to start at the food food is the baseline we got to cut out the processed sugars. We have to cut back on caffeine cut back on the alcohol you know, definitely get rid of that. those foods that can create inflammation, and then see if that makes a difference.
So if that doesn’t make a difference in gut symptoms, like bloating, then I do recommend something like a 30 day cleanse such as what you’re doing, which is where we are using antimicrobial herbals, like warm wood and Oregon grape seed and all of those things in garlic to to basically cleanse the palate in the gut. So get rid of the gut bacteria that doesn’t belong and repopulate with using probiotics, positive gut bacteria and I also like to use binders in my practice binders, like someone’s like fiber or like bentonite clay or inulin things that can bind because I see a lot of providers that whenever they do a gut cleanse, you know, a gut cleanse, you’re killing things, you’re killing bacteria, and whenever you break the cell wall of the bacteria then everything that’s in the bacteria seeps out, right? Those are toxins.
And you want to make sure that you bind them so that you can get rid of them. Because otherwise those toxins can make you feel really, really worse than you already have. But, you know, starting with the food element and seeing you for symptoms improved, sometimes food sensitivity testing can be really important for people to do.
There’s mixed, there’s a lot of mixed reviews. I’m not a huge proponent of food sensitivity, but if somebody’s allergic to, or sensitive to beef, and that’s not like one of the things that My mind goes to or if somebody’s sensitive to asparagus as one of my patients was, you know, and we take those two things out and they feel all of a sudden just so much better than that’s when food sensitivity can be appropriated for those weird foods that you wouldn’t think about removing that the immune system can flag.
So those were kind of thing that’s how I would approach it is you know, so Start out with food, obviously, get rid of the common allergens. And I think sometimes the mistake that people make is that like, Oh, you know, I stopped eating sugar for like a week I didn’t notice a difference or stop eating gluten for a week. And I’m like, you know, you got to give your body some time we live in a culture people want just like results like this.
But it takes a minimum of six weeks to desensitize your immune system, after which at six weeks, you can start to bring in those foods back in to see if you see a response, but very common, I think a lot of times people think that food sensitivity means I will have a gut issue. Yes. The other thing is you can have brain fog. And this is kind of that correlation between gut and brain, right? Sometimes people say, you know, oh, I ate eggs, I feel fine, but I feel really tired after that’s impacting your cognitive function. So again, food Brain gut, all interconnected.
Yeah. The classic comment that you hear from people from all over the world doesn’t matter what background they from, they talk about in their very massive religious events, they have a feast and then they experience food comas.
Getting rid of pro inflammatory foods according to Dr. Elena Zinkov
And then later on in life they have, like me they have a brain injury. And then the food coma happens every single time they eat a meal. And it’s like, they never connect the dots between what I did, for example, what I used to do to myself at Christmas time, I never connected the dots later down the track when early on when I was recovering from stroke, that food was what caused that issue until I did the reduction of consuming those inflammatory foods and I started by removing sugar because I was addicted to sugar.
And I noticed things change dramatically, I noticed that my brain started to get a lot more clarity, I was able to focus better. And then I got curious about decreasing the amount of alcohol was the first thing actually a completely got rid of alcohol, then sugar slowly and then down the track caffeine and then down the track gluten.
And that took it to the next level for me when I got rid of gluten, it took it to the next level. And in my 37 years on the planet before stroke, I had never experienced the focus, the clarity, the impact that I was now having on my body in a positive way. I’d never experienced that before and talk about making better decisions. Talk about becoming more creative and finding better ways to solve problems and talking about finding new ways to connect with people and learn from new people and opening my mind to possibilities that I never would have contemplated before.
And somebody listening that hasn’t been there yet. I think that’s a big stretch. And how did you get there? It’s simple. That fog that was clouding my judgment. People have definitely used that term before. was no longer there. I was I had nothing clouding my judgment. Therefore I became open. And in an open state, I discovered the so many things that I can do this podcast wouldn’t have been possible before the stroke.
No matter what I did to get to this podcast, I wouldn’t have been able to put the time, the energy, the focus, and I never had a why, for why I was doing things and all of a sudden these things just occurred to me and people will say that the often saying this line in the sand the Bill before stroke, and the personality after stroke.
And it wasn’t as a result of a personality influencing, being influenced by damage. It was personality being influenced by a mindset shift. Everything shifted. So there’s a real massive reason why people might get curious about going down this path and approaching recovery from any illness but in my podcast audience from stroke, the functional medicine way I believe.
Absolutely, and whether you are here’s the thing. Whether you’re just addressing gut health head on or thyroid or brain injury, we have to approach it from a total body perspective for my patients who have had a brain injury, we’re working on their diet, we’re working on their lifestyle, we’re working on building healthy relationships, we’re working on their sleep, we’re working on it from all different perspective, we’re not just giving out dexamethasone to decrease inflammation right now dexamethasone may be appropriate for a few days post severe stroke rate just to calm things down a little bit.
But not long term, not something that you just take on a daily basis. And so I think one of the most important things to realize too is that one, the impact that our diet and our lifestyle can have. Number two is that your body will change on you and knew what you were doing five years ago because it because of frequently people say, you know, when I was 30 I was able to get away with all of this and I’m like, great, you’re not 30 anymore.
And you know there’s definitely we have to pay attention to just our own biology as it changes throughout the years and would be stupid to try to approach your body the same way that you were approaching when you were 30. When you’re, you know, when you’re 40, and things like that, and especially if you’re recovering from stroke, yes, maybe back in the day you were able to have beer and wine and it didn’t impact you. But guess what, you were injured. You had a stroke, you’re recovering. It is stupid to not address this from a different perspective.
And honestly, there’s so much more to gain. When you get rid of all the junk in your life. There’s so much more to gain, right. And so sometimes I and I’m seeing actually, younger and younger people. I mean, five years ago, I was seeing mostly women in their 40s in their 50s 60s. I’m seeing 14 year olds with hypothyroidism. I’m seeing 13 year olds with hypothyroidism. I’m seeing women in their mid 20s, early 20s, late 20s. I’m seeing younger and younger people recognizing the importance of addressing these things head on earlier.
I mean, I have 24 year olds that come into my office saying how can I decrease inflammation. And I’m like, wow, we need to start thinking about this earlier because guess what the pace of our life is pretty quick, it’s pretty fast. Whereas before, maybe you could just get away with having one bad night, get away with having a bad weekend or whatever.
You know, nowadays, we really have to be on top of our health, not just so that we feel good But getting back to the why but so you can create the podcast so you can be a better parent but so you can be the professional that you want to be so you can take your company to the next level. And it all starts with really basic principles and things and then when you’re working with a functional medicine provider, and you can really take it up a notch and not just optimize but really, you know, help you break through those plateaus and help you reach your potential.
Iodine and Vitamin D and how it affects the thyroid
Beautiful to wrap up now I just want to touch on iodine and vitamin D or the hormone, the hormone vitamin D which. Tell me a little bit about iodine. So one of the issues that I had when I discovered my amazing endocrinologist was that I had and I know you’ve spoken about the opposite of this point your posts before, but I had switched from iodized salt to Himalayan salt.
And the when I went to my endocrinologist, after all the things that I had been through all the years trying to work out what’s wrong with my thyroid? He asked me the simplest question. He said to me. Has anyone ever checked your iodine levels? And I said, No. And he said, Well, before we do anything, can you please go and get some bloods done and check your iodine levels and it came back with almost zero?
He said, well, that might explain why you absolutely can’t do anything. Ever. And I said to him, Well, okay, so what does that mean? You guys, take an iodine supplement. And let’s see what happens. Try for a week one a day and just see what happens. Sure enough I took an iodine supplement. Everything came back like immediately, like, wow, what just happened, you know. But then I’ve heard you talk about iodine, over consumption about iodine as well, because it’s in table salt. So let’s have a bit of a conversation about iodine.
Yeah. Well, it’s really interesting because iodine is such an important molecule and nutrient because of thyroid health, and so and it’s interesting because things like fluoride can prevent iodine absorption. And now, where’s fluoride? fluoride is in our toothpaste, right? morning, evening. It’s scary.
In Australia, it’s in our water.
It’s in the water, right? And it’s in the water here. And so and then I was, you know, it’s so crazy that I was brushing my son’s teeth the other night and I’m like, does this have fluoride in it, too. Right. And so we’re feeding this to our babies. And then we wonder why there’s all these things that happened down the road. But iodine is just extremely important to thyroid and we know how important thyroid is and things like fluoride can prevent iodine absorption.
But I’m actually seeing, it’s really rare for me to see someone who’s not actively taking iodine to have optimal levels. And typically, in the US, just plain table salt actually won’t have iodine in it, at least here basic salt that you find, it doesn’t have good iodine levels. And so what we’re actually seeing people are becoming more depleted in iodine that compared to iodine overconsumption, and I always before any patient walks through my door, or I see them virtually, I always test their iodine levels because if I’m concerned that there’s a possible thyroid dysfunction and because of how important iodine Is to the building block of T4 and T3 thyroid molecules.
It’s really important for me to address the iodine levels even first before prescribing anything else because that could be the missing piece just like your endocrinologist, smart doctor, right? And suggested that like, why don’t you take iodine because you totally are depleted and see if your symptoms reverse because then your body takes that iodine can make the thyroid hormone.
I believe that lack of iodine for me, cause lack of thyroid function which caused elevated cholesterol levels. Is there a connection there?
Well, again, we’re talking about thyroid because thyroid, you know, lack of iodine can cause thyroid dysfunction or hypothyroidism. And then because your thyroid again it regulates your metabolism, then you’re not gonna be as efficient And metabolizing and breaking down the fat which can cause increased levels of cholesterol.
Yeah, amazing. So let’s, let’s talk about the vitamin D3, which is not a vitamin.
Yes, so vitamin D3. It is a hormone because it’s a signaling molecule. And vitamin D speaking of inflammation is really important and regulating our immune system. And so frequently when we talk about vitamin D because of its impact on the immune system, sometimes when there’s too much inflammation or when the immune system is I would say call it is going haywire.
We need vitamin D3 to kind of calm things down and bring things down and help regulate a better and more efficient immune response. So classically, even in a lot of autoimmune conditions, whether it’s Hashimoto thyroiditis or rheumatoid arthritis or any other autoimmune condition we frequently meet see a deficiency in vitamin D and therefore I really suggest supplementation with that.
And where else, Can we get vitamin D for free,
The sunshine, but I was going to say, unless you’re in Seattle. Go to Australia, right, that’s where the sun is. So, I do have a tip though for people. So sometimes people will apply sunblock and then they will go outside the two areas in your body where vitamin D is best absorbed, it’s on your face and your hands. And so I say go outside, play in the sunshine for 10 minutes and then apply the sunblock because 10 minutes is all you need.
Yeah, lovely. And then you can just wear a hat and you don’t necessarily need to put sunblock on your face.
This has been such a wonderful conversation, fascinating topics that weve spoken about. And if you’re a stroke survivor watching or listening to this, what I would say to you is get curious about One of these things, the one that resonates with you the most, and find somebody to help you out and find somebody to get curious with you, you know, an endocrinologist functional medicine doctor, anyone that you’re speaking to go and see somebody to support you. And if you don’t like the feedback that you’re getting from the doctors that you’re with, seek out somebody else.
That’s right. Absolutely. I would agree with that. Thank you so much for having today. It was such a pleasure. And I always love seeing changemakers like yourself, helping others on their journey to better health because at the end of the day, we’re trying to spread the message of health and well being and help others achieve the quality of life that they deserve.
Yeah, it’s so important. I mean, we can’t there’s no point knowing all this stuff for ourselves and then doing nothing with it. So if you’re watching and you thought this episode was amazing, and it was share it, tell other stroke survivors about it and let them know The work that Dr. Elena does jump onto Instagram at Dr. Elena Zinkov off and follow her. And share it and Dr. Elena, where else can people find you if they want to connect?
Yeah, it’s really easy. You can just go onto my website, proactivehealthnd.com. And there’s a bunch of links there. You can learn more about my hormone potential therapy program, which is where I help people get to the bottom of their hormone imbalances and help create a path toward better health through hormone health. So, but I’m on Instagram all the time trying to share health tips, both you know from a personal professional perspective. And if you have any questions, you can send them through my website or find me on Instagram.
Thanks so much for being on the podcast
Discover how to support your recovery after stroke go to recoveryafterstroke.com