(訪談)自體免疫病，最常見是橋本症(甲狀腺發炎),自然療法,柏格醫生 Dr Berg

Summary

本视频访谈了经验丰富的医生Dr. Dimitri，探讨了自身免疫性疾病的流行情况及其对健康的深远影响。Dr. Dimitri指出，自身免疫疾病已成为美国慢性疾病的主要原因，患者数量超过心血管疾病和癌症患者总和。特别地，他强调了桥本甲状腺炎（Hashimoto's disease）作为最常见的自身免疫性疾病，导致甲状腺功能减退。视频中讨论了该疾病的诊断、潜在原因、症状以及可能的逆转方法，同时强调了营养、代谢功能和微生物组在疾病发展中的作用。

Takeaways

• 📊 自身免疫疾病已成为导致慢性疾病的主要原因，在美国有5000万人患有某种自身免疫疾病，超过心血管疾病和癌症患者人数的总和。
• 🏥 哈希莫托病（Hashimoto's disease）是最常见的自身免疫疾病，是导致甲状腺功能减退（hypothyroidism）的主要原因。
• 👩‍⚕️ Dr. Dimitri 强调，自身免疫疾病不仅仅是器官疾病，更是免疫系统攻击自身组织的慢性炎症性疾病。
• 🔬 哈希莫托病的诊断通常不通过活检，而是通过血液检测甲状腺激素水平（TSH、T3、T4）和超声波检查甲状腺结构。
• ⏳ 自身免疫疾病的治疗可能需要较长时间，甲状腺细胞的再生周期为七年，这使得疾病逆转变得复杂。
• 🛑 哈希莫托病的治疗目标首先是降低自身抗体水平，停止免疫系统对甲状腺的破坏，其次是控制炎症，减少对甲状腺功能的进一步损害。
• 🌡️ 甲状腺功能减退的常见症状包括能量水平下降、体重调节困难、激素失衡、情绪不稳定等。
• 💊 哈希莫托病患者普遍存在维生素D缺乏，以及胰岛素抵抗或代谢功能障碍。
• 🥗 患者还可能存在多种微量营养素的边际缺乏，这些缺乏会影响线粒体功能，降低能量水平和身体效率。
• 🧬 Dr. Dimitri 使用代谢组学测试来评估患者体内的代谢物，以了解营养素的实际利用情况，从而提供个性化的治疗建议。
• 🔗 通过测量代谢物之间的化学转化，可以更准确地评估身体对特定营养素的需求，而不是仅仅依赖血液浓度。

Q & A

为什么自身免疫性疾病比心血管疾病和癌症更为常见？

根据Dr. Demitri的统计数据，在美国，患有自身免疫性疾病的人数约为5000万，这远超过癌症患者（900万）和心血管疾病患者（2200万）的总和。

什么是自身免疫性疾病？

自身免疫性疾病是指免疫系统无法识别自身的组织或器官，将其视为外来物质并进行攻击，导致慢性炎症和器官损伤。

最常见的自身免疫性疾病是什么？

最常见的自身免疫性疾病是桥本甲状腺炎，这是一种自身免疫性甲状腺疾病。

桥本甲状腺炎的主要症状是什么？

桥本甲状腺炎的主要症状包括低能量、体重调节困难、荷尔蒙失衡和情绪不稳定等。

为什么桥本甲状腺炎患者大多数是女性？

大多数桥本甲状腺炎患者是女性，因为女性在一生中经历了许多荷尔蒙变化，如月经、怀孕和更年期，这些变化会导致免疫系统适应性失调。

桥本甲状腺炎是否可逆转？

桥本甲状腺炎在早期阶段可以通过降低自身抗体和控制炎症来停止甲状腺破坏，从而部分逆转病情。然而，对于已经开始服用甲状腺激素药物的患者，完全停止药物治疗的可能性较小。

哪些因素可能引发桥本甲状腺炎？

引发桥本甲状腺炎的因素包括荷尔蒙变化、维生素D缺乏、胰岛素抵抗和微量营养素缺乏等。

如何诊断桥本甲状腺炎？

桥本甲状腺炎的诊断通常通过测量TSH、T3和T4激素水平，以及超声检查甲状腺结构来进行。最终确诊通常需要进行活检。

为什么维生素D缺乏在桥本甲状腺炎患者中如此普遍？

所有桥本甲状腺炎患者都存在维生素D缺乏，这可能与维生素D在免疫系统调节中的关键作用有关。

如何通过营养调整来改善桥本甲状腺炎？

通过补充维生素D、改善胰岛素敏感性和纠正微量营养素缺乏，可以帮助改善桥本甲状腺炎的症状和病情。

Outlines

00:00

🌟 自身免疫疾病：未被察觉的流行病

心血管疾病和癌症分别是排名第一和第二的健康问题，但自身免疫疾病的患病人数超过了这两者的总和。Dr. Demitri 提到自身免疫疾病是慢性病的主要原因，尤其是Hashimoto病，这是一种自身免疫性甲状腺疾病。美国有2600万人患有Hashimoto病，绝大多数是女性。

05:00

🔍 Hashimoto病：不仅仅是甲状腺问题

Hashimoto病是导致甲状腺功能低下的主要原因，但它其实是免疫系统的问题。免疫系统攻击甲状腺，导致慢性炎症和器官破坏。治疗的目标是减少免疫系统的攻击，阻止炎症，改善甲状腺功能。

10:04

💡 Hashimoto病的症状和原因

低能量、体重调节困难和情绪不稳定是Hashimoto病的常见症状。女性患者由于激素周期的变化更易患病。患者常缺乏维生素D、胰岛素抵抗和多种微量营养素不足，这些因素共同导致线粒体功能障碍和能量水平下降。

15:05

📉 线粒体功能障碍与营养缺乏

线粒体是细胞的能量工厂，营养缺乏会导致其功能障碍。Hashimoto病患者通常存在多种微量营养素不足，如锌、镁和Omega-3等。这些不足导致线粒体效率下降，进而影响甲状腺的正常功能。

20:08

🔬 代谢组学测试：个性化诊断新方法

Dr. Demitri 采用代谢组学测试，通过测量代谢物的水平来评估患者的营养状态。这种测试能够检测出血液中未反映的营养需求，提供更全面和个性化的健康评估。

Keywords

💡自身免疫疾病

自身免疫疾病是指人体免疫系统错误地攻击自身组织或器官的疾病。这类疾病是视频讨论的主要主题之一，其中提到自身免疫疾病是慢性疾病的主要原因，并且比心血管疾病和癌症的患病人数总和还要多。

💡Hashimoto病

Hashimoto病，也称为桥本甲状腺炎，是一种常见的自身免疫性甲状腺疾病。视频中提到它是自身免疫疾病中最常见的类型，导致甲状腺功能减退，即甲减症。

💡甲状腺功能减退

甲状腺功能减退，或称甲减症，是指甲状腺激素水平低于正常水平，导致新陈代谢减缓。视频中提到，大多数甲减症是由Hashimoto病引起的。

💡慢性炎症

慢性炎症是指身体某部位长期存在的炎症状态。在视频中，慢性炎症是由自身免疫疾病引起的，特别是当免疫系统攻击甲状腺时，导致Hashimoto病。

💡自身抗体

自身抗体是免疫系统产生的针对自身组织的抗体。视频中提到，自身抗体攻击甲状腺细胞，是Hashimoto病和其他自身免疫疾病发展的关键因素。

💡维生素D缺乏

维生素D缺乏是指体内维生素D水平低于正常需求。视频中指出，几乎所有Hashimoto病患者都存在维生素D缺乏，这与自身免疫疾病的发生有关。

💡胰岛素抵抗

胰岛素抵抗是指身体细胞对胰岛素的反应减弱，导致血糖调节异常。视频中提到，大多数Hashimoto病患者存在胰岛素抵抗问题。

💡微量营养素缺乏

微量营养素缺乏指的是身体缺乏必需的微量元素或维生素，虽然不是完全缺乏，但足以影响健康。视频中提到，Hashimoto病患者常常存在多种微量营养素的轻微缺乏。

💡线粒体功能障碍

线粒体功能障碍是指细胞内线粒体的功能受损，影响能量产生。视频中强调，多种微量营养素缺乏最终会导致线粒体功能障碍，是Hashimoto病发展的一个重要因素。

💡代谢组学

代谢组学是研究生物体内所有代谢物的学科，通过分析代谢物来了解生物体的健康状况。视频中提到，通过代谢组学检测可以更深入地了解Hashimoto病患者的代谢状态。

💡个性化治疗

个性化治疗是根据患者的具体情况来定制治疗方案。视频中提到，通过代谢组学检测，医生可以为Hashimoto病患者提供更加个性化的治疗建议。

Highlights

心血管病是排名第一的健康问题，癌症第二，但自身免疫疾病比两者加起来还要多。

自身免疫疾病是慢性疾病的首要原因，在美国约有5000万人受到影响。

最常见的自身免疫疾病是桥本病，这是一种甲状腺的自身免疫疾病。

大多数甲状腺功能减退症是由桥本病引起的。

桥本甲状腺炎是一种自身免疫性疾病，由免疫系统攻击甲状腺。

在美国，大约有2600万人患有桥本甲状腺炎，其中90%是女性。

甲状腺功能减退症的治疗不仅是补充甲状腺激素，还应关注免疫系统的异常。

甲状腺自身抗体的产生是免疫系统攻击甲状腺细胞的标志。

桥本病的诊断通常不通过活检，而是通过血液测试和超声波等方法。

桥本病的治疗目标是降低自身抗体水平，停止免疫系统对甲状腺的破坏。

甲状腺细胞的再生非常缓慢，需要七年时间。

甲状腺激素几乎影响身体的每一个细胞，直接作用于新陈代谢。

桥本病患者常见的症状包括能量低下、体重调节困难、激素失衡等。

桥本病患者100%存在维生素D缺乏，以及超过90%存在胰岛素抵抗问题。

患者常存在多种微量元素的边际缺乏，这些缺乏会干扰线粒体功能。

线粒体功能障碍是导致桥本病发展的基本问题之一。

医生使用代谢组学测试来检测身体内小分子代谢物的变化，以评估营养状态。

代谢组学测试提供了一种个性化的评估方法，与传统的营养素血液测试不同。

Transcripts

you know what's really fascinating about

the statistics on what type of health

conditions people get like

cardiovascular is number one cancer is

number two but there's some fascinating

information to show that there's another

epidemic condition that's even higher

than both of those combined and that is

autoimmune diseases and so today I

brought in a very competent doctor Dr

Demitri to discuss this this topic

because he has a lot of experience in

there so welcome Dr

Dimitri hello Eric hello Dr bur how are

you I I appreciate you taking the time I

I interviewed you before because you're

actually my doctor so I wanted to tap

into your knowledge base but you you

even mentioned this and this is like

mind-blowing there's so many people that

have autoimmune diseases nowadays um I

mean it's like it dorfs some of these

other conditions which is crazy but what

I want to uh ask you is out of all of

the autoimmune conditions that people

are getting what is at the top of the

list the number one

condition okay let me give a picture can

I show a picture of some stats that

could help uh um okay uh autoimmune

disease is the number one cause of

chronic disease and now I'm going to

refer a few statistics about us

population so while in US there are 9

million people suffering from cancer and

22 from cardiovascular disease there are

50 million probably more people

suffering from a type of autoimmune

diseases autoimmune diseases are

conditions where the immune system does

not recognize its tissues or organs

ourselves so it attacks them considers

them as being estrous uh U particles or

tissues and attacks them this creates a

chronic inflammation and gradually uh

leads to the destruction of the organ

interested now from all these diseases

the number one the most common one is

Hashimoto disease which is an

autoimmune thyroid autoimmune condition

yeah this is interesting because um you

know if you take a look at

hypothyroidism which you know you know

you just assume that the thyroid is not

working that well it's a thyroid problem

but isn't the majority of

hypothyroidism

hashimotos yes the great majority it's

the number one cause of hypothroidism is

Hashimoto's disease so in reality um

would you say that um this Hashimoto is

not necessarily a thyroid disease it's

more of an immune disease would I just

clarify that with me of course Hashimoto

thyroiditis is a autoimmune Condition

it's a chronic inflammatory condition of

the thyroid that is caused from the

immune system itself the immune system

attacks the thyroid gland and gradually

destroy it when the destruction of the

gland is above a certain percentage and

influences the function of the organ

itself we go into hypothroidism a lower

function of the thyroid gland at this

moment in us it's calculated that 26

million

of the population are suffering from

Hashimoto thyroiditis if you consider

that nine out of 10 of these patients

are

women it's a it's a huge part of the

women

population uh that is suffering from

this disease and it's pretty wild that

you you you know I know when I was in

practice people would come in with um

hypothyroidism and they would just think

oh I have low thyroid hormones so I just

need to take my thyroid hormones and

it's going to correct the problem but

this is a little

different this is a little bit

different the the problem here is that

since the thyroid gland is not

recognized from the immune system it uh

produces antibodies it they are called

Auto antibodies which attack the thyroid

gland and then these antibodies um get

attached to thyroid cells and then uh

cells of the immune system are guided

towards these antibodies and destroy the

gland itself so we have a chronic

inflammation of the thyroid but in order

to arrive at that point where the body

produces these antibodies and

distruction and chronic inflammation of

the gland there must be some prior

metabolic um dysfunctions and

deficiencies that brought to that

so uh it's a small this diagnosis it's a

small uh part of the whole problem the

whole

picture so basically there's a Cascade

of things and this is usually late on

the chain of events te tell me some of

the um potential triggers or

causes that precede this condition yes

um first of all while we said that there

are 26 million uh people with hashimotos

and nine out of 10 of these uh people

are women nine of

10 that are diagnosed with Hashimoto

thyroids are women this is caused mainly

because women have a lot of hormonal

adaptations and changes during their

lifetime they start having menstruation

they have mensturation every month they

get pregnant they stop menstruating and

so on and all these change in and out

and changes in the balance to

Progesterone and estrogen um create

adaptations of the immune system and the

theid has to adapt also and these

changes when there are uh the body is

not in an optimal condition guide to

dysfunction of the immune system and the

inflammation that causes the the disease

wow so 18% of the US population us

adults uh which is more than 60

million are have is calculated that they

have Auto antibodies against the

thyroid the Hashimoto is not one the AO

anti against the disease uh are one part

of the diagnosis in order to make the

diagnosis of Hashimoto thyroid it is the

actual is with

biopsy but usually we don't make biopsy

to everyone uh so we measure the TSA

which is a hormone secrete to regulate

pyoid function we measure the thyroid

hormones like T3 and T4 we also see

through

ultrasound uh test the form the the

structure of the theid and all these

data U contribute to make a

diagnosis but let's say that the final

diagnosis the is Hashim modus is a

biopsy diagnos noes about through about

so okay so then um now you you have a

you know a very large clinic in both

Rome and also Greece so what what are

you seeing

um as far as the common things to be

able to reverse this and first of all is

it reversible and then what what are you

finding that you have to change to make

things

better okay yes uh this is a very often

question we have if this is reversible

from patients also there are various

points we can intervene and this um uh

in relation to

reversibility uh when we ask about

reversibility we mean we stop the

destruction of the thyroid we mean the

inversion of the damage of the thyroid

or we mean stopping taking medications

because all this are different points

where the disease has arrived and uh uh

if we answer the first question uh so

stopping the immune system destroying

the thyroid gland and lowering the auto

adding bodies this is uh almost in 90%

of cases we can do that it it'ss um

usually in in six to months to a year

this is something that can um can occure

uh reversing the destruction of the thid

is probably the most important uh for me

and for the patients because uh we

Salvage the thyroid which is uh it's

vital for the quality of life and the

health of the patients and then uh

reversing also the

inflammation of the gland also this is

possible if it's in the um starting

stages of the disease but if the person

has started uh taking an um medication

and T4 usually uh to supplement the

thyroid with hormones uh this is not uh

in most of case this we cannot do uh

cannot reverse and stop taking the

medication because thyroid gland is a is

a gland that is very slow in

regenerating uh each tissue in our body

has a different time of uh regeneration

for example our blood cells regenerate

in a few months three four months uh the

skin cells in a few days and so on but

the theid cells regenerate

uh in they have a time of regeneration

of seven years so it's a very slow

process we had some cases that we follow

them for many years and it happens that

they had they managed to stop taking the

medication but it's not something we can

say for every case or this is going to

happen so reversing the disease means uh

initially the most the first Target

should be to lower the out antibodies so

this means that that the body stops

destroying the gland uh it means also

managing and stopping the inflammation

at the level of thyroid so the cells

that have remained uh they can function

in the best possible ways so this can

bring gradually to a diminishing of the

dose of the supplementation of the

hormone uh through a medication but

stopping complet completely the

medication once this uh the treatment

has started it's not something that we

can see that can it's possible for

everybody and as far as um you know we

know the thyroid hormones go into almost

every actually probably every single

cell in the body so they can they

directly affect the metabolism and so

many different things um what are some

of the common symptoms that someone gets

with a hypothyroid hashimotos type

condition the first symptom that

manifest is um and it's one of the Prime

symptom it's low

energy so the person doesn't have the

energy it used to have uh in Prior years

usually the people often think that this

is due to because they get older which

is not true uh it's a mitochondrial

dysfunction the the energy of the body

is lower um and I need to clarify this

point that the thyroid is a gland is a

it's a hormone that actually regulates

metabolism regulates the rate of

metabolism so our body doesn't function

uh in the same condition uh actually

these conditions change

continuously we are in a in indoors and

it's hot we go outside and it's cold we

can be angry we can be relaxed we can

eat we can

uh do physical exercise all these

conditions

uh need a different metabolic rate so

our body has to adapt to the needs of

energy and this the major adaptation

mechanism of the of this

um uh metabolic rates that change is

regulated through the thyroid gland so

thyroid increases the rate of metabolism

of decreases based on the needs when we

sleep we need lower energy and makes

that possible for the body to have the

Optimum output of energy so when the

thyroid

dysfunctions uh this means that our body

cannot adapt and this when we we speak

about adapting means about the function

of every organ almost every cell in the

body is influenced by the thyroid

hormones so by losing this ability to

adapt and uh respond to Chang in the

environment influences our uh health and

the function of the body as a a whole

one of the first things so that people

note is the lower of the energy levels

because the body cannot adapt to that

then uh the second is difficulty in

modulating regulating the body weight

people that usually have problems with

weight problems increased weight

sometimes even um they cannot get uh

increase their weight uh because have a

higher metabolic rate than needed uh

from the dysfunction of the thyroid but

the most common thing is that people

cannot adapt cannot uh regulate their

body weight they are overweight they

have more weight than they should

because the metabolic rate is low uh and

the body stores fat instead of being

able to to burn it and use it as energy

uh one one other thing is hormonal

hormonal imbalances so in women that

also most of the patients that suffer

from the disease are women we have uh

disregulated uh hormonal Cycles we have

um pain we have inflammation we have

infertility so many problems uh

migraines correlated uh with the

hormonal cycle and hormonal

imbalances another simp symptom which

also influen a lot the quality of life

of these patients is emotional

instability uh this people hasmot can

experience uh within the same day um a

lot of changes at emotional level they

can be tense they can be exhausted they

can be angry they can cry they have so

many Chang they often refer that they

are overwhelmed from thoughts that come

that they cannot control

and uh often they try to handle that

with uh meditation or other

means believing that this are due to

mental causes but the think it's a

hormonal and metabolic imbalance that

when this is corrected all these uh

problems uh uh get improve a lot if not

handled uh completely that's fantastic

what what are um as far as things that

you found are there multiple different

uh things that you're

finding that are like certain patients

are missing in their nutrition or things

or or have you found like there's like

only one thing that always causes this

problem or is it multiple

things actually there are uh some

metabolic dysfunction that are common to

most of the patients with hash Moto

with some

variations uh as in regard to deficiency

everybody I have not find the PA with

Hashimoto have vitamin D

deficiency so this is have vitamin D

deficiencies yes they they every

patients at the moment they are

diagnosed with hashimotos thyroiditis

they have vitamin D deficiency this is

100% or not close it's 100% we have made

the statistics we have announced the

results and it's 100% of patient with

Hashimoto have um vitamin D

defici then one common uh problem uh

also goes hand in hand with hash Moto is

insulin resistance uh also in this case

everybody with hash Moto or more than

90% in this case they are insulin

resistance or have insulin metabolic

dysfunction insulin their cells do not

respond uh to insulin signal they are

they have lost to degree the sensitivity

uh to

insulin uh another very vital problem is

micro multiple marginal micronutrient

deficiencies so these marginal

deficiencies along

with um insulin resistance also

disbiosis alteration of the

microbiome um they end to disrup

mitochondrial function so just to

clarify the marginal you're talking

about there's a um I guess subclinical

or slight deficiency of micronutrients

like trace minerals is that or is there

some other meaning of that okay when we

have a complete deficiency of vitamin

like vitamin D or vitamin C we have

brism have a complete a manifestation of

the disease that is completely uh caused

by the lack of this nutrient when we

have lack of vitamin C have scorbut uh

so in this cases we don't live in a an

environment that there is a complete

deficiency of a nutrient but we have

multiple marginal not complete but uh

deficiencies of micronutrients so they

lack of zinc

magnesium omega-3 and other minerals

potassium and so on uh chromium uh B

complex vitamins

uh vitamin E antioxidants amino acids uh

so the body in order to function needs

166 uh nutrients and elements and this

they have to be present all of them at

the same time in a correct equilibrium

and this can vary from person to person

uh in order for the body to function

optimally and these in most cases there

are multiple deficiencies this not one

of these various micronutrients that are

necessary for life to function to uh to

so our body can function

healthily the thing is that all these

multiple def uh deficiencies end up to

disrupt the mitochondrial function so

one

common uh problem here for this patient

probably one of the basic problems that

bring to the manifestation to the

development of Hashimoto theotis is

mitochondrial dysfunction mitochondria

are little organal that are within the

the cells that 90% of the energy in the

body is produced in these organal so all

these multiple deficiency even though

not complete deficiencies they disrupt

the function of the of the mitochondria

lower energy levels the efficiency of

the body and then the thyroid has to

work more m

so I got it it's a backup let's say that

your body has to produce 100% of energy

and your mitochondria function at the

50% level that's fascinating because so

in this

situation far is just overcompensating

for a lack of mitochondrial production

so one thing that's very unique about

what you do versus other doctors you

have a specialized test that you do that

really pick up um um these subtle

changes that really are very very

important almost like you get more of a

complete picture and I guess that would

be called metabolomics right yes true we

measure small molecules called

metabolites that participate in the

chemical reactions within our uh within

the human body so instead of measuring

the nutrients in the blood because this

does not reflect the deficiency or the

needs of our body because our body tries

to to keep the the concentration the

consistency of the blood uh constant

because if for example someone is

missing calcium even though he has

osteoporosis the levels of calcium in

the blood are going to be within normal

it's even in advanced stages of

osteoporo and lack of calcium because if

the concentrations of calcium go higher

or lower the heart will stop and many

functions or cells will die so the

body tries uh to keep the consistency of

the blood stable so when the

consistency the the levels of a nutrient

the blood changes this means it's very

late it's too too late in order to

overcome this problem we have to measure

chemical reactions that Cur the presence

of the nutrient we want to test for

example we can measure uh the uh

transformation of one metabolite to

another that needs B12 or needs

magnesium on its glutamine and so on uh

so by measuring this chemical reaction

if this is occuring at a normal levels

optimal levels we can see if uh the body

needs more or less of the nutrient we

are testing so basically you know

instead of looking at the uh rdas for

certain nutrients we're looking at how

these rdas are really being utilized in

the body and seeing if they're

sufficient or not depending on that

individual so it's a

uh uh completely different strategy yes

it's individualized yes personalized so

so for those of you listening if you if

you have a condition like this and you

want to get it evaluated a lot deeper

I'm going to put your link down below

where you can um get this test get it

evaluated um I will put that link down

below and I know that you mentioned that

you you have a small amount of time to

do this interview so I just wanted to

cram as much as I can in this interview

and

and just get these uh the overview of

the thyroid and this is just fascinating

information so anyway I want to thank

you for spending the time and uh

hopefully clarifying some of these

confusions that people have about this

thyroid problem hashimotos and not to

mention just autoimmune in general and

how different that is so thank you so

much thank you thank you Dr B for the

interview you're welcome