Insulin is an absolutely essential hormone for life and fundamental for muscle mass synthesis, but when its levels remain constantly elevated, it becomes the main culprit for body fat accumulation, especially at the visceral and abdominal levels. In this episode, we take a deep dive into what happens when our cells become "impermeable" to the action of insulin  as if they were putting on a raincoat that prevents them from hearing its signal, and the pancreas responds by secreting more and more, entering a vicious cycle of hyperinsulinemia and insulin resistance. This metabolic alteration not only makes it difficult to lose weight or gain muscle, but it also has a direct impact on the entire hormonal balance. Throughout the talk, we explain how excess visceral fat first affects the liver, leading to fatty liver and compromising key hepatic functions such as the detoxification of toxins and the proper activation of essential vitamins like vitamin D and B6. As a consequence, problems with mood, sleep disturbances, unexpected spikes in cholesterol, triglycerides, and uric acid may appear, as well as manifestations in hormonal health such as polycystic ovary syndrome (PCOS), acne, or hair loss. To find out if you are going through this process, we address how to identify it simply, whether through a blood test by calculating the HOMA-IR index (multiplying fasting glucose by fasting insulin and dividing by 405, where values equal to or greater than 2.5 suggest resistance) or simply by measuring your waist circumference with a tape measure. Finally, we share the fundamental pillars to recover metabolic sensitivity and remove that waterproofing layer from the cells: the combination of strength and cardiovascular exercise, a daily intake of at least 25 to 30 grams of prebiotic fiber to promote the natural secretion of satiety hormones like GLP-1, the reduction of alcohol and sweeteners such as sorbitol and maltitol, and the targeted supplementation strategy with active ingredients like phytosomal berberine, silymarin, Gymnema sylvestre, or myo-inositol.  I hope you like it :)For more information, you know you can find me on my Instagram @isabelvina where I share daily content, my TikTok @isabelvinabasOn my YouTube channel https://www.youtube.com/channel/UC-dfdxLBcvfztBvRAKZSXGQAnd the supplements formulated by me https://ivbwellness.com

Probiotics in Detail: What They Are, What They Are For, and How to Choose the Right Strain Hello, I am Dr. Isabel Viña Bas, a physician and Scientific Director of IVB Wellness Lab. Few words are used as much and explained as little as "probiotic". It appears in yogurts, capsules, sachets, and products for digestion, immune support, or even intimate health. But just because a product contains bacteria doesn't automatically mean it will help you. With probiotics, the detail changes everything. It is not enough to know that it contains Lactobacillus or Bifidobacterium. We need to know the genus, the species, and, above all, the specific strain; check what benefit has been studied with it, at what dose, for how long, and in what type of person. A probiotic does not work "for the microbiota" in general: it works, if the evidence supports it, for a specific situation. That is why, in this episode, we will cover the complete map. We will see how probiotics, prebiotics, and postbiotics differ; what foods nourish your bacteria; what we know about constipation, irritable bowel syndrome, antibiotics, Helicobacter pylori, childhood, oral health, and mastitis; and what must appear on a label so you can choose with criteria. Probiotics, prebiotics, and postbiotics: three concepts that do not mean the same thing Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit. The definition contains two conditions that we sometimes forget: they must arrive viable, and the benefit must be proven. Not every fermenting bacterium is a probiotic, nor can any fermented food make a specific health claim. Prebiotics are not microorganisms. They are substrates that our bacteria use selectively and that generate a benefit. Many dietary fibers can feed the microbiota, but not every fiber automatically meets the scientific definition of a prebiotic. Postbiotics are preparations of inanimate microorganisms or their components that have demonstrated a benefit. Since they do not require the microorganism to remain alive, they can offer greater stability. Here, it is worth making another distinction: an isolated metabolite, such as butyrate, does not become a postbiotic on its own. The term describes a well-characterized preparation, not just any substance produced by bacteria. I like to imagine it like a garden. Probiotics are specific microorganisms that you incorporate; prebiotics are part of the food that favors certain bacteria; and postbiotics are preparations of inactivated microorganisms and their components capable of continuing to interact with the organism. They are related tools, but not interchangeable. Natural prebiotics: how to feed your microbiota every day Before looking for a capsule, we must look at what the bacteria already living in the intestine are receiving. A varied diet rich in plant-based foods provides different types of fiber and bioactive compounds. The diversity of functions of your intestinal ecosystem is sustained by the diversity of what you eat. If you prefer to reinforce that intake with a specific product, Fiber Total is formulated as a concentrated prebiotic fiber. Among the fermentable substrates, we find fructans and galactooligosaccharides present in foods such as garlic, onion, leek, artichoke, and legumes. Oats and some mushrooms provide beta-glucans. Apples and other fruits contain pectins, while red fruits, coffee, tea, cocoa, turmeric, red onion, or capers provide polyphenols that can also interact with the microbiota. Another interesting tool is resistant starch. Part of the starch in potatoes, rice, or pasta changes structure when cooked and then cooled. Since it remains less available for our digestion, a larger proportion reaches the colon and can be fermented by bacteria. You can cool the food for several hours and consume it cold or reheated; you don't have to eat all your food straight out of the fridge. However, more fiber doesn't always mean feeling better from the first day. In people with irritable bowel syndrome, bloating, or a previously very low intake, suddenly increasing fermentables can increase gas and discomfort. The microbiota also needs progression: introduce variety little by little, drink enough water, and adapt the amount to your tolerance. Butyrate: the message that some bacteria produce when fermenting fiber When certain bacteria ferment fiber, they produce short-chain fatty acids. One of the most studied is butyrate, which serves as an energy source for colon cells and participates in the maintenance of the intestinal barrier. It also intervenes in pathways related to the immune response and metabolism. In research, its ability to influence intestinal signals such as GLP-1 and peptide YY, involved in satiety and glucose control, has been observed. This does not mean that eating a prebiotic reproduces the effect of a GLP-1 agonist medication, but rather that the intestine participates naturally in metabolic communication. The goal should not be to chase a single metabolite, but to favor an ecosystem capable of producing different beneficial compounds. A varied diet, with sufficient fermentable fiber and adapted to individual tolerance, is usually a more complete foundation than looking for an isolated solution. Probiotics for irritable bowel syndrome: the strain matters more than the label Irritable bowel syndrome can manifest with pain, bloating, and changes in bowel habits, with a predominance of constipation, diarrhea, or a mixed pattern. That heterogeneity explains why there is no "best probiotic" universal for IBS. Review of studied strains such as Bifidobacterium longum 35624 (formerly called B. infantis 35624) and Bifidobacterium longum ES1, in addition to the spore Bacillus coagulans MTCC 5856. Some trials have found improvements in specific symptoms, but the results do not allow the effect of one strain to be transferred to all others of the same species. Clinical guidelines also do not agree on recommending probiotics in a general way for irritable bowel syndrome. Part of the evidence is heterogeneous: the strains, combinations, doses, duration, and type of patient change. Just because a formula contains many strains does not guarantee that it is more effective. If you decide to try a probiotic, it is advisable to choose a strain with evidence for the predominant symptom, establish a reasonable trial period, and observe pain, bloating, frequency, and consistency of bowel movements. If there is no improvement, it makes no sense to keep taking it indefinitely out of inertia. Probiotics for constipation: why not everyone improves transit Constipation can depend on fiber and water intake, movement, certain medications, the pelvic floor, the thyroid, or the bowel's own motor pattern. A probiotic does not automatically correct all those causes. In adults with constipation, Lactobacillus reuteri DSM 17938, among other options, has been studied. Some trials have observed an increase in the frequency of bowel movements, although the response can vary and it does not always improve aspects such as consistency or pain. Before choosing one, check the foundation: sufficient food and fiber, hydration, movement, and a routine that allows you to respond to the urge to evacuate. If there is blood in the stool, unexplained weight loss, anemia, severe pain, fever, vomiting, or a persistent change in bowel habits, you don't need to try more probiotics: you need a medical evaluation. Antibiotics and diarrhea: when a probiotic can help Antibiotics act against bacteria responsible for infections, but they also temporarily alter part of the intestinal community. In some people, this translates into antibiotic-associated diarrhea. Certain strains can reduce that risk, especially when taken near the start of treatment. Among the options with the most research are the yeast Saccharomyces boulardii and some strains of Lactobacillus rhamnosus GG. The word "some" is important: we cannot assume that any S. boulardii or any L. rhamnosus will have exactly the same effect. If the probiotic is bacterial, it is usually recommended to separate it by a few hours from the antibiotic to reduce direct contact, following the instructions of the product and the professional. Saccharomyces boulardii is a yeast and is not affected in the same way by antibacterial antibiotics, although it can interact with antifungal treatments. Not everyone should take probiotics without supervision. In immunocompromised people, those with severe illness, central venous catheters, prematurity, or other situations of vulnerability, there is a rare but real risk of infection. In these cases, the decision must always be individualized. Probiotics and Helicobacter pylori: support, not a substitute for treatment Helicobacter pylori can colonize the stomach and be associated with gastritis, ulcers, and a higher risk of certain complications. Its eradication requires a medical regimen that combines antibiotics and acid suppression. A probiotic does not eliminate the infection on its own. Strains such as Lactobacillus reuteri DSM 17648, Saccharomyces boulardii, or Lactobacillus rhamnosus GG have been studied as an accompaniment. In some cases, they can improve the digestive tolerance of the treatment and modestly increase the eradication rate. Their role is to help complete an effective regimen better, not to replace it. After treatment, it must be verified that the bacteria have disappeared through the test indicated by the professional. Feeling better does not confirm eradication, just as continuing to have discomfort does not necessarily mean that the treatment has failed. Omeprazole and microbiota: why you shouldn't stop it on your own Proton pump inhibitors, such as omeprazole or pantoprazole, reduce stomach acidity. They are very useful medications and, in certain diseases, necessary. However, their prolonged use can be associated with changes in the microbiota and, in some people, a higher risk of bacterial overgrowth or deficiencies of certain nutrients. An association does not prove that the drug is the direct cause of all the problems that appear in those who take it. People who need these medications may also be older, have other diseases, and be on more treatments. It is not advisable to turn a list of potential risks into a reason to abandon them suddenly. If you have been taking a stomach protector for a while, periodically ask if the indication continues, if the dose is still appropriate, and if you need to monitor vitamin B12, magnesium, iron, or other parameters. If there is bloating, the professional must assess the cause before adding an extensive combination of probiotics. Probiotics in babies and children: a decision that needs a pediatrician and a specific strain In pediatrics, a small difference in age, diet, or health status changes the recommendation a lot. We should not extrapolate an adult dose to a baby or choose a product just because it says "infant". One of the most researched strains is Lactobacillus reuteri DSM 17938. It has been studied in infant colic, regurgitation, and certain cases of functional abdominal pain. The results are more consistent in some groups (for example, breastfed infants with colic) than in others, and not all guidelines interpret the evidence in the same way. There are also specific strains with evidence for reducing antibiotic-associated diarrhea in children. But the right probiotic depends on the indication, not on whether the box includes children's drawings. The pediatrician must review age, symptoms, type of diet, history, and safety. In a newborn or infant, fever, refusal to eat, persistent vomiting, blood in the stool, drowsiness, dehydration, or failure to gain weight require evaluation. No probiotic should delay it. Oral microbiota: probiotics for cavities and gums under investigation The mouth also houses a microbial ecosystem. Saliva, hygiene, diet, tobacco, glucose, and certain medications change that balance. I can tell you how a prolonged treatment with corticosteroids coincided with a significant deterioration of my oral health and the appearance of several cavities. Strains such as Streptococcus salivarius BLIS M18 and BLIS K12 have been studied for certain oral health goals, and combinations of Lactobacillus reuteri or Bifidobacterium lactis HN019 as a complement in periodontal management. The results are promising, but they still do not turn probiotics into substitutes for hygiene, fluoride when indicated, professional cleaning, or dental treatment. The first intervention to protect teeth and gums still happens with the dentist and with daily habits. An oral probiotic, when it fits, is a complementary tool and must contain the strain that has been studied for that goal. Probiotics and mastitis during breastfeeding: what we know Mastitis can cause pain, inflammation, and a great impact on the continuity of breastfeeding. Strains such as Lactobacillus fermentum CECT5716 and Lactobacillus salivarius CECT5713 have been investigated both in prevention and as an accompaniment to treatment, with favorable results in some trials. Even so, the evidence does not allow all mastitis to be treated in the same way. The current approach includes reviewing the latch and physiological drainage of the breast, controlling pain, and assessing whether there are signs that make an antibiotic or other intervention necessary. The probiotic should not delay the consultation when there is persistent fever, worsening, a fluctuating area, or suspicion of an abscess. During breastfeeding, not just any product labeled as a probiotic works. If its use is considered, the exact strain, the studied dose, and the compatibility with the clinical situation must be verified. Probiotics in autism and rheumatoid arthritis: preliminary results are not treatments The gut-brain axis and the relationship between microbiota and immunity have opened fascinating lines of research. Some strains, such as Lactobacillus plantarum PS128, have been evaluated in small studies with children on the autism spectrum. Probiotic mixtures have also been tested as a complement in people with rheumatoid arthritis. These works can generate hypotheses, but they still do not justify presenting a probiotic as a treatment for autism or an autoimmune disease. Studies usually include few people, last a short time, and measure very different results. "It is being researched" does not mean "it has been proven". In autism, the accompaniment should focus on individual needs and interventions backed by specialized professionals. In rheumatoid arthritis, no probiotic replaces disease-modifying drugs or follow-up by rheumatology. The microbiota may be part of the future of medicine, but communicating science also means respecting the point at which it is today. How to choose a probiotic: the rules you should look at on the label Choosing well starts by changing the question. Instead of "what is the best probiotic?", ask "what strain has been studied for my goal?". Then check these elements. Complete identification. The label should indicate genus, species, and strain: for example, Lactobacillus rhamnosus GG. Two strains of the same species can behave differently. Quantity expressed in CFU or viable cells. The number must correspond to the daily dose and, preferably, be guaranteed until the end of the shelf life, not only at the time of manufacture. Dose backed for that strain. There is no minimum figure valid for all probiotics. Some strains have been studied with hundreds of millions and others with billions of CFU. More quantity does not always mean more effect. Indication and duration. Check if the strain has been researched for the symptom or situation you want to address and for how long. A label with ten species, but without strain codes or a clear goal, provides less information than it seems. Storage and expiration. Some products need refrigeration; others remain stable at room temperature. Follow the manufacturer's instructions and avoid leaving them exposed to heat or humidity. Safety. Check pregnancy, breastfeeding, age, immunosuppression, serious illnesses, allergies, and medication. If the product promises to cure multiple diseases or "repair" the entire microbiota, be wary. When and how to take probiotics There is no single perfect time for all products. The survival depends on the strain, the formulation, the coating, and the manufacturer's instructions. If it has a gastro-resistant coating, it may better tolerate the passage through the stomach. In other cases, taking it with a meal can temporarily buffer acidity. Therefore, the practical rule is simple: follow the regimen of the specific product and maintain consistency during the studied period. If you take it together with a bacterial probiotic, check if it is advisable to separate it by a few hours. It is also not mandatory to take a probiotic for always. Some indications require days or weeks; others may need a different regimen. Define beforehand what change you expect to observe and when you will review it. Without a goal, it is easy to keep buying a product even if it is not contributing anything. A well-chosen probiotic can be a useful tool. But its value is not in carrying many strains, billions of bacteria, or a broad promise. It is in connecting an identified strain with a specific need, a studied dose, and a person for whom it is safe. Transforming your health is a matter of applying science with consistency, day by day. You have in your hands the knowledge to better read a label, distinguish microbiota from marketing, and choose with more criteria what tool your body really needs. I hope you like it :)For more information, you know you can find me on my Instagram @isabelvina where I share daily contentMy TikTok @isabelvinabasOn my YouTube channel And the supplements formulated by me https://ivbwellness.com

Autoimmune Hypothyroidism: Nodules, Nutrition, Fertility, and Pregnancy Hello, I am Dr. Isabel Viña Bas, a physician and Scientific Director of IVB Wellness Lab. The thyroid is a small gland, but its hormones are involved in processes that affect the entire body. When its function is altered, especially when there is autoimmune hypothyroidism involved, questions arise about nodules, medication, antibodies, nutrition, or fertility. The first step is to differentiate structure from function. Having thyroid nodules does not necessarily mean having hypothyroidism or hyperthyroidism, and vice versa: you can have a functional alteration without any nodules present. In consultations, I am asked the same questions over and over: what to do about nodules, why iodine matters so much, what the immune system has to do with it, with thyroid antibodies involved, when it is necessary to start Eutirox, what happens after a thyroidectomy, and how all this intersects with menopause, fertility, or the digestive system. If you have been dwelling on unexplained fatigue for a while, this will be useful to you. Why are thyroid nodules so common? Much more than people think. In an ultrasound, thyroid nodules are found in up to six out of seven people, almost 80% of the population. When palpating the neck, many fewer are detected, because to notice them, they usually need to be at least half a centimeter or a centimeter in size. One of their main causes is a lack of iodine in the diet. The thyroid needs iodine to produce T3 and T4 hormones, and when it does not receive enough, it increases in size in an attempt to compensate. It is important to be clear that nodules speak to the structure of the gland, while hypo- or hyperthyroidism speak to its function. These are two different issues and must be assessed separately. How much iodine the thyroid needs and which sources to choose The recommended amount of iodine is between 150 and 300 micrograms per day. A simple way to get it is to use fine iodized salt in your day-to-day life. Sea salt, flake salt, and Himalayan salt do not serve this purpose; they do not provide the amount of iodine you need. You can also find it in eggs, dairy, and seafood. . Seaweed, on the other hand, is not a recommended source because the amount of iodine they contain varies greatly from one product to another, and it is difficult to know how much you are actually taking. If you have hypothyroidism, you should take iodine, for example with a supplement like IVB TyroEnergy, which combines it with selenium to support thyroid function. It is only contraindicated if there is hyperthyroidism or if you no longer have a thyroid gland due to a thyroidectomy. Additionally, taking between 600 and 800 mg of myo-inositol per day seems to help reduce the size of existing nodules. What is the relationship between autoimmune hypothyroidism and autoimmune gastritis? The autoimmune hypothyroidism can go hand in hand with autoimmune gastritis. This combination is part of what is known as autoimmune polyglandular syndrome type 3. When you have one autoimmune disease, you are more likely to develop another. I say this from personal experience as well: I have autoimmune hepatitis and multiple sclerosis, so I know what I am talking about when I say that these things tend to come in groups. . In autoimmune gastritis, antibodies attack the parietal cells of the stomach. By destroying them, the production of acid, pepsinogen (necessary to digest proteins), and intrinsic factor—essential for absorbing vitamin B12. —decreases. This can translate into poor digestion, because proteins are not digested well, and also into acidity. Often, that acidity is treated with omeprazole, but the real problem is just the opposite, a lack of acid, and the medication can make it worse. A vitamin B12 deficiency can also appear. Its lack can cause reversible loss of mood and dementia, but also a degeneration of the spinal cord that affects stability and the ability to walk, and that part is no longer reversible. To confirm autoimmune gastritis, the doctor must order anti-parietal cell antibodies and anti-intrinsic factor antibodies. Autoimmune hypothyroidism and gluten: do you always have to eliminate it? Having autoimmune hypothyroidism does not force you to eliminate gluten if your celiac antibodies come back negative. The first thing, always, is to rule out the existence of actual celiac disease. with a blood test. If you notice fatigue, abdominal bloating, or diarrhea, you can do an empirical test: remove gluten for two weeks and see if you improve. If after those two weeks you do not notice any change, reintroduce it. A gluten-free diet is hard and expensive, and it also generates quite a bit of social anxiety, as celiac people who have to follow it no matter what know well. There may be a non-celiac gluten sensitivity or wheat sensitivity, in which other antibodies that science does not yet know how to detect attack the intestine in an autoimmune way. That is why, when there is no confirmed celiac disease, the decision depends on your symptoms and how you respond during the test. Can autoimmune hypothyroidism be reversed and Eutirox stopped? When hypothyroidism is already established and the gland is partially destroyed, the damage cannot be reversed. Levothyroxine, which most of us know as Eutirox, provides the hormone that the thyroid can no longer produce on its own. In autoimmune hypothyroidism, antibodies destroy the gland little by little. In some people, that process lasts two years; in others, ten or twenty. The traditional medical approach is usually reactive: wait for the gland to fail completely and then prescribe Eutirox. I prefer to try to slow down the destruction and alleviate symptoms in the meantime, by combining myo-inositol and selenium. The regimen I usually recommend is to take between 600 and 800 mg of myo-inositol along with selenium at midday. How myo-inositol and selenium help thyroid function Myo-inositol reduces antibodies and makes the thyroid more sensitive to the orders it receives from the brain via TSH. I like to say that it gives the gland a finer ear to listen to those signals. Selenium, for its part, helps convert inactive T4 into active T3 inside the cells. This combination can also improve symptoms such as joint pain or brain fog. Antibodies do not just hang around the thyroid; they travel through the body and generate inflammation in other tissues. In short, the idea is to slow down the autoimmune process, lower antibodies, and ensure that thyroid hormones perform their function well inside the cells. Why do thyroid antibodies matter too, and not just TSH? There is a classic approach that says the level of thyroid antibodies does not matter as long as the TSH is within range. I do not agree with that idea, and I say it openly. It is not the same to have 300 antibodies as 4,000. Imagine 300 soldiers slamming doors against a door: they are going to break it much sooner than a single 1.10-meter soldier hitting it. The more antibodies there are, the faster the speed of thyroid destruction, and the inflammation circulating through the rest of the body also increases. That is why TSH is not the only data to look at. The antibody level tells you how intensely the immune system is attacking the gland. What happens after a total thyroidectomy The thyroid can be completely removed due to cancer, a very large goiter, or hyperthyroidism that is not controlled. After the operation, you need to take levothyroxine. . Even so, many patients tell me that they never feel as well again. It is common for them to gain an average of three kilos that stay there, chronic, and are very hard to lose. This happens because Eutirox provides a fixed amount of T4. Before the surgery, the thyroid also produced about 20% of active T3 hormone, and it did so by adjusting it second by second, in an intelligent way. T3 is not administered directly because it has a very short half-life and would have to be taken three times a day. Selenium, myo-inositol, and coenzyme Q10 after a thyroidectomy Selenium and myo-inositol also work in people without a thyroid. Selenium enhances the conversion of T4 from Eutirox into active T3, and myo-inositol helps that T3 stay active longer.After a thyroidectomy for papillary cancer, coenzyme Q10 can also be added. The combination of selenium, myo-inositol, and CoQ10 helps the medication hormone activate and perform its effect well inside the cells.The regimen I usually recommend is to take Eutirox with vitamin C on an empty stomach and wait 45 minutes before eating. The selenium and myo-inositol combo goes at midday, while vitamin D3+K2 and magnesium can be taken with lunch or dinner.How to care for the scar after thyroid surgery A thyroidectomy leaves a scar on the neck, an area that moves every time you swallow. During the first few weeks, silicone gels, such as Kelo-cote or Trofolastín, work well.Afterward, you can switch to healing creams like Cicaplast or Cicalfate for two or three months.Throughout the process, maintain strict sun protection to take care of how the scar evolves.Hyperthyroidism and Graves' disease: can they be cured? Hyperthyroidism can come from an isolated nodule or from Graves' disease. In Graves', antibodies overstimulate the gland and make it produce too much hormone.Those antibodies can also attack the muscles and tissues of the eyes, causing ophthalmopathy: bulging eyes and quite intense itching.When hyperthyroidism comes from an isolated nodule, it can be treated and cured by burning it with radioactive iodine. In Graves' disease, there are three paths: . antithyroid drugs in cycles of up to two years, radioactive iodine, or surgery to remove the thyroid.Radioactive iodine is contraindicated if there is ocular involvement. Surgery is especially indicated when the person is seeking pregnancy or has severe ophthalmopathy.What supplements help with hyperthyroidism In hyperthyroidism, selenium, L-carnitine, quercetin, and N-acetylcysteine are used.These nutrients help reduce symptoms such as tremors, palpitations, and diarrhea, and also slow down the development of the eye disease associated with Graves'.Here, unlike in hypothyroidism, iodine is contraindicated: an overactive thyroid does not need more raw material to manufacture hormones.Menopause and thyroid: why symptoms can coincide Menopause does not directly damage thyroid function. Both are consequences of aging, each on its own.Evolutionarily, the human body was not designed to live more than 40 years. From age 45 on, most hormones begin to drop due to organ fatigue, including the ovaries and the thyroid . Vitamin D and aldosterone also drop.The only hormones that rise with age are cortisol and insulin, which is why more insulin resistance , more fat in the abdomen, more hypertension, and more muscle pain appear.For the thyroid to function well and to avoid symptoms such as fatigue, high cholesterol, or brain fog , you must ensure 150 to 300 micrograms of iodine daily and add selenium, zinc, vitamin C, and myo-inositol.These nutrients make the thyroid more sensitive to the warnings it receives from the pituitary gland and help the hormones activate inside the cells.Perimenopause with hypothyroidism: how to take EutiroxIf you have hypothyroidism, follow the same approach I mentioned for perimenopause and maintain your Eutirox treatment . In this stage, body composition changes and it is normal to gain between three and five kilos. . That might be why it is necessary to increase the hormone dose a little.To absorb it better, take Eutirox with vitamin C on an empty stomach and wait 45 minutes before breakfast.In perimenopause, I also recommend soy isoflavones . They act as estrogen in the skin, hair, and liver, helping to lower cholesterol, and as an anti-estrogen in the breast, so they can even be taken by breast cancer patients who are on tamoxifen.The 5-HTP and saffron extract help control sweet cravings, nervousness, and hot flashes because they raise serotonin. For joint pain, I use chondroitin.Hypothyroidism, fertility, and TSH: why they influence the whole processBoth hypothyroidism and hyperthyroidism can block ovulation and worsen oocyte quality.Hypothyroidism raises prolactin, and that reduces the luteal phase and lowers the progesterone that the embryo needs to implant.Antibodies also fill the follicular fluid with inflammation and oxidative stress, and can cause micro-miscarriages. Instead of a calm environment, like chill-out music, the oocyte finds itself in an aggressive environment, more like constant techno music that makes the entire fertilization process difficult for it.If you are seeking pregnancy, I recommend a prenatal supplement with selenium and increasing myo-inositol up to four grams.The TSH must be below 2.5 . If it is between 2.5 and 4 and there are no antibodies, it is usually not treated with Eutirox. If there are antibodies or the TSH exceeds 4, medication is needed to achieve pregnancy.Elevated thyroid antibodies when seeking pregnancyAbout 15% of women with normal thyroid function have elevated anti-TPO or anti-TG thyroid antibodies , and that increases the rate of spontaneous miscarriages in the first trimester.The antibodies attack the thyroid and throw off the hormonal peaks necessary to ovulate and fertilize. They also circulate in the blood and locally attack the ovaries and fallopian tubes, generating inflammation and free radicals.This is how they destroy that antioxidant bubble that is vital for the development of the embryo . To reduce these antibodies. , I recommend taking myo-inositol and selenium together. The usual dose of myo-inositol is 600 to 800 mg, but when seeking pregnancy, it goes up to four grams to improve the FSH signal. The selenium dose moves between 75 and 100 micrograms.Myo-inositol and selenium act synergistically to reduce both thyroid antibodies and other autoimmune antibodies.Iodine in pregnancy when hypothyroidism existsDuring pregnancy, if you have hypothyroidism, not only can you take iodine, you must: needs almost double , up to about 300 micrograms per day.Until week 12 of gestation, the baby does not yet produce its own thyroid hormone. It depends completely on the mother . From week 12 on, the baby's liver begins to produce thyroglobulin, but it needs the iodine from the maternal diet. to manufacture its own hormones.Without enough iodine, the viability of the pregnancy and the neurodevelopment of the baby are seriously compromised.What diet to follow if you have hypothyroidismThere is no strict and universal diet that everyone with hypothyroidism has to follow. On social media, there is quite a bit of sectarianism around this topic.Gluten only needs to be removed mandatorily if celiac disease exists. If you have autoimmune hypothyroidism and notice bloating or fatigue, you can try removing it for two weeks to see if there is non-celiac sensitivity . If you tolerate it well, continue taking it without fear.Iodine, on the other hand, must be part of your diet if you have hypothyroidism. Asking a slow thyroid to manufacture hormones without giving it iodine is like asking someone for a chocolate cake without giving them chocolate.Iodized salt remains one of the simplest ways to ensure that intake.Foods that should be limited or avoided in hypothyroidismDo not abuse cruciferous vegetables, such as broccoli or cauliflower, because they decrease iodine uptake by the gland.It is also advisable to strictly avoid yuca, cassava, or manioc , because they reduce that iodine uptake and also increase the elimination of thyroid hormones through feces.I also do not recommend fasting or low-carbohydrate diets in hypothyroidism. Both reduce the activation of T4 into T3, lower the basal metabolic rate, and worsen fatigue and brain fog.Subclinical hypothyroidism: when to start medicationThe subclinical hypothyroidism is the phase prior to hypothyroidism. The pituitary gland notices that the thyroid is slowing down and raises the TSH above 4 to insist more, even if thyroid hormones are still within the normal range.In men and women who are not pregnant, medication is usually started when the TSH exceeds 4.2 , especially if there are symptoms or cardiovascular risk factors such as high cholesterol.Between 50 and 60 years of age, if there are no risk factors, you can wait until the TSH reaches 10 before giving levothyroxine.In pregnant women or those seeking pregnancy, medication starts from a TSH of 2.5, especially if antibodies are positive .What is the relationship between hypothyroidism and SIBO?. The hypothyroidism and small intestinal bacterial overgrowth, SIBO, go together more than it seems.T3 is responsible for contracting the muscle of the more than eight meters of the digestive tract. When it is missing, intestinal movement decreases and constipation appears.In addition, hypothyroidism lowers the production of acid in the stomach, and acid is a powerful natural antibacterial. If there is less acid, the intestine moves less (or you also take gastric protectors like omeprazole), and then the bacteria do not die and get stuck in the upper part of the intestine.Those bacteria overgrow and steal nutrients. A vitamin B12 deficiency can appear and, in parallel, an excess of folic acid produced by the bacteria themselves.Symptoms of SIBO and how to repair the intestinal barrier The bacterial overgrowth can cause abdominal bloating, gas, diarrhea, and rosacea. Bacteria produce substances that damage the intestinal barrier and create small holes, which leads to . leaky gut. They also break down enzymes and transporters on the brush border.As a consequence, it is possible to suddenly develop lactose or fructose intolerance. The approach involves using an antibiotic, medical or herbal, and repairing the intestinal barrier with . glutamine, zinc carnosine, quercetin, and probiotics.. Do you have to take Eutirox at the same time every day? It is recommended to take levothyroxine at the same time every day, but it is not strictly necessary if you cannot get up early one day or you forget. Levothyroxine has a very long half-life; it stays in the body for about seven days. That is why, if one day you change the time or skip the dose, nothing serious happens. You can even take the forgotten dose along with the next day's dose. How to understand thyroid health completely Your thyroid health is not reduced to a single TSH value. You have to distinguish nodules from functional alterations, look at antibodies, ensure the nutrients that allow hormones to be manufactured and activated, and adapt the treatment to each stage of your life. Iodine provides the raw material. Selenium helps transform T4 into active T3. Myo-inositol improves the gland's sensitivity to signals from the brain and helps lower antibodies. You also have to understand the relationship of the thyroid with the stomach, the intestine, fertility, pregnancy, and menopause. Thyroid hormones act throughout the entire body, and when they drop or rise in excess, their consequences do not stay just in the neck either. Transforming your health is a matter of applying science with consistency, day by day. You have in your hands the knowledge to better understand your lab results, your symptoms, and the decisions that accompany thyroid care. I hope you like it :)For more information, you know you can find me on my Instagram @isabelvina where I share daily contentMy TikTok @isabelvinabasOn my YouTube channel And the supplements formulated by me https://ivbwellness.com