Latest / hol+ with Dr. Taz MD | The Future of Medicine is Holistic / How to Know If You Have Hypothyroidism: Why a Normal TSH Test May Not Tell the Whole Story | Dr. Amie Hornaman The Thyroid Fixer,
Transcript
- [00:00:00] My next guest was told by six different doctors that nothing was wrong with her. [00:00:05] She gained over 20 pounds battling crushing fatigue and watched her hair fall [00:00:10] out before she finally found answers outside of conventional medicine. We do know that [00:00:15] birth control taken for more than 10 years increases your risk of [00:00:20] hypothyroidism by 283%. Control increases your risk by what? [00:00:25] 283%? 283. Right. This is what the synthetic hormones do [00:00:30] to our thyroid. When we look at every system in your body, from your hair growth, your brain [00:00:35] function, your body temperature, your metabolism, your digestion, every [00:00:40] single system, every single organ has a receptor site on it for [00:00:45] thyroid hormones, specifically for the active thyroid hormone T3. So when we [00:00:50] look at that, we can say, okay, the body is not going to run [00:00:55] without enough thyroid hormone, and we can't just address one system. We can't just address [00:01:00] insulin or just address your low testosterone without coming back and making [00:01:05] sure that the master gland that, that has the final say is, is working [00:01:10] properly. Dr. Amy Hornaman is a doctor of clinical nutrition, a functional medicine [00:01:15] expert, and the founder of the Advanced Thyroid and Hormone Clinic. Known worldwide [00:01:20] as the Thyroid Fixer, she hosts a top-rated podcast in medicine and alternative health, The Thyroid [00:01:25] Fixer, and the author of The Thyroid Fix: The No Nonsense Guide to Fix Fatigue, [00:01:30] Fogginess, and Fat That Won't Budget. Let us welcome Dr. Amy Hornaman [00:01:35] to the show. This episode is sponsored by WholePlus, a holistic health platform built [00:01:40] around education, personalization, and integrative care. WholePlus blends [00:01:45] holistic, integrative, and functional medicine clinics with learning resources like [00:01:50] blogs, YouTube videos, and of course this podcast, so you're not just treated, you're [00:01:55] informed. The platform also includes holistic health quizzes and a curated wellness shop, [00:02:00] helping you make choices that support your body at the root level. Whole Plus [00:02:05] is holistic healthcare designed for real life. Visit us at [00:02:10] wholeplus.co to learn more about the platform. Again, that's [00:02:15] W-H-O-L-P-L-U-S dot C-O. All right, I am so excited about this next topic, Dr. Amy. I don't know [00:02:20] if you know, but I entered the holistic and integrative space, I didn't know it at the [00:02:25] time, but my thyroid was a big part of the story. Essentially, I'd been losing hair [00:02:30] and gaining weight and all of these other things, and my winding journey, which we don't need to get [00:02:35] into, was basically that I had PCOS and I had hypothyroidism. [00:02:40] And just going on a little bit of thyroid medication, along with adjusting my diet, like [00:02:45] completely turned things around for me. So this is a, a topic not only, you [00:02:50] know, one that my patients ask about all the time and so many people have so much confusion around, but one [00:02:55] that's definitely near and dear to my heart. So thank you for joining the show. We're [00:03:00] excited to have you here today. But before we jump into all things thyroid, [00:03:05] very curious about how you landed in this particular space. Tell us a little bit about your story. [00:03:10] Well, our stories parallel, because I too saw [00:03:15] six doctors who all misdiagnosed me. So my story actually started way [00:03:20] back in my 20s, similar to yours. Same. Oh my goodness. Yep. I know, I know. It's crazy. [00:03:25] It is crazy. We're like soul sisters, unfortunately tossed around in the medical system. [00:03:30] But my story started in my 20s. I was actually competing in [00:03:35] fitness and figure competitions, which is like in the world of bodybuilding, right? Right. [00:03:40] And it's when your diet is super strict. Yeah. I mean, we're not just talking about [00:03:45] counting a few macros here and there. It is dialed in. There is nothing [00:03:50] coming into my body that wasn't on paper by my trainer, fish, broccoli, [00:03:55] asparagus, chicken, the whole deal. And then hitting the gym twice a day as well. So [00:04:00] from a nutritional standpoint, from an energy standpoint- [00:04:05] My body should have been losing weight, but it wasn't. Every single week I got on the [00:04:10] scale, the scale went up, and I had to report this- Yeah ... to my coach, right? I had to send him [00:04:15] my, my weekly pictures, my progress pics. Well, there wasn't any progress [00:04:20] because I kept getting bigger and the scale kept going up, and here's my coach- Yeah ... thinking that I'm [00:04:25] binging on donuts and pizza, and that wasn't the case. So of course, I did what [00:04:30] we all do. I started with my doctor to basically say, "Hey, what is happening with my [00:04:35] body? It's, it's like a runaway train here. I have no control." And there was the fatigue [00:04:40] and the hair loss as well. But girl, I was so consumed with the weight gain, [00:04:45] I didn't, I wasn't even paying attention to the hair. I'm like, I'll just- Wow ... throw some extensions in, but I, I [00:04:50] gotta deal with why my clothes are all tight. So I went to my doctor and I [00:04:55] heard the famous words, "You're normal." You're fine. Everything's normal. You're fine. [00:05:00] Yeah. Nothing to see here. Right. Move on. So of course, like [00:05:05] you, I didn't accept that answer. I kept going. So six [00:05:10] doctors all told me, "You're normal. Everything is fine." One of them told me to eat less and [00:05:15] exercise more, and I was like, "You have to be kidding me." You want me to starve [00:05:20] myself? Is that it? Um, I don't think that's a great idea. Did you get the, um, anxiety [00:05:25] diagnosis? You must be anxious or depressed. Did you get that one? That's usually goes in that same bucket. [00:05:30] I'm sure it was in there somewhere. I did, I did get the birth [00:05:35] control option. Mm-hmm. Like, here you go. It must be your hormones. Let me give you- Right ... some birth [00:05:40] control. Yeah. Because ironically, I developed PCOS after that as [00:05:45] well. Ooh. So that's a whole other part of the story. Oh, wow. So the seventh [00:05:50] doctor actually finally diagnosed me. She laid hands on my throat, said, [00:05:55] "Swallow", and she says, "You know, I'm feeling some nodules here on your thyroid. [00:06:00] According to your labs", and of course I don't even know what she tested. We can all guess, right? Right, right. [00:06:05] Probably TSH only. "According to your labs, looks like you have hypothyroidism. Here's a pill." [00:06:10] So I left her office all pumped up. I'm like, yes, I have a name for what's [00:06:15] going on with my body, and I have this pill that's going to fix me. And I took [00:06:20] that pill, Synthroid, levothyroxine, for five months, and it [00:06:25] did absolutely nothing. Oh, no. So I start Dr. Googling, right? Yeah. 'Cause then that's what [00:06:30] we do. Then we jump out- Right ... and now we have ChatGPT. Back then- Right ... it was just Dr. Google. [00:06:35] Right. And I find that there's this other thyroid hormone called T3, and [00:06:40] there's this other thyroid hormone called T2, and oh my gosh, both of them are active and, and that's what gets to [00:06:45] your cells, and that's what gives you metabolism and gives you energy and grows your hair and all this [00:06:50] fun stuff. So I go back to her and I say, "What about this active thyroid hormone? [00:06:55] Can't we combine these two? It doesn't make sense that you're giving me this inactive thyroid hormone [00:07:00] that my body has to, to change and transform and convert." And she says, "That's not [00:07:05] standard of care. I don't do that." And I said, "Thank you. You're [00:07:10] fired. I'm gonna go find someone who does." That's what led me into functional medicine that [00:07:15] optimally, uh, saved my life. It saved my life. And so that's why I am here [00:07:20] with you today doing what I do, specializing in thyroid and hormones, because [00:07:25] I was in a major medical system at the time, and I was still tossed around and, and [00:07:30] given m- six misdiagnoses. So curious, how long ago was that? How many years [00:07:35] roughly? 25, 30 years ago. Yeah. Yeah. I mean, we, we are on the exact, probably the exact [00:07:40] same timeline. That's so interesting. But you know the sad part, and I don't know if you experience this now [00:07:45] with some of the people that you see, but I don't know that it's changed that much. I think there's more [00:07:50] information. I definitely think there's more information, right? So people can maybe start [00:07:55] to ask better questions than maybe what you and I were able to ask at the time, but I [00:08:00] still think the delivery and the changing of the protocol really hasn't [00:08:05] happened in, in my experience. What, you know, from what I'm seeing. I'm sure you're seeing the same thing. You're 100% [00:08:10] right. It hasn't changed, and it blows me away. Yeah. You would think that that would have [00:08:15] advanced and more of a spotlight would have been, you know, shined down on, [00:08:20] on thyroid and hormones, but it's not. Well, let's dive into the thyroid [00:08:25] specifically, because, you know, and you said something else that I actually wanna call out, because this really gets under my [00:08:30] skin, guys, by the way, that doctors nowadays will not touch you. There's a [00:08:35] lot of, like, not doing a physical exam at all, not putting your hand on a thyroid. I don't know how much [00:08:40] thyroid I have diagnosed not through lab work, but by simply [00:08:45] palpating down through the thyroid gland and feeling it swollen or not quite right or it looking a [00:08:50] little bit off. You know, please make sure you're actually getting a real physical [00:08:55] exam. There is still value in that, especially when we're talking about the thyroid. But [00:09:00] what... You know, you call the thyroid the master gland, right? You know, someone else may [00:09:05] argue it's, you know, the pituitary or it's the ovaries or the uterus. Why do you think the thyroid is the [00:09:10] master gland when it comes to all things hormones? So what I always say is, from [00:09:15] head to toe it runs the show, meaning your... When we look at [00:09:20] every system in your body, from your hair growth, your brain function, your body [00:09:25] temperature, your metabolism, your digestion, even into your joints and joint pain, [00:09:30] every single system, every single organ has a receptor [00:09:35] site on it for thyroid hormones, specifically for the active thyroid hormone T3.[00:09:40] So when we look at that, we can say, okay, the body is not going [00:09:45] to run without enough thyroid hormone. And even, like you mentioned, sex hormones, [00:09:50] progesterone- Mm-hmm ... estrogen, testosterone. They are fantastic. Hormones give us [00:09:55] life. And even now we are getting a little bit more attention to perimenopause [00:10:00] and menopause, because right now there's like 5,000 menopause books out. Yeah. But we're forgetting [00:10:05] about the thyroid. Right. We're forgetting about the dictator of those hormones. [00:10:10] And you said it beautifully. I love your show and, and, and I was listening to an episode- Thank you ... and you said [00:10:15] it so beautifully. You said, you know, those, those hormones, they're [00:10:20] not going to work and they're not going to be balanced if your thyroid's off, if [00:10:25] your gut is off. We have to look at how all of these hormones play on the same playground, [00:10:30] and we can't just address one system. We can't just address insulin or just [00:10:35] address your low testosterone without coming back and making sure that the master [00:10:40] gland that, that has the final say is, is working properly. [00:10:45] You know, one of the fascinating areas of medicine, you know, for me, is that we're seeing more and [00:10:50] more how these, like, organs and hormones that we thought kinda lived in these silos, [00:10:55] right? Like, your thyroid lives over here, your estrogen lives over there, your progesterone lives over here. All [00:11:00] kind of, we think of them visually in boxes, and conventionally that's how we were trained to think, but also I [00:11:05] think that's just how everyone thinks now. But, like, that idea that you have a T3 [00:11:10] receptor on multiple organs and tissues in the body, including your bone, [00:11:15] your brain as well, you know, that is very pal- powerful. And I think with the [00:11:20] advent of GLPs and everyone talking about GLPs and saying weight is having more benefit than just weight [00:11:25] loss, I think it's the same idea, right? 'Cause we have GLP-1 receptors in so many different [00:11:30] other systems of the body. We have estrogen receptors and progesterone receptors. And so [00:11:35] fundamentally, you know, my goal and mission has always been we, we have to stop [00:11:40] thinking in parts. We have to understand that all this stuff is interconnected, right? [00:11:45] So with T3, tell us about T3, because it doesn't get tested [00:11:50] routinely, and it doesn't get evaluated. So a lot of people walk around with a, quote-unquote, "normal [00:11:55] TSH" and a normal T4. They have no idea about [00:12:00] T3. So let's get into that. I have more questions, but let's start with T3 before, before we get too into the [00:12:05] weeds with the other ones. Yes. Yes, yes. So T3 is the active [00:12:10] thyroid hormone. So when we look at every single cell, we see it as almost [00:12:15] like a lock and key, where T3 is the perfect key that [00:12:20] fits into the lock on your cell. You don't have a receptor site anywhere [00:12:25] in your body for T4, and that's what I was given in that pill. [00:12:30] Synthroid, levothyroxine, that is T4. That is inactive. So like I said, T4 [00:12:35] has to go through a, a conversion process where it literally [00:12:40] becomes T3, because that's what's going to get to your cell and [00:12:45] activate whatever system it's activating. That's what's gonna give you metabolism, light up your brain, let you [00:12:50] poop every day. That's all dictated by T3. So that T4 has to [00:12:55] convert properly. And here's where conventional medicine fails. [00:13:00] Doctors were taught that in med school, and this is, this is the [00:13:05] thyroid training given in med school, that you test that TSH, thyroid-stimulating [00:13:10] hormone, and if it is flagged high, then you give [00:13:15] T4, and that's all you need. Because, you know, the body, it's just gonna take that [00:13:20] T4 and convert it. Well, wait, wait, wait. Time out. I'm sorry. When we look at that conversion [00:13:25] process of T4 to T3, it is a tough job for the body to do. [00:13:30] Yeah. And especially in this day and age that we're living in, we're living in a toxic soup environment. [00:13:35] Those toxins, that excess cortisol, your disrupted gut from the [00:13:40] Frankenfoods that we're eating, the nutrient deficiencies from our depleted soil, [00:13:45] and not to even mention the genetic snips that can occur, all of those things get in the [00:13:50] way of T4 to T3 conversion. So of course, we have to [00:13:55] look at how much free T3, uh, unbound, [00:14:00] active thyroid hormone you have in your body ready to get to your cells to do its job.[00:14:05] So why do you think conventional medicine misses the mark on that one? Where, where did that come from [00:14:10] to only give T4? Which, by the way, and this is probably gonna take us in a different direction, T4, [00:14:15] most of the T4 preps, like your Synthroid and your Levothyroxine, I think Tirosint [00:14:20] might be an exception, most of them have gluten in them. Mm-hmm. And so a lot of people with thyroid [00:14:25] disorders also have, like, you know, some level of gluten sensitivity or gluten [00:14:30] intolerance, at least in my experience. Curious to see, uh, to know what you think about that. [00:14:35] So I'm... You know, just where did that come from that we could only... You know, that we were supposed to [00:14:40] only prescribe T4 if anyone had any type of thyroid condition? Well, you're [00:14:45] right, this might go down a different rabbit hole, but when we look at the history of thyroid medication [00:14:50] and we go back to the 1800s, the OG thyroid med was [00:14:55] NDT. This is, you know, back in the day- NDT ... they dried out natural desiccated [00:15:00] thyroid. Okay. Gotcha. So we were literally drying out pig's thyroid glands and, [00:15:05] and giving people the, the glandular powder- Mm-hmm of a dried out pig [00:15:10] thyroid gland, and that was helping because that contained T4 and [00:15:15] T3. T3. It mimicked what our thyroid glands actually do produce. [00:15:20] We know our thyroid gland produces T4 and T3 together. [00:15:25] So we were given, we were using natural desiccated thyroid [00:15:30] for decades until Synthroid came along. And [00:15:35] ironically, when you look at the history, which I dove into after last summer [00:15:40] when the FDA came out- That was crazy ... and said, "We're gonna ban your NDT," I started looking- Mm ... at the [00:15:45] history of these medications, and it turns out that T3 was actually [00:15:50] FDA approved in, like, the 1930s. T4 wasn't FDA [00:15:55] approved until later, '50, '60s. So it makes me scratch my head and go, [00:16:00] "Okay, how did we shift to this-" Mm-hmm ... "message that T4 only [00:16:05] is now all you need?" And it has to be that you follow the money trail. It has [00:16:10] to be big pharma stepping in. Oh. Not, uh- Yeah ... we're going to give you [00:16:15] this, you know, billion dollar endowment to your med school, but you know, you need to train your [00:16:20] doctors that, um, Synthroid's all, all you need because the body will just convert just [00:16:25] fine. Right. I, you know, I don't know. I'm sure there's more conspiracy theory behind it, but that's my take. [00:16:30] If you're listening to this and thinking, "I know something is off in my [00:16:35] body, but I don't know where to start," this is for you That's why [00:16:40] I created the Circle. The Circle is my private community where I and my team focus on [00:16:45] understanding your body from hormones and stress to metabolic health and longevity [00:16:50] with real-life guidance that you can actually use. This is about clarity and [00:16:55] consistency and support beyond the exam room and maybe [00:17:00] outside of all the different appointments and experts that you've been running around to. You can try the [00:17:05] Circle with a one-month trial using the promo code Podcast at [00:17:10] wholeplus.co/circle. Again, that's Whole Plus, [00:17:15] wholeplus.co/circle. All right, let's jump back into the [00:17:20] episode. So interesting, because some of the things that we know historically work, I think there [00:17:25] has been such a push to push them out for financial interests. It's really [00:17:30] disappointing because so many people have suffered, you know, in the interim. So getting back to [00:17:35] the thyroid hormone. So we know about TSH secreted from the pituitary, signals the thyroid [00:17:40] gland to make or not make thyroid hormone. But when y- when we think about the thyroid [00:17:45] gland itself, we have T4 that we now know about. We have T3 that is more [00:17:50] biologically active. Are there other thyroid hormones we should be thinking about?[00:17:55] There actually are. So there's T0, T1, and T2. [00:18:00] Zero and one we're kind of putting aside because right now there's not enough [00:18:05] research on them. Right now we consider them inactive. They have a little bit of [00:18:10] a, a role, but not enough to dive into. T2, however, [00:18:15] is a very active metabolite of thyroid hormone. It is a thyroid [00:18:20] hormone. We do find it naturally occurring in natural desiccated thyroid medication [00:18:25] because it is a thyroid hormone produced by the thyroid, so naturally we're going to find it in small [00:18:30] concentrations in that medication. But when we look at the studies of T2, which has [00:18:35] over 30 years of studies, we see that it's a fascinating [00:18:40] hormone. I call it the forgotten thyroid hormone. Hmm. Because what it does is it actually [00:18:45] increases our basal metabolic rate. So the amount of fat that we are burning just sitting [00:18:50] around, the amount of calories we're burning at rest, it increases that. It [00:18:55] also decreases inflammation. It decreases reactive oxygen [00:19:00] species. It helps convert T4 to T3. Interesting. I mean, it is [00:19:05] fascinating when you start looking at this, this thyroid hormone. The latest thing that I found, [00:19:10] and this is research that came out within the last year, is that it actually turns on a [00:19:15] gene that prevents fat accumulation, meaning it's, it's literally [00:19:20] telling our bodies, um, that excess, that, that donut that you had over the [00:19:25] weekend that, yeah, you probably shouldn't have, but you know, you really were craving a donut, it's okay. Normally it would've laid [00:19:30] down, you know, somewhere on your thighs or butt and, and it would've been an extra five pounds. But [00:19:35] we're going to prevent that fat from accumulating while increasing [00:19:40] thermogenesis and the burning of stored body fat. Now, it does all of this [00:19:45] without sending a negative feedback signal to your [00:19:50] pituitary. So what do I mean by that? Oh. Whenever we take a hormone, testosterone, [00:19:55] estrogen, progesterone, T3, T4 It's going to send a message back to our [00:20:00] brain to essentially shut down, I use that term [00:20:05] loosely, you're not gonna get a total shutdown, but you are going to get a slowdown of [00:20:10] that particular hormone production naturally in your body. Now, when we're [00:20:15] replacing hormones, like let's say, uh, we'll take estrogen. When we're replacing that [00:20:20] beautiful estrogen in a woman who's going into perimenopause and menopause, we don't care [00:20:25] about the natural shutdown because it's shutting down anyways. You know, things are, [00:20:30] things are going south. You're not gonna be- Right producing the right amount of estradiol, so let's just [00:20:35] replace it. Same thing with thyroid hormone. If your thyroid is, has been beaten up from [00:20:40] decades of having Hashimoto's, we don't care that it's not producing enough. But the [00:20:45] beautiful thing with T2 is that you can take it without that concern, [00:20:50] without that concern that all of a sudden your labs are gonna look like you're hyperthyroid- [00:20:55] Mm-hmm or your doctor's going to tell you that you have a thyroid problem now. Anyone can implement the [00:21:00] use of T2 to experience that increased metabolism. Is [00:21:05] T2 avail- Well, I've had two issues with T2. First of all, when I go to test it, [00:21:10] it's usually not approved or even not available sometimes even in traditional, like [00:21:15] LabCorp or Quest. So curious about... We can talk about testing in just a second. And then [00:21:20] secondly, like can you write a prescription for T2? Is that even available? [00:21:25] No. Okay. No. So tell us how do we get around those kind of roadblocks? [00:21:30] It's in supplemental form right now. Mm. So I actually have been researching and I, I put it [00:21:35] into my Fixer Formula line because when I started researching it, it was [00:21:40] only available in like a bro science formula with an angry- Ugh gorilla on the front. Yeah. And that [00:21:45] wasn't flying with my 45-year-old menopausal [00:21:50] ladies. Right. So it is available in supplemental form, but you know, I think... I, I struggle with this because we [00:21:55] know how hard it is for patients, for our listeners- Right ... to get [00:22:00] T3, to even get their doctor to prescribe- Right natural desiccated thyroid. Right, right. So it's like, do we [00:22:05] want to put them in that position where they now have to beg for T2, where it's, where [00:22:10] it's FDA control? You know, I, I don't know. I don't know. I kind of like it right now [00:22:15] available in supplemental form, but that's also why you don't have a test for it, because they're only gonna put [00:22:20] an assay at LabCorp for something that you can write a script for. Mm. It's all [00:22:25] connected at the end of the day in terms of what we can and cannot do. So now when it does come [00:22:30] to testing your thyroid, which you've talked about as the master gland, and [00:22:35] we both agree that a TSH and T4 are not enough to understand what's going on with your [00:22:40] thyroid, what is the right testing panel for someone who really wants to dig [00:22:45] deep into their thyroid health and really understand what's going on? Yes. So [00:22:50] beyond TSH and beyond free T4, the inactive thyroid hormone, [00:22:55] which we do like to look at, we like to look at the unbound inactive thyroid hormone as well, [00:23:00] we have to, have to test free T3, [00:23:05] we have to test reverse T3, which is your anti-thyroid hormone. [00:23:10] This actually gives us insight into how well you do convert your inactive to your [00:23:15] active thyroid hormone. So we test reverse T3, and then we look at [00:23:20] TPO, thyroid peroxidase, and TG, or thyroglobulin antibodies. [00:23:25] This is what we're looking at to see if you have Hashimoto's. And when we're looking at [00:23:30] hypothyroidism as a whole, low and slow thyroid function, [00:23:35] 95% of all hypothyroid cases is indeed Hashimoto's. So we're [00:23:40] kind of looking at it to see where are you on the spectrum. Even if those numbers came [00:23:45] back at zero, I would still retest and retest because those antibody [00:23:50] numbers can come back as a seronegative or a false negative. Sometimes [00:23:55] when people are going gluten-free, doing all the things, healing their gut, controlling [00:24:00] their stress, they could have Hashimoto's, but those antibodies continue to, to remain [00:24:05] at zero, which is a good thing. We just wanna- Mm-hmm ... continue testing them to make sure. [00:24:10] That's exactly all of those are in our panels at Whole Plus, and we've been checking [00:24:15] those over and over again on our patients. And sometimes even I think patients will push back and be like, [00:24:20] "Why are you doing all of these numbers?" I'm like, "Because you have to understand, you know, how it all sort of [00:24:25] fits together." Now, if that is the ideal testing panel, [00:24:30] talk us through when should someone go on T3? Is there a place for [00:24:35] T4 at all? And then do you have a different approach when it comes to [00:24:40] managing more of sort of the Hashimoto's or the Graves' or more of the autoimmune thyroid [00:24:45] conditions versus thyroid conditions that don't fall maybe into that autoimmune c- uh, sort of [00:24:50] category? Sure. Sure. Sure. So with T3 and T4, I always get that [00:24:55] question of like, "Why are we even bringing in the T4? If it's inactive, what's the point?" Right. [00:25:00] And here's what I'll say. If your body can tolerate T4, so [00:25:05] what I mean by that is when we look at all hypothyroid cases, and we were [00:25:10] talking about that T4-to-T3 conversion, I really see about 5% to [00:25:15] 10% are T3 only. I am T3 only. [00:25:20] I actually have a genetic SNP that prevents me from converting [00:25:25] my T4 into T3- Mm ... properly. Now, I didn't discover this- Which SNP is [00:25:30] that? Can I ask which one that is? It, it's the DIO1 and DIO2 SNPs. Okay. [00:25:35] Gotcha. The deiodinase enzymes, that's what, that's what we need to [00:25:40] convert our T4 to T3, and I have a SNP on each one. Now, we [00:25:45] know that with genetics, that's just propensity, right? That just tells us [00:25:50] you might have an issue converting your T4 to T3, but [00:25:55] when I experiment on myself and when I add in T4, I [00:26:00] know that that is correct because I will gain 10 pounds in a week and become clinically depressed when I add in T4. So [00:26:05] for me It's not in the mix. For [00:26:10] 90% of other patients, I always say, "You know, T4 is like your savings [00:26:15] account. I want you to have some in savings, and that you can pull [00:26:20] into your checking account, which is T3. So we're going to give you [00:26:25] both checking and savings so you can continuously spend out of [00:26:30] your checking, i.e., you have enough T3 on board to fuel your body. [00:26:35] But at any point in time, if you need a little more, your body can pull from your savings account, [00:26:40] convert that T3 as long as your reverse T3 is less than [00:26:45] 12." That's where I like to see it. Your reverse T3 is less than 12, so we can see that you convert well. [00:26:50] We have all of your systems supported with the nutrients needed to convert that T4 to [00:26:55] T3, and we're going to allow you to have some in savings. Now, that [00:27:00] ratio of how much can we allow each person- Right ... that's unique to each [00:27:05] individual. There might be some people that they need 80% T3, and [00:27:10] they can really only hold 20% T4 in savings. As soon as you go higher than [00:27:15] that, they start getting those hypothyroid symptoms, and we see the reverse T3 go up. So it [00:27:20] really is about personalization. Yeah. But that's the beauty of [00:27:25] thyroid treatment is that we can combine therapies. We can [00:27:30] change the ratio. We can personalize this to you, and there [00:27:35] is no one size fits all. So even if you've been in the conventional system, like [00:27:40] Dr. Taz and I have been, and, and you've been told that you're normal and this is all you need, or you've been given [00:27:45] T4, or if you are hearing the sound of our voices and you are currently on T4 only, [00:27:50] then I want you to know that you only have about a 2% chance of getting optimized on [00:27:55] T4 only. Mm-hmm. 98% of us do need T4 and T3, with a [00:28:00] small percentage of that m- needing T3 only. So that's really how we figure it out. It's all about [00:28:05] personalization. It is all about that. So we're all so different, and you even mentioned the genetic SNPs. Do [00:28:10] you advise people to get those tested to get an idea or do you think looking at an [00:28:15] RT3 is enough to kind of get a picture of what's happening? Usually looking at the [00:28:20] RT3 is enough. I mean, you know, you always have the, the, the, the [00:28:25] biohacking nerds that they wanna go do- Right, right ... and they wanna know their genetic- Right And like I said, I [00:28:30] actually only got my D101 and D102 SNP, the DIO1, DIO2 SNP [00:28:35] tested a couple years ago, but I've known for two decades that [00:28:40] I'm T3 only. So it was just kind of- Mm ... confirmation for me. So [00:28:45] interesting. Well, you wrote The Thyroid Fix, and in it you have so [00:28:50] much information about the thyroid and protocols, and really tackling it, not just from a [00:28:55] thyroid perspective, but from a whole health perspective. Walk us through [00:29:00] some of the other variables that impact thyroid function that maybe aren't just about the [00:29:05] thyroid alone, right? Like, we know T4, T3 conversion is highly dependent on the gut. You mentioned that. [00:29:10] I know that I've seen our T3 increase in high-stress states. That cortisol level [00:29:15] going up will impact that. You know, maybe talk us through the three or four things that [00:29:20] are critical when it comes to optimal thyroid function, maybe before y- we [00:29:25] even get into medications and all that other good stuff. Absolutely. So when we're looking [00:29:30] at hypothyroidism as a whole, like we said, 95% of the cause [00:29:35] of hypothyroidism, 95% is autoimmune. Mm-hmm. So what do we know about [00:29:40] autoimmune? I like to refer back to Alessio Fasano's analogy [00:29:45] of the three-legged stool, 'cause I think that's beautiful. Where we have that one leg, that's [00:29:50] genetics. Genetic predisposition. Your mom, your sister, your aunt have [00:29:55] some kind of autoimmune condition. It doesn't have to be Hashimoto's. It could just be [00:30:00] autoimmune in general. So you have that autoimmunity predisposition. Then the next leg [00:30:05] of the stool is leaky gut, and any gut expert I talk to goes, "Oh, yeah, about [00:30:10] 100% of us have leaky gut." I'm like, "Right? Who, who doesn't at this point?" Mm-hmm. Unless you are [00:30:15] way, way, way ahead of the game, and you've been on a gut healing protocol for years, and you make it your [00:30:20] life's mission. And then the third leg of that stool is a [00:30:25] trigger. So this is where we see hormonal fluctuations, like [00:30:30] during pregnancy, during perimenopause and menopause, and that's a [00:30:35] time, especially in a woman's life, because we, we have wildly flush, fluctuating hormones.[00:30:40] That's a time where we'll see that Hashimoto's switch that may be hanging out [00:30:45] in the off position for years- Hmm ... just the switch is on. And this is where [00:30:50] women say, "It was after my first child that my body went to hell in a handbasket." "It was [00:30:55] after I turned 42 that my body went to hell in a handbasket. I never got it back." [00:31:00] Right, because that, that hormonal fluctuation that occurred, that occurs naturally, [00:31:05] is a stressor on the body. So never mind- Right ... all the other stressors, death, [00:31:10] divorce, uh, a move. I mean, all of those stressors, chemical stressors, [00:31:15] environmental stressors, the toxic soup environment that we're living in. All of those [00:31:20] stressors are a trigger for Hashimoto's. Mm-hmm. [00:31:25] So that's the Hashimoto's bucket. Then over here we have this little 5 to [00:31:30] 10% bucket where we see things like- A history [00:31:35] of eating disorders. So over-restriction, which really could include [00:31:40] what I was doing back in the day with competing. I mean, it wasn't a, an eating disorder, but it was [00:31:45] disordered eating. I mean, when you are counting your macros to that- Right, right ... to that extent and you are [00:31:50] that hyper-focused, um, that's extreme restriction, and that's extreme [00:31:55] exercise to go to the gym twice a day. But I understand it even outside of a [00:32:00] competition, women get into that mindset because they're so frustrated [00:32:05] with their runaway body, with the person that they don't recognize in the mirror. They're trying everything. They're [00:32:10] doing five different diets in a week, and they're hitting the gym twice a day, three times a day [00:32:15] just to feel better and get the damn weight off, right? Mm-hmm. So we also see [00:32:20] kind of behavioral things over here. Um, we do know that birth control [00:32:25] taken for more than 10 years, and I'm guilty as well, I'm not, I'm not throwing shade. I'm [00:32:30] totally guilty- Yeah, yeah ... increases your risk of hypothyroidism by 283%. [00:32:35] It's crazy. Wow. It's crazy. Birth control increases [00:32:40] your risk by what? 283%? 283, yeah. Wow. I [00:32:45] don't know where they got the 83. It's kind of a random number, but it is a stat that I have [00:32:50] seen over and over again and confirmed it with a study. I'm like, oh, yes, [00:32:55] this is true. And this is what the synthetic hormones coming into our body, that I'm sure [00:33:00] you and I were both offered- Right ... with our PCOS. Right. This is what the synthetic [00:33:05] hormones do to our thyroid. Interesting. Wow. We don't talk [00:33:10] about that enough and how... Well, that brings us to a really important conversation around [00:33:15] all hormones, right, for women, and weight and metabolism and their [00:33:20] cycles and the loss of cycles. Where, where's the thyroid in all this [00:33:25] shifting? What's happening with the thyroid, and how much is it playing into sort of [00:33:30] everything from fertility to, you know, the transition to perimenopause, to menopause, to [00:33:35] weight gain? You probably have different answers for all of those, but, you know, I just wanna paint for anyone [00:33:40] listening, like how the thyroid is a big part of all of these transitions as [00:33:45] well. Absolutely. So when we're talking about fertility, we know that a low, [00:33:50] low thyroid function or having hypothyroidism, and you could have it and be [00:33:55] diagnosed and be on T4 only, but you're not optimal, or you could have it and [00:34:00] maybe be undiagnosed and untreated. But we know that thyroid [00:34:05] dysfunction is a huge contributor to infertility and [00:34:10] miscarriages. Yeah. Uh, one of my patients, she had, she had trouble getting pregnant. [00:34:15] When she finally got pregnant, she had two or three miscarriages. She was, of course, [00:34:20] on T4 only. She had Hashimoto's. Her mother had it as well. She was on [00:34:25] T4 only for about 10 years. When we finally tested her, her reverse T3 was through the [00:34:30] roof. We knew that T4 only was not... It was actually keeping her body in a, in a [00:34:35] lockdown hibernation mode state, so naturally she couldn't get pregnant because the body's not [00:34:40] going to let you when it thinks that you're dying. When it literally thinks that you're lying in a [00:34:45] hospital bed fighting for your life, you're not gonna get pregnant. It's not gonna let you. Right. Our bodies are that smart. [00:34:50] So it wasn't until we changed her protocol, lowered her T4, brought in T3, [00:34:55] totally changed up her regimen, that allowed her to get pregnant. So I always joke, I say, yes, you know, [00:35:00] I, I, I got a woman pregnant, ha-ha. Uh, because we fixed her thyroid. So [00:35:05] that's, that's fertility. Then we have actually the baby's brain development. My [00:35:10] stepson is nonverbal autistic. He will never, ever live a life on his [00:35:15] own. He will always need to be cared for until the day that we all die. Yeah. But I look at [00:35:20] mom, and I know that they had fertility issues, and I know they had a couple [00:35:25] miscarriages, and I see hypothyroidism in mom. Mm. I [00:35:30] see that it was never treated, and that plays a huge role in the baby's [00:35:35] brain development in utero. Uh-huh. Then we move on to, like you said, my [00:35:40] answer might be different for perimenopause and menopause. Then we move on to midlife. So we get through the [00:35:45] pregnancy stage, right? So we know that even if you have a successful pregnancy, that [00:35:50] stressor of fluctuating hormones can turn on Hashimoto's. But now we go into [00:35:55] midlife, and now we're in perimenopause, where what's happening? Our progesterone is [00:36:00] dropping, followed by our testosterone. Then our estrogen goes on a wild [00:36:05] rollercoaster ride where we're estrogen dominant one day and estrogen deficient the next [00:36:10] day- Yep ... before we go into menopause where estradiol just jumps off a cliff. [00:36:15] Those fluctuating hormones are a huge stressor on the body, [00:36:20] so that's where we see Hashimoto's present itself during perimenopause and menopause, and [00:36:25] that's what I call thyropause. And this is why I'm, I'm kind of s- dying on a [00:36:30] hill, standing from the rooftop, shouting it out, "Hey, yes, we love that Halle [00:36:35] Berry is out there speaking about her misdiagnosis of herpes when it was really [00:36:40] menopause. That's awesome." Right. Yeah. But what about the master gland? What about [00:36:45] thyropause? And again, we can throw testosterone, progesterone, estrogen at you all day [00:36:50] long. There's a, there's a bioidentical hormone clinic on every corner these days. Oh, yes. We [00:36:55] know. Right. Yeah, you and I can go off on that for a while. Yeah. Yep. [00:37:00] But are they testing the thyroid? And if they are, are they giving everybody a [00:37:05] one-size-fits-all protocol? Yep. And that's what I see. Either they don't test it, or [00:37:10] everybody gets the same treatment, and that's not how the thyroid needs to be treated. It's a [00:37:15] nuanced, beautiful gland, and you are a unique, beautiful [00:37:20] person. So you need that, that nuanced treatment that is going to [00:37:25] fit you and what we see in your labs, and that's why we spend time with patients [00:37:30] to really dissect what they actually need instead of just shipping them some hormones [00:37:35] in a box that everybody gets for $129 a month. [00:37:40] Speaking the same language for sure. These are things that get under my skin because, uh, you know, I would love for it to be that [00:37:45] easy for everybody, but I think you're just gonna get a very band-aided approach. So many women [00:37:50] go on, you know, that very standard HRT protocol and do [00:37:55] well initially, maybe for a month, maybe for two months, 'cause maybe they've gone from a depletion state to [00:38:00] now having everything. But sure enough, you wait long enough and, and, and kind of the wheels start to [00:38:05] fall off again. So, you know, what, what should women be aware of? They're going out there. [00:38:10] They're... You know, now they can get HRT, like you said, from anywhere, whether it's a pellet, [00:38:15] bio-identical, a patch, a pill that's conventionally prescribed. You know, what should they [00:38:20] be thinking about and pushing back on before they fill those prescriptions? [00:38:25] So I would say, first of all, make sure that you are [00:38:30] thoroughly tested. So any doctor that says no to testing, it's time to get a new [00:38:35] doctor. Thank you. Because if they don't want to see everything that's going on inside you, [00:38:40] if they don't wanna be that, that medical detective with you in collaboration to [00:38:45] sit down and say, "Okay, here's your symptoms." Oh, wait, first, my rule of thumb [00:38:50] is any practitioner you work with has to ask you four [00:38:55] words, that you have- Hmm ... to hear these four words: How do you [00:39:00] feel? Yeah. Because we have to know how you feel in order to lay [00:39:05] over those symptoms over your labs. Now we look at it together. Now we say, "Okay, [00:39:10] this makes sense why you're feeling this way. We see this in your labs." Right? We're not [00:39:15] going to treat someone that's like, "I feel great. I'm living my best life." Well, we're not going to give you any kind of [00:39:20] change in hormone replacement or thyroid hormone when you're, when you're saying everything is [00:39:25] cool. So we wanna know how you feel. And then I would say yes, you have to start with [00:39:30] testing, and you have to have somebody that's going to sit down and explain to you that, [00:39:35] that, that puzzle, why you feel a certain way and what we're seeing in your labs, and then what are [00:39:40] we going to do about it. And in The Thyroid Fix, I actually do guide [00:39:45] readers into knowing, being able to interpret their own labs, know [00:39:50] exactly what they need with thyroid hormone replacement, and even changes in [00:39:55] doses so that they can have that educated conversation with their [00:40:00] doctor. And then I also give tips as to what to ask for before you [00:40:05] even go in. And this is... I don't care if you're going into an insurance-based medical [00:40:10] provider- Right ... or if you are going to pay thousands of dollars to a functional provider, you need to know [00:40:15] beforehand how they address thyroid and hormones, and there are some key [00:40:20] questions to ask that will give you the answer as to whether or not you should move forward.[00:40:25] So helpful. And let's talk, uh, for just a couple minutes that we have [00:40:30] remaining. You know, you know there's an explosion, along with all the hormone clinics, there's an explosion of [00:40:35] information around GLP-1s or use of GLP-1s. The perimenopause and [00:40:40] menopause group, by the way, is the largest user of GLP-1 medications and [00:40:45] peptides, you know, all the different peptides that are coming out. One of the big, you know, [00:40:50] there's... GLP-1 medications have gotten a lot of flack that all the side effects are not on there. [00:40:55] They're not really talking about them or, or they've gotten suppressed f- in terms of being, you know, uh, [00:41:00] revealed to the consumer. But one that is revealed is sort of the connection to thyroid, [00:41:05] and thyroid disorders, and thyroid cancer. What do people need to know about [00:41:10] GLP-1 use and thyroid hormones? So I [00:41:15] think you and I take a very similar approach to this. I, I feel like these GLP-1 [00:41:20] medications, it's like a double-edged sword. It, it, it's, it's the, it's the first [00:41:25] medication that has come to market where there's a Jekyll and Hyde effect, where on the one [00:41:30] hand we are seeing it save lives, uh, be the [00:41:35] answer to obesity and type two diabetes- Definitely 'cause we know, I mean, my goodness, carrying around [00:41:40] excess weight is detrimental to your health in so many ways. And then on the other hand, we have the [00:41:45] over users, we have the IG influencers pushing them like multi-level marketing [00:41:50] products, and we have people that are losing their muscle in droves, and we actually are having some [00:41:55] downregulation of the thyroid, not thyroid cancer however. What we're, we have not [00:42:00] had, that I'm aware of in the literature, a single [00:42:05] case of medullary thyroid cancer that is the black box warning on GLPs. When [00:42:10] they came out with that black box warning- Mm-hmm ... they were basically testing rats at [00:42:15] a super physiological dose, 20 times that of, that what a human would actually [00:42:20] ever take. Hmm. Interesting. And in addition to that, those rats, they have [00:42:25] different receptor sites on their cells that we don't have, that [00:42:30] basically set them up for that super physiological dose of a [00:42:35] GLP to induce thyroid cancer. So it's not really a, a, [00:42:40] an, an equivalent comparison to humans, so we can kinda throw that out.[00:42:45] But honestly, the, the muscle loss, the hair loss that [00:42:50] thyroid patients- Oh, yeah ... are already dealing with- Yeah ... the nutrient depletion, the, the [00:42:55] lack of protein intake that women are already notorious for independent of, of [00:43:00] taking a GLP-1. They're not getting in enough protein, which is contributing to their hair loss and [00:43:05] their muscle loss. You know, we're, we're seeing some detrimental effects when it's used inappropriately. [00:43:10] Do you like microdosing GLP-1s? Yes. You like that. So, [00:43:15] so do I. I like the very small doses. But, but as I'm talking to you, I'm wondering, like, for [00:43:20] every patient who's thinking about microdosing a GLP-1, they should be checking their [00:43:25] thyroid as well. 100%. So I have a great story that I [00:43:30] actually tell in the book, and it's worth repeating over- Yeah ... and over, especially for the women out [00:43:35] there that they might be using a GLP-1 right now, and they're like, "This is supposed to work. [00:43:40] This worked for all of my friends and everybody on, you know, Beverly Hills [00:43:45] mom program" Yeah, yeah. Mom Beverly Hills, "But it's not [00:43:50] working for me. Why is that?" So we had a patient, she came in, she was a [00:43:55] full-blown type 2 diabetic. Mm-hmm. I mean, she was one of those that she needed the GLP, and she needs it to [00:44:00] work. Right. Her A1C was an 11.9. She was- Wow ... 100 [00:44:05] pounds overweight. I mean, it was, it, it was full-blown. It was full-blown. Yeah. She was on this drug [00:44:10] for about a year and a half. No movement whatsoever in her A1C, [00:44:15] no movement at all in her weight And we test her thyroid. Now she was [00:44:20] diagnosed Hashimoto's already, 15 years on T4 only. And of course, we [00:44:25] test her, free T3 is low, reverse T3 is high. It's like a 22.[00:44:30] Mm. So again, just like the woman that I shared with the fertility struggles, [00:44:35] this woman, her body was in lock down survival mode. That's what that elevated [00:44:40] reverse T3 tells us. It's like you're basically a bear in hibernation in the winter. [00:44:45] Not much is going to work. So her body wasn't shedding the weight, it wasn't [00:44:50] allowing that GLP to actually impact her A1C. So we start, we [00:44:55] change up her thyroid medication, reduce the reverse T3, get her body out of that [00:45:00] survival mode, bring up that active thyroid hormone, that free T3 from the bottom [00:45:05] of the barrel. Yes, it was within normal limits, but it was low. And then all of a [00:45:10] sudden, her A1C starts dropping. Wow. She actually got the [00:45:15] benefits of the GLP-1. Her A1C drops to a 5.4, and she [00:45:20] loses 150 pounds. Wow. Finally. Now she was paying out of pocket for that [00:45:25] GLP, I mean, she was paying a co-pay, but she wasn't paying the hundreds or thousands of dollars a month that some people are. [00:45:30] I mean, she was just burning money at that point. People are burning money on [00:45:35] GLPs when they're not checking their thyroid and addressing that low thyroid function, or the [00:45:40] non-optimized thyroid function. Mm. Mm, mm, mm. Do you feel like everyone who [00:45:45] is digging into their thyroid should be starting with T3 as, as [00:45:50] their, as their starting point, not even starting with the T4 medications? You know, it [00:45:55] just depends. I mean, I think some people are sensitive, so when we're seeing [00:46:00] cortisol issues, if we're seeing low ferritin, sometimes [00:46:05] starting those people on just T3, they can almost get a little bit overstimulated. [00:46:10] They don't feel good. They feel kind of, I call it icky and sticky. Mm. Like they're a little bit too jittery, like [00:46:15] drank too many Red Bulls kinda feeling. Yeah. Well, then they might be sensitive to the T3. So [00:46:20] if we can balance it with some T4, or maybe we start them with [00:46:25] NDT and a little bit of liothyronine with that NDT just to change the [00:46:30] ratio, then in those cases, that's, that's kind of like the perfect [00:46:35] scenario. Now there are some times where you see that reverse T3 super high- [00:46:40] You start on T3 only because if you give that person with a reverse T3 of a [00:46:45] 25, if you give them T4, they're just gonna continue pushing it to [00:46:50] reverse, and it's gonna keep them in that, that hibernation state. And I think it's important [00:46:55] for the readers to know the reason why I'm saying this, reverse T3 is built into our [00:47:00] bodies beautifully. If you are lying in the hospital, if you're lying in [00:47:05] the ICU or the ER fighting for your life, our bodies know that at that point in time you don't have to burn fat, [00:47:10] think, you don't have to feel good. You just have to lie there and survive. So [00:47:15] reverse T3 will go up to do exactly that, shut down your metabolism, [00:47:20] shut down your energy, shut down your hair growth- Interesting and shuttle all [00:47:25] energy to survival, survival, survival. The problem is, is when reverse T3 [00:47:30] is elevated when we're not lying in the hospital bed. Right. So we don't want it that high when we're [00:47:35] walking around trying to live life. Oh my gosh, I could talk to you about the thyroid probably for [00:47:40] another hour, but you're the thyroid fixer. Your book is The Thyroid Fix. Tell us [00:47:45] what readers can find in your book that maybe we haven't talked about today. So the way I [00:47:50] structured this book is very unique. I mean, obviously I've been in the thyroid space for decades. I've read [00:47:55] every thyroid book out there, and I really wanted to give the reader what they're missing. So [00:48:00] most thyroid books out there will talk about how to heal your thyroid naturally, and that's it. Or they'll be way [00:48:05] too clinical written by endocrinologists, and they still kind of hang on that TSH is the gold [00:48:10] standard theory. I come in right in the middle. We're talking about how TSH is not the gold [00:48:15] standard. We need to look at free T3. We need to look at reverse T3. And then I walk [00:48:20] readers through... Well, we're kind of the same age, so remember the choose your own adventure [00:48:25] books? Oh, yeah. Where you got to like- Yeah ... if this, then you move here. If this- Right. [00:48:30] Yeah ... then you... So that's how I take readers through in The Thyroid Fix, where, [00:48:35] like I said earlier, I'm teaching them how to read labs. I've done this with thousands of people. I can [00:48:40] absolutely teach you how to interpret your own labs, and then to move to that next column, [00:48:45] whether you're on thyroid medication or not, so this is for the diagnosed and the undiagnosed, [00:48:50] and to figure out exactly what you need. So in addition to that hormone replacement, the [00:48:55] thyroid hormone replacement, whether it's NDT, T3 only, T4 and [00:49:00] T3 com- combined, compounded, whatever that combination is, I teach you [00:49:05] exactly what you need. Now, obviously you can't prescribe that for yourself, so that's [00:49:10] where we move down the pipe and I'm actually teaching you how to find a doctor and talk to that [00:49:15] doctor and really make that practitioner a collaborator in your [00:49:20] health, because it all starts with you being empowered, knowing exactly what you [00:49:25] need. And of course, we get into the biohacking. We get into the nutrients. We talk about [00:49:30] diet. But it really starts with getting the right hormones on board, which most [00:49:35] people basically shy away from because, you know, I mean, how dare you actually [00:49:40] teach a person what medication and hormone they need? Right. But I truly believe [00:49:45] that we can put that power into the women's hands, into the reader's hands [00:49:50] and, and give them the, the, the advocacy, that power to have that conversation, that [00:49:55] educated conversation with their doctor. I think that's so helpful for [00:50:00] everyone. At the end of the day, I, you know, continue to see and believe in, you know, even everyone that comes on [00:50:05] the show. I think we're in alignment with the fact that it's personalization, right? And, [00:50:10] and no one can standard- standardize, standardize personalization, [00:50:15] because at the end of the day, you are you, and you have your own unique set of [00:50:20] chemistry, stressors, you know, things that work for you, things that work against you. And I think to [00:50:25] do medicine in any other way, when we try to take shortcuts, is not serving us [00:50:30] well. So I think this is hopefully gonna be an incredible resource for anybody out there [00:50:35] really trying to understand how their thyroid fits into the overall scheme of their health, [00:50:40] what to test, what to ask for, where to start. I think these are the things that are [00:50:45] just so confusing when people are trying to wander this territory. So thank you for taking [00:50:50] time, joining us today to talk about all things thyroid. And if anyone wants to [00:50:55] connect with you, what's a good way for them to do that? Absolutely. So you can go to my [00:51:00] website at dramie.com, D-R-A-M-I-E.com. And on there you'll [00:51:05] find all the links to book a free call if you're interested in working together. You can join [00:51:10] the Facebook group, which is free to the public. It's called Just Fix Your Thyroid, and that's an [00:51:15] amazing group where you can post your labs if you're not sure. If you're like, "Ooh, this [00:51:20] sounds like I'm not quite optimized," or, "It sounds like I might have a thyroid problem," you can get your labs done, [00:51:25] post them in there, and we're in there loving and supporting you and really giving you real world [00:51:30] guidance. And then of course there is the book, which can be found at any [00:51:35] major book seller, Amazon, Barnes & Noble, Target. You can also go to [00:51:40] thyroidfixbook.com. All right, last question: What makes you whole? What makes [00:51:45] me whole is family time and keeping [00:51:50] that sacred. You know, I think as entrepreneurs, it's so easy [00:51:55] to get pulled into that type A driver personality where we go, go, go.[00:52:00] Mm-hmm. And then you overlay that with we're both women, too, so we, we put extra pressure on [00:52:05] us to super multitask and do everything for everyone. Whether it's our [00:52:10] family, our patients, or, or whoever, our friends. We need to take that time for ourselves. And, and I [00:52:15] found in this journey of health and healing and, and [00:52:20] entrepreneurship all combined- Yeah that I need to block out time and keep it [00:52:25] sacred or I don't feel whole. I feel discombobulated, disjointed, broken [00:52:30] apart. I have that coffee time with my husband in the morning. I have my dog walking [00:52:35] time, which I, you know, no is a, is a full sentence for me now. And I, and I'm very proud [00:52:40] of it. After turning 50, I've learned that no- no is a full sentence. I love that. So I keep that time [00:52:45] sacred in order to keep me whole and sane as well. [00:52:50] I love that. I think so many of us come back to family. I always say, you know, I always tell [00:52:55] everyone that if I didn't have my family, I think I could work myself [00:53:00] into a hole and not even realize that I was self-destructing in the [00:53:05] process. You know? Yeah. It's, like, such a great check and such a great way to [00:53:10] experience all the highs and even the lows, right, that come along with whatever we're doing, you know, on [00:53:15] our journey. So I love that. Thank you again for taking time out to join us today. And [00:53:20] for everyone else, don't forget to share this episode with someone who may need more information [00:53:25] about their thyroid or their health in general. And remember, don't forget to subscribe. We post new [00:53:30] episodes every week. I'll see you next time. Before you go, take a second to reflect on [00:53:35] what stood out for you today. Then if you can, leave a quick review wherever [00:53:40] you're listening. It really helps other people discover Whole Plus and start their own [00:53:45] healing journey. And don't forget to follow me on Instagram, @drtazmd. I love [00:53:50] hearing how these episodes are supporting you.