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Thyroid Wisdom with Dr. Gibbs: What We Didn’t Learn in Medical School · Love and Science Fertility

• 0:30
  Speaker 1: Welcome back to the Love and Science podcast, and today we have a wonderful colleague and friend of mine.
• 0:35
  Speaker 1: Her name is Dr Dana Gibbs.
• 0:36
  Speaker 1: She is a board certified ear, nose and throat surgeon who does amazing, amazing work in the space of thyroid and hormones, and I send her my patients because when I'm stumped, dr Gibbs knows just what to do.
• 0:51
  Speaker 1: And so today we're gonna have a lovely conversation about her expertise in the space of hormones and what she what to do.
• 0:55
  Speaker 1: And so today we're going to have a lovely conversation about her expertise in the space of hormones and what she has to offer, what she knows that most of us don't know.
• 1:02
  Speaker 1: So welcome, dr Gibbs.
• 1:04
  Speaker 2: Thank you for having me.
• 1:06
  Speaker 2: This is going to be great.
• 1:07
  Speaker 1: Absolutely so.
• 1:08
  Speaker 1: Can you tell me a little bit about sort of who you are and what you do in the current iteration of your career right now?
• 1:17
  Speaker 2: Sure.
• 1:17
  Speaker 2: So I am a board certified otolaryngologist, head and neck surgeon and otolaryngic allergist turned hormone specialist, and that's quite a mouthful.
• 1:30
  Speaker 2: But the reason I bring that up is because I started my hormone journey back with the thyroid and one of the surgeries that ENT doctors do all the time is remove thyroid nodules or remove thyroid glands, and so I kind of came at hormones from a different perspective than where most endocrinologists come at hormones, and I think that's actually a good thing, because my perspective is different and when you combine perspectives, a lot of times you get new insights, and so I think that's super, super helpful.
• 2:13
  Speaker 1: That's amazing and I see that all the time in what we do.
• 2:16
  Speaker 1: People who are very good surgically, they just they think about things in a way that if you don't have that visual, you might not put the pieces together.
• 2:26
  Speaker 1: So I think that's absolutely fabulous that you have that background.
• 2:30
  Speaker 1: Tell me a little bit more so you know, when I met you in person for the first time I think it was in April I learned something very interesting about you combining your doctor brain and your own fertility journey.
• 2:43
  Speaker 1: Do you mind sharing that interesting story for my listeners?
• 2:46
  Speaker 2: Sure, yeah, and it's very relevant to what's going on here, because I was a tired teen and I was a tired early young adult and to the point where, you know, I had had this dream of going to medical school and becoming a brain surgeon or something like that, since I was, I don't know nine, 10 years old.
• 3:10
  Speaker 2: And when I got into college or got, you know, got close to thinking about going to college and going into college, I was like I can't do it.
• 3:21
  Speaker 2: I know, I'm too tired to go to med school, I can't possibly.
• 3:26
  Speaker 2: And so I didn't.
• 3:28
  Speaker 2: I went to college expecting to get an engineering degree until I figured out that I actually didn't like math as much as that.
• 3:35
  Speaker 2: And then I was kind of stuck for a while.
• 3:38
  Speaker 2: I was like what am I going to do?
• 3:39
  Speaker 2: Oh, my gosh.
• 3:40
  Speaker 2: So I thought, well, okay, I'll go be a research scientist, I'll work in a lab.
• 3:45
  Speaker 2: And so I did that for a couple of years and the funny thing about it was that all the people in the lab who were really having a good time were empties.
• 3:56
  Speaker 2: And I was like, oh well, okay, I guess I'll go take the MCAT.
• 4:03
  Speaker 2: And I did.
• 4:05
  Speaker 2: And I got into medical school and I was like, okay, here we go, this is it.
• 4:10
  Speaker 2: And if I, if I, crash and burn, so be it.
• 4:16
  Speaker 2: And it was a near miss.
• 4:18
  Speaker 2: I mean it was.
• 4:19
  Speaker 2: It was a close, close call because I was still super tired.
• 4:23
  Speaker 2: I was cold all the time.
• 4:25
  Speaker 2: I was, I don't know.
• 4:29
  Speaker 2: I had all kinds of symptoms that I did not recognize at the time.
• 4:33
  Speaker 2: They were thyroid related.
• 4:35
  Speaker 2: I had no idea and I just thought, well, I'm just, I'm just lazier than all those other residents.
• 4:43
  Speaker 2: I don't have the energy to study as hard as they do.
• 4:47
  Speaker 2: I don't remember things as well as they do.
• 4:50
  Speaker 2: You know, there was all this stuff and truthfully, it was like I said it was a near thing.
• 4:56
  Speaker 2: But I managed to graduate med school.
• 4:59
  Speaker 2: I finished residency.
• 5:00
  Speaker 2: You know I'd been to the health clinics multiple times and they'd said, oh, you're just depressed here, take these antidepressants.
• 5:08
  Speaker 2: And nobody not me, not anybody thought one second that I could be hypothyroid.
• 5:17
  Speaker 2: Nobody figured that out.
• 5:20
  Speaker 2: And then, when I was out of residency and I had moved back home to be where my mom was because I was so tired, I couldn't think of anything else to do One of these days, one, I mean, I think I'd been out of residency for maybe four years.
• 5:37
  Speaker 2: At this point I was sitting in an allergy conference and I'd heard the lecture that I was in before, because it was the same foundational thing that they teach you every year.
• 5:49
  Speaker 2: And I got bored and I'm like, okay, I'm going to go into the alt room and listen to the other lecture.
• 5:55
  Speaker 2: And here this guy puts up this list of symptoms and you know, and it was your hair's thin and your, your eyebrows on the sides have fallen out and your nails won't grow and you're constipated all the time and you're you're pasty, pale and you can't build muscle.
• 6:13
  Speaker 2: There's all kinds of stuff.
• 6:14
  Speaker 2: And I sat there and my jaw was just on the floor because every single thing that he said was me and my impression prior to that had been only fat people have hypothyroid problems, and so it was really an eye-opener.
• 6:31
  Speaker 2: And then the next thing he said was I don't know why it works, but some people do better on armor thyroid, even if their TSH is normal.
• 6:39
  Speaker 2: And I didn't care that he didn't know why it worked, I didn't care.
• 6:45
  Speaker 2: I was like he just described me to a T.
• 6:49
  Speaker 2: I'm going to go try what he said.
• 6:51
  Speaker 2: And he was right and it worked and it was like a miraculous oh who is this, what have you done with Dana?
• 6:59
  Speaker 2: And who is this new person?
• 7:02
  Speaker 2: Because I couldn't fall asleep before, because my feet were so cold, I would have to get up and go stick my feet in a tub of hot water before I could lay back down in the bed and fall asleep.
• 7:14
  Speaker 2: Because I couldn't, I just couldn't, and then I would wake up at 2 am drenched in sweat.
• 7:20
  Speaker 2: And so this was every single night.
• 7:23
  Speaker 2: This was my life.
• 7:24
  Speaker 2: I thought I couldn't have a baby.
• 7:27
  Speaker 2: I just I was just told oh, you're never going to have a baby.
• 7:32
  Speaker 2: My periods were never regular.
• 7:33
  Speaker 2: Never, never, never.
• 7:35
  Speaker 2: I would go months without a period.
• 7:38
  Speaker 1: Did anyone think to evaluate you for that?
• 7:40
  Speaker 1: Because, I mean, my gynecology brain is like, oh yeah, Like you know, that's one of the first things you check.
• 7:49
  Speaker 2: Well, I mean, I had been checked many times.
• 7:50
  Speaker 2: Like I said, I checked, I got checked, my TSH was fine.
• 7:52
  Speaker 2: They said, oh, take some antidepressants.
• 7:54
  Speaker 2: You know nobody, and and I wasn't really, you know, starting a business, I wasn't really super urgent about having a baby at that point.
• 8:05
  Speaker 2: Anyway, register that this is a big thing for me.
• 8:14
  Speaker 2: It didn't affect me emotionally in the way that I think a lot of folks who really really want to have a baby would be affected by it.
• 8:19
  Speaker 2: But what it did do was it opened my eyes to that list of symptoms.
• 8:25
  Speaker 2: And you know all these thyroid patients coming through my office, you know, and I'm taking out part of their thyroid or oh, that wasn't cancer, oh, it was.
• 8:33
  Speaker 2: They said it was lymphocytic thyroiditis.
• 8:36
  Speaker 2: Well, that's another name for Hashimoto's disease.
• 8:38
  Speaker 2: And I said to them did you know you have Hashimoto's disease?
• 8:41
  Speaker 2: They're like no, what's that?
• 8:42
  Speaker 2: Nobody paid attention to it.
• 8:45
  Speaker 2: And I would look at them and I would go they have all those same symptoms that I have and we would do their surgery and I would send them off the endocrinologist and they would come back 50 pounds heavier and miserable and I'd go okay, well, what are you doing?
• 9:02
  Speaker 2: Well, they said my TSH was fine.
• 9:04
  Speaker 2: I'm like, oh well, here we go and.
• 9:08
  Speaker 2: And so it felt very out of the box for me to give them thyroid medicine and try to balance them.
• 9:13
  Speaker 2: But they were miserable.
• 9:20
  Speaker 2: And I'd say, look, I'm going to do this and your doc is going to be mad because your numbers are going to change and your TSH is going to be low and all this stuff.
• 9:25
  Speaker 2: And truthfully, I didn't really know what I was doing.
• 9:28
  Speaker 2: Now that I think about it, I didn't really know what I was doing, but everybody that I helped gave me just a little more confidence and eventually I found a lecture series that taught me exactly what was going on, and it was, once again, it was a light bulb moment is, oh, there's more to it than TSH, wow, and.
• 9:56
  Speaker 2: And so then, once I had that knowledge and I knew what tests to order and I knew the right way to treat those people, and my success just got better and better and better.
• 10:09
  Speaker 2: And I started noticing, you know, one of the things that that I would do is is, you know, ordinarily the systems review.
• 10:18
  Speaker 2: And I started noticing, okay, I'm getting people in here who've had a bunch of miscarriages and I'm getting people in here who have had.
• 10:33
  Speaker 2: You know, here's another example.
• 10:34
  Speaker 2: It's like so I saw a lady one year and she was there for sinus problems and her CT was terrible and she needed sinus surgery.
• 10:39
  Speaker 2: And I was like, okay, but you also answered this list of questions and I think you have a thyroid problem.
• 10:45
  Speaker 2: And she was like, well, they said my TSA was fine.
• 10:47
  Speaker 2: I'm like, yeah, I know, but bear with me, let's try.
• 10:50
  Speaker 2: If you hate it, after six weeks we won't keep doing it.
• 10:54
  Speaker 2: And I didn't hear from her for like six months and I'm like, does she hate what's going on?
• 11:01
  Speaker 2: And she's, you know, I don't know.
• 11:02
  Speaker 2: But anyway.
• 11:03
  Speaker 2: So she came back six months later and I was like well, so you're ready to schedule your sinus surgery?
• 11:10
  Speaker 2: She's like no no, I don't need that anymore, I'm completely fine.
• 11:12
  Speaker 2: I just want to refill on that thyroid medicine you gave me.
• 11:15
  Speaker 2: And that moment was wow, I really, I'm really onto something here, because if it's fixing people's immune system problems, what else is it going to fix?
• 11:53
  Speaker 2: Yeah, and people with their multiple miscarriages.
• 11:57
  Speaker 2: I, you know I'm noticing this and I'm like, hey, I know that you came here for allergies, but let's try this thyroid thing on you.
• 12:05
  Speaker 2: And you know, the first person who came back after having carried a baby to turn after multiple miscarriages, um, after after they had let me manage their thyroid through the whole thing, I cried.
• 12:22
  Speaker 2: I still choke up when I think about it, because those people are desperate.
• 12:28
  Speaker 1: They're desperate.
• 12:29
  Speaker 1: Yes, and actually that's a lot of our listeners.
• 12:32
  Speaker 1: Dr Gibbs, if you're listening to this and that is you I want you to be seen and heard right now, because we see you, dr Gibbs sees you and she helps people just like you, yeah, so thank you for sharing that.
• 12:46
  Speaker 1: That is so beautiful, yeah.
• 12:48
  Speaker 2: So tell us oh sorry, go ahead.
• 12:52
  Speaker 2: Um, so.
• 12:54
  Speaker 2: So then the next one that I had success with was a woman who had graves disease, and she had um, she had been on methimazole, which is a thyroid suppressing medicine, for a long time and had been told, well, as long as you're on that, you're not going to be able to have the baby, blah blah.
• 13:12
  Speaker 2: And I said, well, let's try this technique.
• 13:13
  Speaker 2: And so it's like, okay, you're going to be able to have a baby, blah blah.
• 13:15
  Speaker 2: And I said, well, look, let's try this technique.
• 13:16
  Speaker 2: And so it's like okay, you're going to take a little extra methimazole, but then I'm going to give you back some thyroid hormone.
• 13:21
  Speaker 2: And she was able to get pregnant.
• 13:24
  Speaker 2: It was like, dang, there's something, there really is something to this.
• 13:27
  Speaker 2: And so you know, as time went on because you know I was in ENT for 23 years, I was in, I was doing just ENT people started asking me.
• 13:40
  Speaker 2: They're like well, you know, you're taking care of my thyroid, can't you give me menopausal hormones too, can't?
• 13:46
  Speaker 1: you do this, Can't you do that, and I'm like no, no, no, no, no, no.
• 13:49
  Speaker 2: I am an ENT doctor, I cannot do that, but but when I started thinking about leaving the practice where I was at, I was like, okay, what do I want to do?
• 14:00
  Speaker 2: And these are the patients that really light my fire and really float my boat.
• 14:07
  Speaker 2: And no, I'm not doing surgery anymore.
• 14:11
  Speaker 2: No, I'm not getting to do surgery anymore.
• 14:13
  Speaker 2: But I really, boy, I really get a lot out of fixing people when they come in.
• 14:23
  Speaker 2: And most of my patients come in and they're just so tired, that's.
• 14:26
  Speaker 2: You know, weight gain, yes, but fatigue is the number one thing that people come in for, and they have tried everything, so, anyway.
• 14:38
  Speaker 2: So that's, that's kind of my story and that's where I'm at.
• 14:41
  Speaker 1: And then you fix your own thyroid right.
• 14:43
  Speaker 1: Do you can?
• 14:44
  Speaker 2: you share, yeah, and, and.
• 14:46
  Speaker 2: So you know, as things happen, I, like I said, when I was first told that I wasn't going to have a baby, I was like I'm not super chuffed about it.
• 15:00
  Speaker 2: But you know, eventually I met somebody and I was like, hey, this would be good.
• 15:06
  Speaker 2: And, having fixed my thyroid and having fixed my energy levels, my periods were now regular and I was like, would be fixed my energy levels, my periods were now regular, and I was like, would be, and?
• 15:18
  Speaker 2: And I was able to stop my birth control and conceive.
• 15:20
  Speaker 2: And I was 44, I was 44 years old and my baby's 13.
• 15:26
  Speaker 2: She's getting maybe 14 now and so, yeah, she's, she's a miracle baby, so it's pretty good.
• 15:32
  Speaker 1: I just think you know so much in your story is you sort of stumbling upon these sort of adjunct problems, right, Somebody saw you for one thing, but you you listened and you noticed, right, and you you listened to the whole person, not just, oh, I'm here for my sinuses or I'm here for this, but you looked at them as whole people, in the context of their lives, and you thought you know, I think I can make a difference if I tinker with things and you say you don't know what you were doing, but I think you had a hunch, right, Maybe if you didn't understand all the physiology et cetera, but like you knew that you had something to offer these people that had not been tried before.
• 16:10
  Speaker 1: And so by you know your patients trusting you and letting in you, trusting yourself that you had a skill that other people don't necessarily have.
• 16:20
  Speaker 1: And I mean I had excellent training that the things that you talk about I did not hear about in my training just because nobody does, nobody does this.
• 16:28
  Speaker 1: It's like it's like a empiric body of evidence, like it's like it's almost, like you know, experiential at this point and that's why we need more data, I think.
• 16:37
  Speaker 1: But I think that you have something unique to offer humans, unique to offer fertility patients that even us REIs who are double board certified and learn about the thyroid you know, there are people that meet the limit of who I can help, right, and I like to think I can help everybody.
• 16:54
  Speaker 1: But I know, think of scientific doctors, when you know your limitations I have limitations around this sometimes and when I see somebody and I'm like you know I have, I have done everything I can do and they're not getting better, like you're here and you're willing to help, and that's just like such a gift.
• 17:11
  Speaker 1: So would you be willing to share a little bit about your approach to the patient?
• 17:17
  Speaker 1: I'm sure that's evolved over time, but like when, when somebody is referred to you, how do you think about them and how do you decide what the next steps could be?
• 17:28
  Speaker 2: Sure, so I mean, first of all, I validate them.
• 17:33
  Speaker 2: I believe them.
• 17:34
  Speaker 2: You know when they say I'm tired, when they say my hair's falling out.
• 17:38
  Speaker 2: When you know when they say, you know I've had three miscarriages, you know I believe everything that they're telling me.
• 17:45
  Speaker 2: You know when they say I have tried everything to get these 40 pounds off and I eat bark and twigs and nothing else and I still can't lose the weight, I believe them.
• 17:55
  Speaker 2: You know I'm not.
• 17:57
  Speaker 2: Oh, you should exercise BS.
• 18:00
  Speaker 2: I call BS.
• 18:02
  Speaker 2: You know people know what they're doing they do.
• 18:10
  Speaker 2: So you know I'm looking at their history and I go, I go back and I go deep, I go into a trauma history.
• 18:17
  Speaker 2: I go all the way back to.
• 18:18
  Speaker 2: You know, did you have nuchal cord when you were born, did you?
• 18:21
  Speaker 2: You know, did you have in utero trauma?
• 18:24
  Speaker 2: Did you have childhood trauma?
• 18:25
  Speaker 2: Because those things really affect how your body processes stress and stress.
• 18:37
  Speaker 2: You know, cortisol is the master hormone and if you have high, high levels of cortisol in your body, there are lots of stuff that happens.
• 18:47
  Speaker 2: That's theoretically reversible, but you have to know it's there and you have to pay attention to it.
• 18:53
  Speaker 2: So that's number one.
• 18:56
  Speaker 2: But then the things that I learned about thyroid are stuff that's not talked about in general endocrinology at all.
• 19:04
  Speaker 2: As a matter of fact, it's funny I have a presentation coming up with a hospital in India where the CEO of the hospital has had thyroid problems for most of his life and he wants me to convince his endocrinologist that what I do is better than what they do.
• 19:26
  Speaker 2: And I'm not looking forward to it because people who get into their what I know is what there is to know kind of method and attitude they're very hard to convince.
• 19:40
  Speaker 2: So it's.
• 19:41
  Speaker 2: It's almost like you kind of almost have to have had some personal experience of the failure of what mainstream medicine teaches people in order to be open to these new ideas, in these new methods.
• 20:01
  Speaker 2: And the truth of the matter is none of the stuff that I do is absent from the medical literature.
• 20:07
  Speaker 2: It's there, it's not talked about, it's not mainstream, because you know it has been basically ignored and you know if your endocrinology chair says, oh, we don't do things that way, then you just move on that.
• 20:25
  Speaker 2: I mean we, we do what we're told when we're residents and that's what we got, what you know we come away learning, but anyway.
• 20:31
  Speaker 2: So the concept of the thyroid issues that cause infertility center around abnormal signaling, and it's so, you know.
• 20:43
  Speaker 2: We know TSH comes from the pituitary gland, which is signaled by the hypothalamus.
• 20:50
  Speaker 2: That goes to the thyroid, that makes thyroid hormone.
• 20:52
  Speaker 2: It circulates in our blood and it's a feedback loop.
• 20:55
  Speaker 2: That's a very simple concept.
• 20:56
  Speaker 2: But there's a whole other layer of thyroid control that we don't think about and that we don't talk about and that I wasn't taught in med school.
• 21:05
  Speaker 2: I wasn't taught in residency.
• 21:07
  Speaker 2: I didn't learn it until I went looking for the information and even then I didn't know what I was looking for.
• 21:15
  Speaker 2: I just knew there had to be something else there, because the TSH was fine in these people and when I would give them thyroid medicine they felt better and I was like, okay, something else is going on.
• 21:26
  Speaker 2: So what people don't realize is that there's a whole level of the fine tuning of how much T4 gets made into T3 and how the T3 gets through the cell membrane to the nucleus of the cell to start the transcription and make make the process go, to make your metabolism go, and T4 can go down.
• 21:54
  Speaker 2: It's a split pathway, so T4 can be made into T3 or it can be made into reverse T3.
• 21:59
  Speaker 2: And those are the only two pathways.
• 22:01
  Speaker 2: T4 can go down, and your body has defense mechanisms that help you if the brakes come off and you're making too much T4 for whatever reason.
• 22:17
  Speaker 2: And that fine control is something called reverse T3.
• 22:21
  Speaker 2: So, depending on which diadenase enzyme is chosen to take the T4 down, its metabolic pathway is whether you get T3 or whether you get something called reverse T3.
• 22:37
  Speaker 2: And reverse T3 is the same molecule.
• 22:40
  Speaker 2: It's just got the iodine pulled off in the wrong place.
• 22:43
  Speaker 2: So T4, four iodines, t3, three iodines, reverse T3, also three iodines, but the wrong one came off.
• 22:51
  Speaker 2: And so it's like you went to the hardware store to get a key made and they got one of the little ridges wrong, and so you put that key in the lock.
• 23:01
  Speaker 2: You can get it into the lock, but it won't turn, and that's reverse T3.
• 23:09
  Speaker 2: It'll sit on the thyroid hormone receptor and block it.
• 23:13
  Speaker 2: And so if you have, if your ratio, your ratio of the reverse T3 and reverse T3 has useful things that it does.
• 23:24
  Speaker 2: It's very, very important in fetal development.
• 23:27
  Speaker 2: But if, if you have the wrong ratio of reverse T3 to T3 in your bloodstream for whatever reason and there are at least a dozen reasons why this can happen, one of them is a genetic reason.
• 23:41
  Speaker 2: One of them is Hashimoto's disease.
• 23:43
  Speaker 2: One of them is stress.
• 23:44
  Speaker 2: Big one is stress.
• 23:45
  Speaker 2: If you have that balance wrong, then your thyroid signaling is off and it's low and you don't feel good and you have all those symptoms and you go to the doctor and they say your TSH is fine, here, take this antidepressant, just like what happened to me.
• 24:02
  Speaker 1: Mm-hmm.
• 24:03
  Speaker 2: But if you check the correct labs, if you're measuring the reverse T3 and comparing it with a direct ratio to the T3, then you can know, okay, is the signaling good or is it less good, and what do we need to do about it.
• 24:20
  Speaker 2: And comparing it with a direct ratio to the T3, then you can know, okay, is this, is the signaling good or is it less good, and what do we need to do about it.
• 24:23
  Speaker 2: And so that's the first thing.
• 24:28
  Speaker 2: The second thing is that we were all taught that thyroid has this really really long half half life and that you don't have to take it.
• 24:33
  Speaker 2: But you know, every other day, it doesn't even matter if you skip a day.
• 24:37
  Speaker 2: You know, and the truth of the matter is that's really not true.
• 24:41
  Speaker 2: Because a little too much thyroid hormone in your body, a little too much T4 or a little bit not enough T4, affects that fine control.
• 24:51
  Speaker 2: And if it sees that elevated level of T4, because you take thyroid hormone once a day then it turns up that reverse T3, it turns up the enzyme that makes reverse T3.
• 25:02
  Speaker 2: And so you feel bad and you go, oh well, my T4 level isn't high enough, I'm going to take more.
• 25:09
  Speaker 2: And that makes the problem worse and worse and worse.
• 25:12
  Speaker 2: And so you get people in.
• 25:14
  Speaker 2: They're taking 175 micrograms of T4 and their reverse T3 is 50.
• 25:19
  Speaker 2: And you're like, oh well, I know I can fix you.
• 25:23
  Speaker 1: It's kind of like.
• 25:23
  Speaker 1: It almost seems like you're, you know, sort of trying to get something into your house that is a useful part of the household, but you're just putting it in a storage closet.
• 25:31
  Speaker 1: Is that a good analogy?
• 25:37
  Speaker 2: It's more like okay, think of a car.
• 25:40
  Speaker 2: So think of a car, and you've got the gas and you've got the brake, and you've got the parking brake, and you know you've got your T3, which is the gas, which is the gas.
• 25:53
  Speaker 2: And then you've got, you know, your TSH, which is feeding.
• 26:01
  Speaker 2: You know it's feeding the gas, it's feeding, it's feeding fuel into the gas and the T3 is maybe the spark that makes things go.
• 26:12
  Speaker 2: But then you've also got contaminated fuel, or you've got the parking brake on or something else.
• 26:16
  Speaker 2: So you're, you're driving along the highway in you know as, as fast as you can go, but you've got the parking brake, brake on, and you're in first gear.
• 26:24
  Speaker 2: Ah, I see.
• 26:26
  Speaker 2: And so so, yeah, it's, it's the fine control and you can.
• 26:32
  Speaker 2: You can see this in somebody who maybe has Graves disease, and I don't know how often you see Graves disease, because that's when you have way too much T4.
• 26:41
  Speaker 2: And if you check somebody with Graves disease, their reverse T3 will just be super, super high because it's trying to block all that excess T4.
• 26:51
  Speaker 2: And so they may have, they may not feel that bad even with this high level of T4, because they've got all this excess reverse T3.
• 27:02
  Speaker 2: And so then if you go in and you give them tapazole or methamazole, excuse me, they're going to feel bad because they've still got all that reverse T3, but they're not making any now.
• 27:39
  Speaker 2: They're not making any T3 because you cut their T4 off.
• 27:44
  Speaker 1: I mean, this is so more, so much more nuanced than anything that I've ever learned, and I know that it works.
• 27:49
  Speaker 1: And so a lot of our listeners are people for whom they're highly educated, right, they have been in the medical system a really long time and the current fertility treatments they're doing are just not working.
• 28:01
  Speaker 1: So, for instance, maybe they've done four or five embryo transfers and the data say that there should be, you know, 98% chance that they'd be successful at this point, but they're in the 2% of people who haven't.
• 28:13
  Speaker 1: So who is somebody you know specifically in the infertility or you know recurrent pregnancy loss population who should seek you out if they feel that they're doing these treatments and they're just not taking hold?
• 28:29
  Speaker 2: So right.
• 28:30
  Speaker 2: So I would say if you are a physician, you pretty much meet the criteria just based on the fact that you went through medical school and residency, because you're stressed out.
• 28:46
  Speaker 2: And if you are practicing in the current medical system and the current climate of the way medicine is these days, I can guarantee you're stressed out.
• 28:57
  Speaker 2: And, like I mentioned, stress is one of the reasons why this happens.
• 29:03
  Speaker 2: And there's there's a bunch of reasons for that.
• 29:05
  Speaker 2: But if you think about it this way, so think about why your body responds to stress hormones it's it responds with're starving.
• 29:17
  Speaker 2: Your body has T4 already in it.
• 29:17
  Speaker 2: It has 90 days worth of T4, it's going to keep releasing it and releasing it and releasing it for the next 90 days, by which you will by which time you will have starved to death.
• 29:38
  Speaker 2: So it needs fine control.
• 29:45
  Speaker 2: And so if your body is under that much stress and you're calorie restricting, what's going to happen?
• 29:54
  Speaker 2: Reverse T3 is going to go up.
• 29:56
  Speaker 2: It's going to shut you down.
• 29:57
  Speaker 2: It's going to shut your metabolic set point down to keep you from literally starving to death before food is plentiful again in the spring.
• 30:09
  Speaker 2: So that's kind of that's just one of many ways that stress takes you down.
• 30:14
  Speaker 2: So you're saying when you're not, when you're not actually in a survival situation, and that makes sense.
• 30:22
  Speaker 1: I mean.
• 30:23
  Speaker 1: So I will say, you know my patients and my clients, they're mostly physicians, so that's like strike number one.
• 30:27
  Speaker 1: They have fertility struggles, right, which are incredibly stressful, right.
• 30:34
  Speaker 2: Strike two right.
• 30:35
  Speaker 1: Strike two, and I mean not to mention all the other life stressors that you know tug at us all the time, and so you know it sounds like.
• 30:43
  Speaker 1: Well, I mean, we're women, you know tug at us all the time, and so you know it sounds like.
• 30:45
  Speaker 2: Well, I mean, we're women.
• 30:46
  Speaker 2: You know we're expected to be the perfect mom, the perfect wife, the perfect employee or the perfect business person.
• 30:52
  Speaker 2: You know you've got a lot of you've got a lot of expectations of yourself If you're a woman physician.
• 31:01
  Speaker 2: I mean, it's just a fact of the I don't know what to call us the tribe yeah, that's right, it's just a fact of the tribe.
• 31:11
  Speaker 2: We have a lot of expectations of ourselves and if you can move a little bit towards authenticity and go okay, I can let some of this go and ratchet that stress level down just a little bit, then that can really, really help.
• 31:29
  Speaker 2: But sometimes people get stuck in this high, reverse T3 thyroid is blocked.
• 31:35
  Speaker 2: You know, and it's not just thyroid, it's the sex hormones too.
• 31:39
  Speaker 2: If you have high, high cortisol, you are not making adequate estradiol and testosterone.
• 31:45
  Speaker 2: You're just not.
• 31:46
  Speaker 2: So that's another.
• 31:48
  Speaker 2: That's another thing that it's like, you know, work on the stress, but let's fix the thyroid thing first.
• 31:56
  Speaker 2: And sometimes it's to the point where a person is so tired that you tell them, okay, you need to do this kind of exercise and you need to eat this way and you need.
• 32:06
  Speaker 2: And they're like you gotta be kidding me, I can barely get out of bed and get to work in the morning.
• 32:12
  Speaker 2: And so sometimes, if you just kind of tweak the thyroid, if you say, okay, we're going to start you on lyothyronine, which is T3, we're going to do it this way.
• 32:24
  Speaker 2: We're going to start you on lyothyronine, which is T3.
• 32:26
  Speaker 2: We're going to do it this way.
• 32:27
  Speaker 2: You're going to check the labs this often.
• 32:29
  Speaker 2: We're going to get this better so that you have just a little bit more energy, so that you can maybe work on your mind just a little bit.
• 32:36
  Speaker 2: Maybe you do five minutes of breathing exercises a day, maybe you journal a little bit, maybe you hire a coach and start working on your thoughts, um, and anything that you can do to just ratchet things down.
• 32:53
  Speaker 2: Ratchet that stress level down gives you a better chance of conceiving, because I mean, if you're stressed, your body like we're not having a baby now, we might die.
• 33:06
  Speaker 2: We might die.
• 33:09
  Speaker 2: That's where your brainstem is signaling when your stress level is high.
• 33:16
  Speaker 1: And I think, circling back to what you said about the first thing that you do, is you validate, like I do the same thing.
• 33:21
  Speaker 1: I say it makes sense that you are stressed out.
• 33:23
  Speaker 1: It makes sense.
• 33:24
  Speaker 1: All these things are inherently stressful.
• 33:26
  Speaker 1: What can we do to help?
• 33:29
  Speaker 1: It's not about judging oh, you're stressed and that's why it's not happening, because we judge ourselves enough right.
• 33:36
  Speaker 1: So that's something that I help people do is sort of inject some self-compassion and end that cycle of self-judgment.
• 33:43
  Speaker 1: But I think that it's both and it's less address the stress, and there is also likely something objectively going on that many people in conventional Western medicine have not been able to figure out, and so, especially for my folks, it's like let's leave no stone unturned, let's figure out all the things to give you the best possible chance of a successful outcome, right, so?
• 34:09
  Speaker 1: So I think we have just a few more minutes.
• 34:13
  Speaker 1: Dr Gibbs, I'm so grateful that you can impart your wisdom here to our listeners, because there's just like, like you said when I first met you, you're like there are things about the thyroid that I know that most people don't know, and so you have generously offered to share some information about the thyroid, which we'll include in the show notes for sure, so that sure I want to know more about that that they can read.
• 34:37
  Speaker 1: Yeah, Is there anything else?
• 34:39
  Speaker 1: Yeah, go ahead.
• 34:40
  Speaker 2: So I'm sorry, so I have a two hour.
• 34:43
  Speaker 2: It's a, it's a video lunch.
• 34:44
  Speaker 2: And learn that I put together it's a two part lunch.
• 34:47
  Speaker 2: And learn that I that I gave to some local docs here and I've had a couple of people come back and say, wow, you know what?
• 34:54
  Speaker 2: I started using this in my practice and it's really helping and and so it's it's a really handy and useful thing, and I'll give you the link so that you can put it in the show notes, because I think you know, if anybody is interested enough in this, then please come learn it, cause I it sucks being the only one who knows.
• 35:16
  Speaker 1: Yeah, that's right and I think it really really does a lot of our listeners right, mostly many of whom may be endocrinologists but are also the one in four female physicians who have infertility themselves, and so you know, so generous of you to share that I think we need to help each other.
• 35:31
  Speaker 2: It's amazing to me to think that it's one in four.
• 35:34
  Speaker 2: That's just, it's crazy right.
• 35:36
  Speaker 2: It's crazy, it's horrible, but I'll tell you so.
• 35:38
  Speaker 2: So endocrinologists are starting to.
• 35:43
  Speaker 2: I mean, they are suffering under the weight of, you know, years and years of dogma and inertia.
• 35:52
  Speaker 2: And you know, it's like anything in medicine.
• 35:55
  Speaker 2: It's like Louis Pasteur wasn't respected because he wasn't a physician, he was a microscopist or whatever he was.
• 36:02
  Speaker 2: You know, semmelweis said, hey, we should wash our hands, and they put them in an insane asylum.
• 36:08
  Speaker 2: I mean, it was.
• 36:08
  Speaker 2: You know, this is the way medicine is.
• 36:10
  Speaker 2: It's kind of like, it's kind of like step, it's like stomping through concrete to get new ideas out there.
• 36:16
  Speaker 2: But it's starting to happen.
• 36:17
  Speaker 2: And the use of a liothyronine or T3 is starting to be something that more doctors do and it's just like, uh, lyothyronine or T3 is starting to be something that more doctors do and it's just like, okay, how about some guidelines on the right way to do it?
• 36:30
  Speaker 2: Um, and, and that's that's what I've got.
• 36:34
  Speaker 2: But there there is one more little fact that I just want to make sure and I know you have to go but that there are supplements that people can take that will help their adrenal glands work better.
• 36:52
  Speaker 2: And I, you know, just call me up and ask me.
• 36:57
  Speaker 2: I'll tell you, because, yeah, it's just so useful.
• 37:01
  Speaker 1: I think they should book a discovery call with you to see if it would be a good fit.
• 37:04
  Speaker 1: Yeah, help them out, dr Gibbs.
• 37:06
  Speaker 1: Okay, so where can people find you?
• 37:09
  Speaker 1: That's a good segue.
• 37:10
  Speaker 2: Okay, so my website is wwwdanagibsmd and I am on Instagram at danagibsmd as well, and I do have a discovery call link right there on the website.
• 37:23
  Speaker 2: And what I have been doing for physicians in particular is that I can't my medical licenses are Texas and Iowa, so I can't be your doctor, quote unquote but I can teach you and advise you on what to do, and I've had several folks come through basically what I'm calling a coaching program, even though it's not coaching the way you do.
• 37:48
  Speaker 2: Coaching um, and had really good success getting their energy back and and um getting more clarity on what they need to do to manage their stress and their health.
• 38:00
  Speaker 1: I'm I'm the doctor and you're the coach, and it's working out.
• 38:04
  Speaker 1: Yeah, it's working out and people are getting better, and so I think the more we can think outside the box about these things, the more people will not have to suffer like you did and like so many people are currently suffering.
• 38:14
  Speaker 2: Yeah, so thank you.
• 38:16
  Speaker 1: Thank you so much for sharing your wisdom, and I mean kudos, because you figured out a lot of this on your own and you're sharing it with the world, and so I cannot wait to keep collaborating with you, I cannot wait to keep you know, listening to your content and you know, like I said, you help my patients and you help me in so many ways, and I'm so grateful to know you, dr Gibbs.
• 38:37
  Speaker 2: Well, thank you so much, and I do have a podcast too.
• 38:39
  Speaker 2: It's brand new oh great that too.
• 38:44
  Speaker 1: It's brand new, it's called, it's called.
• 38:45
  Speaker 1: It's called beyond the thyroid.
• 38:46
  Speaker 1: So look me up.
• 38:46
  Speaker 1: All right, fabulous Thank you so much.
• 38:48
  Speaker 1: Thank you, yeah, it was wonderful.
• 38:48
  Speaker 1: Bye-bye.