Why You Feel Terrible Even When Your Thyroid Tests Are “Normal”

Welcome to the Dr. Ashley Show. I'm Dr. Ashley Lucas, and today's guest is someone who has made her mission to give women the answers they've been denied for years— Dr. Amie Horniman. She is known as the Thyroid Fixer, and I couldn't be more honored to have her on the show today. She is the founder of the Advanced Thyroid and Hormone Clinic, host of the top-rated podcast called The Thyroid Fixer, which you should definitely check out. She's an international speaker and the author of The Thyroid Fix. She helps women finally understand what's going wrong with their thyroid, their hormones, and their metabolism, and what to actually do about it. Now, if you've ever been told that your labs are normal but you feel anything but, this episode is for you. Welcome, Dr. Amy, to the show. I've been really looking forward to this.

Oh my goodness. Well, thank you so much for having me on. I'm, I'm super excited to talk to your audience.

So I would love to dive in, and I would love for you to share what you would say to a woman who's been told for years that her thyroid is fine, but she does not feel fine. She is starting to believe that she's broken, she's lost hope. Maybe it's just her age, or maybe it's a willpower issue. What would you say to that?

Oh goodness. Well, first I want to give her a big hug and then just tell her it's going to be okay. And then finally, you know what, I, my message that I always tell my audience, even, even our patients, you have to listen to your symptoms, your symptoms that you have that even the medical community might be dismissing. You may have been told, ah, it's normal. It's just part of aging. You just have to get used to it. You know, this is just what happens when you get older. Even if you've been told that. I want you to back up and when you think of your symptoms as gifts, like G-I-F-T-S, gifts, presents given to you by your body, because it's a sign that you need to look deeper. And just remember that we were not built to be fat, foggy, and fatigued. We weren't built that way. We were built to be vibrant and healthy. And I always say, be the badass human that you're meant to be. That's how we should be living life. And if we're not, then there's a problem. And there's a problem that we can look at and actually fix so that you can get back to living your best life.

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Will you share a little bit about your story? I mean, you're known as the Thyroid Fixer. Will you tell us a little bit about that, maybe some of the symptoms you experienced? Because I think we're so disassociated from our bodies at this point that we don't even know what to do with the signals that they're giving us, like which ones to listen to, Uh, which ones should guide us? Um, we could say all of them, but if I took that into my own personal story, I mean, I'd have signals every minute of the day from coming from my body. Um, so will you share a little bit about your story and, and what we should be listening to and help guide us a little bit more?

Ah, of course. So mine was the typical pain to purpose story, like so many of us in the health arena. Many of us have dealt with something that made us go, wait a minute, this is a huge problem here and other people must be dealing with it too. So, mine's no different. I go back about 25 years ago. Back in my early 20s, I was competing. I was competing in bodybuilding competitions but doing the figure part. So, it was a little bit more feminine. No, I didn't look like a dude. But, that more feminine part, but you still had to diet down. You still had to really Work hard, eat, I mean, super clean. You didn't cheat at all unless your coach said, okay, this weekend you can have some sweet potato fries. That's it. You were strict. Chicken, broccoli, asparagus, fish, that's it. Hitting the gym twice a day. Now, I had done plenty of these. I knew what to do. I still had a coach, but I had done plenty of these shows. I knew how my body was supposed to respond. This one particular show I was getting ready for, stepping on the scale, you know, sending my coach the before and after pictures, tracking me, sending in my weight, and the scale goes up instead of down. I'm like, wait a minute, it's 5 pounds heavier. What's going on? Oh, you know, maybe I ate some soy sauce or holding some water. I don't know. Get on the next week, 10 pounds. Like, okay, um, maybe I'll restrict my calories more and I'll go to the gym 3 times in a day instead of just twice. Get on the scale again, 15 pounds. I mean, it just kept going up. By the time I stopped getting on the scale at 25 pounds, I'm pretty sure it went to 40 plus. I'm pretty sure I gained 40 pounds. Once I hit 25, at that point I was depressed. I mean, I was, I was hiding my body in sweatshirts. Um, I could just hear the judgment, the whispers in the gym, like, oh, she's off her diet. She's eating too many donuts. It was just all the same. And I wasn't, and you can't tell everybody staring at you, here you are, the fitness model, the fitness competitor, now you're fat and everybody's staring at you and you can't tell them like, no, wait, it's not me. Like, I'm really not going off my diet. It's something else, but I don't know what it is. So, I started going to my doctor. I went to my doctor, started with my doctor. And he said, you know, you're normal. Everything's fine. Of course. Okay. So I left there. I'm like, mm, yeah, no, I'm not normal. I'm not fine. Second opinion time. So I got a second opinion. I was also told I was normal. Everything was fine. Just eat less and exercise more. Like, I don't think that that's possible. So let's go Dr. Ashley Lucas. So all in all, over the course of probably about 6 to 9 months, I went to 6 different doctors. All dismissed me, all medically gaslit me. They all told me I was normal. Everything was fine. It was all in my head. Eat less, exercise more. So by doctor number 7, and thank God I didn't stop. I often think about that too. Like, what if I would've stopped? What if I would've stopped? I kept going. Doctor number 7 touches my throat and says, swallow. First one, first one to lay hands on me. Touches my throat and says, swallow. Says, mm, you know, you got a th— you got a little nodule here on your thyroid. We have some tests. Looks like Hashimoto's. Looks like you have hypothyroidism. Here's a pill. So I took the pill. I mean, oh my gosh, Ashley, I was so excited. I left her office. I'm like, I got a name now for what's going on with my body. And I got a pill that's gonna fix me, right? I'm so excited. And I took that pill religiously every single day.

I bet you did. For 5 months.

You know what's coming next, right? Nothing. Nothing happened. That pill was Synthroid, levothyroxine. So, for the listeners that are like, "Oh, yeah, I take that too and nothing's happening for me either," right, because that's the inactive thyroid hormone. So, I went back to the best doctor ever, Dr. Google, and I went back to Dr. Google and I started learning that this pill that I had was an inactive thyroid hormone. And then there's this other hormone called T3, and that's active. And sometimes doctors will put T3 with T4 for treatment. So I went back to her and I said, you know, there's this thing called T3. It looks pretty cool. Can we do this? And she goes, no, that's not standard of care. And I said, well, thank you. I'm going to find someone who does. That's what led me into the world of functional medicine. Back then it was integrative medicine. It wasn't— we didn't even have the term functional yet. It was integrative. It was alternative. It was woo. It was fringe, but I didn't care at that point. My functional medicine practitioner spent 83 more minutes with me than any other doctor ever did. You know, I was only getting the 5 to 7 minute visit at every single doctor I saw previously. And he spent 90 minutes with me going through all of my labs, really laying out this beautiful protocol, lifestyle, nutrition, supplements, the right medication. And that is what changed me. That is what gave me my life back. That's how I lost the weight. That's how I regained energy. I mean, I was, I was low in energy. I was losing hair, but you know what? As a woman, when you put on 40 pounds, you really don't care about your energy. It's a side note. You're like, well, that sucks. But, um, all my clothes are tight. So, that was really my focus, but we do know that there are so many other symptoms of thyroid. Now, you know, weight gain, inability to lose weight, fatigue, and hair loss are your big ones. But then, you have loss of the outer corners of your eyebrows, you have anxiety, depression, brain fog, constipation, joint pain, shoulder pain, muscle pain, dry skin, dry brittle nails. I mean, from head to toe, the thyroid runs the show. So, it really affects every aspect of your health.

You were so fit and healthy when you went to the functional medicine practitioner. What were the top 3 things that he advised you to do that actually made change?

So, number 1, we got off of the T4 only and we switched over to Armour thyroid, which is natural desiccated thyroid. Now, that is not ultimately what I'm on today, but that switch made a huge difference. Why? Because natural desiccated thyroid actually contains T3. So, it contains T1, T2, T3, and T4, about 80% T4, 20% T3, T1 and T2 in minuscule amounts, but it contained T3, the active thyroid hormone. So, right away, my body was like, "Whoo! This is awesome." So, that change made a world of difference. And then, of course, my nutrition was fine, right? So, there wasn't much he needed to do there. I knew how to take care of myself, but then he really dialed in the supplementation, because as we know, there are foundational nutrients that you need for thyroid support. So, there's no thyroid medication or thyroid treatment that's gonna work in a dumpster fire. You have to have that foundation down pat for the hormone replacement to work. So, whether you're doing thyroid hormone replacement, bioidentical hormone replacement, you gotta have the foundation down pat. So, we really dialed in those those key nutrients that supported T4 to T3 conversion and supported my thyroid.

So you were going the route of eating less, moving more. From a thyroid perspective, what was actually happening to your metabolism? And for those who feel like they're in a similar path, what's happening to their body?

Yeah, so the thyroid is the master gland. Like we said, from head to toe, it runs the show. That includes your metabolism. It will dictate whether or not you are burning fat or storing it. And if your thyroid function is low, if your T3, that active thyroid hormone, is low, if your reverse T3, another marker that we can check in your thyroid panel, is elevated, putting your body in this survival lockdown mode, there is no possible way to have a metabolism. You could do the best of the best diet, the cleanest diet, just like I did, the cleanest diet, you could go keto, you could go carnivore, you could try every diet under the sun and it's not going to matter. In fact, you can even try a GLP and it's not going to work if your thyroid's in the toilet. We have a patient, we had a patient, we'll have, she's still in the maintenance program, but she came in a couple of years ago, probably 300-ish pounds, full-blown type 2 diabetic. GL— she was on a GLP-1 for about a year and a half. Her A1C was an 11.9, still didn't budge. Weight didn't budge. She didn't feel any different. The GLP-1 wasn't working. Her reverse T3 was elevated. Her free T3 was low. She was on T4 only. We know that profile. Her thyroid was tanked. I mean, even though she was being treated in the conventional medicine sense, she wasn't optimized. She wasn't being treated properly. So she got that diagnosis just like I did, and she got stuck on T4 only, just like I did, and it was doing nothing. So thank God her insurance was at least covering the GLP. She wasn't paying out of pocket. But this is what I tell people. I'm like, before you pay out of pocket for a GLP, like, let's address your thyroid function. Let's optimize that first, cuz then it's gonna work. So once we started addressing her thyroid function, optimizing her, guess what? She lost 150 pounds. The GLP-1 actually started working. Her A1C went to a 5.4. She reversed her diabetes, all because we addressed the master gland that dictates everything else downstream. So, it really does have control and has the final say over whether you're burning fat or storing fat. Okay.

So, this is great. Most of the time, I'd say when you go into a physician, they are looking at TSH. TSH often can look fine. If it looks a little off, then they give you some T4, right? So will you start from the basics? Because I think actually the thyroid is very complicated to understand. And will you share with us maybe what labs we should be looking at? Whatever information you think is going to be the most helpful for someone sitting here either listening to this and treating their thyroid but feel like they're not treating it correctly, or thinking their thyroid's off and not knowing where to start.

Okay, so where we want to truly begin is with thorough testing. So we have to start there. Well, no, let me back up one step further. We have to start with your symptoms. So you want to bullet list out your symptoms, you know, even the ones that in your mind you go, well, that's just aging, or that's just perimenopause. Write it down. Just write it down. Bullet list your symptoms: the weight gain, fatigue, hair loss, constipation, joint pain, shoulder pain, fatigue. Brain fog, anxiety, depression, all of it. Now, we gotta go to testing because we're gonna overlay those symptoms with your testing. So now, we have to get thorough testing. We have to get beyond TSH. Beyond TSH, we have to get TSH, free T4. Yeah, it's something to look at, not as important as free T3. So, we wanna look at the unbound active thyroid hormone floating around in your body. That's what's ready to get to your cells to give you that metabolism to turn on your cells and light them up. Then, we want to look at reverse T3. That's your anti-thyroid hormone. That's basically what puts your body into survival lockdown mode. It puts your body in a hibernation state like you're a barren winter. We want to know whether or not your reverse T3 is high when you're trying to live life. Now, reverse T3 is interesting. It's actually built into our bodies. For a reason. So, if you're in an accident, if you're lying in the ICU or the ER fighting for your life, thank God our bodies know to allow reverse T3 to go up. Because when reverse T3 climbs, it sends a signal to our body that, all right, shut down metabolism. This person doesn't have to burn fat right now. Shut down their brain function. They don't have to make major decisions or think or feel good. Shut down their energy, shut down their gastrointestinal tract, lower their body temperature, and I want you to shuttle all energy to healing this person that is lying there fighting for their life. Cool. That's amazing. Except when reverse T3 is elevated when you're walking around trying to live life, trying to get stuff done, and you're taking the kids here, taking the kids there, you're taking care of yourself, you're getting in the gym, you're running a business, you're cooking dinner, like you're planning your life and you feel like you're lying in the ICU or the ER. We have to test that because that tells us actually how well are you converting your inactive thyroid hormone, either the inactive thyroid hormone that you actually produce by your thyroid or that inactive thyroid hormone that you are taking in the form of thyroid hormone replacement. We need to know if you're converting that properly. So, we want to test that. And then finally, we want to test TPO and TGA antibodies. This tells us if you have autoimmunity. It tells us if you have Hashimoto's. 95% of all hypothyroidism is Hashimoto's. Chances are pretty good if you have hypothyroidism that it's going to be Hashimoto's. But by testing the antibodies, we can kinda see where you are on that path because there are 6 different stages to Hashimoto's. So let's take a look at those antibodies. Let's maybe look at past labs if you had those antibodies tested. So we can see how long has this destruction been going on. Because unfortunately, women will deal with Hashimoto's for sometimes 10, 20 years before they are actually properly diagnosed and before this situation is addressed. And by then, their thyroid gland is so beaten up and so destroyed and so small that it's like, okay, we, we, we can do nothing except properly treat you and replace those hormones. To literally get you back up and running.

Can you reverse the destruction?

You can't reverse destruction, but you can, you can reverse Hashimoto's so you can put it into remission. Now, whether or not you can put it into remission and avoid taking hormone replacement, that's another story. So I get that question asked a ton. And I always say, okay, if we're catching you in the beginning, like right in the beginning where those antibodies are just starting to appear, and if I ask you your symptoms, you're going to be like, you know, I'm a little tired. Maybe that's about it. You know, you're not going to get this laundry list of symptoms like, like we normally see in our clinic. So usually by the time somebody comes to us, they have the laundry list of symptoms. They've been, they've been bounced around in the conventional system, spent a couple thousand in functional medicine that let them down. So, by then, it's basically impossible to reverse it naturally. But here's the other thing, Ashley. I love saying this because I really like shifting people's thought process around this. Thyroid hormone replacement is exactly that. It is hormone replacement. So, just like we'll take estradiol, progesterone, testosterone as our hormones start to go down. Just like you would take insulin if you were a type 1 diabetic, thyroid hormone is a hormone that is no longer being properly made by your body. We can replace that. I don't want you to think of that as a medication. The medications that we want to avoid, those medications that you're like, "Oh, I don't really wanna go on that." Those are your Band-Aid medications that conventional medicine will hand out like candy. If you go into your PCP, and you say, "Hey, doc, I'm gaining weight and I'm fatigued and I'm depressed and I'm anxious," you'll get an antidepressant. You might get 2 or 3, maybe a sleeping pill and a statin too, all day long. Those are the medications that we want you to get off of because we want to find the root cause, oftentimes the thyroid, for your anxiety, your depression, your high blood pressure, high cholesterol. What we don't want to do is put thyroid hormone in that icky medication category because then you're going to shortchange yourself. If you can take a hormone that gives you back your life, then take it. Like, you will have to pry my thyroid hormone and my estrogen and my progesterone and my testosterone out of my dead hands when I'm in the grave. Like, that will be the last day that I will take all of my hormones will be the day I die.

Mm-hmm. What about— so whenever I'm looking at something being off in the body, I feel like there's always this root cause as to why. So same thing, let's say we do have to take this replacement for the rest of our life, but like, why? What happened? Is it just our stressful life that we live? Is it all lifestyle-based? Like, what is the root of the thyroid not functioning the way that it should naturally? Like, we shouldn't— I don't think— I mean I would say if we were in perfect health, we shouldn't see this happening. What is going on?

Well, yes and no. So, sometimes we have to kind of look at the world we live in now. So, thyroid disease is much more prominent nowadays than it was 30, 40, 50 years ago because look at the world we're in. I mean, our bodies are being bombarded with chemicals that didn't even exist 20, 30, 40 years ago. So, we have a new toxic stress burden that we've never had before. You know, unless you have a whole house water filtration system that's reverse osmosis, you're being exposed to fluoride, chlorine, bromide every single day in addition to whatever else they put in our water every single day. I mean, those are toxic halides to the thyroid directly. We also have hormonal fluctuations that just naturally occur. So, when we're talking about Hashimoto's, when we're talking about autoimmune, I love to use the analogy of the three-legged stool where on that one leg you have that genetic predisposition. So, that's just genetics. Your mom, your sister, your aunt, whatever had some autoimmune condition. Maybe it was Hashimoto's, maybe it was Graves', maybe it was rheumatoid arthritis, lupus, anything, any other autoimmune condition. Or maybe you have celiac or psoriasis or RA, something just that genetic predisposition. And then, we have leaky gut, which, okay, that goes back to what I just said. Why do so many people have this leaky gut? Well, the toxins, the environmental toxins, the chemicals in our food that we can barely even pronounce. When a baby is born now, what was that study that came out a couple of years ago? That when they actually tested the umbilical cord or the placenta, there were over 200 chemicals just right there, like, already passed on to the baby as it's coming out of the womb, already toxic, right? So we have that. That's also creating leaky gut. Oh my gosh, we could go on and on and on. Soil depletion, blah, blah, blah. But then we have that final leg of the stool, and that is the stressor. So just like you said, Ashley, yes, the amount of stress that we are under now, social media, AI, constant messaging on the TV, just, you know, just stress. Like you're seeing happy people and you're wondering why, why am I, why aren't I making that much money? Why aren't I that happy? Why aren't I that skinny? You know, and just pressure, pressure, pressure from, from, you know, the time that you're 7 all the way up to the day that you die. We have excess stress, constant stress. And then, we have hormonal stressors. Now, those are something that you're really not going to avoid. Puberty, hormonal cascade, very common time for Hashimoto's to show, for that autoimmune switch to be flipped from the off position to the on position. Pregnancy, beautiful time in a woman's life, hormonal roller coaster, right, ladies? Huge stressor on the body. It's a natural stressor. But I got a friend that's pregnant right now. She's like, get this baby outta me. Like, it's a huge stressor. And then finally, perimenopause, menopause.

Woo.

Yeah. Our hormones go crazy. Then progesterone falls off first, followed by testosterone. Your estrogen's on a roller coaster. Those times in a woman's life where hormones kind of go crazy, that's enough of a stressor on the body. To flip that Hashimoto's switch on. Then, we have things like Epstein-Barr virus. I gotta tell you, I don't know. If you ever test someone who doesn't have EBV, I want you to send them— send me their picture because I'm gonna put them right here. I'm waiting. I have not yet found someone who doesn't have Epstein-Barr virus, which means we were all exposed to mono at some point in our life. It left that EBV stamp and that Epstein-Barr virus stamp automatically sets you up for Hashimoto's. If you took birth control for more than 10 years, you're at a 243% increased risk of having hypothyroidism. So, just that little diatribe that I just went on, that little mini TED Talk alone shows you how do we avoid it. It shows you why it is so much more rampant these days.

Yeah, it could be a little depressing. It seems like it's almost inevitable. I'm on thyroid medication, and I'm so grateful for you looking at my labs and finding that, yeah, I'm focused on T4. I now take some T3 twice a day, thanks to you. I'm trying my best to be consistent. You and I, we follow healthy lifestyles. The stress level is probably a little bit higher. So it does feel inevitable. Will you share with us though, because I want to, I want to sandwich this with what we can actually do to take action. So for you in your lifestyle that I believe is very busy and probably slightly stressful, what are the top 3 things that you focus on? I mean, you take your thyroid medication, HRT. It sounds like those are very important to you, but what else do you do from a dietary lifestyle perspective perspective that you think is really helpful in supporting your body, your thyroid, as we navigate this environment?

Yep, absolutely. So, a couple different things. I would say, obviously, exercise has always been a part of my life. I've carried that on. I used to compete and I still work out and lift heavy to this day. I actually don't do cardio, but I only lift heavy.

Me either. I'm like, my life is like cardio.

I feel like I need that.

I wake up and it's like I'm on the treadmill or something, you know.

I like that. That's true. That's, that's a good one. Yeah.

You lift heavy.

Is your—

yeah, your, your primary type of exercise is lifting.

It really is. Like, I enjoy yoga, but I don't get there enough. I just really prioritize lifting. I prioritize walking my dog in the morning. Like, that's a non-negotiable. So I always go for a walk, get out in nature, walk him. So I guess that would be my cardio, but it's not really cardio. I get my heart rate up when I'm lifting heavy. Yeah. So, that's a key component. And then, I would jump all the way to the other end of the spectrum. I mean, my nutrition's always been fine. That's always good, whole real foods, enough protein. I always prioritize protein to keep my muscles on, lower carbohydrates, no processed food, organic when I can. I follow the 80/20 rule and I talk about that in the book too just to take some pressure off of people. Guess what? I am not perfect. Like, you know, I'm not at all. I'm about 80% good and 20% of the time I will absolutely eat the Oreo and don't put sweet potato fries in front of me because I'm down to go, like, just forget about it. But you have to live life, right? So, I would say about 80/20. I'm good with the nutrition component, lifestyle component. I get good sleep. But then, I would say over here, you know, I mentioned earlier the GLPs. And I said, all right, GLPs aren't gonna work that, but they're also a biohacking tool. And what I have found and what I wrote about in the book is that when you use GLPs properly in the right dose for you, that we can reduce inflammation, we can reduce antibodies. Sometimes we can lower the amount of thyroid medication that someone is on. And I always like to say this too, not that there's a gold star for those who take the lowest dose of thyroid medication. That's not what I'm saying. But what I have seen anecdotally with a few patients and with myself is that we can actually lower the amount of T3 that somebody is taking. And why is that good? If we can lower the amount of T3 and still keep that person optimized, so I'll use myself as an example. I was taking 75 micrograms of T3 twice a day, so a total of 150. And when I started, I mean, I was taking a GLP microdosing for about a year before I tried this. What I wanted to do is experiment to see if I could pull some of that T3 because I've been on that for decades, that same dose for decades. So, first, I pulled out 25 micrograms from my afternoon dose and I held that for about 2 months, still microdosing GLP every week. And then, I'm like, "Okay, let me try one more. I'm going to pull 25 from the morning dose." So now, I'm down to 100 micrograms a day, 50 twice a day. And, I've been carrying that through. That's what I'm on right now. No hypothyroid symptoms came back because I'm keeping my inflammation down from the microdosing of the GLP. I've never been able to reduce my T3 before. The reason why I personally want to pull back a little bit on T3 is because the reality of T3 is that it does burn muscle and fat at the same time. Now, somebody would be like, well, so does DLP. In higher doses, yes, but in the microdoses, no. I want to keep my muscle. We just talked— I lift heavy. I want to, I want to keep it. I want— I'm working hard to keep it, right? I'm eating the protein, I'm getting amino acids, I'm lifting. Why would I want to take extra of something that possibly burn my muscle. Like, I don't want that fast of a metabolism to where I'm burning my muscle tissue. So, by able— by being able to pull back just a little bit on my T3 dose, I've been able to put on a little bit more muscle. So, that's a good give and take. So, in that realm, I would say my GLP and my thymosin alpha peptide that helps my immune system and helps the autoimmunity. Those are my two non-negotiables.

Mm-hmm. Uh, stupid question here. When you are microdosing GLP-1 and taking the consistent higher level of T3, wouldn't your T3 levels just like go up and show you, gosh, you can pull that down? Why did it stay consistent there at that certain level and then you could pull it down and it remained consistent rather than showing you in the fashion that might make sense?

Yeah. I, I, I did not see the increase, like with the microdosing GLP. I didn't see a bump up in my 3, 2, 3 level when I tested.

Yeah.

But I more went with, so I didn't see, I, I didn't notice that. And when I was testing, pulling it, you know what? I didn't even go with my labs. I just went with my, my sense.

Oh, really?

My body by now, I'm like, I'm gonna know if I start to go hypo, even a smidge from pulling this. Oh, I'm, I'm, my body will alert me. And I'll know, but it never did.

I was going to ask how frequently you test your thyroid levels.

Twice a year now. I mean, I really don't need to. I test my hormones more because I'm always kind of like checking those and adjusting. But my thyroid levels, I mean, I could get away with once a year if I could. And just— yeah.

Hmm. When it comes to diet, would you say— you mentioned protein forward. Getting healthy fats. Is there anything else that people need to focus on? I've heard, and I would love for you to share with us if this is, is true from your perspective, that keto can tank the thyroid. What do you feel about that?

Like, you know, carnivore, that kind of thing? Yeah, yeah. Um, it can if it's done too much too long. So what I mean by that, so If we have a patient that is insulin-resistant type 2 diabetic, obviously, we want to pull back on the carbs. Like, we know that. Like, we want to pull back on the carbs. We want to reduce the carbs. We got to get them into a ketogenic lifestyle. Someone has cancer, ketogenic lifestyle, carnivore. I mean, that's beautiful. Autoimmune flares, going carnivore for a short period of time, amazing, calms down inflammation. So, there's a time and place for these diets to be implemented. If you need to go that route, you got to go that route. And not be freaked out about it tanking your thyroid. But what I like to do for my low-carb people is just tell them, you know what, maybe once every 2 weeks, just add in some carbs, you know, throw in some berries, eat a sweet potato. It's not a cheat day, right? We're not going off the rails, but we're just bringing us out of that ketogenic state. Bring yourself out of ketosis. And then that's enough of a signal to the thyroid to be like, whoa, okay, I'm gonna make T3 again. That's good. But even with that being said, I also wanna kind of backtrack and go, you know, it's, it's not as big of an issue as what Instagram makes it, you know, what, what certain influencers will make it. It really isn't that big of a deal because if someone is truly living an amazing carnivore lifestyle and that's what they found that they love, it works for them, it works for their body, they never felt better. I'm not taking them off that. Like, listen, okay, if your T3 drops a little bit, guess what? We'll give you some T3. If you're not on thyroid medication and your T3 drops a little bit, we'll give you some T2 and make sure that you're converting your T4 to T3 and throw in a drop of iodine and make sure you're on magnesium and D and selenium for goodness' sake and you'll be fine. You know, so it's not really something— you're not going to see somebody go into like full-blown hypothyroidism because they drop their carbs. That's right. That's not going to happen. Yeah.

I appreciate you sharing that.

All right.

So, let's say someone's listening to this and they suspect that their thyroid has been ignored, maybe undertreated, not treated. What would you say are the first 3 practical steps that someone could take?

So, okay. So, let's say you are— yes, you might be diagnosed hypothyroid not treated properly, or you have all of these symptoms and you're going, "Hmm, I wonder if the thyroid is my problem." Okay. First, step 1, kind of going back to what we talked about, test thoroughly. You got to test, overlay your symptoms, let's look at those. And then, and this is what I talk about in the book, I actually built the book to kind of be like a choose your own adventure, right? So, you now have the test, you know where they're at. You can see, okay, I am on T4 only, therefore I need to go here. And I need to look at my reverse T3 is a this, so that means I need to go over here and ask for this treatment instead. We're gonna add in a little bit of T3, we're gonna drop your T4, we're gonna make adjustments. So really it is about knowing your labs, making the adjustments to your medication. And yes, that might mean Finding a new doctor and having that conversation with that doctor as well, which I also put in the book, all of the parameters, all of the questions that you need to ask. I don't care if you're calling your PCP office or an OB-GYN and you're gonna use your insurance, or you are going to throw down money to a functional medicine provider. I have questions that you need answered before you exchange your time or your money. And then we go into, okay, now here's how to have that conversation with your doctor to move the needle, to actually get them to respect you as a collaborator in your health, and for them to actually work with you as a collaborator in your health. And if they don't agree and they don't, they don't participate, then you move on and you go back to the beginning and you start that process over again. It sounds tedious, but it's really not. So those would be the steps that I would take. Now, also in the book, of course, we talk about just what you and I talked about already, the foundation. You gotta build the foundation. You can't put any kind of thyroid treatment on a dumpster fire, the nutrition, the supplementation, all of that. But I think, you know, it's— we talk about that a lot and I didn't wanna leave it out of the book, but I also didn't want it to be— I didn't want the book to turn into Another, like, let's just sprinkle some adrenal fairy dust on you and heal your gut and everything will be fine. Like, no, that's not the case with the thyroid. Like, yes, we wanna look at the adrenals. Yes, we wanna look at the gut. We wanna look at your nutrition. We wanna look at your supplementation. We wanna look at your stress level. But we can look at all of that and we could even fix every single aspect that I just mentioned. And if your thyroid's still in the toilet cuz you're on T4 only and your reverse T3 is elevated and we can't quite find the cause, or you have a genetic snip that it just pushes it over to reverse T3. And you've had Hashimoto's for 20 years so your thyroid's itty-bitty, no amount of green smoothies and adrenal detoxes are going to help you. We need to go over here and actually address the problem. But again, if you're in the beginning stages, then yes, maybe you can fix your adrenals, fix your gut, get your nutrition in line, get your supplementation down pat, sleep, cortisol, all of that, throw in some black cumin seed oil, go gluten-free, and now we can maybe keep that at bay to where you don't have to go on thyroid hormone replacement yet as long as you are feeling fantastic.

So, my summary to all of this amazing information is that we all need to read your book. So, will you share a little bit about your book and where we can find that? And then, you've got a great supplement company. I'd love for you to share that, how we can learn about your program. Please.

Sure. Thank you so much. Thank you. So, the book, you can get at any major book retailer, Amazon, Target, Barnes Noble, but you can also go to thyroidfixbook.com. And if you buy from there, what you're going to see is a ton of extra bonuses. So, we have a 20% off code that you get to shop on Fixer Formulas. That's my supplement line where we can where we carry T2 that we talked about in the form of Thyroid Fixer, Metabolism Fixer, along with T3 Conversion Fixer if you're having issues converting your T4 to T3. We have a beautiful iodine supplement in there, magnesium, vitamin D. So, we have it all in there. And then, it's also going to give you a ticket to May 16th. This is our live launch. And what we're doing on May 16th is we— anyone who purchases the book gets a ticket to the Zoom room, which that's interactive. So that's where you're going to be asking me questions. We're answering them live on air. We're doing giveaways only to the people in the Zoom room, live lab reads where we interpret your labs. We're bringing on guest experts. You're going to be able to ask your questions live. So if you buy your book before May 16th, then you get a ticket to that live launch day. We'll send you the agenda so you'll know exactly when you want to pop in over those 5, 6 hours that we're going to be live. Streaming on YouTube, but then you get that Zoom ticket so we can all interact. That is fibroticsbook.com.

Awesome. That's so exciting.

And then yes, the clinic. If anyone wants to connect and become a patient, you can go to dramie.com, D-R-A-M-I-E dot com, and there you can book a free call. We'll chat about which— where you're at, where you're at in your journey, what you're taking, what you're not taking, what are your symptoms, what have you tried and not tried, or even disappointed in with your doctor. And then we'll set you up with perfect program for you. We do prescribe to all 50 states, so we do thyroid and hormones together because they have to go together.

Amazing. Dr. Amy, thank you so much for all of the support you're providing to all of these women who have been so lost. I've been there. I appreciate your advice on my case as well. I really look to you as an expert on this, so thank you so much. Really appreciate it and excited to read your book.

Thank you so much, Ashley. I appreciate you.

Thank you guys so much for listening today, and a huge thank you to Dr. Amy Horniman for this amazing, insightful conversation. Now, if any of today resonated with you, please do not brush it off. Go find her podcast again, that's called The Thyroid Fixer, or go grab her really great book called The Thyroid Fix. If you are listening to this on a podcast platform, please leave us a review. It means the world. If you are on YouTube, drop a comment below and subscribe so that you don't miss the next video. As always, remember, you've got to step up to make the change. Lead with your heart, train your mind, and do not negotiate with your body. I'll see you next time.