Episode #81 The Thyroid Fixer, with Dr. Amie Hornaman

Hey beautiful, it's Dr. Tabatha. I want to share something with you that I believe God is doing right now in women's health. We're in the middle of a massive movement and most people don't even know it. Every single day, 6,000 women in the U.S. enter menopause. That's over 2 million women a year, and by 2030, that's more than 1.2 billion women worldwide. So here's the thing, most of these women feel exhausted, bloated, anxious, disconnected from themselves, and the medical system is Doctors are handing out prescriptions and quick fixes, and no one is helping women heal from the root cause of their issues. That's where Fast to Faith coaches come in. As a certified coach, you'll be equipped to help midlife women balance their hormones, heal their gut, regain their energy, and reconnect their faith, the foundation that so many of us have been missing. And from a business standpoint, woo, this is one of the most lucrative untapped opportunities in the entire health coaching world. The global health coaching industry is expected to reach over $33 billion by 2023, and midlife women are the fastest-growing, highest-spending demographic in that space. Most importantly, these women stay with their coaches. They invest deeply because they are desperate for lasting transformation— body, mind, and spirit. So if you've been feeling that pull and that whisper that you're meant to do more, This is it. Now is the time to rise, to serve, and build a purpose-driven business that not only changes other women's lives but transforms your own in the process. Because when you help one woman heal, you help her family, her marriage, her faith, and her future. That's the ripple effect that we're creating with Fast to Faith. So join me, click the link to come watch this webinar. It might be the one thing that really moves the needle for you in this Next season. I can't wait to see you in there. Hi, I'm Dr. Tabatha, the Functional Gynecologist. I'm a board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. I want to be your functional gynecologist, so welcome. All right, ladies, I know you're going to want to listen to this episode in its entirety today because it's about the thyroid. I have gotten so many messages on Facebook and Instagram about thyroid issues because, unfortunately, so many of us are affected by it. Our thyroid is kind of like The canary in the coal mine. That's how it's described. Like, it will send off the signals if something is wrong. Way back in the day when coal miners used to be underground digging their coal, they would take a canary with them, and if the canary died, they knew that the toxic levels were too high and they need to get out of the cave. And so we like to think of the thyroid as like the canary Dying, I guess. You know, it's like if the other systems are struggling and having issues, your thyroid is going to send out the signal, hey, hey, hey, something's wrong. Please pay attention. Check into these other systems in your body and figure out why the thyroid is struggling to function. And so I want you to think about that. I want you to realize, like, The thyroid itself isn't the problem. Your thyroid doesn't just go bad. You know, God didn't create our bodies to just go into dysfunction and go bad and stop working. Our thyroid doesn't just poop out, you know? It's always like, oh, your thyroid's just a little sluggish. It's just pooped out. It's not working. But we need to ask why. That means something else in another part of your body is affecting Affecting the function of your thyroid. It's either asking it to produce too much, it's being attacked by your own immune system, or it can't produce because of a high toxic burden or something in the way. And so if you have a thyroid issue, you need to figure out why. In this episode, I'm talking with Thyroid Hormone Fixer, so I'm really excited about this. Because we're going to talk about all of these issues in detail and you're really going to start to understand why getting a TSH and sometimes free T4 level is not enough to get a picture of what's going on with your thyroid, and that it's not your thyroid that's the problem, it's the other issues. So this is a really good episode. I want you to share it with everybody you know. You know, even the men in your life, because men are being diagnosed with thyroid issues more and more than ever. So I had one listener message me. Let me just look it up because she wanted to know— she had thyroid cancer, had her thyroid removed surgically, and then she still has antibodies. And so— What that's telling me is that your Immune system is still attacking your own body, and your immune system's not supposed to attack yourself. That's not what it's supposed to do. It's supposed to attack foreign things— viruses, bacteria, silicone breast implants, you know, any foreign objects your immune system is going to attack. But our immune system gets confused and When our immune systems are attacking our thyroid tissue, we create antibodies against it, and that's how we can see how bad the attack is and how the immune response is going. And so those antibody levels should go down, especially if you've had your thyroid removed. Either you have thyroid tissue remaining and it wasn't all completely removed, Or you have new growth of thyroid tissue, potentially thyroid cancer. So it's really important to follow those antibodies over time, but it's also important to figure out what's triggering your immune system to cause those antibodies to be produced and cause that attack. So working with a functional practitioner— Like myself or Dr. Amy, my guest today, can be super helpful in trying to navigate all of that because it is complicated. It's complex. We're not simple beings. You know, I talk about this in the episode today, like we are just not an on and off switch. We're not one thing pings off another. We are complicated systems of integrated systems that everything affects each other. So You need a functional practitioner or an integrative practitioner who really understands physiology, biochemistry, the effects of the environment, all of that. So let me just tell you about my guest today. I'm super excited because she and I are so much alike. I mean, the way we practice is so much alike. I really love it. She is Dr. Amy Horneman. She's the Thyroid Fixer. She's a woman on a mission. To optimize thyroid patients around the world and give them their lives back using her transformational program, The Complete Thyroid Fix Method. After her own experience of insufferable symptoms, misdiagnoses, and improper treatment, Amy set out to help others who she knew were experiencing the same set of frustrations and who were on the same medical roller coaster. So I'm sure a lot of you are going to relate to this episode today. It's really good. So she grabs your hand, she gives you answers, about your health that no one's ever told you. She gives you the actual tools and treatment to fix you. It's a transformational journey. And with the focus on optimizing thyroid function and thus optimizing her patients, Dr. Amy looks at each person as a unique individual and not just a lab value. I love that. I mean, she and I are so much alike. I love it. She examines all factors that tie into thyroid dysfunction and thyroid symptoms and treats the person from top to bottom to give them their life So I'm really excited about this episode. We covered everything that, you know, related to thyroid function. So let me know if you enjoy this. If you do, hit the subscribe button. I would be so honored if you would hit 5 stars, leave me a review, let me know what you're thinking, what you want to hear more of. I do this for you, ladies, so let me know how I can better serve you.

All right, here we go.

Well, welcome, Dr. Amy, to the Functional Gynecologist Podcast.

Thank you so much for having me on.

I'm really excited to be— to talk to you today because thyroid is near and dear to my heart. It's like that was one of the first things that really got me interested in medicine, getting diagnosed with Hashimoto's at 17 after I had my baby in high school. So I've been on this long journey and Little did I know that all of the damage I was doing to my body was really contributing to this autoimmune process that I didn't understand. And I will tell you, like, I went through medical school, right? And I still didn't put the pieces of the puzzle together because it's just not emphasized in conventional medicine that there's anything you can do about autoimmune. And so I love that you are just like debunking everything thyroid. So thanks for being here.

Oh, absolutely. And I'm definitely going to have you tell your story on my podcast because that's so true. Where we normally see Hashimoto's present itself is pregnancy, perimenopause, puberty, menopause, stress, all of those triggers that just flip that switch for Hashimoto's and then people like you start experiencing symptoms.

Right. So, you know, I surprisingly was diagnosed with it. That was 28 years ago. I think it was a fluke because I had a DO physician, but nothing was done about it. You know, nothing was explained. I just knew I had these antibody levels. And so I was told I had hypothyroidism. Here's your Synthroid and go on your way. And that is what you're seeing, right? Over and over. And tell me, let's talk about like, what's the problem with that?

I wish I knew. So we can try to dissect it. And it's funny because that's exactly what I say when I'm talking about people's experience. Here's your Synthroid, go along your way, have a nice day. So that's exactly what happens to people. And then I say women because women are 90 to 95% of the affected population, but women just leave the office and they go, oh great, now what? Or they think they put their hope in that pill.

Yeah.

And they think, this is it. This is what's going to change my life and give me energy and I'll finally lose that weight that I put on. And that's just not the case. And the reason, I asked a group of integrative doctors once that I was giving a presentation to about the thyroid. I said, why are you guys in the Synthroid box? First of all, why don't you test all of the tests that are needed to get the full picture of a patient's health? When they come to you with all of these symptoms? And then secondly, why are you in the T4 Synthroid-only box? And then one doc raises his hand and says, that's all we've learned. So literally, I mean, you know this, Tabatha. I mean, that's what you learn in med school. And so you come out and you go, okay, I'm just going to do the standard of care and treat this way. And I was taught to only test TSH, so that's what I'm going to test. And if it has an H or an L next to it, maybe I'll pay attention to it, but If there's no high or low marker, oh yeah, you're fine, you're normal. And that's the diagnosis that people are given. You're normal, you're fine, eat less, exercise more, you're just getting older. Yeah.

And oh my goodness, like TSH isn't even a thyroid hormone. You know, that's the first place I like to start is like, it's coming from your brain. It's just a response hormone. So let's talk about the bare minimum. Like, what do you mean we need to look at your thyroid in more detail?

Right. So you walk into your doctor's office, if you happen to say, hey doc, I want a full thyroid panel, you're going to get TSH and maybe free T4 if they're a really thorough doctor. But if you want free T3, which is the active thyroid hormone, we want to look at that marker because T4 is inactive. Your cells do not have a receptor site on them for T4. They only have a receptor site on them for T3. That's the active thyroid hormone. We want to look at it because guess what? If we're not looking at what your active thyroid hormone levels are, we have no idea what's going on at the cell level. No clue whatsoever. And then there's reverse T3. So I said free T3, free T3, you'll get tested. Yeah, yeah, yeah. It's your storage. Nice to know. Not as important as free T3 and then reverse T3. So reverse T3, your doctor will most likely say, I've heard this over and over again. We only test that if you're really sick. Well, we only test that if you're in the ICU. And it's like, well, yeah, because that's the body's survival response. So that's going to go up in order to drop your metabolism and slow your body functions because it wants you to survive. So it's going to be up if you're in the ICU or the ER, you experience an injury or trauma, reverse T3 goes up because it's protecting you. Your body is so smart. It's saying, listen, you don't need to burn fat right now. You don't need to have energy right now. You need to live. But what if that reverse T3 is high on a day-to-day basis when you're just walking around doing your— doing work, your job, cleaning the house, taking care of the kids, and you're walking around with a high reverse T3? Well, that's your body in survival mode. So you're walking around with a low metabolism. Low energy, constipation, everything slows down because that reverse T3 is high, so we have to look at it. We look at it whether you're diagnosed or you're undiagnosed. So if you think that you have a thyroid problem, that is still one of the markers that we check. If you already are diagnosed and you're like, hey, I'm not feeling any better, then we have to look at that because that also gives us an indication of whether or not you're converting. So are you converting that inactive T4 to active binding to the cell, cell receptor site, T3, active T3? So we want to look at reverse T3. And then you're right, Tabatha, you're lucky that you had your antibodies tested because so many people go without antibody testing. You have to ask for thyroglobulin and thyroperoxidase. Those are the 2 antibodies. I've also seen doctors only test one antibody. So I get patients' labs back that they had done, you know, within the last 6 months, and they're coming to see me for the first time. And I'm like, um, did your doctor not know that there's 2 that we need to test here? So there are 2 antibodies, and that's the indicator for Hashimoto's. That tells us whether or not you are in an autoimmune form of hypothyroidism called Hashimoto's, where your body's attacking the thyroid gland. Now those antibodies can come back negative, so we do like to— like a false negative, so we like to retest those. And when we're looking at the antibodies, we can't go by the standard lab value range. We really can't go by the standard lab value range for any of them. We have to look at them from a functional perspective, but we can talk about that. But any antibody is an antibody. So even though that standard range for TPO says you're totally normal if you're less than 20, Well, what if you had 18? You still have 18 antibodies. You have 18 soldiers that are going out on a regular basis and attacking your thyroid. That still is the beginning stages of Hashimoto's, and that's where we want to catch you so we can stop it or we can reverse it, or we can help you and help your symptoms. Yeah.

Oh my gosh. So much good stuff to unpack. You know, when you're talking about The different thyroid hormones that we can test and look at. I can just think of like so many patients who have this recurring picture, like their TSH is low, their free and total T4 are low, and then their reverse T3 is high. And so they're being told they're on too much medication, and then they have their medication dose decreased when they already feel tired and sluggish and are overweight and constipated. And Their doctor sees the low TSH and backs down on those. And it's like, you need to understand the reverse T3 is talking to the brain as well and suppressing that TSH. It's so much more complicated than conventional medicine wants to give it credit for. I mean, I wish the thyroid was as simple as 2 markers ping-ponging back and forth, don't you? Like, it would make our job so much easier.

Right.

People would feel amazing, but that's just not the case. So thank you for bringing that up because it's so important that women realize reverse T3 is this whole other picture. I so often see it like 20, 25, you know, and they're like, why? And so I want to talk about like what is causing this elevated reverse T3 because it's so much more common than women realize, right?

It is. It is. So it's not just a trauma injury illness. It can go up in response to high insulin levels. So we see— I mean, insulin is just— it's one of those that I could probably test 100 people and 99 of them are going to have insulin resistance based on functional medicine optimal ranges. So we're not going by whether you are red or have an H next to your fasting insulin on your labs. We're looking at them from a functional perspective, so I really like to see insulin below a six. Above a six, that's insulin resistance. High insulin levels, too much insulin in your body, whether it's from crappy food that you ate, too much sugar, too much processed food, too many carbohydrates, whether it's from not sleeping enough, excessive stress, that insulin going up is going to interfere with T four to T three conversion. And it's going to push up reverse T3. Now, this is kind of hard to grasp if you're a newbie, but if you think of free T4, T4 is your storage, that's your storage thyroid hormone. It has 2 paths that it can take, it has a choice. It can convert to T3, yay, happy dance, or it can convert to reverse T3, boo, bad day. So when it's converting to reverse T3, There are things that are making it convert to reverse T3. It's pushing it in the— on the wrong pathway instead of going on the pathway that it should go. It's going on the wrong pathway. High insulin is one of them. So we have to look at your insulin levels and work on that to lower reverse T3. Things like heavy metals, mold toxicity, Epstein-Barr virus, underlying co-infections like Lyme disease, Epstein-Barr. Different tick-borne illnesses, all of those drive up reverse T3. Estrogen dominance, anemia, not enough ferritin, not enough magnesium, selenium, iodine. Iodine is a big one. If you're iodine deficient, it's going to drive up reverse T3. So there's a lot of factors that we look at when someone is walking around with a high reverse T3 to say, what do we need to fix? What do we need to address?

Okay.

In your body to bring that level back down so that free T4 can find the right path, the good path, the path that's going to give you energy and a metabolism. That's what you want.

Yes, exactly. I think it's so important to realize all of these normal— or not normal, but common things that women are experiencing are driving this dysfunction. You mentioned ferritin. That's a huge one in my patient population because women are coming to me with heavy Periods, you know? They're estrogen dominant. They have so much estrogen going around and they're losing a ton of iron every month. And if you don't have any stores in the bank to pull from, you've got no reserves, like, you're going to be in trouble. And so I just, I love that you are helping women realize that it's all interconnected. Our systems are not working in silos, right? The insulin's a factor, the sex hormones are a factor. It's all playing off It is.

It's, it's so beautifully interconnected, but just so overwhelming to the average person saying, wait, what do I need to look at? How many things do I have to— how many things do I have to get tested? But with the right practitioner, I mean, we, we put the pieces together to just say— I mean, we, we get geeked out over the lab work. We go, yes, there it is, there's your answer.

Yeah, exactly. And so there's all kinds of things that we need to evaluate. You know, you're talking about high toxic burden and gut dysbiosis and stress and all of these factors. So I know that you have your Thyroid Fix method you go through with clients. Can you just kind of walk me through, like, basically what a client would experience and what that looks like when working with you?

Yeah, absolutely. So I always start my patients out, my one-on-one patients out, with a 90-minute consultation So we can really dig deep. And there's a lot that goes into that first meeting because we're looking at all of your labs and we're looking at your lifestyle and your sleep and your hormones and all of those nutrient numbers like vitamin D and mag and selenium and iodine. And of course your thyroid panel. We're looking at everything. We test for everything to get that full picture so we can lay it out and go, okay, let's put this puzzle together. And then we pair it up with your symptoms. So I always say you're more than just a lab value. You're a human being. So we have to look at what are your symptoms. So even though the labs tell us one thing, if your labs are perfect in the functional world, but you're telling me that you feel like garbage, we're going to figure out why you feel like garbage. I'm not going to send you on your way and go, well, you know, oh, you'll just have to deal with it. You're getting older. No, no, no, no.

Yeah.

We are going to figure out why. And, and work and put a treatment plan in place to balance that out. Now I'm really big into giving patients access to me. I know a lot of practitioners say, are you crazy? But I want to keep in contact with my patients. So when we are working together, there's a lot of points of contact and there's— I hate to say 24/7 access, but there's— you have accessibility to me to answer questions because, as you know, as you're healing, Healing is a journey. It's not a one and done. It's not a, here, take this pill and you'll be better, or even take this list of supplements and you'll be better. It's a journey. And really, when working with thyroid patients, it's like peeling an onion. So I always like to start with the obvious. Let's start with the master gland, the thyroid. Let's start peeling away and look at, okay, there's insulin, there's your nutrients, iron, yep, hormones, yep, CBC, CMP, Epstein-Barr virus, Lyme. Fine. That's the outer layer of the onion. And then we start going deeper and maybe we do testing on your gut. Let's look for Candida. Let's do a cortisol panel. So I try to save my patients money and not do all the functional testing right up front, but let's peel the onion. So as we get down in and we're noticing changes here but not here, well, then we might need to dig a little bit deeper. So we just keep digging until people are fixed.

Yeah.

I mean, I've had patients come to me and say, I must be the worst case that you have. No, no, you'd be surprised at how alike you are to so many other people struggling with the same thing that you are. And it really is just, it takes the practitioner that's going to look at the full picture and put your pieces together. And that's really the problem, as you know, with conventional medicine. People will say to me, well, why has no one ever told me this before?

Right.

I go, because they have 5 to 7 minutes with you per your insurance company. They don't have the time to put the puzzle together. And that's why, I mean, it may not even be your doctor's fault. Yes, it might be that's what they learned in med school and they haven't branched out since then, but it could also be they're being dictated by insurance companies to only have 5 to 7 minutes with you and that's it. And they just, they can't put the pieces of the puzzle together.

Yeah, unfortunately, that is all too true. You know, I was in that world for over a decade, so I understand it very well. And you really do need time with the patient. You need to listen to their story. But you hit on such an important point that I want to say it again. Like, people think they're the only ones that feel like crap because we're all so good at covering it up and putting on the face, right? Like, people don't realize that I have chronic back pain. back issues because I run and I do all the things, but I'm in pain. I'm struggling just like you are, you know. And so I want women to not be afraid to like say, I don't care if my labs are normal, I don't feel normal, I need answers. And keep searching until they get them because, you know, docs like you and I are out there and we will help, right?

Yes, exactly. It's funny you bring that up. I, I have a great team. So part of working with me too, you get mindset coaching and you get to meet with a functional diagnostic nutritionist. And we just have just a great cohesive team put in place. And the, the FDN, the functional diagnostic nutritionist I brought on, she has seen 48 doctors until someone finally told her what was wrong with her. Now, it was a multitude of Hashimoto's and heavy metals, and, and I think Lyme is in there. But 48. So if you think that you've seen a lot of docs and still don't have your answers yet, try to hit 48. But no, I saw, I saw 6, and before I was diagnosed, I was misdiagnosed 6 times. It's hard to keep going, but that's really the, the message I love giving to people: be your own patient advocate and do not Stop. You know your body. If you know that there is something not right going on and you're digging for answers and you get told that you're normal, you're fine, you're just getting older, keep going. And you may have to come into the functional realm, into the integrative functional side, but you have to keep going until you find an answer because there is one. Our bodies were not made to be sick.

Right.

We weren't made to walk around feeling like garbage past the age of I know, that's a bunch of bullshit.

I'm sorry. Like, I'm in my prime. And the other thing you hit on, like, even if you have a diagnosis, that doesn't mean you're getting the correct treatment. You know, like, I had that diagnosis, but I never got treated properly. I was— things were never addressed or discussed. My, you know, sleep deprivation as an obstetrician was never discussed. My crazy stressed-out life, my horrible diet, diet, you know, living on gluten and dairy. Like, none of those things were addressed, and those were all driving my disease. And so even if you have gone to the doctor and you got the diagnosis, the diagnosis doesn't mean anything, right? Like, it's really what you do with that diagnosis. So I'm so grateful for what you're doing because it's such important work, and there's so many women out there who don't even realize That they could feel better.

Right, right. And like you said, even if you are on a medication, you go, okay, well, I got diagnosed. I wasn't misdiagnosed. They told me I have hypothyroidism, Hashimoto's, and I have this little pill here, Synthroid, Levo, and that's what they told me would work. Well, I too was on T4 only and I gave it 5 months. I'm very impatient. So after being misdiagnosed 6 times, Gaining 20+ pounds, losing hair, incredibly fatigued. I was eating perfectly, going to the gym twice a day. I was actually getting ready for a figure competition, so I should have been losing, but I was gaining. And then I got stuck on Synthroid. I gave it 5 months and I'm like, this isn't working at all. So again, it could even be your medication just needs changed. We need to figure out if you're converting T4 to reverse T3.

Right.

Maybe we have to address these things over here. Yeah, you can stay on the T4 only, but let's address these things over here that's blocking it from converting to the active thyroid hormone, and then you get a new life. I mean, when the med that you're on— it's fine to be on a medication. I call thyroid medication thyroid hormone replacement therapy because we're replacing hormones that probably aren't being made properly, especially if you have Hashimoto's and Your thyroid's getting attacked on a daily basis. You wouldn't operate very well at work if you were being attacked on a daily basis either, but we can make that work for you instead of against you. So even if you are diagnosed, don't accept feeling like crap. You don't have to.

Yeah. So talk to my listeners about why sometimes they don't feel better on Synthroid. Like, what's the deal with that?

Right, so we covered the conversion. So sometimes when you're on T4 only, you're not converting properly, you're converting that T4 to the wrong path, it's getting converted to reverse T3 path instead of to the free T3 path. So that's one issue, looking at all the different things that interfere with conversion. Another issue can be that you don't tolerate the fillers. Some people are very sensitive to fillers in medication.

Yeah.

And when we're talking about generic T4, it has gluten in it, It has sucrose, it has lactose. So even if we step up a notch and go to Synthroid, Synthroid still has corn depending on the manufacturer. So I really like to, for my sensitive patients, I like to bring them up another level if we are using the synthetics and use something like Tirosint, which is very, very pure, and then add in a T3 component or change over to NDTs, which are natural desiccated thyroid medications, things like Armour, NP Thyroid, Nature-Throid. Now, they still have fillers. Just because we're calling it a natural desiccated thyroid doesn't mean that it's free from fillers. It can still have fillers. So it's really kind of tweaking the medication to fit the individual and to make them feel better. But a lot of times being on T4 only, when we are addressing everything, we're looking at the insulin, we're looking at estrogen, we're looking at all that, And damn, they're just still suffering from symptoms. Then we have to look at, okay, maybe you need a little bit of T3, maybe you need some conversion help, maybe you need a little bit of, just a little bit of NDT with your T4. So it really comes down to that just unique treatment plan for the person. I would say 9 times out of 10, if people aren't feeling better on T4 only, you have conversion issues.

Yeah.

You probably have insulin resistance. You probably have estrogen dominance, and you're probably anemic because we all are. Everybody goes through that at some point in time. You're not eating enough meat. You're having heavy cycles. The xenoestrogens in our world are just off the charts. That's another podcast in and of itself.

Yup.

But I think everybody moves into a state of estrogen dominance, even guys. Even guys. I see a lot of low testosterone, high estrogen in you guys, and then you're walking around with high reverse T3 if you have Hashimoto's, and that's not good.

Yeah. I'm amazed at how much thyroid disease I'm seeing in men nowadays. Like, it was unheard of when I was in medical school, but you hit the nail on the head. I mean, those xenoestrogens and all the toxins in our environment are just driving all of this dysfunction. But I couldn't agree with you more on just the individualized approach to medication, because honestly, that's what I see all day in my patients, is like one woman will just like talk to the moon and back about the Tirosint, and one woman will just love her Armour Thyroid, and one woman needs the Cytomel, one woman hates it. And like, it really is such an individualized thing that you need an expert who's comfortable in all of these different options. Because For the majority of people, Synthroid doesn't help, you know, it's for reasons you've explained. So there are options out there, and I love that you are just like, you know what, sometimes you need some support when your thyroid's being attacked and you're not making that thyroid hormone appropriately. Let's replace it. I mean, that makes total sense. We do the same thing with progesterone and testosterone and other things. So I, you know, I'm all for not being on medications either, but sometimes there's a place for that until we can really get that attack calmed down. You know, our immune system shouldn't attack our own tissue, right?

Right, right.

Yeah. So such good points. So what kind of vitamins and minerals are you usually seeing patients also need in addition to their— for their thyroid support? What are the big ones?

The big ones are, well, vitamin D. I mean, even if people are low in vitamin D, they'll say, well, my doctor put me on a prescription for that. Oh gosh. Okay. I've never seen prescription vitamin D work to raise a vitamin D level. And their goal is just to raise you into above a 30.

Right.

For optimal, we want you around 80. So that prescription isn't going to work. So we have to address the vitamin D deficiency. We have to address selenium. We don't want it too high though. So a lot of times I'll see patients that have read in Dr. Google or a Facebook group that selenium's good and they're taking 200 milligrams of selenium every day and then it's too high and that will interfere with T4 to T3 conversion as well. So we want selenium just right. We want iodine just right. And like you and I discussed, or you posted on Instagram, magnesium deficiency is through the roof.

Yeah.

So that's a big one for conversion. Zinc is huge for T4 to T3 conversion and for your hair because a lot of thyroid patients are losing hair. So they're deficient in zinc, their T4 isn't converting to T3, we don't have that support in place. And it could be as simple as, hey, let's get your vitamin D up, let's get your zinc up, let's get your magnesium up, let's get your iodine out of the toilet and back off on the selenium a little bit.

Yeah.

And then all of a sudden it's just a beautiful symphony. The other thing I like is T1 and T2. So I'm actually working, I'm in the midst of working on a supplement for that because T2 is not as powerful as T3, but it's way more powerful than T4 and it can help the conversion process. We can add T1 and T2 to a T4-only patient and see magic happen in their numbers and their symptoms.

Yeah.

So that's another kind of supportive component, getting the iron up, getting the ferritin level up, not just iron, not just total iron, we want to get the ferritin up as well. So that really good iron supplement with vitamin C is phenomenal. So there are some simple supportive nutrients we can do that help tremendously. I mean, you'd be amazed at how much they— not you, but your listeners would be amazed at how much that they help. And I know you know the benefits of those. Yeah.

Yeah, I, I couldn't agree more. Like, I check all of that because I, I just don't see the benefit in only checking a couple labs and not getting the complete picture because you really— everything ping-pongs off of each other and affects each other. So it's so important, you know. The people that go get their labs drawn get made fun of by the lab technicians locally, like, oh my gosh, are you giving blood? Because I order so much stuff. But it's like— I really do want to see what's going on with you. You know, I want to see that fasting insulin and average blood sugar. I want to see your vitamin and nutrient status. I want to see all of it. So yeah, super important. Do you work with men as well?

Oh yeah. I love, I love working with men, uh, because they're just so, you know, they, they wait till the last minute to ask So you know when the guy's coming in, they're going to be in the tank, right? And all the time, all the time. I mean, this is a nationwide issue, low testosterone. Because guys, your testosterone level, I can actually bitch more about the testosterone standard lab value range more than TSH. TSH has at least narrowed down in the last decade. We're still fighting to get it more narrow. But you guys and your testosterone, my God, it starts at 250 and goes to 1,100 on most lab ranges. I'm going to tell you what, if you're coming in at 285, your doctor's telling you you're normal, you are not normal. You're going to feel like complete garbage. You're going to have no sex drive, no motivation. You're going to be gaining weight. And most likely you're going to be estrogen dominant.

Yeah.

So we don't know what tanked your testosterone. It could be stress. It could be the fact that you You are exposed to xenoestrogens and the high estrogen level pushed down the testosterone. You could be walking around with Hashimoto's as well. But oh man, the guys, I have a special place in my heart because it sucks having low testosterone. It's horrible. Right.

It's the equivalent of menopause in women, right? But they aren't expecting that. They aren't realizing that. It's so true. I mean, I do testosterone pellets and I have considered adding men to my regime because they are suffering and there's really no help out there, at least locally where I am at. And, you know, I don't think men realize because they get that quote-unquote normal level return, but you're like you said, in the 200s, that is not a normal functioning man, you know. And we see that in like 40-year-olds, and that's just not okay.

Yeah, yeah. Across the board in 40-year-olds. I've had, I've had some late 20-year-old patients, you know, with— oh, it's just so sad. It's so sad.

Yeah, it's not— you don't need to live like that. So I love that point. Let's talk real quick about hair loss because I think it's so prevalent in thyroid disease and people just assume that they need to up their medication if their hair is falling out and that's the only issue. So let's talk about, like what the heck's going on with hair loss?

Yeah, hair loss is very complex with a thyroid patient. So number one, we want your thyroid to be optimized. That's first and foremost on the list. So we can't even talk about anything else until we get your thyroid optimized. Once we do that, and even in that process, if we're adding in T3, if you're changing from a T4 to T3, or we're adding in T3 or changing to an NDT medication, I always tell patients, listen, that T3 is going to increase your metabolism. Your hair growth cycle goes through a dormant phase, a growing phase, and a falling out phase. When we increase your metabolism, that's not just fat burning. That is your whole body, your entire body functioning. So at the cell level, that's going to all of a sudden speed up. So if you are hypo and really low, Your hair growth cycles have most likely slowed down. Yes, you're going to be losing some hair. It's going to be thinning because it's not getting the nutrients. We'll get to that. But just in the hair growth cycle phase, that's all of a sudden going to speed up. And then people go, oh my gosh, this medication is making me lose more hair. No, you're experiencing an increased metabolism. So now your hair growth cycles are catching up to what they should be. Yeah. Losing that hair that was just kind of like blah, just hanging out there, not doing anything. So that's part 1. Then part 2 is let's look at your hormone balance. Well, I kind of like to do that both and thyroid and hormone has to be a both and insulin has to be a both and we're doing that all at the same time. But of course we look at what about your ferritin? So if your ferritin is low, hair is not going to grow, period. And then zinc, that's the big one. I want to make sure that ladies, you have enough testosterone. A lot of people demonize testosterone in women. And oh, it's going to change over to DHT. Well, that's not even DHT isn't even a major contributor to hair loss. We get a little bit of androgenic alopecia, but you know testosterone levels being optimized are vitally important for women. So I want your testosterone level optimized. I don't want you estrogen dominant. There's so much that goes into hair loss, but we we chip away at it. I mean we chip away at it. We look at your nutrient status, make sure you're getting enough. Enough protein, use a high-quality collagen supplement. I use one that even when I used it with my alopecia patient who was also Hashimoto's, her hair grew back in her bald spots. And I know because my hairdresser is her hairdresser and she called me and was like, hey, her hair grew back in her bald spots. I said, yeah, that was optimizing her thyroid and actually getting some collagen in her and addressing the different nutrients. But there's so much that goes into hair loss, but it is a state of hope that you should be in because it can be reversed, believe me.

Yeah, definitely. And so much of it is driven from inflammation, right, too? Like, if you don't have your autoimmune thyroid issue in check and you are just systemically inflamed, your hair follicles are going to be inflamed and your hair is going to fall out. So like you said, It's super multifactorial and you got to work on all the pieces of the puzzle.

Definitely. Inflammation is at the core of everything. So when we're looking at what's going on in your body, I think people tend to think of inflammation as, oh, I hurt my elbow and now it's red and inflamed. No, it can be systemic, meaning it's your full body. So when you are in an inflamed state, That can be from autoimmune, that can be from high insulin, that can be from the foods that you're eating or not getting enough sleep. Overexercising can put you in an inflamed state. So inflammation is at the root of everything. And you're exactly right. If you're inflamed, how in the world are nutrients going to get to that follicle to even not only keep it there and keep it growing, but provide enough nutrients to it so that it's full and lush? A lot of people will complain. They'll say, well, I'm not losing hair, but it's really thin. And that's what I experienced. My hair went to like straw-like texture. It wasn't getting any nutrients. So that's part of calming down that inflammatory response. And when we're talking about Hashimoto's or any autoimmune condition, where we see one, we see multiple. So oftentimes, I mean, that hair loss that you're experiencing is a form of alopecia Because autoimmune begets autoimmune. And when we calm down your Hashimoto's, when we calm down your immune system, when we tell those soldiers that are going out and attacking your thyroid, listen, chill out. You can go back to your barracks. You can have a party. Just stay there. Don't go out and attack anything. It's cool. The body's cool. We got this under control. Well, then they stay there and everything calms down.

Yeah.

Then your thyroid starts working better. Then inflammation comes down.

Then your hair starts Yeah. Oh my gosh. I, I hope that my listeners are feeling hope from just listening to you because you— we are not meant to be in this state of inflammation and dysfunction. Like you said, our bodies were created to be in harmony, heal themselves, regenerate, and be amazing beings. It's just we have to remove the impedances, right? We have to remove the triggers and the crap that we're exposing ourselves to. exposing our bodies to. That's all we have to figure out. And so I love it. I think you and I are just like two peas in a pod. We're on the same wavelength with everything. It's so good. Yes. Oh my gosh. So what is like the biggest take-home that you tell your thyroid patients? Is this like a lifelong sentence or is there hope?

Oh goodness, no, there's hope. I mean, once you get optimized, it's smooth sailing. I haven't. I mean, people ask me, well, how often should I get my labs done? I go, well, I go once a year, but that's just to please the insurance company to say, yeah, she got tested. I've been optimized for so long. I'm just— I'm smooth sailing. Now, things can happen in your life that maybe rock the boat a little bit and we have to do some adjusting. But once you get to that optimized state, I mean, life is good. So there absolutely is hope. The message I would give in addition to having hope, not stopping, not giving up, not stopping at one doctor, not stopping at 10 doctors, you keep going until you find the answers as the why. You want the why. Why do I feel this way? I know I'm not supposed to. This isn't me. I feel like I'm in a different body. I look at myself in the mirror and it's not even me looking back at myself. Different person. You know your body, so you don't stop.

Right.

Until you get answers to that why.

Yeah.

And then, I mean, the next part of my message to your listeners would be get all the thyroid labs done. That's the biggest thing that I see. Just like you said in the beginning, I've got my TSH and it was normal. I just saw that on Facebook in a thyroid support group. And I'm like— and you and I go, do people not know by now that you don't just go by TSH? But they don't. Gets the TSH done and goes, well, I got my thyroid tested and it's normal. Like, no, no, no, no, no. We need so much more than that. You can't stop there. So that's another message that maybe people don't realize. There's more testing to be done and you have to get it all in order for us to have that full picture.

Yeah. And one thing I was thinking about while you were explaining that is things change. I mean, when I think over the past 20, 8 years of my diagnosis, I've had periods in my life where I was on Synthroid and then I wasn't on any medication. And then I was like super hypo, non-functioning, requiring antidepressants and everything else because of all my symptoms. And so, I think women need to understand also that you wax and you wane depending on what's going on in your life and the seasons of your life, you know? And so, So just because you're one picture at one point in your life doesn't mean you'll always be that way. I remember my antibody levels being like 900 and 1,100 or something crazy high.

Yeah.

They are like in the single digits last year. You know, I think my TPO antibody was 6 or something. So things change depending on what you do. And so I always say it's not a life sentence. I mean, you have to realize Autoimmune disease is something that is triggered, and once it's triggered, it's hard to turn off. And like you said, you're more apt to have more autoimmune diseases. One begets another. So you need to realize that that's just who you are and be aware of it, but it's not a life sentence in the fact that you don't have to feel miserable. So thank you so much for all your wisdom. This has been awesome.

I love talking to you. Anytime. This has been great. I think we are two peas in a pod. You're so right.

We are. We definitely are. Well, so good. So where can my listeners find you and connect with you, Dr. Amy?

Yeah, absolutely. You can always go to my website at dramyhorneman.com. That's just with a DR. And on there, if you're interested in booking just a free discovery call to find out more about working with me, you can click the book Book a call page, sign up for a time that works for you, and we'll talk.

Awesome. I'll have all those links in my show notes because women need to seek you out. They need to feel better. That's their right. So thank you so much. This has been awesome.

Absolutely. Thank you so much for having me on.

All right. Take care.

Bye-bye.

All right. That was an awesome episode. I hope you got some value out of it. I know I did so many golden nuggets, right? Like, I want you to take something from this episode, incorporate it into your life, and keep working on bettering yourself, being the best version of yourself that you can possibly be. You deserve to feel amazing and vibrant and full of energy and be at the weight weight that you want and be sleeping and have amazing, healthy relationships. Like, that's all possible and doable. And like Dr. Amy and I were saying, so much of it is individualized medicine. You know, it's not cookie-cutter. You can't just come in, get your Synthroid, and be on your way. There's so much more to it. And what's going on with you might be completely different than what's going on with your sister or your best friend who has the same diagnosis. And so it's really important to work with somebody who's going to look at all of these factors. So definitely don't hesitate to reach out to Dr. Amy or myself. I am licensed in over half the country to see women. So if you want to schedule an appointment with me, just Just go to drtabatha.com. It's D-R-T-A-B-A-T-H-A dot com. You can actually sign up right there. All the information is on my website. I would love to help you on this journey toward figuring yourself out, figuring out why your thyroid isn't functioning or if it's not functioning well. So many of us don't even know that our thyroid isn't optimal because no one's checked it. Well, you could just hook up with me and we could check that out and find out, right? So, so many good reasons to work with a functional practitioner. So my golden nugget for today that I loved was Dr. Amy's mention about hair loss. You know, when you're switching medications and you're finally getting on a medication that's working and increasing your metabolism, yes, your hair growth cycle is going It's going to turn back on and you're going to have some hair shedding. It's kind of like after you have a baby, 4 to 6 months later, all of a sudden your cycle of your hair turns back on and you have this shedding period for a few weeks. So I thought that was a cool little nugget of information. But let me know what you guys are thinking about these episodes. I am here for you. I do this for you. If you want to work one-on-one, don't hesitate to reach out. That's what I'm passionate about. I love it. So go out and have a kick-ass week, ladies. Take care. Bye.