Thyroid After 40: What’s Really Slowing Down Your Metabolism?

We are basically doing Thyroid 101 today. So we're going to talk about hyperthyroid, hypothyroid, talk about the signs and the symptoms of each, and we're going to go into cause, causation, what's related and what contributes. And if you're using fragrance or drinking out of plastic water bottles, Thinking it's not a big deal. We're not going to point fingers at you, but I think you want to tune into this one. You're in perimenopause, menopause, or postmenopause, and you're not slowing down. You're just getting started. But the old rules don't apply anymore. The workouts that worked before, they're working against you now. The advice you've been given, incomplete at best. I'm Debra Atkinson, and I'm the founder of Flipping 50, the pioneer in fitness for women in midlife. For more than 40 years, I've been in the trenches with women just like you, and for the last 12, right here on this podcast, and, and the founder of Flipping 50: The Stronger Way app and membership. Welcome to Flipping 50: The Stronger Way, where science meets strength, where you'll find the tools, research, and real talk to build the body and the life you want in your second half. Each week you'll get evidence-based exercise and nutrition strategies, conversations with leading experts, and honest answers to the questions your doctor didn't get answers to in medical school and doesn't have time to answer in an appointment. This is your show. Let's get stronger. From health history information behind the scenes, although it does remain private, We know that probably 90% of our members and students and my private clients have some type of thyroid issue. Most of them, in terms of function, it's low functioning, meaning hyper, not hypo. I'm sorry, hypo, not hyper. She's got that backwards. Meaning it's sluggish, it's slowing down, and it is related to metabolism. So this episode is for all of you who are wondering, is this a part of what's going on? We answer some questions today, um, like why is thyroid number one so important? Myths and truths about thyroid dysfunction. Can we improve thyroid function with lifestyle changes even after medication? Can medication be reduced or discontinued entirely? What are the worst lifestyle habits that contribute Or trigger to thyroid dysfunction, and why midlife thyroid issues seem more common. So stay tuned if you have Hashimoto's or you have not been diagnosed with Hashimoto's but you struggle and you're taking a thyroid medication. We talk a little bit about different types of thyroid medications that you may be taking just one, and through the lens of that. Not really be aware of others. So we'll shed a little bit of light on that too. My guest today is Dr. Eric Osansky. He's a chiropractor, a clinical nutritionist, and certified functional medicine practitioner who's been helping people with hyperthyroidism and Hashimoto's since 2009. He's the author of books called Natural Treatment: Solutions for Hypothyroidism and Graves' Disease: The Hyperthyroid Healing Diet, and Hashimoto's Triggers, and is the host of Save My Thyroid podcast. Dr. Osansky was personally diagnosed with Graves' disease in 2008 and was able to restore his health through a natural approach, and since then has helped others reverse hyperthyroidism and Hashimoto's condition through his Saved Thyroid framework. I think you'll get a lot of value out of this, and I hope that if you do, you'll share this with others who— so many women, and not just midlife women, but younger women, are actually suffering with thyroid issues, perhaps not realizing that their sluggish metabolism or failure to lose weight is related to thyroid. So if you find common denominators like fatigue And hair loss or frequently cold, that can be a sign that metabolism, too, may be slowed in part because of your thyroid function. Let's dive into this episode. Love to hear from you after, so send me a DM on Instagram if you listen to this one and if it was helpful. Dr. Eric, thank you so much for joining me.

Thank you, Debra. Really excited to have this conversation.

Yeah, me too. And as always happens, we let some juicy stuff in the synopsis go wild in the green room, but this is such an important piece. And I think to every woman listening and to every woman who's got a daughter or a daughter-in-law, and it's not just women, but I think women, and I'll ask you to unpack that, are probably a little bit more prevalent in their challenge with And, I want to go back to square one. But, even before that, why is thyroid so important for you? Why this topic became such a key and important part of your career and what you do?

Yeah, it's a great question. Just honestly, it wasn't on my radar as a chiropractor. I just had a regular chiropractic practice for 7.5 years. And I mean, I saw people, I'm sure, who had thyroid conditions, but I didn't really help them with thyroid conditions. I helped them with their, you know, the neck pain, their back pain, and everything else that chiropractors typically help people with. And then just eventually I was diagnosed with a thyroid condition, actually an autoimmune thyroid condition called Graves' disease. And it's not the most popular Mm-hmm. Thyroid condition. Hashimoto's is definitely a lot more common than Graves', but nevertheless, it was a surprise and, you know, just really made me aware of how much— how common— I mean, even before that, I knew it was common, but just once you deal with it personally, it's a whole different story. So, just— yeah, so I dealt with my own Graves' disease journey and then was able to restore my health naturally. And, we could definitely get into that if you'd like. But, once I was able to restore my health, I just realized that there's a lot of people out there who are just following the conventional advice. And, not that there's anything wrong with that, there is a time and place for thyroid medication whether you're dealing with hyperthyroidism or hypothyroidism, but— Mm-hmm. I realize many people need to go beyond that and not just rely on the medication.

So, and you busted through my theory right away, so well done. But so you as a male, what is the ratio of male to female diagnoses of thyroid?

I believe it's about 8 to 1, about 8, you know, 8 females For every, I mean, probably, I mean, a lot more than that. I mean, as far as men and women, I'm thinking hyper and hypo. So, like, would hyper, hypo, yeah, sorry about that. So, about 8 to 1 hypo to hyper. But, I mean, I would say probably about, you know, 80, 90% of people with thyroid conditions are female. You know, I was one of the lucky men that was diagnosed with an autoimmune thyroid condition. And that, That definitely holds true in my practice. Most people that I see are women. Maybe I would say maybe 1 or 2 out of every 10 are men. And that might be generous, honestly. I mean, it seems like maybe I could probably count on my hands how many, or maybe both hands, how many people I see every year that are men. Definitely most are women.

Well, I was— As I ask that question, I think a follow-up question that's probably really good to ask is, how many people do you think are walking around not asking for help, not actually getting diagnosed, that are dealing with it but not knowing or even considering, and maybe a doctor is missing it?

Oh, it's— I'm sure it's got to be millions of people who are undiagnosed, like walking around and have, again, probably more people, definitely more people that have Hashimoto's, hypothyroidism, Hashimoto's. And I mean, to be fair, it does take a while in some cases, just because with Hashimoto's, it— I mean, I should also say most thyroid conditions are autoimmune, which means that the immune system is attacking the thyroid gland. And the underlying autoimmune process It's underlying, I mean, for quite a while. I mean, many times like 5, 10, sometimes even 15 years before it starts affecting the thyroid panel. And so, it's really backwards the way the medical system works. They really should be evaluating the immune system, looking at the autoantibodies because the autoantibodies develop first. And then, of course, another problem is that— They look at the lab reference range when it comes to TSH and even the thyroid hormones. So, TSH, which is thyroid-stimulating hormone and is actually a pituitary hormone when— I mean, I would say an optimal range would be between 1 and 1.5. Maybe some would say between 1 and 2 as far as from a functional medicine perspective, but the range is so broad. So, if someone has TSH of 4, most labs would consider that to be their normal range. Mm-hmm. And so, those people are not diagnosed with a thyroid condition. And again, the antibodies usually aren't looked at until that TSH is out of range. So, that's why I would easily say millions of people just because there are a lot of people that have thyroid conditions and they have a TSH that's above the optimal range but they haven't yet been diagnosed. And then, there are, I'm sure, so many people also who have Elevated autoantibodies and maybe their TSH hasn't been affected yet. So even if they did a blood test, their TSH might look pretty good, like might look between 1 and 1.5. But again, since the antibodies haven't— I mean, since the immune system really hasn't impacted thyroid yet, those people also haven't been diagnosed. And again, they might not get diagnosed for 5, 10 years down the road, if at all.

Okay. I feel like we could actually do this and break this into what would feel like a mini thyroid crash course. And I'd kind of like to do that because you talked about Graves'. There's also Hashimoto's, there's Addison's. And I want to ask, for a listener who may be saying, I wish she would ask this, is every Thyroid issue, one of those, or is that there's also kind of a benign label of just a thyroid issue? It's not functioning well. And could you break down what are the what is the actual hyper or hypo of either of those, and what are signs or symptoms early on that somebody might have?

Sure, we could talk about that. So to answer your question. Graves' Hashimoto's are two autoimmune conditions, but you could have other thyroid conditions that are not autoimmune. You mentioned Addison's was actually more adrenal. Addison's and Cushing's are more autoimmune adrenal issues. Okay. So with as far as autoimmunity, let's I guess let's talk about a little bit like how. We could definitely talk about the symptoms, but also how does someone know if they have Graves' or Hashimoto's? And you could also have the antibodies for both. So there are some people that have antibodies for Graves' and Hashimoto's. And so with the thyroid, again, I mentioned TSH, which is thyroid stimulating hormone. And then you have the thyroid hormones, T4, which is mainly produced by the thyroid gland. And then T3, a little bit of that is produced by the thyroid gland, but T4 converts into T3. And with hyper— well, let's go into hypo because most people have hypo. So, hypo is again when you don't have enough of the thyroid hormones. So, you have lower T4, T3. And again, it might be within the lab range, but many times it's subclinical. So, within the lab range but less than the optimal range. And then, so TSH starts increasing. And the number one reason for that is Hashimoto's. The number one reason for hypothyroidism is Because you get that damage to the thyroid gland and that causes those thyroid hormones to decrease, TSH as a result increases. And so, I'm pretty sure that's not only the number 1 thyroid condition, which again is more autoimmune, but I'm pretty sure it's the number 1 autoimmune condition out of all the different autoimmune conditions out there. Hashimoto's is the most common autoimmune condition. And then, with Graves', you typically have hyperthyroidism when you have Elevated thyroid hormones, and then as a result, you have too much thyroid hormone. So TSH is communicating with the thyroid gland and trying to slow that down, trying to inhibit thyroid hormone production. So you get TSH low. So again, with with hyperthyroidism Graves', you have low TSH, elevated thyroid hormones, and then the antibodies. You have different antibodies. So with the the most common thyroid antibody is thyroid peroxidase or TPO antibodies. And thyroid peroxidase is an enzyme that's important in the production of thyroid hormone. You also have thyroid globulin antibodies, and the thyroid globulin antibodies and thyroid peroxidase antibodies are more closely associated with Hashimoto's. And then you got TSH receptor antibodies, the most common kind being thyroid stimulating immunoglobulins, which stimulate the TSH receptor to produce more thyroid hormone, and that is what happens with Graves'. Again, it's an autoimmune process where those antibodies actually are attacking or stimulating that TSH receptor. And like I said, you could have both thyroid antibodies, but you could also have non-autoimmune conditions besides Graves', Hashimoto's. You could have— I mean, we live in a world where there's so many different endocrine disrupting chemicals. So you could have— I mean, those endocrine disrupting chemicals can lead to an autoimmune condition, but they could also disrupt the thyroid, they could disrupt other hormones. And there are conditions like subacute thyroiditis, which is caused by a virus and isn't autoimmune. And, and when someone has subacute thyroiditis, many times they'll start out as hyper but eventually switch to hypo. And then eventually they usually will normalize, not all the time, but most of the time. There's also what's called multinodular goiter, where someone has multiple thyroid nodules. Which are like little growths on the thyroid gland. And then, a goiter is an enlargement of the thyroid gland. And so, yeah. So, I mean, there's definitely— it's not just Graves' and Hashimoto's. You can have thyroid conditions, hyperthyroid and hypothyroid conditions that are non-autoimmune. And then, as far as symptoms go, I mean, with hypothyroidism, when you have low thyroid, I mean, typically you're going to experience symptoms such as fatigue, coldness is common, weight gain, brain fog, brittle hair. I mean, think of thyroid hormone. It's important because one of the reasons is it is important when it comes to metabolism. So if you have slower metabolism, again, you're going to have typically lower energy. You're going to have— you're going to have coldness, increased weight gain. Constipation is quite common. Whereas hyperthyroidism, when you have that increased metabolism, you might have symptoms such as anxiety. And, I mean, weight loss is common. I lost 42 pounds when I dealt with hyperthyroidism and I wasn't trying to lose 42 pounds. I was 180 trying to lose 10 pounds. And so, I was 182, so I actually went down to 140, which was— yeah. Really, and not everybody loses that much weight. But so, weight loss, hair loss also come with hyperthyroidism instead of coldness, heat intolerance. Anxiety is pretty common with hyperthyroidism, loose stools instead of constipation. So, those are some of the differentiating symptoms. And I mean, there could be sometimes overlap with the symptoms as far as hyper— Not everybody with hyperthyroidism loses weight. Even with my story, again, some people actually gain weight for different reasons. And sometimes, so it can be sometimes a little bit tricky to know what's causing the symptoms. And of course, a lot of things can cause weight gain and fatigue and other symptoms too. So that's why sometimes, I mean, not to excuse the doctors for blowing it off, but they might, if someone comes in and they say, oh, I'm gaining some weight and, you know, I've been feeling fatigued, you figure that they would Okay, there's so much there, and I love it.

And I want to ask, so back to the ratio. So we've established that more women than men, really by a landslide, we're winning. This is not a race we wanted to win. But what about age range within those women? Is it more common for women who are, say, over 40, and we know hormones are beginning to change, whether they're Other symptomatic or not. This episode of Flipping 50 with Deborah Atkinson is brought to you by Alloy Health. Are you dealing with menopause alone? It's not just you. Almost 50% of women wait three or more years before seeking relief from menopause symptoms. That's years of hot flashes, awful sleep, brain fog, mood swings, and maybe. The inability to comply with the lifestyle habits that you know will help you offset muscle and bone loss. Look, I was lucky. I was going through menopause, living in Boulder and Scottsdale, surrounded by functional physicians who were proactive. And then I was shocked to find that for thousands of women in my community, it was nothing like that. So I'm thrilled to share this solution with you that I now use too. Allo was built by women who dealt with all of it. It's an all-in-one platform that connects you with board-certified menopause-specialized physicians and proven effective treatments. Here's how it works. You complete an intake. Allo solutions are available by online prescription, so you'll start with an online form. Get your prescription by being matched with a menopause-specialized physician who reviews your intake. And creates a personalized treatment plan tailored to your needs. Plus, unlimited messaging with your doctor is always included. And then HRT delivered to your door. Once approved, your prescription ships straight to you. No pharmacy trips, no hassle, and support navigating any patch shortages that you may have heard other friends talk about if they're on HRT. Find relief that works for you. Head to myalloy.com and use the code FLIPPING50. Your menopause-specialized doctor will tailor your treatment to your exact needs. Plus, you get unlimited messaging with your doctor. Head to myalloy.com and use code FLIPPING50 to get 20% off your first order. This code is valid on products only. Is this a midlife and beyond thing, or is this— you mentioned hormone disruptors, and, you know, there are a lot of young women exposed to a lot of hormone disruptors too. So who is it age-wise?

Definitely, I see more women that are in their 40s, 50s, 60s, in that range. I'd say like the 40 to 60 age range. I mean, without question, I will see some women in their 20s and 30s, even unfortunately sometimes children and teenagers. But yeah, the majority of people I see again are women and most of them are in their 40s and above. And I mean, it makes sense with the hormone fluctuations. I mean, that's at least one reason why it seems like it's more common in women, maybe not the only reason, but with hormone fluctuations, especially in like perimenopause and menopause, I mean, estrogen sometimes gets a bad rap, but it's an important hormone. You don't want estrogen to be too high, but you also don't want it to be too low because it does play an important role in immune system regulation. Same thing with progesterone. So, if you get— as you get older and those hormones decrease, and again, it's not— well, I mean, this is a— I guess it's related, but what I was going to say, it's not— I mean, It's not like every woman who reaches perimenopause and menopause will, even if they have a susceptibility to Graves' or Hashimoto's, they won't necessarily develop that autoimmune condition. So again, it's not just the hormones. I don't want to blame it just solely on the hormones. It plays a role, but especially if someone— what I see a lot of is stress, and stress affects adrenals, which also will affect the production of sex hormones. So Many times those sex hormones are, you know, not just, they're supposed to be lower when someone hits postmenopause, but many times they'll be less than optimal. They're not supposed to be zero despite what some of these lab reference ranges will show where like progesterone is like less than 5. So, if someone has a progesterone of zero, according to the lab, it might be fine in someone in postmenopause. And, same thing with estrogen. But, if you do—

That woman is not sleeping.

Exactly.

She is not okay with that.

Okay.

All right, well, let me ask you this then. It—

you—

I want to back up to— I think still this, um, endocrine disruption piece is a really important one. And I, I think too that we go for the big pieces and we go for the sexy things like, do I need essential amino acids and do I need creatine and to, to get my muscles up so I have better metabolism? But maybe we're skipping the day-to-day things that we should be paying attention to. And I know I included this in a book, and I know that I talk about it, and I'm, I'm with groups of women frequently. And sometimes what strikes me is that, oh, they didn't get the memo. Because like, I'm really sensitive now that I haven't actually worn perfume for probably 10 to 15 years, somewhere in that, when I learned what a difference it could be making on a cumulative effect with What's in shampoo and conditioners and every other thing. How big a deal is endocrine disruptors, like what we're putting on our skin or our makeup or fragrance, the fragrances in our laundry detergent, for instance? Where does that come in?

Oh, it's huge. I mean, it's a huge factor, like the cleaners, the cosmetics, not to mention, of course, people buying plastic water bottles by the cases every single day at these warehouses and Walmarts and all that. And, that's what they're drinking out of day in, day out. So yeah, it's definitely cumulative effects. I mean, if someone goes on vacation, they drink out of plastic water bottles for a week, I mean, again, that's one thing. But, if it's an everyday thing where they're drinking out of plastic water bottles or again, they're using, like you said, the products, the skincare products, shampoos and, you know, all these products at home that are just disrupting the hormones. So, it's a good point. And, I'm sure that is also playing a role why younger— we are seeing also younger women as well, again, men too, but definitely, again, women, I mean, there's no question women are using products probably more, you know, the skincare products.

Yeah.

When it comes to males. So, we got to also look at that too when it comes to Drinking water out of plastic bottles, I don't know what the rate— I would say it's probably pretty equal would be my guess. But, when it comes to skincare, yeah, no question, it's women. And, if women are using mostly skincare products that are used for— I mean, that contain endocrine-disrupting chemicals, then yeah, that's another big reason why we see an increase in these— Hormone disruptions, including thyroid imbalances?

This is such a tough one, I think, because I mean, if you spray on perfume, it's like, well, I don't feel anything. I feel fine. And likewise with drinking bottled water out of plastic, this one hits home because I've got some 30-something kids that I wanna tell more than is welcome right now. So I just am waiting. When I have my opportunity, I offer what I can. But for them, it's also a step up. They're consciously drinking more water and they realize what's coming out of the tap is not good where they live. So they're doing this and you know, so it's okay. How do you? Can you see this? I mean, is there a way for someone we can test at labs for you know proper thyroid function? But can we test? Like, what is the level of hormone disruptors that I'm exposed to, or the improvement after? What's the answer to that? How do we show people?

You could. I mean, you— there are definitely tests that will look at different endocrine disrupting chemicals. And there's— I mean, I don't want to say you could test for everything. I mean, many people know you could test for heavy metals, you could test for glyphosate, the active ingredient in the herbicide Roundup. And then, yeah, there are panels out there where you could look at some of the different chemicals including the EDCs, the endocrine disrupting chemicals. So, I mean, I can't say I have every single one of my patients do the testing. I usually just assume that they have it. But I mean, some people do want the testing and it's not a bad idea. It's just that as a practitioner, I have to prioritize because the functional medicine tests can become expensive.

Yeah, yeah.

And I mean, if someone's Willing and able to do the testing. And they want— because it— because like you said, it's before and after too. I mean, it's even if they did it, I guess, a before and you don't do an after, you still know, okay, well, I could see what my before is. And that sometimes— sometimes you need that to convince the person to make them realize that, okay, I have all these endocrine disrupting chemicals, you know, in my body. Uh, so same thing with adrenals. Like, just to make an analogy, when I dealt with Graves', I was in denial that— not that stress was a factor, But I thought I was a good— did a good job of managing my stress. And then I did an adrenal saliva test and saw my cortisol was depleted, my DHEA was depleted. So that convinced me and made me realize, okay, I need to focus on stress management and improve my adrenal health. So similar, in some cases it might be a good idea to do one of these tests for people to realize, hey, you know, you really need to stop drinking the plastic out of the plastic water bottles and Maybe at least gradually switch your skincare line and shampoos and all that. I mean, that could get expensive too. I mean, but again, it's your health obviously we're talking about and I don't think it's a crazy amount of money. I mean, especially getting a filter. I mean, you're spending all the money. That adds up too on the plastic water bottles. I mean, it might cost only $5, $6. the case. But again, you're constantly doing that, where for a couple of hundred dollars you get a good filter. And yeah, you got to change the filter every year, but— or probably like twice a year. But still, even if you're spending a little bit more on that, same thing with the skincare, you know, products and the shampoos. Yeah, it might cost a little bit more, but you're absolutely right, it might— in some cases it might be a good idea to, to do such a test.

Yeah. And just to anybody listening, I would— the, the flip side of that, and Dr. Eric, correct me if I'm wrong, but You know, it costs a little bit more in the short term, but in the long term, it's like how much then are we not paying on the back end to fix it with health problems that we could have avoided? And there's not just the cost of you know a prescription is no fun, like right? But it's also that life is compromised. The quality of your life is just not what it could have or should have. I don't think you'll ever regret feeling good, but I just wanted to kind of put that in there and think about that.

I agree, and it's also not just—I mean, the focus here is on thyroid and hormones—but I mean, research also shows that they these endocrine disrupting chemicals, these you know xenoestrogens, microplastics—I mean, they also affect. the permeability of the gut. In other words, contribute or cause a leaky gut. So it's not just the hormones, but it could also affect gut health. So if you're having any type of gut issue, not to say it's definitely the chemicals and the cleaners, cosmetics, drinking out of plastic water bottles, but it could be at least a piece of the puzzle.

Yeah, I love that. And so glad that you mentioned. And I think too, here's where I thought you were going with this. Tell me if I'm wrong, but this is like passed down from one human to the next. So you've got, say you've got a couple of younger, you know, potential wanting to be parents. That is passed down, isn't it? Passed through to generations.

Yeah, I mean, without question. I mean, if the, if the mom has, uh, I mean, if she's overloaded And again, to backtrack, obviously, we all are— we live in a toxic world. You know, we're never going to have like a zero toxic burden.

Yeah.

But the higher the toxic burden, you're absolutely right, that is passed on to, you know, the baby, you know, to developing fetus. And, and yeah, so it's unfortunate, but a lot of infants are born into this world, babies born into this world with a higher toxic burden. And then also another reason for higher infertility, you know, infertility rates, problems with fertility, these endocrine disrupting chemicals too. So, so yeah, it's just, yeah, the more— and then obviously you can't, once you're pregnant, you can't, I mean, you really don't want to get too aggressive when it comes to detoxification. So if you are, if anybody's listened to this and they're looking to conceive, or if they have like children, grand, you know, grandchildren who are looking to conceive in the future, again, maybe educate them because now's the time. You don't want to wait until, you know, you're pregnant and you can't do anything and then your newborn is born with a higher toxic burden. But yeah, that's an excellent point.

Okay. So, I think for so many women here, they're dealing with if we had to choose, and I hate to ignore anyone who who does have issues with hyper, but so many women probably have a slow or a sluggish thyroid, and that is potentially contributing to what feels like a slower metabolism, a feeling that what I used to do that worked doesn't work anymore to maintain my body composition or the fitness level that I had. And so they're really— this is a serious issue. And so I want to look at You know, number one, is there a way to improve thyroid function once we're on medication? Because I know in some cases or circles, this opinion may have changed over the last decade a little bit. But where do you sit with it?

So you're asking if someone's taking thyroid hormone replacements, is it possible to replace— like, like the question is, Once on thyroid hormone, are you always on thyroid hormone, it sounds like, is the question.

Yeah, that is kind of the question.

Yeah, no, it's not true. I mean, without question, if someone is on thyroid hormone, whether it's levothyroxine or desiccated type of thyroid like NP Thyroid or Armour, I mean, if someone's on a higher dose, it is more challenging to get to the point where the person doesn't need to take it and some people do need to be on thyroid hormone long-term. Without question. But it depends on the person. I mean, it depends on what the cause of the problem is. If you are able to address the cause of the problem, whether it's autoimmune like Hashimoto's, you— it comes down to finding, removing triggers, healing the gut, which is easier said than done. I mean, it's definitely not easy, but, but it can be done. And then if it's something directly affecting the thyroid gland like these endocrine disrupting chemicals, I mean, again, you can address that. The problem is the thyroid gland does take quite a while to regenerate. It's not like the liver or the gut as far as healing the thyroid gland. So, it's— yeah. So, but that doesn't mean it's impossible. It just really depends on the person. I definitely have worked with people who have been on thyroid hormone and were able to get off thyroid hormone by addressing underlying cause. But also, I've worked with people who weren't able to get off of thyroid hormone. And I mean, so you really want to have realistic expectations. I mean, if you have Hashimoto's thyroiditis, when I'm working with someone, the number one goal is to address the immune system, to optimize the immune system. If we could get them to the point where they don't need thyroid hormone, that's wonderful. But if not, and but we still are able to, to pretty much reverse the autoimmune component of Hashimoto's where the immune system isn't damaging the thyroid gland. Even if they were to still need thyroid hormone replacements, it's still important because if you have one autoimmune condition, you're at greater risk of developing other autoimmune conditions in the future. So, if we're able to optimize a person's immune system, even if they have to continue taking thyroid hormone, it's still a win because they don't have to worry, A, their thyroid gland won't sustain further damage so they won't need to continuously increase the dose of thyroid hormone if we're able to accomplish that. And then, like I said, they won't develop other autoimmune conditions like rheumatoid arthritis and multiple sclerosis. Again, there's so many different autoimmune conditions.

Okay, so I also want to back up a little bit. So you mentioned different types of thyroid medications, and it's probably a good idea to visit this question because a woman listening really only has the lens that she's looking through, like whatever she might be taking. So whether in my case it's NP, for another woman it may be Synthroid. Can you just talk a little bit about the types of medications that might be given, and do they fall into categories? And is there, is there pros and cons to each that we might want to consider? And is there ever a time when you would say Someone comes to see you and they, they've already known they have thyroid and they're on a certain medication, would you shift that medication for some reason? When I knew the air quality in my new-to-me house was something I wanted to be sure I was confident about, I went to my functional physician friends and asked, and they all pointed me unanimously to Air Doctor. A few of the top things that I've come to love about it is fewer house odors, like Bacon and salmon, and less congestion in the morning, that reduction of allergenic symptoms. And it's cleaner air for kids. As a first-time grandma, that's a no-brainer. Here's how it works. Air Doctor's powerful 3-stage filtration captures extremely small particles, about 100 times smaller than what typical air purifiers can remove. It captures airborne contaminants you don't wanna be breathing in. Dust, pollen, mold spores, pet dander, wildfire smoke, bacteria, viruses, odors, smoke, ozone, and VOCs. Its whisper-quiet operation is not loud like others in the market, and its auto mode features ensures optimal air 24/7. The change filter reminders— no guesswork, no Debra remembering. And here's Really good news. It's an award winner. Air Doctor won Newsweek's Reader's Choice Award for Best Air Purifier. Head to airdoctorpro.com and use code CLIPPING50 and get up to $300 off any of their select Air Doctor models. Plus you get a 3-year warranty absolutely free. All Air Doctor air purifiers come with a 30-day money-back guarantee. Get this exclusive podcast-only offer now at airdoctorpro.com, A-I-R-D-O-C-T-O-R-P-R-O dot com, using promo code FLIPPING50.

Yeah, great question. So as far as the different types of thyroid hormone replacement, you mentioned Synthroid, so that's a type type of synthetic T4, pretty much synthetic T4. And that's the most commonly prescribed thyroid hormone replacements. And I mean, time and place for Synthroid. The problem with levothyroxine, Synthroid, which is synthetic, again, synthetic T4, and the reason it's given, again, it might seem to make sense, the thyroid gland produces mostly T4, so why not just give the person T4. But, a big issue is some people have problems converting T4 into T3. And so, the T4 might not be sufficient and it might look good. They might look at a T4, do a TSH and T4, and maybe those numbers look okay, but many times they don't look at the T3. If they were to look at the— especially the free T3, they might see that lower. And then, there's reverse T3 also. But reverse T3— T3 is the active form of thyroid hormone. Reverse T3 is the inactive form of thyroid hormone. But if someone has like lower T3 levels, and then typically they'll have elevated reverse T3 levels, so that's like indicating that the person may have issues converting T4 into T3. And then if they're only given T4, let's say Synthroid, or even in that more Hypoallergenic. I mean, I don't love Synthroid. There's like Tirosint, which is also T4, but it's more hypo— it doesn't have all the like fillers and stuff that Synthroid has. So it's— if someone has to be on T4, I like Tirosint. But again, it would still present the same problem if the person isn't converting T4 into T3. So then there's— so that person, maybe the prescribing doctor would give T3 like Cytomel, which is a brand of synthetic T3. Or again, there's compound thyroid. Go into a compound pharmacy and get T4, T3 made. And so, the advantage of something like desiccated thyroid like NP Thyroid or Armour is that it has T4 and T3 and then it also has T1, T2, which we're still learning about. And I mean, there are T2 supplements out there now, but you can't test for T1 and T2 on a lab. You could just look at Again, TSH, free T3, or TSH, T4, T3, not just free T4, free T3. You can look at total T4, total T3. But yeah, there are definitely times like if I'm working with someone, I don't have— being a chiropractor, I don't have prescribing rights, so I can't like tell the person like to switch to Synthroid, from Synthroid to like desiccated thyroid. But if someone, let's say if someone has— if they are showing that pattern, if they have a normal T4 and T3 is low. I mean, in a perfect world, we also want to find out, figure out why. Like, why, why are they having that conversion problem to begin with? Most of the conversion takes place in the liver. A good amount also takes place in the gut. So we might— and then stress, high cortisol could affect that conversion. So again, we would probably want to work on liver, gut, adrenals.

Yeah.

But that could take time too. So we don't want to say, okay, just while You know, just let's wait three to six months, and it could take even longer. You know, and that person has low T3, which again is that active form of thyroid hormone. So yeah, in that case, I might say, well, you know, we want to address the cause of the problem. But in the meantime, you might want to see if you could either switch to desiccated or another option. I mean, a lot of especially conventional medical doctors, they're not big fans of. Desiccated thyroid, and so they they might be open to giving T3 like cytomel or another option is just to switch to a functional medicine doctor who would be willing to prescribe desiccated thyroid. But yeah, so if someone is showing that pattern where they're not converting, I definitely will give a different recommendation.

I think you raise a question here, and everybody is wondering why. What? Because I hear the word synthetic, and I'm thinking. Well, that to me sounds like this is fake. My body never made that, so why would I want to take that as a replacement? But why is it that doctors may or may not want or like the desiccated liver or the NP when it seems like, or sounds to an innocent layperson who's taking it, as a better solution? Is it that they don't know or haven't been educated on it?

Well, I mean, there's a few reasons. So, I would say, yeah, they haven't been educated is one reason. So, they're not as familiar with desiccated thyroid. But I mean, there's a few— it might depend on the doctor. I mean, one is— I mean, it does come down to the training that they receive in medical school and even as an endocrinologist. Most of them just are trained that if someone has low thyroid, that's what they give. Is they give again they don't call it synthetic T four. They call it like levithyroxine or Synthroid, which is the again brand name. So so that's that's one. I mean, I I don't like to bring in you know money, but that's a reason too. The profit that they make from like pharmaceutical companies plays a role from from what I understand as well. Just so that's that's also a reason. That, I mean, not just with Synthroid but with other medications. Again, I'd like to think most medical doctors, that's not why, but there's, again, from what I understand, I'm not a medical doctor, that's just what I've heard is that there's those relationships between the pharmaceutical companies, which, I mean, makes sense. We know the pharmaceutical companies, you know, make billions of dollars. And again, that's their job. You know, they have their reps and their reps are visiting these medical offices and telling them not just about Synthroid but other medications. So that's, that's another reason. But they'll also, I mean, they'll mention how, you know, like Synthroid is more standardized, like, you know, how much exactly you're going to get every single time, you know, you prescribe, where they'll make the claim that with desiccated thyroid, that's not the case. But I mean, if you're getting something just off the street, you know, like just like Armour NP thyroid have been around for, for quite a long time. And so, yeah. So again, if I was dealing with hypothyroidism, I'd feel comfortable taking desiccated thyroid. But, that's one of the arguments as well. If you take Synthroid, for example, if you're taking 50 micrograms, you're getting exactly 50 micrograms, whereas if you're taking whatever dose of NP Thyroid or Armour, they'll make the argument that the batches differ. At least, that's one of their arguments and that's Yeah. That's not necessarily the case. And then, I mean, some will say that people don't tolerate desiccated thyroid. And more people, I would say, than not do better on desiccated thyroid than synthetic thyroid hormone, but it does vary. I mean, everybody's different. So, I mean, I think at the very least, a person should be given the option, especially if they're not doing well on synthetic thyroid hormones. So, My goal isn't to— for anybody who's listened to this, if someone's taken Synthroid and their numbers are looking good and they're feeling great, I'm not saying that you should switch to desiccated thyroid. But if someone is taking Synthroid and they still feel lousy, and maybe it's not related to the Synthroid, maybe their adrenals are not where they need to be and they have other imbalances, but you would want to at the very least ask for a full thyroid panel. I mean, look at TSH, look at Free T4, free T3, look at reverse T3, look at the antibodies, and look look at the whole picture. And if things, especially if again that free T3 is on the lower side, even if free T4 looks great, then that's a that's a sign that you're not converting the the the the T4 into T3. And to me, yeah, maybe cytomel would be just as good as desiccated thyroid, which again some people do fine taking synthroid with cytomel. But the point is, many doctors are just stuck on recommending Synthroid or something similar, different type of levothyroxine. And so, yeah, my goal wasn't to convince people to switch to desiccated, but just to have an open mind. And that's— I mean, again, if someone— if I'm seeing someone and they're taking Synthroid and they're happy on Synthroid and the numbers look good, I mean, I'm okay because again, that's not my goal regardless. Whether someone's on Synthroid or whether someone's on Armour is the same as to help improve the person's overall health. But, if they're feeling lousy on any— I mean, if someone's taking Armour and the Armour's not working for them, maybe again they need to switch from that. And, there are some people, I'd say not definitely in the minority, but some people will feel better on Synthroid compared to desiccated thyroid. So again, everybody's different. And like I said, I should just— So, you just want to keep an open mind when considering the different types of thyroid hormone replacement.

Super helpful. Yeah. And, totally concur. That was just, I think, to paint a picture of— you may have never been aware, if you're a woman out there, that there's an array of different things that might or might not be prescribed because you've only been given one prescription. You've probably been on it and stayed on it for a long time. A lot of women's history. So just to be, I think, aware of what, what is out there, what else there is, can be nice just to be a bit more information. I want to ask you this, and this is, you know, whether you are on thyroid medication or not, but I think often, um, it slips that there are other things that we can and should be doing. Um, lifestyle, of course, But among lifestyle, are there other ways that we should be supplementing or consciously eating that will help our thyroid function? Like there's, you know, the— we have to take algebra before we take geometry. Is there things that we would need in terms of nutrients, micronutrients, that will help if those levels are optimal for the thyroid functioning? Whether we are on or not on thyroid meds?

Great question. So yeah, I mean, of course, you want to eat whole healthy foods. And there are certain micronutrients, there's certain minerals that are important for thyroid function. I mean, really, obviously, all the vitamins, minerals, macronutrients, we— I mean, every— as you know, getting enough protein, I mean, all this is important. But I mean, I would say number one diet-wise is just make sure you're eating whole healthy foods and cutting out refined foods and sugars. But of course, there are some foods like selenium that's really important when it comes to thyroid health. And, you know, there's iodine, which definitely controversial when it comes to— a lot of controversy in the world of thyroid health when it comes to iodine.

Yeah.

But yeah, so we could talk more about those if you want. But I mean, I can't say I have— Brazil nuts, for example, are a great source of selenium. And, I can't say I tell everybody, make sure you eat your Brazil nuts. I mean, again, there are other sources like sardines are actually good when it comes to selenium. And then, I mean, yeah. So, I mean, really, it's about variety. If someone's eating just 5 of the same foods every single day, then they probably aren't getting the— The micronutrients, the vitamins, the minerals, and of course, the fatty acids, all these are important. So, a lot of it's about variety. I mean, there is a time and place for supplementation as well. But, I did want— with iodine, it's probably worth mentioning because—

Yeah.

There's so much controversy. You might come across one practitioner who is telling their patients, well, you should take separate iodine supplements and larger amounts of iodine. And then others who are just saying, no, you just want to completely avoid the iodine. And again, it's— I mean, there's no— so, I'll tell you quickly my story in the past. I was definitely on the high iodine bandwagon as far as taking high-dose iodine because again, I was diagnosed in 2008 with Graves'. And around that time, iodine was a lot more popular than it was today. I mean, again, a lot more practitioners encouraging people with thyroid conditions to take high iodine whether the person had hyper or hypo. And, the reason why iodine is important is because it does play a role in thyroid hormone production. So now, if you think of it that way, you would say, well, okay, if I have low thyroid, then that probably means I need iodine. And, if I have hyperthyroidism, I probably want to stay away from iodine. And, it's not that simple. That's the complexity of it. But, I mean, without question, if you're hyper and you take too much iodine, it can make you more hyper. But then, also taking high amounts of iodine could suppress hyperthyroidism, which is why sometimes it's used as a treatment modality for hyperthyroidism. But, I guess getting back to— because Right now, your listeners are probably confused. Okay, what do I do? Do I stay away from iodine? Do I take too much iodine? I mean, do I take iodine supplements? So, I recommend, first of all, I mean, I typically don't recommend separate iodine supplements. I usually recommend getting it from the food you eat. And then, if you're taking a multivitamin with iodine, I'm okay with that. And, some will even be afraid of taking a multivitamin with iodine. And usually, I don't see anything really bad if someone's taking a multi with iodine. But food sources, again, I usually don't see problems with just eating regular food sources. If someone's eating kelp, really high food sources of iodine, that might be a problem sometimes. But eating salmon, for example, or eggs are sources of iodine. So, it's usually try to get what you can from the food. Try to get, again, if you're taking a multi. If someone is interested in supplementing with iodine, again, I would recommend working with a practitioner and doing some maybe urinary iodine tests. So again, I'm not saying there's never a time and place. And so, I'm not anti-iodine. I guess my point is I definitely think iodine's important. And, for those who are recommending to completely avoid iodine, I definitely don't agree with that. But, as far as taking, I'll say this, I have at least a few people every year who see me where it seems like they got into trouble because they were taking higher doses of iodine and that seemed to at least be, I don't want to say necessarily the trigger, but if not, kind of the straw that broke the camel's back. So, I would say if you're thinking about supplementing with iodine, work with a practitioner, do a urinary iodine test. I play it more conservative. I definitely realize iodine's important but try to have the patient I'm working with get it through the food that they're eating as well as a multivitamin.

Excellent. Such great advice. And, where would you say a woman who suspects she might have a thyroid issue go first? What would she do in her own lifestyle? What would she ask the doctor she's working with to test?

Yes, so definitely not just TSH, and definitely not just TSH and T4, which is what many doctors do. So you want to look at— I mean, TSH, definitely would recommend TSH, but then also T4 and T3, preferably free T4, free T3. If they want to do Total T4 and total T3 and free T4, free T3—that's fine. But then again, the antibodies just because most not all the time, but most of the time that you do have autoimmunity when it comes to both hypo and hyper. So at the very least, you want to look at those antibodies. And then in the case of hypothyroidism Hashimoto's, I would say reverse T3. Usually, I don't recommend with hyperthyroidism because most people have elevated reverse T3. Because of the hyperthyroidism, so it's not really providing too much value. But yeah, I would make sure to get that comprehensive blood test. I mean, of course, there are other blood tests too, but we're talking about the ones that relate to thyroid health. And then just realize that you got— you need to go beyond the thyroid. It's not just focusing on the thyroid. Most conventional medical doctors, even though they do all this testing, they're not going to do anything to help you with your immune system if you have Hashimoto's or help with the gut or reducing your toxic burden as we discussed earlier, doing things from a stress management perspective. I mean, stress is huge also with thyroid too. You mentioned lifestyle and we spoke about diet. But I think, and I'll say this quickly, in my case, I think stress was one of the big factors. I did mention my adrenal test earlier, but it was also, Which you would appreciate too. It wasn't just emotional stressors, but I was overtraining as well and wasn't listening to my body. So, these are things that most doctors, when you ask them what caused my thyroid condition, their response is going to be, I don't know. So, get those tests that I just mentioned, but just realize that you might have to work with a functional medicine practitioner, someone who's familiar with thyroid health. Because if you go to a conventional medical doctor, they'll probably just say, let's, you know, take thyroid hormone replacement or anti-thyroid medication if you have hyperthyroidism. And again, a time and place for that, but that's usually where they stop.

Yeah, so very helpful. And I, I want to add a word that you've said here just to everybody listening, that I think for a midlife woman, especially one who's been previously active, that can be tricky to identify overtraining because it may not— for your Your reproductive year self felt like overtraining at all, and yet when hormones shift, and coincidentally for midlife women, there's also just midlife chaos. There's just so many more responsibilities landing on your plate. I will say responsibilities and opportunities, but they all seem to land on your plate at the same time as your hormones are making the biggest shift of your life. And, all of that can change what is overtraining for you, and you may not see it coming. So, I just wanna let you know, listen to the body is one of the most important things, especially for females who've been really conditioned not to, to push through and pay attention to everybody else maybe a little bit more. It's time to really get sensitive and have some people in your corner reminding you.

Yeah.

You do have the cape on. However, you know, stop for a moment before you go too far and see if you can pull back and take care of your adrenals, maybe take care of your stress level and not go over the edge. Eric, thanks so much for all the insight and great reminders, great new content on thyroid and the importance of it. Where can listeners find and follow you?

Yeah, thanks, Deborah. So I have my own podcast, and of course you've been a guest on there. So savemythyroid.com, and you could just click on podcast or just go to your favorite podcast platform and type in Save My Thyroid. And, uh, everything also is on YouTube too. I have a YouTube channel, and then I have a newsletter, Healthy Gut Healthy Thyroid, which you could check out by visiting savemythyroid.com/newsletter. And, and I have my books. I have a book, Hashimoto's Triggers, and which is designed to help you find and remove the triggers associated with Hashimoto's. And then I have a book, Natural Treatment Solutions for Hyperthyroidism and Graves' Disease, which is now in its 3rd edition. And then my most recent book, The Hyperthyroid Healing Diet. And so those, of course, you could find on Amazon. And yeah, I would say those are probably the main. If you go to save my dollar dot com, there are other resources there as well. But I'd say those are the main places.

Fantastic. Thank you so much for your time.

Thanks. Thanks again, Zebra.

The information shared on Flipping Fifty the Stronger Way is for educational and informational purposes only, and not intended as a substitute for. Medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before beginning any exercise program, making changes to your diet, or adjusting any medications or supplements. Individual results may vary. Debra Atkinson and Flipping 50 are not responsible for any injury or adverse outcomes resulting from information presented on this podcast.