The Untold Longevity Secrets of GLP-1s and Thyroid Health with McCall McPherson

This episode is brought to you by Google Health. Stop chasing someone else's definition of health. What matters is what's healthy for you. Google Health offers a new kind of coach built with Gemini for effortless tracking, sleep insights, and holistic coaching tailored to you. Visit googlestore.com to learn more and start a new relationship with your health. Requires Google account, Google Health app, internet, and Google Health premium subscription. Features subject to change. Availability and results vary. Not intended for medical purposes. Works independently of Gemini apps. Check responses for accuracy.

Expedia and VisitScotland invite you to come experience the beauty that awaits in Scotland. The sweep of wild coastlines, quiet lochs, and untamed landscapes. Fresh cuisine that feels rooted in the land. Come experience the kind of stillness that stays with you long after you leave. Plan your Scottish escape today at expedia.com/visitscotland.

Study and play come together on a Windows 11 PC.

And for a limited time, college students get the best of both worlds. Get the Unreal College Deal. Everything you need to study and play with select Windows 11 PCs. Eligible students get a year of Microsoft 365 Premium and a year of Xbox Game Pass Ultimate with a custom color Xbox wireless controller. Learn more at windows.com/studentoffer. While supplies last, ends June 30th. Terms at aka.ms/collegepc.

Sadly, medicine is devolving in the world of thyroid. We were considering really overt hypothyroidism, and then we moved it to subclinical, meaning we don't want to treat these people. Now we're trying to recategorize or research subclinical hypothyroidism into normal thyroid function. Women can't show up to their doctor's office and get treated for 2.5 TSH anymore.

I'm speaking today with McCall McPherson. She is a pioneering physician associate and entrepreneur. She founded the Modern Thyroid Clinic and the Modern Weight Loss Clinic, and she also owns Thyroid Nation. She was honored as the top 200 fastest growing health companies in 2024. This conversation, I think you're gonna have your jaw dropping with some of the information that she is sharing.

Your most important thyroid hormone is called your free T3. It's your active hormone. Less than 1% of the time is your T3 appropriately reflected in your TSH.

So Wow.

If no one's checking that, you won't know. The same study also showed— I thought you might find this interesting— higher levels of T3 are correlated with—

Hey, I'm JJ Virgin, PhD dropout— sorry, Mom— turned 4-time New York Times bestselling author. As a certified nutrition specialist, Fitness Hall of Famer, and globally recognized leader in health, I'm driven to keep asking the tough questions and use my podcast to simplify the science of health into actionable strategies that help you thrive. Want an ad-free experience? You can now subscribe to my exclusive VIP podcast at subscribe2jj.com for just $4.99 a month or $49.99 a year. It's like your daily latte, but better for your health. I'd also love to hear your thoughts on the show. And here's the fun part. When you send me your review, I'll reply to you using my on-demand virtual me. That's right. My team and I created a virtual JJ packed with my books, speeches, and wisdom so I can personally connect with you. Here's how you do it. Subscribe and leave an honest review of the podcast. Take a screenshot of your review, text it to 813-565-2627. That's 813-565-2627. My virtual JJ will reply directly, and trust me, this will make your day. So subscribe now at SubscribeToJJ.com and text me your review. Let's keep thriving together.

You have one new message. Ring, ring, ring. Translating. Disney and Pixar Pixar's Hoppers is now available on Disney+.

You could say that again.

Critics are calling it Pixar's funniest movie ever and a wildly entertaining ride. Blizzard potato. It's certified fresh and verified hot.

Now we party. This is incredible.

Wow, I am clearing the rest of the day.

Disney and Pixar's Hoppers, now available on Disney+. Rated PG.

This episode is brought to you by State Farm. You know those friends who support your preference for podcasts over music on road trips? That's the energy State Farm brings to insurance. With over 19,000 local agents, they help you find the coverage that fits your needs so you can spend less time worrying about insurance and more time enjoying the ride. Download the State Farm app or go online at statefarm.com. Like a good neighbor, State Farm is there.

Eczema is unpredictable, but you can flare less with Evgliss, a once-monthly treatment for moderate to severe eczema. After an initial 4-month or longer dosing phase, about 4 in 10 people taking Evgliss achieved itch relief and clear or almost almost clear skin at 16 weeks, and most of those people maintain skin that's still more clear at 1 year with monthly dosing.

Ebclys, lebrikizumab , a 250 mg per 2 mL injection, is a prescription medicine used to treat adults and children 12 years of age and older who weigh at least 88 pounds or 40 kilograms with moderate to severe eczema, also called atopic dermatitis, that is not well controlled with prescription therapies used on the skin or topicals, or who cannot use topical therapies. Ebclys can be used with or without topical corticosteroids. Don't use if you're allergic to Ebclys. Allergic reactions can occur that can be severe. Eye problems can occur. Tell your doctor if you new or worsening eye problems. You should not receive a live vaccine when treated with EBLISS. Before starting EBLISS, tell your doctor if you have a parasitic infection.

Ask your doctor about EBLISS and visit ebliss.lilly.com or call 1-800-LILLY-RX or 1-800-545-5979.

McCall McPherson, welcome to the show.

I am so excited to be here. Thank you so much, JJ, for having me.

I actually can't believe you haven't been on before. So that's ridiculous. And this whole thing happened because— At the Mindshare Summit this year, we did a panel— totally selfish, I did the panel for me— um, on GLP-1s because I'm just so interested in all of the amazing side benefits they have. And yet people are still missing the point with them. I feel like everyone's missing the point. They're looking at them for weight loss, and I think that's like the least exciting thing about them. I'd love to just start there with you. You've been doing thyroid for so long. How did you start to focus on— because GLP-1s now seem like a real big part of your practice.

Yeah, absolutely. So sadly, you can give a woman back her vitality, her energy, her clarity, her motivation, her libido, but if you can't help her lose weight and feel like herself in her body, you don't— you're not really giving them their full life back. And that's where I found myself for years at Modern Thyroid Clinic. I would perfect all of these women's thyroid function and help them in so many aspects of their life, and they still couldn't lose weight. And it was incredibly frustrating. As much as we don't want how we feel about our body to dominate the landscape of our lives, sometimes it does, and it's hard to get, get around that and work through it. So I have worked— I've looked at all the progressive ways of working through this problem, and when GLPs came out for the weight loss sector, I dug— I, I dove in completely and started harnessing them in my practice, and took women with literally a perfect lifestyle that worked out 4, 5, 6 days a week, ate— I remember a woman telling me, I've been Whole30 since 2018, still couldn't lose weight, seen multiple nutritionists. And it allowed them to begin the process of losing weight with appropriate amounts of effort and then ultimately come off of them and continue that success story. And so I just went all in on this and have been collecting a massive amount of data. I think I probably honestly have the largest data set of any thyroid population in the world for GLPs. So it's been a fascinating and honestly like a sacred journey for us at Modern Thyroid Clinic. And now we're soon launching our sister company, Modern Weight Loss. So very cool.

So you said something and it just brought me back, um, to the whole idea of weight loss resistance that I finally hear people saying now. And for so long it was just poo-pooed that, you know, you just need to eat less, you must be cheating. And I remember early, early on in my career, like literally 35 years ago, I thought that too. And then I was just fortunate to take a group of women away One of them had this amazing ranch in Santa Barbara, so I controlled everything. Uh-huh. And I mean everything. There was nothing they could do. They couldn't— they couldn't eat more than what I was giving them. They had to exercise with what I was doing. And I'm watching and I'm like, this is so interesting. Some of them lost weight, some of them stayed the same, some of them gained weight. And I'm like, okay, well, you can't deny thermogenics. They, of course, have a role. It's not the only thing. And yet there's so many people in the weight loss world that just— I remember hearing Jillian Michaels screaming, as she does, at a— even at me— at a guy on The Biggest Loser going, "It's calories in, calories out." And I'm like, "Okay, that's part, but that's not the whole story." So it sounds like that's what you were seeing with this.

Absolutely. And I value you standing with women so much on this because we have to believe women when they tell us that they're doing all the things. We have to believe them that they are and they're not getting the result. And especially with thyroid people, the effort going in does not lead to the appropriate outcome. And ultimately that's what I want. I don't want people to magically be able to lose weight forever, but I want them to be able to appropriately influence their weight. And so many people, you're right, still are not believing women. And calories in versus calories out is such an antiquated, outdated, simplistic view of this that just— we have to get beyond it, right?

So what else do you— have you found to be at play?

Yeah, so certainly hypothyroid people, but this translates to the better portion of the population as well, has insulin resistance. Right? We have leptin resistance, we have elevations in blood sugar. Basically, we start to, especially with a thyroid problem, lose our metabolic potency over time. And I think that translates to us as we age as well. Our system simply does not run as efficiently as it used to, and we can influence that by building muscle mass and doing these things to raise our basal metabolic rate. But when you have a decade of metabolic dysfunction from hypothyroidism, a loss of insulin sensitivity, a loss of leptin sensitivity, we just are prone to storing fat, and we have to back our physiology out of that mechanism in a pretty controlled and intentional way.

So you said, you know, when you have a decade of this, like, what is the typical time from the outset of hypothyroidism to actually getting diagnosed? Because I will tell you personally For me, it was about a month. Like, I could feel it. Yeah, well, because I used to teach this course called Overcoming Weight Loss Resistance, so I would go through all the signs of subclinical hypothyroidism, and all of a sudden I'm like, oh wow, bing bing bing. It's like, so, yeah, so I didn't suffer, but you made it sound like this could go on for a decade.

Absolutely. And I don't want to go— I know we're not— this isn't about thyroid only, but sadly medicine is devolving in the world of thyroid thyroid, we are considering— we were considering really overt hypothyroidism, and then we moved it to subclinical, meaning we don't want to treat these people, they're subclinical. Now we're trying to recategorize or research subclinical hypothyroidism into normal thyroid function. Oh, absolutely, absolutely. So medicine is advocating for people not to be treated until their TSH is over 10. Or even 20.

Yes. What? I got symptoms at 2.5.

Amen, JJ. I think people get symptoms above 1.8, and women can't show up to their doctor's office and get treated for 2.5 TSH anymore. It simply will not happen. So it can take a decade to get a true diagnosis, and by that point, these people are pre-diabetic. They have cholesterol issues, they have heart disease. I was reading a study this morning about subclinical hypothyroidism causing insulin resistance and a separate one causing heart disease. So it's devastating for our physiology to let that go unmanned.

I did not know this, McCall. I thought that they were actually making the norms— I, I, you know, to me it's like, you want a 1 TSH, you want your— you know, it's like, I thought that they were tightening up those norms and taking it down to more like 0.5 to 2.

They were in like 2018, and then we took a hard turn after a study, and then it's just devolving. Wow. And this is what I'm releasing a book in 2027 on this exact topic, trying to reverse medicine out of this terrible, terrible thing that's happening for these women.

Well, fortunately they can come to you. So, so then you started getting into GLP-1s. What— and I know we were talking offline about this. To me, the most exciting thing about GLP-1s is not the weight loss. And, uh, even this morning I was talking to a friend who said, I opted not to use them. I was gonna use this very low dose of Tirséptin. Peptide, but I opted not to because I realized I could do it with diet. I go, improve insulin sensitivity and reduce inflammation quickly? Really? You know, so I'd love to hear what your, you know, where your enthusiasm is with GLP-1s and how you're looking at them.

I look at them in a similar way as you and a similar way as our patients. So initially, most people get on them for weight loss, and weight loss quickly becomes a very minor positive side effect of these medications because, as you said, the benefits of them are far, far-reaching outside of weight loss. So, um, I've been collecting data specifically even on inflammation with hs-CRP, which is an inflammatory marker, also risk stratifies people for their likelihood of a heart attack, stroke, which obviously we know is the number one killer of men and women in the world. Um, after one injection. I have measured people's CRP and I've seen it reduce over 50% on a microdose of GLP. So another study came out last week that talked about the anti-inflammatory benefits of GLPs, specifically in the time before people actually lose weight. So there are so many benefits of these. And we can go deeper on the inflammation topic because I've uncovered so much fascinating stuff in the, in the literature. But anti-inflammation— I see people's autoimmune numbers drop, Hashimoto's antibodies plummet. They've been studied for MS and shown every clinical marker as well as the progression of MS on an MRI is slowed and reduced on a GLP. Psoriasis, psoriatic arthritis, Alzheimer's, dementia, cancer, 13% reduction in breast cancer risk. What is so sad is the media is talking and spreading all of this fear-based propaganda, honestly, if we can call it that, and creating a lot of anxiety around these side effects of these medications in a medication that has the lowest side effect profile of any medicine I've ever seen, especially when it's used in microdoses. And we're not talking about all these extra benefits of these meds that increase longevity. People's chance even of dying is reduced by 20 to 30% on GLP-1.

I have a theory.

Tell me.

It's a total conspiracy theory.

I want to know.

It's a total conspiracy theory. And, and full disclosure, like, we are using low dose. I started using it couple years ago because I was at a medical conference and Dr. Will Seeds was— William Seeds was talking. He was talking about them and talking about neurodegenerative disease. And, you know, I've got a son with a traumatic brain injury with neurodegenerative disease now. And I was like, okay, turned him around. Yeah, holy smokes. So then I'm like looking more into it and I've got a husband with, you know, high-risk cardiovascular profile with elevated ApoB, dropped it. So I'm just like going, you know, me, I've got a little autoimmune thing, stopped it. So I was like, okay, wow. And so my theory on all of this is, is— and, and I love the argument, oh, but you'll have to be on it forever. I'm thinking, okay, wait a minute, there's no side effects, there's only side benefits. The only side effect is if you dose it incorrectly, you get nauseous or, you know, gastroparesis, or you lose muscle. But you'd lose muscle with any bad diet.

Mm-hmm.

But if you do use it, you could get off your statins, your blood pressure medications, you know, you reduce your risk of cancer. Now you don't go into that big industry that's a trillion dollar. And so my conspiracy theory on all this, I know I'm gonna get flack for this, but I don't care anymore, is that Big Pharma hates it because it's gonna get them off of all the other drugs. That's my conspiracy theory.

There it is. You know mine? Because I asked myself years ago, I'm like, how, how do these meds have all of this potential to create health and healing, like true healing? But all we are doing is recycling various narratives in the media that create fear. Like, who is driving this conversation? And I was talking actually with a patient about it and she's like, I think it's the insurance companies. And I was like, oh my God, I think you're right. They don't want to spend $20,000 a year on millions of people for the— every year for the rest of their lives. So they are propagating— I mean, I have no idea, but I would say it's highly likely that they could be the ones that are creating all of this conversation and fear, because honestly, I can't find another reason why.

Yeah. Here's the big takeaway for all of it, for everybody listening. I think that we've discovered over the last 5 years that the media is ridiculous. Like, I remember back when I went to college, we, um, I was in communications for a bit and we studied the media and there was all this stuff about how you had to fair reporting and everything else. That's gone out the window. So, you know, like, don't get your information there and go look at the research because the research is incredible. And what's amazing now is you can just get on ChatGPT, get the consensus. You know, I love— I'm obsessed with consensus on ChatGPT, and you can get all the studies, and it's very clear that this is like amazing, but not used at the dosing the way that, you know, this— that not for a weight loss thing, for an overall healthspan thing. And, you know, as far as the muscle mass goes, as far as I can tell, it seems to be good for muscle mass and lower myostatin and help you build muscle. So I'm— the whole thing's confusing.

Yeah, there are inherently muscle protective mechanisms and bone protective mechanisms in GLPs, but kind of like you touched on earlier, a great way to lose muscle mass is to starve your body and not give yourself protein and micronutrients or move your body. Doesn't matter if you're on a GLP or not. You will lose muscle mass in those situations. So the opposite is also true. If you're on a GLP in a low enough dose that you can get enough protein, get enough micronutrients, move your body, lift weights, you can easily, easily build muscle on these meds. They are not magically evaporating muscle.

So walk me through someone who wants to use this. Would you— who are the, who are the use cases you're looking at with your patients for using these? And then How are you going about putting them on them?

Yeah. So for me, in our approach, honestly, is— I mean, the reality is, is outside of like a clinical practice, people are like, well, who do you think makes a good candidate for GLPs? And to be honest, I'm like, everyone, everyone. But my favorite people to put on them are women who simply cannot lose weight with effort despite great effort being put in. And so I— my goal is always to rehabilitate that ability for the effort that they put in to create the outcome that they're working for. And so I don't care if a woman needs to lose 10 or 15 pounds or 50 or 60 pounds. If they have dieted, exercised, gone through all the things, obviously optimized their thyroid and hormones, and they can't lose weight, I think they make an incredible candidate. Now, You know, when we first started our program, we started at standard doses and we started creating data and analyzing feedback and really going deep. And before the word microdosing was ever even applied to GLPs, we were doing it in our practice and slowly reducing doses and seeing outcomes. And obviously now microdosing is like a very common household name for GLPs, but, um, we find that at low doses we start standard at no more than a quarter of the starting dose, often even an eighth.

Um, which are you using, tirzepatide, semaglutide, both?

What is which? Good question. So I like to start most people on semaglutide, and the reason is because tirzepatide, in my opinion, is almost too potent. Like, it tends to bomb out people's appetite, and my goal is always I want you to get enough calories, like enough nutrients, enough protein. If you can't do that, we're going to fail long term. And so I think almost tirzepatide is, is overly potent. So often I'll start people on semaglutide, quarter to an eighth of the dose, and only increase them when it loses efficacy if they're trying to lose weight. People don't need to, one, be on diabetic doses of medication when they're non-diabetic, right? So we are applying systemically diabetes-based dosing to the general population, which doesn't work for a lot of reasons. And then secondarily to that, we are determined to increase the dose of this medication on a monthly basis despite it continuing to work at lower doses. And again, people are losing too much weight, they're losing it too fast, they're having side effects, etc. It's just unnecessary. I think the future is in microdosing, tailored dosing, unique dosing protocols that are much, much more conservative than what we have available at this point in an injectable pen dose and method.

From what I hear in Europe, they have pens that you can dial. Like, what is up with us here? You know, with what we have available to us? Not only have I heard that it's like $100 there, Yeah, by pharmacy here you go to a compounding pharmacy, but that you could actually dial your pens to get the dose that you want as opposed to what we have here, which I'm just wondering why the pharmaceutical companies haven't caught on to that here.

They will. They absolutely— it's going to be consumer demanded. It is only a matter of time. People are too— from the concept of microdosing that we had, I mean, it wasn't called microdosing, but in our practice to where we are now, this has wildly gotten to be almost normal in the conversation about these medications. So I think very, very quickly, if they're not already doing studies looking at microdosing and more tailored dosing, it will happen. But yes, there are certain pens that are clickable. You can count the clicks. The downside is you're really not supposed to use the same needle to reinject. So we still need to come up with a better solution. In my opinion, that's certainly compounded meds.

Yeah. So what is happening here? Because I heard all this fear. I was like going, do I need to stockpile that we weren't going to have access to these? What is going on with that? And as a second part of that question, what is up with all of this attack on compounding pharmacists? I've been— I've had so many compounding pharmacy friends over the years, and what always stands out with me with my compounding pharmacy friends is their compounding pharmacies can get raided at any time. They are under so much scrutiny, so they act like they're out there like mixing cocktails in their bathroom. They are like, they, you know, it has to be a sterile environment. They have so many things they have to hold to and they can be evaluated at any time with no warning. So why do they have such— get such a bad rap?

Yeah. Well, you know, I think the time that we are in right now is we are, in my opinion, in the greatest medical advancement that will happen in my lifetime, which is GLPs. I think GLPs will change medicine forever. They are certainly equivalent to the discovery of antibiotics 100 years ago. So not only are they such an enormous advancement, they are incredibly lucrative. For Big Pharma. And Big Pharma makes, like you had kind of mentioned, the majority of their medication back on us, on Americans. These drugs are much cheaper available in other places. And so guess what the next thing that happens is, is they want to really potentially not allow other people to manufacture these meds. And then if they are allowed to manufacture them, they would like other people to not trust and, and buy them. Right. And so I think there is a very intentional situation happening right now. And the dynamic that is happening that honestly evolves on a weekly basis is, you know, the makers of tirzepatide are really working hard to take away the possibility for us to have access to compounded tirzepatide. They have gone really above and beyond and are getting quite litigious in an effort to stop compounding pharmacies from making these medications and even threatening, you know, clinicians who are prescribing them. Unfortunately, we have not succeeded in overturning their desire to halt our ability to access them. And so things are progressing on a weekly basis at this point. But I think that's why we hear a lot about these compounding pharmacies not being good or unsafe, etc., the reality is exactly what you said. It takes basically 4 years to get a license to make these medications, and it is incredibly rigorous. The standards that are held to create injectable sterile medications. Yeah, it's insane. Like, these pharmacies have very specific standards that are tightly regulated. And I think what— where I think that rhetoric came from is there are like black market or gray market GLPs that you can buy online that are research— for research purposes only, not for human consumption. And I wouldn't do that myself. Like, I think that's a little risky and I would never trust those compounding pharmacies. But those are not regulated pharmacies. They are just peptides made in China or Russia and then they're shipped over here for people that can't access them otherwise. And I do think that's risky. I find zero risk in regular regulated 503 and 503 compounding pharmacies, which is what any real licensed medical provider would be prescribing.

Yeah, I think that is so important for everybody to understand because I hear it. I hear this all the time and I hear medical doctors saying this. And, you know, I think they've been told by the pharmaceutical companies and haven't looked outside. Yeah, to see, oh, that actually isn't the case. I hear the same thing in the supplement industry of like, they're not regulated. I go, have you been to a supplement manufacturing plant where they can come in at any time and investigate? You have to have every single bit of your paperwork completely, you know, it's like it is, it is no joke. And so you hear that there too. And I'm like, I don't know what you're talking about, but like, I have been in the manufacturing of supplements for 30 years and that's not the way it works. At all. So I just want to make sure everybody is aware of that. So, um, you mentioned that you're having people come on these and then you're having people come off of them. But I just wonder, like, I look at it and I go, why would we want to come off of them if they have all of these benefits? What do you maintain by getting off of them? Like, why would you want to do that versus just do a cycling low dose?

Agreed. If it were up to me, I mean, people would be on them forever, right? I think there is so much still fear-based propaganda about, oh my gosh, you're going to have to be on this forever. And people don't want to commit to that. Also, it's not the cheapest. And so sometimes finances come, you know, get in the way of people being able to access them on a permanent basis. But I think— and people are like, are they safe to be on forever? I'm like, look, these meds are studied for people to be on them forever. Like, well, we haven't studied past 10 years, have we? We're at 20 now.

We're at 20. What, 20 with like what, liraglutide? Or I know some of the earlier ones.

Yeah.

And when you think about it, I just wonder, like, it would seem to me that we have really damaged a couple of things. We've damaged our L cells. We're not able to produce GLP-1 like we used to. We're probably not able to hear it like we used to.

Yeah.

So I don't know how much we can rehab all of that, but I also just wonder if maybe we used to produce more of it in our, like, 1,000 years ago or something. But, you know, it seems like a wonder compound for what it can do to the body. Um, have you found anything, like, what is your thought on us potentially not producing it like we used to or being resistant to it?

Yeah, I think I haven't found it in the literature, but I can easily sort of extrapolate the idea that physiologically, when we are leptin resistant— when, and that's a measurable thing— when we're insulin resistant, that's a black and white data point. Um, certainly I would expect for us to also be GLP resistant, right? Like, our body can't hear that message as loud as it used to. And so I would imagine those things just correlate with one another. In parallel. And so trying to override and retrain that mechanism is part of the healing process. But yeah, I know, I absolutely believe that we as a society are GLP-resistant, and that can easily, I think, be equated to, you know, bad food, processed food, all, all the things that are involved in the standard American lifestyle.

Yeah, visceral adipose tissue, muscle fat, you know, all the things. What do you think about some of the non-peptide alternatives? I'm excited about this idea of the orals. I think we're going to have some different things that are going to help us raise GLP-1s. I know that there is a supplement— I met this woman at IHS from New Zealand called Kalicurb, which is supposed to raise GLP-1 for a couple hours after taking it. And I also was talking to Dr. Jeff Bland and he said Well, Himalayan tartary buckwheat does this too, that these bitters do these things. Have you looked at any of this to see if any of that would have, like, could be used in conjunction, or maybe to help people be able to use less of it, or to taper off of it if they didn't want to spend the money anymore?

You know, I haven't. I mean, I've had a bottle of CalaCurb in my, you know, pantry for, for years, I think, at this point. Um, and so I'd have to do some beta testing. Right now I'm I'm doing beta testing on true oral formulations of these medications and not finding the same impact, sadly, thus far. But I'm cycling through several of them with a population of patients.

Um, what are you noticing? Are— do they work at all or no?

So I have— I don't have enough data on the inflammatory aspect, but certainly there is little to no appetite suppression, sadly, which I fear could correlate with the anti-inflammatory impact. I think potentially we're losing too much of the absorption in the oral mucosa pathway, but I'll have to report back. I'm a few weeks in at this point, so there's so much data to still be collected. But yeah, I mean, the one thing that I do to transition off, speaking to that, and I do think it's valuable to explore this and other GLP-1 stimulants. I have one right here, yerba mate, right? That's another one that stimulates GLP-1. Um, I use metformin to wean people off and transition off a little more smoothly. It's another medication, but it also has a lot of longevity benefits and still can continue on that influence of reducing leptin resistance, insulin resistance, and elevations in blood sugar.

Now, with metformin, I've always been concerned with metformin and what it does with mitochondria and exercise and reducing exercise capacity. Do you have any issues with that? Do you see that as a problem?

I definitely think it can be, and I think it should be cycled on and off in low doses. So I don't think people need a lot. I think I'm an advocate for 500 milligrams extended release once a day, even just a few days a week. So like skipping it leading up to exercise or post-exercise, I think is, is a good idea, especially for people who are very, very weightlifting-centric in their lifestyle, which I hope is everybody. Me too.

So what are some of the big things that you've seen with patients? And especially like one I'd love to address is I think food noise is a big issue just because of the way— first of all, even in the perfect world, we're not going to get away from processed food. Like, we're just not. I mean, I like to think of myself as a really clean eater and I still eat some processed food. Yeah. So You know, we're still gonna have some of that and that still creates— the minute you eat them, you're like, ooh.

Yeah.

Like, I love this, um, this cereal called Catalina Crunch. Uh-huh. Have you tried that? Absolutely. It's delicious. Okay. So cereal's like my thing. So I have to weigh and me— like, I have to literally measure this stuff. Otherwise I'd be like snarfing out a bag of it. Like, literally we'll have food noise. So that's one of the big things I see with this is it helps shutting down some of the food noise, craving stuff that are our whole lifestyle's engineered us to do. What are some of the big things that you're seeing as benefits from taking these?

I'll tell you my most unexpected one that I feel like for my women and my practice has been pretty life-changing. It almost rehabilitates their relationship with food because I've take them through this cycle of years of thyroid dysfunction, and I think this applies outside of thyroid dysfunction as well. And it's, I can't lose weight. I've got to restrain, restrain, restrain, control, control, control. Oh, of course, inevitably I fail and I give in to Catalina Crunch, and then I feel guilty and ashamed. And then, you know, rinse and repeat that cycle, and I gain 5 pounds of inflammation and water weight, and then I beat myself up, and it really quickly spirals out of control. And then I think that neural pathway gets strengthened in our minds, and then we feel guilty when we eat food, which should not be the case. Food should be fuel. Um, and what this does, and what I've seen it do, is break that cycle. It's, oh, they're able to eat well in a very balanced way, have their Catalina Crunch, and not suffer severe rebound inflammation, water weight, inappropriate weight gain. And so slowly over time, that mechanism of guilt and shame associated with food gets broken. And food becomes fuel and healthy and good and not evil. And it has been truly one of the most sacred experiences in my medical career to see women go through this transformation is incredibly powerful. So that's a little bit of an abstract concept, but cannot be understated.

So. Right.

Yeah.

Yeah, I really appreciate that. I'd love to just switch gears, just since you do have the Modern Thyroid Clinic and, you know, you initially were in this world, you got known for thyroid. I think it'd be remiss to not just talk a little bit. So someone listening, because when you, you talked about how long it could be before someone got diagnosed, and especially with them increasing the range, not decreasing it. I would love for you just to talk through what hypothyroidism really looks like, how someone might know what they should look for in their lab tests, so that— and you do have a virtual— your practice is virtual, right?

So yeah, virtual and nationwide.

Yay! So, you know, so that's because I, I just hate the idea of people suffering. I mean, I had a cousin who, like, her first sign of her hypothyroidism was breaking her hip.

Wow.

Yeah, I was like, when was the last time you went to a doctor? You know, um, but you know, people don't realize what low thyroid function can do left unchecked.

Yeah, yeah. And you know, it's one of those things where it's so important for women to know that they can't go to their doctor with a bunch of thyroid symptoms, which I'll cover in a second, and expect to get an actual answer from their clinician. And the likelihood that you have a thyroid issue, you show up to your clinician and they diagnose you and treat you with it properly, is like like less than 2%. Like, that's just not gonna happen for years and years. Oh, women are dismissed, rejected, told to eat less, exercise more, all day, every day. So, you know, it's—

it—

and it's minimized in medicine, the severity of the symptoms involved with hypothyroidism, and it's devastating. It's life-altering. So first of all, some of the symptoms that women should be looking for are fatigue, brain fog, weight gain, hair loss, dry skin, brittle nails, brittle hair, constipation, low sex drive, elevations in your blood sugar, elevations in your cholesterol that lead to weight gain, even loss of the outer portions of your eyebrows. Medicine says, oh, those are very non-specific symptoms. Just because you have a constellation of them doesn't mean you have a thyroid problem. It could be anything. In fact, I believe and find if you've got 5 or 6 of those, you probably have a thyroid issue. Wow.

Yeah. Yeah. Because outer third of the eyebrow is so classic for so many things.

Yeah, right. Exactly. And it's like when you have a lot of them, if it looks like a duck, it quacks like a duck, it walks like a duck, it's honestly probably a duck. Yeah, right. And so often women will go to their clinician and they'll say, well, I have all these symptoms. I think I have a thyroid problem. Will you please check me? And medicine will only check check one, maybe two markers, neither of which are even remotely able to screen for thyroid dysfunction. They will check your TSH and your T4. I was literally reading a study before we hopped on this call that— so your most important thyroid hormone is called your free T3. It's your active hormone. It's what regulates all of those symptoms that we just talked about. No one ever checks free T3. And I was reading a study that said less than— T3 has the impact on TSH and T4 in labs less than 1% of the time, meaning less than 1% of the time is your T3 appropriately reflected in your TSH. So wow, if no one's checking that, you won't know. The same study also showed— I thought, I thought you might find this interesting— higher levels of T3 are correlated with longer life. Higher levels of T4, which are— is the medicine that everyone's being put on, levothyroxine, Synthroid, Tirosint— having higher levels equal increased mortality. So medicine has this completely backwards and upside down. So women really, really need to be advocating for a full and complete thyroid panel, which is TSH, free T4, free T3, reverse T3, as well as antibodies, TPO and thyroglobulin antibodies. And then look for optimal, not normal ranges. And I'm happy to share my Thyroid Lab Guide with you, JJ. It's free.

And that'd be great. Let's— we're gonna get your, uh, your GLP-1 decoded guide, your lab, your thyroid lab guide. But just give us a little idea there, because again, you know, I know for me, at 2.5 was like lost the outer third of my eyebrows, constipated. I wasn't sweating anymore, which was awesome, but Right, that's another symptom. Yes, it's like kind of good but not good, right?

Totally. You can't detox that way. Um, yeah, so I want people's TSH less than 1.8, which, you know, medicine is beginning the, the concept of not treating people unless their TSH is above 10 and 20.

And I just cannot believe that. Like, I cannot believe that.

It's devastating. And it was based on one study that started this catapult years ago that said, look, people actually aren't getting better if their TSH is less than 10 with treatment, so let's just not treat them because they're not getting better anyway. In reality, what that study should have looked at is the efficacy of the one medication that we're offering these people.

Were they doing Synthroid?

Yeah, levothyroxine. Yeah. And saying, hey, if all these people aren't getting well until they're so severe, maybe we need to look at a different treatment. But that's in fact not what we did.

Yeah. So it wasn't fixing T3. So they're— so they still were probably low in T3, right?

Exactly. They were low in T3. So TSH should be less than 1.8, T4 should be between 0.9 and 1.2, free T3 should be between 3.6 and 4.2. Reverse T3 should be between about 8 and 15. So you guys can write those down, but obviously the guide to— you'll get the guide to—

wow, I'm just flabbergasted by the 10 thing.

Like, flabbergasted. In real time, JJ Virgin, thyroid care is devolving and it is devolving rapidly despite other research coming out that's showing the exact, exact opposite. One fascinating thing that I think applies so much to your people came out in April of this year and said people with higher fat to muscle ratios, their TSH is not valid. So basically anyone with a thyroid problem.

Wait, wait, wait, so people with higher body fat or sarcopenic, maybe if they were skinny fat, right? Yep. Um, what do we know what that range is? I like— I'm— the other thing I'm amazed at, McCall, is like what I learned in I spent one whole semester in, in doctoral school on body composition testing. Mm-hmm. And norms and what we were taught the norms were then and what the norms are now are entirely different. I'm like, wait a minute, we were taught that, you know, at 27% you need to start worrying about metabolic syndrome back then. And now that's healthy. I go, wow, they're worse.

They're not better. You know, It's crazy. How can we be getting worse and not better? And the answer is because we are basing those norms on averages of people in our population. That's also what happens with labs. It's, it's horrible. It's why we have one of the worst health outcome countries in the world.

So can we— with thyroid disease, I don't know, how prevalent is low thyroid function? The, the what's really low thyroid function, not the BS 10 or 20, like, you know, the thyroid function of what you're talking about.

In my opinion, if you are a woman, especially if you are a woman with children, at some point in your, in your life, it's— you will have thyroid dysfunction. It is not a matter of if, but when.

And why is that?

Yeah, I think it's a lot of reasons. So I think we have massive inflammatory lifestyles that drive Hashimoto's, which is the autoimmune condition that then creates in many cases hypothyroidism. We are in a society that primes us for autoimmune disease. In addition to that, I think we are also in a society that is filled with hormone disruptors. So in the same way that our estrogen, our testosterone, our progesterone is being influenced by our environment, our thyroid is also. And then lastly, what medicine does not account for is women's hormones decline as we age and that is not just our reproductive hormones. Our organs, our hormone-producing organs, like a car, like anything else in the world that gets used over time, doesn't function as well. And I find so commonly, outside of Hashimoto's, women's thyroid production hormones just— they, they decrease slowly over our lifetime. And so it's a whole system of reasons, but it is profound and will impact someone's quality of life and their long-term health outcomes in massive, massive ways if that problem is not solved.

So at what age do you find, like, you know, perimenopause, we know this one, that's an obvious one, but I think this one, a lot of these things are not as clear. I'm glad you talked about some of the symptoms. I know I had a, a client who was depressed and, you know, like psychiatrists, I, I go, did you check your thyroid? You know, sure enough. Um, so there's so many different things. What age do you— is there, is there an age that's, that's common for this to start at?

Yeah, you know, I think a couple things. I think especially if you have a strong family history. I mean, I see kids with thyroid dysfunction with massive and severe Hashimoto's, so I think if you're going to the doctor—

ultra-processed food, totally, and toxins playing its role here.

Absolutely. I mean, even like athletes that play on turf or swimmers, like I have a lot of those kids too.

Um, can you reverse that or is that done?

No, you can, you can certainly reverse Hashimoto's. In kids it's a little harder because it's hard to manage like what they eat at school and at their friend's house, and they can't not do swim all summer, you know, but part of it is like developing these tools to try to combat the severity of the flares. But, you know, and then I think the other dynamic is women, we push through. We are people that just deal with how we feel and we grind it out and it becomes our new normal.

And so as we're not being hysterical, I mean, look, right? I mean, that's—

yeah. And then we're told by our doctors It's not your thyroid, it's actually all in your head, it's your fault, go eat less, exercise more, right? So we need objective data to be monitoring. Every time you go to the doctor, get a full thyroid panel. Get it on your own if your doctor won't order it.

There's a million ways. Like, exactly, Function Health.

I mean, and they do a full thyroid panel.

They do. And I'm just thinking, so I was just fortunate early on, like 25 years ago, um, I met this doctor, Dr. Diana Schwartzbein. She was a thyroid fellow. She actually was the one who was treating Suzanne for hormones, but she, I was like, we need to do certification courses. So I actually outlined the business plan of it. And I was teaching the nutrition part and she was teaching all of this. And so I got to learn so much from her. And one thing she always said is, if your thyroid's not functioning well, you will not be able to balance your hormones. Like, you will not be able to go and balance estrogen without good thyroid. I know with your thyroid's not working well, you're not gonna be able to build muscle well. You're going to have more bone loss. So, you know, things you may not think about. I think we tend to think of thyroid and weight, but it's the master regulator. Like, if it's not working well, nothing is working well. Exactly. And it's hugely problematic, just like you said, devastating for your health.

It really is. And I get, you know, these people who are like, I don't want to be on a thyroid medication forever. And my answer is always, look, you know, okay. But if you're not on a thyroid medication, you're going to end up on a diabetes medication and a cholesterol medication and hormones that come from— exactly. So it's like you can fix this core issue that's going to protect so many aspects of your health, or you can try to ignore it and then deal with the real consequences that sometimes are not reversible too late in the game.

Well, you look at it and go, what if we were working with things that are natural in the body and just helping them come back to where they're supposed to be? Versus doing an external drug that's not like— it makes so much more sense. Absolutely amazing. Well, wow, this has been a masterclass. I know we've gone all over the place, but I was like, I can't have you here, the thyroid, the thyroid queen, without talking that too. So you're going to do both the GLP-1 Decoded Guide and the Thyroid Lab Guide, and we will put those at jjvirgin.com/mccall. M-C-C-A-L-L. And wow, this has been great. Worth the wait. Thank you so much.

Thank you so much for having me. This was delightful. And thank you for all of your work supporting and empowering women, JJ.

Be sure to join me next time for more tools, tips, and techniques you can use to look and feel your best and be built to last. Would you prefer an ad-free experience? Join my VIP podcast at subscribe2jj.com for just $4.99 $4.99 a month or $49.99 a year to unlock uninterrupted ad-free access to all the episodes and insights you love. Also, I'd love to connect with you and hear your thoughts on the podcast. Here's how. First, subscribe to the podcast and leave an honest review. Second, take a screenshot of your review. And third, text to 2-813-565-9199 26, 27. That's 813-565-2627. When you do, I'll reply using my brand new Virtual JJ Virgin. It's my on-demand virtual self built from my books, talks, and years of experience so I can interact with you directly. You'll make my day and I can't wait to hear from you. Thanks for tuning in and And I'll catch you on the next episode. Hey, JJ here. And just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional information that's designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. Make sure that you do not disregard, avoid, or delay obtaining medical or health-related advice from your healthcare professional because of something you may have heard on the show or read in our show notes. The use of any information provided on the show is solely at your own risk.

Athletic Brewing Company crafts award-winning non-alcoholic beers for those who want to be part of every round. With over 185 flavor awards, They're exceptional NA beers that fit your lifestyle and any social occasion. Summer's full of good times, and Athletic fits right in. Go to athleticbrewing.com to have brews delivered to your door, or find them at a bar, restaurant, or store near you. Near beer. Athletic Brewing Company. Fit for all times.

You can't reason with the sun. Trust us, we've tried. This summer, it's time to put that angry ball of fire on mute. Columbia's Omni-Shade technology is engineered to protect you from the sun's harsh rays that can burn and damage your skin. The sun is relentless, but so is our gear. Level up your summer at Columbia.com to spend more time outside and less time slathering on aloe lotion. You're welcome. Columbia, engineered for whatever.