In this interview, JJ Virgin and a thyroid specialist discuss why many women’s thyroid‑related symptoms—weight gain, fatigue, brain fog, hair loss, sleep disturbances, anxiety and depression—are often dismissed as normal aging or perimenopause. They explain that 90‑98% of low‑thyroid diagnoses in women actually reflect Hashimoto’s thyroiditis, an autoimmune condition that attacks the thyroid rather than a primary gland failure. The conversation highlights how dysglycemia, insulin spikes, hormonal shifts, infections, mold, heavy metals, and especially gluten (exacerbated by glyphosate exposure) create bidirectional feed‑forward loops that keep the immune system attacking the thyroid and can trigger other autoimmune diseases. The expert outlines a comprehensive testing protocol that includes a 12‑marker dysglycemia panel, a 12‑marker full thyroid panel (including TPO and thyroglobulin antibodies), DUTCH hormone testing, stool and toxin panels, and food‑sensitivity testing. They stress that most thyroid hormone conversion (T4→T3) occurs outside the gland, so focusing solely on TSH and hormone replacement misses the root causes. The recommended approach shifts from merely prescribing thyroid hormone to identifying and breaking the underlying triggers—blood‑sugar instability, gluten sensitivity, glyphosate‑induced molecular mimicry, gut permeability, and hormonal imbalances—to restore immune balance and prevent further autoimmune complications.
Chapters
once the TSH is in a normal range, there's not much else they can do. And it's like, okay, then, you know, your labs look fine, so you just need to go eat less and exercise more and, you know, get used to it. This is kind of what you're going to feel like if you have low thyroid. Or, oh, it's your age, you're postmenopausal, so this is what life is supposed to be like. And they kind of just get brushed off and shoot out and pat it on the head, and, and it's frustrating.
Yeah, I'm really thrilled with the menopause movement going on now because I don't think that most doctors are going to get away with the, "It's just your age, you're just postmenopausal," statements anymore. So thank God. And I mean, part of the title we're doing for this show is "You're Not a Hypochondriac." What are the symptoms that women are experiencing that are real thyroid issues that quite often get dismissed?
The most typical, is that you start to gain weight and no matter what you do, you're, you are not able to lose weight. Fatigue, really chronic fatigue, brain fog, your hair's falling out, you're not sleeping very well, you can't fall asleep or stay asleep. Also anxiety and depression. You know, those symptoms are not only just for low thyroid, right?
Those are perimenopause too.
Those are literally, you can set them on top of perimenopause. You can set them on top of dysglycemia and insulin resistance. But when, when women get labeled as low thyroid, they just push all of those symptoms into that label of low thyroid and kind of just say, wow, this is the way it's gonna be.
But those three all go together.
All three go together and all three are extremely important as we age and as our hormones start to shift, they're all very important and they tell a story. That's how your body communicates with you when something's not quite right is to give you a symptom. But if we, you know, brush it off or we ignore it or we just medicate it, then the underlying imbalance gets worse over time.
Yeah, it makes so much sense. Well, let's flip into the Hashimoto's side of it because I think it's now one of the most common autoimmune diseases in women. Why do you think that is?
90 to 98% of women who've been diagnosed with low thyroid actually have Hashimoto's. And it's hard to say, you know, why we have such a huge prevalence of Hashimoto's right now. But, you know, I think we can speculate the world is growing ever so toxic. And we have a lot of toxins that compete with iodine on the thyroid and underlying infections and mold toxins and all these things that we deal with that can trigger autoimmunity. But I think this is really important because when you have Hashimoto's, you have a primary autoimmune issue. You don't have a primary thyroid issue.
So you have an autoimmune issue that's just showing up as a thyroid problem.
Yes. And in conventional medicine, they give you thyroid hormones, which is appropriate. 'cause you need adequate amounts of thyroid hormone, but they never address this underlying autoimmune issue. And when you have one autoimmune disease, you're at risk for developing multiple autoimmune diseases and thyroid cancer.
What is so interesting to me that I heard so frequently when I was working with clients one-on-one is that they'd come in with an autoimmune disease, they'd see their doctor, and the doctor would say, let's just watch it. Yes. And I'm always like, what are we watching it? Do, you know, why are we watching? Exactly. So if someone is being treated for hypothyroidism, but they are not addressing that autoimmune disease, what would they need to do there? Because then again, it could just set up for other things. That's right. What, what would the difference be?
So essentially you have to take the focus off the thyroid because the thyroid is really just the victim. All right, now, yes, you need to make sure that your thyroid hormones are balanced, but then you've gotta say, okay, Now I have an autoimmune issue. What are the underlying triggers that are causing the immune system to attack the thyroid? And we mentioned a couple of those earlier. Dysglycemia, insulin surges, and blood sugar issues will keep that immune system attacking the body. And then you start to set up these bidirectional feed-forward pathways, which means they just keep going in this loop until you start breaking it. Because like, let's say you eat something that creates an insulin surge. Well, that causes the immune system to attack the thyroid, and then that in turn causes another insulin surge. So it's like it just keeps going until we start to break all of these patterns and triggers that are causing the immune system to attack the thyroid. So we got blood sugar issues, we've got hormonal imbalances and estrogen and testosterone surges, underlying infections and toxins and mold toxins and food sensitivities. Those are— there's a lot of different underlying triggers. That you have to really go in and start to break those cycles to calm down the immune system. So it stops attacking the thyroid, but you prevent it from attacking other parts of the body.
Someone coming in, how would they know? Is it a food sensitivity? Is it gut dysbiosis? Is it mold issues? Is it heavy metals? Is it gluten? Is it, you know, is it insulin resistance? Is it perimenopause? Like, how would they know which, and likely it's not just one, you know, what are you doing to unpack what it could be? And is there like a hierarchy in there?
Certainly. So for us, we test all of those things, right? So I can say, okay, where are the priority triggers that are affecting this particular person? And you're right, there's never one. Right. So patients always ask me, what is my root cause? I'm like, there isn't one root cause.
Wouldn't it be great if there was like one? If you broke your leg, I'm like, okay, well, Yeah, it broke your leg.
Right, they're like, I fixed my blood sugar, so everything else should be good. I'm like, but wait, you have underlying infections and toxins. But we test for all of these things.
So walk me through, like, what's, when you say you test for all these things, what's a typical, someone battling this, what were typical, like, labs that they would wanna make sure they looked at?
Yeah, so first we do blood. I have 12 different markers that make up a dysglycemia panel. So we're really digging in on blood sugar because it's huge. It doesn't mean that someone doesn't have diabetes, right? So someone can have a blood sugar problem way before it gets to diabetes or pre-diabetes. So we're looking for blood sugar variability, so we're looking at fasting insulin, we're looking at fructosamine and Glycomark, and we're looking at all the lipids and all of those things to really dig into, do you have a blood sugar problem? Then we're looking at a full thyroid panel. So my full thyroid panel has 12 different markers. So do you have Hashimoto's? But then what else?
What, how would they know if they had Hashimoto's looking at which, what are you looking at specifically?
So in Hashimoto's, you look at two antibodies, the thyroglobulin antibody and a TPO antibody. TPO stands for thyroid peroxidase antibody. If those are outside of the lab range, in this case we use the lab range. So if those are outside of the lab range, that's pretty indicative of a diagnosis of Hashimoto's. Now, you can still have Hashimoto's even if those antibodies are negative because, you know, the labs aren't always perfect and there's false negatives and things like that. But those are the two markers that they would know if they had Hashimoto's. But what a lot of people don't understand is that all thyroid physiology happens outside of the thyroid. So the thyroid mostly makes T4, but if your body's making enough T4, you're taking T4, what else is happening to that T4 and how does that, work in the body as far as conversion and cell uptake and, and all of that stuff. So you have to look a lot deeper into thyroid physiology. And then we're looking at inflammatory markers and we're looking at liver and gallbladder and kidney function for toxic load. We do a Dutch test, which looks at the full circadian rhythm and cortisol and your hormones and how all of the estrogen and, and is breaking down in the body and how you're metabolizing. We do stool tests and total tox tests. That's pretty much what we do on every patient every time so that we can get the main big triggers. And then we work with patients to get them off the main food sensitivities that we know most people are dealing with. And then if we need to fine-tune, we can do food sensitivity testing too.
Which food sensitivities do you think are the most common ones from what you've seen?
So gluten for one, for people with Hashimoto's. I think the research really, uh, substantiates that most, if not all, women with Hashimoto's have a gluten sensitivity.
I'm so glad you said this, but I think it's so much— we've got the gluten issue, then we've got the glyphosate issue. I can't make this a good thing in any—
like, and then you have the blood sugar issue. So let's, let's—
and then you have the zonulin, you have the leaky gut issue. Like, there's so many things with it.
You just look at and go, just, uh, so I just am like, there's no good thing about gluten. And I don't care. It's a lot of people say, well, I don't have a gluten sensitivity because I don't get stomach issues.
That's one symptom, right? I know, I've, I've literally taken I've taken tens of thousands of people off of gluten. And I think the only time someone says they feel fine when they eat gluten again is they didn't get gluten out. That is my biased opinion. Yes. But unless you're outside of the US. Right. And Canada.
Exactly. But still, like, I tested this 'cause I don't eat gluten ever here. I mean, unless I got into it accidentally and I didn't realize it. But I went to Europe and I ate gluten. I did not feel bad. However, I was wearing a CGM.
Mm.
And it still makes your blood sugar go up. So you're still gonna have that component. So there's no glyphosate, it's much better.
It's gotta do some air squats after that pasta.
Right. We gotta do lots of it.
Yeah. But I, I, I love that you brought that up because I think that's the biggest culprit for so much of this.
Yeah.
Is just that piece. And, and it's impossible to unpack whether it's the gluten or the glyphosate. Right. It's the all.
So there is what we call molecular mimicry. And so the immune— the, the gluten molecule looks very similar to the thyroid molecule. And when you eat gluten and it flares up the immune system, it makes the immune system attack your thyroid also. Now, why is it attacking the gluten? It's probably glyphosate. It's probably who knows what. But that's when we really saw a huge turn in, uh, this gluten sensitivity is when they started using glyphosate.
That makes sense. How long ago was that?
I think it was in the '90s.
Really? Mm-hmm. And that has only been around that long. And look at the damage it's done.
I think they used it like sparingly, but they didn't start like drying it out and dumping it and using it like heavily in the, I think it was early to mid-'90s.
Wow. I didn't realize it was that new.
Yeah.
But that makes sense with what we're seeing in the rise of all these problems.
Because I never heard of a gluten sensitivity when I was growing up. Like, I, it wasn't like a thing. Mm-hmm. Um, but whenever they started using it, when I was, in high school and college, which is when that all kind of started coming out.
It's interesting because that's when I started running a bunch of food sensitivity tests was in the early 2000s. And that's when I started to see all this crazy stuff.
Yeah, I saw a study. They also laid the incidence of type 2 diabetes on top of the increased use in glyphosate, and it literally is exactly the same.
Oh, wow.
It's exactly the same. So anyway, I just find it very peculiar.
Amazing. What a coincidence. That's crazy. Okay, so you talked about the fact that a lot of what happens with the thyroid happens outside the thyroid. I think it'd be interesting to walk through this because, you know, we've got thyroid stimulating hormone, but we also have the conversion from T4 to T3, which is super important, and that's not happening in the thyroid. And there's a lot of things that can mess with that, and especially stress. Walk us through what happens outside, outside of the thyroid that's so important for good thyroid health and function.
Yeah, I think this is so crazy. So they effectively are looking at thyroid function by measuring TSH, and TSH isn't even made by the thyroid, it's made by the pituitary. So there's things that happen between when TSH is produced and when it hits the thyroid. So there's things that could go wrong outside of it even being a thyroid problem. So that's really important to know.
