You're Not A Hypochondriac: The Truth About Thyroid Labs According to Dr. Heather Stone

The thyroid issue is the symptom.

That's right, it is the symptom. 90 to 98% of women who've been diagnosed with low thyroid actually have Hashimoto's. The number one thing that I see is ignoring and brushing off Hashimoto's, and the reason this happens is because they don't have any other drugs that they would give you. How long ago did they introduce thyroid replacement hormone? 1891 is when they first introduced like a glandular thyroid hormone. And that is how they're treating low thyroid today. It has not changed. Wow. And we know so much more about thyroid physiology in the human body and female physiology and female hormones.

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Thank you for having me here. I'm excited.

Oh, I'm thrilled you're here, 'cause this is such a big topic, and we actually haven't talked about it in quite a while, digging into thyroid. And what I'd love to start with is why so many women with thyroid problems feel like they're not being taken seriously by the healthcare system. Like, what's up?

Yeah, I think for so many women who've been diagnosed with low thyroid, the solution in traditional or conventional medicine is to medicate with thyroid replacement hormone. And then once your labs look good, like once the TSH is normal—

And what's normal? What do they consider normal?

Yeah, so a normal TSH, well, it depends on where you are in the country, but—

Really?

Yes. So these lab ranges changes because the way they get these lab ranges is they take a region of the country and they will take an average and they graph those on a bell-shaped curve and then they'll take the middle and then they'll go 2 standard deviations out and that's normal. So like from the East Coast to the West Coast, it's amazing. The other day I was looking at a lady's labs. We had run her labs and then she had some from another, uh, hospital or another clinic and their ranges were all off. And in one of her labs it was out of normal. And then another set of her labs, it was within the lab range.

I really honestly have never heard that it varied by region.

Oh yeah. Which is crazy because we think that those lab ranges are like standardized and They get them from research, but in reality, they get them from averages of the region of the people going into the labs. And then you think about, well, who goes into the labs? And it's not like healthy 20-year-olds. It's like, you know, all of us that are dealing, you know, later in life, dealing with health issues. And so that's where they get those averages. Now, when you fall outside of those averages or those lab ranges, they can diagnose you with a disease. Right? And that's when they get medication. So like, on average, I would say that lab range is 0.5 to 5.0. Now some of those lab ranges are 0.45 to 4.5.

So you can see, that's what I've seen. That's— I guess that was the California ranges.

Yeah, that's the California ranges.

But again, they're based on averages that are not healthy people. Why are we doing it this way? I don't understand it.

Well, that's where really functional medicine has really started to shine, because we want to take optimal functioning ranges. It's not like, okay, we're just gonna go by averages, but where should someone be in an optimally functioning range? And we really like it to be 1 to 2, and then it can even go up to 2.8, even to 3, and you would be okay. But once it starts to get over 3, we know that the body's metabolic rate is really starting to slow down. So back to your original question, it's like, well, why do they, you know, feel like they're being brushed off and not heard? And it's because 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.

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 going to 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. So there, 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 it likely it's not just one, but 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, 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, it— 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, 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, 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 think about this.

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, I don't care. It's a lot of people say, well, I don't have a gluten sensitivity. Sensitivity because I don't get stomach issues when I eat gluten.

That's one symptom. Right. I know, I've, I've literally 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, 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 not— Just 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, how long ago was that?

I think it was in the '90s.

Really? Mm-hmm. 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, it wasn't like a thing. Mm-mm. 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. 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.

Yeah.

Okay, so you talked about the fact that a lot of what happens with the thyroid happens outside the thyroid. Mm-hmm. 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. So, 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. So TSH does exactly what it says. It stands for thyroid stimulating hormone. So its job is to stimulate the thyroid to make T4. It mostly makes T4, it makes a little bit of T3. So then after the thyroid produces T4, or even after you take your thyroid medication, you know, your Synthroid or Levothyroxine or whatever, that's T4. Now all the other thyroid physiology happens outside. Essentially what has to happen is you've gotta take T4 and make it into T3. Now, there's all kinds of enzymes and nutrients and vitamins and minerals that the body needs to be able to convert T4 to T3. So you got to look at your, your mineral vitamin profiles. And everybody's probably heard of selenium. Everyone's like, oh, take selenium. There's like a gajillion magic thyroid supplements on the market, and mostly it's selenium. Okay, well, that's a small piece of the puzzle. So mostly this conversion happens in the liver. So about 70% of conversion happens in the liver. So you've got to think about liver function and, you know, your toxic load and how well your liver's functioning, all your detoxification pathways. So that's going to play into this conversion. And then 20% of the time, that conversion also happens in the gut. So then you've got to look at the gut, you've got to look at, you know, dysbiosis and any kind of gut issues, because it's going to impact your conversion. But then on top of that, now that you convert T4 to T3, you know, you have little proteins that carry these thyroid hormones all around the body so that then they can get to their delivery place and dock at the cell where they can actually be used. But if our hormones are out of balance, if we don't have enough or we have too much estrogen and testosterone, that carrier protein can't come off. So you got a lot of inactive thyroid hormones floating around in your system, and you can't dock them on the cell if your other hormones aren't in good balance. So I think the big picture here is that the human body does not work in parts and pieces. It just doesn't. And the more that we can start to expand and understand that it works as an organism altogether, and we have to stop like separating everything and thinking we have a thyroid problem because it doesn't exist in isolation.

And I think the point you're making here is really important for people to hear is that the thyroid issue is the symptom.

That's right. It is the symptom.

And in 98% of the cases, this is an autoimmune issue that if you do not resolve why you're having the autoimmune issue, you have the symptom of low thyroid, the next symptom could be gastritis, or it could be— Sure. There's all sorts of other ones that go down the line.

Yeah. If we think about thyroid, essentially its job is to regulate metabolism, your metabolic rate. Okay. But your metabolic rate, when I say metabolism, most women directly think about weight, mm-hmm, right? Their weight and can they lose it or can they not? Right. So, but it's your metabolic rate. How efficiently is your body taking in glucose or a ketone or whatever energy source and turning it into energy for you? How effectively is your body essentially functioning on all levels and on all aspects? And you talked about stress, right? So if you're really stressed out, your body's in survival. It's not about optimizing your hormones and optimizing everything. It's like, what do I need to do to get through this situation, this stressful situation I'm in, the best way that I can? So your body's always working to survive. It's always working for you. So like your blood sugar and your toxic load and your stressful— a stressful environment is all going to impact your thyroid hormones. They're all going to be working together to help the organism, you, survive in the best possible way.

So what happens then, like, if you end up with more stress? Is that one of the big things I've always heard is that directly impacts your ability to convert, your ability to then convert from T4 to T3. So basically you're not going to be able to You have this—

you have this other hormone that will not— I don't know if it's a hormone, but it's a marker that we look at called reverse T3. And it's kind of like the breaker switch. So your body's always regulating, how much am I converting T4 into T3? And it's always evaluating your environment. But if you have a lot of stress, and that also could be stress is underlying infections and all that stuff that we were talking about, is the body under stress? Instead of going from T4 to T3, it goes to reverse T3. Just think of that as like water. It's just protecting. It's like a safety switch to, you know, a safety valve so that your body doesn't over, you know, it doesn't start to keep producing energy when you don't need it at that time.

So someone coming in who has any of those symptoms you talked about and they go in and they have a TSH, I mean, can they really tell anything from that? Or what all would they really need to see besides someone getting a tox and all the rest, but like just specifically the thyroid, would it be that they'd need to do a TSH, a T4, a free T3, the antibodies, reverse T3, like, or is there a minimal one they could see if there's initially a problem?

Yeah, I would say the minimal one they need to do is, yes, the TSH can be helpful. I mean, I've seen TSHs in the hundreds, right?

So it's like—

Hundreds? Okay, you got a major problem and you need some thyroid hormone.

Wow, how could someone even—

You wonder if they, how they could be walking around.

But I had a cousin like this, who had like severe hypothyroidism. The first, her first indicator was she broke a hip.

Isn't that crazy?

And they discovered it. I'm like, what is with you? Like, who, who walks around like this?

Yeah.

I noticed when mine went over 2, I could feel it. I went in, I'm like, something's wrong.

Yeah. Well, some of us aren't super in tune with our body and we just keep moving forward and we just keep pushing forward. And, but, um, it is amazing when someone's TSH is super high, I automatically am like, is there something going on with the pituitary? Do they have a tumor or something like that? But you have to look at all the other thyroid markers to make sure that it's telling you what you think it's telling you, right? Because there could be a problem somewhere else. So yes, a TSH can be helpful. In my opinion, by itself, it's kind of useless, especially if you're having those symptoms. But look at a TSH, and then you need a total T4, free T4, a total T3, and a free T3. And you can kind of see, all right, what is happening with thyroid physiology here. And yes, you should get the antibodies. No matter what. That way, you know, is it an autoimmune condition? Am I— thyroid's just being affected? So I think those are the minimum thyroid hormones or markers that you need to see if there's a true thyroid problem and what could it be.

So what do you think that other doctors are getting wrong here when they're, they're treating thyroid problems? Like, what would be your top 3 things you would say, uh, that's probably not the best way to do this?

Yeah, I think the number one thing that I see is ignoring and brushing off Hashimoto's. And the reason this happens is because they don't have any other drugs that they would give you for Hashimoto's. And so once they diagnose you with low thyroid or hypothyroid, the only thing in the toolbox is thyroid hormones. Now, I'm not saying that that isn't necessary, because it is necessary, but just ignoring the fact that you have an autoimmune condition and waiting to see, and we're going to keep an eye out on this. And I always think You're going to keep an eye out on it for— yeah, keep attacking my thyroid.

I'm kind of amazed that Big Pharma has not come out with a drug for Hashimoto's, with it being the problem that it is. I'm glad. And right, you know, because then people would not do all the stuff they can do that can heal it.

And well, think about this. So they have come out with drugs to address other autoimmune issues, but those drugs suppress immune function. So the side effects of those drugs are huge, right?

Yeah.

Cancer, infections, and they're significant. Those drugs create side effects that are worse than what we're dealing with right now. So that's why they don't usually give like an immune suppressant to Hashimoto's. They just wait until it becomes RA, wait until it becomes MS, and then they'll suppress the immune system. But there is no one drug approach that is going to help, uh, address this whole autoimmune issue because it's not a one system thing. And yes, they can override and shove down the immune system, but side effects are way bigger than that.

Are there any other autoimmune titers that someone should be looking at when they go in to look at their thyroid levels?

I would say it depends on their symptoms. Like if they have a lot of joint pain and they have, you know, other symptoms that might be consistent with autoimmunity, or if their doctor's like, it seems like you have autoimmune, but I'm not really sure. Like a lot of people will have a positive ANA titer and they can look for, uh, more of lupus, rheumatoid, even MS. Hmm. Yeah. So for my patients that I do a, a panel, but that's if I, I can see like a lot of symptoms that are autoimmune related and I know they have one autoimmune disease, or maybe the Hashimoto's antibodies came back negative. There's a more extensive autoimmune panel that I typically run just so I No, I don't love labeling, uh, with diseases cuz I think we get attached to those labels and I don't want it to become like an identity, but I wanna know.

It sounds like though, from what you're explaining, that all sorts of different things can lead to an autoimmune disease. Where it's attacking is just a symptom.

That's right.

And really, if you're seeing any autoimmune titers going up, what you just need to look for now is why and what are the different things that are causing the problem, whether it's thyroid, or something else.

That's right. The label is less important than the triggers.

Labels are just for insurance coding and big pharma, as far as I can tell.

Exactly. Exactly. It doesn't help me really one bit. Cause like I just had a patient who has, she was diagnosed with RA and then I did the traditional testing that we always did. And, uh, all she has Hashimoto's as well. And she had no idea, but I know she has autoimmunity, but I don't necessarily care about the label. I just wanna know what her, her primary triggers, that's gonna allow me to know where to start with treatment. And all her joint pain is completely gone within just a few weeks. But it's just because you know exactly what to treat when you do appropriate testing.

It was interesting when I wrote The Virgin Diet, I wrote it because I was working with a lab teaching, and one of the lab tests was a food sensitivity test, right? And so I just saw the impact of all this, and I also saw how gluten was playing a role. And so I, was using it for weight loss. And the side effect was people were like, "My joints don't hurt anymore." Exactly. I'm like, "What?" We had a woman with psoriatic arthritis. She goes, "I'm off all my medications." I'm like, "What?" You know, I had solely been like focused. My whole focus had always been weight loss. So I was like, "Oh, wow. That's— what a cool side effect." Gosh, for so many people, pull the gluten out.

Yeah, and it's interesting, right? Really try to help women focus that their weight is just another symptom, right? To stop getting on this, like, one fad diet after another and trying to force the body to lose weight. But if you figure out why, how come my body's communicating with me? Yeah. This way, what's going on underneath the surface that's not allowing my body to have, uh, ideal metabolic, um, function. And yes, in inflammation and food sensitivities. Exactly. And all those things. Will contribute.

It's a biometric assessment. Like, I treat weight, and that's why I don't even believe at looking at weight. You've gotta look at what your weight's made up of. And I always say, you would not have your blood pressure taken, have it high, and start all this shaming. You would just go, "Oh wow, that thing I did made my blood pressure high. This is the same thing. Let's do the same thing. Let's not be a crazy person with this." Please throw your scales away. Yeah, no, ditch the scale.

Let's just throw it away.

Bioimpedance machines, monitor total body water, knock off that whole traditional scale because it rewards you losing muscle. Like, it's so ridiculous.

It's crazy.

Back over to these top 3 things doctors are getting wrong when they treat thyroid problems. We got one.

Yes, we did get one. So not checking— did I say not checking for Hashimoto's and just running a TSH? And I think also really understanding that when they label someone with low thyroid, they just assume that all of their symptoms that they're dealing with are because of low thyroid, even though their labs might be normal. So they're not really digging to figure out like what else might be causing this. I already found the disease and I'm medicating the disease and the labs look good. So they look no further and just say, well, go eat less and exercise more. And I don't know how to do that. Go look online. So that's another one that I think is really detrimental because like I said earlier, the body's communicating with you that something's not right. And just to think that it's because they've been diagnosed with low thyroid and not figuring out what else might be causing that symptom is I think it's a disservice.

Absolutely. Any other things that they're getting wrong?

Yeah, I think it might be obvious, but I was looking this up the other day and I'm like, how long ago did they introduce thyroid replacement hormone? Like, how long has this—

how long has it been?

1891 is when they first introduced like a glandular thyroid hormone, and that is how they're treating low thyroid today. It has not changed. Wow. And we know so much more about thyroid physiology and the human body and female physiology and female hormones. And it's literally like we are stuck in the 1800s. Okay. High TSH, low thyroid, thyroid hormones, and you're on your way. And I just think that that is absolutely insane that we have not kept up with the research and our knowledge. Our treatment is literally still the same.

If someone's thyroid is low, if they are not producing enough T4, can you get them back without using hormones to producing enough T4, or will they always need to be on hormone replacement?

It depends. If someone has Hashimoto's and the immune system has attacked and kind of killed off part of their thyroid, more than likely they're gonna have to take thyroid hormones. And that's not the end of the world, but we just wanna make sure that your, first of all, your thyroid hormones are normal where they should be or optimized. But now we got to get to work on the thyroid metabolism. Like, let's make sure those thyroid hormones that you're taking are actually doing their job in the body. But it's important to note, if your thyroid hormones are low, it will trigger your immune system to attack your thyroid even more, which is why I say it's really important to make sure that that T4 is accurate. But then that is just like step one. Now we got to figure out thyroid physiology.

It feels very similar to blood pressure where you would want to get your blood pressure under control with medication and then, sure, start working on everything else. Not let your blood pressure stay high because that's so damaging, right?

I mean, there's so many things that could happen with thyroid hormones being so low. Like, what— essentially, your metabolic rate is extremely, extremely low. I mean, I've seen women, like we talked about earlier, where their TSH is so high they're barely getting out of bed. I mean, I've also seen other women— the body is so amazing that it's starts adapting and you don't even know. And your TSH is—

I think that was my cousin that I was like going, oh my gosh, how have you been walking around like this? Mine went over too, and I'm like sounding an alarm.

And— but it's really important for your brain function. It's like how your body makes energy, and it's how your body is really effectively, uh, utilizing glucose. You need your thyroid to communicate in that way, which is why there's such a, a huge dysglycemia or blood sugar issue with women who have low thyroid. So you're looking at dementia and cognitive issues and all hormones are gonna be all messed up if your thyroid—

osteoporosis.

Yes. So it's important that we have adequate levels of thyroid hormone, even if we have to take thyroid medication. And, and a lot of women stop thyroid medication because when they get on it, they think, oh, it's not working because I don't feel any different, even though their thyroid levels might be good in the blood. But what's been missed is the thyroid metabolism after they take it hasn't been addressed.

Well, when you say the levels look good in the blood, would they just be looking at TSH and they're not looking at things like free T3? Like, if all those numbers were normal, then does that mean that they're at the right levels, or is that still not indicative that—

Yeah, if the TSH is normal and then total T4 and free T4 are normal, it means that either your thyroid's producing enough T4 or your medication that you're taking is adequate. And now we got to get to work on the other stuff, or we gotta look beyond the thyroid and say, okay, what else is creating these issues?

That makes sense. And with thyroid medication, I don't know if this happened or not. Did they take the glandular off the market? No. What's gone on with that?

I think everyone just—

I ordered like a year supply. I'm like, get me, get me enough.

No, I think everyone totally freaked out and I have not heard about it. I heard that they just took it off the table, but the glandular—

You do not want a bunch of angry— No. 'Cause I think it'd probably be a lot of peri and postmenopausal women.

Yeah.

You know, yeah, we will storm the house.

Yeah, so your Armor Thyroid and the NP Thyroid, it's gonna be T4 and T3. If there is an underconversion problem, you're kind of bypassing that, but that doesn't also mean that all physiology is still good, but it's a good piece of the puzzle. And then you've got your levothyroxine and Synthroid that are T4. And there's some other ones out there, but those are the main ones.

What are your opinions on those ones?

This is what I would say. It is difficult for some women to get balanced with the right thyroid hormones. So if they're balanced with the thyroid hormones that they're taking, I usually try not to mess with it and then fix everything else. If I had to go on thyroid medication, because I deal with Hashimoto's and, and all of that myself, but I caught it early, so I haven't had to go on thyroid medication. But I would look at like a, a Tyrosint. Which is T4, but it's super clean. So a lot of the levothyroxine and Synthroid, those have gluten and corn and, you know, that is the thing that we're trying to get all these ladies off of.

Gluten in the thyroid medication.

Yeah.

You cannot make this up.

I'm not like you. It's crazy. So usually I'm like, if you're stable on that right now and I can get all other things like regulated, I'm not gonna mess with that. But Tyrosine, It comes in a gel cap and it's super clean. It's in MCT oil. And so it's like the best. And then they even make it in a pouch. So if someone's sensitive to the gelatin, then they make it in a pouch that you just squirt it in your mouth. Mm-hmm. So that's the cleanest form. And then the second, I would probably do more of an Armor where it's more natural, a glandular.

And how often do you have to just give someone, say, some extra T3?

Um, I would say often I do that. Yeah, I would say I do that often while we're fixing the underlying issue.

So let's talk weight loss because that's what everyone wants to hear about too. Yeah, yeah. And I think just to be clear, as this is my next book, we're not talking about weight loss, we are talking about fat loss. We are talking about holding onto muscle. Now, one of the doctors I used to do workshops with years ago, one of the things she always says, you cannot balance hormones in a vacuum. And if your thyroid's not working well, you're not gonna be able to build muscle, you're not gonna be able me balance your—

Sure.

Hormones. So just on that piece alone, it's mission critical. But, you know, I know probably one of the first signs for a lot of women that their thyroid's not working well is weight. Yep. So what do you think the biggest mistakes are with women when they're like getting on thyroid to lose weight?

Well, I think the biggest mistake is that they expect the weight's gonna come off when their thyroid hormones are level. And that's why I said earlier, they get frustrated because they assume that the only thing that's going on is that they have a thyroid issue and that's why they're gaining weight. Even though it is one of the first symptoms, they get on their thyroid hormones and nothing really happens and they're like, well, this doesn't work. And I think that's what a lot of women go wrong with weight is cuz they think it's attached to one thing and they—

yeah, that's, that's the same thing with HRT. And I'm like, well, but now you still have to go do the work. You still have to do all the other things.

Yeah. So understanding and knowing that low thyroid plays a big role in the metabolic rate and your body's physiology, but it isn't the only thing. And the thyroid, like we were talking earlier, doesn't also work in a vacuum. It literally communicates with every single cell in your entire body. And it doesn't usually just go awry by itself. Like, it's all connected.

So you have a program that's called, I think, Thyroid Transformation Blueprint.

Mm-hmm.

7 pillars. Mm-hmm. And what I would love to pull out of that is, which is the biggest pillar that women tend to overlook and that has to be there? I would assume all 7 are mission critical for healing.

Yes.

But is there one or two that—

and they all, they all do go in order. But I would say we gotta start with the first one because if you don't have the first one, your foundation is missing. And this is why a lot of women also struggle with releasing weight. So first of all, you have to have your goals. Um, and that seems very obvious. They have to be specific and measurable, but underneath your goals, you have to have your motivation. And the weakest motivation is weight loss. That's the weakest thing. If that worked, we would not have 80% of the population overweight or obese in this country. But it's not about the weight loss. It's, it's gotta be about your quality of life. It's like, what does the weight loss, or what is even getting healthier? What is the increased energy and the sleeping better and all those goals we have? What does it mean to you? Like, why, how would that change your life? Because we all think that healing happens like this, right? We take one thing out, we should lose all of this weight. We do one thing, add thyroid medication, and all of our symptoms should go away. But really it's about working with the body, developing a great relationship with your body, listening and continuing to like stack healthy habits so that you're, you tip the scale and your body starts going in the right direction. But you're gonna have peaks and valleys. And if you don't have these motivations there, you'll never make it out of the valley. And then you go back to beginning, right? You give up, you stop, you go back to the beginning starting point, and then you start up that first hill again until the first valley. And then you, you keep doing this over and over. So like, I wanna know, like, what are you passionate about? What is your purpose? Like, what are you living for? Like, how would your life change? I wanna create a picture of what it is that they're trying to create. And so that gets them out of the, I just need to lose weight. I want to go from a size 12 to a size 8. I'm like, who cares? You really don't care about that.

And then you'll be a size 8 and you'll go, I want to be a size 4.

And it's never good enough.

Yeah, it's never, never.

And then you worry when you get there, is it all going to come? Like, we go crazy when we're overly focused on the weight. We really are focused on the completely different.

Well, and I mean, my big joke I say when I'm speaking is I go, here's, here's what a traditional scale will do for you. You have a perfect day. You ate perfectly, you exercised, you drank all your water, and you get on the scale the next morning and you know exactly what's gonna happen. It's going up. I know. It's like it always does. And you're like, what the hell? I'm quitting.

I know. Isn't that so crazy?

That's why I just go, please just don't do this. Yeah. I am a big scale person. I'm not a scale fan for bioimpedance, but I think you get it on every day and you don't look, just like go to your phone and then once a week, take the average. Yep. And just, am I trending in the right direction? Yep. But even more important than that is, am I getting stronger? Am I feeling better? My clothes fitting better? You know, but strength more than anything else.

Yeah.

It's, it's huge. It's just mission critical.

Yeah. So that's the first pillar. And I think it's so important to start shifting our mindset otherwise.

Well, without that, nothing's gonna happen.

That's right. Yeah. We just keep on this cycle. And it's so crazy. And the diet industry, they live off of that, right? They live off of one fad diet after another, lose 30 pounds in 30 days.

I'm hoping that the GLP-1s are at least shining the light now on that we can't do that anymore because it's so dramatic.

Tell me why you think.

Yeah. Well, I think because the pharma dosing's too high. Mm-hmm. If you used it just to dial down the noise on the food noise and get a little of insulin sensitivity and reduce inflammation, cool. That's not how they're being used in most of these settings. And so now you've got food noise shut down and people are just dropping weight like crazy. And this is such a damage to the metabolism. It's gonna put 'em into a major hole. And now all of a sudden, people are worse off than ever. And it's way worse than they've seen with traditional diets. Like traditional diets, you'll lose 20, 30 pounds and gain it back. But this one, it can be 50, 60, 80, and gain it back. Yes. And you know, you lose muscle and fat and gain back fat and lose muscle and fat and gain back fat, and your metabolic hole is devastated. So that's where I think it's really shining a light. I actually think it's exposing a problem we've always had, but it's now much more extreme. Yeah. Because of what this can do. So hopefully now people are starting to pay attention. I feel like now they're going, oh, you shouldn't lose muscle. We're finally starting to get that.

Yeah. I think it's really devastating and, and I, you can't, ever balance the body with a drug. You can maybe low dose with GLP-1 just to get them moving in the right direction, but they have to work too.

Yeah, you've got to do the work.

You have to learn how to, to build muscle and regulate your blood sugar and figure out what you're supposed to be eating to balance your physiology. But I, I agree, I think it's really detrimental. But I have lots of patients that are on it.

They're like, okay, well, they must be because 1 in 7 people apparently are on it. So I'm sure you must have some.

I don't want to stay on it, but I don't want to gain the weight back. So how you work with me, and it's pretty interesting when they are really doing high doses of these GLP-1s. I'm looking at their fasting insulin, it's through the roof. I'm like, you are literally storing fat.

Wait, wait, wait, they're doing a high-dose GLP-1 and their fasting insulin's high?

Way high, and higher than it was because I can see pre and post labs.

That is wild.

Well, it increases insulin production. It's a secretagogue, essentially.

I remember back in the days when I was at Gold's Gym, And the guys who inject insulin, I'm like, you guys are nuts.

That's crazy.

I mean, bodybuilders do some crazy stuff. I'm like, whoa. You know, but it can help you build muscle.

Sure. But then when they're doing it too much and their insulin is significantly high, now they're just creating this whole insulin resistance thing. Wow, that's horrific. It's even worse. And so helping them fix their physiology while reducing and getting off of it and then teaching them how do we keep moving forward after It's been, you know, it's, it's been an interesting challenge that I've had over the last couple year or so.

Is there anything else in your pillars that's like something that people go, that's in there? That's a surprising thing.

Yeah. Pillar number 2 is you have to have comprehensive testing because everything else flows from there, right? So if you don't have comprehensive testing, you can't analyze and diagnose appropriately. You can't customize a treatment plan. One of my pillars, pillar number 5, is that you need a coach, but it really kind of all flows down from what are we treating?

You know what's so amazing to me is that gut testing and toxin testing are not standard. Like, can you— you have Hippocrates saying it all starts in the gut and then we don't do gut testing.

Yeah.

It's like you look and go, well, if I was gonna do anything, shouldn't it just start with a gut test? I mean, there's so much to it.

Yeah. I don't necessarily think you could, like, for me personally, I wouldn't just do gut testing first because everything's connected, right? Like if you don't fix your blood sugar, you're not gonna really fix the gut, right? Because you know, the, the microbiome is really impacted by the environment, right? And so you've gotta start working on the environment. Your microbiome is affected by your toxins and the things that it's dealing with. So looking at it all together globally is imperative. You know, it's like you, if you have a high toxic load and you've got dysglycemia, you're not gonna fix the gut. But if you have gut infections and you've got food sensitivities and you've got a leaky barrier, you're also not, it's like all connected. Yeah.

And it's just surprising though that for the majority of people, they probably have never had a stool test.

And a good stool test.

Right. A real like a Vibrant or Tiny Health or a GI Map. And they've probably never had a tox test.

No. And I think a lot of people would say, I had a stool test and it came back negative. I'm like, wait, tell me what you had. And they're like, well, Cologuard. I'm like, well, that was just screening for blood. There was just like a blood screening to make sure you didn't have colon cancer, or— but we're talking about like an actual really thorough stool test where we're looking at your whole microbiome. We're looking at inflammation and fat. We're looking at infections. We're looking at all kinds of different things cuz it tells us a whole world of information.

It's amazing. Yeah.

Yes. Can tell us the, the microbiome, the types of bacteria can tell us if you're in fight or flight. It can tell us And if you have leaky gut, you're gonna have a leaky barrier system everywhere. So it'll be a leaky brain, it'll be leaky lungs. And so all these barrier systems communicate. It's pretty cool.

Yeah, it is. It is wild. Which GI test do you use?

We use Genova.

So, ooh, let's go into, you, you mentioned some mindset stuff. What do you think are some of the biggest false beliefs that women have that just keep them stuck? This whole downward thyroid spiral?

Yeah, I love that question. So there are 3 main false beliefs that we all deal with. Number 1 is, I'm not enough. And that is, you know, our self-worth. But it is, I will do that when, I'll do that, you know, it always is pushing us on the back burner.

Women do that the worst.

Yeah, we think we put everybody's needs in front of ours. And sometimes I think we use as an excuse to stay stuck.

It was the number one question I asked my community years ago. If you're not where you want to be with your health and your weight, why not? And I thought it would be gluten. I was like, I figured they're just going to say gluten or cheese. And they said, I don't feel good enough. And I was like, wow.

Isn't that amazing?

Not what I expected.

A lot of women don't realize that until you start talking about, well, what does that look like and how does that show up? And they're like, oh, Oh, yeah. So most of us do deal with that one. The other one is that it's not available to me. So that would be something like, you know, Dr. Heather has blonde hair, that's why she could heal. Yeah. That has nothing to do with anything.

She's tall, so she gets that.

Right. And I mean, I've even done that in my life too. Like when I looked at other people and they were being really successful, I would think, oh, that must come easy to them. And then you talk to them like, no, they work their butts off. Like they, they really made it a priority. So it, it's not that it's not available to me.

Yeah. It is. Uh, I had a great mentor early on who'd say, whenever you hear those kinds of things, put right after that, so I don't have to. Oh, that's a good one. Oh yeah.

That's a good one. Mm-hmm. The other, the false belief that they have is they think that it's something that's out of their control or like genetic, right?

So they think that clearly it's not genetic if they're rising, it's going like this.

That's right. And so I just, I ask people, if you don't know where your false belief is, where is it that you're stuck? And then write down the excuses that you make for yourself, right? So like, I'm too old, or I'm in perimenopause. That's like, it's not available to me. You know, a lot of women will say I'm not worth it, or I don't have time, or I have other responsibilities. That's all that's on my mind.

So I don't have to, so I don't have to. I was thinking that whole genetic thing. Do you remember? When the GLP-1s were just coming out and they did something with an obesity doc at one of the top research hospitals. And she sat down and said, well, you know, something about like 50% of obesity is genetic. And it's like, well, if we had half a percent of the population who were obese at the turn of the 19th century, and now it's over 40%, how's that genes? Like genes that couldn't, they don't change in 100 years. That's right.

And it is crazy. And I think now, I don't know why they keep saying, saying that, but now with the study of epigenetics, we know that we can influence gene expression with our environment, whether that is— a lot of times people think environment outside, which is fine. It's the water, the air, the, your house. It's the environment. It's also the internal environment. Your thoughts, your emotions, your, all of that stuff creates the environment in the body. But we can have all control over gene expression by changing our environment, which is so cool.

Isn't it cool? It's so fantastic. So it's right back in our hands.

Yeah, I think it's important to also think about some of the false beliefs that we have, we didn't even create. Like we didn't choose that false belief. It has been, we kind of started to believe it because our mom said it.

Right, we just forgot to question it.

That's right, our friends are saying it. Kind of like, you know, everyone starts to have cognitive decline and dementia as they age. I'm like, wait a second, have you ever thought about that? Surely you've known someone that was 80 that didn't have that. Right? And so it's going through and thinking about, well, what are, what do I believe that might not be true? And let's think about different thoughts or find examples in life that will get your brain to say, oh, maybe that's not true.

Right. I love that one so much. That is what I've made my focus on now is like, I wanna see the most successful, brilliant women in their 60s, 70s, 80s. And there's amazing ones.

They are.

Women do what they're doing.

That gives me goosebumps. Right? I look at that too. There's some amazing success stories. Successful women that are just brilliant, you know, in their 70s and 80s.

I started buying into, there was a popular, now not popular doc who was saying, oh, you know, once you, you'll never be as fit as you were in your 20s and 30s and blah, and all this stuff. And as I was approaching my 60s, I went, you know what? I'm gonna get in better shape than my 20s. And I was in ridiculous shape in my 20s and I did it. And I was like, that's it. I'm like, the minute you tell me, oh, you— I'm that contrarian person who wants to go and prove them wrong.

Exactly.

And so, I mean, that's what I'd say is just go prove 'em wrong. There's always —yep. So let's do a little mic drop question. When you look at women who truly reverse their symptoms and reclaim their vitality and their life, what do they start doing differently that most women never even realize matters?

They started changing their belief system. That I think if I look at all the ladies that truly went through a transformation, and I'm thinking of one in particular, she's 70 and her blood work looks better than the 20 and 30-year-olds. She lost 70 pounds and she is just a completely different person than when she started. And if you asked her, she would say, my mindset changed. You know, she believed she could and she believed that her body could heal.

Yep. I totally buy into all of that. 100%. I'm a big Dr. Joe Dispenza fan and it's just all the breaking the habit of being yourself. Yep, exactly. Yes. Okay. We are gonna do a speed round. Ready? So this is the first things that come to mind here. Most overlooked thyroid symptoms?

I would say probably brain fog. Biggest myth about hypothyroidism? That it all starts in the thyroid.

One lab every woman should ask to get tested? The Hashimoto's labs. So the antibody ones? Yeah, the antibodies. One food that worsens Hashimoto's for many women?

Gee, which could this be? We talked about gluten, which is really a big one, but I'll also throw in dairy. You said it earlier, but I always take everyone off of gluten and dairy.

One daily habit that supports thyroid health.

Movement. Let's just say movement.

Can never go wrong with that. Where can people learn more about your work?

So the best place to find me is on Facebook. I have a, a large, I hear Facebook's having a resurgence. Well, I have a really big Facebook group called Happy, Healthy, and Lean. I think there's like 220,000 ladies in that group right now. Wow. You know, that's where I'm mostly, I do Thyroid Thursdays, I I do masterclasses and it's a really amazing, good support system. So yeah, that's mostly where I'm at.

That's incredible. We'll link up to that in the show notes. I'm gonna put everything at jjvirgin.com/drheather and we will link up, I think you have a Thyroid Transformation Quick Start, right? Yeah. Guide. Yes, we'll— Yep, I sure do. Link up to that as well so they can get more of Dr. Heather. And thank you so much for joining me and digging into all of this.

Yeah, thanks for having me.

It's been great. If today's conversation resonated with you, I want you to hear this. If you've been feeling exhausted, foggy, inflamed, and like your body just isn't working the way it used to, you are not crazy and you're definitely not a hypochondriac. Your body may simply be asking for a deeper level of investigation and care. Dr. Heather's work is helping thousands of women uncover those root causes behind their symptoms and reclaim their health. And if you want to learn more, she has a Thyroid Transformation Quick Start Guide that walks you through the steps you can take. So I am putting this at JJVirgin.com/DrHeather. And if you know someone who's struggling with thyroid issues, a friend, a sister, or a colleague, send them this episode, because sometimes the most powerful thing we can do is help someone realize they're not alone and there is a path forward. Thanks for listening to Well Beyond 40, and I will see you next time.